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This TED talk notes that dozens of countries have laws that restrict the travel or stay of people with HIV. This pushes the disease underground. Due to stigma and fear of legal repercussions, these laws prevent people from seeking diagnosis and treatment, which lowers life expectancy and quality of life for the patients and can increase the incidence of HIV in the population.

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Transcript of "HIV -- how to fight an epidemic of bad laws"

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TED Talk Subtitles and Transcript: There is an epidemic of HIV, and with it an epidemic of bad laws -- laws that effectively criminalize being HIV positive. At the TEDxSummit in Doha, TED Fellow Shereen El-Feki gives a forceful argument that these laws, based in stigma, are actually helping the disease spread.

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Emma Jones, June 24, Environmental Health

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Emma Jones, June 24, Environmental Health

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Iowa Public Radio recording from River to River show.
A study was conducted to see how Iowa is impacting the Mississippi River and Gulf of Mexico compared to other states. Iowa has the highest amount of chemicals in the runoff and river water due to the amount of farming, which has drastic impacts on health both on people in Iowa and those downstream.

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A new study from University of Iowa researchers shows the nitrate flowing from Iowa farm fields is a large part of the total load in the Mississippi and Missouri Rivers.

During this episode of River to River, Ben Kieffer talks with one of the authors of the study, research engineer Chris Jones, about the devastating impact nutrients from Iowa farmland is having downstream.

In the second half of the show, University of Iowa political scientist Bill Reisinger provides some insight on tensions in Eastern Europe, including how Ukraine faked the murder of a journalist allegedly to foil a Russian assassination plot.

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New Study Shows Iowa Farms Deposit more Nitrates into Rivers than Surrounding States

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A new study from University of Iowa researchers shows the nitrate flowing from Iowa farm fields is a large part of the total load in the Mississippi and Missouri Rivers. During this episode of River to River, Ben Kieffer talks with one of the authors of the study, research engineer Chris Jones, about the devastating impact nutrients from Iowa farmland is having downstream.

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Arianna Roberts, June 24, 2018, Laws/Policies/Politics

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Arianna Roberts, June 24, 2018, Laws/Policies/Politics

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This New York Times article examines the multiple bills that congress is putting forward to address the opioid epidemic. Researchers and experts who have reviewed the bills are skeptical that the efforts will be enough to successfully solve the opioid problem in the United States. The opioid epidemic is a very important public health issue, related to addiction and overdose: according to the article, 42,000 people died from opioid related deaths in 2016.

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Despite some good ideas, addiction researchers say, the legislative effort falls short of the coordinated response the epidemic demands.

If the opioid crisis could be solved by the sheer weight of proposed legislation, Congress would be able to pat itself on the back. Last week, the House began two weeks of voting on what will be more than 50 bills about the epidemic, and the Senate has its own stack of opioid bills wending through the chamber.

Some of the bills authorize actions that all involved agree would help ease the epidemic, such as increasing access to treatment or allowing doctors to more easily identify patients who are shopping for multiple prescriptions.

Then there are measures like the " Synthetic Drug Awareness Act," the first bill that came to the House floor, which calls for a study of the effects of synthetic drugs like "spice" and "bath salts" on adolescents. Or the " Poison Center Network Enhancement Act," meant to improveand build awareness of the national poison control call center.

Taken as a whole, addiction researchers say, the legislative effort has some valuable ideas but falls short of the coordinated response warranted by an epidemic that claimed at least 42,000 lives in 2016, more than guns or car crashes. Some of the measures would probably have little effect, they say, and many evidence-based strategies to expand treatment go unmentioned.

"I didn't really see that many groundbreaking proposals," said Joshua Sharfstein, a vice dean of public health at Johns Hopkins University and the former health and mental hygiene secretary in Maryland, who reviewed the dozens of bills.

The volume of legislation reflects the desire of lawmakers on both sides of the aisle to show that they can take action on a growing public health crisis that has touched Americans across the country and in every social class. Opioids legislation is a popular focus for lawmakers facing re-election this fall, and House Republican leaders have been eager to draw attention to their members' work on the subject.

So have outside groups. The American Action Network, a nonprofit aligned with the House Republican leadership, is running digital ads around the country highlighting the anti-opioids work of vulnerable members. Senate Majority PAC, a group that supports Democrats, has created an ad about an opioid bill sponsored by Senator Joe Manchin III, of West Virginia, who is running for re-election.

In the House, the leadership is bringing many individual bills to the floor, allowing the maximum number of legislators to say they sponsored their own piece of legislation and won passage. At a news conference last week, 10 members each gave a short speech about the constituent story that inspired their bill. (During the Q. and A.portion of the conference, reporters asked about immigration policy.) The leadership has set up an opioids crisis website to highlight the bills. And there's a social media hashtag: #opioidcrisis

The list of members sponsoring opioid bills is filled with Republicans facing tough re-election bids. As Politico recently noted, more than half of the Republicans in races considered to be "tossups" by the nonpartisan Cook Political Report are chief sponsors of a House opioids bill. Most of the bills are ultimately expected to be packaged into one piece of legislation this week.

The House's effort has the patina of bipartisanship - most bills have sailed through their committees on broad bipartisan votes, and many of the bills in the first batch passed the full House on voice votes.After all, what legislator would want to be on the record opposing an opioids fix?

But Democrats have been privately grumbling about a rushed process that has ignored their favored ideas for battling the epidemic. "If the first principle of legislation is do no harm, we will have succeeded," said Representative Peter Welch, a Democrat from Vermont who sits on the House Energy and Commerce Committee. "But if the goal of legislation is to solve a problem, we will have failed."

