bbcuk--2019-04-22--Older women exploited by IVF clinics says fertility watchdog

Older women exploited by IVF clinics, says fertility watchdog

Older women are being exploited by IVF clinics "trading on hope", the fertility watchdog has warned.  Sally Cheshire, chairwoman of the Human Fertilisation and Embryology Authority (HFEA), told the Daily Telegraph some private clinics were using "selective success rates" to target older women.  IVF is less likely to be successful as a woman gets older.  Since 2004 the number of women in their 40s undergoing fertility treatment has doubled to 10,835 in 2017.  The latest HFEA figures show that, among those using their own eggs, out of 2,265 embryo transfers in 2017, just 75 women aged 43 to 44 ended up with a baby.  For those over 44, the success rate was even lower - amounting to 1% between 2004 and 2017.  Mrs Cheshire told the BBC that some women were not being told their "realistic chance of success" when sold the treatment.  She said all UK clinics needed to be "transparent" about the costs involved, as well as the likely outcome.  Mrs Cheshire added that the clinics giving "selective statistics" tended to be "foreign".  "If you have treatment in the UK, all those clinics are regulated by us - by and large it's a good sector," she said.  "What we're concerned about are more of the foreign clinics who are coming to the UK who are investing here... who absolutely are not being honest."  NHS guidelines recommend that women under 40 should be offered three full cycles of IVF, while those between 40 and 42 should be offered one full cycle. However eligibility criteria varies in different areas of the country.  IVF is not usually recommended for women over the age of 42 because of low success rates.  Mrs Cheshire said some parts of the sector were using "blatant" sales tactics to persuade "vulnerable" women to undergo treatment.  The 50-year-old said she had even been offered IVF treatments herself, by staff who were unaware of her role with the regulator, at a visit to a fertility show in Manchester.  "We now see things like 'guaranteed baby or your money back','' she told the Telegraph.  Mrs Cheshire also called for the watchdog to be given powers to regulate prices, saying that some private centres were charging up to £20,000 for cycles - four times as much as she said treatments should cost.  She said prices were often inflated by the growing use of "add-on treatments", such as embryo glue and endometrial scratches, offered by clinics to boost chances of success.  Caroline, 40, wishes someone had sat her down and given her a realistic cost for her IVF treatment but says that often medical staff do not know for sure.  She was originally led to believe the cost would be £5,000 but it is now at least £16,000.  "The list of treatment costs is just jargon and there are so many options. I think I needed someone to sit me down and say to me 'this is you and this is what it will cost'," she said.  The cost is not the only downside of IVF treatment for Caroline - the hormones have added negatively to the experience.  "I am taking some time off from treatment as I find injecting all the hormones really messes with me emotionally. The injections have bowled me over and made me completely lose it."  Adding: "When you're crying your eyes out at work it's not a good look."  However, Caroline, whose full name we are not using at her request, thinks she will continue with the treatment as she has two vials of sperm left and will likely spend another £10,000.  However, earlier this year the watchdog, which regulates all fertility services in the UK, warned that these were being offered without conclusive evidence that they increase the chance of pregnancy.  Its website now has a "traffic light" rating for such treatments. None have been given the green light, which indicates there is more than one quality trial showing the procedure is effective and safe.  Have you undergone fertility treatment? Do you feel you were persuaded to do so? Please share your experiences by emailing haveyoursay@bbc.co.uk.  You can also contact us in the following ways:


bbcuk--2019-06-24--Gambling addiction clinic to help addicts aged 13 to 25

The NHS is to open its first gambling clinic for children and young people.  The National Problem Gambling Clinic will aim to offer support to addicts aged 13 to 25.  It is part of an expansion of support for those with an addiction announced in an NHS long-term plan which will see 14 clinics open around England.  The Gambling Commission, which regulates the industry, said it was essential people had easy access to support and treatment.  The parents of one young man who took his own life after battling with a gambling addiction also welcomed the announcement.  Jack Ritchie, from Sheffield, started gambling with his dinner money at the local bookies when he was 17. Seven years later, he took his own life.  His parents Liz and Charlie, who founded the charity Gambling with Lives, say the seriousness of Jack's situation was not recognised.  They said their son saw his gambling habit as "a bit of fun" at the beginning. But it soon got out of control.  "But in the end he thought it controlled him."  Liz Ritchie welcomed the news of the clinic for young people. "Of course it's wonderful. And if Jack had had a referral there, then it probably would have saved him.  "But the links to primary care are vital. Jack referred himself to his GP, but he didn't know to refer him. So we need proper training for all our GPs."  Henrietta Bowden-Jones, founder and director of the National Problem Gambling Clinic, said: "Gambling disorder is a destructive condition which doesn't discriminate. It wrecks lives, pulls families into debt and can leave people feeling suicidal."  The new clinic for young people will open this year in London as part of an expansion of NHS services across England.  Fourteen other clinics for adult gambling addicts are set to open - the first in Leeds this summer, followed by others in Manchester and Sunderland.  Until now, specialist face-to-face help has only been available in London at a clinic focused on addicts aged 16 and over.  Health Secretary Matt Hancock said: "I have seen first-hand the devastating impact gambling addiction can have on people's lives and I am determined to do everything I can to help anyone affected get the help and support they need.  "We know that too many young people face their lives being blighted by problem gambling - so these new clinics will also look at what more can be done to help them."  Mike Kenwood, director of development at GamCare - a charity providing support and advice to people affected by problem gambling, told BBC Radio 5 Live more education on the issue "is badly needed" in schools.  "In school you would have been more likely to receive education and awareness sessions around things like drugs and alcohol, safe sex, healthy eating in PSHE [Personal, Social, Health and Economic education] lessons," he said.  "There is a broader agenda which address all those things, but gambling is missing from it."


birminghammail--2019-11-08--Children as young as five treated at gender identity clinics - including dozens of Birmingham kids

More than 30 children from Birmingham were being treated at a gender identity clinic last year, exclusive figures have shown.  Those are the findings of a Reach Data Unit investigation - which can reveal that, across England, kids as young as five are under the care of the Gender Identity Development Service.  There were at least 30 children being treated in 2018/19 who had been referred from the Birmingham area.  Some 21 children had been referred by Birmingham Cross City CCG and nine by Birmingham South and Central CCG.  Fewer than five children from the Sandwell and West Birmingham CCG area were also receiving treatment, though the actual figure was suppressed to protect patient anonymity.  The Tavistock and Portman NHS Foundation Trust runs the Gender Identity Development service, which is based in London and Leeds and is the only one for children and young people in Great Britain.  The Trust said some of the children they see will have been born as male but may not feel like a boy when older - or may prefer wearing clothes or playing with toys that are stereotypically for girls.  They may also feel or say that they are a girl.  In the same way, some children born as female might feel or say they are a boy.  Others might say that neither 'boy' nor 'girl' is the right word for how they feel about themselves.  The Trust said the figures exclude cases that were open but where the child had not yet been seen.  The 30 kids treated at the clinic who’d been referred by Birmingham CCGs was down slightly from 34 the year before, but up from 29 in 2016/17.  It is possible that some of the children from previous years were still receiving treatment in 2018/19 so were included in more than one year of analysis.  A spokesperson for the charity Mermaids said: "It's vital that transgender and gender diverse children get the support they need immediately so they can avoid the distress caused by feeling lost, trapped and alone.  “Research shows a high instance of self-harm and suicidal tendencies amongst kids and teens struggling with their gender identity and the figures are backed up by our own 25 years of experience.  “The good news is that worried parents see a huge difference in their children when they're allowed to explore their gender and express who they are.  “Moods improve, school grades get better, friends are made and a kid who'd seemed sad, angry and isolated comes back to life.  “That's why the guidance from the World Professional Association for Transgender Health advises affirmative care, which means allowing people to live as the gender they truly are, not the gender assigned to them at birth.  “Unfortunately, the Tavistock Centre chooses to take a more questioning approach.  “This, combined with a wait for consultations of up to two years and a further wait to access puberty blockers, is causing a tortuous delay for many young people and we would urge the government to give more funding to the service and for our NHS specialists to assume the WPATH approach.”  Across England, there were at least 2,942 children aged 17 and under receiving treatment from the Gender Identity Service in 2018/19.  Children born as girls were far more likely to be treated by the service - accounting for 2,019 of the total.  Nationally, six children aged five who were born as girls were receiving treatment in 2018/19.  Fewer than five children aged six who were born as boys were also receiving treatment that year.  A total of 27 children aged six were being treated, 49 aged seven and 62 aged eight.  There were 80 children aged nine, 79 aged 10 and 116 aged 11.  The remaining 2,523 children being treated were aged between 12 and 17.  The NHS advises that parents who think their child might be trans or non-binary should visit their GP.  A spokesperson from the Tavistock and Portman NHS Foundation Trust said: “We work closely with young people and their families – plus local healthcare teams when appropriate – to provide support and information as they explore their gender identity development.  “We treat every young person who visits our service individually on a case-by case basis.  “Our clinicians have no preference or expectation for what pathway each young person may choose to follow in relation to their gender identification.  “We appreciate that it can be difficult for young people and their family while waiting for a first appointment at GIDS and are working hard to reduce the waiting times.  “Those on the waiting list can contact a GIDS clinician for any concerns or queries while waiting for a first appointment.  “GIDS is a highly specialist service and operates in a network model with local services.  “There is an important role for local mental health services to support young people with co-occuring mental health or developmental difficulties.  “Similarly, increased awareness of the range of options open to young people and local support to explore their gender preferences prior to attending highly specialist services is helpful as a substantial proportion of young people referred to the service do not ultimately follow a physical treatment pathway.”  THE NUMBER OF CHILDREN RECEIVING TREATMENT UNDER THE GENDER IDENTITY SERVICE, BY YEAR

newsdesk@birminghamlive.co.uk (Alice Cachia, David Bentley)


breitbart--2019-09-16--Pete Buttigieg Renewed Support for Abortion Clinic Headed by Klopfer Staff

