Children's Geographies; 04/01/2023
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Evaluation &the Health Professions, Ahead of Print. This systematic review provides an overview of the unique challenges allied health professions face in the translation and implementation of evidence into practice, which remain relatively under reported and uninformed by a theoretical basis of behaviour change. MEDLINE, EMBASE, CINAHL and Scopus databases from 2010 to 2022 were […]

The post Factors Influencing the Translation of Evidence Into Clinical Practice for Hospital Allied Health Professionals in Terms of the Domains of Behaviour Change Theory: A Systematic Review was curated by information for practice.

The pandemic’s effects on South Florida’s real estate industry are well documented. Prices for homes and land skyrocketed, as did apartment, retail, office and industrial rents. Dozens of cranes filled the skyline. Billionaires moved to or expanded their holdings in the region.  This “flight to Florida” will continue, experts said at The Real Deal’s South […]

The post “Flight to Florida” will continue despite high costs, limited inventory: takeaways from The Real Deal Miami forum appeared first on The Real Deal.

The post Resilient Hospitals: An inter-regional guidance on strengthening resilience to health emergencies and disasters in health facilities was curated by information for practice.

The post State and local tax exemptions drive more than half of nonprofit hospitals’ $37.4 billion tax benefit, study finds was curated by information for practice.

Electroconvulsive therapy (ECT) induces a generalized seizure under anesthesia with an electrical current for treatment-resistant patients and may be underutilized. To our knowledge, no large-scale, American, … Read the full article ›

The post Electroconvulsive therapy (ECT) and Psychiatric rehospitalization rates: a retrospective study was curated by information for practice.

Around the world, it can still be very hard to live as an openly gay man. Host Michel Martin learns more from two LGBT activists: Jamaican Maurice Tomlinson and Nigerian Bisi Alimi.

November has started off wetter than usual, with several weather systems moving through since the Halloween rain and snow event. Despite the much needed rainfall, we continue to see precipitation deficits since early September.

Up until Tuesday evening, 50 Cent held the distinction of throwing the worst first pitch in the history of all ceremony.

The president of Focus on the Family says he’s “encouraged” by Tuesday’s election results even as he acknowledged both victories and setbacks for the pro-life movement.

The Kemerovo regional court ruled to send Alexander Spesivtsev, a resident of Novokuznetsk, to compulsory treatment, the regional Office of the Public Prosecutor said. The defendant, Alexander Spesivtsev, is a serial killer, who killed at least 34 victims and ate them during the 1990s. Spesivtsev will undergo treatment at a special psychiatric hospital.

With the continuous and rapid evolution of the technological era, digital currencies are gaining popularity daily. They have been gaining traction from the past half-decade. Despite the fluctuations in bitcoin and other cryptocurrencies' value, more and more people start seeing cryptocurrency as a profitable investment. For instance, if we talk about Bitcoin, one of the most popular types of cryptocurrency, it has taken over the digital currency market. If we further discuss its fame, you'll see that it is being used in some of the biggest business names around the globe, including Microsoft, Overstock, and AT&T, now accept it as a method of payment. Here, you might be thinking, why do people use cryptocurrency and cryptocurrency wallets? What are their pros and cons? Is it worth investing in cryptocurrency wallets in 2020? If you have such questions, get them answered here. But first, let us tell you about the MOST USEFUL cryptocurrency wallets. A lot of wallets are designed solely for the storage of cryptocurrencies. At a time when there was a peak in online currency exchanges and thefts, there was a need to create a wallet that will provide ultimate protection. OWNR Wallet is one of the safest bitcoin wallets to buy crypto in 2020. It helps people in keeping their digital money safe from external threats. Along with security, OWNR Wallet offers a variety of useful features for both holders and traders.

PPDS is participating at EquipHotel 2024 (3-7 November), with the latest innovations in its portfolio of hospitality display solutions, plus the launch of a brand new ‘all inclusive’ streaming partnership for Philips MediaSuite TVs.

The Korea Research Institute of Standards and Science (KRISS) announced that they have developed an advanced disease diagnosis and treatment system based on nanomaterials.

The Korea Research Institute of Standards and Science (KRISS) announced that they have developed an advanced disease diagnosis and treatment system based on nanomaterials.

Despite ongoing efforts to improve safety, many cities in the United States continue to face high crime rates, posing significant challenges for the residents and city officials. But which are the most dangerous cities in the U.S.?

