The Associated Press: US Agency: Hospital Forced Nurse To Participate In Abortion
Vermont's largest hospital forced a nurse to participate in an abortion procedure over her moral objections in violation of federal law, a government civil rights agency said Wednesday. The University of Vermont Medical Center in Burlington could lose some federal funding if the two parties cannot agree within 30 days on the hospital's policies on employee participation in abortions, the Office for Civil Rights of the U.S. Department of Health and Human Services announced. (Ring, 8/28)

NPR: Trump Administration Says Hospital Forced Nurse To Assist In Abortion
In 2017, the complaint alleges, the nurse was misled by her employer to believe she was assisting in a procedure scheduled after a miscarriage. "After [she] confirmed that she was, in fact, being assigned to an abortion, [her employer] refused her request that other equally qualified and available personnel take her place," the complaint reads. She then participated in the procedure and "has been haunted by nightmares ever since," according to the complaint. (Simmons-Duffin, 8/28)

The Washington Post: Trump Administration Accuses Vermont Hospital Of Forcing Nurse To Participate In Abortion
The notice of violation, sent Wednesday to the University of Vermont Medical Center, is the latest example of the Trump administration’s focus on protecting “religious freedom” — a core value for antiabortion activists and other social conservatives key to the president’s political base. The action against UVM medical center is the third enforcement action taken in the 1 1/2 years since the Department of Health and Human Services created a conscience and religious freedom division within its civil rights office. It is the first that deals specifically with a health-care worker’s objection to participating in an abortion. (Goldstein, 8/28)

Modern Healthcare: Vermont Hospital Accused Of Forcing Nurse To Assist In Abortion
UVMC disputed the allegations, which it said were based on a complaint from a former employee. "We flatly deny that we schedule any employees to participate in procedures they register objections to," UVMC spokeswoman Annie Mackin said. "We promptly and thoroughly investigated (the allegations) and determined that they were not supported by the facts." (Meyer, 8/28)

Vermont Public Radio: Feds Issue Violation Notice To UVMMC After Nurse Reports Performing Abortion Against Conscience
Stephen Leffler, interim president of UVM Medical Center said the hospital investigated the allegations and found they were not supported by the facts. He said to his knowledge, UVM Medical Center has never compelled an employee to participate in a procedure they were not comfortable with. Leffler also disputed federal regulators' characterization of UVMMC as not having cooperated with their investigation. "From the outset, and as recently as this month, we offered to discuss our policies and practices with them," Leffler said. "We asked to receive their advice on how those policies and practices could be improved, consistent with our obligation to our patients." Leffler said the Office for Civil Rights did not take UVMMC up on the offer. (Corwin, Hirschfeld, Elder-Connors And Davis, 8/29)

The Atlantic: Nurse Allegedly Forced To Assist Abortion Against Her Will
This case is the latest signal that the Trump administration is pointedly championing the rights of religious Americans. As Roger Severino, the head of the Office of Civil Rights, told me in an interview, “Religious-freedom laws are the ones mentioned in the very first amendment to the Constitution—they have pride of place. And they have been neglected for too long.” (Green, 8/28)

ABC News: Trump Administration Backs Vermont Nurse Who Says She Was Forced To Assist With Abortion
Severino told reporters he felt it was a form of discrimination against employees' religious beliefs. He is pressing the case under the "Church Amendments," which are laws enacted in the 1970s to protect anyone who objects to performing abortion or sterilization procedures on religious grounds. "There is room for disagreement on these issues without having to coerce people," Severino said. (Flaherty and Tatum, 8/28)

CNN: Medical Center's Federal Funding Threatened After Nurse Says She Was Forced To Participate In An Abortion
Severino declined to specify whether the abortion in which the nurse was allegedly compelled to participate was a pre-viability procedure, saying that "this was not an emergency circumstance" and that the Church Amendments don't make a distinction. He also declined to specify the number of witnesses, beyond "several," who were involved in the Office of Civil Rights' "fully investigated" probe into the allegations, adding that "we have enough to support our findings." (Kelly, 8/28)

The Hill: Trump Administration Accuses Hospital Of Forcing Nurse To Assist In Abortion 
The hospital could potentially lose millions of dollars in federal grants. According to the agency, the hospital has received $1.6 million over the past three years as part of the Ryan White HIV/AIDS Program. (Weixel, 8/28)

USA Today: Vaping Lung Injuries: People Use E-Cigarettes For THC, Marijuana Oil
Federal health officials are under fire for their unclear public warnings after one death and nearly 200 cases of vaping-related lung illnesses, which some say are related to the far riskier practice of vaping marijuana oil rather than nicotine. Some state health department and news reports suggest many of the cases of lung problems involve tetrahydrocannabinol, known as THC, the chemical in marijuana that causes psychological effects. (O'Donnell and Alltucker, 8/28)

The Washington Post: Maryland, Virginia Among 22 States Reporting Incidents Of Vaping-Related Illness
Maryland and Virginia are among 22 states that are reporting cases of vaping-related illness. At least one death has been reported, in Illinois. Maryland announced Wednesday that the Department of Health and the Maryland Poison Center at the University of Maryland School of Pharmacy have identified five individuals who have developed severe lung illness after using e-cigarettes. All required hospitalization, according to a news release. (Demkovich, 8/28)

The Baltimore Sun: Five Hospitalized For Possible Vaping-Related Illness In Maryland
Five people in Maryland have been hospitalized in the past two months with severe lung illnesses after using e-cigarettes, joining almost 200 nationally who became sick and one who has died in Illinois. The Maryland Department of Health and the Maryland Poison Center at the University of Maryland School of Pharmacy reported the illnesses in four adults and one minor, according to a news release. They continue to investigate the cause of the illnesses in people using the electronic devices, known as vaping. (Cohn, 8/28)

