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Beyond the silos: integrating HIV and global health

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Article source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31466-1/fulltext

Salesforce Wants to Take the Health Insurance Industry to the Cloud

Enterprise software company Salesforce (NYSE:CRM) recently announced the upcoming launch of a new cloud service tailored to health insurance companies. Available this fall, the new software follows a strategy the company has used many times before in customizing platforms for other specific industries. This service could be a big deal, as it addresses several issues facing the health insurance industry and its customers.

What is it?

Health Cloud for Payers, as the new cloud-based service is called, is essentially an expansion on the existing Health Cloud that was launched back in 2016 for healthcare companies. This new iteration of the software will address the other half of the equation when it comes to patient care: the company responsible for picking up the bill.

Health Cloud for Payers will help centralize the data a health insurance company has on its members. Having information on things like benefits and claims in one place will help an insurance company’s service department be more efficient. And features like the automation of case-management tasks and care requests will drive better results for patients and insurance-plan sponsors.

Included in the service will be the ability for payers to custom-build new customer-facing digital systems that help simplify access to benefits and other help.

Speaking about the new industry-specific platform, Salesforce’s chief medical officer, Dr. Joshua Newman, said: “Payers around the world are no longer just competing against one another, they’re being compared to any company providing a convenient user experience that builds loyalty. With Health Cloud for Payers, Salesforce is providing a solution that makes it easier for insurance companies to streamline workflows and connect with both members and providers in more effective ways.”

Why it matters

Salesforce’s attempt to improve the health insurance industry and outcomes for patients is obvious good news. Health insurance has come under fire in recent years for various reasons, including the skyrocketing cost to acquire care. So any improvement in industry operations and patient experience should be something everyone can get on board with.

The new-and-improved Health Cloud should be good news for insurers and patients, but it’s even more important for Salesforce. Customizing existing software to the needs of a specific industry has been the company’s template over the years. Offerings include tools for the digital retail, automotive, banking, and telecom industries, among others. That complements acquisitions of complementary software businesses and partnerships with third-party developers on Salesforce’s AppExchange.

Two men and a woman gather around a computer displaying graphs and charts in an office.

Image source: Getty Images.

That has provided 20%-plus growth for years for the enterprise software company as it chases bigger rivals in the business services space, like Microsoft (NASDAQ: MSFT) and Oracle (NYSE: ORCL). This puts Salesforce on track to achieve its goal of $20 billion in annual revenue by 2022, on its way to a longer-term push to become one of the world’s largest technology companies in the next two decades. Salesforce hasn’t been shy about its lofty aspirations, but the fastest-growing enterprise software company ever has a track record for exceeding its own guidance.

Thus, new custom-made tools in the cloud for a huge industry like health insurance look like a good way to drum up more growth. Helping patients connect with insurance providers more conveniently in a digital format looks like a win for all parties.

Article source: https://www.fool.com/investing/2018/07/20/salesforce-wants-to-take-the-health-insurance-indu.aspx

My Health Record opt-out debate is getting silly but government is at fault

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(Image: Getty Images/iStockphoto)

“Gawd. This debate is becoming stupendously ridiculous,” tweeted Dr Norman Swan on Friday. He’s the presenter of the ABC’s Health Report and one of Australia’s most respected broadcasters.

“It’s the most important piece of health infrastructure in a generation and it’s been hijacked by the privacy ideologues. Everyone retains the right to choose. Get over it and stay in!! Can’t believe it,” he said.

Swan is right. The debate over whether or not to have your health records uploaded to a central digital repository has indeed become stupendously ridiculous. But not for the reasons he thinks.

Yes, some of those opting out are making daft claims. We’ve seen, for example, the curious argument that because My Health Record might perpetuate incorrect data, and presumably because enforcement agencies can gain access, it is a tool to make Australia into an autocratic police state. Yeah nah.

There were also overblown concerns about Google’s reCAPTCHA being used.

But there are genuine concerns out there. People don’t fear that My Health Record won’t be useful. They’re worried that their medical data might be misused, and they’re not satisfied with the answers they’re getting.

The Australian government has lost the public’s trust when it comes to protecting their data. That trust needs to be earned back.

