Sandy to Harvey: will lessons from day laborers be learned or forgotten?

Massive “clean-up” projects are underway in Houston and the surrounding region. As the waters brought by Hurricane Harvey recede, individuals seeking work—day laborers—will be assembling in damaged neighborhoods and offering their skills. It was a commonplace scene following Superstorm Sandy’s destruction in 2012, and in Harvey’s disaster zone, day laborers are already on street corners and in parking lots offering to work.

I hope the workers’ experiences from Superstorm Sandy are lessons being reviewed by officials, leaders, and funders in Houston. It would be time well spent if they read “Day Labor, Worker Centers & Disaster Relief Work in the Aftermath of Hurricane Sandy.” It was written by faculty at the City University of New York and published one year after the catastrophic storm. They authors write:

“within the first week after Sandy…day laborers were in high demand and among the first core of workers to respond to the disaster relief, cleanup up and reconstruction efforts.”

The area around Houston has a robust population of day laborers. There are thousands of individuals who seek work daily or sporadically at well-known gathering spots. The Latino Day Laborer (LDL) Health Initiative in Houston identified more than 70 locations in the city where workers gather for jobs. The LDL Initiative, which began in 2013, is a collaborative research project coordinated by the University of Texas Health Sciences Center and the Fe y Justicia Worker Center.

Jose Lenin of Fe y Justicia conducts a safety training session in 2016 with three day laborers.

The project’s major activity involved recruiting and interviewing 350 day laborers about safety hazards, injuries sustained, and strategies to protect themselves. Some of the workers were later involved in testing the effectiveness of different work-related injury prevention interventions.

Although they work in an informal sector of the economy, day laborers still have the same right to a safe workplace as those employed more traditionally. Day laborers need to be provided proper equipment, safety gear, and training. If they speak up about safety concerns to an owner or manager, it’s illegal to retaliate against them. But often that’s not how it plays out and not what happened for many day laborers following Superstorm Sandy.

As the recovery kicks into high gear in the Houston area, individuals making decisions about how and where to invest disaster-response funding would be wise to coordinate with the LDL Health Initiative’s leadership. Day laborers will—and already are—removing debris, using chainsaws, pulling out drywall and carpeting, and repairing roofs. They can be easy prey for unscrupulous employers and homeowners who will jip them of their pay and create obstacles for to do their jobs safely.

To protect against abuse to Houston’s workers, the following are recommendations from “Day Labor, Worker Centers & Disaster Relief Work in the Aftermath of Hurricane Sandy”:

• Recognize the important role played by day laborers in relief and reconstruction;
• Distribute and make widely available gloves, googles, safety boots, and other personal protective equipment;
• Allocate funding to worker centers which are the established community link to day laborers;
• Enforce worker safety and wage theft laws; and
• Protect clean-up and reconstruction workers from threats of deportation.

Day laborers who rebuilt neighborhoods following Superstorm Sandy lent their expertise to make these recommendations. Will the lessons they provided be learned in Houston or forgotten?  Now’s the time to embrace the former.

 

Article source:Science Blogs

Popeyes, KFC’s supplier has sanitation problem, Senator takes notice of unsafe conditions

Drivers honked and waved. They gave thumbs up to the 30 people on the sidewalk. The group was holding signs outside a North Carolina poultry plant. “El baño” – the bathroom – was the word catching the drivers’ attention.

The scene on August 14 was a demonstration in front of the Case Farms poultry plant in Morganton, NC. The company supplies chicken to KFC, Popeyes, and Taco Bell.

Alisa Olvera outside of Case Farms poultry plant in Morganton, NC.

The reason for the peaceful protest?

The Case Farms plant has a sanitation problem. Workers don’t have access to the bathroom when they need to use it. Are KFC, Popeyes and other firms that buy chicken from Case Farms —-hundreds of millions of pounds each year— ignoring the problem?

If they aren’t touched by the indignity of restricting bathroom breaks at Case Farms, surely they care about the sanitation problem.

The protesters went to the poultry plant to deliver a letter to the plant manager. The group included former Case Farms workers. The manager wouldn’t accept it personally. The delegation left it with the security guard. The letter said:

“The Western North Carolina Worker Center (WNCWC) is representing a group of Case Farms workers who have identified the lack of access to bathroom breaks as the top workplace issue for your workers.”

The letter continued:

“We are asking for your presence at a meeting …to discuss this important issue and to see what we can do to work together to find a solution to this issue.”

They proposed a meeting in mid-September at the St. Charles Catholic Church in Morganton, NC. Case Farms has yet to respond to the request.

Irma Matul worked for six years at the Case Farms plant in Morganton, NC. She was at the demonstration and spoke to the local reporters who were covering the event. [Translated from Spanish] Matul said:

“They won’t let you go to the bathroom if you ask to go to the bathroom. Sometimes they even shame the workers that need to go to the bathroom. It is very sad because they don’t give access to go to the bathrooms when workers have the biological need to go to the bathroom.”

Case Farms issued a statement saying they “respectfully disagree with the allegations.” The company added

“We believe if we treat our employees with respect and dignity, and listen and address their concerns and issues, we will continue to be successful.”

Hunter Ogletree with WNCWC agreed with that statement.

“The poultry workers we know are hard-working, dedicated, and thoughtful. …They know it takes a team, and they’re eager to be part of that team, and build on success.

However – in order to start a dialogue, Case Farms needs to respond to our invitation to engage. Which they have refused to do.”

On the day of the demonstration, the Case Farms’ workers learned that a U.S. Senator has his own concerns about the poultry company’s operations. Ohio Senator Sherrod Brown wrote a pointed letter to Case Farms’ CEO Thomas Shelton about poor working conditions in the company’s plants, including dozens of willful and repeat OSHA violations. Case Farms also operates two poultry processing plants in Brown’s home state.

The Senator referred to an investigation by reporter Michael Grabell which was published at ProPublica and The New Yorker. Grabell describes a company history of hiring refugees because they are least likely to complain, delaying appropriate medical care for injured workers, and interference in workers’ efforts to organize a union.

The company says “worker safety is an integral component of its culture,” but Senator Brown challenged that assertion. He wrote:

“This statement does not appear to square with this recent report and the company’s history of serious OSHA violations.”

I’ll be eager to learn if Case Farms’ CEO responds to Senator Brown’s letter. The Western North Carolina Worker Center and its allies should make sure that YUM Brand’s CEO Greg Creed (KFC and Taco Bell) and Restaurant Brands International’s CEO Daniel Schwartz (Popeyes) get a copy of the Senator’s letter and Michael Grabell’s article in The New Yorker.

 

Article source:Science Blogs

Another new study finds the Affordable Care Act is not a ‘job killer’

The idea that the Affordable Care Act is a job killer is one of those regularly debunked talking points that won’t disappear. So, here’s yet more evidence that the ACA has had very little impact on the labor market.

