ACA heads back to court, with health care for millions on the line | MSNBC

Health care hasn’t been a front-burner issue for the political world in recent months, but today in the 5th Circuit Court of Appeals, the fight over the Affordable Care Act returns to the national spotlight.

A panel of federal judges in New Orleans takes up the future of Obamacare on Tuesday, hearing from states that say it’s unconstitutional and from Justice Department lawyers directed by President Donald Trump to oppose the entire law, too.

The Texas v. United States case is as multifaceted as it is important, so let’s dig in with some Q&A.

It’s been a few months since I’ve thought about this and I’m feeling a little rusty. What are we talking about again?

The U.S. Supreme Court already sided with the ACA – twice – but the Republican tax plan changed the policy landscape a bit. As regular readers may recall, when GOP policymakers approved their regressive tax plan, they simultaneously zeroed out the health care law’s individual mandate penalty. And that, in turn, gave several far-right attorneys general an idea: they could once again file suit against “Obamacare,” arguing that the penalty-free mandate is unconstitutional, and given the mandate’s importance to the system, the entire law should be torn down.

That sounds like a rather desperate ploy. Is anyone actually buying this argument?

Yes. Shortly after the 2018 midterm elections, U.S. District Judge Reed O’Connor – a Bush-appointed jurist in Texas – agreed so enthusiastically with the Republican arguments that he struck down the entirety of the Affordable Care Act. That ruling, however, didn’t go into effect, and it’s currently on hold as the appeals process moves forward.

I’ve heard for months that this case was about Republicans trying to get rid of protections for Americans with pre-existing conditions, but it sounds like that ruling was even more sweeping.

Correct. The judge in the case could’ve ruled against the ACA in a narrower way, but he decided instead to take a sledgehammer to the American health care system, because he felt like it, giving Republicans even more than they expected.

Did the ruling make sense?

It did not. Even some conservative legal experts, who’ve been deeply critical of the ACA, have criticized the decision, with one calling it “embarrassingly bad.”

So the 5th Circuit will reverse it, right?

For health-care advocates, that’s certainly the hope. The trouble is, the case will appear before a three-judge panel, and two of the judges were nominated by Republican presidents: one from George W. Bush, the other from Donald Trump. (The third judge in this case was a Carter appointee.)

Didn’t I hear something about a possible standing issue?

The 5th Circuit recently asked both sides in this case to explain why those defending the ACA have the right to participate in the case.

I’m confused. Why wouldn’t they?

Because originally, the case pitted Republican opponents of the health-care law against the Justice Department, which was responsible for defending the ACA. The Trump administration, however, switched sides, endorsed the Republican argument, and asked the judiciary to destroy the existing health care system. Congressional Democrats and several state attorneys general intervened to defend the law, but there’s some question as to whether or not the 5th Circuit will allow them to argue the case.

And if the appeals court rejects the appeal over standing concerns?

Then the lower court ruling would stand and the case would be appealed to the U.S. Supreme Court.

Is that likely?

For now, that’s unclear. It’s possible the 5th Circuit was just being thorough, and once the standing issue is resolved, the case will focus in earnest on the mandate and the question of whether the entirety of the ACA must be torn down. (Even Trump’s Justice Department has conceded that Democrats should be seen as having standing in this case.)

My family has health security because of the ACA and you’re making me awfully nervous.

In the short term, don’t panic. The Affordable Care Act is still the law of the land, the consensus among legal experts is that the case against the law is very weak.

That said, those same legal experts thought no judge in his/her right mind would take the last anti-health-care lawsuit seriously, and three Supreme Court justices endorsed it anyway. The high court is even more conservative now than it was a few years ago.

You’re still not making me feel better.

Well, then let me close with one final observation. The last time the Supreme Court considered the legality of “Obamacare,” it prevailed in a 6-3 ruling. Of the six justices in the majority – Roberts, Kennedy, Ginsburg, Breyer, Kagan, and Sotomayor – five are still on the nine-member bench. It’s why, when push comes to shove, most of the people involved in this fight believe common sense and a sensible approach to the law will ultimately prevail.

Three hours of oral arguments will begin in Louisiana later today.

This content was originally published here.

Overtreatment, Lax Scientific Standards Raise Concerns in Dentistry | Forum | Forum | KQED

Chances are a dentist has told you to floss more. But studies from the Cochrane Institute and the American Dental Association have found that many common oral health recommendations such as biannual cleanings, yearly x-rays and flossing have not been verified through scientific research. Forum discusses efforts to steer dentistry toward more evidence-based practices and we’ll talk about challenges facing the field, including charges that many dentists overtreat their patients.