Detroit Free Press: Michigan Investigates Illness, Lung Infections Possibly Tied To Vaping
They're showing up in emergency rooms around the country complaining of shortness of breath, chest pain, cough, fever, and sometimes nausea and vomiting. One thing they all have in common: They used e-cigarettes, and health officials suspect that vaping made them sick. The Michigan Department of Health and Human Services reports it is investigating six cases of e-cigarette/vaping-associated lung infections — part of a national wave of 203 possible cases associated with e-cigarette use in 23 states. (Shamus, 8/28)

Des Moines Register: Vaping-Related Illnesses In Iowa Tied To THC Prompt More Questions About E-Cigarettes' Safety
Three of the four young Iowans who experienced respiratory illnesses after using e-cigarettes said they used vaping products containing tetrahydrocannabinol, or THC, a chemical in marijuana, according to the Iowa Department of Public Health. Health officials reported more than 190 cases of severe respiratory illness among American teenagers and young adults who had vaped, according to the U.S. Centers for Disease Control and Prevention. Their symptoms, reported over the summer, include cough, fatigue, dizziness, headache, vomiting and diarrhea, chest pain and difficulty breathing. (Fleig, 8/28)

LoHud: 14 New Cases Of Vaping-Related Lung Illness Hit New York, THC Probed
Another 14 cases of vaping-related illness have been reported in New York since state health officials earlier this month first warned that 11 people using vaping devices had to be hospitalized. The new tally of 25 cases in New York comes after the first vaping-linked death was suspected in Illinois and nearly 200 vaping-related lung diseases are being investigated across the country. (Robinson, 8/28)

Boston Globe: Mass. Health Care Professionals Told To Look Out For Cases Of Severe Lung Illness Associated With Vaping
Massachusetts officials are instructing health care professionals to look out for respiratory illnesses that might be related to vaping, after nearly 200 cases of mysterious lung illnesses have surfaced across the country. The Massachusetts Department of Public Health notified some 25,000 doctors, nurses, and physician assistants Tuesday to watch for respiratory illnesses in patients who said they use e-cigarettes or vaporizers of any kind — and report those cases to the state. (Gans, 8/28)

The Hill: Milwaukee Issues Health Alert On Vaping 
Milwaukee is urging residents to stop vaping after multiple teenagers have been reportedly hospitalized for lung damage related to the e-cigarette devices. The city issued a health alert regarding vaping on Wednesday, USA Today reports. (Klar, 8/28)

Ottawa Citizen: E-Cigarettes: Canada’s Health Officials Watching Lung Problems In The US
News that nearly 200 cases of severe lung disease in the U.S. might be linked to vaping has health officials in Ottawa and across the country on alert. Health Canada and the Public Health Agency of Canada are monitoring the U.S. situation and working with U.S. officials but have not seen any evidence of similar pulmonary illness clusters in Canada related to e-cigarettes. The Public Health Agency of Canada has alerted provincial and territorial health officials and asked them to report any possible incidents. (Payne, 8/28)

The Associated Press: Doctors Don't Always Know What Patients Will Owe For Meds
It's the No. 1 reason patients don't fill their prescriptions: sticker shock. While the price of almost any good or service can be found online, most Americans don't know what they'll owe for a prescription medication until they get it. Unexpected costs contribute to the estimated 20 to 30 percent of prescriptions that are never filled, which can lead to health problems from untreated medical conditions. (Perrone, 8/28)

Stat: Medicare Paid Millions For Drugs Already Covered By Hospice Benefits
Despite a previous warning, the Center for Medicare and Medicaid Services failed to take steps to ensure the Medicare Part D program does not also pay for medicines that should be covered under the Medicare Part A hospice benefit, resulting in an estimated $161 million in duplicate payments  in 2016, according to a new federal government analysis. Specifically, Medicare, Part D paid $422.7 million for 6.7 million prescriptions for beneficiaries who received hospice care. (Silverman, 8/28)

Modern Healthcare: CMS Paying Twice For The Same Hospice Drugs, Watchdog Says
The figure stemmed from the amount Part D paid for drugs that hospice organizations should have paid for under Part A, according to the new report. It's likely hospices should have paid for much of the remaining $262 million of the $423 million audited total drug costs, even though hospices told OIG they should not be responsible for that sum. The report recommended that the CMS ensure hospices provide drugs covered under the hospice benefit by working with them directly. OIG also suggests that the CMS create and implement a strategy to ensure it doesn't double pay in the future. (Brady, 8/28)

The Wall Street Journal: New Concerns Emerge About Long-Term Antidepressant Use
How long is too long to be on antidepressants? More Americans are taking antidepressant medications like Prozac and Zoloft for extended periods of time: One-quarter of people on the drugs have used them for a decade or more, according to data from the National Center for Health Statistics. But even the longest rigorous studies of antidepressants’ safety and efficacy have followed patients for only a couple of years. (Petersen, 8/28)

Bloomberg: Hepatitis C Drugs Whose Prices Drew Criticism Get FDA Warning 
Drugs that treat hepatitis C, whose high prices have previously sparked outrage, can in rare instances cause liver failure and other complications, the U.S. Food and Drug Administration said. The FDA said it had received reports that drugs made by Gilead Sciences Inc., AbbVie Inc. and Merck & Co. can in some cases lead to worsening liver function in patients who already had moderate or severe liver damage, according to a statement Wednesday. The agency said the drugs remain safe for patients with mild liver disease. (Spalding and Edney, 8/28)