Experts who reviewed the package of legislation said there were several bills that could make a difference in helping prevent people from becoming addicted to opioid medications, and a few that could help those already struggling with addiction to get treatment. There are also some long-term investments in pain research that could pay off, though not for the currently afflicted: Both the House and Senate legislation would direct the National Institutes of Health to invest more in studying pain treatments that are not addictive.

In February, The Upshot asked a broad panel of experts to recommend priorities for battling the opioid crisis. They overwhelmingly emphasized addiction treatment as most important, citing the expansion of Medicaid to cover more people and the broadening of medication-assisted treatment as particular priorities.

One of the most costly proposals up for a vote this week does not expand who is covered by Medicaid, but would allow Medicaid to pay for addiction treatment inside large residential hospitals, something currently permitted only on a state-by-state basis.Another bill would allow Medicare to cover certain forms of addiction treatment for the first time. Another would expand the types of health care providers who could prescribe medications that help treat people with opioid-use disorders.

But treatment is not the primary focus of this crop of bills. Instead, a large number address various matters related to the prescribing of drugs; the tracking of prescribing; and the packaging and disposal of medications. Many of these measures could be helpful in preventing new cases of addiction: A recent study cited by the Department of Health and Human Services suggests that over half of those in treatment for opioid-use disorders began by using prescription medications.

But the push comes as prescriber behavior is already changing, amid recent policy changes meant to deter the overuse of opioid medications in medical care. Prescriptions for opioids have been falling since 2012, according to a recent study, even as the overdose death toll has continued to rise.

There are also, of course, many bills calling for studies.

Another missed opportunity, addiction experts said, is the legislative strategy to encourage creation of more treatment options for patients who need them. Earlier legislation, including the recent big spending deal passed by Congress, created short-term state grants for local anti-opioid priorities. But what health care providers and other entrepreneurs really need is a more permanent source of funding,so that those setting up clinics or companies will know they can remain in business over the long term, said Caleb Alexander, a professor at the Johns Hopkins Bloomberg School of Public Health. The shorter-term grant programs may not provide the nudge, he said.

"States are getting $500 million here or $200 million there," he said. "At any given moment, it's unclear whether the rug is going to be pulled out from under them."

President Trump has unveiled his own set of preferred opioids policies, many focusing on enhanced law enforcement approaches. The White House has signaled its approval of a number of the House bills under consideration, including the one that would expand coverage of hospital addiction treatment and two that seek to limit trafficking of synthetic opioid drugs, like fentanyl.

The Senate is moving ahead with its own legislative push on opioids, though the midterm politics differ in that chamber. Passing opioid bills in the coming months could benefit several Democratic incumbents who are up for re-election in states where the crisis is particularly severe, such as West Virginia, Ohio and Pennsylvania.

Nonetheless, an aide said Senator Lamar Alexander, Republican of Tennessee and the chairman of the Senate health committee, would lead an effort to bring a package of measures to the Senate floor.

More legislation may follow. Representative Greg Walden of Oregon, the Republican chairman of the House Energy and Commerce Committee and a leader in the current House opioid strategy, has said any holes in the current legislation can be patched in the future.

"While these bills are not our first efforts in this fight, you have my word they will not be our last either," he said in the news conference. "We know there will be more work to do, even after these become law."

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Congress Is Writing Lots of Opioid Bills. But Which Ones Will Actually Help?

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Despite some good ideas, addiction researchers say, the legislative effort falls short of the coordinated response the epidemic demands. If the opioid crisis could be solved by the sheer weight of proposed legislation, Congress would be able to pat itself on the back.

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PFA and PFC Chemicals in CO Groundwater (Joshua Morrison, Environmental Health, June 24)

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PFA and PFC Chemicals in CO Groundwater (Joshua Morrison, Environmental Health, June 24)

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I'll share some (Environmental Health related) work I was involved with earlier this summer. I had the great opportunity to help with this study: www.pfas-aware.org/. PFA and PFC chemicals were detected in water supply for communities near Colorado Springs. We evaluated people's exposure to these chemicals, and tested their blood for these chemicals. PFCs were also recently found in groundwater in Boulder County: www.thedenverchannel.com/lifestyle/health/boulder-county-community-warned-drinking-water-could-be-contaminated.

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Laura Cornwell, 6/22/2018 - Infectious/Communicable Diseases

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Laura Cornwell, 6/22/2018 - Infectious/Communicable Diseases

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When this story aired back in April, it piqued my interest as a former East-coaster. Researchers (including ColoradoSPH students working on this study) have long known that ticks carry a variety of viruses, including some unique to CO. While ticks have not historically been prevalent in CO, the changing climate has researchers concerned about increased presence (of ticks and the diseases they carry) in the future.

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Dan Salkeld doesn't like plunging toilets, filling out tax forms, or clipping his children's toenails. But he loves collecting ticks in Colorado.

The northeast, he says, is humid and chock full of ticks and mosquitoes. "Here, we have snow covered mountains and pine forest and the ticks are not in the same numbers. It's pleasant," says the disease ecologist with Colorado State University. He estimates he's collected about 7,000 ticks over his career.

When it comes to ticks people tend to think of the east coast, where the pests are everywhere and they carry Lyme disease. But we have ticks, too -- well into the Rocky Mountains -- and they might be carrying their own disease cargo. That's what Salkeld and his colleague, Alyssa Beck, have come to Rocky Mountain National Park to find out.

