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Chattanooga City Council changes course on health plan

Confronted by a packed room full of upset city retirees, the Chattanooga City Council on Tuesday appeared ready to back off a switch in health insurers for 2018 and stay with BlueCross BlueShield of Tennessee.

Last week a group of retirees hammered the switch to United Healthcare, saying they’d been told they might have to switch their longtime doctors or lose access to specialty care at the Chattanooga Heart Institute.
At a planning meeting Tuesday, city Human Resources Director Tina Camba said United Healthcare would not cover services from the heart institute. A late resolution was added to the Tuesday night voting agenda to extend the contract with BlueCross for the coming year.

This is a developing story. Stay with the Times Free Press for updates.

Health dept. fires accountability director

OKLAHOMA CITY — Board members with the health department voted to fire the agency’s director of accountability.

In a closed door executive session, members decided they would terminate Jay Holland, who currently serves as the director of the Office of Accountability Systems.

The office is tasked to receive and fairly investigate complaints or information from Oklahoma State Department of Health employees and other members of the public concerning any possible violations of laws or rules regarding OSDH.

“This position was created out of the previous scandal that involved the department of health,” said acting commissioner Preston Doerflinger. “This board needs to have very good information directly from the reports in those areas and that will happen with the CFO, that will happen with other parts of the agency and it definitely will happen with this role.”

The board did name an acting interim director for the office, but we are told that process is underway.

Clark County School employees sue Teachers Health Trust – Las Vegas Review

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The embattled Teachers Health Trust, which provides health insurance for thousands of Clark County School District employees and their dependents, faces a new legal challenge.

District employees on Tuesday filed a class-action lawsuit alleging breach of contract, consumer fraud and other actions that they say has resulted in employees paying more for their health care and receiving less.

The lawsuit, filed in state District Court in Las Vegas, names both the trust, its seven trustees and WellHealth Quality Care, which manages the trust’s network of doctors, as defendants. It claims that WellHealth violated its contract with the trust by refusing to pay claims, charging a $20 co-pay that was higher than the $10 cap, and leaving teachers with higher yearly out-of-pocket expense than the $6,800 cap that was promised.

“They were paying insurance premiums for something they didn’t ultimately get,” said Mitchell Bisson, one of two attorneys representing the employees. “They were supposed to get product A, they got product Z — if any product at all.”

In some cases, employees were sued over unpaid medical bills or were refused medical treatment, the lawsuit states.

But the lawsuit also lays blame on the trust and its Board of Trustees, claiming that they turned a “blind eye” to the “gross mismanagement and ineptitude” of WellHealth.

“The problems with WellHealth were well known to the Teachers Health Trust, and to its individual trustees, yet nothing was done,” the lawsuit states. “It is estimated that there may be as many as 30,000 union members who, like plaintiffs, paid health insurance premiums to WellHealth but did not receive the promised health care.”

The trust’s chief operating officer, Kim Phillips, said in an email that the trust had no comment. WellHealth did not immediately return a request for comment.

The lawsuit is the latest blow to the trust, which also faces a whistle-blowing legal challenge from members of its former executive board.

The former trust employees — CEO Gary Earl, Chief Operating Officer Felipe Danglapin, Director of Operations Philip DiGiacomo, and executive assistant Michael Ielpi — claim that the trust breached its fiduciary duty by entering into no-bid contracts that hiked its administrative costs from WellHealth and other providers.

The former employees say they witnessed a series of questionable financial decisions by trust managers and alleged that Earl was rebuked when he questioned a proposal to build four clinics that would cost over $1 million each.

The former employees last summer had plans to sue the trust and John Vellardita, executive director of the Clark County Education Association. But the trust struck first, filing a lawsuit against the plaintiffs that accused them of releasing confidential information to the district and making unauthorized purchases on trust credit cards.

The trust also is locked in battle with the Clark County School District, which filed an unfair labor practice complaint over lack of access to financial information required for contract negotiations, where health care is likely a contentious point.

Teachers have lobbied the district for higher insurance contributions, but the School Board has lost faith in the trust’s financial capabilities. Its proposal to switch to UnitedHealthcare insurance instead, however, has also been met with strong resistance by educators.

This is a developing story. Check back for updates.

Contact Amelia Pak-Harvey at or 702-383-4630. Follow @AmeliaPakHarvey on Twitter.

EU health and food safety experts warn of stubborn salmonella

There were 94,530 human cases of salmonellosis reported in the EU in 2016.


The number of salmonella food poisoning cases in the European Union has risen by 3 percent since 2014 in a “worrying” reversal of a decade-long declining trend, EU health and food safety officials said on Tuesday.

Salmonella bacteria was the most common cause of food-borne illness in 2016, accounting for 22.3 percent of outbreaks, compared with 11.5 percent in 2015, the European Centre for Disease Prevention and Control (ECDC) and the European Food Safety Authority (EFSA) said in a report.

There were 94,530 human cases of salmonellosis reported in the EU in 2016, it said. Salmonella enteritidis, the most common type and one mostly linked with eating eggs and poultry, accounted for 59 percent of cases originating in the EU.


“The increase shown by our surveillance data is worrying and a reminder that we have to stay vigilant,” said the ECDC’s chief scientist, Mike Catchpole.

Salmonella food poisoning can cause diarrhea, fever, stomach cramps and vomiting. These symptoms typically come between one and three days after infection and last four to seven days. More severe cases can cause death. A total of 1,766 people were admitted to hospital with salmonella in 2016 and there were 10 salmonella deaths.