In a new study from the National Bureau of Economic Research, a team of Stanford University economists found that even though different regions experienced varying labor market effects likely related to the ACA, the overall impact to jobs numbers was insignificant. In particular, researchers wrote: “Our findings indicate that the average labor supply effects of the ACA were close to zero but that this average masks important heterogeneity in its effects.”

The study addresses estimates from the Congressional Budget Office released before ACA implementation that said the health reform law — which made it possible for most Americans to access affordable health care regardless of employment status — could reduce the size of the labor force by up to 2 percent by 2024. However, since key provisions of the ACA went into effect in 2014, the Stanford researchers found that differing labor market effects across the nation essentially cancelled each other out.

“The idea that the ACA is a job killer — we don’t see that actually happening,” study co-author Gopi Shah Goda, deputy director and senior fellow at the Stanford Institute for Economic Policy Research, told me.

To conduct the study, Goda and colleagues investigated whether regions with bigger ACA-related coverage gains also experienced larger changes in their labor markets. The study did come with a big challenge however — because the ACA covered the entire nation and became effective for everyone at the same time, researchers didn’t have an obvious or natural control group.

To make up for that, researchers teased out regions where labor market changes would likely be unrelated to the ACA — those would end up being the control group — so they could more clearly isolate which impacts were actually associated with the health reform law. Here’s how Goda explained it: Say there’s one region home to a low rate of uninsured people who would be eligible for Medicaid expansion and another region with a high rate of uninsured people eligible for Medicaid. If labor market changes occurred within the first region, researchers could reasonably assume those changes would have happened anyway; however, if changes were only documented in the second region, researchers could reasonably associate the changes with the ACA.

“We’re trying to understand the causal impact of the ACA on the labor market,” Goda said. “So we had to find a way to create a control group so we could understand the effects of the ACA relative to what would have happened without the ACA.”

Goda, along with colleagues Mark Duggan and Emilie Jackson, found that in areas with a high share of people who were uninsured and eligible for private insurance subsidies, labor force participation fell significantly. On the other hand, in areas with a high share of uninsured people but with incomes too low to qualify for marketplace subsidies, labor force participation went up significantly. They write: “These changes suggest that middle-income individuals reduced their labor supply due to the additional tax on earnings while lower income individuals worked more in order to qualify for private insurance. In the aggregate, these countervailing effects approximately balance.”

The study also found “little evidence” that the ACA impacted part-time employment, self-employment and hours worked. Also of note, states that expanded their Medicaid programs typically experienced larger average decreases in unemployment. Overall, however, the aggregate labor market effects both in states that did expand Medicaid and those that didn’t were relatively small.

While the study doesn’t tease out the precise reasons for the labor market changes, Goda had some hunches. For example, she said it’s possible that people eligible for Medicaid decided to make job changes that would allow them to qualify for marketplace subsidies and therefore gain private insurance coverage. Or it could be that Medicaid enrollment led to some people becoming healthier and increasing their labor force participation.

Goda, who said she and colleagues hope to continue this line of research as more ACA data comes out, said it’s fair to use the study’s findings to refute claims that the ACA is a job killer.

“We hope these findings are taken into consideration whenever discussions of the ACA or changes to the ACA are being made,” she told me. “I think because the impacts of the ACA over the last few years have been different than what was predicted, it makes sense to consider these labor market non-effects whenever considering changes to the law.”

In more good ACA news released this month, the Centers for Disease Control and Prevention’s National Center for Health Statistics reported that in the first three months of 2017, 28.1 million people of all ages were uninsured — that’s half a million fewer uninsured people than in 2016 and 20.5 million fewer uninsured people than in 2010. Overall, from 1997 through 2013, the percentage of adults ages 18 to 64 who were uninsured generally increased. However, more recently, rates of uninsured adults have gone down each year, from more than 20 percent in 2013 to about 12 percent in the first quarter of 2017.

For a copy of the new ACA labor market study, visit the National Bureau of Economic Research.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for 15 years. Follow me on Twitter — @kkrisberg.

Article source:Science Blogs

Syphilis prevention vs. politics

Last week’s New York Times featured a great article on a syphilis outbreak in Oklahoma. Reporter Jan Hoffman documented some of the impressive work state health investigators are doing to contain the outbreak, from using Facebook to discern likely transmission routes to showing up at the homes of people with positive test results and offering them rides to treatment centers.

CDC warned earlier this year that syphilis rates are on the rise throughout the US. Primary and secondary syphilis, the disease’s most infectious stages, rose 19% in a single year (2014-2015), and that trend appears to be continuing. The majority of these P&S cases are among men who have sex with men, but rates are also rising among women and some newborns. Pregnant women with untreated syphilis can pass the disease to their fetuses; congenital syphilis, which can cause stillbirth as well as severe illness and death in infants, has also been increasing since 2012. CDC’s map shows Oklahoma as one as several states where the syphilis rate experienced a 101-200% change from 2011 to 2015; Oregon, Idaho, Utah, North Dakota, Nebraska, Kansas, Iowa, West Virginia, and Hawaii showed changes of more than 200% over the same time period.

Source: Centers for Disease Control & Prevention, 2017: CDC Call to Action: Let’s Work Together to Stem the Tide of Rising Syphilis in the United States

A few months before that, when CDC released its STD surveillance report for 2015 (read Kim Krisberg’s report on that here), the agency’s news release sounded an alarm:

“We have reached a decisive moment for the nation,” said Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “STD rates are rising, and many of the country’s systems for preventing STDs have eroded. We must mobilize, rebuild and expand services – or the human and economic burden will continue to grow.”

In recent years more than half of state and local STD programs have experienced budget cuts, resulting in more than 20 health department STD clinic closures in one year alone. Fewer clinics mean reduced access to STD testing and treatment for those who need these services.

Chlamydia, gonorrhea and syphilis are curable with antibiotics. Widespread access to screening and treatment would reduce their spread. Most STD cases continue to go undiagnosed and untreated, putting individuals at risk for severe and often irreversible health consequences, including infertility, chronic pain and increased risk for HIV. STDs also impose a substantial economic burden: CDC estimates STD cases cost the U.S. healthcare system nearly $16 billion each year.

In other words, we’re failing to stop the preventable spread of STDs because the people in charge of budgets are being penny wise but pound foolish. For 2017, federal STD prevention funding suffered a $5 million cut (to $152 million), and President Trump’s proposed 2018 budget slashes it by 17%. In Oklahoma, the state legislature passed a 2018 budget that cuts the state health department budget by 3%.

Years of cuts to public health budgets are problematic on their own, but now they’re coupled with increased federal hostility to the programs and providers we need in order to address STDs (and other aspects of sexual and reproductive health) effectively. It’s not new for House Republicans to try to eliminate the Title X program, which funds reproductive healthcare for millions of low-income people, or to deny reimbursement to Planned Parenthood for services it provides to Medicaid beneficiaries, but this is the first time in a while they’ve had a president who’s likely to sign off on such destructive moves. Title X clinics performed nearly six million STD tests in 2014. Planned Parenthood provides more than 4.2 million tests and treatments for STDs — and, as Texas learned recently, there’s no easy replacement for Planned Parenthood.