Mentioned on Air:
The Truth About Dentistry (The Atlantic)

Joel White, distinguished professor in restorative dentistry, UCSF School of Dentistry; vice chair, Department of Preventive and Restorative Dental Sciences

This content was originally published here.

7 Heart Numbers That Could Reveal Health Risks

Resting heart rate

Your resting heart rate is simply how many times your heart beats per minute while you’re at rest. A lower resting heart rate is associated with a lower risk of death.  That’s because a lower rate is usually a sign of greater cardiovascular fitness. Athletes, for example, are more likely to have a low resting heart rate because they’re in better physical shape. (Certain medications, including beta-blockers used to control blood pressure, can also lower heart rate.) A condition known as bradycardia, in which the heart rate is too slow, occurs most often in older people.

A good time to check your resting heart rate is first thing in the morning, before getting out of bed. Check it regularly; an exercise monitor can help, but you can do it easily without one. Just take your pulse for 15 seconds and multiply by 4. If you notice that the rate is beginning to trend upward, you may need to boost how much you’re exercising. A rise in resting heart rate over a 10-year period was associated with an increased risk of death, according to a study of more than 29,000 participants that was published in the medical journal JAMA. 

For most people, a resting heart rate between 60 and 100 beats per minute is considered normal, but stress, hormones and medication can affect your rate. Although taking a brisk walk, swim or bike ride raises your heart rate temporarily, these activities make the heart more efficient over time. They may also help you lose weight, which can reduce your risk. If you are overweight or obese, your heart has to work to pump extra blood through your larger frame. Over time, an overworked heart muscle gets thicker, which can lead to heart failure. 

Blood glucose level

Your blood sugar level can fluctuate depending on the time of day, what you eat and when you eat. That’s why a fasting blood glucose test is the most commonly used way to take a reading. You want to see a number less than 100. The body’s inability to regulate blood glucose is the primary component of diabetes. As the digestive system breaks down food into sugar, insulin — a hormone made by the pancreas — helps transport blood glucose into your cells. Diabetes develops when there is too much sugar in the blood because the body either fails to make enough insulin or because the body’s cells become resistant to it. Your doctor may also order an A1c blood test, which is the primary screening used in diagnosing and managing diabetes. The A1c test measures a person’s blood sugar levels over the previous three months, and a normal A1c reading is below 5.7 percent.    A low-fat, low-sugar, high-protein diet with plenty of fruits, vegetables and whole grains is the best dietary prescription for keeping blood sugar in check. Ensuring you get enough vitamin D is also critical; in studies, those with the highest levels of vitamin D in their bodies had the lowest risk of developing diabetes. Consider taking a D supplement of between 800 and 2,000 IU per day, and focus on eating high-protein foods such as dairy products fortified with vitamin D. 

Body mass index

Body mass index, or BMI, is a screening tool often used to determine body fat. It’s a ratio of weight to height that, when too high, can classify someone as overweight or obese. The higher the BMI, the greater the risk for heart disease, stroke, high blood pressure, certain cancers and other chronic illnesses. The National Heart, Lung, and Blood Institute offers an online calculator to estimate your BMI. Generally, a BMI score between 18.5 and 24.9 indicates normal weight. Someone with a BMI between 25 and 29.9 is considered overweight; a score of 30 or higher is considered obese, a major risk factor for heart disease. 

But BMI doesn’t always accurately reflect a person’s body composition. Athletes and other people with very muscular builds may have a high BMI but little body fat. On the other end of the spectrum, BMI may underestimate body fat in older individuals who have lost a lot of muscle mass. 

If your BMI is too high, set realistic short- and long-term goals for dropping the excess pounds through healthy eating and exercise. Shedding as little as 5 percent of your body weight can result in significant changes to your health.

Waist circumference

Some experts consider waist circumference a better way to measure body fat than relying on BMI alone, and people who carry fat around their abdomen, instead of on the hips or elsewhere, are at greater risk for heart disease and type 2 diabetes. To measure your natural waist, grab an old- fashioned tape measure and stand without pushing out or sucking in your belly. Wrap the tape measure around your torso just above your hip bones. (If you lean to one side, a crease forms at the point of your natural waist.) Exhale, then measure. In general, men should aim for a waist circumference of less than 40 inches, while women should shoot for less than 35 inches.  


Studies have found that mixing brief bouts of fast walking, running or biking with longer stretches of slower-paced exercise is more effective at burning abdominal fat than only steady-state exercise. 