The EFSA and ECDC report, which looked at outbreaks of food-borne disease in the EU, said that overall outbreak numbers were broadly stable, with 4,786 food-borne outbreaks in 2016 compared with 4,362 in 2015.

Campylobacter, common in chicken meat, caused a high number of infections, though fatalities were low, the report said.

Listeria infections, which are generally more severe, led to hospitalization in 97 percent of reported cases. Listeriosis killed 247 people in the EU last year.

Holiday gift guide 2017: Health & Fitness

Holiday gift guide 2017: Health Fitness

Whether you have a fitness enthusiast, a nutritionist wannabe or a yoga guru on your shopping list, everyone can use the gift of good health. Here are 5 health-inspired gifts ideas.

Whether you have a fitness enthusiast, a nutritionist wannabe or a yoga guru on your shopping list, everyone can use the gift of good health.

Here are 5 health-inspired gifts ideas:

1. 8K Flexwarm Jacket

For your favorite hiker or outdoor enthusiast, pick up a jacket that is guaranteed to keep them warm.

8K Flexwarm jackets are heated apparel designed to let you adjust the heat inside the jacket from a smartphone app. The brand offers jackets and vests with a printable heating technology that provides three different heat zones and heat levels. With a push of a button the interior can heat up as high as 122 degrees Fahrenheit in as little as six minutes.

The jackets are powered by a battery pack so users can stay warm for up to 6 hours.

Price: $228, available at 


2. Fitbit Iconic

If you’re shopping for someone who wants to upgrade their fitness tracker or find one that’s a little “smarter,” consider Fitbit Iconic.

The Iconic is Fitbit’s first smartwatch and latest release. It comes with a number of new features like personal workouts you can follow right on your wrist. In its personal coach feature, you can watch sequences that guide you through a 7-minute HITT (high-intensity interval training) type workout, a 10-minute ab series and chest exercises. Plus it includes complete waterproof swim tracking and on board music to keep you motivated.

The built-in GPS has been updated in the Iconic so you can see real-time pace and distance data, as well as elevations.

Another major improvement is their sensor technology. The watch uses a Sp02 sensor that can estimate blood oxygen levels, which could help track important health insights like sleep apnea.

Price: $299.95, available at


3. Upstep Insoles

Finding the perfect-fitting sneaker is not always easy, but a new service called UpStep makes insoles custom designed for all your daily activities and sports.

To give you or your loved ones the perfect fit, the company sends a footprint kit and questionnaire so you can note what activities and injuries you’re working with. Once you send back your impression, UpStep’s podiatrists designs an insole specifically to your feet and needs, which the company says will help you perform at your best and reduce your risk of injury.

Price: $260, available at


4. Halo Sport

If you have a hardcore workout fanatic on your list, take a look at Halo Sport. They’re headphones that stimulate specific learning areas of your brain to optimize your athleticism.

The process is called neuropriming, and it works by putting the brain’s motor cortex in a temporary state of hyperplasticity, or hyperlearning. The company says when you wear them during a workout, it improves neuromuscular output which can lead to more precise, coordinated, and explosive movement.

In one case study, collegiate athletes who combined halo sport with training improved leg strength by 12 percent in two weeks.

Price: $599, available at


5. Moov HR Sweat

One of the new must have fitness accessories this year is your own personalized fitness coach. Moov HR is a wearable with AI-powered voice coaching that pushes you through high intensity workouts based on heart rate so you burn more calories in less time.

Unlike other heart monitors, Moov HR uses LED lights and optical sensors to measure blood density around the temples to give you the most accurate heart rate data. 

It can be worn as a sweatband or swim cap (Moov HR Swim) and works with Moov’s personal coach app to give you move-by-move voice coaching in running, cycling and bodyweight circuit programs. The device also tracks and analyzes your performance during and after your workout so you can see you calorie burn, plateaus and progress.

Price: $99.95, available at  


Here’s the Surprising Reason Lindsey Vonn Spreads Cheese on Her Injuries

There is something special about Lindsey Vonn. No matter how many times she gets knocked done, she gets right back up, including after her latest fall at Lake Louise in Canada during the Audi FIS Ski World Cup. “I’ve definitely had my fair share of setbacks; that’s just a part of ski racing,” says Vonn. “We push ourselves to the limit, and we are going 90 miles an hour down an icy mountain, and sometimes things go wrong…and so I just figure out a way to pick myself back up.”

One secret behind the 33-year-old’s ability to bounce back: cheese. Yes, you read that correctly, cheese. In fact, the gold-medal Olympic skier recently posted a series of Stories on Instagram about the dairy product. In one, the creamy stuff is being smeared all over her right knee. Vonn’s caption: “Some cheese therapy. My favorite.”

0a00c_lvonncheese Here's the Surprising Reason Lindsey Vonn Spreads Cheese on Her Injuries

RELATED: Everything You Need to Know About Runner’s Knee–Even If You’re Not a Runner

But does it really work? “There is no validated scientific evidence for applying cheese, per se, to bruises and injuries,” says Michele Olson, PhD, a professor of exercise physiology at Auburn University in Alabama. “There may be some anti-inflammatory benefits for eating or ingesting cheese, but nothing magical about applying it superficially.”

Vonn, who recently launched her signature skiwear collection with Under Armour, would disagree. The skier has been using this recovery practice with cheese called Topfen for years. “It is an Austrian cured cheese with anti-inflammatory properties,” she says.

“I believe what they are trying to do is to create a poultice which has been practiced in traditional medicine,” explains John Lucey, PhD, director of the Center for Dairy Research and professor of food science at the University of Wisconsin-Madison. “The materials used for poultices are often moist, warm, semi-solid type materials and have been used to help drain abscesses, reduce swelling, etc. The poultice is packed around the infected areas and then wrapped in bandages.”