As US Representative Nita Lowey (D-New York) noted in an opinion piece for The Hill, “The attacks on women’s health don’t stop at our own borders.” One of President Trump’s first executive actions was a worse-than-ever version of the global gag rule, which is harming many other countries’ efforts to reduce STD transmission — and as Zika cases have demonstrated, infections acquired in other countries can end up sexually transmitted here.

In addition to testing for and treating STDs, we also need prevention efforts that help people avoid unprotected sex. The Trump administration has attacked these, too, with abrupt early termination of Teen Pregnancy Prevention programs in communities across the country. As Kim Krisberg reported recently, grantees were testing and disseminating sexual health interventions aimed at improving sexual health, including strategies to reduce STDs and sexual violence. One of the projects facing early termination, she noted, is the Seattle-King County FLASH curriculum, which is in the process of rolling out to schools across the country and “is designed to be inclusive of LGBT students and is just as relevant for young people who decide to abstain from sex as it is for those who don’t.”

Among TPP grant programs — all of which appear to have lost funding — are three in Oklahoma. Choctaw Nation of Oklahoma is “replicating evidence-based teen pregnancy prevention programs in middle schools, high schools, and alternative schools in Choctaw, McCurtain, and Pushmataha counties, three counties in Southeast Oklahoma with some of the highest teen pregnancy rates.” Oklahoma City-County Health Department collaborates with local partners to bring elementary and middle schools evidence-based programs such as Cuidate!, Making Proud Choices, Making a Difference, Be Proud! Be Responsible!, Draw the Line/Respect the Line, and Sisters Saving Sisters. Youth Services of Tulsa, Inc. by 2020 aimed to serve 10,000 youth in middle school, high school, alternative school, juvenile detention, community-based, specialized, and clinic settings. Unless their TPP funding is restored or replaced, thousands of teens will miss out on important sexual health education as a syphilis outbreak threatens health in their state.

Evidence-based sexual health education that’s inclusive of LGBT students — or adults, for that matter — is especially important for stopping the spread of syphilis, given that the majority of cases are in gay and bisexual men and other men who have sex with men. Turning away from inclusive, evidence-based sex ed and taking an anti-LGBTQ tone, as this administration has done, risks cutting LGBTQ individuals off from information that can help them make healthy decisions when it comes to sex. “Abstinence-only sex ed and ‘no pro homo’ laws keeps kids in the dark, leaving them with bodies they don’t fully understand and experiences they have no context for,” writes BuzzFeed contributor John Paul Brammer. “I was uneducated — about gay sex, about consent — and that made me more vulnerable.”

Reading about hardworking Oklahoma public health investigators in the New York Times makes me proud of what public health can do — and fearful of how bad things will get as support for effective public health programs keeps eroding.

Article source:Science Blogs

Weight Loss Physicians Mesquite TX

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What are the Advantages to Finding the Best Weight Loss Physicians Mesquite?

There are so many weight loss products on the market, and it may be overwhelming and hard to select the ideal option. Luckily, medical weight loss has offered patients with a doctor supervised weight loss alternative which is made up of carefully monitored programs made to yield terrific results that last.

Since many diet medications are proven to have unpleasant side effects and also to induce irreversible harm, the best weight loss program beneath a top weight loss doctor can yield remarkable results with no need for potentially harmful drugs. Rather, Weight Loss Physicians Mesquite TX such as Dr. Michael Cherkassky use scientific procedures, healthy diet adjustments, and prescription drugs like Adipex (phentermine) to help patients achieve their fantasy weight.

Dealing with Weight Loss Physicians Mesquite TX rather than over the counter alternatives also suggests that you are going to have the continuing support and advice of a qualified and licensed physician. Having a trusted support system may be a remarkable advantage whilst losing weight and can frequently make the difference between weight loss failure and achievement.

Best Weight Loss Physicians Mesquite TX – Dr. Michael Cherkassky

Mesquite Weight Loss Physicians

As soon as you’ve made the choice to locate a weight loss doctor, you will next have to sort through the available weight loss programs in your region to find the one which’s ideal for you. The very first order of business is to locate a top weight loss doctor who’s fully registered and licensed. You need to ensure, as always, that you’re placing your well-being at the very best of hands. Another terrific method to spot the ideal weight loss service would be to have a look at the testimonials and reviews available.

Together with Dr. Cherkaskky, there is no denying that his patients have been quite effective at losing the weight. Many of the patients, such as Ricky, have been in a position to shed hundreds of pounds and keep off them long following the weight loss service in total. Understanding the success rate in the weight loss clinic you pick is critical as weight loss services are a certain investment and you deserve the very best outcomes.

He unites natural weight loss procedures and weight loss services to his state-of-the-art program. When selecting from one of the numerous area weight loss clinics, we know how simple it’s to become overwhelmed by all of your alternatives. Together with the doctor supervised weight loss program provided by Dr. Cherkassky, we are aware that you’re going to be comfortable knowing that your health is in the palms of a few of the very best weight loss specialists around.

He considers that starvation and anxiety aren’t the keys to healthy weight loss. Rather, he encourages individuals to suppress their cravings with diet modifications and prescription medications like Adipex (phentermine), all while permitting them to eat foods that they enjoy in moderation.

Dr. Micahel Cherkassky is one of the best weight loss physicians for patients from Mesquite TX and these other areas of Dallas, Texas: Mesquite, Garland, Duncanville, Hutchins, Lancaster, Addison, Richardson, Grand Prairie, Carrollton, Sunnyvale, Desoto, Wilmer, Fort Worth, Cedar Hill, Arlington, Rowlett, Coppell, Plano, Euless, Sachse, Red Oak, Seagoville, Grapevine, Ferris, Forney, Lewisville, Bedford, The Colony, Colleyville, Rockwall, Wylie, Hurst, Flower Mound, Allen, Southlake, Crandall, Midlothian, Frisco, Mansfield, North Richland Hills, Palmer, Kennedale, Fate, Lavon, Lake Dallas, Waxahachie, Keller, Haltom City, Little Elm, Nevada, Roanoke, Lillian, Terrell, Copeville, Venus, Mc Kinney, Rosser, Princeton, Argyle, Royse City, Denton, Prosper, Kaufman, Scurry, Ennis, Avalon, Josephine, Burleson, Haslet, Elmo, Alvarado, Aubrey, Maypearl, Justin, Melissa, Crowley, Farmersville, Caddo Mills, Ponder, Keene, Krum, Kemp, Cleburne, Celeste.

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Weight Loss Physicians Mesquite TX – Dr. Cherkassky – 972-203-6681

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Mesquite Weight Loss Physician

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Mesquite Weight Loss Physician – Dr. Michael Cherkassky

For a lot of people, weight loss is a subject that occupies the minds of many, most notably finding the best Mesquite weight loss physician. A weight loss doctor is a person who focuses on providing patients with doctor supervised weight loss strategies made to yield great results that last a lifetime.

