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List of Alzheimer’s Disease Medications (28 Compared …

Posted: August 31, 2017 at 9:45 pm


Aricept Rx C N 21reviews

5.0

Generic name:donepezil systemic

Drug class: cholinesterase inhibitors

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

6.0

Generic name:memantine systemic

Drug class: miscellaneous central nervous system agents

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

5.0

Generic name:donepezil systemic

Brand names: Aricept, Aricept ODT

Drug class: cholinesterase inhibitors

For consumers: dosage, interactions, side effects

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

6.0

Generic name:rivastigmine systemic

Drug class: cholinesterase inhibitors

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

4.0

Generic name:memantine systemic

Drug class: miscellaneous central nervous system agents

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

9.0

Generic name:donepezil systemic

Drug class: cholinesterase inhibitors

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

5.0

Generic name:memantine systemic

Brand names: Namenda, Namenda XR

Drug class: miscellaneous central nervous system agents

For consumers: dosage, interactions, side effects

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

7.0

Generic name:galantamine systemic

Brand names: Razadyne ER, Razadyne, Reminyl

Drug class: cholinesterase inhibitors

For consumers: dosage, interactions, side effects

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

10

Generic name:galantamine systemic

Drug class: cholinesterase inhibitors

For consumers: dosage, interactions, side effects

2.0

Generic name:galantamine systemic

Drug class: cholinesterase inhibitors

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Prescribing Information

6.0

Generic name:rivastigmine systemic

Brand name: Exelon

Drug class: cholinesterase inhibitors

For consumers: dosage, interactions, side effects

For professionals: A-Z Drug Facts, AHFS DI Monograph, Prescribing Information

Generic name:vitamin e systemic

Drug class: vitamins

For consumers: dosage, interactions, side effects

Generic name:vitamin e systemic

Brand names: Alpha E, Aqua-E, Aqua Gem-E, Aquasol E, E Pherol, Vita-Plus E Natural, Aquavite-E, E-400 Clear, E-600, E-Gems, Nutr-E-Sol

Drug class: vitamins

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph, Natural Product Monographs

Generic name:ergoloid mesylates systemic

Drug class: miscellaneous central nervous system agents

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Generic name:donepezil / memantine systemic

Drug class: cholinesterase inhibitors

For consumers: dosage, interactions, side effects

For professionals: Prescribing Information

Generic name:vitamin e systemic

Drug class: vitamins

For consumers: dosage, interactions, side effects

Generic name:vitamin e systemic

Drug class: vitamins

For consumers: dosage, interactions, side effects

Generic name:vitamin e systemic

Drug class: vitamins

For consumers: dosage, interactions, side effects

For professionals: AHFS DI Monograph

Generic name:donepezil / memantine systemic

Brand name: Namzaric

Drug class: cholinesterase inhibitors

For consumers: dosage, interactions, side effects

For professionals: A-Z Drug Facts, Prescribing Information

Generic name:vitamin e systemic

Drug class: vitamins

For consumers: dosage, interactions, side effects

7.0

Generic name:galantamine systemic

Drug class: cholinesterase inhibitors

For consumers: dosage, interactions, side effects

Generic name:vitamin e systemic

Drug class: vitamins

For consumers: dosage, interactions, side effects

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List of Alzheimer's Disease Medications (28 Compared ...

Alzheimer’s disease: a son’s diary – KPCnews.com

Posted: at 9:44 pm


The reality of this disease is that theres no remission. Theres no stopping it. Theres no slowing it down. Theres no cure, and theres no survivors. Author unknown

My mother passed away on April 4, 2004, of congestive heart failure. She was diagnosed with mild to moderate Alzheimers Disease about 10 years prior to her death.

I was her primary caregiver. I saw first hand how Alzheimers gradually robs a person of their memory and ability to think and comprehend what is happening around them. They gradually lose their ability to care for themselves.

She talked a lot about her distant past but couldnt remember what she did a few hours earlier that day. She constantly repeated the same stories from her past without realizing she was repeating them.

I kept a partial daily journal of her gradual decline for her neurologist. On Feb. 21, 2004, about two months before she died, I wrote: Forgets to use toilet (portable toilet set up next to her living room chair). Goes in Depends. Soils self and doesnt realize the mess it makes in her pants and on her body.

Forgets to wash hands and face even when wash cloth and soap placed at sink. Forgets to brush teeth. Cannot tell when hands are dirty. Messy with food, dropping crumbs on clothing and floor and doesnt realize it.

Sometimes puts clean Depends on over dirty one. Questions the need to change clothes.

Difficulty getting her to eat. Lost 30 pounds in 18 months from 147 pounds to 117.

At night calls out to me why is the alarm going off when no alarm sounded.

Leaves lights on. Doesnt know day of the week, time of the year. Doesnt remember names or recognize people by name. Doesnt know age and date of birth.

Says she heard children playing on the hallway stairs and knocking on the front door. When I come home from work and ask her if she had visitors she may say yes and mention someone but I find out later she had no visitors.

Twice I tried home nursing care to give me a break. The first time I came home at noon and found the young woman sitting on the living room couch with her boyfriend after giving her strict instructions not to let anyone in the house. The second time the nurse was fine for two weeks then quit the business. I continued caring for my mother while working a full-time job.

On Feb. 23, 2004, I wrote in my journal: 3:30 p.m. Overpowering smell of excrement when I enter back door. Mom in her living room chair did not make it to the portable toilet in time. Defecated partly in toilet and in her pants. Excrement on the carpet, and on her hands and legs.

Took her upstairs to the bathroom and put her bath tub shower to clean her off. Pick excrement from her finger nails. She doesnt understand but cries when I tell her the problem. I get angry at her and raise my voice. I dress her in clean clothes, then clean up the living room mess, scrubbing the carpet, portable toilet, chair cushion.

I help mother back into her living room chair, and kiss her and say Im sorry for being stern with her but had to make her get in the tub. Serve her supper. Go to a City Council meeting and a house fire scene. Arrive home about 9 p.m. Help her into bed after giving her the last of her medications. This feels good, she said as I turn out the light.

After nearly 10 years of giving her care I couldnt do it anymore. My late brother, my late sister and I met with mother to persuade her to move from the house to a nursing home. My sister explained I could no longer care for her. She cried and said, This is my home.

My sister walked into the dining room in tears. I told my brother and sister I would continue looking after her in the house.

About a month later she was rushed to the hospital with congestive heart failure and died.

Today more than 5 million Americans have Alzheimers disease, including 110,000 Hoosiers, according to the Alzheimers Association Greater Indiana Chapter. Alzheimers is the nations sixth-leading cause of death in the U.S.

The association offers free education for families affected by Alzheimers and other dementias. Two free programs are being offered next month in LaGrange and Steuben counties.

Dementia Conversations: Driving, Doctors Visits, Legal & Financial Planning will be offered from 5:30 to 7 p.m. Tuesday, Sept. 19, at the LaGrange County Council on Aging, 410 E. Central Ave., LaGrange.

Understanding and Responding to Dementia-Related Behaviors will be offered at 6 p.m. Thursday, Sept. 28, at Fairview Missionary Church, 525 E. C.R. 200N, Angola.

The sessions are free but registration is requested by contacting the Alzheimers Association Helpine at 1-800-272-3900. A full listing of education programs is available at alz.org/Indiana.

Its been more than 13 years since my mother passed away, but every time I read about Alzheimers disease I think of her. Every time I hear someone joke Its the big A when they forgot something, I may laugh but then I think about my mother. Its really no laughing matter if youve been a caregiver for someone with Alzheimers disease.

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Alzheimer's disease: a son's diary - KPCnews.com

Traditional Health Clinic – Acupuncturist In Knoxville, TN …

Posted: at 9:44 pm


Drug-Free Respiratory Treatment

for the Whole Family

The Salt Spa at Traditional Health Clinic is East Tennessee's first and onlySalt Spa,providing the benefits and healing effects of Salt Therapy. The Salt Spa rooms aremicroclimate-controlled, allergen-free environments, providing a constant flow of dry,aerosolized salt.

The Adult Salt Room

Sit back in a comfortable recliner and enjoy a relaxing salt therapy session. Easy listening music and soft lighting enhance the experience.

The Children's Salt Room

The Kid's Salt Room isa play area with unique difference - it's like a sandbox but instead of sand, kids play in a whole lot of rock salt! Toys for fun and play are provided. Supervising adultsjoin the session on a cozy bench, at no extra cost.

Discover the many benefits of salt therapy

Relieve Symptoms of:

allergiesasthmaCOPDsinusitiscold/flubronchitispsoriasis, eczema, dermatitisstress

Optimize Wellness for:

breathing for athletes, singers and musiciansdetoxification of respiratory systemgeneral respiratory hygienerelaxation and stress reliefsleep

Help to Offset Influence of:

air pollutionelectronic pollutioncity stress

Help to Prevent:

sinus, respiratory and earinfectionscold/fluallergies,asthma and COPDBronchitisPneumonia

The Salt Spa at Traditional Health Clinic

tel: (865) 588-1755

6210 Highland Place Way Knoxville, TN 37919

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Traditional Health Clinic - Acupuncturist In Knoxville, TN ...

Naturopathic Medicine Helps People Manage Chronic Pain Without Addictive Opioids – Markets Insider

Posted: at 9:44 pm


WASHINGTON, Aug. 31, 2017 /PRNewswire-USNewswire/ --As a medical discipline that emphasizes a holistic approach and natural treatments, naturopathic medicine offers safe and effective alternatives to highly addictive drugs for managing chronic pain. Licensed naturopathic doctors are trained to start with non-drug approaches to chronic pain management. Opioid painkillers are only used as a last resort. This is according to the American Association of Naturopathic Physicians (AANP), which today released a new FAQ for consumers on how naturopathic medicine helps people manage chronic pain without addictive drugs, in partnership with the Institute for Natural Medicine (INM).

The FAQ describes how licensed naturopathic doctors develop personalized pain management treatment plans. These plans take into account the root causes of each person's pain and all its manifestations. Root causes can include lifestyle, nutrition, work and leisure activities, current and past stressors, and relevant previous injuries.

