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Anthem To Buy Advanced Care Provider Aspire Health

Signage is displayed on the exterior of an Anthem Inc. Blue Cross Blue Shield office building in Wallingford, Connecticut, U.S., on Tuesday, Nov. 22, 2016.  Photographer: Michael Nagle/bloomberg

Anthem said it will buy Aspire Health, joining rivals by getting further into the business of providing medical care outside the hospital in the community.

Privately held Aspire is a provider of “community-based palliative care,” often used by patients facing serious illness , the company says. Aspire said its clinicians help patients manage “pain, shortness of breath, fatigue, constipation, nausea, loss of appetite, difficulty sleeping and depression.”

Financial terms of the deal weren’t disclosed but it’s another sign Anthem, which owns Blue Cross and Blue Shield plans in 14 states, plans to get further into providing medical care like health insurance rivals UnitedHealth Group, Humana and Aetna, which is selling out to the large drugstore chain, CVS Health.

“Anthem is focused on enhancing our ability to offer innovative, integrated clinical care models that can improve the quality of healthcare and deliver better outcomes,” Anthem CEO Gail Boudreaux said in a statement. “With the addition of Aspire Health to Anthem’s other clinical care assets such as CareMore Health and AIM, we will be able to offer our consumers, customers, and other health plan and provider partners a broader array of programs and services that meet their diverse needs and drive future growth opportunities for our company.”

Aspire was founded by former U.S. Sen. William Frist, also a noted heart surgeon before he entered politics, and Brad Smith, who is Aspire’s CEO. Aspire has grown across the country and has contracts with more than 20 health plans in 25 states, the company said.

“Several studies have repeatedly demonstrated how advanced illness programs can provide high patient and family satisfaction, reduce hospitalization, and decrease costs,” Smith said in a statement. “As part of Anthem, we believe we will be able to further scale our model and positively impact the lives of even more consumers and families, making home-based advanced illness care available to patients who need it.”

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US issues health warning after employee in China suffers ‘abnormal sensations of sound and pressure’

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US issues health warning after employee in China suffers 'abnormal sensations of sound and pressure'

The U.S. State Department issued a health alert after a government employee stationed in China was diagnosed with a mild traumatic brain injury, evoking memories of the series of so-called “sonic attacks” on American diplomats in Cuba.

The U.S. official, who was assigned to the southern city of Guangzhou, reported “subtle and vague, but abnormal, sensations of sound and pressure,” the State Department said in an alert Wednesday.

The notification from the department said Washington was not currently aware of any similar situations inside or outside the diplomatic community.

The State Department, which did not link the case in China to any other incident, said anyone in China who experienced “acute auditory or sensory phenomena accompanied by unusual sounds or piercing noises” should move away from the area.

Unexplained incidents in Cuba

The health alert has inevitably raised comparisons to the flurry of unexplained incidents in Cuba that prompted the withdrawal of most U.S. personnel from the capital city of Havana in 2016.

At that time, the U.S. called back embassy staff stationed in Cuba after they complained of symptoms like hearing loss, dizziness, visual difficulties, headaches and fatigue.

The cause of those reported cases still remains a mystery.

– Additional reporting by Eunice Yoon.


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Congo Ebola vaccination campaign begins with health workers

Congo began an Ebola vaccination campaign Monday in a northwest provincial capital in a major effort to stem an outbreak that has already made its way from rural towns into a city of more than 1 million people.

The campaign comes a day after the health ministry announced that a nurse has died from Ebola in Bikoro, the rural northwestern town where the outbreak began and was first announced in early May. The death toll is now 27.

There are 49 hemorrhagic fever cases: 22 confirmed as Ebola, 21 probable and six suspected, according to Health Minister Oly Ilunga.

“We have established surveillance mechanisms and are following all cases and contacts,” he said. “The response is well-organized because we have also put in surveillance measures at the entry and exit points of Mbandaka.”

In a hopeful sign, two patients who were confirmed as positive for Ebola have recovered, and are returning to their homes though they will be monitored, Ilunga said. They have left the hospital “with a medical certificate attesting that they’ve recovered and can no longer transmit the disease because they have developed antibodies against Ebola,” he said.