The name-calling of “privacy ideologues” and the we-know-better-than-you suck-it-up arrogance of some in the medical professions are at the very least unhelpful. Just as unhelpful are the ham-fisted “reassurances” of health minister Greg Hunt.

“One of the thing’s that’s happened is there’s been a number of statements which have been incorrect,” Hunt said on ABC Radio on Wednesday.

“I would gently correct those, the statement about access by law enforcement bodies, incorrect. The statement about the ability for anybody to access it, incorrect. The statement about the ability to override the system, incorrect.”

But Hunt hasn’t provided any evidence to say exactly why the statements, which he doesn’t cite, are incorrect. It’s just hand-waving.

“The [Australian] Digital Health Agency [ADHA] has again reaffirmed today that material, which is the case for every medical record in the country, can only be accessed with a court order,” Hunt said, but that’s not what the law says.

Hunt says people’s privacy settings can’t be overridden, but the AHDA says they can.

“If you have set an access code for your My Health Record and there is a serious threat to your life, health, or safety, emergency access to your record may be provided,” says the ADHA website.

Hunt says that can only happen in a “deep, profound medical emergency”, but again the ADHA says otherwise.

“Emergency access may also be granted to lessen or prevent a serious threat to public health or safety. For example, access to your My Health Record may help identify a source of dangerous infection, when you’re in a hospital, and prevent it from spreading.”

One could be forgiven for thinking the minister doesn’t quite understand how any of this works.

Reassurances that people’s digital medical records can be kept secure have been equally pathetic.

Claire Coulton, a spokesperson for Royal Far West health and education services, told ABC News: “The security of a paper health record is no more secure than a digital one. Someone could break into a clinic in the CDB tomorrow and steal hundreds of thousands of medical health records there.”

I could discuss how silly that argument is, but I’m too busy laughing. Meanwhile, Prime Minister Malcolm Turnbull has been invoking filing cabinets.

Meanwhile, while the government and medicos have been telling us anecdotes about how a health record might have made things easier in this or that specific circumstance, there’s been a remarkable lack of hard data.

Hunt makes the point that My Health Record has been around for six years. There was a trial involving 1 million people, and there are now 6 million records in the system. So surely there’s some hard data on how healthcare costs have been cut, and health outcomes improved? No?

Apparently not. In a piece titled Top 10 most awkward questions about the MHR, The Medical Republic reported that “you can’t easily get to a short and precise description of what the project is meant to achieve”.

“The problem of course, even if the project had well-defined goals and KPIs … is measurement. No one is measuring any of this in relation to this project. This [is] partly because these things are so complex to report and measure anyway. The point is we haven’t set proper targets and so we aren’t measuring progress or success.”

Given that the medical profession prides itself on its scientific credentials, that seems a curious omission.

The biggest mistakes of all, in my view, is that the My Health Record project fails to follow contemporary privacy practices. The most notable are the fundamental breach of trust in flipping the system to opt-out, and retaining data even when a user wants to delete their record. Such behaviour would be straight-up illegal under Europe’s General Data Protection Regulation (GDPR), for example.

Stephen Easton sums that up well at The Mandarin, a site that covers Australian government policy, programs, and public projects.

“The e-health backlash shows that a lot of people now disagree with the government’s view that the records are in their interests. Worries about privacy, information security, and the medical utility of the revamped records have grown considerably since four years ago, when an external review panel told then-Health Minister Peter Dutton there was strong public support for the e-health system, and it was clear that it would change to an opt-out model,” Easton wrote.

“The sudden rush for the exit in just the first few days of the My Health Record opt-out period — and a clear sense of indignation among many critics at the presumption that they would want to have an enduring national e-health record automatically created, with some problematic terms and conditions — suggests a miscalculation.”

He’s right. But so far the government seems to think that drowning out the critics is the way to go, rather than listening to the genuine concerns and building a better system.

Related Coverage

My Health Record systems collapse under more opt-outs than expected

When citizens rush to opt out of an Australian government service, it says something about their levels of trust. When the system falls over under heavy load, it proves them right.