The Associated Press: US Agency Sees Low Risk In Contaminated Blood Pressure Drugs
U.S. health officials on Wednesday tried to reassure patients that they face very low risks from ongoing contamination problems with widely prescribed blood pressure drugs. Drugmakers have issued more than 50 recalls since last July linked to low levels of a probable cancer-causing chemical found in generic drugs taken by millions of Americans. The contamination underscores the Food and Drug Administration's struggle to police an industry that increasingly relies on overseas manufacturing plants in China and India. (8/28)

Stat: Vertex Sinks On Reports Of Deaths Of Patients Taking Cystic Fibrosis Drug
Thirty patients have died after taking a Vertex (VRTX) Pharmaceuticals treatment for cystic fibrosis, according to a government database, news that sent the company’s share price down as much as 4% on Wednesday morning. The deaths, reported to the Food and Drug Administration’s database of side effects, relate to patients who took Symdeko, a Vertex medicine approved last year. Reports to the database are commonly submitted by health care professionals and often contain incomplete information about how patients died and what other medicines they were taking. (Garde, 8/28)

The Wall Street Journal: Juul Introduces Checkout System To Combat Underage Purchases
E-cigarette startup Juul Labs Inc., facing blame for a surge in teenage vaping, is offering more than $100 million in incentives to retailers to install a new electronic age-verification system intended to curb illegal sales to minors. The modification to point-of-sale software blocks each Juul purchase until the shopper’s driver’s license or other government identification has been scanned. It also limits each purchase to a maximum of one vaporizer and four refill packs. So far, Juul said, Cumberland Farms Inc., QuikTrip Corp. and other chains representing 40,000 outlets have agreed to adopt the system. (Maloney, 8/28)

In other news —

Bloomberg: Philip Morris, Altria Deal Seen As Public Health ‘Nightmare’ 
Philip Morris International Inc. and Altria Group Inc.’s potential remarriage has public-health groups concerned about one behemoth dominating the most popular products used to get a nicotine fix. The potential combined tobacco group with a market value of nearly $200 billion would create a patchwork family consisting of the three leading brands in cigarettes, vaping and heated tobacco. (Gretler, 8/28)

Stateline: New Trump Rule On Medical Interpreters Could Leave Immigrants Behind 
Nevertheless, the Trump administration intends to relax an Obama-era federal rule requiring that medical providers let patients know about their right to language interpretation services — and for people with disabilities, communication assistance such as qualified sign language interpreters or written information in alternative formats for the visually impaired. The administration insists that the current requirements are onerous and costly for providers. The change could have far-reaching effects: More than 27 million U.S. residents speak English less than “very well” or not at all, according to the U.S. Census Bureau.

Austin American-Statesman: Agencies See Drop In Public Benefit Signups Ahead Of Green Card Rule
Texas nonprofits already are seeing the “chilling impact” of families dropping public benefits even before a new federal immigration policy takes effect Oct. 15, said Cheasty Anderson, senior policy associate for the Children’s Defense Fund-Texas, at a news briefing Wednesday. The “public charge” rule makes it harder for green card applicants to live and work permanently in the country if they receive public benefits such as food stamps. Although the rule does not apply to all immigrants — such as naturalized U.S. citizens, refugees or those who already have green cards — the fear has spread across the Central Texas immigrant community and beyond, Anderson said. (Flores, 8/28)

San Francisco Chronicle: SF, Santa Clara County Ask Judge To Block ‘Public Charge’ Immigration Policy
Officials in San Francisco and Santa Clara County have asked a federal judge to block a new Trump administration regulation targeting legal immigrants who use — or are likely to use — public benefits before the rule goes into effect in October. San Francisco City Attorney Dennis Herrera and Santa Clara County Counsel James R. Williams filed a joint lawsuit against the Department of Homeland Security last month challenging the “public charge rule.” (Sanchez, 8/28)

Meanwhile, in other news —

The Wall Street Journal: Local Leaders Criticize Plans For New Child-Migrant Shelters
The Trump administration aims to build new permanent shelters for unaccompanied child migrants in California, Virginia and Florida, drawing criticism from local officials opposed to the president’s immigration detention policies. The federal government is planning shelter space for as many as 1,370 unaccompanied children in the three states, according to documents made public earlier this month and recently highlighted by some irate Democrats. (Lazo, 8/28)

Reuters: U.S. To Pay For Thousands Of Doses Of HIV Drugs For Venezuelan Migrants
The United States said on Wednesday it will provide thousands of doses of HIV medication to treat Venezuelans in Colombia as part of regional efforts to manage care for millions of migrants fleeing the crisis-hit nation. U.S. Health and Human Services (HHS) Secretary Alex Azar told Reuters about the decision in a phone interview following a meeting this week of health officials from 10 countries in the Colombian border city of Cucuta. (8/29)

The Hill: Advocates Sue In Attempt To Speed Up Nebraska Medicaid Expansion
Medicaid advocates in Nebraska have filed a lawsuit to try to force state officials to offer coverage sooner than the official 2020 rollout date. According to the lawsuit filed Wednesday by Nebraska Appleseed, the state will miss out on approximately $149 million in federal funding by delaying implementation of Medicaid expansion until Oct. 1, 2020. (Weixel, 8/28)