NewJeans’ hit “Super Shy’ has earned a spot in Pitchfork’s list of the best songs of the decade. It was the only K-pop track to be featured on Pitchfork’s list of...

[more...]

The crystal structure of calcium atorvastatin trihydrate was redetermined from previously published synchrotron powder diffraction data to give a much-improved agreement with two independent density-functional theory calculations.

With ever-improving quantum-mechanical computational methods, the accuracy requirements for experimental crystal structures increase. The crystal structure of calcium atorvastatin trihydrate, which has 56 degrees of freedom when determined with a real-space algorithm, was determined from powder diffraction data by Hodge et al. [Powder Diffr. (2020), 35, 136–143]. The crystal structure was a good fit to the experimental data, indicating that the electron density had been captured essentially correctly, but two independent quantum-mechanical calculations disagreed with the experimental structure and with each other. Using the same experimental data, the crystal structure was redetermined from scratch and it was shown that it can be reproduced within a root-mean-square Cartesian displacement of 0.1 Å by two independent quantum-mechanical calculations. The consequences for the calculated energies and solubilities are described.

Rotations of small- and wide-angle X-ray scattering samples during acquisition are shown to give a drastic improvement in the reliability of the characterization of anisotropic precipitates in metallic alloys.

The effect of boron in BxGa1−xN/SiC heteroepitaxy was established by X-ray diffraction reciprocal-space maps on symmetric 0002 and asymmetric 11 {overline 2} 4 reflections. The density of screw and edge threading dislocations was quantified in the framework of the mosaic model.

BGaN epilayers with boron contents up to 5.6% were grown on SiC substrates by metal–organic chemical vapor deposition. The effects of boron incorporation on the structural and optical properties were studied by high-resolution X-ray diffraction (XRD), atomic force microscopy (AFM), Raman spectroscopy and photoluminescence (PL) spectroscopy. XRD reciprocal-space maps around the symmetric 0002 and asymmetric 11 {overline 2} 4 reflections allowed evaluation of the lattice constants and lattice mismatch with respect to the underlying substrate. XRD rocking curves and AFM measurements indicated the mosaic microstructure of the epilayer. The impact of boron content on crystallite size, tilt and twist is evaluated and the correlation with threading dislocation density is discussed. The deterioration of optical properties with increasing boron content was assessed by Raman and PL spectroscopy.

Nanometric precipitates in metallic alloys often have highly anisotropic shapes. Given the large grain size and non-random texture typical of these alloys, performing small- and wide-angle X-ray scattering (SAXS/WAXS) measurements on such samples for determining their characteristics (typically size and volume fraction) results in highly anisotropic and irreproducible data. Rotations of flat samples during SAXS/WAXS acquisitions are presented here as a solution to these anisotropy issues. Two aluminium alloys containing anisotropic precipitates are used as examples to validate the approach with a −45°/45° angular range. Clear improvements can be seen on the SAXS I(q) fitting and the consistency between the different SAXS/WAXS measurements. This methodology results in more reliable measurements of the precipitate's characteristics, and thus allows for time- and space-resolved measurements with higher accuracy.

X-ray diffraction from dislocation half-loops consisting of a misfit segment with two threading arms extending from it to the surface is calculated by the Monte Carlo method. The diffraction profiles and reciprocal space maps are controlled by the ratio of the total lengths of the misfit and the threading segments of the half-loops. A continuous transformation from the diffraction characteristic of misfit dislocations to that of threading dislocations with increasing thickness of epitaxial film is studied. Diffraction from dislocations with edge- and screw-type threading arms is considered and the contributions of the two types of dislocations are compared.

The two most abundant CaCO3 polymorphs, calcite and aragonite, are universally recognized for the richness of their morphology to which different twins make relevant contributions. The epitaxial transformation calcite ↔ aragonite has long been debated. While the twinning has been thoroughly treated, the homo-epitaxy occurring within each of these minerals has, inexplicably, been overlooked to date, both experimentally and theoretically. Twinning can be deceptive to the point where it can be mistaken for homo-epitaxy, thus making the proposed growth mechanism in the crystal aggregate wrong. Within the present work, the first aim is a theoretical investigation of the homo-epitaxies among the three {10.4}-cleavage, {01.2}-steep and {01.8}-flat rhombohedra of calcite. Accordingly, the specific adhesion energies were calculated between facing crystal forms, unequivocally showing that the {01.2}/{01.8} homo-epitaxy competes with the generation of both {01.2} and {01.8} contact twins. Secondly, the calculation of the specific adhesion energy was extended to consider homo-epitaxy for the {10.4} rhombohedron. The two-dimensional geometric lattice coincidence has been tried for the {00.1} pinacoidal form as well.