VO2 max

Unless you’re an athlete, you’ve probably never been tested for VO2 max. But this measurement can give you a unique perspective on your aerobic fitness. The higher the number, the healthier your overall cardiovascular system. (The numbers above represent the 50th percentile of fitness for 70-year-olds in the United States.)

VO2 max is typically measured by having the subject run on a treadmill to the point of exhaustion. But researchers have developed a calculator that allows you to plug in numbers such as your waist circumference and resting heart rate to determine your VO2 max at home. When the researchers tested their calculations against participants’ actual VO2 max tests, the results were remarkably accurate. The online calculator at worldfitnesslevel.org will tell you both your VO2 max score and your “fitness age,” giving you an idea of whether you’re as young as you feel.

Any kind of cardiovascular exercise — whether it’s running, biking, even weight training — done at a high enough intensity will help to improve your overall VO2 max score. 

This content was originally published here.

What if My Dentist Hasn’t Sent My Child to the Orthodontist? | American Association of Orthodontists

You don’t have to wait for your dentist to refer your child to an orthodontist.

Parents are often the first to recognize that something is not quite right about their child’s teeth or their jaws. A parent may notice that the front teeth don’t come together when the back teeth are closed, or that the upper teeth are sitting inside of the lower teeth. They may assume that their dentist is aware of the anomaly, and that the dentist will make a referral to an orthodontist when the time is right. A referral might not happen if the dentist isn’t evaluating the bite.

AAO orthodontists don’t require a referral from a dentist to make an appointment with them.

Dentists and orthodontists may have different perspectives.

Dentists are looking at the overall health of the teeth and mouth. He/she could be looking at how well the patient brushes and flosses, or if there are cavities. While dentists look at the upper and lower teeth, they may not study how the upper and lower teeth make contact.

Orthodontists are looking at the bite, meaning the way teeth come together. This is orthodontists’ specialty. Orthodontists take the upper and lower jaws into account. Even if teeth appear to be straight, mismatched jaws can be part of a bad bite.

A healthy bite is the goal of orthodontic treatment.

A healthy bite denotes good function – biting, chewing and speaking. It also means teeth and jaws are in proportion to the rest of the face.

The AAO recommends children get their first check-up with an AAO orthodontist no later than age 7.

Kids have a mix of baby and permanent teeth around age 7. AAO orthodontists are uniquely trained to evaluate children’s growth as well as the exchange of baby teeth for permanent teeth. Orthodontists are expertly qualified to determine whether a problem exists, or if one is developing.

AAO orthodontists often offer initial exams at no (or low) cost, and at no obligation.

Visit Find an Orthodontist for AAO orthodontists near you.

When you choose an AAO orthodontist for orthodontic treatment, you can be assured that you have selected a highly skilled specialist. Orthodontists are experts in orthodontics and dentofacial orthopedics – properly aligned teeth and jaws – and possesses the skills and experience to give you your best smile. Locate AAO orthodontists through Find an Orthodontist at aaoinfo.org.

This content was originally published here.

Dentacoin Combines Forces with MobiDent to Promote Preventive Digital Dentistry

June 20th, 2018: We are beyond thrilled to announce our new partnership with MobiDent, an India-based company aimed at making in-home, prevention-oriented dental care accessible and affordable to everyone.

“MobiDent is attempting to create a new Ecosystem for dentistry by creating a new generation of dentists (called Digi Dentists), who are trained in home dental care at the MobiDent Academy for Digital Dentistry, empowered with Caddy Clinic and connected to families who can use our Digital Dentistry Revolution Platform to avail on-demand preventive dental care that is convenient, inexpensive and safe. Now if there is a currency available to all connected parties, why wouldn’t we use it?”, shares Vivek Madappa, Co-Founder at MobiDent.

MobiDent’s Caddy Clinic: “Dental Clinic in a Suitcase”
for Affordable & Accessible Dental Care

MobiDent was founded in January 2011 by Dr. Devaiah Mapangada and serial entrepreneur Vivek Madappa in Bangalore, India’s Silicon Valley. Its unique proposition is called Caddy Clinic, or “dental clinic in a suitcase” and it comprises a portable dental chair and dental instruments and equipment required for basic dental procedures.

Through its revolutionary mobile dental care services, MobiDent brings benefits to both patients and dentists. Patients receive regular dental care right at lower costs and without the unpleasant time-consuming visits in the dental offices. Practicing dentists have the opportunity to treat more patients and young professionals can start their career with lower risk and great savings compared to the investment needed for opening a conventional dental practice*. For the last 4 years the concept has attracted 40 dentists across India with 65 000 patients.