Omaha.Com: Nebraska Appleseed Files Lawsuit Seeking Earlier Start Date For Expanded Medicaid Coverage
The suit asks the Nebraska Supreme Court to order state Medicaid officials to implement voter-approved Medicaid expansion by Nov. 17. That’s nearly a year earlier than the Nebraska Department of Health and Human Services planned to start offering the coverage. The plans called for kicking off the new coverage on Oct. 1, 2020. (Stoddard, 8/29)

Lincoln Journal Star: Medicaid Expansion Lawsuit Challenges State's Implementation Delay
"Tens of thousands of Nebraskans are experiencing similar challenges as they wait for coverage," said James Goddard, director of Appleseed's economic justice program.The Nebraska Department of Health and Human Services announced in April that Medicaid expansion for 90,000 uninsured Nebraskans would not be implemented until Oct. 1, 2020. (Walton, 8/28)

KCUR: 'We Get It': Aetna Apologizes As Kansas Pushes To Fix Medicaid Problems 
Aetna Better Health is struggling to keep its Medicaid contract with KanCare, to the point that state officials found fault with Aetna’s recent plan to improve services. But Kansas lawmakers had two words this week for the company: Keep trying. At a two-day hearing, health care providers told lawmakers how Aetna isn’t paying them on time. Aetna executives took responsibility for the shortfalls, which have put the company at risk of losing its contract after the state said it wasn’t in compliance and later rejected a proposal to fix the problems. (Koranda, 8/28)

Hartford Courant: Concerns Increase Over Fate Of Nine High-Vacancy Nursing Homes Targeted For Medicaid Cuts
In the weeks since the operators of nine nursing homes with high vacancy rates learned they stand to lose a total of about $6 million in Medicaid funding, concerns about closures, major job losses and trauma to elderly residents have intensified.All nine homes slated for cuts have filed appeals with the Department of Social Services, officials confirmed Wednesday. (Kovner, 8/28)

Nashville Tennessean: How Did One Murfreesboro Pharmacy Earn Title Of State's Largest Purchaser Of Opioids?
But from a nearby building in the same strip mall, its owners ran a complex web of pharmaceutical businesses that purchased millions of opioid pills during the peak of Tennessee’s prescription opioid boom, while the overdose death rate was skyrocketing. One of the companies, Reeves-Sain Extended Care, was the state's top buyer of opioid pills from 2006 to 2012, according to U.S. Drug Enforcement Agency data obtained and released publicly by the Washington Post in July. However on Monday — more than a month after the release — the pharmacy's current owner contested the data, claiming its repackaging company originally reported information incorrectly to the DEA. (Hineman, Sauber and Reicher, 8/28)

Seattle Times: Anyone In Washington State Can Now Obtain Naloxone, The Opioid Overdose Medication
Washington public health officials have been trying to get Naloxone, a medication that reverses opioid overdoses, to as many people as possible. The state’s top doctor aided this push Wednesday by making Naloxone available to anyone through a pharmacy. Dr. Kathy Lofy, the state’s health officer, signed a “standing order” for Naloxone, also known by the brand name Narcan. The order is statewide and allows any person or organization to obtain the medication from a pharmacy without a prescription. (Blethen, 8/28)

North Carolina Health News: NC Needle Exchange Programs Expand Their Reach Despite The Odds 
Roughly three years after syringe exchange programs became legal in North Carolina, more people than ever are receiving clean needles and kits to help them reverse an overdose. Collectively, North Carolina’s syringe exchange programs — operated by local health departments, as well as faith-based and other community organizations — had more than doubled their number of participants from just under 4,000 people in 2016-17 to more than 9,600 in 2018-19. (Engel-Smith, 8/29)

And read Part Two of KHN's coverage of the burgeoning pain industry in India —

Kaiser Health News: In India’s Slums, ‘Painkillers Are Part Of The Daily Routine’
In the crowded waiting room of Dr. Sunil Sagar’s clinic, in the working-class neighborhood of Bhagwanpur Khera, a toddler breathes from a nebulizer. Fever is widespread, and the air quality in Delhi has reached “severe-plus emergency.” The patients sit, motionless, but there is somehow tremendous noise. The clinic is a squat cement building draped in wires, a red cross on the door. Sagar sits behind a desk in a small, open room, as a squad of assistants escort patients to him. He seems utterly unflappable. A father with a troubled look sits down next to the doctor, holding a baby. Sagar listens to the baby’s chest with a stethoscope, pulls out scrap paper and writes a prescription. The father hands over a few rupees, and Sagar places the bills into a money drawer under his desk. The entire exchange takes perhaps two minutes. (Varney, 8/29)

Read Part One: Beset By Lawsuits And Criticism In U.S., Opioid Makers Eye New Market In India

The Associated Press: Pinterest To Direct Vaccine-Related Searches To Health Orgs
Pinterest said Wednesday it will try to combat misinformation about vaccines by showing only information from health organizations when people search. Social media sites have been tryingto combat the spread of misinformation about vaccines. Pinterest previously tried blocking all searches for vaccines with mixed results. (8/28)

Reuters: Pinterest Will Direct Vaccine Searches To Major Health Groups
The move is an aggressive effort to moderate content by the newly public social media company. Social media platforms have been increasingly under fire for promoting misleading and incorrect content, including by opponents of vaccination. Pinterest said a search for “measles,” “vaccine safety” and other related health terms now would return results from organizations including the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP) and the WHO-established Vaccine Safety Net (VSN). (Culliford, 8/28)

TechCrunch: Pinterest Starts Displaying Information From Health Organizations For Searches Related To Vaccines
“What we and others have observed is an enthusiasm gap between those creating and disseminating harmful health misinformation and those creating resources rooted in settled science,” wrote Ifeoma Ozoma, Pinterest’s public policy and social impact manager. “Generally, there’s more accessible and visually compelling health misinformation than science-based journal articles on the virtues of vaccinations. In addition, we’ve found that some purveyors of health misinformation have a financial incentive.” (Shu, 8/28)

