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

Best Dallas Weight Loss Programs

The interesting post Best Dallas Weight Loss Programs was originally seen on: http://www.bestweightlossdoctor.com/

Best Dallas Weight Loss Programs – Dr. Michael Cherkassky

If you’ve been thinking of losing some weight or improving your health, one of the best Dallas weight loss programs may be the right choice for you. The great thing about medical weight loss is that it can be applied to so many individual needs, whether it be significant weight loss or more general health improvement. With Dr. Cherkassky, you’re getting more than just a diet, you’re getting a weight loss program that focuses on sustainable progress and real results. So many of his patients have reported not just losing weight, but also realizing a more healthy body and improved self-esteem.

Dr. Michael Cherkassky focuses on his patients’ overall health above all. His services include everything an individual might need to lose weight and to develop habits and skills that will keep them looking and feeling great for years to come. Working with a specialist is more than just a financial investment; it’s an investment in your current and future health, which means you deserve the best. When selecting from the weight loss clinics in your area, you’ll want to choose a doctor like Dr. Cherkassky who will work with you closely to reach your goals.

Best Dallas Weight Loss Programs - Dr. Michael Cherkassky - 469-434-3380

Best Dallas Weight Loss Programs – Dr. Michael Cherkassky – 469-434-3380

There are many doctors who label themselves as weight loss specialists, but how can you select only the best physicians? Perhaps the best way to find the ideal service is to ask around and see what people in your area are saying. Ask family and friends and do an online search! You’ll be sure to find lots of information that will help you to make your choice, and we guarantee that a search of Dr. Michael Cherkassky will yield impressive results.

Best Dallas Weight Loss Programs – Dr. Michael Cherkassky – 469-434-3380

If you would like to give medical weight loss a try with this trained specialist, we invite you to give us a call today at 469-434-3380 to learn more about the advantages of our Dallas weight loss Programs.


Best Dallas Weight Loss Programs syndicated from https://weightlossdrtexas.wordpress.com

Liked on YouTube: Dallas Weight Loss Program – Dr. Michael Cherkassky – 469-434-3380

Dallas Weight Loss Program – Dr. Michael Cherkassky – 469-434-3380
Best Dallas Weight Loss Program –
http://bestweightlossdoctor.com/dallas-weight-loss-program/
Dr. Michael Cherkassky – Call 469-434-3380

Weight gain and loss are both sensitive topics and ones that are on the minds of many individuals who are considering a weight loss program Dallas. When looking at ads for different programs, odds are the loss of weight is by far the most advertised component, but there is really so much more to a successful weight loss program. In fact, the best weight loss doctors are those who understand that losing weight is only a “side effect” of the most important goal, which is to nurture and develop a more healthy lifestyle.

Dr. Michael Cherkassky is one of the medical weight loss specialists that has his priorities exactly right. His first goal is to help patients incorporate healthy habits and routines into their day. Improved nutrition, healthy diets, and exercise are just some of the items that Dr. Cherkassky emphasizes during his service. By doing so, he ensures that he gives his patients the tools they need to keep staying healthy after the services are over. Once these habits are developed, weight loss is inevitable, and Dr. Cherkassky’s patients have experienced this first hand.

All it takes is a quick online search to see just how many people have lost a significant amount of weight while under the tutelage of this specialist. Not only have they reported significant loss, but they also laud his approach for its ability to make them feel great across the board, both in terms of weight and overall health. When it comes to selecting from medical weight loss physicians, you certainly can’t go wrong with Dr. Michael Cherkassky.

Dallas Weight Loss Program – Dr. Michael Cherkassky – 469-434-3380

If you would like to learn more about what weight loss clinics and weight loss programs can offer you, we invite you to give the doctor a call today at 469-434-3380. We would love to provide you with the best weight loss program Dallas TX.

Michael Cherkassky, M.D.
12850 Spurling Road, Suite #110
Dallas TX, 75230
469-434-3380
http://bestweightlossdoctor.com

Dallas Weight Loss Program, Dallas Weight Loss Programs, Weight Loss Specialist Dallas, Dr. Cherkassky, Dr. Michael Cherkassky, Weight Loss, Medical Weight Loss, Weight Loss Clinics, Weight Loss Doctor, Weight Loss Doctors, Weight Loss Physicians, Weight Loss Specialists, Weight Loss Service, Weight Loss Services, Weight Loss Specialist Dallas TX, Weight Reduction
via YouTube https://youtu.be/S3wRQZk2a4g


Liked on YouTube: Dallas Weight Loss Program – Dr. Michael Cherkassky – 469-434-3380 syndicated from https://weightlossdrtexas.wordpress.com

Best Dallas Weight Loss Program

The blog post Best Dallas Weight Loss Program was originally published on: http://bestweightlossdoctor.com

Best Dallas Weight Loss Program

Weight gain and loss are both sensitive topics and ones that are on the minds of many individuals who want to find the best Dallas weight loss program. When looking at ads for different programs, odds are the loss of weight is by far the most advertised component, but there is really so much more to a successful weight loss program. In fact, the best weight loss doctors are those who understand that losing weight is only a “side effect” of the most important goal, which is to nurture and develop a more healthy lifestyle.

Michael Cherkassky, M.D. 12850 Spurling Road, Suite #110 Dallas TX, 75230 469-434-3380 http://bestweightlossdoctor.com https://goo.gl/maps/qLf8yKt3WA42 https://plus.google.com/+MichaelCherkasskyMDDallas

Dr. Michael Cherkassky is one of the medical weight loss specialists that has his priorities exactly right. His first goal is to help patients incorporate healthy habits and routines into their day. Improved nutrition, healthy diets, and exercise are just some of the items that Dr. Cherkassky emphasizes during his service. By doing so, he ensures that he gives his patients the tools they need to keep staying healthy after the services are over. Once these habits are developed, weight loss is inevitable, and Dr. Cherkassky’s patients have experienced this first hand.