The neutralization of acidic solutions containing U (IV) and Ce (III) at room temperature in glove box atmosphere and in the presence of dithionite results in coprecipitation of these elements as amorphous solid solutions CexU1–xO2±y. The solubilities of the precipitates with different mole fractions (x) of Ce(OH)3 (x = 0.01 or 0.1) were determined in 1 M NaClO4 solutions between pH 2.2 and 12.8 under reducing conditions. The solids were investigated by a variety of methods (chemical analysis, SEM-EDX, XRD, XPS, XAS) to determine the nature of the solid solutions formed, their composition and the valence state of Ce and U. X-ray photoelectron spectroscopy confirmed the oxidation states of the solids both before and after the equilibration as Ce (III) and U (IV). The amorphous coprecipitates reached equilibrium relatively fast (∼1 week). The release of Ce from the coprecipitates was totally dominated by the release of uranium over the whole pH range. The Ce concentrations decrease slightly with the decrease of Ce content in the solid, suggesting that CexU1–xO2±y solids behave thermodynamically as solid solutions. The concentrations of U in equilibrium with the coprecipitate were in excellent agreement with the solubility of UO2(s) under reducing conditions reported in the literature. The conditional solubility product of Ce(OH)3 from the coprecipitate was several orders of magnitude (∼4 in the near neutral pH range and ∼18 in the acidic range) lower than that of pure Ce(OH)3(s). The activities and activity coefficients of Ce(OH)3(s) in the coprecipitate were also estimated. Activity coefficients are much less than 1, indicating that the mixing of Ce(OH)3 with UO2 is highly favorable.

; Credit: /Rose Wong for NPR/KHN

Claire Lang-Ree was in a lab coat taking a college chemistry class remotely in the kitchen of her Colorado Springs, Colo., home, when a profound pain twisted into her lower abdomen. She called her mom, Jen Lang-Ree, a nurse practitioner who worried it was appendicitis and found a nearby hospital in the family's health insurance network.

After a long wait in the emergency room of Penrose Hospital, Claire received morphine and an anti-nausea medication delivered through an IV. She also underwent a CT scan of her abdomen and a series of tests.

Hospital staffers ruled out appendicitis and surmised Claire was suffering from a ruptured ovarian cyst, which can be a harmless part of the menstrual cycle but can also be problematic and painful. After a few days — and a chemistry exam taken through gritted teeth — the pain went away.

Then the bill came.

Patient: Claire Lang-Ree, a 21-year-old Stanford University student who was living in Colorado for a few months while taking classes remotely. She's insured by Anthem Blue Cross through her mom's work as a pediatric nurse practitioner in Northern California.

Total Bill: $18,735.93, including two $722.50 fees for a nurse to "push" drugs into her IV, a process that takes seconds. Anthem's negotiated charges were $6,999 for the total treatment. Anthem paid $5,578.30, and the Lang-Rees owed $1,270.45 to the hospital, plus additional bills for radiologists and other care. (Claire also anted up a $150 copay at the ER.)

Service Provider: Penrose Hospital in Colorado Springs, part of the regional health care network Centura Health.

What Gives: As hospitals disaggregate charges for services once included in an ER visit, a hospitalization or a surgical procedure, there has been a proliferation of newfangled fees to increase billing. In the health field, this is called "unbundling." It's analogous to the airlines now charging extra for each checked bag or for an exit row seat. Over time, in the medical industry, this has led to separate fees for ever-smaller components of care. A charge to put medicine into a patient's IV line — a "push fee" — is one of them.

Though the biggest charge on Claire's bill, $9,885.73, was for a CT scan, in many ways Claire and her mom found the push fees most galling. (Note to readers: Scans are frequently many times more expensive when ordered in an ER than in other settings.)

"That was so ridiculous," says Claire, who adds she had previously taken the anti-nausea drug they gave her; it's available in tablet form for the price of a cup of coffee, no IV necessary. "It works really well. Why wasn't that an option?"