Which is exactly what Vonn seems to have done in the second post to her Stories, which shows her cheese-laden knee wrapped in Hyperice Knee—a portable cryothetapy device designed to treat and prevent pain and inflammation. Vonn wrote: “Cheese on the bottom, @hyperice on the top. Getting better.” 


0a00c_lvonncheese Here's the Surprising Reason Lindsey Vonn Spreads Cheese on Her Injuries

RELATED: The Best Workout to Do When You’re Really Sore

“There are a few components in cheese that could have some potential anti-inflammatory type of effect,” Lucey adds. “These include specific types of bacteria like some probiotics, if present. And there are some types of bioactive peptides with this possible benefit.” Though he notes, however, that most of these perks, if not all, are thought to come from eating cheese.

So what does that mean if you find yourself banged up and bruised? Well, experts such as Charla Fischer, MD, an orthopedic surgeon at NYU Langone Orthopedic Hospital who specializes in spine surgery and back and neck problems, wouldn’t point you toward the dairy aisle at your local grocery store.

“I know that athletes are really in tune with all the anti-inflammatory foods,” says Dr. Fischer, “but as far as placing things externally to help affect inflammation around the soft tissue … I haven’t heard of cheese or any sort of dairy product [that does that].” 

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Dr. Fischer’s recommendation for speeding up recovery? The good old RICE method— rest, ice, compression, and elevation. “If you notice that something is swollen after an activity, doing those things are always going to be helpful,” she explains.  “If you have a knee with a little bit of swelling, just resting it, getting your knee above heart level, maybe an ACE wrap for a little compression—not anything too tight because you don’t want to cut off circulation—and ice always helps with swelling.” She recommends icing for 20 minutes three times a day.

Dr. Fischer also advises that you be cognizant of your pain levels post injury: If it is less than a 4 on a scale of 1 to 10 after three to five days, then you are on the right track, she notes. But if it is above a 4, you might want to consider calling your primary care doctor.

As for Vonn, the cheese remedy doesn’t seem to have held her back in any way. She’s racked up an impressive two Olympic gold medals and 77 World Cup victories after all! If she finds it works for her, we guess that’s all that really matters.

Try These 3 Yoga Moves for a Healthier, Stronger Spine

When you think about building strength, your spine may be the last body part that comes to mind. But a strong back can not only reduce your chances of injury; it’s also key for your balance, mobility, and posture. In the video above, Nicole Katz, founder of Yoga 216, takes us through three yoga-inspired moves that help strengthen and stretch the muscles around the spine.

To complete the routine, all you need is one minute, a small space, and a yoga mat. Do each move a few times on both sides, at a relaxed pace.

WATCH THE VIDEO: These Are the Yoga Poses Everyone Does Wrong

Lateral Flexion

Start by putting your knees on the mat and sitting back on your heels. Place your right hand beside you on the mat and raise your left arm straight up in the air. Lean your upper body over to the right, bending your right elbow and curving your left arm over your right shoulder, making a U shape. Hold this position for five seconds. Then switch sides.

Thoracic Twist

Lie on the left side of your body in the fetal position, with your knees together at a 90 degree angle. Put your left arm straight out in front of you and place your right arm over your left arm, so your fingertips. Then slide your right arm across your body back so your right arm and shoulder touch the floor on your right side; your neck should turn to the right side as well. Then slide your right arm back to the starting position and repeat. You should feel this stretch in the upper spine as well as your lower back, says Katz.

WATCH THE VIDEO: 3 Yoga Poses to Do When Your Back Is in Knots

Bridge Roll

Lie on your back with your arms at your sides, palms facing up, and your knees bent. Then, rolling your spine from the top vertebrae, lift your hips in the air, keeping your shoulders on the mat, to form a bridge with your body. Hold the bridge position for a few seconds, then roll your spine as your lower your hips back down to starting position.

10 Wellness Trends You’re Going to See Everywhere in 2018, According to Pinterest

If the thought of living healthy in the new year makes your mind turn to treadmill workouts and broccoli recipes, then Pinterest’s top wellness trends for 2018 is for you. Encompassing healthy habits that benefit your mind, body, and soul, the just-released list has something for every Pinner—61% of whom say Pinterest is where they find ideas to be their best selves. Here’s a look at the food, fitness, and feel-good trends that will be all over your boards next year.

The trend: A gut feeling

Is it just us, or did gut bacteria totally take over in 2017? Feeding yours with GI-friendly grub offers major health benefits, including reduced inflammation. Expect digestive health to still be buzzy in 2018—and start by pinning recipes starring the best probiotic foods for your gut.

The trend: Strength over size

More and more Pinners are hopping off the treadmill and onto the strength-training bandwagon, and with good reason: Strength training builds muscle, sure, but it also improves your balance, keeps your bones healthy, and helps you burn fat—yes, really. But it’s not the slimming effects that will reign supreme in 2018. Next year is about celebrating the amazing things your body is capable of.

The trend: Let’s clear the air

If you already eat clean, it’s time to consider the air you breathe in 2018. Air purifiers and plants that do the work for you make great additions to a healthy home. They keep your rooms free of smoke, dust, and other allergens and reduce the effect these can have on your body.

RELATED: 5 Plants That Can Help Purify Indoor Air, According to Science

The trend: The post-workout

Consider the post-workout like an after-party: Sometimes it’s as big a deal (if not bigger!) than the main event. Recovering from tough workouts means knowing the best snacks and meals to eat, the best cool-down stretches to flow through, and the best compression gear to throw on to help you feel better fast.