My Health Record opt-outs will not sink system: Turnbull

Australian Prime Minister Malcolm Turnbull says the government’s My Health Record won’t be sunk by large numbers of people opting out of the system.

ADHA pins My Health Record opt-out issues on users with incorrect information

Call waiting times have been reduced, says the digital health record operator, and a spokesperson for the human services minister says systems were not overloaded.

Tens of thousands opt out of My Health Record, but can Immigration and local councils view the rest?

The ADHA says it’ll refuse access to medical records without a court order or warrant. But the law allows that policy to change at any time.

Cancelled My Health Record data to be kept in limbo

Those choosing to opt-out of the My Health Record service will still have their data visible if they reactivate their account.

Less than 2 percent of My Health Record trial users opted out

Perhaps more worryingly, the use of privacy controls is sitting under the 0.1 percent mark.

My Health Record opt-out period from July 16 to October 15, 2018

The window for Australians to opt out of an electronic health record has been announced by the government.

Article source: https://www.zdnet.com/article/my-health-record-opt-out-debate-is-getting-silly-but-government-is-at-fault/

Health-Care Coverage Is Increasingly Determined by Where You Live

Robert Kingsland will have to pay hundreds of dollars if he goes without insurance next year, even though Congress recently repealed the Affordable Care Act’s penalty for not having coverage. That is because his home state of New Jersey just imposed a fine of its own for letting insurance lapse.

In California, Aaron Brown’s small business association likely won’t be able to provide the cheaper health policies promoted by the Trump administration. California banned the creation of many associations that offer such policies.

Article source: https://www.wsj.com/articles/health-care-coverage-is-increasingly-determined-by-where-you-live-1531933372

US health care companies begin exploring blockchain technologies

The sprawling U.S. health care industry has trouble managing patient information: Every doctor, medical office, hospital, pharmacy, therapist and insurance company needs different pieces of data to properly care for patients. These records are scattered all over on each business’s computers – and some no doubt in filing cabinets too. They’re not all kept up to date with current information, as a person’s prescriptions change or new X-rays are taken, and they’re not easily shared from one provider to another.

For instance, in Boston alone, medical offices use more than two dozen different systems for keeping electronic health records. None of them can directly communicate with any of the others, and all of them present opportunities for hackers to steal, delete or modify records either individually or en masse. In an emergency, doctors may not be able to get crucial medical information because it’s stored somewhere else. That can result in direct harm to patients.

There might be a way out, toward a health care system where patients have accurate and updated records that are secure against tampering or snooping, and with data that can be shared quickly and easily with any provider who needs it. In my work on health care innovation at the Center for Health Law Studies, at Saint Louis University School of Law, I have been following the rise of a technology that may help us address the weaknesses in today’s health care record-keeping: blockchain.

A secure system to store private information

Blockchain systems, best known in connection with cryptocurrencies like Bitcoin, are networks of databases stored in different places that use securely encrypted messages to connect with each other over the internet. Information can’t be deleted, but it can be updated – though only by authorized users, whose identities are recorded along with their actions.

That would keep years of patient data secure and make any human errors in data entry easy to track down and correct. Patients themselves could review and update information, and even add new information they collect or observe about their own conditions. Both hacking and fraud would be extremely difficult.

There are many blockchain systems, each with its own security methods and practices, but developers are working to help them connect with each other, working out how to make the process of collecting records much cheaper and faster than today.

Helping patients and practitioners

Blockchain can also help other areas of the health care industry. The Centers for Disease Control and Prevention are developing blockchain-based systems to share data on threatening pathogens, analyze outbreaks, and manage the response to public health crises. Some commentators have even suggested that a blockchain system might help track opioid use and abuse.

Clinical trials, too, may benefit from blockchain. Today, patchy data and inefficient communication among all players involved in clinical trials pose serious problems. The drug discovery and development processes could see similar benefits.

Pharmaceutical companies currently monitor drug shipments and delivery through an inefficient web of scattered databases. In 2017, Pfizer and other drugmakers announced their support for MediLedger, seeking to transfer those tasks to a blockchain – which Walmart is already doing to track its food shipments.