In Colorado, the average charge for the code corresponding to Claire's first IV push has nearly tripled since 2014, and the dollars hospitals actually get for the procedure has doubled. In Colorado Springs specifically, the cost for IV pushes rose even more sharply than it did statewide.

A typical nurse in Colorado Springs makes about $35 an hour. At that rate, it would take nearly 21 hours to earn the amount of money Penrose charged for a push of plunger that likely took seconds or at most minutes.

The hospital's charge for just one "IV push" was more than Claire's portion of the monthly rent in the home she shared with roommates. In the end, Anthem did not pay the push fees in its negotiated payment. But claims data shows that in 2020 Penrose typically received upward of $1,000 for the first IV push. And patients who didn't have an insurer to dismiss such charges would be stuck with them. Colorado hospitals on average received $723 for the same code, according to the claims database.

"It's insane the variation that we see in prices, and there's no rhyme or reason," says Cari Frank with the Center for Improving Value in Health Care, a Colorado nonprofit that runs a statewide health care claims database. "It's just that they've been able to negotiate those prices with the insurance company and the insurance company has decided to pay it."

To put the total cost in context, Penrose initially charged more money for Claire's visit than the typical Colorado hospital would have charged for helping someone give birth, according to data published by the Colorado Division of Insurance.

Even with the negotiated rate, "it was only $1,000 less than an average payment for having a baby," Frank says.

In an email statement, Centura said it "conducted a thorough review and determined all charges were accurate" and went on to explain that "an Emergency Room (ER) must be prepared for anything and everything that comes through the doors," requiring highly trained staff, plus equipment and supplies. "All of this adds up to large operating costs and can translate into patient responsibility."

As researchers have found, little stands in the way of hospitals charging through the roof, especially in a place like an emergency room, where a patient has few choices. A report from National Nurses United found that hospital markups have more than doubled since 1999, according to data from the United States Bureau of Labor Statistics. In an email, Anthem called the trend of increasing hospital prices "alarming" and "unsustainable."

But Ge Bai, an associate professor of accounting and health policy at Johns Hopkins University, says when patients see big bills it isn't only the hospital's doing — a lot depends on the insurer, too. For one, the negotiated price depends on the negotiating power of the payer, in this case, Anthem.

"Most insurance companies don't have comparable negotiating or bargaining power with the hospital," said Bai. Prices in a state like Michigan, where Bai said the UAW union covers a big proportion of Michigan patients, will look very different from those in Colorado.

Also, insurers are not the wallet defenders patients might assume them to be.

"In many cases, insurance companies don't negotiate as aggressively as they can, because they earn profit from the percentage of the claims," she says. The more expensive the actual payment is, the more money they get to extract.

Though Anthem negotiated away the push fees, it paid the hospital 30% more than the average Level IV emergency department visit in Colorado that year, and it paid quadruple what Medicare would allow for her CT scan.

Resolution: Claire and her mom decided to fight the bill, writing letters to the hospital and searching for information on what the procedures should have cost. The cost of the IV pushes and CT scan infuriated them — the hospital wanted more than double for a CT than what top-rated hospitals typically charged in 2019.

But the threat of collections wore them out and ultimately they paid their assigned share of the bill — $1,420.45, which was mostly coinsurance.

"Eventually it got to the point where I was like, 'I don't really want to go to collections, because this might ruin my credit score,'" says Claire, who didn't want to graduate from college with dinged credit.

Bai and Frank say the state of Maryland can provide a useful benchmark for medical bills, since it sets the prices that hospitals can charge for each procedure. Data provided by the Maryland Health Care Commission shows that Anthem and Claire paid seven times what she likely would have paid for the CT scan there, and nearly 10 times what they likely would have paid for the emergency department Level IV visit. In Maryland, intravenous pushes typically cost about $200 apiece in 2019. A typical Maryland hospital would have received only about $1,350 from a visit like Claire's, and the Lang-Rees would have been on the hook for about $270.

Claire's pain has come back a few times, but never as bad as that night in Colorado. She has avoided reentering an emergency room since then. After visiting multiple specialists back home in California, she learned she might have had a condition called ovarian torsion.

The Takeaway: Even at an in-network facility and with good insurance, patients can get hurt financially by visiting the ER. A few helpful documents can help guide the way to fighting such charges. The first is an itemized bill.