This sort of weight loss service consists of customized diet and exercise plans designed to target the root cause of each individual’s weight gain. Through the program, a top weight loss doctor will also closely monitor your progress to ensure that you’re successfully losing weight in a healthy, effective way. The best weight loss program is only going to begin after a thorough medical evaluation and examination. This manner, the weight loss specialist will have the ability to determine whether there are some pre-existing issues that may or may not be impacting your weight gain and capacity to lose weight.

Mesquite Weight Loss Physician

You need to be certain that you’re healthy enough to diet that is why meeting with your physician is so important. You need to make sure that you’re not residing with a pre-existing condition that can affect your ability to lose weight or create a specific weight loss path inadvisable. Discussing with your physician will help you to have a better idea as to what your needs are and how to go about meeting them.

When it comes to medical weight loss, there are three main weight loss providers. These include bariatric physicians, nutritionists, and endocrinologists. Bariatric surgeons are often recommended for individuals that have lots of fat to lose, such as one hundred pounds or more. For these patients, exercise and diet may need to be preempted by surgical intervention. Nutritionists are concerned primarily with helping patients to adjust their diet. The ultimate goal is to assist the patient to develop a much healthier outlook toward diet and exercise. A nutritionist often plays a crucial part in any weight loss program. Endocrinologists are concerned with thyroid and pancreatic problems. In cases where medical conditions such as hypothyroidism are making it more challenging to stay at a wholesome weight, endocrinologists function to see to the person’s underlying problem so that they can finally start to get rid of the weight.

Finding the Right Mesquite Weight Loss Physician

Deciding that weight loss specialist is best for you is just another area in which your main care provider can be of help. He or she can assist you to better understand which weight loss clinic or group of weight loss professionals is ideal for your requirements.

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Mesquite Weight Loss Doctor

Mesquite Weight Loss Doctor was originally seen on: http://bestweightlossdoctor.com

The Best Mesquite Weight Loss Doctor – Michael Cherkassky, M.D.

Adult obesity is a frequent problem that affects a staggering number of Americans, and also a Mesquite Weight Loss Doctor like Dr. Cherkassky is just the individual to come to if you’re searching for a solution to your weight reduction. While countless diet plans may boast of the amazing results they’re able to provide, very few have the ability to provide the results they promise. But with the help of a weight loss provider, a growing number of individuals have finally managed to bid goodbye to the pounds and say hello to a healthier, more energetic body and mind.

Not just have weight loss doctors managed to assist people in losing the weight, the evidence demonstrates that participating in a doctor supervised weight loss system can cause longer lasting results. While many systems lead to a rapid reduction, so few of them really help the person to maintain the healthy weight. The extreme calorie cutting or medications may yield great immediate results, but what’s going to help you to keep off it in the long run? The response: a qualified weight loss physician with a professional, scientifically-based weight loss program.

Mesquite Weight Loss Doctor – Michael Cherkassky, M.D.

If you are interested in researching weight loss programs and in finding a Weight Loss Doctor Mesquite TX in which to receive weight loss solutions, you need to first consult with your primary care provider. He or she is, without doubt, the foremost authority on your health and medical history and can give you a clearer idea of exactly what your needs are moving forward. Given your particular struggles and your objectives, a decision can be made regarding how much weight you need to lose and maybe what kind of medical weight loss doctor will best fit your requirements.

About Michael Cherkassky, M.D.- Mesquite Weight Loss Doctor

Dr. Cherkassky is a licensed medical doctor that serves patients from Mesquite and these other areas of Dallas, Texas: Dallas, Mesquite, Mesquite, Garland, Duncanville, Hutchins, Lancaster, Addison, Richardson, Grand Prairie, Carrollton, Sunnyvale, Desoto, Wilmer, Fort Worth, Cedar Hill, Arlington, Rowlett, Coppell, Plano, Euless, Sachse, Red Oak, Seagoville, Grapevine, Ferris, Forney, Lewisville, Bedford, The Colony, Colleyville, Rockwall, Wylie, Hurst, Flower Mound, Allen, Southlake, Crandall, Midlothian, Frisco, Mansfield, North Richland Hills, Palmer, Kennedale, Fate, Lavon, Lake Dallas, Waxahachie, Keller, Haltom City, Little Elm, Nevada, Roanoke, Lillian, Terrell, Copeville, Venus, Mc Kinney, Rosser, Princeton, Argyle, Royse City, Denton, Prosper, Kaufman, Scurry, Ennis, Avalon, Josephine, Burleson, Haslet, Elmo, Alvarado, Aubrey, Maypearl, Justin, Melissa, Crowley, Farmersville, Caddo Mills, Ponder, Keene, Krum, Kemp, Cleburne, Celeste.

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Best Weight Loss Physician Mesquite TX – Dr. Cherkassky 972-203-6681

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Weight Loss Doctor Mesquite TX – Dr. Cherkassky – 972-203-6681

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Weight Loss Clinic Mesquite TX – Dr. Michael Cherkassky – Call 972-203-6681

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Best Weight Loss Mesquite TX – Dr. Cherkassky – Call 972-203-6681

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Medical Weight Loss Mesquite TX – Dr. Cherkassky – Call 972-203-6681

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Mesquite Medical Weight Loss – Dr. Michael Cherkassky – (972) 203-6681

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Dallas Weight Loss Program – Patient Success Stories

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Dallas Weight Loss Program Interview – RoseMary

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RoseMary: Best Dallas Weight Loss Program Interview

Dr. Michael Cherkassky is a Dallas medical weight loss doctor who has been helping patients lose weight for more than 25 years. In this video, a patient talks about her experience with the weight loss clinic and the weight loss program.

How long have you been following this weight loss program and how has it been going?

I have been coming to this clinic and following this weight loss program for the last five months. I have done very well and have gone from a 3X down to an Extra Large.

What it was like when you first came into the weight loss clinic?

I heard the weight loss program from my daughter. She had been coming in and was starting to lose weight. So I decided to come here too and starting losing weight during the first month. It was awesome. I mean, I lost 6 pounds. It is an excellent program because I feel better than when I first started. I can walk more. I don’t have heavy breathing. It has been a good experience.

What other things did you try, before you came here?

I have tried all kinds of things to lose weight. I’ve tried Garcinia. I’ve tried practically all the diet pills that they sell at Walgreens. Nothing that I tried was working. I was getting bigger and bigger. When I came here just, I just decided to try it. I am planning to stay on the program until I reach my weight loss goal and then I will probably stop.

Dallas Weight Loss Program Interview – Michael Cherkassky, M.D. – Call 469-434-3380

Was there a particular thing that made you decide that you needed to get help losing weight?

For me mostly, it was health reasons. I needed to get the weight off because I was a borderline diabetic. Diabetes runs in my family. I lost my parents to that, so I had to do something. Doing it on my own was not easy. I tried and tried. I heard about the doctor, and I decided to see him. He is an excellent physician. They help you a lot here at the clinic.

How did the doctor help you with dieting and diabetes?