Salkeld dressed in a short sleeve T-shirt and a baseball hat. Beck, a student at the Colorado School of Public Health and (on this day) an apprentice tick-hunter, took a different tack. The Wisconsinite says she's collected far too many ticks by accident, so she's zipping into a full-body Tyvek suit. It even has a hood.

"It's like the marshmallow in Ghostbusters," Salkeld tells Beck. "If you just direct it for the wind, you should inflate."

They pull out white flannel flags that they'll use to entice the ticks out of the grass and bushes and head off down a well-trafficked trail through Ponderosa pine forest. They aren't as interested in the ticks themselves as they are in what might be hiding inside the bugs -- specifically, two viruses. One of them is called Colorado tick fever.

"Apparently it's horrendous," says Salkeld.

There's no treatment. The virus gives people fever, chills, aches and fatigue, but it goes away.

"You don't have chronic impacts later on," he says, unlike with something like Lyme disease.

But the researchers are also looking for something much worse, Powassan virus. It's a nasty disease currently sickening people in the Northeast and Great Lakes regions. According to the Centers for Disease Control and Prevention, the virus can give people anything from a fever and headache to brain swelling, confusion, seizures and even memory loss. Luckily, it's very rare. Only about 100 cases were reported in the U.S. since 2007.

"We don't know if that's affecting people here. But that's one of the new poster children of tick-borne disease because it's seems to be coming south and affecting more people than it has done. And it can be fatal," says Salkeld.

Way before Powassan became a problem in other parts of the country, scientists found it out here in Colorado.

"But few people have looked ever since," says Salkeld. Until now.

Salkeld and Beck are hiking through Ponderosa pine forest, dragging those white flannel flags across the ground. They're at about 8,000 feet of altitude, with a backdrop of stunning mountains, a herd of elk lounging about in a golden meadow complete with meandering stream, and 15 minutes in, no ticks.

And then, there it was: the first tick, clinging to the flannel that it thought would provide its next blood meal. Salkeld used tweezers to drop it into a glass vial. From there on out, it was pretty much tick galore.

By the end of the day, the researchers had nearly 100 of the creatures, sorted by location. They were crawling on top of each other, in writhing balls.

"Yeah, that's a little tick orgy," said Salkeld.

The tick orgies will eventually make their way to the lab bench of a scientist named Alex Byas, the official tick grinder and virus extractor.

"That is my job today, yes," says Byas, who is also a veterinarian and a PhD student at CSU studying West Nile virus.

Byas opens a lab fridge to reveal a Ziploc bag full of vials of ticks. They look dead, but they aren't. She needs them alive to keep the potential viruses inside them fresh.

"They're all balled up because they're really cold. But once you take them out and bring them back up to room temperature they'll get really active, which makes them sometimes kind of hard to pull out of the tube," she says. "They can be surprisingly fast."

Byas will wrangle the reawakened ticks into little tubes, with some liquid and a metal ball that looks like a BB. Then she'll plop those into a machine that will grind them into the consistency of fine coffee grounds, or as Byas calls it, "tick smithereens."

She'll take the smithereens and separate out the liquid, the part that might have viruses floating around inside. Finally, she'll run a series of tests for Colorado tick fever and Powassan virus. She's keeping her mind open to other possibilities because, she says, you never know what you might find.

"You don't know exactly what's going to be in there, so you can look at a very large library of possibilities," she says. "That's how -- sometimes -- viruses that we don't even know about are discovered."

Byas and her colleagues should know by the end of the summer if these Rocky Mountain wood ticks contain Colorado tick fever and Powassan virus. They'll keep collecting and checking in coming years because things are always changing.

"Historically we really haven't had much of a tick problem here in Colorado. However, we know that climate change is dramatically influencing the distribution and rates of tick-borne diseases in other parts of the country," says Danielle Buttke, a veterinary epidemiologist with the National Park Service and a public health officer with the U.S. Public Health Service.

There are other changes afoot in the Rocky Mountains. Deer and elk are coming down with chronic wasting disease.

Researchers in other parts of the country have noticed that when deer populations drop, Buttke says, "the following year and sometimes the next year we have a really, really high number of ticks looking for blood meal hosts." Instead of biting deer, they turn to people. Buttke says it's all speculation whether chronic wasting could lead to a temporary spike in tick-borne disease here in the Mountain West, but it's a possibility.

"And that's a concern particularly in this area because people aren't practicing the preventative behaviors needed to prevent these diseases," she says, probably because people tend to forget there are ticks here in the first place.

Luckily, the diseases they carry are completely preventable. Buttke says people just have to remember that there are ticks out there in the mountains - as high as 10,000 feet in altitude - and check themselves for the parasites when they return from a hike.
This story was produced by the Mountain West News Bureau, a collaboration between Wyoming Public Media, Boise State Public Radio in Idaho, Yellowstone Public Radio in Montana, KUER in Salt Lake City and KRCC and KUNC in Colorado.

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The Rocky Mountains Have Ticks. Scientists Want To Know What Viruses They're Carrying

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Dan Salkeld doesn't like plunging toilets, filling out tax forms, or clipping his children's toenails. But he loves collecting ticks in Colorado. The northeast, he says, is humid and chock full of ticks and mosquitoes. "Here, we have snow covered mountains and pine forest and the ticks are not in the same numbers.

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Mental/Social/Emotional/Behavioral Health

Description:Child marriage, defined as a formal marriage or informal union before age 18, is a reality for both boys and girls, although girls are disproportionately the most affected. Child marriage is widespread and can lead to a lifetime of disadvantage and deprivation.

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This is an interesting talk from NPR that discusses the conflicting issues with e-cigarettes. While they may help adults quit actual cigarettes, they are guiding teens towards trying real cigarettes. It's an important discussion that shows how kids growing up now may not see the danger of vape pens.