"I just think it's wrong in the U.S. to charge so much," says Jen Lang-Ree. "It's just a little side passion of mine to look at those and make sure I'm not being scammed."

Bai, of Johns Hopkins, suggests asking for an itemized explanation of benefits from the insurance company, too. That will show what the hospital actually received for each procedure.

Find out if the hospital massively overcharged. The Medicare price lookup tool can be useful for getting a benchmark. And publicly available data on health claims in Colorado and at least 17 other states can help, too.

Vincent Plymell with the Colorado Division of Insurance encourages patients to reach out if something on a bill looks sketchy. "Even if it's not a plan we regulate," he wrote in an email, departments such as his "can always arm the consumer with info."

Finally, make scrutinizing such charges fun. Claire and Jen made bill-fighting their mother-daughter hobby for the winter. They recommend pretzel chips and cocktails to boost the mood.

Bill of the Month is a crowdsourced investigation by KHN and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it!

This content is from Southern California Public Radio. View the original story at SCPR.org.

Many hospitals around the country, including Medstar Washington Hospital in Washington DC., have started sharing their prices online in compliance with a recent federal rule.; Credit: DANIEL SLIM/AFP via Getty Images

A colonoscopy might cost you or your insurer a few hundred dollars — or several thousand, depending on which hospital or insurer you use.

Long hidden, such price variations are supposed to be available in stark black and white under a Trump administration price transparency rule that took effect at the start of this year. It requires hospitals to post a range of actual prices — everything from the rates they offer cash-paying customers to costs negotiated with insurers.

Many have complied.

But some hospitals bury the data deep on their websites or have not included all the categories of prices required, according to industry analysts. A sizable minority of hospitals have not disclosed the information at all.

While imperfect and potentially of limited use right now to the average consumer, the disclosures that are available illustrate the huge differences in prices — nationally, regionally and within the same hospital. But they're challenging for consumers and employers to use, giving a boost to a cottage industry that analyzes the data.

While it's still an unanswered question whether price transparency will lead to overall lower prices, KHN took a dive into the initial trove of data to see what it reveals. Here are five takeaways from the newly public data and tips for how you might be able to use it to your benefit

1) As expected, prices are all over the map

The idea behind the requirement to release prices is that the transparency may prompt consumers to shop around, weighing cost and quality. Perhaps they could save a few hundred dollars by getting their surgery or imaging test across town instead of at the nearby clinic or hospital.

Under the Trump-era rule, hospitals must post what they accept from all insurers for thousands of line items, including each drug, procedure or treatment they provide. In addition, hospitals must present this in a format easily readable by computers and include a consumer-friendly separate listing of 300 "shoppable" services, bundling the full price a hospital accepts for a given treatment, such as having a baby or getting a hip replacement.

The negotiated rates now being posted publicly often show an individual hospital accepting a wide range of prices for the same service, depending on the insurer, often based on how much negotiating power each has in a market.

In some cases, the cash-only price is less than what insurers pay. And prices may vary widely within the same city or region.

In Virginia, for example, the average price of a diagnostic colonoscopy is $2,763, but the range across the state is from $208 to $10,563, according to a database aggregated by San Diego-based Turquoise Health, one of the new firms looking to market the data to businesses, while offering some information free of charge to patients.

2) Patients can look up the information, but it's incomplete

Patients can try to find the price information themselves by searching hospital websites, but even locating the correct tab on a hospital's website is tricky.

Typically, consumers don't comparison-shop, preferring to choose convenience or the provider their doctor recommends. A recent Peterson-KFF Health System Tracker brief, for instance, found that 85% of adults said they had not researched online the price of a hospital treatment.

And hospitals say the transparency push alone won't help consumers much, because each patient's situation is different and may vary from the average— and individual deductibles and insurance plans complicate matters.

But if you do want to try, here's one tip: "You can Google the hospital name and the words 'price transparency' and see where that takes you," says Caitlin Sheetz, director and head of analytics at the consulting firm ADVI Health in the Washington, D.C., metro area.

Typing in "MedStar Health hospital transparency," for example, likely points to the MedStar Washington Hospital Center's "price transparency disclosure" page, with a link to its full list of prices, as well as its separate list of 300 shoppable services.

