For Sale: Jane Austen’s Wince-Inducing Descriptions of 19th-Century Dentistry

After dinner one evening in September 1813, Jane Austen sat down to write a letter to her sister Cassandra. Austen, who had published Pride and Prejudice earlier that year, had much to report from the home front. She had accompanied three nieces and her brother Edward to a Wedgewood china shop, she wrote, where they’d perused the wares. Other news was less pleasant: Earlier that day, they’d been to the dentist for an hour of “sharp hasty screams.”

“The poor Girls & their Teeth!” Austen wrote. “Lizzy’s were filed & lamented over again & poor Marianne had two taken out after all.” The dentist—a Mr. Spence, who could have been one of several Spences working as dentists at the time—had even gone after her niece Fanny’s teeth, though they had seemed in decent shape. “Pretty as they are,” Austen recounted, the dentist had “found something to do them, putting in gold & talking gravely.” That didn’t sit right with Austen, who wrote that the tool-happy man “must be a Lover of Teeth & Money & Mischief.” Austen remarked that she “would not have had him look at mine for a shilling a tooth & double it.” Her note, which is going under the hammer at Bonhams on October 23, is an intriguing (if squirm-inducing) dispatch from an era of grisly dental work.

At the time Austen penned the letter, dentistry was still painfully unstandardized. Treatments varied widely, and troublesome teeth were often yanked out by people from all sorts of professions. “In London and large towns, surgeons were available to pull out teeth, but elsewhere, apothecaries, quack tooth-drawers, and even blacksmiths might oblige,” write historians Roy Adkins and Lesley Adkins in Jane Austen’s England: Daily Life in the Georgian and Regency Periods.

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Austen’s reference to filings in the letter “shows the diversity of practice because of the lack of scientific understanding of the causes of decay,” explains Rachel Bairsto, head of museum services at the British Dental Association Museum, in an email. There was a lot of disagreement about whether various interventions would offer the patient relief, or just plunge them deeper into pain. Though filing had historically been used to smooth out uneven teeth, Bairsto adds, some practitioners recommended it as a way to prevent cavities. Others disagreed, arguing that it “made more space to trap food.” In any event, Bairsto writes, “overzealous filing could make the teeth more sensitive.”

Even where tooth-pullers and oral hygiene tools were available—and it was mostly the wealthy who could access them—they weren’t necessarily a good idea. “Early toothbrushes with their horsehair bristles often caused more problems than they prevented,” writes medical historian Lindsey Fitzharris in The Guardian. “Toothpastes or powders made from pulverised charcoal, chalk, brick or salt were more harmful than helpful.” Eighteenth- and 19-century animal-hair bristles were breeding grounds for bacteria, which could make any existing mouth trouble even gnarlier.

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Though holes in teeth were sometimes patched, fillings “were not commonly practiced, as they were expensive and often didn’t last long,” Bairsto writes. Extraction was the more common, and decidedly miserable, route. An extraction was often accomplished with the help of a dental key (also called a tooth key), which Bairsto describes as “rather a fearsome-looking instrument.” It’s a nightmarish claw-and-rod contraption, and it would have been wielded without anesthetic. Bleeding and infection often followed.

Once the infected incisors or meddlesome molars were out, they would sometimes be replaced with dentures, which could be made from walrus or hippo ivory, porcelain, or teeth removed from other unfortunate people, living or dead. (When the Battle of Waterloo felled thousands of soldiers, “clients back in England were happy to wear dentures made from the teeth of fit young men killed in battle, which became known as ‘Waterloo teeth,’ or, more coyly, ‘Waterloo ivory,’” Adkins and Adkins note.) Dentures weren’t without their drawbacks, Bairsto writes: They had a tendency to stink and rot in the mouth, “and the use of a fan was required to waft the stench.”

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By the middle of the 19th century, the world’s first dental school had opened in Baltimore, Maryland, reported, and across the pond, Queen Victoria had helped make it fashionable to own a personal set of dental tools. Her scalers—tools used to scrape off gunk—were outfitted with mother-of-pearl handles and gold detailing. That was of no help to Austen.