Ebola, however, does in many cases remain longer in semen, and therefore can be transmitted through sexual contact for some months after recovery.

Congo’s health delegation, including the health minister and representatives of the World Health Organization and the United Nations, have arrived in Mbandaka, the northwestern city of 1.2 million where Ebola has spread, to launch the vaccination campaign Monday.

Dr. Eric Ekutshu, a doctor in the Wangata health zone in Mbandaka, received the vaccine Monday as part of a ceremony presided over by officials.

“I’m glad I have received the vaccine against Ebola,” he said. “I ask the others (contacts and nursing staff) to get vaccinated to protect themselves. Everyone must adhere to this vaccination campaign with the goal of protection.”

Guillaume Ngoie Mwamba, director of the Expanded Program on Immunization, was the first Congolese to receive the vaccine in Mbandaka.

“This is to give a message of safety and assurance to all of the population exposed to the epidemic,” he said.

Two dozen vaccinators, including Congolese and Guineans who administered the vaccine in their country during the 2014-2016 outbreak, are in Mbandaka to start injecting the 540 doses that have arrived, the health minister said.

It will take five days to vaccinate about 100 registered patients, including 73 health care staff, who have had contact with patients and their relatives in the Wangata and Bolenge health zones of Mbandaka, he said.

The vaccination campaign will then move to the other two affected areas, the Bikoro and Iboko health zones.

More than 7,500 doses are available in Congo, WHO said Monday, adding that an additional 8,000 doses will be available in the coming days.

The vaccine, provided by U.S. company Merck, is still in the test stages, but it was effective toward the end of the Ebola epidemic that killed more than 11,300 people in Guinea, Sierra Leone and Liberia from 2014 to 2016. A major challenge will be keeping the vaccines cold in this vast, impoverished, tropical country where infrastructure is poor.

Congo President Joseph Kabila and his Cabinet agreed Saturday to increase funds for the Ebola emergency to more than $4 million. The Cabinet also endorsed the decision to provide free health care in the affected areas and to provide special care to all Ebola victims and their relatives.

The U.S. Agency for International Development has said that it has provided an initial $1 million to combat the Ebola outbreak. The funds are going to WHO in support of its joint strategic response plan with Congo’s government.

The spread of Ebola from a rural area to Mbandaka has raised alarm as Ebola can spread more quickly in urban centers. The fever can cause severe internal bleeding that is often fatal.

“It’s concerning that we now have cases of Ebola in an urban center, but we’re much better placed to deal with this outbreak than we were in 2014,” WHO’s director-general, Tedros Adhanom Ghebreysus, said at the U.N. health agency’s annual meeting in Geneva on Monday. “I am pleased to say that vaccination is starting as we speak today.”

Tedros said he is “proud of the way the whole organization has responded to this outbreak, at headquarters, the regional office and the country office.”

This is Congo’s ninth Ebola outbreak since 1976, when the disease was first identified. The virus is initially transmitted to people from wild animals, including bats and monkeys. It is spread via contact with the bodily fluids of those infected.

While Congo has contained several Ebola outbreaks in the past, all of them were based in remote rural areas. The virus has twice made it to Kinshasa, Congo’s capital of 10 million people, but was effectively contained.

There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 percent of cases, depending on the strain.


AP writers Carley Petesch in Dakar, Senegal, and Geir Moulson in Berlin contributed to this report.


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Study: Exercise 4 Times a Week for a Healthy Heart

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Fighting Health Disparities at the Barbershop

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How tomato sauce can boost your gut health

If like me, you enjoy the occasional bowl of pasta with fresh tomato sauce, then I’ve got great news for you. Research fresh out of the pan has found that cooked tomato sauce helps to improve the activity of probiotics in the gut.

Does tomato sauce boost gut health? And if so, should we choose raw or cooked?

Over the past few years, researchers and consumers alike have been taking interest in whether or not the foods that eventually reach our tables are “functional.” But what are functional foods?