By clicking on the list of shoppable services, consumers can download an Excel file. Searching it for "colonoscopy" pulls up several variations of the procedure, along with prices for different insurers, such as Aetna and Cigna, but a "not available" designation for the cash-only price. The file explains that MedStar does not have a standard cash price but makes determinations case by case.

Performing the same Google search for the nearby Inova health system results in less useful information.

Inova's website links to a long list of thousands of charges, which are not the discounts negotiated by insurers, and the list is not easily searchable. The website advises those who are not Inova patients or who would like to create their own estimate to log into the hospitals' "My Chart" system, but a search on that for "colonoscopy" failed to produce any data.

3) Third-party firms are trying to make searching prices simpler – and cash in

Because of the difficulty of navigating these websites — or locating the negotiated prices once there — some consumers may turn to sites like Turquoise. Another such firm is Health Cost Labs, which will have pricing information for 2,300 hospitals in its database when it goes live July 1.

Doing a similar search for "colonoscopy" on Turquoise shows the prices at MedStar by insurer, but the process is still complicated. First, a consumer must select the "health system" button from the website's menu of options, click on "surgical procedures," then click again on "digestive" to get to it.

There is no similar information for Inova because the hospital has not yet made its data accessible in a computer-friendly format, said Chris Severn, CEO of Turquoise.

Inova spokesperson Tracy Connell said in a written statement that the health system will create personalized estimates for patients and is "currently working to post information on negotiated prices and discounts on services."

Firms like Turquoise and Health Cost Labs aim to sell the data gathered from hospitals nationally to insurers, employers and others. In turn, those groups may use it in negotiations with hospitals over future prices. While that may drive down prices in areas with a lot of competition, it might do the opposite where there are few hospitals to choose from, or in situations where a hospital raises its prices to match competitors.

4) Consumers could use this data to negotiate, especially if they're paying cash

For consumers who go the distance and can find price data from their hospitals, it may prove helpful in certain situations:

• Patients who are paying cash or who have unmet deductibles may want to compare prices among hospitals to see if driving farther could save them money.
• Uninsured patients could ask the hospital for the cash price or attempt to negotiate for the lowest amount the facility accepts from insurers.
• Insured patients who get a bill for out-of-network care may find the information helpful because it could empower them to negotiate a discount off the hospitals' gross charges for that care.

While there's no guarantee of success, "if you are uninsured or out of network, you could point to some of those prices and say, 'That's what I want,'" says Barak Richman, a contract law expert and professor of law at Duke University School of Law.

But the data may not help insured patients who notice their prices are higher than those negotiated by other insurers.

In those cases, legal experts say the insured patients are unlikely to get a bill changed because they have a contract with that insurer, which has negotiated the price with their contracted hospitals.

"Legally, a contract is a contract," says Mark Hall, a health law professor at Wake Forest University.

Richman agrees.

"You can't say, 'Well, you charged that person less,'" he notes, but neither can they say they'll charge you more.

Getting the data, however, relies on the hospital having posted it.

5) Hospitals still aren't really on board

When it comes to compliance, "we're seeing the range of the spectrum," says Jeffrey Leibach, a partner at the consulting firm Guidehouse, which found earlier this year that about 60% of 1,000 hospitals surveyed had posted at least some data, but 30% had reported nothing at all.

Many in the hospital industry have long fought transparency efforts, even filing a lawsuit seeking to block the new rule. The suit was dismissed by a federal judge last year.

They argue the rule is unclear and overly burdensome. Additionally, hospitals haven't wanted their prices exposed, knowing that competitors might then adjust theirs, or health plans could demand lower rates. Conversely, lower-cost hospitals might decide to raise prices to match competitors.

The rule stems from requirements in the Affordable Care Act. The Obama administration required hospitals to post their chargemaster rates, which are less useful because they are generally inflated, hospital-set amounts that are almost never what is actually paid.

Insurers and hospitals are also bracing for next year when even more data is set to come online. Insurers will be required to post negotiated prices for medical care across a broader range of facilities, including clinics and doctors' offices.

In May, the Centers for Medicare & Medicaid Services sent letters to some of the hospitals that have not complied, giving them 90 days to do so or potentially face penalties, including a $300-a-day fine.

"A lot of members say until hospitals are fully compliant, our ability to use the data is limited," says Shawn Gremminger, director of health policy at the Purchaser Business Group on Health, a coalition of large employers.