All it takes is a quick online search to see just how many people have lost a significant amount of weight while under the tutelage of this specialist. Not only have they reported significant loss, but they also laud his approach for its ability to make them feel great across the board, both in terms of weight and overall health. When it comes to selecting from medical weight loss physicians, you certainly can’t go wrong with Dr. Michael Cherkassky.

Best Dallas Weight Loss Program – Call 469-434-3380

If you would like to learn more about what weight loss clinics and weight loss programs can offer you, we invite you to give the doctor a call today at 469-434-3380. We would love to provide you with the best weight loss program Dallas TX.


Best Dallas Weight Loss Program syndicated from https://weightlossdrtexas.wordpress.com

Best Dallas Weight Loss Specialists

Best Dallas Weight Loss Specialists was originally published to: Michael Cherkassky M.D. Weight Loss

Best Dallas Weight Loss Specialists – Dr. Michael Cherkassky

If you’re at all familiar with weight reduction services and the many options available, chances are you’ve at least heard of the best Dallas weight loss specialists , but what exactly are weight loss physicians? These doctors are medical professionals who specialize in providing weight loss programs to patients who are looking to lose weight in a safe and doctor-supervised way. Unlike other techniques, medical weight loss focuses on the overall health of the patient, ensuring that they’re losing weight through healthy diet and exercise and in a manner that allows the patient to keep the weight off for years to come.

Dr. Michael Cherkassky is a doctor who operates one of the most well known weight loss clinics in the Dallas area. His expertise in the field of weight reduction and his many years of helping patients see real results has made him a specialist in high demand. He has carefully developed his weight reduction service, incorporating nutrition, exercise, and helpful supplements. A quick online search yields tremendous results; countless current and former patients raving about the results they saw while working with Dr. Cherkassky. Even better, these patients speak constantly about how much better they feel and how the weight not only came off, but stayed off afterward.

Best Dallas Weight Loss Specialists – Call 469-434-3380

Best Dallas weight loss specialists

Best Dallas weight loss specialists during weight loss appointment

So many people find themselves trapped in an endless circle of diet after diet. Sometimes they lose weight and sometimes they don’t. Even more frustrating is that often the weight they lose doesn’t stay off. What could be worse? However, with a weight loss program like that offered by Dr. Michael Cherkassky, patients can finally see lasting results. If you would like to experience first hand the amazing talents and techniques of Dr. Cherkassky, don’t hesitate to give us a call at 469-434-3380. Phone us today and ask any questions you might have about the many benefits of weight loss specialists Dallas TX.


Best Dallas Weight Loss Specialists syndicated from https://weightlossdrtexas.wordpress.com

Health and environmental groups sue EPA over new rules on toxics

Earth Justice, the United Steelworkers, the Asbestos Disease Awareness Organization, the Environmental Defense Fund and other public interest groups are suing the Trump administration over two new regulations to address toxic substances. The groups filed petitions last week with the U.S. Court of Appeals for the 9th Circuit. They are asking to court to review the rules which EPA published on July 20, 2017. The groups will argue that the regulations are contrary to Congress’ intent.

The Natural Resources Defense Council’s Daniel Rosenberg and Jennifer Sass use these photos to illustrate the matter.  It’s the difference between what Congress intended when it amended the Toxic Substances Control Act (TSCA) and what EPA administrator Scott Pruitt has done with the new law.

Courtesy of D.Rosenberg and J.Sass at NRDC and their blog post “To Pruitt EPA: See You and Your Illegal TSCA Rules in Court.”

 

One of the rules being challenged addresses the process and criteria for identifying high-priority chemicals for risk evaluations. The criteria adopted by EPA narrows the breadth of their assessments to only include certain uses of the chemical being evaluated.

“The Trump EPA deliberately bypassed the law’s clear requirement that safety assessments be based on ALL uses of a chemical. By allowing some or even most chemical uses to be ignored, the EPA proposes to do the very thing the new law was intended to halt,” said Mike Belliveau, Executive Director of the Environmental Health Strategy Center.

Carving out this use or that use misrepresents the numerous ways in which individuals are exposed to a toxic substance. Slicing and dicing potential exposures was a weakness in the 40 year-old law. Congress intended to fix that deficiency when it amended TSCA in 2016.

As Richard Denison at Environmental Defense Fund writes:

“In reforming TSCA, Congress explicitly required that EPA determine whether or not a chemical substance, not individual uses, presents unreasonable risk, and to do so by conducting comprehensive risk evaluations.  This is because, while exposures resulting from certain uses of a chemical viewed in isolation may present low risk to some groups of people, when multiple exposures are combined and when all potentially susceptible subpopulations are considered, such a chemical may well present unreasonable risk and warrant restrictions.”

The second rule being challenge is a companion to the first. It addresses the procedures for determining whether a high-priority chemical present an “unreasonable risk to health or the environment.”  That’s a key phrase in the 2016 amendments. It was crafted to ensure the law puts primacy on health protection.

Three different lawsuits on the rules have been filed by public interest groups. The Environmental Defense Fund is party on one of the suits, the Natural Resources Defense Council on another lawsuit, and a coalition of groups including Safer Chemicals Healthy Families and the Union of Concerned Scientists are parties on the third lawsuit (here, here). The groups filed their petitions with the Court last week, but are not yet required to lay out their arguments which challenge the two new EPA rules.

Article source:Science Blogs