He talked to me and told me what I needed to do, how I was supposed to eat, and general dieting. “Watch your calories.” That was the main thing. I learned a lot from him. How to eat now, how to eat better. I stopped eating a lot of greasy foods, fast food, but now I’ve learned to eat better. The diet pills (Phentermine, Sensotherapy) do work. They work wonders.

Are you primarily taking Phentermine?

I am taking Phentermine and Sensotherapy.

Tell me about your experience with Sensotherapy.

I started taking the white Sensotherapy capsules first, but I felt that those were not helping at all, so then I tried the blue ones. They told me to take one when I started feeling hungry. I only have to take one. I take it late in the afternoon, and I do good. They give you energy and help you. I am alert now. I don’t just sit on the couch. That’s all that I was doing before. I was just sitting on the sofa, watching TV. The supplements help me feel less hungry, and they give me a lot of energy. They are outstanding.

I have more energy now because I’m not as heavy. I can go outside and do things, like work on my plants. I’m delighted that I came to the weight loss clinic. It’s excellent.

Dallas Weight Loss Program Interview – New Patient Discount

Are you able to exercise more now that you have energy and have lost some weight?

Oh yes. I can walk more. Before I could only walk two houses down and I’m out of breath. I have a dollar store across the street on West Berry; there are all these stores around, restaurants, so I walk. It’s terrific.

Did you find that the program is difficult to follow?

This weight loss program is straightforward to follow. It’s just watching your calories, count your calories. I am on a 1200 calorie day diet, and it’s excellent. Sometimes I get in the mood, and I go over, but yes it’s excellent. Just watching your calories is the key. I dropped the Cokes, and I drink a lot of water. Mostly, I eat at home. I eat a lot of fruits, vegetables.

Has the weight loss program changed the types of food that you want to eat?

Well, you can still eat what you want to eat. It’s just smaller portions. You got to learn to eat smaller portions, which is just not hard, because on these pills, for me, after the third bite, I feel full. That’s how they help for me. If I know, if I get invited, my son will take me out to eat, for dinner, On The Border, I’ll take the pill before I go, the bottle of water, then I’m good. I get a plate of food, but I only eat very little because I feel full. It’s like your stomach shrinks after being on a diet and then once you start eating, if you go out to eat, you’re going to feel full right away. That’s what I do. He’s just a miracle worker with these pills [laughs].

The office staff is wonderful, and I’ve had no problem with them. They are very polite. They tend to your needs. Ask, “Do you need some water? Do you need the crackers? The stuff they put on their crackers. What are your cravings? Do you crave chocolate? Or, do you want cookies?” My thing was cookies. I liked baked cookies, especially at night, with milk. I don’t know what they put on the cookie. I eat it. But I haven’t eaten a cookie in the last two months. They put that, I don’t know what it is, but it’s good [laughs]. It works, whatever it is.

Learn More about the Dallas Weight Loss Program

To find out more about this Dallas medical weight loss program and to get answers to any question that you might have about weight loss, please call the clinic to schedule a weight loss consultation, call 469-434-3380.

Dallas Weight Loss Program Interview – RoseMary posted first on https://weightlossdrtexas.wordpress.com

Dallas Weight Loss Program – Review from Rosemary – Call 469-434-3380

Watch video on YouTube here: https://youtu.be/Ti6Ve9Esa10
via MichaelCherkassky,M.D.A

Dallas Weight Loss Program – Review from Rosemary – Call 469-434-3380 posted first on https://weightlossdrtexas.wordpress.com

Occupational Health News Roundup

At the Tampa Bay Times, Neil Bedi, Jonathan Capriel, Anastasia Dawson and Kathleen McGrory investigate a June 29 incident at Tampa Electric in which molten ash — commonly referred to as “slag” — escaped from a boiler and poured downed on workers below. Five workers died.

A similar incident occurred at Tampa Electric two decades earlier. If the company had followed the guidelines it devised after that 1997 incident, the five men who died in June would still be alive, the newspaper reported. In particular, the five deaths could have been avoided if the boiler had been turned off before workers attempted maintenance. Tampa Electric says cost wasn’t a factor in deciding to leave the boiler on; however, experts say it costs hundreds of thousands of dollars each time a boiler is shut down. Bedi, Capriel, Dawson and McGrory write:

Tampa Electric officials said they had done similar work hundreds of times, including six maintenance jobs on slag tanks this year.

But experts told the Times the June 29 procedure — removing a blockage from the bottom of a slag tank while the boiler is running — is always risky.

Randy Barnett, a program manager at industrial training company National Technology Transfer Inc., who worked in coal-fired power plants for decades, called the practice “obviously unsafe” because it exposes workers to a trio of hazards: slag, high temperatures and extreme pressure.

Said Charlie Breeding, a retired engineer who worked for the boiler manufacturer Clyde Bergemann: “It does not take a genius to figure out that it is dangerous. Common sense tells you that when you’re dealing with molten ash well above 1,000 degrees in temperature, it’s dangerous.”

There is no guarantee the slag building up in the boiler will stay there.

Even the smallest change in conditions inside the boiler — a slightly different composition of coal feeding its fire, for example — can cause a plug to melt, sending the molten lava rushing into the tank below.

“All of a sudden, you’ve opened up the hole,” said George Galanes, who spent decades working in power plants in Illinois before becoming a consultant for Diamond Technical Services.

Galanes said the plants he worked at would never do that. “Too much risk,” he said.

Read the entire investigation at the Tampa Bay Times.

In other news:

Politico: Ian Kullgren reports that OSHA has erased data on worker fatalities from its home page and replaced it with how companies can voluntarily cooperate with the agency. The worker fatalities didn’t only get buried on an internal web page, the list was also narrowed to only include workplace fatalities for which a citation was issued. Previously, OSHA had a running list of worker deaths on its home page that included the date, name and cause of death and included all deaths reported to the agency, regardless of any citations issued. A Department of Labor spokesperson told Politico that the change was to ensure the public data was more accurate. However, worker advocates disagree. Kullgren quoted Debbie Berkowitz, senior fellow at the National Employment Law Project, who said: “It’s a conscious decision to bury the fact that workers are getting killed on the job. That is totally what it is, so that [Labor Secretary Alexander] Acosta can say, ‘Hey, industry is doing a great job and we’re going to help them.'”

Wisconsin Public Radio: Danielle Kaeding reports that three new lawsuits have been filed against Fraser Shipyards in northern Wisconsin for failing to protect workers from unsafe lead exposures. The suits mean the company is now facing four lawsuits on behalf of 44 workers. Earlier this year, Fraser agreed to OSHA fines of $700,000 for exposing workers to lead. Now, workers are seeking compensation for injury, illness, medical care and lost work. Last year’s OSHA investigation, which revealed that Fraser Shipyards was aware of the lead risk, also found that 75 percent of 120 workers tested had elevated blood lead levels. Fourteen workers had blood lead levels up to 20 times the legal exposure limit. Kaeding quoted attorney Matt Sims: “A gentleman who could speak fluidly and without hesitation before this toxic exposure now stutters when he speaks. He’s had changes in his personality. He finds it difficult to focus on everyday mundane tasks that any person wouldn’t have trouble with, and he experiences tremors to the extent that he’s unable to hold a welding torch anymore.”