“All foods are functional to some extent because all foods provide taste, aroma, and nutritive value,” explains researcher Clare Hasler in a Journal of Nutrition article.

“However,” she goes on to clarify, “foods are now being examined intensively for added physiologic benefits, which may reduce chronic disease risk or otherwise optimize health.” And those foods seen to bring specific health benefits are deemed “functional.”

Probiotic foods — such as certain types of yogurt, kefir, or kimchi — fall into this category, as they boost the population of good bacteria in our guts, which contribute to our overall health in many ways.

Now, however, researchers from the Universitat Politècnica de València in Spain are looking at how gut bacteria interact with antioxidants in the gut.

Specifically, senior researcher Ana Belén Heredia and her team were interested in seeing how tomato sauce — rich in antioxidants — would behave in the presence of good bacteria in the gut.

And, since tomato sauce can be served raw or cooked, they wanted to understand what effect this would have on the antioxidant-gut bacteria interaction.

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Antioxidants and probiotics

Tomatoes are considered a healthful food because, among other things, they contain a pigment called lycopene — an antioxidant that helps to protect cells from damaging factors. Existing research also suggests that tomatoes have probiotic properties — that is, that they can boost the activity of healthful bacteria in the gut.

In the current study, the research team conducted in vitro experiments to see how Lactobacillus reuteri — one of the main bacterial species that contribute to gut health — would interact with antioxidants derived from tomato sauce, and how the cooking process would influence that interaction.

For this purpose, the researchers chose to use pear tomatoes, as they have a higher content of lycopene.

“We have evaluated the viability of the probiotic strain along the digestive process individually and the presence of antioxidants from vegetable sources, as well as the impact of the probiotic strain on the changes suffered by antioxidant compounds and the resulting bioaccessibility,” explains Heredia.

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Cooked or raw?

The results of their experiments — now published in the Journal of Functional Foods — indicate that the digestive process resulted in a loss of antioxidants, both in the case of raw and cooked (fried) tomato sauce.

Also, the presence of L. reuteri appeared to prevent some of the antioxidants from being absorbed into the blood system.

At the same time, however, the research team found that the antioxidants from the tomato sauce enhanced the positive effects of L. reuteri. And in this context, cooked tomato sauce appeared to be more effective than the raw equivalent.

Cooking the sauce also transformed the lycopene present in the tomato — a process known as cis-trans isomerization — which actually helped to preserve the integrity of this antioxidant through the digestive process, allowing more of it to be absorbed.

“We worked with raw and fried tomato to determine the impact of processing,” notes Heredia.

And among the results, we found that serving meals rich in probiotics with fried tomato sauce boosts its probiotic effect; as well as causing a progressive isomerization of the lycopene of the tomato, from form cis to trans throughout digestion, which positively results in an increased final bioaccessibility of this carotenoid.”

Ana Belén Heredia

These results suggest that, when assessing foods for health benefits, it is important to look not only at the effects that cooking may have on them — by submitting their components to various chemical transformations — but also at the impact of the digestive process on these nutrients.

An increased awareness of both of these effects, the researchers argue, would allow companies in the food industry to create truly “functional” foods that can boost our health.

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Sports’ Newest Battlefront: Mental Health

This isn’t a typical sports story, but I think it’s an important one.

Over the past few months, a handful of high-profile athletes have come forward to talk about their personal issues with mental health. The Olympic legend Michael Phelps opened up on his struggleswith depression, as did the NBA All-Star DeMar DeRozan of the Toronto Raptors. Another basketball All-Star, Kevin Love, currently in the playoffs with the Cleveland Cavaliers, went public about his battles with anxiety—including a panic attack he suffered during…

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Donald Trump knows terrifyingly little about women’s health

President Trump has shown himself to be deeply interested in women’s bodies: As a radio show guest, he graded them, part by part. As a presidential candidate, he attributed tough questions from them to their wayward bleeding. And now, as president, he’s restricting their access to health care. A rule Trump is expected to outline Tuesday will strip sexual health funding from clinics that perform or refer for abortions, which if Texas’s experiment is any guide, will vastly reduce women’s access to effective forms of contraception in the name of preventing abortion.