"Since 1999, the rate of overdose deaths that involved opioids nearly quadrupled, with over 183,000 people dying just from prescription opioid overdoses," said Michelle Simon, PhD, ND and Chair of the INM Board of Directors. "While strong pharmaceuticals and even over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) certainly have a place in treating pain, they're not the first choice of licensed naturopathic doctors. Instead, naturopathic doctors are trained to engage theinherent healing capacities of the human body. This can include applying dietary recommendations, nutritional supplements and botanical medicines that help reduce inflammation and the pain it causes."

The complete FAQ, "How do naturopathic doctors help people manage chronic pain without highly addictive opioids?" can be found here.

About the Institute for Natural MedicineThe Institute for Natural Medicine (INM) is a national not-for-profit 501(c)(3) organization that provides public education about naturopathic medicine and increases consumer access to naturopathic doctors. As a close partner to the American Association of Naturopathic Physicians, the INM strives to increase consumer and physician choice in safe, effective healthcare that improves patient outcomes and lowers costs. For more information visit http://www.naturemed.org or call 855-799-4490.

About the AANPThe American Association of Naturopathic Physicians is the professional association that represents licensed naturopathic physicians. The AANP strives to make naturopathic medicine available to every American, and to increase recognition of naturopathic physicians as the identified authorities on natural medicine. Learn more at http://www.naturopathic.org.

Media ContactRob Wyserel="nofollow">rob@capital-content.com|212-920-1470

View original content with multimedia:http://www.prnewswire.com/news-releases/naturopathic-medicine-helps-people-manage-chronic-pain-without-addictive-opioids-300512196.html

SOURCE Institute for Natural Medicine

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Naturopathic Medicine Helps People Manage Chronic Pain Without Addictive Opioids - Markets Insider

SA marks Traditional African Medicine Day – South African Broadcasting Corporation

Posted: at 9:44 pm



South African Broadcasting Corporation
SA marks Traditional African Medicine Day
South African Broadcasting Corporation
Sixty four-year-old Wowo Meje says she had suffered a persistent cough for years. Even after an operation on her throat the cough continued until she sought alternative forms of treatment. "I think the herbs helped my cough. Yes I've been coughing for ...

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SA marks Traditional African Medicine Day - South African Broadcasting Corporation

Transforming the traditional health care sector – The Herald

Posted: at 9:44 pm


Over 80 percent of the population is seeking traditional health care options

Runyararo MuzavaziFeatures WriterWhen an individual falls ill many would prescribe that they visit a clinic or hospital to seek a remedy for their ailment.Thats the faith that people have in western medicine.

There is however, a large section of society that has turned to traditional healers and using alternative medicines when looking for a cure for their illnesses.

Statistics released by the Ministry of Health and Child Care on Monday show over 80 percent of the population is seeking traditional health care options.

Due to this high demand for such services, Government has given the green light to traditional healers to establish their own medical aid societies for the convenience of both the client and the service provider.

Pan-African Positive Womens Coalition Zimbabwe country coordinator, Tendai Westerhof says the initiative is progressive as Government acknowledges the existence of effective traditional medicines.

This is very good and welcome as Government acknowledges that more than 80 percent of people seek medical services from that sector.

Government is recognising the existence of alternative medicines. This new development must be seen as an option complementing existing services that have proven to work, she said.

Ms Westerhof added that it was important for communities to be enlightened on the new developments to curb incidences of abuse of funds.

There is need to ensure that the affected communities understand the proposed development to safeguard against abuse of public funds and people being jilted.

There would be a need to ensure that proper training is done to prepare the traditional and faith healers in handling public funds as these are different from tithes and offerings that are normally given in the church, she said.

Economic hardships and good service delivery at traditional health institutions have left the people with no choice but to go for traditional healing.

People are suffering and experiencing economic hardships and have different religious and traditional beliefs hence they prefer traditional healers for quick fix solutions as they are desperate to have turnaround in their lives.

The only challenge is there are some of the medicines and treatment used by traditional healers that might not have been proven to work; their medicinal properties are not known, the containers are not clearly labelled with the quantities and actual ingredients used to prepare the traditional medicines.

It is a fact that there are many quack medicines and cures being sold in the streets that have flooded the black market and which pose a danger to public health, said Ms Westerhof.

Incorporating traditional health care and the convectional health care is however, a great way to go according to Ms Westerhof.

There is need for Government to continue building the capacity of traditional healers together with health care workers on the importance of managing certain ailments that can only be successfully treated in modern health-care facilities.

There are certain ailments that traditional healers cannot treat or cure. Diseases like HIV/AIDS do not have a known cure and the only thing that has proven to work by stopping the further spread of HIV in a persons body are the anti-retroviral treatment.

This must never be compromised by traditional or faith healing as we have seen many people losing their lives needlessly after being advised by traditional healers or prayed for by prophets to abandon their treatment, she said.

She urged traditional healers to work hand in hand with hospitals in terms of healing ailments.

Traditional healers must continue to refer their clients to health care services for certain ailments that they cannot treat. Prophets can always play a role in lifting up a persons spirit when they are sick as the spirit never gets sick but the physical body will need treatment from a health-care facility.

Prophets, faith healers must encourage those on ART to continue taking their treatment as ART is for life and visiting health-care centres for the usual medical check-ups in the same way many people go to church on a Sunday. How will a clients medical record be kept or prescribed? she asked.

According to Ms Westerhof it would be prudent for this initiative to be piloted by a few traditional healers who are ready to establish medical aid facilities to avoid mistakes and inconveniencing patients.

SAYWHAT executive director, Jimmy Wilford said there is need for people to be educated on how the medical aid will work so as to do away with the stigma around traditional healing.

Looking at the literal operation of a medical aid and traditional healing, there is need for more work to be done to get rid of stigma around the use of traditional medicine.

There is selective use of traditional medicine in Zimbabwe which calls for a paradigm shift that is led by Government involving all stakeholders, he said.

He asked questions on whether the health sector was prepared to embrace traditional healing.

There is need for concerted efforts from religious, traditional and political leadership to be honest with each other and show leadership on this issue.

Look at traditional male circumcision and how it has moved to be part of the convectional health care.

There must be something that can be learnt from traditional healing that can improve health service delivery.

The question that remains is are healthcare workers prepared to embrace traditional medicine? said Mr Wilford.

Health seeking behaviour amongst youth is something that various stakeholders have to work on, its actually a societal challenge.

In terms of traditional medicine, the legal provisions have been there before, just that here and there for various reasons its making some headlines.

Young people shape their views on traditional medicine guided by the societal beliefs and how the young people were socialised. Our society stigmatises traditional medicine possibly its colonial hangover or its more to do with Christianity but there is a general stigma associated with accessing traditional medicine.

As such, young people decision to access or not access is determined by the level of stigma on traditional medicine in that community, Mr Wilford said.

Community Working Group on Health executive director Mr Itai Rusike said there is no harm in people taking refuge in both streams.

Traditional healers can start their own medical aid societies and their schemes should be regulated within the provisions of the medical aid societies. This applies for example in relation to the setting of fees for traditional healers, the setting of standards for registering and monitoring the medical aid societies, registration and supervision, he said.

Mr Rusike suggested that the practicality of the medical aids be monitored to avoid any inconveniences.

The issue of standards of governance for the traditional healers medical aid societies will need to be tackled as this has been a major weakness in the private medical aid societies.

The medical aid societies for the traditional healers should satisfy certain criteria of good governance, including the membership, powers and functioning of its Board in relation to the societys members, for it to be registered, or to stay registered.

Without this there will be very poor protection of consumer rights in this sector and people will be left without cover but as passive spectators in the process.

The issues of fragmentation of the traditional healers also need to be addressed.

The Medical Aid Societies Bill is a great opportunity to recognise and acknowledge the critical role played by the traditional healers in our health delivery system.

The Ministry of Health and Child Care as the regulatory authority will need to strengthen its enforcement and inspection capacities, said Rusike.

He added that the issue of ease of payment and affordability are the main reasons for the increased affection for traditional health care.

The right of choice by about 80 percent of people in Zimbabwe that consult traditional healers is thus linked to the ability to pay for services in the public and private sectors as the majority poor do not have any medical insurance cover hence its easier to negotiate payment terms with a traditional healer and in some instances payment does not necessarily need to be cash.

The general decline of the health services, lack of drugs, obsolete equipment, and long distances to the health facilities and the attitude of health workers have also contributed to some patients seeking services from the traditional healers, Rusike said.

He suggested that there be an incorporation of traditional health care and the convectional health care for patients to have holistic healing.

In some developed and developing countries, traditional medicine has been integrated into the public health delivery system at various levels and is receiving official attention and funding, with clear legislative and operational frameworks that ensure that Traditional Medicine is accessible and available to those who need the service, he said.

Many Zimbabweans consult traditional healers at some point in their lives, indicating that traditional health practice is an important component of the Zimbabwes health care delivery system at both the individual and community level.

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Transforming the traditional health care sector - The Herald

Leading Chiropractor, Nasim Gorgani, DC, is to be Recognized as a 2017 Top Doctor in Los Altos, California – PR NewsChannel (press release)

Posted: at 9:44 pm


Nasim Gorgani, DC, Chiropractor at Chiropractic and Therapy, has been named a 2017 Top Doctor in Los Altos, California. Top Doctor Awards is dedicated to selecting and honoring those healthcare practitioners who have demonstrated clinical excellence while delivering the highest standards of patient care.

Dr. Nasim Gorgani has been in practice for more than three years, and she has already become renowned as one of the top chiropractors in the Los Altos area. Her career in alternative medicine started in 2014 when she graduated with her Doctor of Chiropractic Degree from the west campus of the prestigious Palmer College of Chiropractic in San Jose, California.

Dr. Gorgani provides chiropractic solutions for a wide range of conditions, and in patients of all ages, helping them overcome chronic and acute pain. Conditions treated by her include Headaches/head injuries, Sciatic nerve pain, soft tissue injuries, neck, back and pelvic pain, Carpal Tunnel Syndrome, Plantar Fasciitis, TMJ, spine injuries and deformities, sporting injuries, and musculoskeletal injuries. She is known for her holistic approach to chiropractic treatments, combining exercise, rehabilitation and chiropractic wellness programs.