CNN: Wage theft at the White House? Daniella Diaz reports that the Secret Service can no longer pay hundreds of agents to protect President Trump and his family, with more than 1,000 agents already having hit federally mandated caps for salary and overtime. The caps and salaries were initially devised to last the entire year. Secret Service Director Randolph Alles told CNN the budget problem isn’t just related to the Trump family, but has been going on for many years. Diaz reported: “According to the report, Alles has met with congressional lawmakers to discuss planned legislation to increase the combined salary and overtime cap for agents — from $160,000 per year to $187,000. He told USA Today this would be at least for Trump’s first term. But he added that even if this were approved, about 130 agents still wouldn’t be able to be paid for hundreds of hours already worked.”

ProPublica & NPR: In response to Michael Grabell’s and Howard Berkes’ investigation into a Florida law that allows employers to escape workers’ compensation costs for injuries to undocumented immigrant workers, the second-highest ranking member of the Florida Senate has pledged a legislative review of the law in question. During their investigation, the reporters found that nearly 800 undocumented workers in Florida had been charged with workers comp fraud for using fake identification during the hiring process or in filing for workers’ comp. Some of those injured workers were detained and deported. Grabell and Berkes write: “(Republican state Sen. Anitere) Flores said she is especially concerned about companies who may hire undocumented workers knowing that the threat of prosecution and deportation may keep them from pursuing workers’ comp claims if they are injured at work. ‘That’s borderline unconscionable,’ Flores said, adding that she’ll seek the legislature’s review of this use of Florida law as part of a planned broader look at the state’s workers’ compensation law.”

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for 15 years. Follow me on Twitter — @kkrisberg.

Article source:Science Blogs

Sammies highlight federal employees’ valuable contributions to public health

As the Trump Administration proposes slashing federal agency budgets and calls for “deconstruction of the administrative state,” it’s worth reminding ourselves of the many valuable contributions federal employees make to public health. One good way to do that is to read about the honorees of the Partnership for Public Service’s Samuel J. Heyman Service to America Medals. The “Sammies” program overview explains:

The Partnership is a nonprofit, nonpartisan organization whose mission is to help make our government more effective, and the Sammies honorees represent the many exceptional federal workers who are doing just that—breaking down barriers, overcoming huge challenges and getting results. Whether they’re defending the homeland, protecting the environment, ensuring public safety, making scientific and medical discoveries, or responding to natural and man-made disasters, these men and women put service before self and make a lasting difference.

The 2017 list of honorees includes 26 individuals and teams whose work has contributed to the public good. A few examples:

• At CDC, Tedd V. Ellerbrock has played a leading role in the President’s Emergency Plan for AIDS Relief (PEPFAR), which since 2003 has helped more than 11 million people worldwide receive HIV/AIDS treatment.
• At EPA, Surabhi Shah and an interagency Urban Waters team advance “partnerships with local, state and federal agencies, businesses, nonprofits and philanthropies to clean up pollution; spur redevelopment of abandoned properties; promote new businesses; and provide parks and access for boating, swimming, fishing and community gatherings.”
• At HHS’s Centers for Medicare and Medicaid Services, John Pilot and Heather Grimsley started work in 2001 on the model for today’s Accountable Care Organization structure, which is helping us move towards a system that rewards the quality, rather than just the quantity, of care that healthcare providers deliver.
• At the US Forest Service, Sarah Jovan and Geoffrey H. Donovan developed a way to use tree moss to detect localized air pollution, which led to tighter monitoring and regulation of polluters in Washington state as well as other cities adopting this low-cost method of pollution monitoring.
• At HUD, Thomas R. Davis and the Rental Assistance Demonstration Team established public-private partnerships to generate $3.9 billion in private investments for the rehabilitation of 60,000 affordable housing units. The number of private-sector dollars invested for each dollar of public money has doubled since 2015.

The stories of all 26 honorees are inspiring, and they represent just a small fraction of all the excellent and valuable work federal employees do for this country. Let’s honor their contributions, and encourage our elected officials to make sure they have the resources necessary to continue their essential work.

Article source:Science Blogs

There’s no BIG problem in work comp pharmacy – and that’s scary.

In the fourteen years I’ve been surveying work comp payers on their views on pharmacy, I’ve not seen so little consensus among respondents on emerging issues.

In past years compounds, physician dispensing, opioids, price inflation, and new drug introductions have all been named by at least a plurality of respondents. Not so this year.

Here are some of the 24 respondents’ concerns:

legalization of marijuana – lots of talk about it but concern is what do you do about it, how do you handle it, pay for it, authorize it, etc. so many unknowns and little understanding

state regulations and how to bring information on those changed regulations and how to operate under the new regs back to adjusters and case managers at the desk level and to PBMs

I’m concerned we’ll see branded topicals increasing over the next few years despite a lack of efficacy and inflated prices. teracyn, speedgel, etc aren’t useful

advent of all new formularies, no one has grappled with legacy claims in that environment, thinking is formularies will get docs to taper it off – docs who prescribe all this don’t know how to taper, so finding the right docs and facilities is a real issue for legacy claims

acquisition of comp pbms and consolidation of the work comp PBM industry

Physician Dispensed Drugs and non-controlled home delivery – not just cost but formulary and safety and quality of care

what interventions can they do to to affect drug pricing, especially some of the drugs that have minimal alternatives

more problematic than opioids is the combination of benzodiazepines and sleep aids

watching very closely Evzio, naloxone prescribing practices as part of CDC

still a soft market so anything you can do to reduce costs is important

While payers are seeing good success in reducing opioid utilization and total drug spend, there are a host of troubling issues out there.

Here’s why this is a big issue.

Payers are all too used to getting screwed by unethical and very creative profiteers intent on sucking money away from employers and taxpayers by exploiting loopholes. Branded topicals, “independent” mail order pharmacies and novel drugs are all great examples of these tactics, often hidden under and supported by claims that these promote healing and health despite a total lack of supporting evidence.

In past years when doctor dispensing, the opioid crisis, or compounds were top-of-mind for most respondents, the industry joined together to come up with solutions. That obviously isn’t the case today, leaving patients exposed to crappy providers interested only in profits coming up with myriad ways to game the system.

What does this mean for you?

It’s not the one big problem that’ll get you, it’s the many small ones you may not even notice.

Article source:Managed Care Matters

Big news in work comp pharmacy

Finishing up the Annual Survey of Prescription Drug Management in Workers’ Comp this week (I hope!).  24 payers responded this year – TPAs, Insurers, State funds, and very large employers. Each provided specific data about their pharmacy programs, data which provides remarkable insights into what’s really going on.

Something jumped out at me that I had to get out immediately…

Two big takeaways – drug spend dropped by almost 10 percent…

while opioid spend decreased even more – almost 14 percent.

Wrap your head around that.