His group and others have called for increasing the penalty for noncomplying hospitals from $300 a day to $300 a bed per day, so "the fine would be bigger as the hospital gets bigger," Gremminger says. "That's the kind of thing they take seriously."

Already, though, employers or insurers are eyeing the hospital data as leverage in negotiations, says Severn, Turquoise's CEO. Conversely, some employers may use it to fire their insurers if the rates they're paying are substantially more than those agreed to by other carriers.

"It will piss off anyone who is overpaying for health care, which happens for various reasons," he says.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation).

This content is from Southern California Public Radio. View the original story at SCPR.org.

Police tape blocks access from a street leading to the building complex where the Capital Gazette is located on June 29, 2018, in Annapolis, Md. The suspect barricaded a back door in an effort to "kill as many people as he could kill," police said.; Credit: Mandel Ngan/AFP via Getty Images

Jury selection in the trial of the gunman who fatally shot five employees at the Capital Gazette newspaper in Annapolis, Md., on June 28, 2018 gets underway on Wednesday.

Jarrod Ramos, 41, has pleaded guilty — but not criminally responsible for reason of insanity — in the killings of John McNamara, Rob Hiaasen, Gerald Fischman, Wendi Winters and Rebecca Smith. The mass shooting was one of the deadliest attacks on journalists in modern U.S. history.

"There is a sense that you don't want this to be the thing that makes your life change," Phil Davis, the paper's former criminal justice reporter who now works at the Baltimore Sun, told NPR.

Davis was hiding under his desk while live tweeting the shooting that day. Later, he was part of the Pulitzer Prize-winning team that put out a paper the very next day.

"That's kind of what drove me to continue as a criminal justice reporter. Once I got the feeling of like, 'no we're going to get back to exactly what we do. We're going to tackle this how we would even if it wasn't us and try to go at it from the perspective of a local community newspaper,'" Davis said.

Bruce Shapiro, the executive director of the Columbia University's Dart Center for Journalism and Trauma, said what made this shooting reverberate in newsrooms across the U.S. was "the idea of a newsroom full of colleagues being murdered just because they are journalists. It's an identity based attack."

Attacks on journalists in the U.S. haven't stopped there. During his time in office, President Donald Trump tweeted that the news media is the enemy of the people. Associated Press journalists were threatened and had their equipment damaged by supporters of Trump during the Capitol insurrection on Jan. 6. And last year, during the protests in Minneapolis over the murder of George Floyd by police, the U.S. Press Freedom Tracker reported at least 160 threats to journalists across the country in one week--mostly by police.

Shapiro says the trial is a reminder to the public of the risks and costs local reporters take daily.

"The reality is that local newsrooms all over the country cover extraordinarily difficult events affecting their own families, neighbors, kids, schools whether that is wildfires, whether that is mass shooting, whether that is COVID-19," Shapiro said.

The Capital Gazette trial has been delayed several times due to COVID-19, turnover in the public defender and state's attorney's offices, and rounds of court hearings. Davis says he hopes the long-awaited trial brings some closure.

"Certainly for the families of the victims themselves, I look forward to being on the other end of this trial," he said. "And whatever the outcome is, being able to embrace them and support them just to bring them some sort of closure."

Today, less than a week before the third anniversary of the shooting, the judge has called a pool of 300 people to determine the 12 that will sit as jurors. They will then determine Ramos's mental sanity during the attack.

Steve Mercer, a former Maryland public defender, said the defense has the burden to prove Ramos's sanity. He said that in cases like these, the defense will look at motive and intent. One possible motive, Mercer says, is Ramos' "long-simmering feud with the paper."

Ramos sued the paper for defamation in 2012 after reporters wrote about his guilty plea on charges of criminal harassment and 90-day suspended jail sentence. But that motive might not hold up.

"I think there's a big gap between sort of being upset about a story that's published ... and then going in and committing a mass shooting," Mercer said.

Mercer adds what presents a challenge to both the defense and prosecution is Ramos's conduct after the shooting. He was found by police under a desk at the scene of the shooting with a pump-action shotgun which was purchased legally a few years before.

"The defense may point to it and say that it shows just a disconnect from reality and a lack of awareness of what was going on," Mercer said.