In 2016, MobiDent was placed among the Top 10 from 19,000 business ideas, participating in India’s largest entrepreneurship competition organized by The Economic Times & IIM-A. From the same 10 projects, MobiDent won the first prize awarded by the Royal Academy of Engineering, London.

* Unlike in conventional dentistry where founding a clinic typically costs upwards of Rs.8 lakh ($12,000), the MobiDent taxi model costs only Rs.75,000 ($1,125) and its van model – between Rs.1.5 lakh ($2,250) and Rs.3 lakh ($4,500). Source: www.knowledge.wharton.upenn.edu

Intelligent Prevention & Digital Technology:
Where MobiDent Aligns with Dentacoin

MobiDent also differs from traditional dentistry by its strong focus on preventive dental care, which reduces the chances for serious problems by 80-90%, and thus reduces the costs and pain, according to Dr. Devaiah Mapangada. On that note, MobiDent offers special annual packages for home services which include two home visits per year for a check-up, cleaning and polishing, as well as unlimited tele-consultations, a dental health report, and 10% off on any further treatment.

“This digitized, prevention-oriented, patient-centered approach towards dentistry is in complete alignment with the core mission of Dentacoin. We believe that our cooperation with MobiDent will help dentists achieve the needed higher efficiency while simultaneously dramatically improve patients’ access to preventive dental care,” comments Ali Hashem, Key Account Manager at Dentacoin Foundation.

Dentacoin (DCN) Implemented by MobiDent
for Payments & Rewards

“The moment I heard about Dentacoin, I was open to explore its potential. If the world is heading into a digital revolution, it is necessary to have a new, universal currency, which is not influenced by governments, countries and politics. A currency that can connect all of us digitally, ensuring trust and transparency”, explains Vivek Madappa, Co-Founder at MobiDent.

Now each purchase of Caddy Clinic (available on Indiegogo) will allow dentists to receive a 5% discount and claim their reward in Dentacoin, if they start using Dentacoin Trusted Reviews and accept DCN as a means of payment for their services.

In the upcoming months, MobiDent plans to release a mobile app to easily connect patients with dentists, where Dentacoin will also be implemented.

MobiDent in cooperation with Dentacoin sets a new direction in dentistry, focused on improving dental care and making it affordable through shifting the paradigm from “sick care” to patient-centered preventive dental care and utilizing the digital technology advantages. This partnership will also help expand the Dentacoin network, which currently consists of 4000+ dentists using our tools and thirty five clinics in 14 countries, accepting DCN as a means of payment for dental services. See all Dentacoin partner clinics

This content was originally published here.

American Health Care Treats Canadians Who Cannot Wait

Canadian Medicare, our northern neighbor’s universal health care system, generally receives rave reviews from proponents of nationalized or socialized health care, but the Fraser Institute found that more than 63,000 Canadians left their country to have surgery in 2016.

As Americans contemplate overturning our health system in favor of one similar to Canada’s, we must ask why so many leave.

The Canadian system consistently ranks low or lowest across numerous metrics in the Commonwealth Fund’s extensive survey on health care. With regards to specialists and surgeries, the United States ranked best or nearly best.

The Fraser Institute study did not examine where Canadians traveled for surgery, but given proximity and our much better metrics, most probably came here.

Surgeries
are scheduled after patients are seen by the surgeon, and most people see
surgeons only after a referral by either their primary care physician in
America, or their general practitioner in Canada. In the United States, 70% of
patients are able to be seen by specialists less than four weeks after a
referral. In Canada, less than 40% were seen inside of four weeks.

After being advised that they need a procedure done, only about 35% of Canadians had their surgery within a month, whereas in the United States, 61% did. After four months, about 97% of Americans were able to have their surgery, whereas Canada struggled to achieve 80%.

America
is significantly outperforming Canada in surgery wait times even as it’s likely
that tens of thousands of Canadians come here to use the American system.

General surgery, procedures such as appendectomies, cholecystectomies, and hernia repairs, make up the largest portion of those who leave Canada for care. Based on the latest available date from the Organization for Economic Cooperation and Development, the total Canadian case load for many of these procedures is about 10% of America’s.

America’s
health system is certainly flawed and in need of reform, but there is clearly
something working well enough that our system, despite already treating 10
times more cases of appendicitis, can absorb the dissatisfied Canadians.

This
has been a consistent trend since at least 2014, when an estimated 52,513
Canadians left for their medical care. In 2015, the number went down slightly
to 45,619. 2016 exceeded the 2015 number with an estimated 63,459 patients
seeking care elsewhere.