The trend: A treat for tresses

Resolve to treat your hair as well as you treat your skin in 2018. Whether that means whipping up homemade, all-natural shampoo or simply washing your hair less, healthy hair tips for softer, shinier locks are going to be even more popular in the new year.

RELATED: 21 Reasons Why You’re Losing Your Hair

The trend: The vitamin for brighter skin

Just a few drops of a vitamin C serum as part of your daily skincare routine can help reduce signs of aging, thanks to the vitamin’s powerful antioxidant properties. Brighter, firmer skin, fewer fine lines, and a more even skin tone can be yours thanks to serums like SkinCeuticals CE Ferulic Serum ($165, 

The trend: The most underrated exercise

The ancient Chinese practice of tai chi—which combines gentle, flowing movements with deep breathing and meditative thoughts—is winning over modern fitness fanatics. Try this low-impact exercise for its serious relaxation benefits and ability to reduce pain.

The trend: Wait, you can eat those?

We fell in love with essential oil diffusers in 2017; what better way to turn a home into a calming sanctuary or an invigorating den of creativity? Now, as 2018 approaches, we’re curious about how to incorporate them into our diets too. But serious word of caution: Only ingest essential oils labeled as food grade! Many essential oils are not safe for internal use.

The trend: Self-care staycations

A lot of us had a lot to fight for in 2017, which meant carving out crucial “me time” to practice restorative, re-energizing behaviors to keep us moving forward. Self care, once maligned as indulgent, became a necessity. In 2018, taking a break will still be important—even if you don’t leave your couch.

The trend: New prop on the block

Move over blocks and blankets: The yoga wheel is the latest fan-favorite yoga prop. The wheel allows for deeper stretches and self-massages, and it can support you through more challenging postures. Yogis on Instagram are already obsessed and celebs are joining in on the trend, so get pinning!

Prison Sentences Shouldn’t Be Death Sentences: How To Fix Correctional Health Care

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Health Notes: UF Health Jacksonville is among 89 hospitals involved in a national improvement collaborative for … – Florida Times

UF Health Jacksonville is among 89 hospitals involved in a national improvement collaborative for children seen in the emergency room or hospitalized with asthma. Asthma affects nearly 10 percent of American children and is a leading cause of pediatric emergency visits and hospitalizations.

Jennifer Fishe, associate medical director of the pediatric emergency department at UF Health Jacksonville, is leading the Pathways for Improving Pediatric Asthma Care initiative at UF Health Jacksonville, the only hospital in Florida participating in the program.

The project will provide resources that will help health care providers select and provide appropriate medications, choose appropriate tests and effectively counsel families. It will also offer continuing medical education and American Board of Pediatrics Maintenance of Certification credits to physicians who meet qualifying criteria.


The deadline to sign up for 2018 health insurance under the Affordable Care Act, also known as Obamacare, is Friday. It is six weeks earlier than last year.

The Florida Blue Centers at St. Johns Town Center and River City Marketplace will be open for people to sign up for coverage 8 a.m. to 7 p.m. through Friday. Florida Blue’s office inside the Winston Family YMCA, 221 Riverside Ave., is also enrolling people. Those hours are 9 a.m. to 7 p.m. through Friday. People do not need to be members to enter.

Florida Blue recommends making an appointment online at to shorten wait time. People wishing to sign up for coverage should bring their last income tax return, a photo ID and a current insurance card if they have one.


Mayo Clinic is the first medical center in Northeast Florida to achieve recognition and accreditation for critical neurological clinical services such as administering electroencephalograms, which record brain cell communications, among other laboratory and monitoring techniques. The American Board of Registration of Electroencephalographic and Evoked Potential Technologists awarded the certification, which is based on stringent review of the technical quality of EEGs and laboratory policies and procedures.


Stereotactic radiosurgery has emerged as a standard of care in human oncology over the last few decades, but has only recently become available in veterinary medicine. Less than 20 specialty centers across the country possess the technology and clinical expertise to provide it for pets. That list now includes Southeast Veterinary Oncology and Internal Medicine, which has an office at 204 Corporate Way in Orange Park. The upgrade was made possible by a partnership with national cancer care provider PetCure Oncology, an industry leader in radiation oncology for pets.

Picture of Health: Can AI Eye Scan Reveal What Ails You?

The light-sensitive layer found at the back of a person’s eyes contains more than just cells that detect shadows and light — it also contains information about the health of a person’s entire body. And now, artificial intelligence can glean this information from a single snapshot, new research suggests.

The new AI algorithm, which analyzes images of this light-sensitive layer of the eye, called the retina, could one day provide on the spot diagnoses of various ailments from diabetes to autoimmune and neurodegenerative diseases, the researchers claim.

The AI algorithm was presented by Dr. Ursula Schmidt-Erfurth, the director of the ophthalmology department at the Medical University of Vienna, earlier this month at a scientific meeting in Vienna. Research on the algorithm was published Dec. 8 in the journal Ophthalmology.

Schmidt-Erfurth’s research focuses on using AI to detect signs of various diseases in the images of the retina. [‘Eye’ Can’t Look: 9 Eyeball Injuries That Will Make You Squirm]

“From a simple color photo of the retina, you can tell how old the person is, what gender are they, what is their smoking history, their blood sugar level and blood pressure,” Schmidt-Erfurth said. “But we can also use an image from an optical coherence tomography scanner and that gives us much more detail.”