First steps in the US

In addition to the major pharmaceutical companies’ supply-tracking experiment, other major U.S. health-care companies are beginning to explore blockchain technology. In early 2018, five of the country’s largest health-care companies started using a blockchain system to collect data on health-care providers’ demographics.

What’s most striking about this collaboration – including a medical claim processor and a national medical testing lab – is that it includes major health insurers that directly compete against each other: Humana and the UnitedHealth Group. That signals a potential shift toward industry-wide approaches to handling health care data.

Europe takes the lead

Europe offers some examples and useful guides for U.S. efforts to use blockchains in health care.

In 2016, the European Union began funding a multinational collaboration with privacy companies and leading research universities to build a blockchain system that would aggregate and share biomedical information between health care organizations and individual patients all across the EU. Among other things, this would offer patients secure personal health data accounts online, accessible from computers and mobile devices.

Using a similarly collaborative approach, Sweden recently began rolling out an interoperable blockchain health data platform called CareChain. CareChain is being publicized as “infrastructure that is owned and controlled by no one and everyone.” Companies and individual people can use the system to store health information from disparate sources. The system also lets developers create apps and services that can access the information, to analyze users’ data and offer them tips, ideas and products to improve their health.

Offering an idea of what’s possible is Estonia, which since 2012 has been using blockchain technology to secure health care data and transactions, including putting 95 percent of health data in electronic form. All of the country’s health care billing is handled electronically, and 99 percent of its prescriptions are digital.

That’s a future the U.S. could look forward to, as it experiments on its own and learns from the experience of these existing projects.

Article source: http://theconversation.com/us-health-care-companies-begin-exploring-blockchain-technologies-99926

Lancet Global Health Article, Commentary Examine Tracking Aid For RMNCH

Lancet Global Health Article, Commentary Examine Tracking Aid For RMNCH

The Lancet Global Health: Tracking aid for global health goals: a systematic comparison of four approaches applied to reproductive, maternal, newborn, and child health
Catherine Pitt, assistant professor in the Department of Global Health and Development at the London School of Hygiene Tropical Medicine, and colleagues compare the methodologies of four initiatives — Countdown to 2015, the Institute for Health Metrics and Evaluation (IHME), the Muskoka Initiative, and the Organisation for Economic Cooperation and Development (OECD) — to estimate aid for reproductive, maternal, newborn, and child health (RMNCH). The authors note, “The four approaches are likely to lead to different conclusions about whether individual donors and recipient countries have fulfilled their obligations and commitments and whether aid was sufficient, targeted to countries with greater need, or effective. We recommend that efforts to track aid for the Sustainable Development Goals reflect their multisectoral and interconnected nature and make analytical choices that are appropriate to their objectives…” (August 2018).

The Lancet Global Health: Improving tracking of aid for women’s, children’s, and adolescents’ health
In an accompanying commentary, Gavin Yamey, director of the Center for Policy Impact in Global Health (CPIGH) at Duke University’s Duke Global Health Institute; Marco Schäferhoff, managing director at Open Consultants; and Kaci Kennedy, policy associate at CPIGH, cite results from the study by Catherine Pitt and colleagues and discuss the proceedings of a consultation convened to develop a new method to “accurately track spending on RMNCH by donors and low-income and middle-income governments and, ultimately, accelerate progress in reducing maternal and child deaths worldwide” (August 2018).

Article source: https://www.kff.org/news-summary/lancet-global-health-article-commentary-examine-tracking-aid-for-rmnch/

Former Health agency’s top attorney charged after OSBI determines she sent threats to herself

The former top lawyer at the Oklahoma Health Department was accused Tuesday in a criminal charge of sending threatening emails to herself in an attention-seeking ploy.

Julie Ezell, 37, of Edmond, resigned as general counsel Friday, shortly after confessing, according to an investigator’s affidavit.

“I am so sorry,” she wrote in the resignation email to Tom Bates, interim commissioner of the Health Department.

She posed in the emails as a medical marijuana advocate who threatened retribution if the Health Department imposed restrictive rules on its use. “We would hate to hurt a pretty lady. You will hear us,” one email said.