Work comp PBMs and payers succeeded in eliminating one of every seven dollars spent on opioids; yes, overall drug spend was down a full 10 percent, driven in large part by lower utilization of opioids.

When opioids are eliminated, the drugs needed to counteract their awful side effects – everything from constipation to sexual dysfunction to gastrointestinal distress to depression – are reduced as well.

The programs, processes, analytical resources, clinical staff, research, and patient outreach that’s driven this stunning result are largely PBM-delivered (with some notable exceptions).  These services are clearly improving the quality of care delivered to work comp patients, while reducing costs for employers and taxpayers.

A shipload of opioids has been taken out of circulation, eliminating the possibility of diversion, misuse, or abuse.

What does this mean for you?

Healthier patients, lower costs, reduced disability. 

 

Article source:Managed Care Matters

Public health officials call on HHS to restore grant funding for preventing teen pregnancies

In July, public health departments across the country got a letter from the Trump administration abruptly cutting off funding for teen pregnancy prevention efforts in the middle of the program’s grant cycle. The move means that many teens will miss out on receiving an education that could — quite literally — change the trajectory of their lives.

The abrupt funding cut — which came down without reason or explanation, according to grantees — also cuts off research efforts right at the evaluation stage. That’s the stage when public health practitioners rigorously assess a program’s outcomes, gather evidence of its effectiveness, and determine what works and what doesn’t. That’s exactly what we should want from our public investments — evidence, not anecdotes — and it’s exactly how you tackle a problem as complex and as costly as teen pregnancy. Teasing out the evidence is how we sort the aspirational from the effectual.

And determining what works to prevent and reduce teen pregnancy is a worthy endeavor. According to the Centers for Disease Control and Prevention, while the U.S. teen birth rate recently hit a record low — the birth rate among young women ages 15 to 19 dropped 8 percent between 2014 and 2015 — the U.S. is still home to one of the highest teen pregnancy rates in the industrialized world. And that rate comes with impacts, including upping the risk that teen girls won’t graduate from high school, which has a generational domino effect in and of itself, as well as racking up billions in societal costs related to health care, foster care and lost tax revenue. Plus, nearly all teen pregnancies are unplanned, which makes investing in their prevention sound public policy.

At a news conference held earlier this month and hosted by the Big Cities Health Coalition (BCHC), health officials from cities on opposite coasts — Baltimore and Seattle — spoke about the importance of preventing teen pregnancy in their communities and the on-the-ground impact of abruptly losing federal funding that had already been awarded and appropriated. Both the Baltimore City Health Department as well as Public Health — Seattle & King County are among the 81 grantees who received a letter from the U.S. Department of Health and Human Services (HHS) in July saying the five-year grant they’d already been awarded through the agency’s Teen Pregnancy Prevention Program would be ending two years early, in 2018 instead of 2020.

Both Leana Wen, Baltimore’s health commissioner, and Patty Hayes, director of Public Health — Seattle & King County, said there was no dialogue, discussion or explanation for the funding cut. The announcement didn’t even come in a special notice. Instead, both health officials found out about the cut when they received their usual, yearly notice-of-award letter in which the end date had been pushed up by two years. Hayes said Seattle’s program manager quickly reached out to HHS for an explanation and was basically told the agency was moving on to implement the cuts.

“It’s just an arbitrary decision that we’re trying to appeal,” Hayes said during the BCHC news conference.

Hayes and Wen are among 20 public health officials from around the country who signed onto a BCHC letter to HHS Secretary Tom Price asking him to reconsider the cuts. Also, in July, Democratic senators wrote to Price asking him to explain his plan to “unilaterally” cut the teen pregnancy prevention grants short. The letter states:

Since the start of the grant projects and prior to the recent notification of early termination, (the HHS Office of Adolescent Health) has ensured the program includes high quality implementation, rigorous evaluation, innovation and learning from results. The pace of progress has accelerated dramatically since the federal investments in evidence-based teen pregnancy prevention began. Since 2010, pregnancy rates among 15- to 19-year-olds has declined by 41 percent nationwide — more than double the decline in any other six-year period since rates peaked in 1991 — and is at a historic low. Seventy-five percent of pregnancies among this population remain unintended. The (Teen Pregnancy Prevention) Program has been proven to support young people in delaying sexual initiation and adopting sexual health behaviors that help them avoid unintended pregnancy.

In Baltimore, the grant termination means a cut of $3.5 million, which means 20,000 students in grades seven through nine will lose access to comprehensive reproductive health education, Wen said. The funding cut also means the agency won’t have the resources to continue training teachers or members of a local youth advisory council that does peer-to-peer education.

Wen said Baltimore has made huge progress in reducing its teen birth rate — it fell by 44 percent between 2009 and 2015. She’s worried that losing any ground on that front will only lead to fewer educational and economic opportunities for Baltimore youth, fewer young women graduating from high school and greater public costs to the community.

“We should be doing everything we can to empower youth to succeed and thrive,” Wen said during the BCHC news conference. “We see the impact in our cities, and we urge the federal government and HHS to reconsider this drastic cut, taking into account the future of all of our youth across the country.”

In Seattle and King County, where teen pregnancy rates have gone down by more than half since 2008, public health officials were using their $5 million Teen Pregnancy Prevention grant to evaluate the effectiveness of a sexual health curriculum they recently updated called FLASH, which includes a variety of strategies to help reduce teen pregnancy, sexually transmitted diseases and sexual violence. During the BCHC news conference, Hayes said FLASH has been used all over the U.S. and the world, with about 80,000 FLASH lessons downloaded in the span of just one year. She noted that the curriculum is designed to be inclusive of LGBT students and is just as relevant for young people who decide to abstain from sex as it is for those who don’t.

However, Public Health — Seattle & King County hadn’t had the chance to rigorously evaluate the curriculum to tease out its exact impacts, such as whether it increased the number of students who delay sex or the number of young people who practice safe sex. That’s what it was using its HHS grant funding for – to measure the effectiveness of the curriculum. The public health agency had already recruited more than two-dozen schools in multiple states to take part in the evaluation; thousands of students participated in the FLASH curriculum and an independent evaluator was hired to analyze the outcomes.

But now that HHS has shut down the grant funding early, that data will be lost. Hayes said she believed there was a “good chance” the evaluation would have shown that FLASH does, indeed, make a positive difference in young people’s lives. Without such evidence, however, it may become more difficult to persuade schools to adopt the curriculum. Hayes said her agency has filed an administrative appeal with the HHS Office of Adolescent Health in the hopes of getting the funding restored.

Hayes said she believes the funding cut is due to both across-the-board budget cuts, but also to an ideological shift on how to address teen pregnancy.

Beyond the particular efforts that the HHS grants were supporting, the abrupt funding cuts also impacts both agencies’ overall capacity to prevent teen pregnancy in their communities. In Baltimore, Wen said the funding gap will “create a huge hole in our ability to deliver services.” At Public Health — Seattle & King County, Hayes said the grant supported a significant portion of the agency’s teen pregnancy prevention efforts.