Optical coherence tomography (OCT) is a technique commonly used in ophthalmology that takes 3D images of the retina and allows the doctor to examine in detail what is happening in each layer of the light-sensitive tissue. Artificial intelligence, however, can do this much more precisely and much faster, Schmidt-Erfurth told Live Science.

In the presentation, Schmidt-Erfurth showed how such an AI algorithm could accurately spot signs of diabetes in the retina. Patients with diabetes frequently develop a condition called macular edema, which is essentially accumulation of fluid in the macula, a layer of the retina responsible for sharp central vision. If left untreated, the macular edema can cause permanent damage and vision loss.

“The algorithm gives you precise information about how much fluid is there, which the image by itself does not provide,” Schmidt-Erfurth said. Doctors could assess how well macular edema treatments are working by looking at these fluid levels — a decrease in fluid over time would show that the treatment is effective, she added.

The same algorithm could also detect the earliest signs of age-related macular degeneration (ARMD) and even predict how the disease will progress, Schmidt-Erfurth said.

ARMD is the most common cause of vision impairment in elderly people, according to Schmidt-Erfuhrt. About 60 percent of people older than 50 years show early symptoms, Schmidt-Erfurth said. However, only 15 percent of these cases eventually progress to the advanced stages of the disease. Similar to the diabetes-related macular edema, ARMD leads to a blurring of central vision. The person gradually stops being able to distinguish details and may even struggle to recognize faces.

“With this technology, we can predict the risk” of a person progressing to more serious stages, Schmidt-Erfurth said. “By training the algorithm on large data sets of previous patients, we can identify patients that are at risk to develop the disease in comparison to other patients, which will never develop the advanced disease.”

The high-risk individuals would then receive early treatment, which could potentially help them maintain their eyesight into old age.

The biggest advantage of the technology, Schmidt-Erfurth said, is the fact that it doesn’t require a specialist to interpret the results.

“Artificial intelligence will make therapy available to millions of people who until now are not diagnosed,” she said. “It’s very easy, you don’t even need to go to see an eye doctor.”

Schmidt-Erfurth’s earlier technology is already approved for commercial use in Europe and has been deployed in five hospitals across the continent. It uses AI to detect signs of diabetic retinopathy, a condition in which the blood vessels in the retina break down, from 2D color photographs of the eye.

Originally published on Live Science.

No insurance required at Junction City health clinic

Patients pay a monthly fee for Direct Primary Care at UnityPoint Health-Junction Medical

PEORIA — A new model of primary healthcare which skips the insurance company and provides unlimited doctor’s visits for a monthly fee is now available in Peoria.

Dr. Anton Grasch has been providing Direct Primary Care at UnityPoint Health – Junction Medical in the Junction City Shopping Center for about a year and a half. Also at the clinic is Dr. Mike Jongerius, who is in the process of transitioning his patients into the model.

Grasch, who first learned about Direct Primary Care in 2013 while doing his residency with UnityPoint Health, is enjoying the freedom the new model brings to patient interactions. He can now talk to patients about anything without having to figure out how to code it for the insurance company.

“It was always a problem, how to code and bill for a conversation about diet,” said Grasch. The new model also allows him to come up with innovative ways to improve his patients’ health.

“I’m hoping to eventually do things like cooking classes and yoga with patients,” he said.

Direct Primary Care also allows Grasch to talk for as long as necessary — appointment times are not limited — and even consult with patients over the phone or video chat on the computer.

“I can call and talk straight to my doctor and I don’t have to come into the office,” said Rachel Amsbaugh, 32, of Washington, one of Grasch’s patients. “For some things, like a twisted ankle, I can describe fairly well what hurts and where it hurts, and I can get advice without having to go in. Having that relationship with my doctor is very beneficial.”

Patients can even call the doctor in the middle of the night, though Grasch said that doesn’t happen much. Just knowing they can leave a message and then see the doctor first thing in the morning is enough for most non-emergency situations, he said. Being able to reach the doctor at any time helps reduce expensive emergency room visits.

“My five-year-old jumped off a diving board and landed on my sternum, and I thought I broke my sternum,” said Amsbaugh. “It was on the weekend, so I called the office and left a message. The next morning Dr. Garsch ordered an x-ray for me, and it turned out I was fine.”

A growing trend across the country, Direct Primary Care was started by independent physicians frustrated by the limitations of working with the traditional insurance billing system. UnityPoint Health might be the first healthcare corporation to offer the model, said Blake Long, UnityPoint’s Marketing Communications Manager.

“We’ve done some research and haven’t found any others doing it,” he said.

Participants in the UnityPoint plan pay according to their age, ranging from $59 a month for patients 17 years and younger, to $89 a month for patients over 65. The monthly fee includes an array of routine tests and procedures, including EKG, urinalysis, joint injections, and rapid strep screening. While insurance is not required for patients to sign up for the program, it is encouraged to pay for things not covered under the plan, including hospitalizations and visits to a specialist.

UnityPoint Health is currently talking to several area employers interested in including Direct Primary Care in their health insurance program, said Long.

“There are some studies which suggest that Direct Primary Care leads to healthier employees,” he said. Healthy employees are more productive and cost less. Another plus is that employees miss less work if they can consult with their doctor over the phone.

Amsbaugh has been seeing Dr. Grasch for about a year and she is very happy with the Direct Primary Care plan.

“It’s just nice to be able to have someone there when you need it. If something does go down in the middle of the night and and you need your doctor, you will be able to get your doctor, not someone who doesn’t know you. That continuity of care is something other types of health plans don’t give you.”

Leslie Renken can be reached at 686-3250 or Follow her on, and subscribe to her on



Oregon just average on health, report says

(Above: Despite the hikers and climbers who flock to Mount Hood and the state’s other outdoor enthusiasts, Oregon is average in an overall health rankings.)