Article source: https://newsok.com/article/5601630/health-agencys-top-attorney-resigns-after-medical-marijuana-rules-controversy

Saharan dust creates health hazard, hurricane hindrance


  • The sun sets through Saharan dust in Houston on Sunday, July 1. For a few days the city was covered in the dust that had traveled across the Atlantic Ocean from Africa. A new dust storm created hazy skies again this week. (Elizabeth Conley/Houston Chronicle) Photo: Elizabeth Conley, Staff Photographer / Houston Chronicle / ©2018 Houston Chronicle

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This NASA graphic from June 28 shows dust from the Saharan Desert makes its way west from the country of Chad in central Africa.

This NASA graphic from June 28 shows dust from the Saharan Desert makes its way west from the country of Chad in central Africa.

Photo: NASA Earth Observatory


While you wait for the skies to clear of Saharan dust, have a laugh at these weather memes.

While you wait for the skies to clear of Saharan dust, have a laugh at these weather memes.

Photo: Tumblr



It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter



It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

Photo: Twitter



It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat

Photo: @TexasHumor Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter



It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: @TexasHumor Twitter

Photo: @TexasHumor


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter



It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #TexasSummer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #Texas #Summer Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #Texas #Summer Twitter

Photo: Twitter


It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #Texas #Heat Twitter

It’s summer in Texas and these memes perfectly describe the struggle of dealing with months of intense heat.

Photo: #Texas #Heat Twitter

Photo: Twitter




Repeated weather advisories regarding Saharan dust have been issued this month.

Satellite models from NASA’s Earth Observatory showed plumes of dust blowing across the Atlantic in late June—most of it originating from the Bodele Depression, a dried Saharan lake bed in northeastern region of the central African country of Chad. Easterly trade winds blow the dust westward across the Atlantic to the Amazon, the Caribbean, and states along the Gulf Coast, including Texas.

Lynnanne Nguyen reports.


Media: Fox4



After traveling across the ocean, the dust visibly manifests in Houston as hazy beige or gray skies during the day and bright orange or yellow skies at sunrise and sunset.

“It’s not so much out of the ordinary,” meteorologist Matt Lanza, managing editor of Space City Weather, told the Chronicle earlier this month when the first Saharan dust blanketed the city. “It only happens a couple times per summer.”


SCIENTIFIC REASONS: Houston’s beautiful orange pink sky at sunset, explained

Meteorologist Travis Herzog of KTRK-TV ABC13 says the dust clouds normally sweep through Houston in the summer months of May, June and July.

The dust brings with it a variety of implications for people and for the environment.

It is mainly a respiratory hazard, said Dr. David Engler, a Houston allergy and immunology specialist.

Engler said Tuesday that his practice has seen an increase in patients with respiratory trouble over the past three to four weeks. Young and elderly patients, as well as patients with chronic lung conditions such as emphysema or severe asthma are most vulnerable.

“Go outside, get in your car, leave the air conditioning on, recirculate (your air),” Engler said. He said he tells patients with respiratory risks to minimize their time outside.

For those who have no choice but to go outside, Engler recommends wearing N95 masks as a preventative measure. The masks, which filter out 95 percent of particulate matter, can be bought at local hardware and home improvement stores. Online the N95 masks are sold in boxes of 10, 20 and more with prices ranging from about $7 to $25 per box depending on the features and sellers.

Engler also suggests taking an extra shower after coming back indoors.

MILKY SKY: Saharan dust making for dingy Houston skies

“Take the clothes you’ve been wearing—either put them right in the washing machine or maybe put them in a covered hamper,” he said. “(The dust) really sticks in the hair, so make sure to not only shower but to shampoo also.”

From an environmental perspective, the Saharan dust and the winds that transport it act as a hurricane deterrent.

“We think a dust storm has three main components that can suppress a hurricane,” NOAA researcher Jason Dunion said in a NASA article.

“One, it’s got super-dry air. Hurricanes don’t like dry air in the middle parts of the atmosphere, and that’s exactly what the Saharan Air Layer has,” he said. “A Saharan dust storm also has a very strong surge of air embedded within it, called the mid-level easterly jet, that can rip a storm apart that’s trying to develop. We call that vertical wind shear. And then the third piece is all this dust.”