“It does shrink our program,” Hayes said, “and so it’s not without great implications.”

Visit CDC to learn more about the benefits of investing in teen pregnancy prevention.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for 15 years. Follow me on Twitter — @kkrisberg.

Article source:Science Blogs

Reducing opioids CAN reduce pain

Yes, patients can be weaned off opioids AND reduce their pain levels.

That’s the conclusion of a Vox article providing an excellent, detailed, and thorough review of a study published in the Annals of Internal Medicine Vox (thanks to Health News Review for the head’s up).

Here’s the abstract’s conclusion…

Very low quality evidence suggests that several types of interventions may be effective to reduce or discontinue LTOT [long term opioid therapy] and that pain, function, and quality of life may improve with opioid dose reduction.

Let’s parse this out.

The AIM study was based on a review of 67 clinical studies; it wasn’t “primary research.” Researchers found most of the studies on this issue had either a poor methodology or low sample size. And, relatively few were even of “fair” or “good” quality.

The 12.000 pain patients in these studies volunteered to taper off opioids; they were obviously motivated and wanted to make the change. So, it’s not possible to use this research when thinking about how to address non-volunteers as “involuntarily pulling patients off the drugs (may not) lead to similar outcomes.”

And this…

Crucially, the studies also looked at what happened when these reductions in opioid doses were paired with alternative treatments, including alternative medicines like acupuncture, interdisciplinary pain programs, and medication-assisted treatment for addiction. This is very, very different from a situation in which a patient is taken off opioids and effectively left stranded without any other form of care.

Conversely,

[the CDC concluded] there are simply no good long-term studies looking at the effects of opioids on long-term pain outcomes, while there are many studies showing that long-term opioid use can lead to bad results in other areas, including addiction and overdose.

Here’s a major point made in the study and Vox article – we HAVE to stop looking to opioids as a first-and-only line of treatment for pain.

the lack of access to non-opioid strategies may be one big reason that doctors resorted to opioids in the first place. The drugs offered an easy answer — if ultimately an ineffective one — to the many problems doctors faced, including patients who had complicated pain problems that physicians didn’t fully understand and tight schedules driven by the current demands of the health care system that made it hard to take the time to work through a patient’s individual problems. [emphasis added]

AND, we HAVE to allow/encourage/pay for alternative treatment.

What does this mean for you?

Suggest different initial treatments for pain, and get creative when helping patients who want to get off opioids.

Article source:Managed Care Matters

NASA team provides free satellite public health data to researchers and communities

by Dominika Heusinkveld, MD, MPH

Researchers at NASA and the University of Arizona, among others, are hoping to make real-time air quality forecasting a reality in the next few years. The NASA Health and Air Quality Applied Sciences Team, or HAQAST, is collaborating with health departments, county and state agencies, and university researchers to get the word out about its satellite data. The data, available for free online, can help track air quality indicators, heavy metals in air, dust, and other atmospheric components which can affect human health.

Photo courtesy of NASA Image Library

NASA satellites have been collecting data for years on nitrogen dioxide, ozone, particulate matter, and sulfur dioxide. The time period of available data depends on when the individual satellite was launched. The HAQAST team hopes to encourage local stakeholders to make use of it.

NASA HAQAST Team Leader Dr. Tracey Holloway says,  “Hopefully when [agencies] see that satellite data and other NASA resources can answer their [public health] questions, they will take advantage of all the amazing satellite and other data available.”

A past NASA project, the Air Quality Applied Sciences Team (AQAST), was the genesis of the current HAQAST project. AQAST aimed to increase the utility of satellite data to researchers and public agencies while improving communication with stakeholders such as the public and government officials.

“We publish papers in journals but it’s not really percolating into policy,” said Avelino Arellano, Jr., Associate Professor of Data Assimilation and Atmospheric Chemistry at the University of Arizona’s Department of Hydrology and Atmospheric Sciences.

The AQAST project was an important way to connect the data to stakeholders. One of the AQAST projects resulted in a brief video with President Obama explaining how satellite data has been helpful in tracking nitrogen dioxide, a common air pollutant. Arellano sees the video as one of the success stories of AQAST.  Another was improving communication and relationships between agencies like NASA, the EPA, and NOAA.

“AQAST was instrumental in showing how satellites can ‘see’ trends in air pollution, even in areas where no other monitors exist. As a result, the EPA used satellite data in their public report on clean air trends for the first time in 2016,” says Holloway.

HAQAST plans to build on those successes with a wider emphasis on human health, says Holloway. Input from satellite data can greatly improve current air quality forecasts, but these are still not accurate on a local scale and require finer resolution to be more useful.

“We don’t really have a good forecast for air quality yet,“ says Arellano. For instance, air pollution is worse during rush hour, but many of the older satellites only pass over an area once a day, so the differences in air quality between morning and afternoon rush hour are not seen.

A new satellite, called GOES-16, should fill in some of the blanks and provide finer resolution data. According to a NASA website its instruments “can provide a full disk image of the Earth every 15 minutes, one of the continental U.S. every five minutes, and [have] the ability to target regional areas…as often as every 30 seconds.”

In addition, more research will be needed to fully utilize the data and to integrate it with human health.

“In forecasting I’m not really sure that there’s a connection between what the satellite sees and what you breathe,” Arellano says. “We need to connect studies on air quality and data on air quality to health.”

For example, while pollution has been linked to cardiac events (such as heart attacks) and lung disease, more studies need to be done on the relationship between air quality and hospitalization events. These relationships are extrapolated in much of the current research; direct correlations would provide a clearer picture.

Arellano would like to see public health agencies and federal agencies such as the National Weather Service utilize the satellite data.  He would also welcome collaborations with nonprofit agencies. The main limitation he encounters is lack of connections between researchers and nonprofits. Fortunately, outreach is an important part of HAQAST’s mission.

“We have a Twitter account (@NASA_HAQAST), the new website, a semi-monthly newsletter, and even a YouTube channel,” Holloway says. In addition, the team hosts two meetings per year with a variety of local and national agencies.

“We’ve found…that listening is the most important part – we need to hear where new information could be helpful… then the scientists on our team work to figure out new ways to answer open questions,“ Holloway says.

She encourages interested agencies to contact the team. “Our mission is to serve the public and maximize the benefit of satellite data for health and air quality. ”

 Want data? Here’s where to get it:

• Worldview: Users can make layered maps from daily, monthly, and yearly data.   Good for new users, and user-friendly.
• Giovanni: Users can make maps, map plots, and download data.  Also good for new users.
• ARSET: the Appled Remote Sensing Training program. Offers online training on how to use satellite remote sensing data.
• For more advanced users: download the data files for mapping or plotting from https://earthdata.nasa.gov/earth-observation-data/near-real-time. Will require the use of advanced data management software.

Dominika Heusinkveld, MD, MPH is currently a graduate student in the University of Arizona’s Environmental Science and Journalism programs. Her interests are environmental health, health communication, and science journalism.

Article source:Science Blogs