Moreover, both countries have had comparable rates of private health insurance coverage for the past 20 years, roughly 60-70%. But the Canadian private insurance market is entirely supplemental—it covers co-payments for services not covered or not entirely covered by the provincial insurance.

Primary coverage, which is the predominant form of insurance in America, is all but illegal in Canada, and would be under “Medicare for All” as well.

In the United States, government insurance covers gaps left by the private market. Private insurance is the norm and Medicare and Medicaid provide a health insurance safety net for elderly or low-income Americans.

In Canada, government-provided Medicare is the primary form of insurance, and private plans merely fill in gaps in coverage for those with more disposable income or employee benefits. The two systems are mirror opposites of one another.

Health care is a product of the labor of physicians, nurses, technicians, and a whole ecosystem of health care workers. If making the government the primary payer for these services is so smart, why does the universal system next door shed patients by the tens of thousands to ours?

American health care can be improved and should be; American health care performs about middle-of-the-pack for many other items on the Commonwealth Fund survey. There are many inefficiencies, often government-imposed, that increase the cost of health care and restrict the insurance market.

The administration already has loosened some regulations that will give employers more flexibility in providing health benefits and has begun to push for price transparency, which also should bring down costs.

Whatever the case may be, reforming American health care should focus on enabling our strengths. Under no circumstance should we tear it down and build it anew to resemble the system whose citizens escape by the tens of thousands just to be treated in a timely manner.

The post American Health Care Treats Canadians Who Cannot Wait appeared first on The Daily Signal.

This content was originally published here.

World Health Organization declares Ebola outbreak an international emergency | Science | AAAS

An Ebola victim was laid to rest Sunday in Beni in the Democratic Republic of the Congo.

World Health Organization declares Ebola outbreak an international emergency

The World Health Organization (WHO) today declared that the Ebola outbreak in the Democratic Republic of the Congo (DRC), which surfaced in August 2018, is an international emergency. The declaration raises the outbreak’s visibility and public health officials hope it will galvanize the international community to fight the spread of the frequently fatal disease.

“It is time for the world to take notice and redouble our effort,” said WHO Director-General Tedros Adhanom Ghebreyesus said in a statement. “We all owe it to [current] responders … to shoulder more of the burden.”

As of today, Ebola has infected more than 2500 people in the DRC during the new outbreak, killing more than 1650. By calling the current situation a Public Health Emergency of International Concern (PHEIC), WHO in Geneva, Switzerland, has placed it in a rare category that includes the 2009 flu pandemic, the Zika epidemic of 2016 and the 2-year Ebola epidemic that killed more than 11,000 people in West Africa before it ended in 2016.

The declaration does not legally compel member states to do anything. “But it sounds a global alert,” says Lawrence Gostin, a global health lawyer at Georgetown University in Washington, D.C. During the West African epidemic, for instance, the U.S. Congress supplied $5.4 billion in the months after WHO’s emergency declaration.

Even as they declared the emergency, WHO officials attempted to tamp down reactions they said could harm both the DRC’s economy and efforts to stop the outbreak. “This is still a regional emergency and [in] no way a global threat,” said Robert Steffen, the chair of the emergency committee that recommended the PHEIC designation and an epidemiologist at the University of Zurich in Switzerland, during a press teleconference today. He added in a written statement: “It is … crucial that states do not use the PHEIC as an excuse to impose trade or travel restrictions, which would have a negative impact on the response and on the lives and livelihoods of people in the region.”

The DRC’s minister of health, Oly Ilunga Kalenga, issued a statement accepting the declaration but expressing concern about its motives and the potential impact on his country. “The Ministry hopes that this decision is not the result of the many pressures from different stakeholder groups who wanted to use this statement as an opportunity to raise funds for humanitarian actors,” Kalenga wrote. He said such funds could come “despite potentially harmful and unpredictable consequences for the affected communities that depend greatly on cross-border trade for their survival.”

Steffen’s committee previously declined three times, most recently last month, to recommend that WHO declare the outbreak an international emergency. What changed, he said today, was the 14 July diagnosis of a case of Ebola in the large, internationally connected city of Goma, from which 15,000 people cross the border into Rwanda each day; the murders last weekend of two health workers in the city that is currently the Ebola epicenter of the DRC; a recurrence of intense transmission in that same city, Beni, meaning the disease now has a geographical reach of 500 kilometers; and the failure, after 11 months, to contain the outbreak.

Funding is also at issue. In June, WHO announced its funding to fight the outbreak fell $54 million short; today, accepting the emergency committee’s recommendation, Tedros said the funds needed to stop the virus “will run to the hundreds of millions. Unless the international community steps up and funds the response now, we will be paying for this outbreak for a long time to come.” (A written report from today’s meeting added: “The global community has not contributed sustainable and adequate technical assistance, human or financial resources for outbreak response.”)