The dust particles are thought to suppress cloud formation, according to NASA, which prevents the intensification of ocean waves in tropical disturbances.

SILVER LINING: African dust is ‘kryptonite’ for Houston’s hurricanes

The dust is also linked to algal blooms, though this issue is less relevant to Houston. According to NASA, the dust clouds deposit iron in the coastal waters of West Florida. A plant-like bacteria, called Trichodesmium, uses that iron to convert nitrogen in the water into a form that is usable by other marine organisms. Higher levels of iron mean more usable nitrogen, which encourages blooms of toxic algae, known as a red tide. However, this phenomenon tends to affect the coast of Florida more than that of Texas.

Wednesday’s forecast for Houston calls for a partly cloudy day with a high of 97 degrees and a low of 79, according to the Weather Channel. The chance of rain is slim, at just 10 percent. ABC13 predicts a Wednesday high of 98, and a low of 78. The haze from Saharan dust will, however, remain.

“African dust is expected to linger with at least light amounts covering the entire state,” the Texas Commission of Environmental Quality said in its Wednesday forecast. “The heaviest dust is forecast to remain over the northern half of the state” and “parts of Houston are predicted to fall under the lower to middle end of the ‘moderate’ range.”

Article source: https://www.chron.com/news/houston-texas/houston/article/Saharan-dust-creates-health-hazard-hurricane-13083513.php

Zika and health cuts blamed for rise in baby death rates in Brazil

The number of children dying in their first year of life has risen in Brazil for the first time since 1990.

It’s a worrying setback for a country once seen as a model of poverty reduction.

The infant mortality rate rose by nearly 5% between 2015 and 2016, an increase health officials and specialists have blamed on the outbreak of the Zika virus that year, as well as cuts to health services prompted by an economic crisis from which Brazil is struggling to recover.

Fatima Marinho, director of the non-communicable diseases department and information and analysis at the health ministry, said she expects the 2017 figures to exceed the 2015 levels.

“We are going backwards, not forwards,” Marinho said. “We cannot go on with the situation. Or we lose everything we have gained in 15 years.”

Denise Cesario, executive manager of the Abrinq Foundation, a non-profit group in São Paulo that focuses on children’s and teenagers’ rights, said: “The rate is very significant. It is very worrying if we consider that this economic crisis will still impact on social conditions for years to come.”

Infant mortality is regarded as one of the key measures of a country’s development. Brazil was praised for its success towards meeting the UN millennium development goal targets in a 2010 study published in the American Journal of Public Health, which said the country had made “rapid strides in improving maternal, newborn, and child health”.

But government figures for 2016 revealed by the Folha de S Paulo newspaper, and since published by the health ministry, showed that Brazil’s infant mortality rate rose from 13.3 deaths per 1,000 live births in 2015 to 14 deaths per 1,000 live births in 2016, a 4.8% increase and the first since the current system of tracking progress began in 1990.

Even relatively affluent states like São Paulo showed a 2.7% increase. Nationally, the death rate for children up to the age of five also rose nearly 4%.

Brazil had been lauded for combining economic growth with poverty reduction via landmark government programmes like the Bolsa Família – or family allowance – a cash-transfer scheme for families who made sure their children remained in school and were up to date with vaccinations.

In 2014, however, the country fell into recession. Faced with a deficit after winning re-election, President Dilma Rousseff began to cut spending and in 2016 the budget for Bolsa Família failed to match inflation.

Funding was slashed for the Rede Cegonha (the Stork Network), a government health programme for women that focused on birth, postnatal health and family planning, said Cesario.

Rousseff was suspended in May 2016 and impeached three months later. Her replacement, Michel Temer, introduced more drastic cuts and froze spending.

Government officials have been so alarmed by the increase in infant and child deaths that they called a special meeting of state health secretaries in June. Deaths from preventable diseases like diarrhoea and pneumonia also rose in 2016. Folha also reported a 12% increase in deaths from diarrhoea in under-fives, with 19% of those occurring in semi-arid regions that have been battling drought in recent years.

“How can children in Brazil in the 2000s die of diarrhoea? This number is shocking,” said Marinho, noting that the birth rate fell by around 5% percent in 2016 because women were avoiding having children during the Zika epidemic.