CNN: Measles: 'Reasonable Chance' United States Will Lose Elimination Status
There's a "reasonable chance" the United States will lose its measles elimination status in October because of ongoing measles outbreaks in New York, according to Dr. Nancy Messonnier, director of the US Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases. "It certainly is incredibly frustrating and upsetting to the public health community that we may lose measles elimination status, because we do have a safe and effective vaccine," Messonnier said. (Cohen, 8/28)

The Hill: CDC: US On Verge Of Losing Measles Elimination Status 
For a country to have its elimination status rescinded, measles must have been spreading continuously for a year. Two outbreaks began in New York City and Rockland County, New York, in autumn 2018, with more than 900 cases between the two locations. Numerous cases have been concentrated among the city and county’s Orthodox Jewish enclaves, many members of which have religious objections to vaccinations. The last year has seen other measles outbreaks in 29 other states, but none of them were as long-lasting. (Budryk, 8/28)

The Associated Press: ‘Dramatic Resurgence’ Of Measles Seen In Europe, WHO Reports
The World Health Organization says there has been a “dramatic resurgence” of measles in Europe, in part fueled by vaccine refusals, with nearly 90,000 people sickened by the virus in the first half of 2019. In a report issued Thursday, the U.N. health agency said the number of measles cases from January to June this year is double the number reported for the same period in 2018. Measles is among the world’s most infectious diseases and is spread mostly by coughing, sneezing and close personal contact. (8/29)

Newsweek: Cesarean Sections Probably Don't Cause Autism Or ADHD: 'Correlation Doesn't Equal Causation'
A new study that combines data from over 20 million births has found that a Cesarean section delivery is associated with autism spectrum disorder (autism) and attention-deficit hyperactivity disorder (ADHD). However, the study does not indicate that Cesarean section deliveries cause autism or ADHD. The truth is much more difficult to decipher, and provides an excellent case study for the old adage that correlation doesn't equal causation. (Whitehouse, 8/29)

Reuters: Possible Link Between C-Section And Autism, ADHD
The statistical analysis, published in JAMA Network Open, does not prove that having a C-section directly causes such problems. Other factors that lead doctors to order a surgical delivery of the baby may underlie the link. The researchers collected studies covering more than 20 million deliveries dating back to 1999, to create a large pool of data to assess risks associated with cesarean delivery that may not be evident in the smaller individual studies. (Emergy, 8/28)

US News & World Report: C-Section Tied To Higher Risk Of Autism, ADHD
"Our study does not provide irrefutable proof that C-sections cause psychiatric disorders. Association is not causation," Tianyang Zhang, a researcher at the Karolinska Institute in Sweden and lead author of the study, tells U.S. News. "However, we believe that the study provides information that may help parents (and) doctors to make informed decisions about how they want their births to be," Zhang adds. (Galvin, 8/28)

The Telegraph: Babies Born By Caesarean One Third More Likely To Develop Autism 
Dr Pat O’Brien, Consultant Obstetrician and Spokesperson for the Royal College of Obstetricians and Gynaecologists: “This systematic review and meta-analysis shows an association between caesarean birth and autism and ADHD, but a number of underlying factors which may have led to the development of these conditions were not accounted for. Therefore, the findings of this paper do not show that caesarean birth leads to autism and ADHD.” (Donnelly, 8/28)

Stat: A Heretical Approach To Chemotherapy Is Extending Patients' Lives
No scientist with even a rudimentary moral compass and an ounce of intellectual humility takes human experiments lightly, given how much can go wrong. But Dr. Robert Gatenby was especially aware of the stakes. An oncologist at Moffitt Cancer Center in Tampa, Fla., he has spent years studying how tumor cells respond to chemotherapy, especially in patients whose cancer has metastasized well beyond the original tumor, as when malignant prostate cells invade bones like gang members expanding their turf. Now Gatenby was ready to put his theories to a real-world test by treating men with advanced prostate cancer in a way that broke all the rules. (Begley, 8/29)

The New York Times: Why Aren’t More Women Working? They’re Caring For Parents
Aisha Adkins would rather have her own place, instead of living with her parents. She would also like a job, a car, a master’s degree and savings. But at 35, a decade after graduating from Georgia Southern University in Statesboro with a specialty in social services, she has had to put off those goals. Her mother, Rose, received a diagnosis of dementia six years ago, at 57, and cannot be left alone. Since then, Ms. Adkins has been consumed with her care. “I’ve gone on three dates in the last three or so years,” she said. (Porter, 8/29)

The Associated Press: Deaths Caused By Drivers Running Red Lights At 10-Year High
The number of people killed by drivers running red lights has hit a 10-year high, and AAA is urging drivers and pedestrians to use caution at traffic signals. In 2017, the latest figures available, 939 people were killed by vehicles blowing through red lights, according to a AAA study of government crash data. It’s the highest death toll since 2008 and 28% higher than in 2012. AAA says two people are killed every day in the U.S. by drivers who don’t stop for the signals. (8/29)

PBS NewsHour: Why Doctors Are Increasingly Prescribing Nature
As rates of chronic disease among children have skyrocketed over the past few decades, pediatricians have increasingly looked for solutions beyond the clinic. Sometimes that means actually prescribing time outside. Special correspondent Cat Wise reports from Oakland on the medical evidence that indicates escaping modern urban life, even temporarily, can yield health dividends. (Wise, 8/28)