The health of Oregonians remains in the middle of the pack among states, pulled down by low rates of immunization and high school graduation, but boosted by physical activity and fewer drug deaths, according to an annual report.


America’s Health Rankings found that Oregon improved by a notch, moving from 21st place in 2016 to 20th this year.


This is the 28th annual report from the United Health Foundation, which promotes health nationwide. The report, based on federal, state and local data, rates a wide range of factors such as deaths, infections, obesity, smoking, pollution and the number of health care providers per capita.


Massachusetts, Hawaii and Vermont, in that order, rank in the top three for health with Arkansas, Alabama and West Virginia at the bottom of the heap.


Here’s a look at the key findings for Oregon:

Generation at risk: America’s youngest facing mental health crisis

Alex Crotty was just 11 when things started feeling wrong.

It wasn’t just a matter of being unhappy. She always felt empty and miserable — never content or connected to other children. For years, she suffered alone, filled with shame. She switched schools, but that didn’t help. Generation at risk: America's youngest facing mental health crisis

“I didn’t feel unloved. I just felt numb to the world. Like, I was surrounded by great things, but just I couldn’t be happy. And I didn’t know why that was,” Alex told NBC News.

Finally, at 14, she decided to break her silence. “I can’t feel anything,” Alex simply told her mother, Heather Olson of New York. “So she just gave me a hug, cradled me in her arms on the bed, and was like, ‘Well can you feel me? Can you feel my love?'”

“A hug and kisses was the only thing that came to mind at the spur of the moment, but that was precisely what she needed to start the journey forward,” Olson said.

Alex was diagnosed with major depression and anxiety. Now 16, she is in therapy and on medication. She’s far from alone. Generation at risk: America's youngest facing mental health crisisCourtesy Heather Olson

There is an acute health crisis happening among members of the youngest generation of Americans, with critical implications for the country’s future.

The Centers for Disease Control and Prevention reports that 1 in 5 American children ages 3 through 17 — about 15 million — have a diagnosable mental, emotional or behavioral disorder in a given year.

Only 20 percent of these children are ever diagnosed and receive treatment; 80 percent — about 12 million — aren’t receiving treatment. Generation at risk: America's youngest facing mental health crisis

Recent research indicates that serious depression is worsening in teens, especially girls, and the suicide rate among girls reached a 40-year high in 2015, according to a CDC report released in August.

“Child and adolescent mental health disorders are the most common illnesses that children will experience under the age of 18. It’s pretty amazing, because the number’s so large that I think it’s hard to wrap our heads around it,” said Dr. Harold Koplewicz, founding president of The Child Mind Institute, a nonprofit children’s mental health advocacy group.

Over the next few months, NBC Nightly News will examine the state of American children’s mental health, including reports on what has led to this increase — especially in anxiety and depression — treatment obstacles, promising research and innovative programs to help children.

Is your toddler depressed?

Mental health problems may actually start much earlier than previously thought.

A toddler who is crying for hours and angrily stomping his or her feet may not be having a temper tantrum, but showing signs of depression. Research suggests that 1 percent to 2 percent of children 2 to 5 years old have depression, said Dr. Joan Luby, director of the Early Emotional Development program at the Washington University School of Medicine in St. Louis and a pioneer in the study of the condition in preschoolers.

She believes untreated depression in toddlers can lead to more depression later in life.

“Young children are more cognitively sophisticated, more emotionally sophisticated, than we previously understood. They have complex emotions. They’re aware of emotions in their environment. They feel emotions like guilt,” Luby said. “They have all the prerequisites of what depressive symptoms are.” Generation at risk: America's youngest facing mental health crisis

That may show up as constant sadness and low self-esteem. A child may not want to play with a favorite toy or with friends over a sustained period of time.

Vickey Harper of St. Louis became worried when her 2-year-old daughter, Myla, began having “scary” tantrums that sometimes lasted almost an hour. The girl would scream, kick and hit her mother in the face.

“My gut was just telling me that something was not right,” Harper said. Mental illness runs in the family, but she was surprised when doctors suggested Myla had depression.

The girl is taking part in Luby’s research to see whether early intervention can make a difference. Parents are coached on how to play with and respond to their kids — exercises meant to help kids recognize their emotions, like being sad, angry or nervous. The hope is that will help them learn to control those feelings and “change a lifelong trajectory,” or prevent episodes of depression later in life, Luby said.

Now, Myla’s long tantrums are gone.

“She is not the same kid that walked into those therapy sessions,” Harper said. “She can tell me when she’s feeling something. She still yells sometimes, but it’s on a much smaller scale.”

Why adolescents are so vulnerable

Teens are known for their moodiness, and adolescence — a particularly turbulent time of life — is one of the most vulnerable periods to develop anxiety and depression. About 50 percent of cases of mental illness begin by age 14, according to the American Psychiatric Association. A tendency to develop depression and bipolar disorder nearly doubles from age 13 to age 18.

But for teens like Alex Crotty, depression is very different from adolescent angst, Koplewicz said.

“Teenagers have a different kind of depression. They don’t seem sad. They seem irritable,” he said. “This really has an effect on your concentration, which will affect school. It will affect your desire to continue playing sports. It’ll affect your desire of being with your friends.” Generation at risk: America's youngest facing mental health crisis

Warning signs also include the duration and the degree of symptoms, he said. Take notice if your teen is experiencing moodiness or irritability for more than two weeks and it’s occurring every day, for most of the day, and if you see a change in sleep patterns and a change in desire to work and socialize.