The South Bend Tribune reported in October 2017 that Liam Morley, an employee for several years at the Klopfer abortion clinic known as The Women’s Pavilion, was listed as the proposed administrator of the new Whole Woman’s Health Alliance clinic that had applied for a license to perform drug-induced abortions in South Bend.  Rep. Jim Banks, a Republican from Indiana, tweeted the history of Buttigieg’s opposition to a pro-life pregnancy center slated to open next door to the “direct descendant to Ulrich Klopfer’s house of horrors”:  The Tribune noted that, in August 2016, Morley identified herself to its reporter as director of the Pro Choice South Bend group:  Morley said at the time that Pro Choice South Bend, which provides community outreach for women seeking abortions, was not directly involved in efforts to launch another clinic. The Tribune on Friday placed numerous phone calls and e-mails and left messages seeking comment from Pro Choice South Bend, but no one from the group responded. Morley could not be reached for comment.  According to the report, the South Bend area had not had an abortion clinic since November 2015 when notorious abortionist Klopfer ended his appeal of the state’s decision to revoke his medical license amid numerous violations of health and safety standards.  Klopfer’s abortion clinics in Fort Wayne and Gary had also been shut down.  In December 2017, Granger family physician Dr. Laura McGuire expressed concerns about the former South Bend abortion clinic.  “We know that there is an organization here that has the same kind of profile as Dr. Klopfer wanting to come back in our town,” she said, reported WSBT News.  However, in August, Chris Meagher, Buttigieg’s national press secretary, said, “The mayor is deeply concerned by what he views as a new and extreme assault on Roe v. Wade in legislatures across the country,” reported the  Chicago Tribune.  Meagher added the current 2020 Democrat presidential contender “believes that the truly radical idea in this debate and around abortion care is one of banning abortion outright.”  “The South Bend clinic would be the only one for a radius of several counties,” Meagher continued. “It is a restriction on a woman’s right if she is low-income, or doesn’t have a vehicle, and she has to visit multiple times, but the clinic is dozens of miles away.”  In April 2018, Buttigieg created a firestorm when he vetoed a decision made by the South Bend Common Council to allow a pro-life pregnancy center, the Women’s Care Center, to open next door to Whole Woman’s Health.  According to the news report, Buttigieg said his decision to veto the decision was made based on his beliefs of what was best for the neighborhood.  “Issues on the legality or morality of abortion are dramatically beyond my paygrade as a mayor,” Buttigieg said. “I don’t think it would be responsible to situate two groups, literally right next to each other, in a neighborhood, that have diametrically opposed views on the most divisive social issue of our time.”  “Today, we applaud Mayor Pete Buttigieg for standing up for what is right and putting women and families of South Bend first,” the group said in a statement. “This veto shows that he is listening to the community and ensuring access to quality health care is available.”  However, University of Notre Dame president the Rev. John I. Jenkins, who serves on the pro-life Women’s Care Center board, said he was “saddened” by the veto.  “Far from enhancing the harmony of the neighborhood, it divides our community and diminishes opportunities for vulnerable women to have a real choice,” Jenkins said.  As the Washington Free Beacon reported, the pro-life Women’s Care Center ultimately opened across the street from its originally proposed location.  Whole Woman’s Health of South Bend has been providing abortions without a license since June due to a federal judge’s preliminary injunction, reported the Chicago Tribune, but its trial over the final license is scheduled to begin in August 2020.  The abortion provider has called the state’s insistence that it meet the requirement of “reputable and responsible character” as “politically motivated” and “medically unnecessary.”  In 2015, Klopfer’s medical license was suspended after he allegedly failed to report an abortion performed on a 13-year-old girl.  The remains of 2,246 unborn babies were found inside Klopfer’s Will County, Illinois home. Klopfer passed away on September 3.


cbsnews--2019-02-08--Supreme Court blocks Louisiana abortion clinic law

Supreme Court Chief Justice John Roberts joined the four liberal members in temporarily blocking a Louisiana law that would have closed some of the few remaining abortion clinics in the state. Justice Brett Kavanaugh wrote the dissenting opinion.  Abortion rights groups were closely following the case, saying they feared this court, with a new conservative justice, would allow it to take effect — a sign it would permit greater restrictions on abortion rights.  That of course is still possible, as this is only a temporary measure until the court decides over the next few months whether it will hear this case next term. The Supreme Court did not give a reason for granting the stay.  The four conservatives dissented. Justice Brett Kavanaugh wrote separately, saying he would allow the law to take effect but was prepared to reverse course if it did in fact burden a woman's access to abortion, as opponents claimed. The other conservatives didn't join Kavanaugh's dissent, presumably because they believe (as they did in the 2016 case) that the law does not burden a woman's access to abortion.  The law, originally enacted in 2014, has never taken effect. The Supreme Court temporarily stayed the law last week. Justice Samuel Alito said in a brief order Friday that the justices need more time to review arguments for and against the law. The law requires doctors at abortion clinics to have admitting privileges at a nearby hospital. Should the law go into effect, abortion providers say at least one and maybe two of Louisiana's three abortion clinics would have to close.  The Supreme Court struck down a similar law in Texas in 2016, with Justice Anthony Kennedy serving as a deciding vote in the 5-3 decision. Kavanaugh, a conservative jurist who many Republicans hope will help shift the court to the right, has since replaced Kennedy.  A judge in the federal district court in Louisiana struck down the law in 2017, but it was upheld by a federal appeals court in September. The appeals court said it's not clear that any clinic would close.


cbsnews--2019-05-21--Supreme Court abortion clinics face protesters amid restrictive new state laws

Supreme Court, abortion clinics face protesters amid restrictive new state laws

Abortion clinics are facing protesters emboldened by a flurry of restrictive new state laws as they reassure confused patients that the laws have yet to take effect, abortion providers said.  "We have actually had many people calling and say, 'Are you open? Are you still seeing patients? Is abortion now illegal? Will something happen to me if I come for care?'" said Dr. Willie Parker, one of two doctors providing abortions at the Alabama Women's Center in Huntsville recently.  Last week, Alabama enacted the nation's strictest abortion law, making performing abortions a felony at any stage of pregnancy with almost no exceptions. Women who came through the doors held hands with loved ones or curled into chairs as they waited. A television set to a cable news channel aired a segment about Alabama's abortion law.  It is one of only three abortion clinics in the state, and the only one that provides abortions when a woman is up to 20 weeks pregnant. Some patients drove from Mississippi and other neighboring states because of a shortage of clinics.  "Our doors are open, and we continue to be here for women in our communities, and we intend to keep it that way," said Dr. Yashica Robinson, an obstetrician and gynecologist who provides abortions at the clinic.  Georgia , Kentucky , Mississippi and Ohio have also passed laws that prohibit abortion when a fetal heartbeat is detected — about six weeks, before many women know they are pregnant. Missouri and Louisiana are close to enacting similar bans.  None of the laws has taken effect, and all are expected to be blocked while legal challenges work their way through the courts.  But the restrictive bans have since sparked a "Day of Action", triggering demonstrations across the U.S. in defense of abortion rights.  Some lawmakers hope two new conservative justices nominated by President Donald Trump will provide the votes for the Supreme Court to overturn its 1973 Roe v. Wade decision that legalized abortion nationwide. It's a prospect leading many to take to the steps of the High Court to protest.  Hundreds turned out in support of reproductive rights at demonstrations organized by Planned Parenthood on Tuesday, even bringing out some faces of the 2020 Democratic presidential primary field, including Mayor Pete Buttigieg, Sen. Bernie Sanders and Sen. Amy Klobuchar.  "The right for a woman to control her own body is a fundamental constitutional right and we have got to do everything we can to defend it," Sanders told reporters outside the Supreme Court.  Other Democratic contenders including Sen. Elizabeth Warren, Sen. Kamala Harris and Beto O'Rourke issued statements on social media saying they stood alongside those demonstrating in support of women's reproductive health care.  Energized protesters also showed up at Mississippi's only abortion clinic, with 100 people gathering on some days singing and waving signs— double the usual number, clinic owner Diane Derzis said.  "They know they're winning, and they don't care what they need to do," she said.  Messages in pink and blue chalk remained on a sidewalk recently near the hot pink building in Jackson that houses the clinic: "Babies are murdered here" and "Repent. Turn to Christ."  Clinic administrator Shannon Brewer took a call from a pregnant woman wanting to schedule an abortion for next week. Brewer told her about the requirement for two trips to the clinic — the first for state-mandated counseling and the second, at least 24 hours later, for the procedure.  She told the woman that no bags, purses or children are allowed. The ban on bags and purses is because of security concerns and the ban on children is because of protesters, Brewer explained after she was off the phone.  "People are screaming at the women as they come in," she said. "That's not good for a child."  POWER House, a group that offers escorts to women seeking abortions in Montgomery, Alabama, for the first time hired an off-duty police officer to watch over escorts and patients because of the attention generated by Alabama's new abortion law, said Mia Raven, the group's executive director.  Six anti-abortion protesters gathered outside the Montgomery clinic on a recent day, carrying signs reading "Babies Are Murdered Here" and depicting aborted fetuses.  Abortion opponents disputed the claim that protesters were more aggressive because of the new state laws and push to overturn Roe v. Wade.  "We have not really had any reports of any heightened activity in the area of protesting of the clinics or anything like that," said Zemmie Fleck, executive director of Georgia Right To life.  In Atlanta, doctors who provide abortions are talking about how to practice in accordance with the Georgia law if it's not blocked in court and goes into effect as scheduled in January, said Dr. Lisa Haddad, an associate professor in gynecology and obstetrics at Emory University School of Medicine. Georgia includes an exception to save the life of the mother, but Haddad said doctors will need protocols to determine when to invoke that provision.  She said a doctor who was prepared to provide abortions in Georgia decided against immediately taking the job after the new law passed.  "Many of us are drained by this whole process," she said.


drudgereport--2019-11-06--Judge strikes down rule allowing clinicians to deny abortions for moral, religious reasons...