Because oral hygiene was expensive, Bairsto writes, “it is unclear” whether the Austens routinely used toothbrushes. For the most part, writes historian and Austen biographer Lucy Worsley in Jane Austen at Home, “Jane and her family simply had to put up with the small aches and ailments of life.” Even so, references to dentistry—and the anxiety that a visit to a dentist might incite—appear in some of the writer’s fiction. In Emma, Harriet has “a tooth amiss,” and is reported to appear a bit “out of spirits.” That’s “perfectly natural,” readers are told, “as there was a dentist to be consulted.” In Austen’s realm, even fictional characters knew that a visit to a dentist could sour an afternoon.

Janeites are a devoted bunch—the sight of her writing table, at the Jane Austen’s House Museum in Chawton, England, often prompts rapt reverence, or even tears—and the letter is likely to be catnip for her most enthusiastic reader-disciples. (Bonhams expects the letter to sell for somewhere between $80,000 and $120,000.) For everyone else, it’s a macabre memento from a time when the sharp end of a dentist’s tool was a place you really, truly did not want to be.

This content was originally published here.

As He Attacks Medicare for All, Mayor Pete Gets Campaign Cash From Health Care Executives

Thirty-seven-year-old South Bend, Indiana mayor and presidential candidate Pete Buttigieg has undergone a dramatic shift in health care policy in less than two years.

Responding to criticism of his vague health care policies in early 2018, Buttigieg “declared” on Twitter that, “Most affirmatively and indubitably, unto the ages…I do favor Medicare for All.”

Later, as he entered the Democratic presidential primary, he landed on a kind of compromise: a single-player option he likes to call “Medicare for All Who Want It” that lets him show support for those frustrated by the high costs and substandard results of the American health care system while preserving the profit-driven forces that have contributed to that system.

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Now, as he continues to promote his plan, which critics call “Medicare for Some,” he’s taken an antagonistic approach to true Medicare for All, as proposed in the Medicare for All Act, and to his opponents who support it: Sen. Bernie Sanders (D-Vt.), who “wrote the damn bill,” and frontrunner Sen. Elizabeth Warren (D-Mass.), who is cosponsoring and continues to support it.

In a new digital video ad from Buttigieg’s campaign, corporate consultant and former Facebook executive Joe Lockhart says, “Bernie Sanders and Elizabeth Warren believe that we have to force ourselves into Medicare for All, where private insurance is abolished.” Lockhart cofounded Glover Park Group, a corporate consulting and lobbying firm with current and recent clients in the health sector including ​Boehringer Ingelheim Pharmaceuticals, Horizon Therapeutics, Intuitive Surgical, and Sanofi U.S.

A still from Buttigieg’s recent anti-Medicare for All digital video ad.
Pete for America

Pharmaceutical, health insurance, and hospital industry donors have flocked to Mayor Pete all year. As of mid-2019, he was second only to Donald Trump in overall campaign cash from donors in the health sector. Among Democratic candidates, he was second to former Vice President Joe Biden in terms of pharmaceutical and health insurance donations.

A Sludge review of Buttigieg’s recent third-quarter campaign finance report shows that as he rails against Medicare for All, executives and other managers in the health sector have kept the money flowing.

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Over 100 individuals in leadership, legal, consulting, or financing roles in health sector donated $200 or more to Pete for America between July and September. These donors include pharmaceutical industry leaders such as the chief corporate affairs officer at drugmaker Pfizer, the president of Astex Pharmaceuticals, a state lobbyist for Biogen, a vice president of public policy at Novartis, and the deputy vice president at the nation’s largest pharmaceutical trade association, PhRMA, as well as attorneys for AbbVie, Johnson & Johnson, and Merck.

The donors identified by Sludge gave a total of close to $97,000 to the Buttigieg campaign in the third quarter of 2019. Below are these donors’ employers, occupations, and total amount donated from July through September.