Teenagers also think about suicide more often — and 5,000 young people take their own lives every year in the United States, Koplewicz added.

For years, Alex was too scared to reach out for help because she thought that if she told her parents about her depression, they wouldn’t believe her or they would overreact and send her to a “psych ward,” she said.

It’s why The Child Mind Institute is collecting brain scans from 10,000 children and teens, hoping to identify biological markers of psychiatric illness. The project could improve the diagnosis and treatment of mental disorders.

After medication and therapy, Alex is doing great.

“I am so much stronger after coming out of this,” she said, urging other kids to speak up. “If you always feel like something’s wrong, talk to somebody. If you feel like you’re blaming things on yourself all the time, talk to somebody. Just if things don’t feel good, talk to somebody.”

Broward Health leaders indicted on charges of violating open-meetings law

The top leaders of Broward Health have been indicted on charges of violating Florida’s open-meetings law, throwing the public hospital system into the worst turmoil of its years of crises and investigations.

Summonses were issued Tuesday.

A grand jury indictment names Broward Health board chairman Rocky Rodriguez, interim CEO Beverly Capasso, General Counsel Lynn Barrett, board member Christopher Ure and former board member Linda Robison. The charges are second-degree misdemeanors, carrying maximum penalties of a $500 fine and 60 days in jail.

Gov. Rick Scott, who appointed all of the board members, typically suspends public officials who face criminal charges. The governor made no announcement as of Tuesday afternoon. If he suspends the two current board members, it would leave Broward Health with just three of its seven seats filled.

Will Congress Keep Children’s Health Insurance Program Afloat …

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It’s a beautiful morning in Pittsburgh, but Ariel Haughton is stressed out. She’s worried her young children’s health insurance coverage will soon lapse.

“So, we’re like a low-middle-class family, right?” she says. “I’m studying. My husband’s working, and our insurance right now is 12 percent of our income — just for my husband and I. And it’s not very good insurance either.”

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The policy that covers the couple requires high fees to even see a doctor, and it has a high deductible for further treatment.

In contrast, her young children — 2-year-old Nonnie and his big sister, Rose — are covered right now through the Children’s Health Insurance Program, or CHIP, a federal-state program that was created two decades ago to ensure that kids whose parents don’t have a lot of money, yet make too much money to qualify for Medicaid, can still get health care.

Right now, that coverage for the children doesn’t cost the family anything.

But Pennsylvania’s CHIP program is forecast to run out of money in February.

Though 9 million kids across the U.S. get their health insurance through CHIP, Congress let the program expire Sept. 30.

Since then, states have been burning through the cash that remains in their CHIP accounts, and parents, doctors and state officials are wondering whether Congress will save what has traditionally been a popular program with strong bipartisan support.

“CHIP is probably one of the most successful government programs we’ve enacted in the last couple of decades,” says Timothy McBride, a professor of health economics at Washington University in St. Louis and chairman of that state’s Medicaid oversight committee, which also oversees CHIP.

Keeping kids insured doesn’t cost much, he says, and it sure pays off.

It’s extremely important,” he says, “because it’s developmental — it’s vaccines. You know it can reduce the likelihood that a person has a lifelong chronic disease.”

The experience of Ariel Haughton’s daughter, Rose, bears that out.

Haughton says her own insurance policy charges $150 for each of her doctor visits, but her kids’ policy doesn’t. That allows her to take Rose and Nonnie for care when they need it.

“That’s not a small deal to a family like mine,” Haughton says. “A hundred and fifty dollars. If you have to pay that, you kind of ask yourself, like, ‘Are they sick enough? Does this merit a doctor visit?’ “

A few years ago, Rose came down with a fever and a rash on her face. It didn’t seem severe, but Haughton took Rose to the pediatrician anyway, just to check.

“The doctor looked at her and she said, ‘She has Lyme disease,’ ” Haughton recalls. “And she found a little tick!”

The doctor put Rose on antibiotics immediately and the little girl’s symptoms went away. If left untreated, Lyme can turn into chronic arthritis or other chronic problems.

“I know that if I had had to pay $150, I would have thought, ‘You know, let’s wait,’ ” Haughton says.

Dr. Todd Wolynn is the Haughtons’ pediatrician. He says families all over Pittsburgh are worried about the lapse in the federal insurance program’s funding.

“Parents are literally telling us they don’t know what to do,” Wolynn says. “They make too much to get Medicaid and they don’t have jobs or earn enough to get the commercial insurance. I don’t know what to tell them to do.”

Doctors and patients around the country are worried as CHIP money runs out in one state after another.

Utah announced it will end CHIP at the end of January if Congress doesn’t come up with money for the program. West Virginia’s CHIP board voted to end the program Feb. 28. And Colorado sent letters to its CHIP families saying that without new money the program will be cut off at the end of January.

Oregon has already run out of federal money and is borrowing from its Medicaid budget to ensure that its 80,000 CHIP kids keep their coverage through April.

“I’m absolutely opposed to kicking these vulnerable families off of access to health care,” says Oregon Gov. Kate Brown. “It’s appalling to me that Congress is not taking action and is not doing their jobs on this issue.”

Measures to fund the program passed in their relevant committees in the House and Senate in October, but then hit a snag when lawmakers couldn’t agree on other budget cuts to pay for CHIP.

Ariel Haughton says lawmakers should have gotten ahead of the problem.

“They could have worked on something in August or July, and passed it in September,” she says, “instead of just letting funding lapse and playing this game of chicken with our children’s health insurance.”