Get breaking news alerts and special reports. The news and stories that matter, delivered weekday mornings.  A federal judge in New York on Wednesday struck down a new Trump administration rule that would have allowed health care clinicians to refuse to provide abortions for moral or religious reasons.  U.S. District Judge Paul A. Engelmayer of the Southern District of New York rejected the federal rule after women's groups, health organizations and multiple states sued the Department of Health and Human Services, arguing the exemptions were unconstitutional.  Engelmayer ruled that the so-called conscience rule was too coercive, allowing HHS to withhold billions in federal funding unless health care providers complied.  "Wherever the outermost line where persuasion gives way to coercion lies, the threat to pull all HHS funding here crosses it," Engelmayer wrote in a 147-page decision, according to Reuters. He added that the rule was "arbitrary and capricious."  The ruling came in three consolidated lawsuits, according to The Associated Press. One consisted of 19 states, the District of Columbia and three local governments.  "The refusal of care rule was an unlawful attempt to allow health care providers to openly discriminate and refuse to provide necessary health care to patients based on providers’ ‘religious beliefs or moral objections,’" New York Attorney General Letitia James, who led the lawsuit for the states, said. "We will continue to use every tool at our disposal to protect access to health care and protect the rights of all individuals.”  The Trump administration rule, which would have taken effect Nov. 22, would have allowed providers and health care organizations to opt out of performing abortions and other services if the clinicians objected to them on moral or religious grounds.  Opponents argued the rule posed a threat not just to women seeking abortions but also to LGBTQ patients because providers could argue that treating them was against their personal beliefs.  “Today’s decision is an important victory against the Trump administration’s cruel and unlawful attempts to roll back critical patient protections,” said Alexa Kolbi-Molinas, senior staff attorney with the Reproductive Freedom Project at the American Civil Liberties Union, one of the plaintiffs. “Everyone is entitled to their religious beliefs, but religious beliefs do not include a license to discriminate, to deny essential care, or to cause harm to others.”  Supporters of the rule said the judge's ruling forced providers to perform procedures against their wills.  “This decision leaves health care professionals across America vulnerable to being forced to perform, facilitate or refer for procedures that violate their conscience," said Stephanie Taub, senior counsel for the First Liberty Institute, the largest legal organization in the U.S. dedicated to protecting religious liberty. "The Trump administration’s HHS protections would ensure that health care professionals are free to work consistent with their religious beliefs while providing the best care to their patients.”


drudgereport--2019-12-14--LA high schools to open sexual and mental health clinics...

Dozens of Los Angeles high schools will soon host clinics providing sexual and mental health services for teenagers as part of a wellness program that officials say is a groundbreaking model of comprehensive on-campus care.  The school-based clinics announced this week are a collaboration between Planned Parenthood and county public and mental health officials, and will ultimately be available to roughly 75,000 teens at 50 schools. They will offer birth control, emergency contraception like Plan B, testing and treatment for sexually transmitted infections, pregnancy testing and counseling, and a range of mental health and substance abuse resources.  The reproductive health services extend beyond what public school nurses have traditionally offered, and because California law permits teens older than 12 to receive birth control and related treatment without parental consent, the care is confidential. The centers do not offer abortions.  The “wellbeing centers” will also be staffed by two health educators with master’s degrees in public health, who will facilitate classes and groups on substance use prevention, behavioral health and sexual health. The county’s mental health department will run support groups on stress, anxiety and depression.  Dr Ron Tanimura, director of student medical services at the Los Angeles unified school district (LAUSD), said he expected the centers would help reduce STD and STI rates, which have been increasing in recent years in the region.  “When we are looking at the rise of chlamydia, gonorrhea and syphilis rates, we want to make sure we are approaching this as a public health issue,” said Tanimura. “Now we have an avenue for kids to seek services right there. They don’t have to miss school.”  The program is launching at a time when the White House and conservative groups have aggressively targeted Planned Parenthood. Earlier this year, the organization withdrew from a federal family program that provides health services and birth control after the Trump administration passed a new rule banning referrals to doctors who perform abortions.  Under Trump, the health and human services department has also promoted sexual education that emphasizes abstinence despite overwhelming evidence that this kind of curriculum does not change teen sexual behavior or prevent pregnancy. California prohibits abstinence-only education and requires more comprehensive programs. Last year, legislators also passed a new law mandating that public colleges provide abortion medication.  The involvement of Planned Parenthood in LA schools has already sparked some backlash from conservative groups and rightwing media, though officials have emphasized that the organization and the reproductive health services are just one component of the larger wellness initiative. Planned Parenthood is currently operating in five of the sites, but it plans to expand to other schools.  “Young people trust Planned Parenthood with those services,” said Ellen Sanchez, a consultant with the public health department. “They know they will get honest and accurate information and their confidentiality will be protected.”  Kanchi Tate, a program manager with the LA department of mental health, said it was critical that students have access to a private setting to ask questions about sexual or mental healthcare: “You may have a student suffering for a long time or they may know something is not right, but they don’t know where to go … If it’s on campus, it’s part of the conversation and it becomes normal.”  Roughly one in four students report feeling depressed, said Dr Barbara Ferrer, LA county director of public health: “We have a lot of evidence about the high levels of trauma that students have experienced … This combines the best we know about the kind of services that young people are asking for and are in need of.”  Ferrer said the county could not shy away from reproductive health services even if it inspired controversy: “We’re not going to ignore a whole set of needs that young people have. We have a lot of students that are sexually active. We can’t put our heads in the sand.”  Dr Brian Nguyen, a University of Southern California assistant professor of OB/GYN, who is not affiliated with the program, said he expected the services could help reduce rising STI rates in the region.  “When you bring the services to people, they’ll use it,” he said, noting that women tend to take care of their sexual health more than men. He hoped this would fix that disparity in schools: “It ensures that a wider audience that would ordinarily not engage in sexual reproductive health would have access.”


eveningstandard--2019-06-18--First private clinic promises aposfast-accessapos medical cannabis to Londoners

First private clinic promises 'fast-access' medical cannabis to Londoners

London’s first private clinic promising faster access to medical cannabis is to open in Harley Street.  Its backers say it will offer a “lifeline” to patients suffering chronic pain or neurological conditions who are unable to access cannabis-derived medicines on the NHS.  The Medical Cannabis Clinics — London will be the second in the country to be opened by ECH (European Cannabis Holdings) Medical. In March it opened the UK’s first clinic in Cheadle, Greater Manchester.  Medical cannabis was legalised in the UK last year but is currently unlicensed, meaning it can only be prescribed by specialists or a GP acting under the instructions of one. Families say it is almost impossible to access it on the NHS, despite its legalisation.  Cases such as those of Billy Caldwell, 13, and Alfie Dingley, seven, have highlighted the benefits of cannabis oil to children with epilepsy who suffer multiple seizures.  The London clinic will not have a paediatric department at the outset. Appointments cost £200 and prescriptions will cost £600 to £700 a month. Former government drugs czar Professor David Nutt, of Imperial College London, told BMJ that “ignorance” of the value of cannabis medicines among doctors was holding back their use.  The Government says the evidence for the effectiveness and cost-effectiveness of medicinal cannabis is “embryonic”. A review of Nice guidelines, which determine whether the NHS should pay for it, is due to be published in the autumn.  The London clinic will have a GP who can assess patients and refer them to an on-site specialist with the power to approve a prescription. Cannabis treatments will be offered where conventional treatments have failed.  The clinic will offer “potentially life-changing” treatment for arthritis, epilepsy, multiple sclerosis, Alzheimer’s and Parkinson’s. It may also benefit people with psychiatric conditions and stroke patients. More than 150 people are said to be on a waiting list.  Clinical director Professor Mike Barnes, the consultant neurologist who helped secure the first medicinal cannabis licence for Alfie Dingley, said: “This clinic will represent a lifeline to the thousands of patients who have found other treatments ineffective.”


eveningstandard--2019-12-04--Candice Brown details 'battle' against clinical depression and PTSD