Circuit Court Judge Judge Michael Wachs will ultimately decide if he ends up in prison or a state psychiatric hospital.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Insufficient data on service members exposures to emissions from open-air burn pits for trash on military bases in Iraq and Afghanistan is one of the reasons why it is not possible to say whether these emissions could cause long-term health effects, says a new report from the Institute of Medicine.

Cardiac arrest strikes almost 600,000 people each year, killing the vast majority of those individuals, says a new report from the Institute of Medicine. Every year in the U.S., approximately 395,000 cases of cardiac arrest occur outside of a hospital setting, in which less than 6 percent survive.

Inherent features of registries that rely on voluntary participation and self-reported information make them fundamentally unsuitable for determining whether emissions from military burn pits in Iraq, Afghanistan, and other locations in Southwest Asia caused health problems in service members who were exposed to them, says a new congressionally mandated report from the National Academies of Sciences, Engineering, and Medicine.

For her role in transforming a safety net hospital into a national model for high-quality, cost-efficient health care, the National Academy of Medicine today announced Patricia Gabow is the recipient of the 2019 Gustav O. Lienhard Award for Advancement of Health Care.

A new report from the National Academies of Sciences, Engineering, and Medicine finds that there is no risk-free setting for giving birth, whether at home, in a birth center, or in a hospital.

While the world waits for a vaccine to prevent COVID-19 infection, international and multigenerational teams of engineers have come together through the National Academy of Engineering’s COVID-19 Call for Engineering Action to find creative solutions to problems caused by the pandemic.

Six months into the COVID-19 pandemic, many hospitals are still faced with staffing shortages due to the sheer volume of patients, staff illnesses, and non-COVID care that cannot be delayed.

While progress toward developing a vaccine to prevent COVID-19 infection continues to dominate conversations about the pandemic, international and multigenerational teams of engineers have come together once again through the National Academy of Engineering’s COVID-19 Call for Engineering Action to find creative solutions to myriad pandemic-related problems. Their ideas aim to combat misinformation, help people most at risk, and prevent the spread of the virus.

We are humbled and grateful for the messages of support we have received from our friends and colleagues across the country and around the world following the violence at the U.S. Capitol.

Sexually transmitted infections (STIs) impose billions of dollars in medical costs in the U.S., but STI prevention and control is chronically underfunded, stigmatized, and siloed from efforts to promote overall health and well-being, says a new report from the National Academies of Sciences, Engineering, and Medicine.

The U.S. Department of Veterans Affairs’ Airborne Hazards and Open Burn Pit Registry should be optimized to be a user-friendly resource and focus on improving health care quality and access for veterans and providing two-way communication between veterans who participate and the VA.

Priyank Kharge in his keynote at ET GCC Annual Conclave 2024 reiterates the purpose to establish Karnataka as a knowledge and skill capital topped with innovation and GCC policy for investments to follow.

PITTSBURGH (September 2, 2016) ... The potential to develop "materials that compute" has taken another leap at the University of Pittsburgh's Swanson School of Engineering, where researchers for the first time have demonstrated that the material can be designed to recognize simple patterns. This responsive, hybrid material, powered by its own chemical reactions, could one day be integrated into clothing and used to monitor the human body, or developed as a skin for "squishy" robots.

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In this long format story of Sir Ganga Ram hospital’s IT modernization, ETCIO brings you an in-depth track of how CIO Arun Goyal unleashed the cloud potential for the hospital’s business and technological growth.

Constellation said it is seeking guidance from regulators after FERC's decision about co-location, which had become a promising prospect for Big Tech's plans to quickly access large amounts of power for its AI expansion instead of waiting for years to connect to the grid.

Entrepreneur Aaron Galimor created Brass Roots' snacks in 2019, and the brand's flagship brand, Roasted Sacha Inchi, is made from sustainably sourced, organic, plant-based ingredients.

Growing demand for specialty ingredients is driving expansion of the ingredient-solutions provider’s manufacturing capacity.

UK intellectual property investment group Tekcapital PLC has announced a major expansion of its MicroSalt brand.

Both products deliver an elevated snacking experience that blend together two favorite classic snacks into one product. 

Stacy's Rise Pies, available now through Thanksgiving, aim to help drive awareness of the disparity in funding for women business owners.

Five U.S.-based food, beverage, and CPG women entrepreneurs will compete for $60K in cash and in-kind prizes on Nov. 14 at The Town Hall by Skylight in NYC.