The New York Times: Surfing With A Disability
Dylan Hronec has been in a wheelchair since he was 2 years old. Surfing is his favorite activity. “When you’re surfing you don’t really think about anything else — it’s the closest thing to an out of body experience,” said Mr. Hronec, 27, who has cerebral palsy and uses a special surf board retrofitted with handles to help him grab on. “I’m more in control of my body and my muscles in the water. So I’m not limited in any way.” (Ellin, 8/29)

The New York Times: Tattoo Needles May Trigger Allergic Reactions
Tattoos can cause allergic reactions, and tattoo needles, even clean ones, may be partly to blame, a new study found. Previous studies have shown that tattoo inks contain high amounts of nickel, chromium, cobalt and mercury, which are transported to the lymph nodes and can cause allergic reactions. But now researchers have found that an additional source of metal is the needles themselves. (Bakalar, 8/28)

The New York Times: Peloton Is A Phenomenon. Can It Last?
As far as indoor cycling machines go, the $2,245 Peloton bike is nothing special. It has a sleek black and red frame. It has a big screen. It’s on Wi-Fi. But a combination of aspirational infomercials (“This … is fitness evolved.”) and streaming classes taught by glamorous instructors has led Peloton to sell 577,000 of its bikes and treadmills in five years. Richard Branson is a fan. So are Jimmy Fallon, Kate Hudson and the Obamas. (Griffith, 8/28)

The Washington Post: Florida Caretakers Charged With Abuse Of Woman In Attain Incorporated Group Home After Review Of Video
The caretaker who called authorities said the disabled woman had been acting out and ended up with minor injuries. But surveillance video would reveal the full story of a patient “willfully tortur[ed] and maliciously punished,” police said. The footage shows four employees at a Florida group home shoving and hitting the woman. One staffer steps with her full weight on the patient’s head as she struggles on the ground — force that “could have easily caused great bodily harm or even death,” a Mount Dora police detective wrote in an affidavit. (Knowles, 8/28)

Georgia Health News: Marketer For Health Sharing Ministries Under State Investigation
An Atlanta-based company that markets health care sharing plans is being investigated by the state insurance department, Georgia Health News has learned. Other states also have investigated Aliera, according to published reports. (Miller, 8/28)

Reuters: Let It Burn: U.S. Fights Wildfires With Fire, Backed By Trump
It was the kind of fire that has terrified communities across the drought-ridden U.S. West in the past few years: a ponderosa pine forest ablaze in the mountains of New Mexico filling the air with thick, aromatic smoke. Except this fire was deliberately set by state penitentiary prisoners, dressed in red flame-resistant clothing and dripping a mix of gasoline and diesel around trees and scrub. (8/28)

The CT Mirror: Mental Illness Is A Distraction In Conversations On Gun Violence, Advocates Say
Two days after gunmen killed more than 30 people in Dayton, Ohio and El Paso, Tex., Julie Learson rallied with 250 Connecticut residents on the steps of the state Capitol. But unlike the scores of adults and children who held signs demanding legislative action to stop mass shootings, Learson clutched a piece of cardboard that read, “White supremacy and toxic masculinity are terrorist ideologies, not mental illnesses.” (Lyons, 8/29)

California Healthline: Governor’s ‘Mental Health Czar’ Seeks New Blueprint For Care In California
In a career full of twists, turns and high-powered assignments, Thomas Insel may now be embarking on one of his most daunting tasks yet — helping California find its way out of a worrisome mental health care crisis. This year, he assumed a new role to help Gov. Gavin Newsom revamp mental health care in the state. Newsom called Insel his “mental health czar,” though his position is unpaid and Insel says it grants him “no authority.” Even so, he is zigzagging across California this summer, visiting mental health facilities to try to understand what works and what doesn’t. (Waters, 8/28)

Dallas Morning News: Texas Is Kicking Far Fewer Little Kids Out Of The Classroom Thanks To This Law 
Dallas was among the first districts in Texas to move away from suspensions for children in the early grades by banning such discipline except in extreme cases. Research has repeatedly shown that black students and those with disabilities are suspended at higher rates than average and are more harshly punished for similar infractions than their peers. (Ayala, 8/28)

The Advocate: Woman's Hospital Invests In Germ-Fighting Technology 
Woman's Hospital in Baton Rouge has invested in patented electrostatic technology to deliver disinfectant to the sides, underside and backside of surfaces, which conventional cleaning methods might miss. Healthcare facilities must contend with a wide range of infection threats, from influenza viruses to antimicrobial-resistant organisms such as methicillin-resistant Staphylococcus aureus that can cause healthcare-associated infections, according to a news release. (8/28)

Des Moines Register: Ed Brown In Negotiations To Step Down From His Job As CEO Of The Iowa Clinic
The longtime chief executive officer of the Iowa Clinic is in negotiations to step down from his job at the expansive medical practice in central Iowa. Ed Brown is in talks with the board of directors for the Iowa Clinic to leave the position after more than two decades, according to Jennifer Tinnermeier, chief legal officer for the clinic. She did not elaborate on why Brown is leaving. (Rodriguez, 8/28)

Modern Healthcare: Priority Health, Total Health Care To Merge In Southeast Michigan
Priority Health and Total Health Care announced Wednesday a plan to merge in which Detroit-based Total Health will become a wholly owned subsidiary of Grand Rapids-based Priority, officials said. The proposed deal must gain state approval to become final, potentially later this year, said Marti Lolli, Priority Health's chief marketing officer. (Greene, 8/28)