Great British Bake Off winner Candice Brown has described suffering with clinical depression, chronic phobia and post-traumatic stress disorder (PTSD) as a "real battle" in a new interview about mental health.  The TV personality, who won the competition in 2016, said baking and group therapy has helped her, adding that she also takes medication.  Speaking on the Open Mind podcast, she told ex The Saturdays singer Frankie Bridge that while she was initially "reluctant" to accept the prescription, she has been taking "various" drugs for five years.  The 34-year-old explained: "I suffer with clinical depression, chronic phobia and PTSD.  "It's hard and people don't realise, it's a real battle. People might be like, 'Oh she's jumping on the bandwagon,' but they've got no idea what has been going on in my brain for the past five or six years.  "It's been s**t, sometimes I get angry and it's probably going to be with me forever. When it got really bad, baking was what I would do.  "I'm on medication, I have been for five years, various different ones."  The famous baker admitted she was initially angry that she would have to "rely" on medication, but now accepts she has a "chemical imbalance."  “Group therapy taught me that bouts of depression will probably be a reoccurring thing," she said. "It p****d me off that I would have to rely on things. Now I know it’s not my fault."  The former PE teacher added that she has struggled to go to work on particularly difficult days and said she has experienced "not very nice thoughts of how I could get out of it."  She said: "At its worse I was being dragged out of bed by my feet and the duvet being shut in the bathroom, so there was nothing on the bed, so I had to get up. Those were the really bad days."  After winning Bake Off, Brown appeared on the 2018 series of Dancing On Ice and was partnered up with professional skater Matt Evers.  In January, Brown returned to the Bake Off tent for a New Year's special but missed out on being crowned star baker, as series 8 runner up Steven Carter-Bailey triumphed.


fortune--2019-10-08--The Clinic of the Future Could Treat Video Game Addiction: Brainstorm Health

China Open to a Partial Trade Deal With the U.S. Even as Tensions Spike


fortune--2019-11-14--Cleveland Clinic, Duke, MIT, and USC to Split a No-Strings-Attached $1 Billion Gift

Daimler Will Cut 10% of Mercedes Management as the Costly Switch to Electric Cars Hits Home


liveaction--2019-03-29--Pro-life medical clinics get Title X funds as Planned Parenthood sees cuts

The Department of Health and Human Services has announced that The Obria Group, a pro-life medical organization, has been awarded a $1.7 million grant per year for the next three years — a total of $5.1 million — in Title X federal family planning funding in California. This is a direct result of the Trump administration’s rule change, which requires that Title X funding recipient organizations must separate, both physically and financially, their abortion businesses from their non-abortion family planning services. In addition, groups receiving funding are no longer allowed to refer for abortions. Before the rule change, agencies were required to refer for abortions, which meant that pro-life facilities wouldn’t qualify for the funding. That has now changed, as previously reported by Live Action News:  The new HHS rule reportedly “[p]rohibit[s] referral for abortion as a method of family planning” and “eliminates the requirement that Title X providers offer abortion counseling and referral,” according to the press release. “It protects Title X healthcare providers so that they are not required to choose between participating in the program and violating their own consciences by providing abortion counseling and referral.” (emphasis added) Prior to the rule change, Title X recipients were required to refer for abortion. Section 59.14 of the rule states: “A Title X project may not perform, promote, refer for, or support abortion as a method of family planning, nor take any other affirmative action to assist a patient to secure such an abortion.”  Planned Parenthood tweeted today that as a result of the Title X rule change, many of its affiliates just learned that they have lost funding:  The Washington Examiner points out that the new rules “are being contested by states and pro-abortion rights groups who say that they amount to a ‘gag rule’ for doctors. The organizations have said they would have to either re-build their facilities or turn down the funds entirely because of the rule.” The family planning grants, they note, “are intended to pay for birth control, testing of sexually transmitted diseases, and cancer screenings for 4 million low-income people” and are not supposed to go toward abortion. However, when funding goes to a facility that provides not just family planning, but abortions using the same buildings, doctors, and staff, that money is fungible. That means no matter what, that funding is helping to prop up the facility’s abortion business.  The video below helps to explain:  READ: Medical pregnancy centers fight lie that Planned Parenthood is about women’s health  “Many women want the opportunity to visit a professional, comprehensive health care facility—not an abortion clinic—for their health care needs; today, HHS gave women that choice,” Obria CEO Kathleen Eaton Bravo said in a statement, quoted by The Daily Signal. “Our goal is to basically say we’re going to build a model of comprehensive, holistic medical clinics so that a woman [facing an unplanned pregnancy] never has to darken the door of a Planned Parenthood again,” Bravo told The Daily Signal. “We are her health care provider,” she said. “It is a brand that has been desperately needed for 45 years, to unite the [pro-life] movement under this medical model.”  In a fact sheet released by The Obria Group, the organization notes that the Title X funding will be used toward:  The groups adds, “These services will be provided by seven grant subrecipients at 21 family clinic locations serving more than 90 cities across four California counties: Los Angeles, Orange, San Diego, and Santa Clara.”  The group also noted in a press release that “Obria is a nonprofit affiliate network that operates 21 health clinics and 11 mobile clinics in five states with 78 licensed medical professionals providing comprehensive health care services including: pregnancy testing and counseling, prenatal care through delivery, HIV/AIDS testing, pregnancy ultrasound, breast and cervical cancer testing, well-woman care and pap smears, STD testing and treatment, sexual risk avoidance education, adoption referral, and post-abortion support. Obria clinics do not provide contraceptives and do not do abortions, offering women and their families healthy, life-affirming care.”  “Like” Live Action News on Facebook for more pro-life news and commentary!


nationalreview--2019-04-08--Employees Quit NHS Transgender Clinic over Kids Experimental Treatments

Employees Quit NHS Transgender Clinic over Kids’ Experimental Treatments

Five employees of Britain’s National Health Service (NHS) have quit a controversial NHS transgender-therapy clinic, citing fears that children are being misdiagnosed as transgender and given harmful and irreversible hormone treatments.  The five former clinicians at the Gender Identity Development Service, which is based in London and Leeds, expressed their concerns to the British daily The Times. Each of them was part of a team charged with deciding whether patients as young as three should be prescribed hormone blockers to prevent the onset of puberty. The number of child referrals to GIDS skyrocketed from 94 in 2010 to 2,519 in 2018.  Later when patients reached age 16, they would be prescribed a regimen of sex hormones in order to develop the physical characteristics of the gender with which they identify.  The clinicians said they were concerned that the root causes of some of the children’s gender dysphoria were not being ascertained carefully enough before diagnosis and that they sometimes felt pressured to prescribe the treatment against their better judgment. They added that they suspected some of the youngsters were actually gay but had been victims of homophobic bullying.  One of the clinicians said the reason some clinic workers stayed in their positions was to protect children from inappropriate therapy.  “I felt for the last two years what kept me in the job was the sense there was a huge number of children in danger,” the staffer told the Times. “I was there to protect children from being damaged.”  Another staffer lamented that, “This experimental treatment is being done on not only children, but very vulnerable children.”  Over the past three years, at least 18 staff are have reportedly quit the clinic over similar fears of haphazard diagnoses of child gender dysphoria.  GIDS, part of the Tavistock and Portman NHS Foundation Trust, pushed back on accusations of irresponsible diagnoses, claiming that its staff carefully considers whether to prescribe hormone therapy for individual children.


naturalnews--2019-01-23--Just 3 sessions of aerobic exercise per week can relieve clinical depression

(Natural News) A systematic review published in the journal Depression and Anxiety suggests that aerobic exercise has significant antidepressant effects for people with clinical depression. More specifically, the review reported that three 45-minute sessions of moderate-intensity aerobic exercise every week may relieve clinical depression.  A team of researchers from Greece, the U.K., and Canada evaluated the antidepressant effects of aerobic exercise on people suffering from clinical depression. The research team looked at 11 studies with a total of 455 adult participants.  Instead of taking antidepressant drugs – which is the conventional treatment for depression – the participants underwent supervised moderate-intensity aerobic exercise for an average of 45 minutes, thrice a week for a period of 9.2 weeks. (Related: Stopping exercise can plunge people back into depression after only THREE DAYS, study concludes.)  The results showed that the exercise routine significantly improved the symptoms of depression, regardless of their severity. In addition, in trials for individuals with a lower risk of clinical depression, aerobic exercise produced moderate-to-large antidepressant effects. For trials with short?term exercise interventions or up to four weeks, exhibited large antidepressant effects.  Based on these findings, the research team concluded that aerobic exercise can relieve symptoms of depression and may be used as an effective treatment for this mental illness.  Depression is a life-threatening and burdensome mental illness. In recent years, the number of people suffering from this mental illness has increased. According to the World Health Organization (WHO), around 300 million people around the world suffer from depression. Furthermore, it is estimated that 15 percent of the adult population will experience depression at some point in their lives.  100% organic essential oil sets now available for your home and personal care, including Rosemary, Oregano, Eucalyptus, Tea Tree, Clary Sage and more, all 100% organic and laboratory tested for safety. A multitude of uses, from stress reduction to topical first aid. See the complete listing here, and help support this news site.  A person with depression may experience the following symptoms:  In addition to aerobic exercise, there are other non-drug treatments available that help beat depression. These include the following:  Read more news stories and studies on natural ways to battle with depression by going to BeatDepression.news.


naturalnews--2019-08-21--Clinical review finds electroacupuncture treats postoperative urinary retention in women