The Buttigieg campaign provided Sludge with the following statement:

Pete has always supported making Medicare (or a similar public health insurance vehicle) available to all Americans in order to achieve universal health care. He consistently describes his health care plan as a pathway to Medicare for All, which is likely why the health insurance industry has attacked his plan. For instance, our campaign website says, “If private insurers are not able to offer something dramatically better, this public plan will create a natural glide-path to Medicare for All.” Simply put, he has the same end goal as some of the other candidates in the race but differs on how to get there. 

Health sector interests including pharmaceutical manufacturers, health insurers, and hospital groups generally oppose Medicare for All, as it would allow the government to negotiate down drug and care costs, cutting into industry profits. Democratic Party political groups have accepted significant amounts of money from lobbyist bundlers who have pharmaceutical and health insurance clients, as Sludge and Maplight have reported.

In July, Sanders created and signed a pledge to reject all contributions over $200 from the PACs, executives, and lobbyists of pharmaceutical and health insurance companies, urging his opponents to join him. Biden, who did not sign it, has, like Buttigieg, reaped the benefits of large donations from industry executives.

According to the Center for Responsive Politics, Buttigieg’s campaign has recieved $1,266,225 from individual donors in the health sector through the third quarter.

Mayor Pete is no stranger to special-interest support. His very first successful political campaign was fueled by lobbyist fundraisers, as the Center for Public Integrity/TYT reported, and as of July 2019, this year’s effort has been led by 94 contribution “bundlers,” or well-connected supporters who raised at least $25,000 in campaign checks for him.


After City Incentives, South Bend Real Estate Executives Donate to Mayor Pete’s Presidential Campaign

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Illegal RV sewage dumping in Seattle pollutes waterways and poses a public-health hazard | The Seattle Times

Since 2015, the number of parked RVs located within the Sodo and Ballard neighborhoods of Seattle has increased dramatically, now totaling hundreds. Many of these RV owners fail to follow proper waste-disposal protocols, instead discharging their accumulated sewer wastes, including “black water,” directly into the city storm drains. The result is that untreated sewage is being released directly into our local waterways.

Using Environmental Protection Agency wastewater pump-out and treatment statistics, it’s estimated that Seattle RV campers likely discharge more than 1 million gallons of untreated sewage annually into our waterways, including the Duwamish Waterway and Salmon Bay. For comparison, a July spill of 3 million gallons from the West Point Treatment Plant closed multiple King and Kitsap counties’ beaches and could lead to enforcement actions.

To better understand the potential impact of RV discharges, the Sodo Business Improvement Area and Ballard Alliance commissioned Anchor QEA, a Seattle-based environmental science and engineering firm, to evaluate existing water-quality data and collect a storm drain water sample from a heavily populated RV parking area in Sodo. The sample from the storm drain in the midst of the RVs registered 300 times greater than the state water-quality standard for fecal coliform bacteria.

Sadly, this sampling result is consistent with recent trends in deteriorating water quality in the area. For example, historic water quality monitoring data showed a decades-long improvement in the Duwamish River — until 2015, when fecal coliform bacteria measurements began to spike upward. This coincides with the movement of hundreds of RVs into Sodo.

While a more definitive pollution-identification study is needed on the relative impact of illegal black-water discharges, the data points strongly suggest that illegal dumping of sewage and trash, along with unsanitary conditions in unregulated RV encampments, increase public-health risks and could result in serious outbreaks of communicable diseases such as hepatitis A and typhus.

Not only do these poor waste-management practices have the potential to endanger RV residents, but they frustrate ongoing efforts to clean up our waterways and adversely impact the marine environment and public health.

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Seattle is known worldwide as an environmental leader and the protector of Puget Sound. However, the data indicates that unchecked dumping of untreated waste into Seattle’s stormwater system threatens to undo decades of cleanup and restoration. Turning back this tide of pollution starts with stopping the proliferation of dilapidated and malfunctioning RVs — something we have raised with Mayor Jenny Durkan as well as the City Council. While the mayor’s office has engaged productively, council members turn a blind eye to the issue, choosing instead to keep the status quo and continue to allow derelict RVs to remain parked on our neighborhood streets, threatening the safety of our waterways.