Despite his heroically keen focus on the female form, Trump has flaunted ignorance of the kind of material that gets covered in basic sex ed. On video aired by MSNBC’s Chris Hayes, Microsoft founder Bill Gates recalls ruefully that Trump asked him, on two separate occasions, what the difference is between the HIV and HPV viruses. This is basic stuff, but he shows no interest in really mastering it, despite the vast power he now exerts over the lives of those it affects.

In theory, this is information that Trump — who once joked that avoiding sexually transmitted diseases was his personal Vietnam — might find relevant to his own life. After all, two women who say they had extramarital affairs with the president, former Playmate Karen McDougal and adult performer Stormy Daniels, separately told CNN’s Anderson Cooper that Trump did not use a condom. “You know, we talked about it right beforehand,” McDougal, who described a 10-month relationship, told Cooper. “He was starting to and then he’s like, I don’t like these things.” According to the Centers for Disease Control and Prevention, “consistent and correct use of latex condoms is highly effective in preventing sexual transmission of HIV, the virus that causes AIDS,” and “consistent and correct use of latex condoms may reduce the risk for genital human papillomavirus (HPV) infection and HPV-associated diseases (e.g., genital warts and cervical cancer).”

Disregarding the weight of medical evidence about how to reduce health risks isn’t just a personal choice that Trump has made for himself; it’s also his administration’s policy. The Department of Health and Human Services announced last month it would lower its standard of evidence to encourage programs for teens that favor “sexual risk avoidance,” or abstinence. Never mind that the rigorous nine-year study the department itself commissioned of four federally funded abstinence-only programs showed they had “no overall impact on teen sexual activity.”

The rule to be announced Tuesday is expected to deny Planned Parenthood and independent clinics of millions of dollars they receive under the Title X program to provide low-income women with services like cancer screenings, birth control and tests for pregnancy and sexually transmitted diseases. Under long-standing federal restrictions, none of the funds go to abortion services, but the new rule would reportedly bar funds from any clinic that performs or refer for abortions. Or, in the words of the White House, “ensure that Federal funds are not used to fund the abortion industry.”

This is consistent with a promise Trump made during the campaign, when he praised Planned Parenthood but said they would be defunded unless they ceased providing abortions. “I said defund. I didn’t say pay. I said I have a lot of respect for some of the things they do, the cervical cancer on women,” he told Fox News’s Sean Hannity in February 2016, though who can know if he understood that the way the clinics prevent “the cervical cancer on women” is by vaccinating against and screening for HPV. But Planned Parenthood would get no funds to perform those services, Trump went on, “not while they do abortions.”

Republicans, including House Speaker Paul D. Ryan (Wis.), claim other health clinics can step into the breach opened by excluding Planned Parenthood and other clinics. That’s not what a study published last year in the New England Journal of Medicine found; in the two years after Texas barred Planned Parenthood from receiving state women’s health funds, Texas women’s access to the most effective forms of contraception dropped by a third, and births among women covered by Medicaid grew 27 percent.

Say you take at face value the claim that the policy change is about reducing the number of abortions. If so, wouldn’t it make more sense to follow in the footsteps of Colorado, which cut its teen abortion rate in half when a pilot program provided the same effective, long-acting reversible contraception free?

Instead, this is an administration that has dragged migrant teenagers seeking abortions to court and considered subjecting them to medically-unproven experiments in “abortion reversal.” All because, in the words of a top Trump administration official, “refuge is the basis of our name and is at the core of what we provide, and we provide this to all the minors in our care, including their unborn children, every day.” And yet it’s also the same administration that plans to separate living children from their migrant parents and is considering warehousing them on military bases. The administration has already withdrawn funding from family planning groups working overseas if they refer for or counsel about abortions — leaving women in the same places Trump called “s—hole countries” in more desperate conditions and, according to prior research from the Bush era, likely increasing the number of unsafe abortions.