![Image: Clinical review finds electroacupuncture treats postoperative urinary retention in women](wp-content/uploads/sites/91/2019/08/electroacupuncture- acupuncture-alternative-therapy-pain-relief-2.jpg)  * * *  ([Natural News](https://www.naturalnews.com)) Electroacupuncture can [greatly improve symptoms of postoperative urinary retention](https://www.science.news/2019-07-17-electroacupuncture-treats- postoperative-urinary-retention-in-women.html)Â in women, according to a review published in the journalÂ  _Evidence-Based Complementary and Alternative Medicine_. In the article, researchers fromÂ [ _Guangzhou University of Chinese Medicine_](http://www.at0086.com/GUCM/) in China looked at data from randomized control trials that used electroacupuncture for treating postoperative urinary retention, a complication usually associated with anesthesia and surgery. This was done to determine the safety and efficacy of the procedure.  The team looked for relevant studies in databases such as PubMed, EMBASE, CENTRAL, and Web of Science. They also conducted a search using local databases in China, Japan, Korea, and Russia. They found 23 studies that investigated how electroacupuncture affects postoperative urinary retention.Â These studies included 1,861 patients in total.  The team found that electroacupunctureÂ has therapeutic effects on those with postoperative urinary retention. These effects included increased bladder capacity, reduced discomfort during urination, andÂ decreased residual urineÂ volume, which eliminated the need for catheterization.  The researchers also found that electroacupunctureÂ producedÂ better results than other therapies, such as exercise and meditation.Â ElectropunctureÂ even caused fewer side effects and was comparatively safe as a treatment.  âFurther research is needed to understand [the] long-term efficacy and the mechanism of action of the intervention,â the researchers wrote [in their report](https://www.hindawi.com/journals/ecam/2018/7612618/).Â âLarge-scale, long-term RCTs with rigorous methodological quality are needed to clarify the role ofÂ [electroacupuncture]Â in [postoperative urinary retention].â  [![ebook](https://www.naturalnews.com/Images/Heart-Disease- Ebook-150.png)](https://prevent-and-reverse-heart-disease.naturalnews.com)|  _ **Discover how to prevent and reverse heart disease (and other cardio related events) with this free ebook** : Written by popular Natural News writer Vicki Batt, this book includes [everything you need to know](https://prevent-and- reverse-heart-disease.naturalnews.com) about preventing heart disease, reversing hypertension, and nurturing your cardiac health without medication. [Learn More.](https://prevent-and-reverse-heart-disease.naturalnews.com)_   ---|---      ## Understanding urinary retention  People with urinary retention areÂ [unable to emptyÂ their bladders completely](https://www.niddk.nih.gov/health-information/urologic-diseases /urinary-retention). The condition can either manifest as acute (short-term) or chronic (long-term). A person with acute urinary retention cannot urinate at all even if her bladder is full, causing great discomfort and pain. In some cases, the condition can be life-threatening and requires emergency treatment. A person with chronic urinary retention, on the other hand, is able to urinate but is unable to fully empty their bladder. People who have this condition may not know that they have it until it causes complications, such as [urinary tract infection](https://naturalpedia.com/chronic-urinary-tract-infection- causes-side-effects-and-treatments-at-naturalpedia-com.html) (UTI) or [urinary incontinence](https://naturalpedia.com/urinary-incontinence-causes-side- effects-and-treatments-at-naturalpedia-com.html).  Urinary retention can beÂ causedÂ by many things, such as:    * An obstruction in the urethra (i.e., urinary tract stones, tumors and cancers, constipation)   * Weakened bladder   * Nerve problems (due toÂ vaginal childbirth, [diabetes](https://naturalpedia.com/diabetes-causes-side-effects-and-treatments-at-naturalpedia-com.html), heavy metal poisoning)   * Medication (i.e., antihistamines, decongestants, anesthesia)  Many patients experience urinary retention after surgery. BeingÂ given anesthesia to block pain signals and intravenous (IV) fluid to address any potential blood loss oftenÂ results toÂ this. The combination of anesthesia and IV fluids can lead to a full bladder afterward with no way of discharging. For most people, normal bladder function is restored once the effects of anesthesia wear off.  A recent study published in theÂ  _World Journal of Anesthesiology_ Â tookÂ [a closer look at postoperative urinary retention](https://www.wjgnet.com/2218-6182/full/v8/i1/1.htm). In this systematic review of literature, researchers from different institutions in India found that postoperative urinary retention is surprisingly common: Over 70 percent of the cases they investigated involved some degree of the condition.  ## Other natural remedies for urinary retention  Aside from electroacupuncture, there are [other ways to manage urinary retention](https://www.healthline.com/health/urine-retention-home-remedies) that don’t require popping another pill.    * **Peppermint oil** **:** [Peppermint](https://naturalpedia.com/peppermint-sources-health-benefits-nutrients-uses-and-constituents-at-naturalpedia-com.html) oil is known for its healing properties and its ability to relieve pain. But a recent clinical trialÂ looked at the efficacy of peppermint oil inÂ helping with postpartum urinary retention in women and found that adding a few drops of peppermint oil to the toilet water can promote urine flow. (Related:Â [Acupuncture found to be an effective pain reliever for women in labor compared to spinal-epidural anesthesia](https://www.naturalnews.com/2018-06-25-acupuncture-found-to-be-an-effective-pain-reliever-for-women-in-labor-compared-to.html).)   * **Dandelion:** This wild herb, known for its anti-inflammatory properties, can be steeped in hot water to treat bladder inflammation and retention.   * **Stinging nettle** **:** [Stinging nettle](https://naturalpedia.com/stinging-nettle-sources-health-benefits-nutrients-uses-and-constituents-at-naturalpedia-com.html) is a plant well-regarded in traditional medicine for its ability to relieve symptoms of urinary dysfunction, including retention.  Learn more natural ways of improvingÂ bladder health in women at [WomensHealth.news](http://WomensHealth.news).  **Sources include:**  [Science.news](https://www.science.news/2019-07-17-electroacupuncture-treats- postoperative-urinary-retention-in-women.html)  [Hindawi.com](https://www.hindawi.com/journals/ecam/2018/7612618/)  [NIDDK.NIH.gov](https://www.niddk.nih.gov/health-information/urologic-diseases /urinary-retention)  [WJGNet.com](https://www.wjgnet.com/2218-6182/full/v8/i1/1.htm)  [Healthline.com](https://www.healthline.com/health/urine-retention-home- remedies)


newspunch--2019-10-12--Tavistock Children’s Gender Clinic Being Sued Over ‘Misleading’ & ‘Experimental’ Treatments

The UK’s first state-sponsored child gender reassignment clinic is being sued by the mother of a 15 year old patient and a nurse who used to work at the center.  They say “experimental” treatments are being forced on kids as young as 11.  RT reports: The suit, first reported by the Times, alleges the Tavistock clinic in Leeds, and its Gender Identity Development Service (GIDS), painted an “inaccurate and potentially misleading” picture about the risks of hormone blockers, which are used to delay sexual development in children who wish to switch genders.  The case was brought by the mother of a 15-year-old patient at the clinic – who has only identified as “Mrs. A” – and Sue Evans, who worked there as a mental health nurse between 2003 and 2007. Evans told the Times she was concerned with how rapidly children were recommended for hormone treatment at the clinic, which some experts say can have serious medical risks, including loss of fertility and the ability to have an orgasm. Families are not made aware of some of those dangers, Evans said.  Mrs. A – who said she wanted to remain anonymous to protect her child’s identity – expressed concern that “no one, let alone my daughter, understands the risk” of the hormone procedure, which she called an “experimental treatment.” Proper informed consent cannot be obtained under those conditions, she added.  On its website, Tavistock describes its GIDS program as a “highly specialised clinic for young people presenting with difficulties with their gender identity.” However, the facility has increasingly come under fire in recent months over concerns doctors there were misleading patients and rushing them into potentially dangerous treatments.  In an open letter published over the summer directed at Tavistock head Polly Carmichael, another former employee at the clinic, psychologist Kirsty Entwistle, said the center was moving too fast with too little evidence.  “It is a problem that GIDS clinicians are making decisions that will have a major impact on children and young people’s bodies and on their lives, potentially the rest of their lives, without a robust evidence base,” Entwistle wrote.  The Tavistock clinic said it would not comment on any pending legal matters in a statement to the Times.  “It is not appropriate for us to comment in detail in advance of any proposed legal proceedings,” the clinic said. “The GIDS is one of the longest-established services of its type in the world with an international reputation for being cautious and considered.”


newyorkpost--2019-03-20--Clinic accused of liberally prescribing unneeded opioids

Clinic accused of ‘liberally’ prescribing unneeded opioids

COLUMBIA, S.C. — A pain management clinic with facilities in Tennessee, North Carolina and South Carolina is accused of “liberally” prescribing unnecessary opioid painkillers.  News outlets report the U.S. Department of Justice joined three lawsuits this month that accuse the company, Pain Management Associates, of benefiting from over-prescribing the addictive drugs. The lawsuits, filed by former employees, were then partially unsealed.  Plaintiffs accuse the clinic of over-prescribing opioids to justify more urine screens, as the lab that handled the screens was owned by clinic owner Daniel McCollum.  One lawsuit says McCollum also owned a pharmacy that provided patient drugs. One lawsuit says most patients had Medicare, and so McCollum received federal reimbursements he wasn’t entitled to.  Several clinic offices were raided by the FBI in October. McCollum’s attorney, Rebekah Plowman, declined to comment.


npr--2019-01-15--Clinics Struggle To Resolve Fears Over Medicaid Sign-Ups And Green Cards