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Kids who vape and use other forms of e-cigarettes are likely to try more harmful tobacco products like regular cigarettes, but e-cigarettes do hold some promise for helping adults quit.

That's according to the National Academies of Science, Engineering and Medicine, which published a comprehensive public health review of more than 800 studies on e-cigarettes on Tuesday.

"There is conclusive evidence that most products emit a variety of potentially toxic substances. However the number and intensity is highly variable," says David Eaton, who heads the committee that wrote the report. He is also the dean and vice provost of the graduate school of the University of Washington, Seattle.

"In some circumstances, such as their use by nonsmoking adolescents and young adults, their adverse effects clearly warrant concern. In other cases, such as when adult smokers use them to quit smoking, they offer an opportunity to reduce smoking-related illness."

In fact, 15 of the studies NAS reviewed found that when teens and young adults use e-cigarettes, they are more likely to try regular tobacco within a year.

"We found that kids who tried e-cigarettes, hookah, or smokeless tobacco or cigars - any non-cigarette tobacco product - were all twice as likely to try cigarettes a year later, compared to kids who hadn't used any of those other tobacco products," says Shannon Lea Watkins, a public policy researcher at University of California, San Francisco. Watkins and her colleagues also found that the effects of using non-cigarette products compound: "Kids using two or more non-cigarette products were four times as likely to report using cigarettes a year later."

However, it is not yet known how much tobacco they use on a regular basis and whether it became a habit. More long-term studies are needed.

The NAS report also indicates that there is some evidence that e-cigarettes may help adults already smoking regular cigarettes quit, but only if they switch exclusively to e-cigarettes.

Eaton emphasized that there is insufficient evidence on whether e-cigarettes work as well as either no treatment or FDA-approved smoking-cessation treatments, such as nicotine patches or gum, to get smokers to quit.

E-cigarettes are still fairly new and are largely unregulated. The were introduced only in 2003 as an alternative to tobacco-containing cigarettes, which is why the government requested that the analysis be conducted.

The report found that most e-cigarettes contain nicotine, even if they are marketed as flavored like bubble gum and potpourri.

The report also found that emissions from e-cigarettes do contain some harmful byproducts like metal, but far less than conventional cigarettes.

"Conventional cigarettes burn, and in the process of burning tobacco, a large number of fairly toxic chemicals are generated in the tobacco smoke," Eaton says. So there are more adverse health effects related to these combustible products.

However, a recent national survey suggests adults do not believe that e-cigarette vapor is toxic.

Food and Drug Administration Commissioner Scott Gottlieb says the report "helps identify areas that need further study to better understand the net public health impact of e-cigarettes ... . We need to put novel products like e-cigarettes through an appropriate series of regulatory gates to fully evaluate their risks and maximize their potential benefits."

FDA commissioned the report at the direction of Congress to evaluate evidence of health effects of e-cigarettes after it delayed proposed regulations last year.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, issued a statement expressing disappointment that the FDA has not acted quickly enough to regulate these products. "This report shows what happens when a new product is introduced without meaningful government oversight. It demonstrates why the FDA should fully and aggressively implement the overdue e-cigarette regulations that took effect in August 2016," it says.

The national academies report calls for more studies.

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E-Cigarettes Likely Encourage Kids To Try Tobacco But May Help Adults Quit

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Kids who vape and use other forms of e-cigarettes are likely to try more harmful tobacco products like regular cigarettes, but e-cigarettes do hold some promise for helping adults quit. That's according to the National Academies of Science, Engineering and Medicine, which published a comprehensive public health review of more than 800 studies on e-cigarettes on Tuesday.

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Jimmy Winslow  6/21/18    Mental/Social/ Emotional/Behavioral Health

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Jimmy Winslow  6/21/18    Mental/Social/ Emotional/Behavioral Health

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This article details how societal problems, in this case police brutality, can have a massive impact on the mental health of a community, like black Americans. Health researchers found that when police officers in the United States kill unarmed black Americans, it damages the mental health of black Americans in those states.

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Activists for racial justice have long expressed concern that the rash of headline-grabbing police killings of black Americans was damaging the mental well-being of African-American communities.

A report published in The Lancet, a leading British medical journal, on Thursday appears to give credence to those concerns.

Using mental health survey data and a database of police shootings, a team of health researchers concluded that when police officers in the United States kill unarmed black people, it damages the mental health of black Americans living in those states.

The mental health of white Americans was not similarly affected, the researchers found. Nor were negative health effects associated with police killings of unarmed white Americans or armed black Americans.

While these findings might seem unsurprising, particularly to African-Americans, the researchers contended that their study was a significant attempt to assess the measurable, if indirect, harms that police violence has inflicted on the broader psychological and emotional well-being of African-Americans.

"'Having seen something so horrific and traumatic that happened to someone else, I'm reminded in a very painful and salient way that the deck might be stacked against me,'" Atheendar S. Venkataramani, one of the study's authors, said of how black people might perceive police killings. "It's really about all the kinds of insidious ways that structural racism can make people sick."

Dr. Venkataramani, an assistant professor of medical ethics and health policy at the University of Pennsylvania, conducted the study along with Jacob Bor of Boston University, David R. Williams of Harvard and Alexander C. Tsai of Massachusetts General Hospital.

The researchers analyzed responses from 2013 to 2016 to the Behavioral Risk Factor Surveillance System, a national survey that interviews more than 400,000 adults, selected at random each year, about their health. They juxtaposed responses to questions regarding mental health with data from Mapping Police Violence, a database of police killings around the country.