Jurandi Frutuoso, executive secretary of the national council of health secretaries and a former health secretary of north-eastern Ceará state, said less than half of Brazil’s health spending comes from government – the rest is from private health plans and people’s own pockets – and spending has failed to keep pace with the growing population, technological advances and medical inflation. At the same time, the proportion spent by federal government has fallen, leaving cash-strapped states and cities unable to pick up the slack.

“The system lives with very serious under-financing,” he said.

Cesario said the country’s next president must prioritise children. Temer is not standing in presidential elections in October.

“We need the next president to be committed to childhood, to understand the situation of the most vulnerable families, so we can prioritise children,” she said.

Article source: https://www.theguardian.com/global-development/2018/jul/17/zika-health-cuts-blamed-rise-baby-death-rates-brazil

Advisers applaud House bills to expand health savings accounts

Last week, the House Ways and Means Committee approved a roster of bills designed to increase HSA contribution limits and the number of people who qualify to use them.

“It’s exciting to see Congress recognize that we need to expand the use and availability of HSAs and to remove some of the limitations,” said Peter Stahl, president of consulting firm Bedrock Business Results.

One of the bills would increase the annual contribution limits — currently $3,400 for an individual and $6,900 for couples — by allowing contributions to the amount of the deductible and out-of-pocket limitations. HSAs are paired with high-deductible health plans.

Another bill would enhance the ability of spouses to contribute to HSAs, and another would allow seniors who are still working to continue to contribute to HSAs.

Investment advisers were happy to see the House action because HSAs — tax-advantaged savings and investment accounts for medical expenses that are expected to reach about $52 billion in assets next year — are becoming increasingly popular with their clients.

“We’re encouraging it, and for the most part our clients are taking advantage of HSAs,” said John Jespersen, lead financial adviser for Buttonwood Financial Group. “From a fiduciary perspective, it makes sense to empower individuals to take greater responsibility for their health care.”

Ned Hodder, owner of Hodder Investment Advisors, said he is noticing more interest in HSAs from young clients as well as 401(k)-plan clients, who are both looking for ways to increase tax-deferred savings.

Money in HSAs can be contributed and withdrawn tax-free for medical expenses. In retirement, money withdrawn for non-medical uses is subject to income tax.

“I’d like to see the amount you can contribute increase,” Mr. Hodder said.

Fidelity Investments also backs the HSA reform bills.

“Proposals that would increase contribution limits and allow for spousal catch-up would position HSAs as an even more valuable tool for health savers,” Meg Reilly, Fidelity vice president for policy communications, wrote in an email.

Adjusting those limits upward is likely to be a struggle this year. Most of the HSA bills approved last week drew significant Democratic opposition.

Rep. Richard Neal, D-Mass., ranking member of the House Ways and Means Committee, asserted at last Wednesday’s committee vote that the bills are designed to undermine the Affordable Care Act.

“The provisions we are considering today provide America’s wealthiest another option to stash tax-free money at a cost of $92 billion to tax payers,” Mr. Neal said. “Most of the legislation today does very little for the average American. Instead, we should be strengthening and protecting already existing health programs like the ACA, Medicare and Medicaid — not slashing them.”

The bills could be approved by the Republican-majority House but then stall in the Senate, where Democrats have enough members to filibuster.

“It’s difficult to get any legislation passed because it’s purely along partisan lines,” Mr. Stahl said.

Roy Ramthun, president and founder of HSA Consulting Services, sees a glimmer of hope.

“We’re mostly hearing [from Democrats] about Medicare for All, but I’m sure there is some support for HSAs at the center of the political spectrum,” Mr. Ramthun said. “Moderate Democrats don’t have a big objection to HSAs.”

The fact that HSA expansion ideas are getting committee votes now gives them momentum.

“It would not surprise me to see some of them make their way into legislation that becomes law,” said Jack Towarnicky, executive director of the Plan Sponsor Council of America. “If not this year, then in future years.”

Article source: http://www.investmentnews.com/article/20180716/FREE/180719942/advisers-applaud-house-bills-to-expand-health-savings-accounts