Clinics Struggle To Resolve Fears Over Medicaid Sign-Ups And Green Cards  Last September, the Trump administration unveiled a controversial proposal — a policy that, if implemented, could jeopardize the legal status of many immigrants who sign up for some government-funded programs, including Medicaid.  The Trump proposal is still working its way through the public comment and evaluation process, and could go into effect as early as this year, though some state attorneys general say they would challenge any such policy in the courts.  In the meantime, some doctors and clinics are torn: They want to keep patients informed about the risks that may be coming, but don't want to scare them into dropping health benefits or avoiding medical care right now.  "We are walking a fine line," says Tara McCollum Plese, chief external affairs officer at the Arizona Alliance for Community Health Centers, which represents 176 clinics in the state. "Until there is confirmation this indeed is going to be the policy, we don't want to add to the angst and the concern," she says.  However, if immigrants do come to a clinic asking whether using Medicaid now might affect their legal status down the road, trained staff members are ready to answer their questions, McCollum Plese says. (According to legal specialists, the rule would not be retroactive — meaning it wouldn't take into account a family's past reliance on Medicaid.)  Other providers prefer to take steps that are more proactive to prepare their patients, in case the proposal is adopted. At Asian Health Services, a clinic group that serves Alameda County, Calif., staff members pass out fact sheets about the proposed changes, provide updates via a newsletter aimed at patients, and host workshops where anyone with questions can speak to legal experts in several Asian languages.  "We can't just sit back and watch," says CEO Sherry Hirota. "We allocate resources to this, because that's part of our job as a community health center — to be there not only when they're covered," she says, "but to be there always" — even when that coverage is in jeopardy.  Currently, people are considered "public charges" if they rely on cash assistance (Temporary Assistance for Needy Families or Supplemental Security Income) or need federal help paying for long-term care.  Trump's proposed change to that rule, which is awaiting final action by the U.S. Department of Homeland Security, would allow the federal government to consider immigrants' use of an expanded list of public benefit programs, including Medicaid, food stamps and Section 8 housing as a reason to deny lawful permanent residency — also known as green card status. Medicaid is the state-federal health insurance program for low-income people.  If the proposed rule change goes into effect, it could force patients to choose between health care and their chance at a green card, McCollum Plese says. "And most people will probably not take the services."  Already, some immigrant patients are skipping medical appointments out of fear stoked by the proposed rule, according to providers and advocates.  "For now, our focus has been on correcting misinformation, not necessarily raising awareness among those who haven't heard about the potential changes," says Erin Pak, CEO of KHEIR Center, a clinic group with three locations in Los Angeles. "This is a proposal that thrives on fear and misunderstanding," she says, "so we wanted to be thoughtful about how and when to engage patients on the issue, given that nothing has passed into law."  The Department of Homeland Security is reviewing more than 200,000 comments from the public before it issues a final rule. And it's still possible the department won't adopt the rule at all, legal experts say.  At KHEIR Center, most patients are immigrants from Korea. Many are highly aware of the proposed rule because of the coverage it has received in Korean-language media, according to Kirby Van Amburgh, the center's director of external affairs.  Other groups served by the clinic, such as Latino and Bengali immigrants, have tended to ask few questions, Van Amburgh says.  Trained staff address patients' questions one-on-one, she says, and hand out a fact sheet when needed.  Last month, L.A. Care health plan, which covers more than 2 million Medicaid enrollees in Los Angeles County, hosted a webinar on the topic for about 180 providers. David Kane, an attorney at Neighborhood Legal Services of Los Angeles, led the webinar and urged doctors to tell concerned patients that nothing has changed yet — and that most immigrants would not be affected.  If the federal government adopts the rule, it would not be effective immediately, he notes; there would likely be a 60-day grace period before the changes take effect. After that, implementation could be further delayed or stopped in court.  John Baackes, CEO of L.A. Care, has been critical of the Trump administration's proposal, and says his organization offered the webinar because of the estimated 170,000 clients — legal immigrants — who could potentially be affected.  "I think we've got to let people know what could come, and try to give them more accurate information so that they don't act imprudently," Baackes says. To do that, "we have to stay current."  This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. KHN is not affiliated with Kaiser Permanente.


theblaze--2019-10-02--Planned Parenthood secretly built a mega-clinic in Illinois so more Missouri residents can get abo

Planned Parenthood secretly built a 'mega-clinic' in Illinois so more Missouri residents can get abortions  They used a shell company to keep the plan hidden


npr--2019-04-23--Hospitals Chafe Under A Medicare Rule That Reduces Payments To Far-Flung Clinics

Hospitals Chafe Under A Medicare Rule That Reduces Payments To Far-Flung Clinics  Eric Lewis' plans of expanding his community hospital's reach have been derailed.  As CEO of Olympic Medical Center, he oversees efforts to provide care to roughly 75,000 people in Clallam County, in the isolated, rural northwestern corner of Washington state.  Last year, Lewis planned to build a primary care clinic in Sequim, a town about 17 miles from the medical center's main campus of a hospital and clinics in Port Angeles.  But those plans were put aside, Lewis says, because of a change in federal reimbursements this year. Medicare has opted to pay hospitals that have outpatient facilities "off campus" a lower rate — equivalent to what it pays independent doctors for clinic visits.  Over the past decade, hospitals have been rapidly building outpatient clinics or purchasing existing independent ones. It was a lucrative business strategy because such clinics could charge higher rates, on the premise that they were part of a hospital.  With its new policy, Medicare is essentially saying that an off-campus office is an off-campus office, regardless of whether it's owned by a hospital, a group of doctors or a solo practitioner.  Taking that position will save Medicare — and possibly patients — money.  The federal insurer bore the brunt of its members' extra charges, but beneficiaries sometimes picked up part of that expense through deductibles and copayments. Patients with commercial insurance often were blindsided by high bills — going to what seemed to be a normal primary care clinic, only to discover they were charged a hospital facility fee, for example.  Health policy analysts say the new policy represents an important step in rationalizing payments. Part of a strategy called "site neutral" payment, the new policy has its roots in the Obama administration and was part of the Bipartisan Budget Act of 2015.  "You don't care about where [your treatment is] happening. You care that it's a safe and inexpensive procedure," says Gerard Anderson, director of the Johns Hopkins Center for Hospital Finance and Management. "And the facility fee just adds to the cost with very little added value."  The new payment structure may financially hurt some hospitals, he and other experts acknowledge. But making reimbursements more uniform across providers facilitates competition and may lead commercial insurance to follow suit — which could translate to more savings for patients.  This year, the policy's two-part phase-in cut Medicare payments for clinic visits to outpatient departments by 30%, according to the rule finalized in November. By 2020, the payment rates will be cut by 60% compared with what they were last summer.  The Centers for Medicare & Medicaid Services estimates that the change will save the federal government $380 million this year and patients an average of $7 every time they visit a hospital-owned clinic. Clinic visits are the most commonly charged service for hospital outpatient care under Medicare.  It could also cut down on consolidation in the industry, health care economists say, by closing the loophole that created incentives for hospitals to purchase independent physician practices and charge higher rates for services at taxpayers' expense.  The American Hospital Association filed a lawsuit late last year alleging that CMS overstepped its authority when setting the new reimbursement schedule. Olympic Medical Center is among the plaintiffs.  The hospital association claims that the new rule infringes on a precedent Congress set with the 2015 budget law. That legislation standardized Medicare payments for clinic visits to physicians' offices and new hospital outpatient facilities, but allowed most hospital-affiliated departments that existed at that time to continue receiving a higher rate, according to a comment letter from the Medicare Payment Advisory Commission. The group is a nonpartisan agency that advises Congress.  The differential for site-based payments was designed originally to help hospitals offset the higher costs they incur for maintaining the staff and equipment to handle a wide variety of treatments, says Christopher Whaley, an associate policy researcher at the research organization Rand Corp.  But that financial relief became an incentive for hospitals to buy independent practices, says Dr. Ateev Mehrotra, associate professor of health care policy and medicine at Harvard Medical School. Hospitals were able to charge higher prices for services performed at newly acquired clinics.  Mehrotra says the new CMS rule could be a way to slow down the trend.  "This isn't going to fully put the brakes on it," he says, "but it could be one push on the brakes here — to kind of push that consolidation down."  Some health care analysts have urged the government to expand the number of services covered by the site-neutral policy, including paying hospitals' on-site clinics a rate equivalent to what independent doctors receive.  Hospitals acknowledge that the change implemented by CMS could lead to savings in the health care system, but they say it comes at the cost of patients' convenient access to medical care. In Washington state, Lewis anticipates a loss of $1.6 million for his hospital.  The lack of a clinic in Sequim means ailing patients there will not be able to get care close to their homes, Lewis says.  "If you're well-to-do financially, these aren't big problems," Lewis adds. "But I think the poorest, elderly, sickest of our society will pay the price of this policy."  Melinda Hatton, general counsel for the hospital association, agrees. "I think access trumps a couple extra dollars in copays every single time," she says.  On the other hand, many independent physicians support the change. Marni Jameson Carey, executive director of the Association of Independent Doctors, says she hopes the rule will curb consolidation.  According to a recent report by the consulting firm Avalere, the number of hospital-owned physician practices more than doubled from 35,700 to 80,000 between July 2012 and January 2018. Hospitals own more than 31% of all physician practices, the report found.  Jameson Carey says such mergers can also cause problems for the local economy. When a nonprofit hospital acquires an independent clinic, it effectively removes a tax-paying business from the area. That's because nonprofit hospitals are exempt from paying certain federal, state and local taxes — in exchange for providing community benefits.  "So, not only do they [hospitals] get the facility fee," Jameson Carey says, "they don't have to pay taxes."  Kaiser Health News is a nonprofit news service and editorially independent program of the Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente.


npr--2019-08-22--Addiction Clinics Market Unproven Infusion Treatments To Desperate Patients