Dr. Gorgani is already known for her enthusiasm and for her passion for helping and healing people. She was inspired to enter the world of alternative medicine by the example set by her parents, who are both University Professors and scientific researchers. Her dedication and commitment makes Dr. Nasim Gorgani a very worthy winner of a 2017 Top Doctor Award.

To learn more about, please visit: http://www.nasimdc.com.

About Top Doctor Awards

Top Doctor Awards specializes in recognizing and commemorating the achievements of todays most influential and respected doctors in medicine. Our selection process considers education, research contributions, patient reviews, and other quality measures to identify top doctors.

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Leading Chiropractor, Nasim Gorgani, DC, is to be Recognized as a 2017 Top Doctor in Los Altos, California - PR NewsChannel (press release)

A Sea of Health and Environmental Hazards in Houston’s Floodwaters – New York Times

Posted: at 9:43 pm


Photo Navigating floodwaters brought by Harvey on Tuesday in Houston. Credit David J. Phillip/Associated Press

Officials in Houston are just beginning to grapple with the health and environmental risks that lurk in the waters dumped by Hurricane Harvey, a stew of toxic chemicals, sewage, debris and waste that still floods much of the city.

Flooded sewers are stoking fears of cholera, typhoid and other infectious diseases. Runoff from the citys sprawling petroleum and chemicals complex contains any number of hazardous compounds. Lead, arsenic and other toxic and carcinogenic elements may be leaching from some two dozen Superfund sites in the Houston area.

Porfirio Villarreal, a spokesman for the Houston Health Department, said the hazards of the water enveloping the city were self-evident.

Theres no need to test it, he said. Its contaminated. Theres millions of contaminants.

He said health officials were urging people to stay out of the water if they could, although it is already too late for tens of thousands.

Were telling people to avoid the floodwater as much as possible. Dont let your children play in it. And if you do touch it, wash it off, Mr. Villarreal said. Remember, this is going to go on for weeks.

Flooding always brings the danger of contamination and disease, though epidemics from floods in the United States have been rare. This inundation, which put nearly 30 percent of the nations fourth-largest city underwater, will pose enormous problems, both immediately and when the waters finally recede.

Dr. David Persse, Houstons director of Emergency Medical Services, said officials were monitoring the drinking water system and the sewer system, both of which he said were intact so far. But hundreds of thousands of people across the 38 Texas counties affected by Hurricane Harvey use private wells, according to an estimate by Louisiana State University researchers, and those people must fend for themselves.

Well water is at risk for being contaminated, Dr. Persse said, and the well owner is really the one who is responsible. In the City of Houston, we have folks that use well water but we strongly recommend against it and this will sound awful we dont take responsibility for it.

Harris County, home to Houston, hosts more than two dozen current and former toxic waste sites designated under the federal Superfund program. The sites contain what the Environmental Protection Agency calls legacy contamination: lead, arsenic, polychlorinated biphenyls, benzene and other toxic and carcinogenic compounds from industrial activities many years ago.

Kathy Blueford-Daniels grew up just a block away from one of those sites, a wood-treating facility that used cancer-causing creosote and other toxins. As a young girl, she would try to avoid the plant and the pungent, oil-like goo that lined the ditches around it.

Now 60, Ms. Blueford-Daniels still lives on the same block, in Houstons Fifth Ward. So when Harveys rains started to pour into her neighborhood, she immediately began to wonder what the rising waters would carry off the old industrial property.

I wasnt so fearful of the storm. But Im scared of that site, she said. I thought: This is going to be a travesty. The contamination could be going anywhere.

An E.P.A. spokesman, David Gray, said in a statement that the agency would inspect two flooded Superfund sites in Corpus Christi, but he did not specify which ones or say whether additional sites elsewhere in Texas would be checked.

Houston also lies at the center of the nations oil and chemical industry, its bustling shipping channel home to almost 500 industrial sites. Damaged refineries and other oil facilities have already released more than two million pounds of hazardous substances into the air this week, including nitrogen oxide as well as benzene and other volatile organic compounds, according to a tally by the Environmental Defense Fund of company filings to Texas state environmental regulators.

Were very concerned about the long-term implications of some of the emissions, said Elena Craft, a senior health scientist and toxicologist at the Environmental Defense Fund in Texas.

As well as the flooding and the impact on pipelines, theres underground and aboveground storage tanks, she said. Its a suite of threats.

Houstons sewer systems have also long struggled with overflows, drawing scrutiny from federal regulators who worry about raw sewage seeping into groundwater. Like dozens of cities across the country, Houston has been negotiating a consent decree with the E.P.A. that would require the city to upgrade its pipes and overhaul its maintenance regime.

Houstons had problems with their sewer system in the past. They already had cracks and leaks that were allowing storm water to get into the sewers, said Erin Bonney Casey, research director at Bluefield Research, a water-sector consultancy based in Boston.

When it rains, the sewer pipes get infiltrated with storm water. The pipes exceed their capacity and you get discharge of a mix of sewer water and storm water, she said. As you can imagine, this raises major concerns around disease and contamination of local water supplies.

Marc Edwards, the Virginia Tech professor who helped identify the Flint water contamination crisis, said Houstons abundance of private water wells added to the citys woes. People who evacuate return home and use them, to their great risk.

Poop from animals and humans that normally does not get into the water supply is present in the wells, he said, and if they are present in water that you drink it would cause massive epidemics in a matter of days.

He added: Everything else, as horrible as it is, is really a more chronic secondary concern. Its pretty rare that those things are present in flood water, short term, in levels that can kill you.

Stan Meiburg, a former acting deputy director of the E.P.A., said one hope was that there was just so much water that it might dilute pollutants and fecal matter in the water.

But he also worried about people who had three or four feet of water in their houses and would not realize that all the pesticides and hazardous products they keep under the sink would now have contaminated their houses.

After Katrina, when the floodwaters receded, we had to go around to assist communities to pick up debris and leftover chemicals, like propane tanks, pesticide containers that were compromised and household hazardous waste, said Mr. Meiburg, now director of graduate programs in sustainability at Wake Forest University.

The water is going to be polluted, he said. You know that from the get-go.

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A Sea of Health and Environmental Hazards in Houston's Floodwaters - New York Times

Trump Administration Sharply Cuts Spending on Health Law Enrollment – New York Times

Posted: at 9:43 pm


Over all, 12.2 million people selected or automatically re-enrolled in marketplace plans for 2017, although the Trump administration said in June that the number of customers who paid their premiums had dropped to 10.1 million. Similar drops have occurred in previous years after people lost coverage after they failed pay their premiums.

The administration officials who briefed reporters on Thursday said it made no sense to continue spending as much on promoting the laws coverage options because most Americans know about them already. Instead of television ads, the administration will run radio and digital ads and send emails and texts to existing enrollees, they said. They added that any outreach would emphasize that the enrollment period will be much shorter this year from Nov. 1 to Dec. 15. Last years open enrollment period ran from Nov. 1 through Jan. 31.

People are aware the products are out there, one official said, and they are aware they can sign up.

Although no navigator group will lose its funding completely, the amounts they get will be based on how close they came to meeting their enrollment goal for 2017. If a group reached only 30 percent of its enrollment goal, for example, it would receive 30 percent of the grant it got last year.

We are moving forward by matching funding to performance, one official said.

Another official added that last year, navigator groups enrolled about 80,000 people less than half of what the groups aspired to, and only 0.7 percent of overall enrollees for 2017 in marketplace plans. Some groups, they said, enrolled only a handful of people.

But the figures they cited appeared not to include people who met with navigators to sort through coverage options but enrolled later on their own a not insignificant group, according to past surveys on enrollment.

Navigators defended their work. Alisha Keezer, a health care navigator at the Maine Lobstermens Association in Kennebunk, said the cutbacks were shocking to all of us.

We had no forewarning, Ms. Keezer said. This is heartbreaking. Here in Maine, we have helped many fishermen enroll in coverage self-employed people who have never had health insurance before.

The navigator groups whose funding may be cut are only in the 38 states that rely on the federal Affordable Care Act marketplace, HealthCare.gov. Twelve other states run their own marketplaces and fund their own enrollment programs.

Its very disappointing that the administration is minimizing the importance of in-person assistance to millions of people who have relied on it to understand how to enroll and how to use their insurance, said Shelli D. Quenga, the program director at the Palmetto Project in South Carolina, a nonprofit group that received about $1 million to help with outreach and enrollment in the last 12 months. These are not easy discussions for people who may have been uninsured all their lives.

Ms. Quenga said it was not true that most eligible people now know about the coverage available under the Affordable Care Act. Its ludicrous to believe that everyone now knows that the Affordable Care Act is alive and well and open for enrollment, Ms. Quenga said. Many people believe that the law is dead, or will be dead, based on the administrations claims.

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Trump Administration Sharply Cuts Spending on Health Law Enrollment - New York Times

Short Answers to Hard Questions about Health Threats from Hurricane Harvey – New York Times

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What about other diseases spread by mosquitoes, like West Nile?

West Nile virus is endemic in the United States and outbreaks are triggered by several factors, including the concentrations of culex mosquitoes, humans who are not immune, and birds who are not immune. (The virus builds up to higher concentrations in bird blood than in human blood, so mosquitoes tend to pick it up from them to give to humans.) Birds were also probably driven away from coastal Texas by Hurricane Harveys winds.

In 2005, in the wake of Hurricane Katrina, there was initially no increase in cases of West Nile virus or St. Louis encephalitis, which is also spread by mosquitoes, noted Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. But a year later, there was a surge in dangerous neuroinvasive West Nile disease in the affected regions of Louisiana and Mississippi: Cases of encephalitis and meningitis more than doubled. Researchers from Tulane Universitys School of Public Health and Tropical Medicine speculated that more people were bitten that year because they were outside doing reconstruction work or living inside partially-destroyed houses that mosquitoes could invade easily.

The big thing Im worried about is norovirus, said Dr. Persse, Houstons chief medical officer. Thats the cruise ship virus with a lot of people in a small space, it can spread really quickly.

The disease causes vomiting, diarrhea and dehydration. It is not normally fatal to otherwise healthy people, but severe dehydration can kill frail older adults.

In shelters, it can be hard to control. Health officials try to stop outbreaks by quickly taking the sick to separate rooms where they are given food and entertainment, there is no wait for toilets and the floors are washed frequently with bleach.