When the first known Ebola case in Goma was diagnosed this week, concern spiked about international spread. In addition to being a metropolis of nearly 2 million people where Ebola may spread quickly and be difficult to trace, Goma has an international airport. Separately today, the government of Uganda, in conjunction with WHO, issued a statement describing the case of a fish trader who died of Ebola on 15 July; she had traveled from the DRC to Uganda on 11 July before returning to the DRC.

“Although there is no evidence yet of local transmission in either Goma or Uganda, these two events represent a concerning geographical expansion of the virus,” Tedros said. The risk of spread in DRC, [and] in the region, remains very high. And the risk of spread outside the region remains low.”

Last month, the outbreak’s first known Ebola fatalities outside the DRC were reported in a 5-year-old boy and his grandmother. The two had traveled from the DRC to Uganda after attending the funeral of a relative who died from Ebola.

Health officials are also worried about the safety of those battling the outbreak. Since January, WHO has recorded 198 attacks on health facilities and health workers in the DRC, killing seven, including two workers who were murdered during the night of 13-14 July in their home in Beni. The two northeastern DRC provinces that have experienced the outbreak are also plagued by poor infrastructure, political violence, and deep community distrust of health authorities.

Josie Golding, epidemics lead at the Wellcome Trust in London applauded the declaration of the public health emergency. “There is a grave risk of a major increase in numbers or spread to new locations. … This is perhaps the most complicated epidemic the world has ever had to face, yet still the response in the DRC remains overstretched and underfunded.”

Gostin called the declaration “long overdue. Until now the world has turned a blind eye to this epidemic. WHO has been soldiering on alone, bravely alone. And it’s beyond WHO’s capacity to deal with all of this violence and community distrust.”

PHEICs are governed by the International Health Regulations, a global agreement negotiated in the wake of the 2003 SARS outbreak. The regulations, in force since 2007, stipulate that a PHEIC should be declared when an “extraordinary” situation “constitute[s] a public health risk to other States through the international spread of disease” and “potentially require[s] a coordinated international response.”

WHO officials also today addressed the thorny conflict over whether a second, experimental Ebola vaccine, in addition to a Merck vaccine that has already been given to 161,000 people in the DRC, should be deployed there now. Officials worry that Merck’s stockpile—although it is being stretched by reducing the dose of the vaccine being given to each recipient—will be depleted before the outbreak ends. But on 11 July, Kalenga gave a firm “no,” rejecting the use of any new experimental vaccine in the country because of unproven effectiveness and the potential for public confusion. (A Johnson and Johnson [J&J] vaccine that has been shown to be safe in healthy volunteers is waiting in the wings and its use has been advocated for by several infectious disease experts.)

But today, Michael Ryan, the executive director of WHO’s Health Emergencies Programme, said the organization still supports introducing the J&J vaccine if it can win “appropriate national approval.” “The Ministry has expressed concern about introducing a second vaccine … mainly around the issue of confusion in the local population. We are working through those issues about where and when the vaccine could be used,” Ryan said.

David Heymann, an infectious disease epidemiologist at the London School of Hygiene and Tropical Medicine, and formerly WHO’s assistant director-general for Health Security and Environment, said today’s emergency declaration may have set a precedent. “The Emergency Committee appears to have interpreted the need for funding as one of the reasons a PHEIC was called—this has not been done in the past.”

This content was originally published here.

La Jolla Dentistry: Dr. D’Angelo and team know the power of a smile – La Jolla Light

The dental trio of Dr. Joseph D’Angelo, Dr. Ashley Olson and Dr. Ryan Hoffman comprise one of the largest dental practices in La Jolla — in both number of dentists and office space.

Recently, they expanded their hours to make their comprehensive dentistry services more convenient for their patients. Now, the La Jolla Dentistry office is open Monday and Wednesday evenings, and also on Saturdays, which is quite unusual for a dental practice.

Dr. Ryan Hoffman, who joined the team almost two years ago, told the Light that accommodating the lives of their busy patients is important. “In addition to the technology and all the services we provide, the convenience of coming here is key for working families with children in school, or for college students with strict schedules.”

The D’Angelo, Olson, Hoffman dental office has been located at 1111 Torrey Pines Road since 2004, when Dr. D’Angelo ran a solo practice. “I started out with one or two treatment rooms and gradually doubled in size,” he said. “Then, we doubled again. We have 10 treatment rooms now, and we’ve increased the types of services we provide.”