Sacramento Bee: California Lacks Oversight Of Hospice Facilities, Caregivers
In California, where the population is rapidly aging and end-of-life care is on the rise, patient advocates and researchers say the state’s oversight of hospice facilities and hospice care has not caught up. Largely subsidized by federal money through Medicare, hospice care consists of nurses entering hospitals, nursing homes or patients’ homes to ease patients’ pain in their last months of living. (Chen, 8/28)

Boston Globe: As Costs Mount, States Scramble For New Ways To Pay For Late-In-Life Care
The cost of such care is growing as the population ages, straining family finances and Medicaid budgets. Holding out little hope that a gridlocked Congress will come to the rescue, states are jumping into the breach. At least a dozen are crafting policies — ranging from caregiver subsidies to expanded home care services to insurance funded through payroll withdrawals — to help millions of disabled seniors afford personal care assistance. (Weisman, 8/28)

Milwaukee Journal Sentinel: Lawyers For Quintez Cephus Accusers Criticize UW-Madison Reinstatement
Lawyers for the two women who accused fellow University of Wisconsin-Madison student Quintez Cephus of sexual assault — charges of which he was acquitted by a jury — are calling on the university to further explain its decision to reinstate Cephus. ...Cephus, a wide receiver for the Badgers, was criminally charged with two counts of sexual assault in August 2018. He pleaded not guilty and sued the university in federal court in an attempt to pause the Title IX process until the criminal case was over. (Vielmetti, 8/28)

The Washington Post: ‘Cold, Callous Letter’ Critical Of D.C. Homeless Encampments Stirs Controversy
An organization that promotes development in a fast-gentrifying District neighborhood is defending a letter critical of homeless encampments that some advocates called insensitive. NoMa Business Improvement District President Robin-Eve Jasper wrote in the public letter that “conditions are worsening” for pedestrians who use underpasses beneath railroad tracks that bisect the neighborhood. The letter notes increasing reports of harassment and aggressive panhandling by those living in the encampments. (Moyer, 8/28)

The Washington Post: Austin's Homeless Crisis Is Latest Target In National Debate Over Right To Sleep On The Streets
Christopher Paul hasn’t felt a police officer tapping at his foot in more than a month — the tap, tap, tap that usually meant he was about to get another citation that he was never going to pay. Living on the streets for five years after he lost his graphic design job, Paul has been having undisturbed nights since the Austin City Council and mayor eased restrictions on “public camping” this summer, a move that liberal lawmakers billed as a humane and pragmatic reform of the criminal justice system. But the change has drawn the ire of Republicans and local business owners who decry it as a threat to public safety and the local economy, exposing a partisan clash over how to manage poverty and affordable housing in America’s cities. (Craig, 8/28)

JAMA Internal Medicine: Association Of Animal And Plant Protein Intake With All-Cause And Cause-Specific Mortality
In this cohort study of 70 696 Japanese adults followed up for a mean of 18 years, higher intake of plant protein was associated with lower total mortality. Moreover, substitution of plant protein for animal protein, mainly for red or processed meat protein, was associated with lower risk of total, cancer-related, and cardiovascular disease–related mortality. (Budhathoki et al, 8/26)

Health Affairs: Contribution Of Care Source To Cancer Treatment Cost Variation In The US Military Health System
The US Military Health System (MHS) provides universal access to health care for more than nine million eligible beneficiaries through direct care in military treatment facilities or purchased care in civilian facilities. Using information from linked cancer registry and administrative databases, we examined how care source contributed to cancer treatment cost variation in the MHS for patients ages 18–64 who were diagnosed with colon, female breast, or prostate cancer in the period 2003–14. (Eaglehouse et al, 8/5)

The Henry J. Kaiser Family Foundation: The Status Of Participation In The Title X Federal Family Planning Program
New regulations issued by the federal Office of Population Affairs (OPA) in March 2019 prohibit Title X clinics from providing abortion referrals, require physical separation of abortion services, and mandate prenatal care referrals for all pregnant women. These regulations have resulted in eight separate lawsuits against the regulations. Although a preliminary injunction initially blocked the regulations from being implemented, the 9th Circuit Court of Appeals stayed the injunction and the rule became effective July 15, 2019. (8/27)

JAMA Internal Medicine: Use Of “Doctor” Badges For Physician Role Identification During Clinical Training
Clinical care teams in academic medical centers consist of members with various functions and levels of training. Patients and their families are often disoriented by the changing tide of medical staff. Reports show that only 40% of inpatients correctly identify their hospital physicians.1 Role misidentification, or incorrect identification of an individual’s contribution to the health care team, has negative consequences for patient care and physician wellness. Frequent role misidentification of female physicians may contribute to a lesser sense of belonging, a perception of a lack of self-efficacy for career advancement, and increased burnout.2,3 Although role misidentification is anecdotally acknowledged to be a common occurrence, to our knowledge, there are no evidence-based reports about its prevalence or possible interventions. (Foote et al, 8/26)

The New York Times: Big Pharma Is Starting To Pay For The Opioid Crisis. Make Those Payments Count.
In 1998 tobacco manufacturers reached an unprecedented agreement with 46 states, which had sued the companies for engaging in decades of deceptive marketing practices that contributed to an epidemic of tobacco-related illness and death. Over the next 20 years, the industry paid some $125 billion to the states.But two decades later, only a fraction of the tobacco proceeds — less than 3 percent nationally in 2019 — has been spent on public health matters related to tobacco use. In New York, some of the money went to a public golf course. Alabama installed security cameras in its schools. (8/28)