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Sodo BIA and the Ballard Alliance have shared this study with Seattle officials and have asked to partner with the Washington State Department of Ecology, the Washington Department of Health, King County, and Seattle Public Utilities to develop approaches to stop this ongoing problem.

It is time to stop ignoring the impacts of unregulated RV encampments and illegal raw-sewage dumping. It is disturbing to think that something as basic as enforcing city codes regarding dumping raw sewage from RVs could roll back decades of progress made in cleaning and protecting Puget Sound.

This content was originally published here.

Patient With Measles Who Visited Disneyland, L.A. Starbucks May Have Exposed Visitors: Health Officials

A measles patient visited Disneyland last week while contagious and could have exposed others to the disease, the Los Angeles County Department of Public Health said Tuesday.

The patient was at the theme park on Oct. 16, between 9:15 a.m. and 8:35 p.m., and before that, at a Los Angeles Starbucks coffee shop on 3006 S. Sepulveda Blvd. on Oct. 16, between 7:50 a.m. and 10 a.m.

Anyone who visited Disneyland or the coffee shop during those time periods could be at risk of developing measles for up to 21 days after being exposed.

Those who believe they may have been exposed should review their immunization records, reach out to their health care provider as soon as possible and watch out for symptoms, including fever and an unexplained rash.

Those who experience symptoms should stay home and call their doctor immediately, health officials said.

#PressRelease : Measles Exposure Advisory – Confirmed #measles case traveled throughout Southern California. View https://t.co/cDtfp6XY16 for more info. More times and locations may follow as details become available. pic.twitter.com/k2zllK0kgC

— LA Public Health (@lapublichealth) October 23, 2019

The disease is considered among the most contagious viruses in the world. About 90% of people who have never been immunized experience the symptoms seven to 21 days after exposure, authorities said.

“The measles virus can remain in an environment for several hours, so when we list public exposure sites we take that into consideration. Individuals that were in those potential sites while that person was infection could be at risk of being exposed,” health officer Nichole Quick told KTLA.

So far in 2019, there have been 19 confirmed cases of measles among Los Angeles County residents, and another 11 cases among non-residents who traveled through the county, health officials said.

The majority of those cases were found among patients who were not immunized or did not know whether they had ever been immunized, according to the health department.

“For those who are not protected, measles is a highly contagious and potentially severe disease that initially causes fever, cough, red, watery eyes, and, finally, a rash,” Los Angeles County Health Officer Muntu Davis  said. “Measles is spread by air and by direct contact even before you know have it. The MMR immunization is a very effective measure to protect yourself and to prevent the unintentional spread of this potentially serious infection to others.”

Public Health officials said they will provide an update with additional locations and time periods in which people could have been exposed to measles in connection with this patient.

This content was originally published here.

Dracut orthodontist sinks his teeth into hydroponic gardening

James Pelletier, an orthodontist, created a hydroponic vegetable garden in his Dracut back yard to grow a better crop of tomatoes in a smaller space. Watch video at lowellsun.com. SUN photos /Julia Malakie)

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DRACUT — James Pelletier says he’d cry if he ever came home to find his tomato plants wilted.

“The biggest fear every hydroponic gardener has is a power failure,” he says.

The Dracut orthodontist circles around his labor of love on a recent Friday to make sure the solar-powered garden in his backyard is running seamlessly. The Big Boy tomatoes that grow in bato buckets are not yet ripe. All are bright green, some plumper than others.

As the sun bears down on Pelletier and the tight rows of tomato plants, he shares that he has trained them to thrive on one vine. “Because one vine doesn’t allow them to grow bushy and get wet, and get diseases,” he explains, reaching out to pull a velvety sucker from one plant.

Above, the crop; at right, a jar of sauce made from his tomatoes.

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“You only want one grow point, and that’s how you have one vine.”