What explains these seemingly disparate actions is that for Trump, and social conservatives whom he is amply repaying for their support, medical facts, public health considerations, or carefully assembled empirical studies are beside the point. It’s about values, about who gets to be empowered to make their own decisions and who will be subject to the most brutal forms of control, and whose historically enforced power will remain intact. If you’ve gone to one of those sex-ed classes, and not the abstinence kind, you might have heard that knowledge is power. Again and again, the Trump administration — and indeed the president himself, the archetype of a man insulated from consequences — has shrugged in reply: when you have power, who needs knowledge?

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WHO Says New Ebola Outbreak Is Not Yet a Top Health Emergency

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A longtime Google investor draws this simple chart on a napkin to explain health tech to company founders

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Krishna Yeshwant, a doctor and investor with GV, Alphabet’s venture firm, takes a lot of meetings with entrepreneurs that have lofty goals to fix health care.

But different patients have different needs.

So to help entrepreneurs empathize with their users, he came up with a simple, foursquare box that he’ll scrawl on a napkin, in meetings. He drew it for me at HLTH, a major health conference, that happened in Las Vegas earlier this month.

Yeshwant came up with the idea while practicing medicine.

He soon realized that his own patients, many of whom are lower-income and struggling with complex health problems, wouldn’t adopt the same solutions as the tech workers in his Google network.

He also learned in the clinic that social needs shouldn’t be divorced from medical problems; they’re inextricably linked. And entrepreneurs need to keep both in mind, not just the person’s health history.

“It’s hard to get your medicine if your pharmacy keeps changing because you have to keep going to different shelters, and sometimes your shelter is in a new city and you don’t have a car, or a cell phone, or a credit card, or a bank account, or you can’t read or speak English,” he explained.

The key is to build a deep understanding of the user. “It’s hard for someone who hasn’t walked in those shoes to have full empathy for the patient,” he said.

Start-ups in each category

One of the first things he’ll ask the entrepreneur to do is to point to where their product might be in the box. Some are dead on, while others haven’t thought it through.

Here are a few examples of companies that Yeshwant and I would put in each category. This is broadly the case, although there might be exceptions:

  • Low medical/low social needs: Virtual doctor apps, concierge primary care, wellness tests (23andMe, Forward, One Medical)
  • High medical/low social needs: Cancer tests, expensive therapies and medical devices (ZappRx, Turing Pharmaceuticals, Merck, Pfizer, Medtronic)
  • High social/ low medical needs: Services to treat depression in homeless vets, home monitoring tools for seniors that are starting to “age in place,” transportation services to help people get to appointments (PatientPing, Circulation Health, Pear Therapeutics)
  • High social/high medical needs: Programs for Medicaid patients to treat diabetes, services to help people without insurance access the medications they need (Cityblock Health, GoodRx, Aledade, CareMore, Iora Health)

According to Yeshwant, far more tech entrepreneurs gravitate to opportunities to serve those with the lowest medical and lowest social needs — essentially their own network. Those with a health background tend to be more eager to tackle the opposite population with the highest medical and social needs, as they’re aware that this group is the biggest driver of health costs.

In his view, venture capital often lean towards the therapeutics companies that fit into the low social complexity/high medical complexity quadrant, such as costly novel drugs for cancer or diabetes. In January, a single therapy to treat a rare form of blindness received a price tag of $850,000.

Who’s left out?

Yeshwant says he’s found companies in all four boxes, but the biggest struggle involves finding investments in the low medical complexity/high social complexity quadrant. It’s particularly hard to find ideas in that quadrant with a strong business model.

He’d particularly like to see more investment in tools and services to support people with substance abuse issues, such as alcohol and opiates, as well as people who struggle with homelessness or transportation gaps.

“We often ignore people in this category because they are young or healthy enough to still be able to cope in shelters or by riding the bus, but their situation is a set-up to move from low medical complexity to high medical complexity when chronic diseases start to set in and they are unable to afford or organize themselves to access basic care,” he said.

What do you think about this “foursquare framework?” Let me know @chrissyfarr on Twitter.