The annual health survey is done by telephone on a rolling basis throughout the year, and the researchers analyzed responses given by residents in states where a police killing had occurred in the three months before they were interviewed. They found that black Americans reported more "not good" mental health days in the period after a police killing of an unarmed black person, and that the killings accounted for up to 1.7 additional days of poor mental health a year.

The study's authors could not say definitively that the respondents to the health survey knew about the police killings that had happened in their states, or describe how, precisely, the news about the killings might have harmed their mental health.

Still, Dr. Venkataramani said the effects were observable and real. If anything, he said, the findings might understate the extent of the trauma, as some police killings of unarmed African-Americans have become events of national significance, reaching far beyond the states where they occurred. (The study cited, among the most notable examples, the police killings of Oscar Grant III in California, in 2009; of Michael Brown Jr. in Missouri and Eric Garner in New York, in 2014; of Walter Scott in South Carolina and Freddie Gray in Maryland, in 2015; and of Stephon Clark in California, earlier this year.)

"Maybe this is the tip of the iceberg," Dr. Venkataramani said.

While a study like this one helps to underscore the impact of police killings on black communities, what's important is what is done with the findings, said Mama Ayanna Mashama, an activist and organizer in Oakland, Calif., who practices natural wellness healing. Ms. Mashama said she had seen firsthand how police violence can cause anger and angst, and damage the self-esteem of black Americans.

"We have to find ways of de-escalating police response to black people," she said. "It has to become policy. It has to become part of how it's implemented from the top down. We have to have trauma-informed practices everywhere: in the schools, in families, in workplaces."

Follow John Eligon on Twitter: @jeligon

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Police Killings Have Harmed Mental Health in Black Communities, Study Finds

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Activists for racial justice have long expressed concern that the rash of headline-grabbing police killings of black Americans was damaging the mental well-being of African-American communities. A report published in The Lancet, a leading British medical journal, on Thursday appears to give credence to those concerns.

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A Brazilian civil society diplomat speaks about  gun control and drug laws. She speaks about influencing national policy through social movements by changing the narrative, utilizing data and including those from diverse perspectives. I found it interesting how America impacted the gun control referendum in Brazil.

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Ilona Szabó de Carvalho: 4 lessons I learned from taking a stand against drugs and gun violence

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Throughout her career in banking Ilona Szabó de Carvalho never imagined she'd someday start a social movement. But living in her native Brazil, which leads the world in homicidal violence, she realized she couldn't just stand by and watch drugs and guns tear her country apart.

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As an Idaho girl who grew up 45 minutes from Elmore County, this article caught my eye. Bubonic plague is a rare occurrence in humans today, but it is still frequently found in rodents like ground squirrels and mice. Lucky for us it is now treatable by antibiotics.

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Earlier this week, state health officials confirmed a case of bubonic plague in a young boy in Elmore County, Idaho.

Bsip / Getty Images / Via gettyimages.com

The child is currently recovering from the potentially deadly disease, according to a statement from the Central District Health Department in Boise, Idaho. It is the first human case of plague in Idaho in 26 years.

"It appears this case was bubonic plague ... the child had a high fever that prompted his parents to take him to a health care provider where he was treated and tested," Christine Pearson, a spokesperson for the Central District Health Department, told BuzzFeed News in an email.

It is unclear whether the child, who has not been publicly identified, contracted the disease in Idaho or on a recent trip to Oregon. In both states, plague has historically been found among rodent populations, such as ground squirrels and mice, but it rarely infects people. There have only been two human cases in Idaho and eight cases in Oregon since 1990.

Plague was identified among ground squirrels in Idaho in 2015 and 2016. However, this year there have been no indicators of plague among squirrel populations, such as unusual behavior or die-offs, according to the report.

The plague, also called the bubonic plague and " Black Death," might sound like an ancient epidemic from history textbooks, but it actually never really went away. Plague cases still occur all over the world today. However, you probably don't hear about it much because the disease is relatively rare and can be treated with antibiotics.

Each year, there are about 1,000-2,500 cases of the plague around the world, mostly in Africa, Central Asia, India, and the northern part of South America, according to the US Centers for Disease Control and Prevention (CDC). The most recent outbreak occurred in Madagascar in 2017 - there were 2,417 cases and 209 deaths, according to the World Health Organization.

Plague cases also occur in the US, typically in the northern parts of New Mexico and Arizona, Colorado, Oregon, and Nevada. There is an average of seven cases of plague in the US each year. In 2015, a teenage boy in Colorado died from the plague after experiencing flu-like symptoms for a week.

Thanks to modern medicine, we are now able to prevent the spread of plague and treat cases before they become potentially life-threatening. And we no longer have those terrifying "plague doctor" outfits with the bird masks.

The plague is caused by a bacteria called Yersinia pestis, which is usually spread to humans from infected fleas or rodents.

Plague occurs naturally in certain rodent populations that carry Yersinia pestis. Fleas can pick up the bacteria from the infected animal and pass it to humans by biting their skin. Humans can also get the plague from contact with infected animals and, rarely, from an infected human - but it depends on the type of plague. There are three types: bubonic, pneumonic, and septicemic.

Bubonic plague is the most common type, and it's the one spread through the bite of a bacteria-carrying flea or an infected animal. Symptoms include a fever; headache; chills; and swollen, painful lymph nodes (buboes) in the neck, armpit, and groin that can turn into pus-filled sores. Pets also can develop swollen glands under the jaw, in addition to other symptoms like lethargy, loss of appetite, and fever.