After years of trouble with growing tomatoes and subsequently running out of space in his yard for more tries, Pelletier, 57, wanted to find a way to grow the vegetables every year without having to move it to a new spot. He wanted something easier than conventional gardening. Pelletier read books on hydroponic gardening — a method of growing plants without soil — and made several attempts at the garden before building his current one two years ago. Three solar panels supply energy to batteries that run two special pumps and an aerator that, in turn, feed the tomato plants. Instead of soil, Pelletier uses coconut fiber and perlite.

He regularly pours different liquid nutrients into a reservoir built into the ground, which are then pumped into each tomato plant. Once the buckets the plants are in reach a certain level, the fluid drains back into the reservoir. The cycle repeats four times a day.

“I’m a scientist in my heart. I just get a lot of satisfaction out of doing it,” Pelletier says. “I am creating something from nothing and tweaking it this way and that way over the years to get it to do exactly what I want it to do.

It’s like a big, huge science experiment and, when it goes good like this, it feels great.”

The garden’s greatest threat according to Pelletier is blight, a plant disease that actually hasn’t affected his garden. There’s also a pesky chipmunk who sneaks into the garden to steal tomatoes. On this recent Friday, the chipmunk made an appearance, having stolen a small, green one.

After the science comes the fruit of Pelletier’s labor. Once the tomatoes have ripened, he and his wife, Karen, pluck them and prepare them for canning, sometimes with the help of their daughter, Mollie Andrews, 30. On the weekends they sit on their deck to can the tomatoes in Mason jars before storing them away.

The irrigation system for James Pelletier’s hydroponic vegetable garden in his Dracut backyard is powered by these solar panels. The garden also includes a bed of asparagus, center. SUN photos /Julia Malakie

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Karen makes sauce from the tomatoes, and dishes that also incorporate the other vegetables growing in their backyard such as zucchini. Pelletier says he also gives out canned tomatoes to relatives and neighbors across the street.

“I love it. He works very hard on it,” Karen, 58, says. “It takes a lot of time, but he enjoys gardening so we get a lot of beautiful vegetables from it.”

Follow Amaris Castillo on Twitter @AmarisCastillo

Batteries on the top shelf of this cabinet store power produced by Pelletier’s solar panels.

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Smoke From Wildfires and Horse Respiratory Health – The Horse

Smoke is an unhealthy combination of carbon dioxide, carbon monoxide, soot, hydrocarbons, and other organic substances. Smoke particulates, which are a mixture of solid particles and liquid droplets in the air, can irritate horses’ eyes and respiratory tracts, and hamper their breathing.

“Owners should limit their horses’ activity when smoke is visible,” said UC Davis veterinary professor John Madigan, DVM, MS, Dipl. ACVIM, ACAW.

During California wildfires with persistent smoke several years ago, the Tevis Cup—a 100-mile endurance race—was postponed based on adverse air quality for exercising horses. This is an example of important management decisions that can protect horse health.

It is important to use human health air-quality advisories and apply them to horse events where horses will be exercising and breathing harmful smoke. If humans’ eyes burn and are bothered by smoke,  you can assume horses will be in the same boat. Providing horses with resting from exercise, limiting smoke exposure when possible, and monitoring for signs of increased respiratory rate or cough should be at the top of owners’ to-do lists when wildfires are near. And should a concern arise, always consult your veterinarian.

“It’s also important to provide horses with plenty of fresh water, which keeps airways moist and helps them clear inhaled particulates,” said Madigan.

If a horse is having difficulty breathing, contact your veterinarian immediately to ensure the horse has not developed a reactive airway disease or bacterial infection accompanied by bronchitis or pneumonia. Horses can suffer from constriction of the airways, just as humans can.

In cases of heavy smoke exposure, it can take four to six weeks for smoke-induced damage to heal, during which time the horse should not be heavily exercised. Premature exercise could aggravate the condition, delaying healing and compromising the horse’s performance for weeks or months.

“If the horse has further smoke-related problems, such as persistent cough, nasal discharge, fever, or increased rate of breathing or labored breathing, the owner should contact a veterinarian, who may prescribe respiratory medications such as bronchial dilators or other treatments that will hydrate the horse’s airway passages and reduce inflammation,” Madigan said. “The veterinarian also may recommend tests to determine whether a secondary bacterial infection is contributing the horse’s respiratory problems.”