Dr. Persses medical teams are walking through shelters now looking for people vomiting. Shelter populations are thinning out as people return home or find other places to stay, so the danger is decreasing.

After Hurricane Katrina, 200,000 refugees ended up in 750 shelters in 18 states, and there were scattered outbreaks of various diseases, the C.D.C. said.

About 1,000 cases of diarrhea in more than 20 shelter clusters were reported. One Dallas-area shelter had 30 skin infections with MRSA, an antibiotic-resistant form of staphylococcus bacteria.

Officials worried about tuberculosis transmission, one new case was found in a shelter. Health authorities were able to trace about 70 percent of the patients they knew had previously been on TB treatment so they could be kept on it, the C.D.C. said. TB patients who are taking their antibiotics are usually not infectious.

That is not likely, but dead bodies may leak feces that will contaminate the water and could lead to gastrointestinal infections.

First, make sure that your electrical system is safe and there are no gas leaks. Check for structural damage.

Once inside, there is likely to be toxic sludge. Throw out any food that has come into contact with floodwaters, unless its well packaged in metal, waterproof glass or hard plastic containers. Even then, wash it off first.

Dont run gas-powered electrical generators indoors or use gas or charcoal grills indoors. These can cause carbon monoxide to build up and kill you.

Many people are already back into their homes that have been flooded with two or three feet or more of water, said Winifred J. Hamilton, director of the environmental health service at Baylor College of Medicine. We are already seeing piles of carpet and sofas on the curb.

As the water dries, she said, you are going to have mold spores made airborne.

She advised anyone who has asthma, respiratory disease or is immune-compromised not to take on the cleanup. You should get someone else to do it if possible, she said. And wear personal protection equipment so that you are not breathing in toxins.

Yes, watch out for snakes. Humans arent the only creatures who were seeking dry ground.

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Short Answers to Hard Questions about Health Threats from Hurricane Harvey - New York Times

The Unexpected Health Impacts of a Hurricane – NBCNews.com

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Eight years after Hurricane Katrina devastated the New Orleans area, a 4-year-old boy died after playing on a backyard Slip 'N Slide. He had been infected with a brain-destroying amoeba called Naegleria fowleri.

It was the first time the amoeba had been found in tap water in the U.S. and health officials said it had likely grown there as a result of Katrinas devastation.

But not because of any toxic gumbo spread by floodwaters. Instead, the state health department said, the microbe grew in water pipes that stretched across neighborhoods emptied by the hurricanes destruction. As fewer people drew on water supplies, water could sit in pipes for longer, creating a warm and nourishing environment for the amoeba to grow.

The solution: flushing the pipes repeatedly with fresh water and chlorine disinfectant. But the problem remains. Evidence that the amoeba still survives in the water system keeps popping up, even as late as this summer.

Related: Killer Amoeba Lurks in Louisiana Tap Water

Its a valuable lesson about expecting the unexpected after a flood. People are sharing social posts about getting tetanus vaccines, about potentially deadly bacteria in fresh floodwaters and about outbreaks of cholera. But the U.S. is not especially prone to outbreaks after natural disasters.

Increases in infectious diseases that were not present in the community before the flood are not usually a problem, the Centers for Disease Control and Prevention notes.

Most immediate health problems after any disaster in the U.S. are fairly ordinary, said Dr. Michael Millin, associate professor of emergency medicine at Johns Hopkins University School of Medicine and medical director for fire and EMS services in Prince Georges County, Maryland.

There will be sunburns, insect bites, he said. People may get dehydrated if they run short of clean drinking water, or get an upset stomach if they drink contaminated water. But ordinary problems can turn deadly fast during a disaster. Patients with chronic medical conditions such as diabetes or kidney disease may run out of the supplies they need to manage their disease and they can become very ill and even die.

Carbon monoxide poisoning is also a big threat as people run generators and dont set them far enough away from houses, or cook on grills inside garages or too near to windows or, even inside their homes.

But some health dangers from floods are subtler and longer-term.

"I think we are going to be looking at a 15- to 20-year recovery for the region of Texas that is affected," said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

"I think it is going to be the most complex and costly disaster recovery in U.S. history, including the very widespread impact of the flooding."

Here are some of the risks:

Thursday morning at least two explosions sent smoke into the air at a flooded chemical plant operated by Arkema Group. Experts said the chemicals in the smoke would dissipate quickly, but 15 deputies were treated and released from hospital after breathing in the irritating smoke.

Those chemicals are unlikely to cause long-term damage, but the Houston area has dozens of Environmental Protection Agency Superfund sites. They include the Brio refining site 20 miles south of the city, where petrochemicals such as diesel, toluene, ethylbenzene and jet fuel were reprocessed; Crystal Chemical Co., where herbicides including arsenic-based products were made and which has a history of releasing arsenic after flooding; the French site where petrochemicals and heavy metals were dumped and where they remain in the soil and water; and others.

Related: Thousands Take Shelter from Harvey in Houston

Solvents such as ethylbenzene and toluene can get into air, water and soil but break down quickly. However, heavy metals such as lead and mercury never leave soil and if they get spread by flood waters, they can settle into farmland, grazing pasture, get into groundwater and settle in peoples yards. The effects can take years to discover but both are nerve toxins especially dangerous to infants and young children.

The flood has passed through and over gas stations, repair shops and storage depots and there will be no controlling where the waters spread and deposit chemicals from these locations.

"There is going to be a level of contamination that we have never seen before in floodwater because of the proliferation of chemicals plants, oil refineries," Redlener predicted.

"Even when the waters recede, well still have the soil surfaces where the water was that will still be rife with pollutants of all kinds. When will it be safe to drink water, have kids walk around barefoot? I dont think anyone knows yet."

Most Houston area hospitals have done a good job of preventing permanent damage and none are expected to have to close long-term. For instance, the Texas Medical Center, home to Texas Childrens Hospital, Baylor College of Medicine, MD Anderson Cancer Center and other very high-profile hospitals, installed floodproof doors in its underground connecting passageways.

But smaller clinics, such as ambulatory care centers, dialysis centers and drugstore-based walk-in clinics are sprinkled throughout neighborhoods and those that have been badly flooded could be out of operation for weeks or months. Pharmacies, too. Houston was difficult to get around pre-Harvey, and after this catastrophic flood it will be even harder. Displaced people and those who lack cars will be especially unable to find alternatives for daily care.

Patients who are on dialysis, if they dont get dialysis, they get short of breath and they can get pretty sick, Millin said. Patients can die after missing just a few treatments.

"Huge numbers of adult Americans, close to 50 percent, are taking some sort of really important medications: asthma medication, heart medication," Redlener said. "Are the supply chains for those medications working properly? Because if not, we are going to see complications of some illnesses, even fatalities."

More immediately, thousands of people are trapped by the floodwaters, unable to get to local pharmacies, or to be reached by ambulance. "What happens if somebody gets really sick? Or if a child has a serious asthma attack and has to go to the hospital?" Redlener asked.

It's already happening. "People can't go to pharmacies because they're not open. They're under water," said Dr. Terri Schmidt, chief medical officer for one federal medical response team at the Houston Convention Center. "They can't get their regular medications. There are lots of behavioral and mental health issues because people are stressed again are off their medications."

Even a little water damage can cause long-term problems for a house. Mold grows quickly, and people who were not sensitive to mold spores before can acquire a sensitivity if they breathe in large amounts, the CDC advises.

"You can predict enormous problems with mold infestation," said Redlener.

And people's efforts to clean up could worsen them. "If the HVAC system was flooded with water, turning on the mold-contaminated HVAC will spread mold throughout the house, CDC cautions homeowners on its website.

More immediately, homeowners may come back to flood-damaged homes and turn on electricity without thinking. Doing so in standing water could be deadly. If you see frayed wiring or sparks, or if there is an odor of something burning but no visible fire, you should immediately shut off the electrical system at the circuit breaker, the CDC advises.

And salvaging a wet car can also be tricky. Car batteries, even those in flood water, may still contain an electrical charge and should be removed with extreme caution by using insulated gloves. Avoid coming in contact with any acid that may have spilled from a damaged car battery, the CDC notes.

Food touched by flood waters should be thrown out, unless it was in impermeable packaging and even then the packaging should be thoroughly cleaned with soap and water or a bleach solution. The Food and Drug Administration issued a warning earlier this week about food distributors and the risk of using food contaminated by flood waters.

The trauma of being flooded, of fleeing homes, of losing property and of spending days or weeks on end in crowded shelters with little or no privacy, will add up, Redlener said.

"The mental health issues here are going to be considerable," he said. Post traumatic stress disorder, depression and anxiety are all possible consequences of surviving a disaster.

Kids especially, may suffer long term, said Redlener, a pediatrician who helped found the the Childrens Health Fund to help kids with such problems. Many will have been separated from their parents. "Children are very vulnerable psychologically," he said.

Related: Houston's Zika Virus Hotspot

The immediate flooding can actually wash away mosquitoes and clear out the places where they shelter, such as inside sewer pipes, dumped tires and in stagnant ponds. But after things start to dry out, weeks and months and even years down the road, debris and new ponds of standing water could provide even more places for disease-carrying mosquitoes to breed and spread.

Houston is home to mosquitoes that spread West Nile virus, dengue, Zika and other potentially deadly infections.

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The Unexpected Health Impacts of a Hurricane - NBCNews.com

The Long-Term Health Consequences of Hurricane Harvey – New York Times

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Visits to the doctor for conditions such as asthma and heart disease also increased significantly after Hurricane Iniki. Harvey caused the shutdown of dozens of dialysis centers. Patients with kidney disease rely on dialysis several times per week, and missing even one session can have severe consequences.

But large floods and other natural disasters have longer-term physical and mental health consequences were less attuned to. Well after the event has faded as a top news story, victims continue to suffer and struggle.

A 2012 systematic review published in Environment International documented floods tolls on human health, also covering longer-term effects. Flood-affected areas can experience higher mortality rates for months. For example, after Hurricane Katrina, the mortality rate in the New Orleans area was 47 percent above normal for the first half of 2006, up to 10 months after the storm. After Iniki, the mortality rate from diabetes went up significantly in the year after. Heightened rates of chronic illnesses can persist in flooded areas for decades.