Jason was hallucinating. He was withdrawing from drugs at an addiction treatment center near Indianapolis, and he had hardly slept for several days.  "He was reaching for things, and he was talking to Bill Gates and he was talking to somebody else I'm just certain he hasn't met," his mother, Cheryl, says. She remembers finding Jason lying on the floor of the treatment center in late 2016. "I would just bring him blankets because they didn't have beds or anything."  Cheryl had taken Jason to the clinic out of desperation. Jason, now in his late 30s, has struggled with addiction since he was a teenager. Cheryl saw his drug use escalate after he was prescribed a benzodiazepine for his anxiety, and he eventually began using heroin and meth. Over the years, Jason would try to get into recovery, but treatment programs didn't help him for very long.  "I thought he was going to die," Cheryl says. (Side Effects and NPR are using only first names because Jason worried he would lose his job if his employer found out about his addiction history.)  In late 2016, she saw a local TV news segment about a clinic called Emerald Neuro-Recover. The staff there treats addiction with something called NAD therapy, an IV infusion that can contain amino acids and other nutritional supplements, including nicotinamide adenine dinucleotide, a compound found in living cells.  The infusion, which is delivered over 10 to 15 days, cost $15,000, and it wasn't covered by insurance. But the TV report said Emerald's treatment was "proven to wipe drug cravings away." Cheryl was intrigued.  Emerald and dozens of other companies across the U.S. say NAD therapy can address conditions from anxiety to depression to chronic fatigue and even Alzheimer's.  And clinicians offering the treatment say that it reduces or stops cravings for alcohol or illicit drugs in up to 90 percent of patients. The treatment has gained attention on addiction recovery blogs and in the mainstream media.  But such claims about NAD therapy and addiction are not supported by scientific evidence, and they may conflict with federal and state regulations against deceptive marketing of medical treatments. Emerald and other addiction treatment clinics use these claims on websites, social media and in the news to attract clients looking for help. Emerald even used patients' stories to promote the therapy — in some cases, more than a year after the patients returned to using illicit drugs.  In an interview with Side Effects Public Media, Emerald leadership defended its use of the therapy. "It's not really controversial; it's just novel or new," says John Humiston, a family medicine physician and the company's medical director. "The cravings we expect to be gone within days."  Earlier this year, Emerald leadership discussed NAD therapy with Side Effects but cut the interview short amid questions about the treatment's efficacy. Company officials declined another interview and did not respond to follow-up questions via email. For that reason, Side Effects was unable to ask them about Jason's case.  Treatment centers touting high success rates can sound appealing to vulnerable people suffering from addiction or to their families, even if there's no solid evidence to support their methods. "[Clinics] know this is a really desperate population," says Basia Andraka-Christou, a health policy researcher focused on substance use disorders at the University of Central Florida.  Unsubstantiated claims have long been a part of addiction treatment. For instance, in the late 19th century, a doctor dubbed his formula the "Double Chloride of Gold Cure" and sold it via mail order for addiction, claiming a 95% cure rate. "In a week the desire to drink will be gone," read one advertisement.  More recently, NAD therapy is among a wide range of unproven treatments currently marketed to people with addiction, including the herbal extract kratom, and other types of supplements. The FDA and the FTC cracked down on a few of these last year but have limited resources to police the market for unproven treatments. And that leaves consumers on their own to sort out fact from fiction.  While patients spend time and money on ineffective treatments, they miss out on proven therapies that can reduce their risk of relapsing, including behavioral counseling and medications approved by the FDA for treating addiction, says Andraka-Christou. "We do actually now have evidence-based treatments available," she says. "But you still do have these quack treatments popping up."  Numerous companies make bold claims about NAD therapy. A Las Vegas clinic says, "IV NAD+ therapy has a 90% success rate at reducing cravings and a 7% relapse rate."  A clinic in Pooler, Ga., says NAD therapy can provide "rapid reduction or even elimination of cravings, restoring clarity of mind and enthusiasm to be alive."  Another center in Greenville, S.C., says, "Withdrawal signs of addiction go down approximately 70-80% on the first day and continue to decline as the therapy progresses."  Similar glowing testimonials from Emerald led Cheryl and Jason to meet with Emerald leadership in late 2016, including founder Joe Pappas and patient liaison Amora Scott. Cheryl recalls, "They said, 'This is going to fix it. ... It has never not worked for us. It works for everyone.' "  Jason insisted his mother shouldn't pay thousands of dollars for his treatment. She had already spent too much money on him. They decided not to come back.  "Well, then Amora started calling me and calling me and calling me," Cheryl says. Unknown to Jason at the time, Cheryl says Scott persuaded her to pay for the treatment upfront.  Cheryl took out an advance on her credit card and met Scott at a gas station to hand over the money. "When I gave her that check, I looked at her and said, 'This is to save my son's life,' " Cheryl recalls.  Fifteen thousand dollars could seem like a bargain for such a quick fix — one that "restore[s] the brain to its pre-addiction neurologic state," according to a press release from Emerald.  But there has been little research on the effects of the formulas used by Emerald and similar clinics.  "I don't know where those claims could come from, but it doesn't seem realistic to me," says Emily Zarse, an addiction psychiatrist in Indianapolis. She says there's insufficient evidence to support using NAD therapy over other standard treatments: "There's no actual data on any of these things."  For an additional $400 fee, Emerald patients can have their brain scanned at a nearby clinic to document their progress with NAD therapy. An Emerald brochure shows a series of scans from a woman whose "brain is suffering from alcoholism." Areas that glow red, orange and yellow — "HYPERACTIVE and OVERACTIVE" — totally disappear from the scans after 12 days of NAD therapy, according to the company.  "This is totally bogus," says Leslie Hulvershorn, an addiction psychiatrist at the Indiana University School of Medicine with expertise in brain imaging, who reviewed the images via email. "We do not have research in our field that allows us to use EEG or any other brain imaging technique to document treatment response."  NAD, which is an important coenzyme in several cellular processes, including energy metabolism, is being researched at Harvard for its role in aging. Supplements claiming to boost NAD levels have recently gained popularity for purported anti-aging benefits. But NAD's benefits in addiction treatment are unproven, and providers cite unpublished research to make sweeping claims.  One pilot study cited among some NAD therapy providers shows close to 90% of patients have reduced cravings after 10 days of treatment. The study falls short of the standard used by the scientific community to weigh evidence: It did not compare NAD therapy to a placebo or other treatment. It also did not undergo rigorous peer review, and the results have not been published in a scientific journal.  A doctor involved with that study, Richard Mestayer, says he is used to skepticism. Mestayer runs a clinic in Springfield, La., that offers NAD therapy. He says it is unclear how NAD therapy helps with addiction but that his personal experience convinced him it works.  "I think there's a lot of stuff we don't know yet," he says. "I was a skeptic, but when a two-by-four hits you in the head every time, you say, 'Oh, I better pay attention.' "  The hallucinations started several days into Jason's treatment at Emerald. Cheryl wanted to take him to the emergency room.  Rapidly withdrawing patients from benzodiazepines can cause dangerous side effects, such as seizures — it can even be fatal, says Zarse. "There are two types of withdrawal symptoms that can kill you: alcohol and benzodiazepines," she says. "It can cause enough misfiring in the brain that it can lead to brain death."  The standard treatment is to slowly wean someone off benzodiazepines. "They even give benzos for benzodiazepine withdrawal in jail — that shows you how serious this is," Zarse says.  Still, Cheryl says, Emerald staff told her to take Jason home rather than to the hospital. She decided to go to the ER anyway after Jason tried to throw himself through a wall.  Jason was still hallucinating when he arrived at the ER, and then the seizures started. "He was just totally out of it for about three days," Cheryl says. "Not even alert."  One of the doctors who treated Jason noted in his medical records: "Unclear exactly what this NAD substance/medication is."  When Jason left the hospital, he returned to Emerald to finish the treatment. "I didn't know what else to do," he says.  Jason says the therapy didn't work. He white-knuckled his way through abstinence for three months before he relapsed. "One day out of the blue, I called somebody up and just was going to do it one time," he says. "You know how that goes."  The federal Food and Drug Administration has not approved NAD therapy, according to a spokesperson for the agency.  Substances marketed as treatments for specific conditions are considered medications and must be approved by the FDA for that purpose, says Andraka-Christou. For medications, FDA approval requires three phases of human clinical trials. Without that approval, it would violate FDA regulations to market a treatment for that condition.  More broadly, making unsupported claims about a medical treatment or supplement violates federal rules. Both the FDA and the Federal Trade Commission regulate how companies advertise treatments and supplements.  But no publicly available information could be found to show that either agency has taken enforcement action against any clinic offering NAD treatments.  Spokespeople for the FDA and the FTC said via emails that their agencies could not comment on specific cases. "All advertising under our jurisdiction must be true, not deceptive, and supported by competent and reliable scientific evidence," wrote the FTC spokesperson.  "The FDA takes action against companies that engage in 'health fraud,' " said the email from the FDA.  Lack of FDA action doesn't mean it is acceptable for clinics to market the therapy, says Chris D'Adamo, an assistant professor at the University of Maryland who researches dietary supplements.  "The FDA can be slow, and it's understandable because there are so many [potential enforcement issues] out there," he says. "There could still be cause for concern."  Since its inception, Emerald has featured patient stories on social media and in news coverage, much of which uncritically repeats the company's claims about ending addiction. But several of these same patients went to jail for drug and alcohol offenses soon after being treated at Emerald.  In a 2017 TV news story about Emerald, a man says that Emerald helped him get his alcohol and pill addiction under control. Reached by phone, he told Side Effects and NPR that he reluctantly said those things to get the TV interview over with. "[NAD therapy] was a complete waste of my time and my family's money," he said. "It did absolutely nothing for me." (He asked to remain anonymous because many of his family and friends don't know about his addiction, and he worries about his future job prospects.)  He added that he also experienced a seizure when the doctor quickly cut him off from alcohol without antiseizure medication. He says he started drinking again about a week after he finished NAD therapy, and he was arrested for drunken driving a few months later.  In another video Emerald posted on YouTube in 2017, an Indianapolis man is seen leaving Emerald on a sunny day. "I feel wonderful," he says. "Using heroin, I had a lot of racing thoughts, anxieties, cravings. All that's gone." He tells other people who use heroin to go to Emerald.  Six months later, he was in jail for possession of a syringe. Reached by phone, he said that the treatment didn't work for him, and that he received it free of charge.  Emerald still promoted patient stories like these on social media until December 2018. The company began removing content from its website, YouTube and Facebook shortly after Side Effects began reporting this story.  Emerald executives declined to provide Side Effects with a patient to interview.  Asked about cases of relapse among Emerald patients, Humiston replied: "What I've seen is that [the treatment is] very effective." Humiston started work at Emerald in January 2019, but he was a medical adviser for the company before then, and emails between Cheryl and Emerald staff indicate that he was consulted about Jason's treatment there.  Humiston says he believes in the treatment he offers: "It's got quite a reputation of success. Nothing's 100 percent, although for most people, it is 100 percent. That's been my experience."  But Humiston acknowledges that he does not regularly track patients' long-term outcomes: "That's the reason to get a study organized," he says. Last year, Humiston told a local TV station that a clinical trial was forthcoming, but it has not materialized.  Humiston first learned about NAD therapy from a man named William Hitt. Hitt is often credited with originating the treatment, but he was not a doctor or a researcher. According to a lawsuit brought by the state of Texas in the mid-'80s, he falsely claimed to be a doctor when he treated AIDS patients with "injections of the patient's own filtered urine." Forced to shut down in Texas, he moved to Tijuana, Mexico, where Humiston worked with him from 2003 until his death in 2010.  Humiston himself has had trouble with his medical license. The Medical Board of California reprimanded him, according to investigation documents, for committing "gross negligence in his care and treatment" of his teenage son, who almost died in 2016 when Humiston failed to seek proper treatment for the boy's heart infection. Documents say Humiston began performing IV treatments on the boy before he was 3 years old, which may have caused the boy's heart issues.  Asked about the investigation, Humiston said there was "inaccurate information put in there" but that he accepted a public reprimand from the medical board "just to end it." He did not respond to emailed follow-up questions about the disciplinary case.  Humiston applied for an Indiana medical license in November 2018, and the state granted it. He became Emerald's medical director in January. He is at least the sixth doctor to work with the company in its three years of operation.  When asked in January about Emerald's claims and the origins of NAD therapy, Star Voigt, the CEO at the time, declined to answer further questions. "We're trying to help people," she said. "So if you're going to go into that, then I'm going to ask you kindly to leave."  Side Effects sent further questions via email, but the company did not answer them. Instead, Voigt sent a statement from Humiston expressing concern that Side Effects' reporting wouldn't be balanced or objective. Voigt left the company soon after.  Cheryl wrote to Emerald's founder Pappas a few months after Jason left Emerald. She told him that Jason was facing an $11,000 medical bill from his hospital stay and that he still struggled to stay away from illicit drugs. She reminded Pappas that stopping benzodiazepines cold-turkey — what Jason went through at Emerald — is dangerous and goes against standard medical practice.  Cheryl wanted a refund so she could pay off Jason's medical bill. "Can we compromise?" she wrote.  Scott, the patient liaison, wrote back that Humiston believed Jason should be tested "for mold ... infections, and/or inflammation in the blood and body." Instead of a refund, Emerald offered further NAD treatments and another therapy — for $3,000.  Cheryl and Jason declined the offer. "First, do no harm," Cheryl wrote back. She filed complaints with the FTC and the state attorney general, but nothing came of it. (Indiana law allows the state attorney general to prosecute companies for deceptive advertising. The office would not confirm or deny whether it is investigating Emerald's practices.)  The hospital eventually did waive the $11,000 bill. But Cheryl still has not received a refund from Emerald.  "I feel like I owe her the money," Jason says. "At some point, I'll pay it back." He says he finally got help with his addiction through a local 12-step program that he has been part of for two years. Looking back at his treatment at Emerald, he says he felt duped into trying NAD therapy. "I think it's taking advantage of people."  "I can't believe that no one stops them," Cheryl says. "You've got these people selling snake oil, and they're getting away with it."  This story was produced by Side Effects Public Media, a reporting collaborative focused on public health, in partnership with NPR and Kaiser Health News. Jake Harper is on Twitter at @jkhrpr.