This content was originally published here.

The John Fornetti Dental Center Presents Dentistry For Our Vets 2018

Iron Mountain, MI – The John Fornetti Dental Center will present Dentistry For Our Vets on Saturday, November 10, 2018. Dentistry For Our Vets provides free dental care to our veterans in need.

Dr. John and Dr. Dan Fornetti, along with their team of employees, volunteers and sponsors will be hosting their 5th annual Dentistry For Our Vets on Saturday, November 10, 2018. Those over age 18 in need of dental care will be able to choose between one free extraction, filling or hygiene cleaning. Registration begins at 8:00 a.m. and patients will be seen on a first come, first served basis until 3:00 p.m.

The media is invited to join the many volunteers and patients to spread free smiles across Iron Mountain through Dentistry For Our Vets at The John Fornetti Dental Center. We are turning our parking lot into an outdoor waiting room, with a heated waiting area and burn barrels, but please remember to bundle up and stay warm.

91% of U.S. veterans are ineligible for dental benefits. Dr. John Fornetti of Iron Mountain, MI, thinks as Americans, we can do better. In response, Dr. John started Dentistry For Our Vets. The John Fornetti Dental Center’s 2017 event was able to serve 58 veterans, providing over 162 procedures, and over $20,000 in services donated.

Dentistry For Our Vets will be held at The John Fornetti Dental Center, located at 100 S. Stephenson Avenue, Iron Mountain, MI. from 8:00 a.m. to 3:00 p.m. Anyone interested in volunteering their services for the event can find more information by calling (906) 774-0100 or visiting us on the web here and on Facebook.

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Being a Loud Woman May Be Good for Your Health, According to a Study

Managing our emotions is often complicated. Sometimes it’s necessary to mitigate them, remain silent, and keep calm in moments of stress. We don’t want them to harm our personal relations. But on other occasions, what works best to maintain our relationships is to speak out and express ourselves. After all, letting out all that we’re feeling and thinking can help us see things from a different perspective. However, what you may not be aware of is that both behaviors can have significant effects on your health.

Bright Side wants to talk to you about a study that claims raising the volume of your voice is not always a bad idea.

Auto silence is a behavior people engage in when they’re afraid to express their real emotions. If properly externalized, they worry their feelings may affect their relationships with people close to them in some way, such as family members, friends, or employers. They choose auto silence because they dread having to start a disagreement, being the cause of an argument, or even breaking up a relationship.

More than 300 women participated in the study.

The North American Menopause Society (NAMS) conducted a study where they evaluated 304 married women who were near or after menopause. They reported experiencing certain feelings about putting someone else’s needs before their own, such as self-silencing, to avoid damaging a relationship. This type of behavior was met with bouts of constipation, an increase in cholesterol levels, depression, and obesity.

More yelling, less stressing

One of the points that researchers measured was the frequency at which these women experienced anger or euphoria outbursts. They addressed these as moments when they were able to let their emotions out by raising the volume of their voice and verbally stating what made them feel frustrated. Those who showed this behavior more often registered as having better health than those who didn’t. They also experienced the psychological benefits of preventing the repression of these emotional states.

Hiding your emotions has physical consequences.

Maintaining a facade of joy and calm doesn’t mean that this state is real. It’s a behavior that’s related to a greater sensitivity to rejection. A permanent state of alert that triggers the levels of stress are closely associated with the decrease of life expectancy in both men and women worldwide. During these episodes, blood pressure and glucose levels rise, so the chance of developing a cardiovascular condition increases.

There’s a healthy way to express yourself.

Although raising our voices from time to time to let go of negative emotions can be liberating, we must also consider that it enables us to say things that don’t help our relationships. In another experiment carried out with cancer patients, women showed some improvements by openly expressing their emotions. On the contrary, progress slowed when negative feelings were prevalent. For this reason, it’s good to keep in mind that showing respect for you and those around you is essential to maintain a healthier body and relationships.