Many studies document a surge in mental health diagnoses in populations that experience floods. These, too, can last years. Six months after floods in Mexico in 1999, a quarter of the affected population still had symptoms of trauma or depression. Increased rates of both could still be detected two years later, particularly among those among those who had experienced the worst aspects of flooding: flash floods, mudslides, the witnessing of injury or death, and displacement.

Similarly, months after floods in Thailand and South Korea, those with more harrowing experiences were four times more likely to have symptoms of post-traumatic stress disorder or depression.

In a post-Katrina assessment, the Centers for Disease Control and Prevention found that though a quarter of respondents lived with someone who needed mental health counseling, fewer than 2 percent received it. Another C.D.C. assessment found that one-fifth to one-quarter of New Orleans police officers had symptoms of P.T.S.D. or depression three months after the flood. Other analyses showed that suicide rates spiked in New Orleans in this period and that rates of P.T.S.D. among workers there were high.

Floods can also have lasting effects on infants and children. With access to obstetric services challenged during and after a flood as well as negative effects on pregnant womens physical and mental health researchers have found worse pregnancy outcomes in flooded areas. One study of women who became pregnant in the six months after Hurricane Katrina found that exposure to the hurricane was associated with earlier delivery and delivery of a lower-weight infant. Another study of pregnant women exposed to flooding in North Dakota in 1997 had similar findings, but also found increased risks to the mother, including anemia, eclampsia and uterine bleeding.

Research tells us how we might respond to natural disasters like Harvey. Recommendations include public education about health effects and precautions, and improved surveillance programs to detect diseases or complications that usually increase after a disaster. They also include monitoring communities for mental health problems, then providing the services needed to care for them, and paying special attention to pregnant women. If you or those you know have been directly affected by Harvey, the C.D.C. has many helpful links on how to cope with a disaster or traumatic event.

Everyone is understandably focused on the immediate dangers from flooding. But analysis of previous natural disasters shows that Harveys survivors will need attention and care far into the future.

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The Long-Term Health Consequences of Hurricane Harvey - New York Times

Why Tencent is plowing tens of millions into American health tech start-ups – CNBC

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The largest Chinese internet players, Tencent, Baidu and Alibaba all have investment teams in Silicon Valley and other U.S. tech hubs.

But Tencent in particular has set its sights on health care, the U.S.' fifth-largest economy, say people familiar. The company is motivated in part by the health-care problems in China, which include a shortage of doctors and high rates of some cancers.

China is expected to have more than 800,000 lung cancer cases by 2020 on account of pollution and high smoking rates. It also has more people living with Alzheimer's disease than any other country.

"The health-care problems in China are huge," said Ted Driscoll, a Silicon Valley-based medical investor with the Chinese investment firm Decheng Capital. "They (Chinese investors) are interested in any start-ups that have a novel way of dealing with it."

Some of these U.S. companies have not yet expanded to China, but others used the investment to build a presence in the country.

One of Grail's first moves was to merge with a Chinese company called Cirina, founded by notable Chinese scientist Dennis Lo. That deal, if successful, would allow Grail to commercialize its cancer test in both Asian and Western markets.

There's also a huge interest in bringing artificial intelligence to China, with broad support from the government. AI is viewed by policymakers as a tool to replace some of the tasks typically performed by human doctors, so more people can access the treatment they need.

Walter De Brouwer, founder of Scanadu, recalls that technologies like AI were attractive to Tencent's investment team.

"How I see it is that in America, we went from paper to e-health to mobile health to AI health," he said. "In China, they have an opportunity to leapfrog straight from paper to AI."

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Why Tencent is plowing tens of millions into American health tech start-ups - CNBC

Destruction in chemical hub Houston raise post-hurricane health concerns – PBS NewsHour

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MILES OBRIEN: Todays explosions at the Arkema chemical plant northeast of Houston are underscoring concerns about the hazards of dangerous chemicals in the area.

Houston is a major hub for refineries and has some of the largest petrochemical operations in the country.

Our science producer, Nsikan Akpan, has been looking into those concerns. He published a piece this week documenting some of the other leaks and ruptures in the region.

It is on our Web page.

Nsikan, tell us a little bit about what we know about Arkema, first of all, what is happening there.

NSIKAN AKPAN: So, Arkema produces organic peroxides, so these compounds that are used to make plastics.

And the thing is that they are inherently unstable. So, they tend to react with other elements in the environment. They are also very sensitive to the heat. So, Arkema was storing these compounds in refrigerated boxes. And when the power went out, the heat rose, it led to pressure to build, and you had this explosion.

MILES OBRIEN: And, unfortunately, the backup systems didnt keep the materials cool, and hence you had this difficulty.

Lets listen basically to Richard Rennard, who is an executive with Arkema.

RICH RENNARD, Arkema: What we have is a fire. And when you have a fire where hydrocarbons, these chemicals, are burning, sometimes, you have incomplete combustion and you have smoke.

And any smoke will be an irritant to your eyes or your lungs or potentially your skin. So, if you are exposed to that, we certainly are encouraging anyone that may be exposed to the smoke coming from this fire to call their doctor or to seek medical advice.

MILES OBRIEN: So, point well-taken. Its not as bad as an outright leak, I suppose, but, with the smoke, there is some concern, isnt there?

NSIKAN AKPAN: Exactly.

I mean, these compounds are corrosive, which means, like I said, they tend to react with things. So, they want to react to the water in your eyes. They want to react with the compounds in your skin.

And that might explain why 15 deputies from the sheriffs office were sent to the hospital, because, you know, potentially, they were exposed to this incomplete burn that he brought up.

MILES OBRIEN: Good reason they have that mile-and-a-half zone around it where people shouldnt go in for now, until this gets sorted out.

Lets look at the bigger picture here. Houston, in general, huge petrochemical facilities, a number of them. You have had a chance to kind of look at the big picture. Tell us what people are looking at, what concerns there are.

NSIKAN AKPAN: So, the Sierra Club looked into EPA data, and they found that 170 chemical, petrochemical and also oil and gas hazardous waste facilities exist in Harris County, which is home to Houston.

Many of these facilities exist in floodplains. And we know that at least a dozen of them were damaged by the hurricane.

MILES OBRIEN: Obviously, a lot of petrochemicals in Houston. Give us an idea of the types of concerns, the specific problems that can crop up.

NSIKAN AKPAN: So, it is known that petrochemical companies, that they have these emissions whenever they start up and shut down.

And so, before the hurricane even arrived, there were reports, regulatory filings by these companies showing that they were releasing hundreds of pounds of these chemicals into the air. But most of them were done in a controlled way, which isnt so much of a hazard to the environment.

If you leak these very slowly, they spread out in the air and they are not going to be toxic to somebody. What happened was, after the hurricane hit, there was so much rain, there was so much wind that there was damage to what are called floating roof tanks.

And so the floating roof tank is exactly what the name suggests, right? So you have a roof that moves up and down depending on how you fill the tank. And what that allows is, it allows for a certain amount of venting. It allows for a certain amount of the chemical to turn to vapor.

What happened was, at some of these facilities, these tanks took on so much water, that their roofs actually collapsed into the liquid that they were holding, which allowed the vapors to escape into the air.

MILES OBRIEN: So, lets talk about other potential hazards. A lot of Superfund sites in Houston. What about those?

NSIKAN AKPAN: So, there about a dozen Superfund sites in Harris County.

Many are in the floodplains. And so far, Harris County has issued about 45 boil water advisories, and I think about and there are about 160 issued for the state.

MILES OBRIEN: OK. So you could ask the question, we knew a hurricane could hit Houston, of course. Are these facilities, when you look at the big picture, are they hardened enough against that threat?

NSIKAN AKPAN: Well, so, other studies have looked at these floating roof tanks and shown that, when hurricanes hit, that they do tend to take on destruction.

So, due to the fact that they are built with very thin walls, that they have very unsturdy foundations, these things do tend to move around when there is a lot of rain and a lot of wind.

MILES OBRIEN: Nsikan Akpan is our science producer. Thank you.

NSIKAN AKPAN: Thank you, Miles.

MILES OBRIEN: There are lots of questions about the health risks associated with this explosion, and what people need to know about the air and water in Houston.

Dr. Anthony Fauci of the National Institutes of Health is here to guide us on some of the public health questions about these toxic chemicals.

First of all, give us an idea. When we hear about chemicals like organic peroxides or benzene, those kind of things either in the air or the water, that naturally raises peoples concern. Help us calibrate how concerned we should be.

DR. ANTHONY FAUCI, Director, National Institute of Allergy and Infectious Diseases: Well, it depends on the concentration of these things.

You were just talking about the smoke because of the fire and the burning. The authorities in that area cordoned off the area, so that you have a circle around, so that you dont get direct exposure to that.

Exposures, if they are mild, in the sense of barely just a small concentration, its mostly an irritant, particularly the peroxides, that in that smoke would irritate the skin or even irritate the lungs. So, for the most time, it could be either just a little bit of a nuisance irritant, or if you get a really big whiff of it, particularly people who have, for example, reversible airways disease, like asthma or different types of hypersensitivity diseases, you could get a serious problem.

For the most part, what Im seeing and Im hearing that is being done there about cordoning off an area to keep people far enough away that at worst it would be just an irritant, hopefully, it stays that way, and we dont see any more of it going to where people are.

MILES OBRIEN: What about when we hear about chemicals that end up for one reason or another in the water itself? How big a concern should that be?

DR. ANTHONY FAUCI: It really depends on what the chemical is.

You had mentioned hydrocarbons, things like benzene and toluene. Those are a little bit more than irritants, because they can be absorbed from the gastrointestinal track and from the lungs.

And when it does, that what you can do is that you can then have toxicities systemically or to different organs. That is really with a whopping dose, so I dont want people to get concerned that if it is a really diluted in water, that there is going to be a problem.

But at its worst, it does have the potential to cause organ system dysfunction, like liver, or kidneys, or even central nervous system, and even some cardiac arrhythmias.

But, again, thats in the extreme. You dont want people to be concentrating that that is going to happen to them if they are in the water and you have a very low concentration of these.

But, ultimately, the capability of that is, it really depends on what the dose is and the concentration.

MILES OBRIEN: Tell us about some of the other immediate health concerns people in your position have as they look at Houston.