Septicemic plague occurs when the bacteria enter the bloodstream, and it causes fever, extreme fatigue, stomach pain, hemorrhaging, and acral gangrene, which is a loss of blood flow and tissue death in the fingers or toes, which can cause the skin to turn black.

Pneumonic plague is the most contagious and severe form of plague, and it's the type that can spread from person to person or develop when bubonic plague spreads to the lungs, called secondary pneumonic plague. It causes flu-like symptoms in addition to blood-tinged coughing and pneumonia.

There is no vaccine for plague, but if it's diagnosed early, it can be treated with antibiotics and supportive care. Plague has a case-fatality rate between 30% and 100%, when there is no treatment, according to the WHO.

It's still incredibly rare to contract the plague, but it's always important to take precautions to avoid fleas and rodents.

Plague isn't an imminent threat in the US, but you should still take steps to protect yourself and your pets - especially if you live in the Western or Southwestern US. The CDC recommends making your home and workplace rodent-proof and removing rodent habitat areas, avoiding contact with wild rodents, wearing gloves to dispose of rodent carcasses, and using insect repellent with DEET outdoors.

You can also decrease your risk by treating your pets for fleas with effective medication and preventing them from hunting or eating rodents in endemic areas.

Caroline Kee is a health reporter for BuzzFeed News and is based in New York.

Contact Caroline Kee at caroline.kee@buzzfeed.com.

Got a confidential tip? Submit it here.

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A Rare Case Of Plague Has Been Confirmed In A Young Boy In Idaho

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The plague, also called the bubonic plague and " Black Death," might sound like an ancient epidemic from history textbooks, but it actually never really went away. Plague cases still occur all over the world today. However, you probably don't hear about it much because the disease is relatively rare and can be treated with antibiotics.

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This article talks about a new methodology being developed by a team in Switzerland that could potentially replace insulin pumps. The treatment is an implant of synthetic cells that release insulin every time caffeine is ingested. This could prevent cases of Insulin shock so commonly seen in patients with insulin pumps that forget to eat. The theory is to make the insulin release dependent on diet instead of "timed intervals" by a pump.

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In the not-so-distant future, type 2 diabetics may be able to forego insulin pumps and instead manage their condition with a shot of espresso or a mug of filter coffee.

A team of researchers based in Switzerland have invented a designer implant that dispatches medication whenever it detects caffeine in the bloodstream. The results of the first study, published in Nature Communications, have been extremely promising - at least, in mice.

Type 2 diabetes affects over 400 million people worldwide and costs the US health system $825 billion every year. If you develop the condition, it means the body has lost its ability to respond to insulin and regulate the blood's glucose levels, i.e., the body has become insulin resistant. Because of this, glucose levels spike after every meal.

One way to manage the condition is to regularly and frequently take pinprick samples to monitor blood sugar levels. When the blood sugar level is known, it is possible to adjust an insulin-administering pump to return levels to normal. Needless to say, the process can be time-consuming, cumbersome, and inconvenient - so Martin Fussenegger, a biotechnologist at ETH Zurich in Switerzland, and his co-workers came up with an innovative and user-friendly solution.

The team designed an implant using human kidney cells that release insulin when triggered. These were then covered in a " caviar"-like structure of gel capsules to stop the body's immune system attacking the cells while, at the same time, allowing the caffeine in and letting the medication out so that it can disperse into the bloodstream.

To test their new invention, they used a mouse model. The implant was inserted under the skin of 10 diabetic mice who were then given a variety of drinks with different levels of caffeine. Think herbal tea, coke, instant coffee, black tea, and milkshakes.

All drinks, with the exception of the milkshake and herbal tea, triggered the release of the medication. What's more, the higher the caffeine levels, the stronger the dose.

Why use caffeine as the trigger (aside from its many, many health benefits, of course)? As far as the researchers know, there are very few traces of caffeine in most drink and food, at least not in high enough levels for the implant to register. This makes it easy to control and stops anyone from accidentally triggering the implant. At least in theory.

It also makes it easy for most people to incorporate it into their daily routine, whether it's a Starbucks after breakfast or a post-lunch tea.

"You have a tea or coffee in the morning, another after lunch, and another at dinner, depending on how much drug you need to get your glucose back down," Fussenegge told The Guardian.

Unfortunately, it might take a few years before it is fit for purpose. The treatment will have to go through several tests and trials, not least in humans, before it can be approved by the FDA or any other regulatory body.

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New Way To Manage Type 2 Diabetes Trades Insulin Pumps For A Cup Of Coffee

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In the not-so-distant future, type 2 diabetics may be able to forego insulin pumps and instead manage their condition with a shot of espresso or a mug of filter coffee. A team of researchers based in Switzerland have invented a designer implant that dispatches medication whenever it detects caffeine in the bloodstream.

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Rick DeVoss, 6/19/18 Race/Class, Gender, Society

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Rick DeVoss, 6/19/18 Race/Class, Gender, Society

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This episode from Invisibilia reviews a theory of mental health treatment where emphasis is put on ensuring patients encounter a more or less normal lifestyle. A case study of Geel, Belgium is presented where patients are placed with host families as part of their treatment plan. The theory continues on to state that relatives may not be the best providers of a normal environment and host families can be very good therapeutic outlets. There is also emphasis on changing the U.S. stigma of mental health disorders.

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In this episode we find that the solution can be the problem. The hour begins with a charming couple from Utah who stumble across a clever fix to their clogged drain problem one day while they are showering together.