He said the office is fully equipped to handle just about any dental concern — from implants to veneers, gum recontouring, cosmetic and restorative dentistry, and Invisalign treatments.

Dr. Olson, who joined Dr. D’Angelo seven years ago, noted: “We are continually evolving technology in our office so it gives us added tools to provide exceptional care.”

The philosophy of providing impeccable care permeates throughout the staff, and Dr. D’Angelo is proud of creating such a culture. The office space has a warm and welcoming feel and the treatment rooms have TVs in the ceiling and mounted on the wall.

Dr. Hoffman pointed out that more younger clients are coming in the door these days: “I’m seeing and hearing a lot more in terms of cosmetics, whether it’s Invisalign or veneers, or before-and-after products, because social media makes dentistry so accessible to many more people these days.”

Dr. D’Angelo added: “Every patient seems to have an understanding that they need to take care of their teeth, and fillings and crowns and cleanings are part of that. But I still say two-thirds of what we do is want-based. For the vast majority of people, even though they have regular dental needs, the things they want seem to take precedence over things they know they need.

“People have come to realize that a smile they feel comfortable with — and a smile they can share with other people — impacts everybody around them.”

He explained that patients aren’t accepting ugly removable appliances and bridges anymore, either, they want implants and Invisalign, and they want their teeth white. Those desires drive the practice, with 3,000 patients and more walking through the door each day.

All three dentists agree that it really all comes down to the power of a smile.

As Dr. Olson put it: “(A beautiful smile) improves your work life, your love life, and your sense of self-esteem.” Dr. Hoffman added that on a personal note, “I have friends who’ve never been in a serious relationship and they’ve invested in their smile and now they’re engaged! It’s not necessarily the smile that did that, but it’s the confidence that came from the smile that altered their personality.”

And that smile power is also reaching seniors. Dr. D’Angelo commented: “It’s amazing how many people in their 70s are still highly concerned about how their smile looks. When they feel confident about their smile it makes them feel younger, feel healthier, feel more engaged. We’re changing people’s lives. From that standpoint, what we do is incredibly rewarding.”

The La Jolla Dentistry office of Dr. Joseph D’Angelo, Dr. Ashley Olson and Dr. Ryan Hoffman at 1111 Torrey Pines Road, Suite 101 in La Jolla is a fee-for-service practice, which means it participates with all PPO plans as an out-of-network provider. (858) 459-6224. joethedentist.com

Business Spotlight features commercial enterprises that support La Jolla Light.

Courtesy Photo
The reception area at La Jolla Dentistry, 1111 Torrey Pines Road, Suite 101, La Jolla. (858) 459-6224. joethedentist.com
The reception area at La Jolla Dentistry, 1111 Torrey Pines Road, Suite 101, La Jolla. (858) 459-6224. joethedentist.com (Courtesy Photo)

This content was originally published here.

Child detention is a mental health crisis

The children who have been detained in overcrowded, squalid migrant camps at the border aren’t just facing poor living conditions. They are also facing higher risks of serious mental health problems, some of which could be irreparable.

The big picture: Children are fleeing life-or-death situations in their home countries, and instead of healing their psychological and emotional trauma, federal officials are exacerbating the damage through means that the medical community views as flagrant violations of medical ethics.


The literature is clear: People who seek asylum and are detained in immigration camps, especially children, suffer “severe mental health consequences.” Those include detachment, depression and post-traumatic stress disorder, which put them at higher risk for committing suicide.

What they’re saying: Medical professionals remain appalled at what they’ve seen and are raising alarms the U.S. immigration system is still needlessly hurting the already vulnerable mental health of these kids.

  • Marsha Griffin, a pediatrician in Texas, visited the Ursula detention center in late June with colleagues from the American Academy of Pediatrics. She recalled a young boy in a cage crying because his father had been taken to court and he had lost his aunt’s phone number. Another child relinquished his space blanket, saying it led to nightmares. “This is child abuse and medical neglect,” Griffin said.

Between the lines: Parents and other adult caregivers are usually the only source of stability for children. Every expert interviewed said separating them in any capacity is psychologically damaging and morally intolerable.

  • “The children who are separated — I’m speechless,” said Rachel Ritvo, a child psychiatrist who has practiced at Children’s National Medical Center. “That was what was done in slavery. That’s what was done in the Holocaust.”

The bottom line: “Most kids will have lasting scars from what they have seen or are enduring right now,” said Wes Boyd, a psychiatrist and bioethicist at Harvard Medical School who has evaluated more than 100 asylum seekers in the past decade. “They’re going to need as much medical help as they do legal help.”