DR. ANTHONY FAUCI: Yes.

Well, it really is a broad spectrum. It goes from anything from the immediate, acute thing, and we have already seen it on TV multiple times. You have people, for example, who could drown, that tragic situation of a family drowning in a van.

You have people who could get electrocuted. You could have injuries. That is the first thing. Then, when you have the water which is contaminated with sewage, you can have multiple problems with that.

It could be, you could have gastrointestinal problems by inadvertently swallowing some of the contaminated water that is contaminated with sewage, and you can get a variety of bacterial or viral types of gastroenteritis.

Also, you can irritate or even get infections in the skin. You could have either obvious lesions, scrapes and cuts, for example, in your lower body. We have seen people who are in the water up to their waists. Those are the kind of things that people need to be aware of. That is one of the reasons why Secretary Price of HHS declared a public health emergency and why our own CDC, the Centers for Disease Control and Prevention, are working with the local and state authorities to make people aware of this broad spectrum of health hazards that you need to pay attention to.

MILES OBRIEN: As you look toward the long-term, what are the real concerns and were talking years down the road for people who have been through something like this?

DR. ANTHONY FAUCI: Well, for the long-term down the road, clearly, whenever you have traumas like this with natural disasters, there always is the situation of mental issues, namely, depressions, either de novo depressions in people who have not been depressed or exacerbations of people who have a propensity to depression, and even post-traumatic stress disorder.

Also, as I think people dont fully appreciate sometimes, when you have a situation like this that were seeing on the ground, people get dissociated from their medical care. They dont have access to their standard medicines that they take, or they need medical care that they get interrupted can have long-term effects on their health later on, as well as immediate effects on their health.

So, those are the kind of things that you dont immediately think of when you think of a hurricane or a flood, but that are important health issues.

MILES OBRIEN: Dr. Anthony Fauci is the director of the National Institute of Allergy and Infectious Disease.

Thank you for your time.

DR. ANTHONY FAUCI: Good to be with you.

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Destruction in chemical hub Houston raise post-hurricane health concerns - PBS NewsHour

Health Care Providers Can Use Design Thinking to Improve Patient Experiences – Harvard Business Review

Posted: at 9:43 pm


Executive Summary

Design thinking has taken hold in health care, leading to the development of new products and improved design of spaces. Yet it remains underused in addressing other important challenges, such as patient transportation, communication issues between clinicians and patients, and differential treatment of patients due to implicit bias, to name just a few. If more leaders embrace design thinking, they can leverage a deeper understanding of patients to solve such problems, achieving better clinical outcomes, improved patient experience, and lower costs along the way.

A hospital administrator recently talked to us about an issue that is all too common for patients: missed medical appointments. The story was about a woman named Mary (a pseudonym), a patient with a painful chronic condition who continually failed to keep her regular appointments. In an effort to better understand the problem at hand, the administrator tried to put herself in Marys shoes, and asked about her experience: Was there an issue with transportation? Did she need other appointment reminders aside from the paper letter mailed to her home and the standard phone call?

Slowly, Mary began to reveal the reasons why she never made it to herappointments. Her journey to the hospital was quite daunting. For starters, her painful physical condition required her to arrange door-to-door assistance and special transportation. Everyone involved had to be on the same page for her to make it to her appointment on time, and coordinating the logistics was onerous and stressful.

Mary faced an additional set of challenges once she got to the hospital. Mary sought care at a large academic medical center with multiple entrances and towers; at times she was expected to travel long distances due to the sheer size of the facility. She worried that she wouldnt be able to find someone to push her in a wheelchair, or that she might get lost. Simply thinking about the various hurdles of this journey made Mary anxious to the point oftalking herself out of going at all.

Each year approximately 3.6 million people miss or put off medical appointments due to transportation issues, leading to annual costs for health care providers in the billions of dollars. Missed medical appointments, or no-shows, often create several operational challenges as well, from difficulties rescheduling clinical staff to interference with patient care and treatment. While the consequences of missed appointments have been widely studied, the specific reasons patients fail to show up are not always as clear. But until we understand these reasons, we wont be able to solve the problems. This is where paying closer attention to the entire patient experience from what happens before people get to the hospital to what happens after they leave can help.

Many leading hospitals are starting to focus more on understanding the patient experience to solve these kinds of problems, as well as to improve overall patient experience and to lower costs. Yet its not always easy to get key stakeholders to consider nonclinical aspects of this type of work.

One of the most promising approaches for understanding patients experiences has been design thinking, a creative, human-centered problem-solving approach that leverages empathy, collective idea generation, rapid prototyping, and continuous testing to tackle complex challenges. Unlike traditional approaches to problem solving, design thinkers take great efforts to understand patients and their experiences before coming up with solutions. This thorough understanding of patients (for example, those who regularly miss appointments) is what guides the rest of the process. And because design thinking involves continuously testing and refining ideas, feedback is sought early and often, especially from patients.

Design thinking has already taken hold in health care, leading to the development of new products and the improved design of spaces. Yet it remains underused in addressing other important challenges, such as patient transportation, communication issues between clinicians and patients, and differential treatment of patients due to implicit bias, to name just a few. If more leaders embrace design thinking, they can leverage a deeper understanding of patients to solve such problems, achieving better clinical outcomes, improved patient experience, and lower costs along the way.

How might design thinking be applied to the persistent and costly problem of no-shows? In Marys case, she couldnt explain her concerns throughthe standard patient experience survey, which is initiated after an appointment and which comprisesgeneral questions focused on the medical visit. Were it not for the hospital administrators initiative to ask Mary what was going on, her concerns may have gone both unnoticed and unaddressed.

This tailored, human-centered approach of problem solving is the foundation of design thinking. Hospitals versed in design thinking would identify this general challenge and then assign a team or task force (ideally a multidisciplinary one) to spend weeks or even a few months studying the patients it affects. The team would use qualitative research methods, such as surveys, focus groups, and observations, to better understand peoples experiences. They would seek out patterns and aim to define the real problem at hand. For instance, a team investigating several no-shows would quickly see that many cases do not necessarily involve a patients forgetfulness or time management. Theyd find that the issue faced by patients like Mary is often more socioemotionalthan organizational.

After this phase, the team would brainstorm possible solutions, and then begin rapid prototyping to test them. Depending on the proposed solution, a prototype could be anything from a physical mock-up to a skit or a flowchart. For example, if the team wanted to design a screening process to identify individuals with transport-related concerns, they could design a simple computerized simulation that illustrates how that process might look and feel to both patients and staff. Once created, this prototype would be tested by relevant stakeholders and perhaps even outside parties to collect critical feedback. Often, the feedback indicates when or how to modify solutions, or whether to go back and gather more information. The result is a solution focused on what will most help the patient.

There are already a few promising examples of design thinking being used to create a better experience for patients. For instance, the department of obstetrics and gynecology at Mayo Clinic used design thinking to reimagine prenatal care. They wanted to better meet the expectations and needs of expectant mothers, who desired a greater emphasis on the emotional experience of pregnancy, rather than just the clinical side of it. Through interviews with and observations of local expectant mothers, the design thinking team learned that it was extremely important for these women to have a sense of community. So the department created online care communities, facilitated by nurses and other pregnancy advisers. The result was an overall improvement in how prepared and empowered these expectant mothers felt.

At Johns Hopkins Hospital, elements of the design thinking process are embedded in the hospitals approach to improving care. To provide the human touch that is necessary to improve the patient experience, we have a team of coaches, trained inthe importance of empathy in clinical settings, that teaches caregivers how to partner with patients and be more present with them. For instance, coachesteach clinical staff how to reject a patients request when necessary (for example, when asked for more pain medication) while still projecting a caring message. On the patient side, we have a team of advocates that visit people facing unusually difficult circumstances, such as having to endure a long wait without food or water before surgery. Advocates offer support by connecting them to the right staff members or simply by listening to their concerns. Advocates support patients and encourage them to be engaged in their own care. This often involves identifying what matters to them and their loved ones and, above all, recognizing the patient as a whole person, not as a condition or an illness.

Design thinking can be used to address challenges in a variety of domains related to the patient experience. Consider reimagining the emergency-room waiting experience. Because care is prioritized based on the severity of a patients condition, wait times are difficult to predict. Patients and their families often spend hours waiting to be seen and treated. Design thinking may uncover new ways of helping patients feel comfortable and safe during such long waits. An approach that starts with investigating the patients perspectives, including their greatest pain points, may give administrators ideas for how to make the emergency room experience more bearable.

Its every health care leaders mission to improve patient experiences. Design thinking is a useful process for doing so, as it requires decision makers to empathize with patients, think creatively, prototype, and continually test solutions to these problems. The answers to problems like no-shows start with getting to know Mary and patients like her.

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Health Care Providers Can Use Design Thinking to Improve Patient Experiences - Harvard Business Review

Meredith Celebrates New Fitness Center – Meredith College News

Posted: at 9:43 pm


The Meredith community gathered on August 28 for the unveiling of the new Lowery Family Fitness Center in the Weatherspoon Complex.

A $1 million gift from Ann Lowery, 74, named the new fitness center after her parents, Herman and Ruth Lowery.

This is the kind of reveal I wanted with all of these students here, said Lowery. The best thing about this fitness center is we can all benefit from it and it will help our health and well-being.

The expansion increased the size of the fitness center by 5,400 square feet and will allow for more personalized training, more dedicated staff, and longer operating hours. Meredith athletic teams will also benefit from new areas for team training and sports conditioning. The enhancements will help in recruitment of top-ranked athletes.

There is so much excitement and gratitude for this gift, says Marie Chamblee, dean of education and health and human sciences. This fitness center will provide a place for students and athletes to be active and to be involved.

The Lowery Family Fitness Center has 11 treadmills, 8 bikes, 8 elliptical cross trainers, 4 ascent trainers, 2 rowers, and 6 power lifting racks. To compare, the previous fitness center had 10 cardio machines. There are also free weights, kettlebells, resistance machines, physio balls, medicine balls, bands, and accessory equipment available.

Along with the new equipment is new technology.

On all the cardio equipment are QR codes that can be scanned into the LFconnect App, and it will record the exercise, sets, repetitions, and weight lifted, says Erica Roelofs, director of the Lowery Family Fitness Center. Also, individuals can bring headphones to plug into the machines that allow them to listen to any TV in the fitness center.