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Aspen Becker, 6/19/18, Environmental Health

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Aspen Becker, 6/19/18, Environmental Health

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This article details a study that our own Dean, Dr. Jonathan Samet, is currently working on. It is an unprecedented study that has identified 6.4 million people worldwide who have been exposed to radiation and are at risk of health complications. Specifically, they have found 230 uranium mining sites that have or are putting populations at risk of radiation exposure.

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Newsroom | Colorado School of Public Health | University of Colorado Denver

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ColoradoSPH. At the forefront of changing how we expand health boundaries, prevent disease, and save lives.

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June 19, 2018
Race/Class/Gender/Society
This is an episode from the RadioLab podcast which discusses and shares a families decision on identifying as Black or White. Racial history throughout the Ohio town has shaped this family's decisions on how they choose to perceive themselves. It reveals the difference in how the two daughters were treated growing up in Ohio based on the fact that one choose to identify as black and the other choose to identify as white.
Link: In addition to the link below, RadioLab episodes can also be found on Spotify.

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The complex racial history of two towns in Ohio leads members of the same family to disagree strongly about whether they're black or white.

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Patrick Ryan, June 18th, Non-infectious disease/Lifestyle

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Patrick Ryan, June 18th, Non-infectious disease/Lifestyle

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I thought that this was an interesting article from NPR discussing new and innovative ways to help those suffering from the opioid epidemic to engage in life saving recovery treatment. Despite having evidence based treatments for opioid use disorder, simple access to such treatments has been a major barrier to the recovery of these patients. The article addresses some of the stigma in medication assisted treatment which persists.

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More than 115 Americans are dying every day from an opioid overdose. But a study out Monday finds that just three in 10 patients revived by an EMT or in an emergency room received the follow up medication known to avoid another life-threatening event. The study, published in the Annals of Internal Medicine, followed 17,568 patients who overdosed on opioids between 2012 and 2014 in Massachusetts. It looked at survival rates over time and whether or not patients received medicines that treat addiction.

Of the patients who did receive medication, 17 percent took buprenorphine, known by the brand name Suboxone, for roughly four months. They had a 40 percent lower death rate after one year, as compared to those who did not take any medication. The results for the 11 percent of patients who took methadone were even stronger: They cut their death rate by 60 percent.

Buprenorphine and methadone both reduce the urge to get high on powerful street drugs which can lead to another overdose.

A small percentage, 6 percent, of patients were on the opioid blocker, naltrexone (brand name Vivitrol), but often for just one month. They were no more likely to be alive after a year than those who were not offered or did not take a medication.

"The stunning finding here is that we have effective treatments for people who survive an overdose but only three in 10 are getting those medications," says Dr. Marc Larochelle, the study's lead author.

For some perspective, Larochelle mentions the routine recommendation that patients who've had another life threatening event, a heart attack, take aspirin.

"The mortality reduction we see with these drugs is similar to giving someone who suffers a heart attack aspirin - it's one of the most effective treatments we have in medicine," said Larochelle, who's a primary care physician and researcher at the Grayken Center for Addiction at Boston Medical Center.

But he points to a big difference: 98 percent of people in this country get aspirin for a heart attack.The gap in care is similar to findings from a 2015 study from the U.K., but this is the first to follow U.S. patients seen in a hospital or by EMTs, says Dr. Nora Volkow, who directs the National Institute on Drug Abuse.

"A great part of the tragedy of this opioid crisis is that, unlike in previous such crises American has seen, we now possess effective treatment strategies that could address it and save lives," Volkow wrote in an accompanying editorial. "Yet tens of thousands of people die each year because they have not received these treatments."

Some things have changed since the 2012-2014 period of this study. A growing number of physicians are getting the waiver required to prescribe buprenorphine and the number of patients they can manage has increased from 100 to 275.

That includes emergency room physicians who until recently have not offered buprenorphine to overdose patients. A bill that has wide support in the Massachusetts legislature would require that all acute care hospitals offer the medication in the ER and offer follow-up care. In some places, hospitals are opening walk-in clinics and in Boston, there's a mobile van that take buprenorphine prescribing to the streets.

To understand why so few patients get methadone or buprenorphine, one need only cross the street from Boston Medical Center where Larochelle works. There are clinics that offer both drugs, and there's a needle exchange, focused on harm reduction for drug users who are still in active addiction. In the early morning hours, some men and women were lining up for their daily dose of methadone, while others were starting their day with a shot of heroin or fentanyl.

Scott, a 38-year-old from Lowell, Massachusetts, says he's overdosed three or four times, but wasn't offered Suboxone, a brand name for buprenorphine, until after his third overdose.

"The problem is, a lot of these doctors don't want to prescribe anything like that after the person has an overdose because they feel like they'll abuse the medicine," Scott says. (We're only using first names for people may still be buying illegal drugs.)

Scott says he has abused Suboxone. It and methadone are both opioid-based medications. Taken as directed they block cravings for something stronger without making the patient high.

But with Suboxone, some people take extra doses to get high, or layer it with alcohol or other medications, Scott says.

Few doctors are trained to or have experience managing such complex addictions. Scott says he can "understand why their reluctant to prescribe stuff" like Suboxone.

Scott switched from Suboxone to methadone within the last year. Unlike Suboxone, which patients can get from a primary care doctor, during routine medical care, methadone is tightly controlled, typically only available at designated clinics.

Scott says he prefers methadone because he doesn't take anything out of the clinic that he could abuse.

Sometimes it's the patient who is reluctant to start medication-assisted treatment.

"There's a perception that people aren't "clean" unless they're abstinent from all substances and that plays into keeping people away from medication treatment, which is the most effective treatment," says Aubri, who used to be dependent on heroin and has overdosed in the past. She is on methadone and says it works for her.