Lawmakers and staffers in Congress say CHIP funding will likely be included in an end-of-year spending bill. But as of now, there is no CHIP funding bill scheduled for consideration.

Heat-not-burn tobacco ‘is a health risk’

94d4d__99180247_gettyimages-696190440 Heat-not-burn tobacco 'is a health risk'Image copyright
Getty Images

Image caption

The health risks are lower than smoking cigarettes

“Heat-not-burn” tobacco products are harmful to health even though they are safer than regular cigarettes, say UK experts.

The advisory panel to the government said the devices produce “a number of compounds of concern”, including some that can cause cancer.

Manufacturers say their products are aimed at smokers who want the “taste of tobacco with no smoke and less smell”.

The panel was concerned that young non-smokers might start using the products.

There were also worries that the products could lead people to take up smoking cigarettes.

The Committee on Toxicity (Cot) looked at the available evidence about the risks of two heat-not-burn products that have recently gone on sale in the UK – IQOS and iFuse.

Harmful compounds

The devices heat tobacco to a high enough temperature to create a vapour but not smoke.

They are different to e-cigarettes, which vaporise a liquid containing nicotine – the highly addictive compound in tobacco smoke.

The committee found that people using heat-not-burn products are exposed to between 50% to 90% fewer “harmful and potentially harmful” compounds compared with conventional cigarettes.

Image copyright
Philip Morris Limited

But it was unable to quantify the exact health risk.

Prof Alan Boobis, committee chairman, said: “The evidence suggests that heat-not-burn products still pose a risk to users. There is likely to be a reduction in risk for cigarette smokers who switch to heat-not-burn products but quitting entirely would be more beneficial.”

There was not enough evidence for the committee to compare heat-not-burn with e-cigarettes.

But the committee noted: “If people perceive e-cigarettes as safe this perception could transfer to heat-not-burn tobacco products, despite a lack of data on which to establish this.”

Public Health England says there is a large amount of evidence that shows e-cigarettes are much less harmful than smoking – at least 95%.

“We encourage smokers to try e-cigarettes as a way of stopping smoking. People who combine e-cigarettes with support from their local stop-smoking service have some of the highest quit success rates.”

Quitting tobacco-use completely is still the healthiest option, say health experts.

A spokesman for Philip Morris Limited, which makes IQOS, said: “We are encouraged by today’s statement of the UK’s Committee on Toxicity and will continue to share our scientific evidence.

“We believe that smoke-free alternatives, including heated tobacco products like IQOS and e-cigarettes, have significant potential to be less harmful than cigarettes and can play an important role for smokers and public health.”

Simon Clark from the smokers’ group Forest said: “Electronic cigarettes are a step too far for many smokers so if the government wants smokers to quit there has to be a range of products that fills the gap between combustible tobacco and e-cigarettes.”

Nintendo Seeking New Android Game Partnerships: Report

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Expand your perspective with the OnePlus 5T

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In a world where flagship prices continue to rise sharply, OnePlus’ business model manages to offer an exceptional experience that starts at just $499. So what does the OnePlus 5T bring to the table?

Bigger than ever, but still the same size. The OnePlus 5T is a half inch bigger than its predecessor yet has the same body size thanks to the immersive 6-inch Full Optic AMOLED display that features an 18:9 aspect ratio.

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Take aim with Oneplus’ dual camera setup. The 5T offers a dual camera that features a 16 and 20MP sensor. This particularly setup has been optimized for low-light and portrait photography.

A User Experience that doesn’t get in the way. OnePlus’ OxygenOS software brings you a clutter-free, smooth software experience that feels like “stock Android” yet offers tons of customizable features that lets you tailor the experience to your needs.

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We need to talk about Android’s upgrade problem

Android and iOS have been doing battle ever since 2008, and in that time, there have been some long-running problems with both operating systems. The iPhone’s notification system is a mess, Android took way too long to put a battery percentage on the status bar — oh, and Android’s upgrade system is a complete and utter mess.

While most of the problems that blighted both OSes at launch have been fixed by now, Android’s “fragmentation” issue — the fact that most Android phones are running different versions of Android, and new updates are incredibly slow to roll out — has only become worse with time.

Google released new data Monday on the state of the Android union, and simply put, it’s not pretty. Android 8.0, the latest version released on August 21st, is currently installed on 0.5 percent of all Android devices. Current flagships like the Galaxy S8 and Note 8 won’t be getting Android 8.0 until 2018, and the vast majority of Android devices currently in circulation won’t get the update at all.

Things get even worse when you look at the rest of the Android field. It’s not like there’s a bunch of devices sitting on Android 7.0, waiting to be updated: Android 7.0 and 7.1 has a combined share of 23.3 percent, 6.0 has 29.7 percent, and Android 5.0 is at 26.3 percent.

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To put all this in perspective, iOS 11 was released on September 19th, nearly a full month after Android 8.0. As of December 4th, 59% of all iOS devices were running iOS 11, 33% are on iOS 10, and just 8% of devices are on something older.

This isn’t for a lack of trying on Google’s part. Google kicks updates out to its own Pixel and Nexus phones as fast as it can. But for everyone else, there’s too many links in the chain: Google releases an update, the  the manufacturer has to tweak it and fix all the unique bugs it creates on every single device, and then mobile carriers has to make sure that the new update works on its network. Often, manufacturers and carriers won’t both to spend the time and money doing all this, because the lack of software support creates a reason for customers to upgrade and get the new features.

So, not specifically Google’s fault, but absolutely Google’s problem. Unfortunately, there’s no solution on the horizon, and at least based on the data for Android 8.0, things are getting worse, not better.

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