The center will give students wellness opportunities not offered before and three physical education courses will be taught in the facility this semester. During those times, the campus community will still have access to the center.

I am very excited that Meredith College is able to provide a facility with so many options to help all improve and maintain their health and wellness to keep going strong, Roelofs said. I truly believe that we have all the essential equipment that any individual could want in a facility. I hope all students, faculty, and staff utilize this great facility as much and as often as they are able.

Roelofs also noted that with the exception of the treadmills, the cardio equipment is self-powered, which allows the center to operate with lower energy costs.

The fitness center is now open to the campus community with the following hours.

Monday - Thursday 7 a.m.-10 p.m.Friday 7 a.m. - 7 p.m.Saturday 9 a.m.-8 p.m.Sunday 12 noon - 10 p.m.

In addition to Lowerys gift, The Parents Fund raised $135,000 in the last two years to support the Fitness Center renovation. And a gift from The Cannon Foundation helped to support the fitness renovation in an effort to enhance enrollment and retention.

To see photos from the renovation process visit meredith.edu/beyondstrong/facilities-and-technology/renovations

Tags for this article:campus events athletics student life wellness

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Meredith Celebrates New Fitness Center - Meredith College News

Hy-Vee to partner with Wahlburgers Restaurants, Orangetheory Fitness – Quad City Times

Posted: at 9:43 pm


As the retail landscape changes, Hy-Vee plans to partner with Wahlburgers restaurants and Orangetheory Fitness, in a move the grocery chain says reinforces its "longstanding commitment to health and wellness, culinary expertise and customer service."

Hy-Vee Chairman, President and CEO Randy Edeker announced the strategic partnerships Wednesday.

The grocery store chain plans to build, own and operate 26 Wahlburger restaurants, nearly doubling that brand's locations. It also plans to put Orangetheory Fitness outlets in or adjacent to Hy-Vee stores.

These unprecedented collaborations reinforce our companys longstanding commitment to health and wellness, culinary expertise and customer experience, said Edeker, in a news release. However, they also represent a bold step to deliberately evolve our business to meet the change in our customers lifestyles and spending habits. These partnerships keep us on the leading edge as the retail grocery industry evolves.

According to the Bureau of Labor Statistics, grocery spending trends began to shift in 2014, and last year, more meals were eaten outside the home than were consumed at home. Millennials spend 44 percent of their food dollars annually on eating out, according to the Food Institutes analysis of the USDA food expenditure data from 2014. Income spent in restaurants and on take-out meals has risen from 34 percent in 1974 to 50 percent in 2014.

There is a changing landscape in the retail industry, Edeker said. Hy-Vee has a responsibility to our customers, employees and communities to look for new ways to strengthen our company. With this type of progressive action, Hy-Vee is well positioned for future growth.

Wahlburgers is a family-friendly burger chain that operates 17 locations in nine states and Canada. Its owners include Executive Chef Paul Wahlberg and celebrity brothers Mark and Donnie Wahlberg. Mark Wahlberg already has a partnership with Hy-Vee, which sells its his Performance Inspired Nutrition line.

Hy-Vee plans to franchise the 26 Wahlburger units in seven Midwestern states, with its first franchise opening in West Des Moines in mid-2018.

Orangetheory Fitness, an intensive group training workout center, operates 750 studios nationwide, and plans to open an additional 1,500 in the next two years. The first Hy-Vee partnered center will open this year in the Twin Cities.

In addition to placing the studios in or near its stores, Hy-Vee dietitians will offer fitness center members dietetic services, along with samples of nutritional products and store tours that showcase products that meet Orangetheory Fitness customers' needs. The partnership bolsters Hy-Vees focus on health and wellness, company officials said, which currently includes in-store dietitians, HealthMarkets, chefs, fresh and organic produce and pharmacies.

Like our members, we know that many Hy-Vee customers are looking for more convenient ways to access fitness and healthy eating options in one location this partnership solves that need," said Orangetheory Fitness Chief Brand Officer Kevin Keith, in a news release.

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How to make room for family fitness after school starts – Buffalo News

Posted: at 9:43 pm


Nearly 85 percent of parents in Western New York believe their children should regularly be involved in sports, yet only 16 percent of school-aged kids in the region get the hour of daily physical activity recommended by the federal Centers for Disease Control and Prevention.

The disparity is among the more striking findings in a "State of Play" reportissued this summer by the Aspen Institute Sports & Society Program for the Ralph C. Wilson Jr. Foundation and Community Foundation for Greater Buffalo.

The report underlines what many parents already know: The nature of organized youth sports has changed, and fewer kids these days are outside running, biking or playing pick-up games than children did a generation or two ago.

"I think a lot of it has to do with screen time. Kids don't know how to play anymore," said Stacy Ribbeck, chair of the Physical Education Department in the Depew Union Free School District.

Fitness benchmarks are easier to hit during summer, when the weather generally cooperates, activities abound and structured days tend to be the exception, not the rule.

The school year differs. In the coming weeks, schedules will fill. Educational demands will grow. The weather will become less predictable.

Still, the importance of physical fitness will remain as will its benefits.

"Getting kids to move helps prevent or delay chronic disease," said Carol DeNysschen, professor and chair of the Department of Health, Nutrition and Dietetics at SUNY Buffalo State. "Their ability to focus and concentrate goes up and it helps increase learning. It helps their overall balance and mental acuity, which helps them better handle stress."

Active kids also benefit communities. If one in four youths in Western New York just 25 percent met the daily CDC fitness recommendations, and stayed active into adulthood, it would mean that 7,500 fewer of them would become overweight or obese, according to the Aspen Institute. It would shrink direct medical costs by $127 million, spare $135 million in productivity losses and salvage 10,015 years of life.

[MORE BACK TO SCHOOL STORIES: Read stories to help you start a morning workout routine and streamline school year meal planning Saturday in the print edition of WNY Refresh in The Buffalo News]

Ribbeck and DeNysschen said they understand the struggle parents face when it comes to helping their children and themselves regularly include exercise in their routines, especially during the school year.

"It's a time crunch," Ribbeck said, "but you've got to do it."

Here's how.

WHAT PARENTS (AND KIDS) CAN DO

Jenna DeNysschen and her family's toy poodle, Missy, run the Tails on Trails race in 2014 in Orchard Park.

"Engaging parents in the effort is the biggest key in getting kids to become more physically active," DeNysschen said. "Kids love it when their parents do something with them, whether it's shooting hoops or going for a walk, playing kickball, basketball, catch."

DeNysschen is encouraged when she sees parents and school-aged children wearing fitness trackers. The devices can help family members set up challenges to take more daily steps or tackle more flights of stairs. Other ideas include:

Take a family walk or bike ride: "Our neighborhood knows we're always out on our bikes," DeNysschen said of herself, her husband, Martin, and their daughters, Ashley, 13, and Jenna, 11. They take quiet side streets to Green Lake near their Orchard Park home. The family also will pile into the car with their windhound, named Dash, and Missy, their toy poodle, and head to Chestnut Ridge Park for a run. "The dogs are 10 years old," DeNysschen said, "but they don't act that way."

Enroll the kids in an organized activity or sport: Organized sports take place in schools, municipal recreation programs and beyond, including gymnastics, dance, running, biking and more. The Depew district, using a federal grant this summer, created a four-week day camp that focused on "lifetime activities" including tennis, swimming, Can Jam, cup stacking and Four Square, the latter of which is kind of like volleyball without a net.

Plan a weekly family activity day: Set aside one day each week to do something active as a family. The DeNysschens like to swim during summer, hike, bike and run when the weather allows, and snowshoe in the winter.

Sneak activity into your daily routine: This goes for you and your kids. "It can be something as simple as taking the stairs instead of the escalator or elevator, turning TV commercials into fitness breaks or parking a little farther from your destination to get in those extra steps," Ribbeck said.

Participate in a family fun run or walk: Hundreds are offered year round in the region. They are a great way to combine family time with healthy activity. The DeNysschens have signed up to run the Holly Jolly 5K on Dec. 2 in Orchard Park.

The 5K Chicken Wing Run takes place Sunday downtown and the Hospice Dash 5K Sept. 16 in Niagara County. Find more races at buffalorunners.com.

Make fitness fun: Families can buy playing card decks that list simple physical activity requirements on them, DeNysschen said. For instance, the 3 of spades will ask someone to do three pushups; draw a 9 of hearts and you will have you do 9 jumping jacks. "Nighttime, when it's time to put on a movie, why not stop every half hour and do a little physical activity: pushups, triceps lifts. Just make it fun instead of just sitting all the time," DeNysschen said. You also can turn chores into family games. "Race to see how fast you can get the house cleaned or rake the leaves in the yard," Ribbeck said, "and then try to beat your time next week."

Start somewhere: "Get up 15 minutes earlier, and somewhere during the day you have that time to exercise," DeNysschen said. "If it's in the morning, great; after dinner, clean up the kitchen and go for a walkOver time, let that time grow."

Set an example: "I know a lot of kids have sports but I always tell people, 'If your kids have a practice, drop them off and go for a walk or a run,'" DeNysschen said. "Do something while they're practicing nearby and you're right there to pick them up."

"I'll be honest. How many parents really need to get moving at the same time?"

WHAT TEACHERS (AND STAFF) CAN DO

Jordan Hibbs, 17, pulls himself across monkey bars during physical education class at Depew High School in June. (Derek Gee/Buffalo News)

"When you have teachers who are giving students the opportunity or the nudges to stay active, that's huge," DeNysschen said.

Send the right signals: Signs and posters stationed in hallways and classrooms that show the proper way to do wall squats or wall pushups can help students engage in exercise while waiting for a class, lunch or the bus.

Incorporate fitness: While preparing for quizzes during class time, teachers can assign students who are able to do a particular exercise when they get a wrong or right answer, including a few jumping jacks or lunges. Last school year, Jenna DeNysschen had a teacher who included 15 minutes of physical activity during the middle of homework assignments. Students had to write down what they did. "She loved that," her mother said, "and when she brought it home, I made sure we did something together." Websites including gonoodle.com and fueluptoplay60.com, can provide other ideas to answer the teacher question, 'How can I get my students out of their seats but still learning?'" DeNysschen said.

http://buffalonews.com/2017/08/31/depew-students-look-add-fitness-time-new-school-year-schedules/

Encourage intramural sports: "Noncompetitive team sports provide a safe outlet for a student who isnt physically coordinated, isnt physically in shape or lets face it, isnt so excited about competitive sports," DeNysschen said. "Keeps kids engaged in a fun way."