osce--2019-12-13--OSCE and Aarhus Centre Sarajevo conclude Environmental Legal Clinics Programme in Sarajevo

SARAJEVO, 13 December 2019 –The Environmental Legal Clinics Programme, organized by the OSCE Mission to Bosnia and Herzegovina and Aarhus Centre Sarajevo, concluded today in Sarajevo. Twenty students from the universities of Sarajevo and Istočno Sarajevo were awarded certificates for their participation.  From September to December 2019, law students from the two universities had the opportunity to enhance their knowledge on environmental law, through a combination of expert-led lectures and workshops focusing on the Aarhus Convention and its application in Bosnia and Herzegovina (BiH).  “Strengthening legal expertise on the environment is vital to addressing serious issues, including toxic air pollution, poor waste management and illegal construction, as well as for strengthening access to justice and ultimately for building a safe and sustainable future for all BiH citizens,” said Kathleen Kavalec, Head of the OSCE Mission to Bosnia and Herzegovina. “I am proud to award certificates to BiH’s future lawyers, certain that they will continue to further enhance their knowledge and skills on this essential topic and contribute to improving the quality of life, health, and security of the people of this country.”  After the completion of the project, successful students will have a chance to apply for volunteer opportunities with the Aarhus Centre Sarajevo to gain further practical experience on environmental cases and to give back to the local community.  “Environmental lawyers are a true ray of hope at a time when pollution and devastation of the environment and natural resources are threatening the very survival of human civilization," said Emina Veljović, Executive Director of Aarhus Centre Sarajevo. “That is why the Aarhus Centre advocates for the introduction and strengthening of environmental law studies at universities in BiH. The OSCE Mission to Bosnia and Herzegovina and the City of Sarajevo have recognized the value of this initiative, and, with their support, we have educated a new generation of young lawyers, in the hope that this knowledge will inspire them to launch their initiatives for the benefit of all citizens in BiH.”  Sunčica Kovačević, a Law student at the University of Istočno Sarajevo, said: “The Environmental Legal Clinic, as one of the best extracurricular activities I have undertaken, offered us an opportunity to gain knowledge on Environmental Law, through interactive workshops and the ideal ratio of theory and practice. This precious experience will shape my future engagement as a lawyer, but also as an environmentally conscious citizen.”  The OSCE Mission to Bosnia and Herzegovina will continue to support the Aarhus Centres in BiH in implementing activities aimed at promoting and strengthening both access to justice and environmental protection in Bosnia and Herzegovina.


pinknewsuk--2019-07-30--Northern Irelands gender identity clinic takes no new patients in over a year

Northern Ireland’s gender identity clinic takes no new patients in over a year

Health services across the UK continue to treat transgender people as if they have a mental illness, while Northern Ireland’s adult gender identity clinic (GIC) has failed to treat any new patients in over a year, according to a leading LGBT+ rights campaigner.  Ellen Murray, executive director of Transgender NI, has warned that many trans people are turning to “unregulated self-medication out of desperation” as waiting times for GICs continue to grow.  In a speech to be delivered at the Amnesty Pride Lecture in Belfast on Tuesday evening (July 30), Murray will say: “Waiting lists have spiralled over the past number of years, and the adult service in Northern Ireland hasn’t taken new patients in over a year.  “What we’ve seen this turn into on the ground is trans people being forced into expensive private healthcare and unregulated self-medication out of desperation, and has an enormous toll on the mental health of trans community members here.  “Lives are put on hold, dreams are set aside and suffering is let to fester because of an expensive and inefficient healthcare system based on the model that puts more emphasis on preventing transition for the wrong reason than actually promoting the rights of the community that needs it most.”  According to Murray, trans people are failed by a system which carries echoes of Britain and Ireland’s homophobic past.  “Healthcare services for trans people developed during the criminalisation of homosexuality, where trans identity was seen as a serious mental illness, and was treated with forced electroshock therapy and institutionalisation,” she will say.  “The healthcare services we see today are an echo of that dark past, and their invasive assessments, insistence on conformity to gender stereotypes and the continued treatment of trans identity as a mental health condition harms our communities, young and old.”  The 2018 National LGBT Survey found that 80 percent of trans people who accessed or tried to access a GIC found the process difficult, with long waiting times the most common barrier.  Northern Ireland’s trans health services—based at the Brackenburn Clinic in Belfast–have a waiting time target of 13 weeks. NHS England GICs have a target of 18 weeks, though in reality patients can be left waiting for anything up to three years.  PinkNews has contacted the Belfast Trust, which is responsible for Brackenburn, for comment.