Go deeper: Growing up, and parenting, as a refugee

This content was originally published here.

My Orthodontist Thinks I Need Invisalign

I don’t try to make bad choices. Really, I don’t. In fact, I don’t think most people set out to do make them either. I think we all end up in a place we hoped not to be and in retrospect say, well, that was probably a bad idea.

Such was my life this past week when I found myself sitting in an orthodontist’s office being handed an estimate for approximately $8,000 (for Invisalign, I don’t want more braces, of which $3,500 would be covered by my insurance), that would essentially correct (or finish) the job I assumed was completed when I paid $4,000 to get my teefus fixed back in 2012. As sad as it is that if I have to pay all over again, how we got to this point is so much dumber than you can possibly imagine.

It all started in 2007 when I told my then-dentist I wanted braces. In order to do so, I was going to have to get my wisdom teeth removed, so I had all four of my wisdom teeth removed at the same time. Can we talk about that for a minute? Yes, let’s. If you’ve had your wisdom teeth removed, you know they can do general (put you out) or local (numb your mouth) anesthesia. Because all of my wisdom teeth were erupted, they opted for local anesthesia. This is where I learned about how my body responds to numbing agents and pain killers. Basically, it doesn’t. My mouth was numb for a solid 10 minutes before I started to feel the orthodontist literally breaking my teeth in half with some pliers.

Nigga. I cried so hard. It hurt so much, but I made it through thinking that I’d get some pain killers and be high off my gourd for the next week. First, they prescribed me Vicodin. It didn’t work. Then Percocet. Which also didn’t work. Literally, my body didn’t respond to pain killers AT ALL. I pretty much had to wait out the pain in the fetal position on my couch at home for a week and some change. After that experience, I put braces out of my mind, because short of checkups, I didn’t want anything unnecessary done to my teeth.

But then (and we’re about to get to the shenanigans now), while riding around in my car in 2011, I heard a commercial for braces and I said to myself, “P, you should get braces.” There was some number to call, so I called it. And it led me to a dentist’s office in Maryland. Well, I live in Washington, D.C., so that made sense. I scheduled an appointment and showed up for my consultation. And no lie when I tell you I was so dumbfounded at this office: the dentist was a black man but his entire office looked like a Pitbull video shoot. I was in an office full of some of the most beautiful women I’d ever seen. And they all worked there. As far as medical office spaces go, it might as well have been heaven.

I even remember calling a few of the homies to be like, “If you need a dentist, THIS IS WHERE YOU NEED TO BE!” I got my consultation and was told the braces would run me $4,000, and I’d walk away with pristine pearly whites. And all of the work would be handled in-house. And I should just come to them for regular dental services. Cool. SIGN ME UP.

That’s where it started going downhill. For one, while I thought the office was unreal, it was easily the most inappropriate office I’d ever been in. The dental assistants were a little too friendly and familiar. I’m not saying it was a happy endings spot or anything, I’m just saying the folks who worked there were super comfortable in ways that I’m not sure are…appropriate. Well, I got my braces and paid the cost to be the boss. Once that was done, and because my insurance changed, that office was no longer an option. Which made me sad, but I also figured that one complaint might take that office off the map anyway, so perhaps it was just time to move on.

I had permanent retainers on the back of my teeth and recently, the retainers on the back of my top row snapped. Because I could feel my teeth almost immediately start to shift, I found an orthodontist and scheduled an appointment the same way I found any new doctors: I checked the list of folks who would accept my insurance and looked for the black folks.

I went in for an appointment, and in the nicest possible way (and without professionally shitting on her fellow unnamed dentist), the orthodontist was like, “Yeah, your teeth ain’t supposed to do what they’re doing, ever, but since I wasn’t there in the first place, I’m not sure if this is accidental or intentional.” You can imagine how hard I clutched my pearls since I JUST got my braces off in 2012. I asked if she was saying the other dentist fucked up my teeth but made it look like the job was done and she would neither confirm nor deny this. I told her that’s what I get for staying at an office because everybody looks like J.Lo.

In order to address and correct the issue, the estimate came back a cool $8,000 strong. I’d feel dumb not getting them fixed since that was a decision I made in the first place and my teeth would just start crip walking again. Mildly, but a crip walk is a crip walk. But I can’t help but thinking I got got by a dentist’s office that didn’t feel right and stuck me for $4,000 out of pocket. And my teeth aren’t terrible, but the new ortho noticed some things that she had various curiosities about.

And it all takes me back to the fact that I seriously picked an office for braces based on a radio ad.

The moral of the story: Don’t pick dentist offices based on radio ads.

This content was originally published here.