Join a wellness committee: Teachers, staff and parents make up these committees. Most schools have them.

Be mindful of age groups: Elementary school students like to jump, throw, kick and catch but can struggle to combine these exercises. Try them individually, a bit at a time, DeNysshchen recommended. Middle school ages 9 to 12 is the time teach kids that physical activity can remain fun. "They can be competitive," she said, "but teach them how to lose gracefully or deal with setbacks or weaker teammates. Very few are Olympians at this age so keep the sport focus in its place as healthy, a stress reliever and a social outlet."

Backpack shopping trip can be a challenge

FAMILY ACTIVITY RESOURCES AT THE BUFFALO & ERIE COUNTY LIBRARIES

Children take turns playing Four Square during the Depew Wildcats for Life summer camp this summer in Fireman's Park . (Derek Gee/Buffalo News)

365 Activities for Fitness, Food, and Fun for the Whole Family: Super sports, great games, exciting experiments, and nutrition nuggets, Julia E. Sweet

The Amazing Fitness Adventure for Your Kids, Phil Parham

The Art of Roughhousing: Good old-fashioned horseplay and why every kid needs it, Anthony T. DeBenedet

Keeping Kids Fit: A family plan for raising active, healthy children, Len Saunders

Sneaky Fitness: Fun, foolproof ways to slip fitness into your childs everyday life; with 50 all new sneaky recipes!, Missy Chase Lapine

Strong Kids, Healthy Kids: The revolutionary program for increasing your childs fitness in 30 minutes a week, Fredrick Hahn

For more ideas, visit the Buffalo & Erie County Librarys Outdoor Recreation subject guide here.

email: refresh@buffnews.com

Twitter: @BNrefresh, @ScottBScanlon

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How to make room for family fitness after school starts - Buffalo News

USDA Providing Nutrition Help to States Hit by Hurricane, Flooding – Gilmer Mirror

Posted: at 9:41 pm


WASHINGTON,Aug. 31, 2017 USDAs Food and Nutrition Service (FNS) is actively working with officials in Texas and Louisiana to ensure that people impacted by Hurricane Harvey have access to food now and after emergency operations are completed.

In this time of crisis, with many grocery stores closed and other sources of food unavailable, USDA is committed to ensuring that our fellow Americans get the vital nutrition they need and is streamlining procedures to make that happen, said Secretary of Agriculture Sonny Perdue. President Trump made it clear to his cabinet that helping people is the first priority, and that process and paperwork can wait until later. USDA is already doing the work to help people in need today.

USDAs Food and Nutrition Service (FNS) is working with officials in the affected region to help feed displaced and affected residents. The agency has granted several waivers in Texas allowing schools in the National School Lunch Program to provide free meals. It has also provided more flexibility to schools in what they can feed kids, given the challenges of preparing specific foods during this period.

FNS works every day to ensure Americans have access to food, but it is during events like this that we have to be nimble, said FNS Administrator Brandon Lipps. Our job is to make it as easy as possible for our programs to be administered in a way that ensures no one affected by this disaster goes hungry.

Steps already taken by USDA in Texas include:

Details of waivers can be foundhere. FNS is concurrently providing technical assistance to Louisiana and offering support as needed.

The FNS response efforts go beyond these programs. The FNS WIC program has policies in place to allow the state flexibility in program design and administration to support continuation of benefits to participants during times of natural disasters. With a number of WIC clinics damaged or closed during the hurricane, FNS held a conference call with Texas WIC State agency to provide this information and offer any other technical assistance needed to ensure WIC participants received help in obtaining food.

Although USDA food has not been requested as yet, FNS has coordinated with the Texas State Department of Agriculture to provide food deliveries to voluntary organizations as needed. FNS has determined the available USDA food supplies in Arkansas, Louisiana, Oklahoma and Texas in anticipation of requests by the Federal Emergency Management Agency to provide food deliveries.

FNS is also ready to support the state for other SNAP waivers that may be needed to support recipients who have lost food due to the disaster and to simplify the application process for affected households, as well as waivers covering Child and Adult Care Food Program sites and schools used as shelters.

In addition, FNS will provide infant formula and food to infants and children housed in disaster congregate shelters if requested. FNS can typically fulfill a request for these items 24-48 hours after receiving a request from the state or the FEMA.

In the coming weeks, at the states request, FNS also stands at the ready to offer continuing food assistance through the Disaster Supplemental Nutrition Assistance Program (D-SNAP) after commercial channels of food distribution have been restored and families are able to prepare food at home, Perdue emphasized.

To simplify program administration in disaster conditions, the D-SNAP application and eligibility process is shortened and streamlined. In times when D-SNAP becomes necessary, low-income households not normally eligible under regular program rules may qualify for D-SNAP if they meet the disaster income limits, which are slightly higher, and have qualifying disaster-related expenses such as loss of income, damage to property, and relocation expenses. Additionally, ongoing SNAP clients may also receive disaster assistance in the form of a supplement, when their benefits are less than the monthly maximum, to help replace food destroyed in the disaster.

USDA's Food and Nutrition Service administers 15 nutrition assistance programs, including the National School Lunch and School Breakfast programs, the Child and Adult Care Food Program, the Summer Food Service Program, the Special Supplemental Nutrition Program forWomen, Infants and Children,and theSupplemental Nutrition Assistance Program, which together comprise America's nutrition safety net. For more information on FNS assistance during times of disaster, visitwww.fns.usda.gov.

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Personalized Nutrition: Hype or Hope? – Nutritional Outlook

Posted: at 9:41 pm


Just about everywhere you look, tailor-made products and services are transforming the consumer experience. Personalization is the name of the game, whether its getting e-mail offers for flights seemingly hand-picked for you, or scrolling through a Facebook feed thats designed to show you exactly what you want to see. For supplement firms, it means offering consumers more tools that allow them to make the best dietary decisions for themselves, rather than handing out one-size-fits-all recommendations.

Personalization is all about consumers no longer trusting the experts and wanting to become more empowered and confident to create their own healthy eating patterns, says Joana Maricato, research manager at New Nutrition Business. She adds that consumers no longer see dietitians and health professionals as the experts on food and health, and their beliefs are becoming more fragmented.

Food and supplement companies big and small are taking notice. Last October, Campbell Soup invested $32 million in personalized nutrition start-up Habit, which aims to offer a variety of tailored approaches to nutrition, including DNA testing, consumer-specific dietary advice, and customized ready-to-eat meals delivered straight to consumers doors. And in the supplements space, Maricato points to the small, but growing, number of companies with personalization concepts.

Most large and medium-size players in the market have started to form teams focused on [personalized nutrition], have designed and developed pilots, and started to look for opportunities to participate or win in that space, Rony Sellam, CEO of personalized health-analytics firm Segterra (Cambridge, MA), tells Nutritional Outlook. Segterra is the company behind InsideTracker, a personalized nutrition service that encourages users to assess the effectiveness of their diet with at-home tests and an online analytics platform buoyed by the advice of health professionals.

Blood testing, wearable devices, apps, and DNA testing are among the many forms personalized nutrition can take today, but which concepts are backed by research, and which are driven primarily by hype?

The Challenge of Nutrigenetics

One aspect of personalized nutrition thats attracted plenty of attention in recent years is nutrigenetics, the concept of using some degree of DNA testing to arrive at dietary recommendations specific to an individuals genetic makeup. In theory, nutrigenetics would allow firms to perform a full or partial DNA analysis of an individual and identify single-nucleotide polymorphisms (SNPs)variations in the genetic code that can sometimes suggest susceptibility to certain diseases, explains Raymond Rodriguez, PhD, professor, Department of Molecular and Cellular Biology at the University of California, Davis (Davis, CA). Then, based on that analysis, the firm would provide dietary recommendations that are optimized for the genetic predispositions of that person.

Many of the companies in the personalized nutrition market are relying on a small number of SNPs in a small number of genes to make assumptions about diets that can minimize risk for some future disease or disorder, Rodriguez explains.

But as compelling as the idea of nutrigenetics is, and as affordable as it has become (most commercial tests range from $99$300 nowadays), do we actually have the published research to back it up? Studies have long found that different people respond differently to the same diet, and that DNA may be associated with those different responses. For instance, a 2014 study found that individuals with a higher number of obesity-associated genetic variants who also consumed high levels of saturated fats were more likely to have a higher body mass intake (BMI).1

But as with many such studies, researchers relied on self-reported dietary information to construct this trial. Meanwhile, the kind of research most needed for nutrigenetics to really get the approval of the broader scientific communitylong-term, dietary-intervention clinical studiesis sorely lacking at the moment.

There are no large-scale clinical studies in relation to personalized nutrition, says Jos M. Ordovs, PhD, director, Nutrition and Genomics, and professor, Nutrition and Genetics, at the Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University (Boston). What we have is a smorgasbord of small, inconclusive, irreproducible studies scattered in the scientific literature that are cherry-picked by the interested parties to support their individual claims. He adds that he has seen promising early DNA-based research in the areas of weight management and cardiovascular health for certain specific foods and nutrients, but that overall, we dont have validated evidence from the perspective of nutrigenetics that the approach really works.

One reason for the scarcity of clinical research is the difficult nature of studying the relationship between genetics and diet. Hooman Allayee, professor, Departments of Preventive Medicine & Biochemistry and Molecular Medicine, at the Keck School of Medicine, University of Southern California (Los Angeles), explains that while its now become relatively easy to obtain high-quality genetic data, its much tougher and more costly to build a large-scale, long-term study where the participants are held to a controlled diet. Even then, if an association is found between one or more genetic variants and dietary intake, more rigorous research that controls for both the diet and the particular genetic variant would still be necessary to replicate the findings, says Allayee.

That kind of rigor is what I think is missing in the field, Allayee says. Thats where the hang-up is. People havent gone and validated these gene-dietary interactions.

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