Washington Times: The Demonization Of Vaping 
Despite the overwhelming evidence of the deadly danger of cigarette smoking, the government and media are now weirdly obsessing over one of the few proven tools to help smokers quit smoking. Vaping, which contains no tobacco and uses electronic devices, also called e-cigarettes, to produce vapor from liquids instead of burning tobacco, is used by millions of adults to help wean them off cigarettes. However, vaping is now being hysterically touted by some as an “epidemic” and the Food and Drug Administration (FDA) is considering banning the manufacturing of flavored vaping liquids. States such as Hawaii have attempted vaping bans and failed, while municipalities such ultra-leftist San Francisco, which has a real epidemic of illegal drug use and filthy drug needles littering its streets, has stupidly focused instead on banning the sale of vaping liquids. (Paul Crespo, 8/28)

Bloomberg: Trump Isn't Taking Credit For Curbing Opioid Shipments From China 
Of all people, you wouldn’t expect President Donald Trump to be shy about taking credit for his achievements. When it comes to China’s role in America’s opioid crisis, though, he’s been uncharacteristically modest. Mail carriers including FedEx Corp., Amazon.com Inc., United Parcel Service Inc., and the U.S. Postal Service were ordered to search for and refuse deliveries of the synthetic opioid fentanyl from China in a tweet-storm last week. “President Xi said this would stop – it didn’t,” Trump wrote, echoing a theme from earlier this month. (David Fickling, 8/28)

Miami Herald: Medicare Must Keep Up With Strides In Alzheimer’s Research
A new study published in the Journal of Managed Care and Specialty Pharmacy found that Medicare spending on Alzheimer’s disease is surprisingly low. The study examined almost 340,000 Medicare beneficiaries and found that in the last year of life, Medicare spent $1,300 less on patients with Alzheimer’s disease than other beneficiaries. The lower costs were often due to avoiding complex care, such as chemotherapy for cancer, for loved ones with advanced dementia. (Susan Peschin, 8/28)

The Washington Post: Unions Shouldn’t Use Their Health Insurance As A Weapon Against Universal Coverage
Imagine a world where elementary school attendance was limited to those children who had a parent whose job offered, or whose union had negotiated, this benefit. While this scenario is patently absurd, it’s exactly the policy we’ve accepted for access to health care. And during this Democratic presidential primary, it has been particularly troubling to see unions, whose original purpose was to help workers collectively gain access to better pay and benefits, use their own negotiated health plans as a weapon against the push for universal health care — and to see candidates contorting themselves in response. (Rebecca Kolins Givan, 8/28)

The New York Times: My Doctor Said I Wouldn’t Walk. I Can.
I was born with bleeding on the brain, which caused me to develop a type of cerebral palsy known as spastic quadriplegia, which affects both the arms and the legs. Early in my childhood, I received inadequate medical care because of instability in my family life. When I was 7 years old, a court granted custody of me to my grandmother on my father’s side, and my life took a turn for the better.I can’t imagine what it must have been like for her then — at 67, when she should have been enjoying some leisure after all her societal toil — taking on the responsibility of raising a young child, let alone a physically impaired one, in an ableist society. (John Altman, 8/29)

Stat: Medical Education Needs To Stop Burning Out Students.
Students’ time in medical school should help them grow and become insightful, caring doctors. Instead, medical education is somehow turning smart, gifted, enthusiastic applicants into exhausted and unhappy students who become interns, residents, and physicians at increased risk of depression and burnout.I’m no stranger to the demands of medical school. My father and father-in-law were both doctors. I’m a pulmonologist, my wife is a nephrologist, and we have a son who is an internist and another who is in medical school. These issues are personal to me. As the dean of a medical school, they also focus my efforts to modify the learning environment to keep pace with new generations of students. (Augustine M.K. Choi, 8/29)

The New York Times: The Great Fortune Of Ordinary Sadness
I’m getting teary-eyed at a fruit stand, running my fingers lightly over the fuzzy skin of a peach while willing my bottom lip to stop its ridiculous quiver. I will not cry. A little change of plans is nothing to be sad about, as sad things go. A few weeks ago, I was supposed to have picked up my teenage son after a month at summer camp on a riverbank in North Carolina, the place he loves more than anywhere on earth. Next year he plans to work there all summer as a counselor, and after that he’ll be off to college with future summers unspooling toward his adult life, away from us. (Mary Laura Philpott, 8/29)

St. Louis Post Dispatch: Federal Judge's Pithy Ruling Underscores Case For Affirming Abortion Rights
Missouri Republican state lawmakers tried their best to defy the U.S. Supreme Court in a flagrant attempt to deny women their constitutional right to an abortion, but at least for now, it has failed — and deservedly so. A federal judge ruled Tuesday that the Legislature, in passing House Bill 126, unquestionably overstepped the legal boundaries outlined by the Supreme Court and stopped it from going into effect, as planned, on Wednesday. (8/28)

Louisville Courier-Journal: Kentucky Rep. Thomas Massie More Concerned About Gun Rights Than Lives
In a recent opinion column in the Courier Journal, Reps. Jim Jordan and Thomas Massie presented their rambling arguments against gun control. In what is clearly an appeal to their bases for future votes, they make their case for doing nothing and continuing the acts of omission at which they are now well-practiced. (Bill Holmes, 8/28)

Kansas City Star: Is Racism In Kansas City Causing A Public Health Crisis?
A black man living in Kansas City’s urban core can expect his life to end nearly 20 years earlier than a white woman who lives roughly 10 minutes away. This stark disparity in life expectancy is the impetus for a resolution that would declare racism a public health crisis and address public health disparities resulting from racial inequities. (8/29)