But Aubri says the way methadone is delivered is demeaning.

"It feels like a jail," Aubri says. "There's literal bars across the gates that don't open 'til a certain time. There's security guards. no one wants to be there. The only reason people go is because they need it."

Many communities continue to reject applications to open methadone clinics. Patients in rural areas often drive more than an hour each way to get their daily dose. The obstacles to care contribute to a feeling among many opioid addiction patients that doctors and hospitals just don't want to help.

"They treat us like crap," says Deana, as she hugs her husband Phill. "We're not like this because we're bad people, you know."

Deana and Phill have many stories about feeling mistreated in hospitals. But Phill is having the opposite experience now, taking Suboxone, through a clinic at the Boston Health Care for the Homeless Program.

"They give you the counseling, the therapy, it's like a family," says Phill, pausing as a ambulance wails by. "They make you feel welcomed and loved and give you that sense of hope that I can have a drug free life. I don't have to use."

Even at just 3 in 10 patients, Massachusetts was likely offering better opioid medication treatment than many states as of 2014. That's because 97-percent of the state's residents have health insurances, the highest rates in the country. In many parts of the U.S., it's difficult to find someone who will prescribe a patient methadone or buprenorphine.

"We just still have overwhelming stigma for patients with the disease of addiction," says Sarah Melton, a professor of pharmacy practice at East Tennessee State University.

Larochelle worries that patients, as seen in this study, are still not staying on treatment for more than a few months.

"We need to reevaluate how we're providing the care and make sure we can keep people there when they're there," Larochelle says.

Dr. Volkow is alarmed by one other finding. 34 percent of patients receive at least one prescription for an opioid and 26 percent were prescribed a benzodiazepine during the 12 months after their overdose.

"This indicates that guidelines cautioning against prescribing opioids and their co-use with benzodiazepines are not being followed," Volkow writes.
This story is part of a reporting partnership that includes WBUR, NPR and Kaiser Health News.

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After An Overdose, Patients Aren't Getting Treatments That Could Prevent The Next One

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More than 115 Americans are dying every day from an opioid overdose. But a study out Monday finds that just three in 10 patients revived by an EMT or in an emergency room received the follow up medication known to avoid another life-threatening event.

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Sari Ennis, June 18th, 2018, Mental/Social/ Emotional/Behavioral Health

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Sari Ennis, June 18th, 2018, Mental/Social/ Emotional/Behavioral Health

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This is a video by stakeholders regarding the FDA Food Safety Modernization Act. In this they discuss the implementation strategies for food safety standards. This includes transparency, the impacts that the implementation of this legislature will have on different operations and how enforcement will be achieved. It also voices concerns on how relationships with the public, operations, and the agencies will be impacted. This focuses heavily on social health and how the relationships between individuals is paramount and how it is important to take the emotions of others into account in order to be successful in the implementation of policies.

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FSMA: The Future Is Now - Stakeholder Perspectives

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Clare Mikhail, June 18, 2018- Infectious/Communicable Diseases 

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Clare Mikhail, June 18, 2018- Infectious/Communicable Diseases 

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This Ted Talk given by

Arik Hartmann  examines the question:

Our treatment of HIV has advanced. Why hasn't the stigma changed?

After being diagnosed with HIV, Arik, chose to live transparently, being open about his status, in an effort to educate people. In this candid, personal talk, he shares what it's like to live with HIV -- and calls on us to dismiss our misconceptions about the disease.

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Get a daily email featuring the latest talk, plus a quick mix of trending content.

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Arik Hartmann: Our treatment of HIV has advanced. Why hasn't the stigma changed?

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The treatment of HIV has significantly advanced over the past three decades -- why hasn't our perception of people with the disease advanced along with it? After being diagnosed with HIV, Arik Hartmann chose to live transparently, being open about his status, in an effort to educate people.

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Title: Lauren Davis - June 18, 2018 - Race/Class/Gender/Society 

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Title: Lauren Davis - June 18, 2018 - Race/Class/Gender/Society 

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Description:  In the podcast, Bad with Money with Gabby Dunn, the episode, The Gender Pay Gap (aka Why There Aren't Any Female Elevator Operators), Gabby explores the maddening and bizarre history of the gender pay gap - and discovers a startlingly potential solution.  Featuring Claire Suddath (Bloomberg Businessweek), Andrea Johnson (National Women's Law Center Senior Counsel for State Policy), and Dane Atkinson (CEO SummAll).

Link:  You can also listen on any streaming device that has podcasts by searching for Bad with Money.

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The Gender Pay Gap (aka Why There Aren't Any Female Elevator Operators) - Panoply

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It's been a hard week. We're still on vacation, but wanted to drop in to remind you to be kind to yourself in times of grief and anger. So, we're revisiting our episode about the importance self-care in the wake of police violence. There...

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Hadley Kelly                        June 18, 2018               Mental/ Social/ Emotional/ Behavioral Health

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Hadley Kelly                        June 18, 2018               Mental/ Social/ Emotional/ Behavioral Health

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The topic of suicide has been on the forefront of current media outlets from guest experts in suicide prevention to articles on social media discussing warning signs. This topic has since brought journalist, Lynn Keane to discuss her personal story of losing her son to suicide. She led a TED talk to discuss the importance of treating mental illness and to reduce the stigma in seeking help.

TEDxTalks. “Suicide Prevention .” YouTube, YouTube, 18 Mar. 2015, www.youtube.com/watch?v=L8Vx_5Zr_kM.

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Suicide Prevention | Lynn Keane | TEDxYouth@Toronto