Do you communicate your feelings in some other ways? How would you change the way you express yourself to improve your relationships? Tell us what you think in the comments!

This content was originally published here.

Elijah Cummings has died: Baltimore congressman is dead at 68, from longstanding illness and health issues – CBS News

Representative Elijah Cummings, of Baltimore, died early Thursday at the age of 68, his office said. Cummings passed away at Johns Hopkins Hospital at 2:45 a.m. from “complications concerning longstanding health challenges,” his office said.

He hadn’t returned to work after having a medical procedure that he said would only keep him away for about a week, The Baltimore Sun noted.

Maya Rockeymoore Cummings, the chairwoman of the Maryland Democratic Party and Cummings’ wife, said in a statement that Cummings was “an honorable man who proudly served his district and the nation with dignity, integrity, compassion and humility.”

“He worked until his last breath because he believed our democracy was the highest and best expression of our collective humanity and that our nation’s diversity was our promise, not our problem,” Rockeymoore Cummings said. “I loved him deeply and will miss him dearly.”

House Speaker Nancy Pelosi ordered the flags at the Capitol to be flown at half staff in his memory. The White House, too, lowered its flag.

“He was not just a great congressman, he was a great man,” House Minority Leader Chuck Schumer said on MSNBC Thursday morning.

Baltimore Mayor Bernard C. Young said in a statement that “people throughout the world have lost a powerful voice and one of the strongest and most gifted crusaders for social justice.”

President Trump praised Cummings’ “strength, passion and wisdom” in a tweet, despite the insults he hurled at Cummings this summer.

“My warmest condolences to the family and many friends of Congressman Elijah Cummings. I got to see first hand the strength, passion and wisdom of this highly respected political leader. His work and voice on so many fronts will be very hard, if not impossible, to replace!” the president tweeted shortly before 9 a.m.

The House Oversight and Reform Committee chairman, a Democrat and 23-year House veteran, was a key figure in the impeachment inquiry into Mr. Trump and a recent target of intense criticism from the president.

Cummings missed two roll call votes Thursday, the first day back following a two-week House recess. He previously released a statement saying he’d be back by the time the session resumed. He hadn’t taken part in a roll call vote since Sept. 11.

The procedure already caused Cummings to miss a September hearing on Washington, D.C., statehood. The statement didn’t detail the procedure.

He previously was treated for heart and knee issues.

Humble beginnings

A sharecropper’s son, Cummings was a formidable orator who passionately advocated for the poor in his black-majority district, which encompasses a large portion of Baltimore as well as more well-to-do suburbs.

As chairman of the House Oversight and Reform Committee, Cummings led multiple investigations of Mr. Trump’s dealings, including probes in 2019 relating to the president’s family members serving in the White House.

The president responded by criticizing Cummings’ district as a “rodent-infested mess” where “no human being would want to live.” The comments came weeks after Mr. Trump drew bipartisan condemnation following his calls for Democratic congresswomen of color to get out of the U.S. “right now” and go back to their “broken and crime-infested countries.”

Cummings replied that government officials must stop making “hateful, incendiary comments” that only serve to divide and distract the nation from its real problems, including mass shootings and white supremacy.

“Those in the highest levels of the government must stop invoking fear, using racist language and encouraging reprehensible behavior,” Cummings said in a speech at the National Press Club.

Cummings told the Baltimore Sun that he had only spoken to Mr. Trump one-on-one once, in 2017. Cummings recalled saying: “Mr. President, you’re now 70-something, I’m 60-something. Very soon you and I will be dancing with the angels. The thing that you and I need to do is figure out what we can do — what present can we bring to generations unborn?”

Working way up

Cummings’ career spanned decades in Maryland politics. He rose through the ranks of the Maryland House of Delegates before winning his congressional seat in a special election in 1996 to replace former Rep. Kweisi Mfume, who left the seat to lead the NAACP.

Cummings continued his rise in Congress. In 2016, he was the senior Democrat on the House Benghazi Committee, which he said was “nothing more than a taxpayer-funded effort to bring harm to Hillary Clinton’s campaign” for president.

Cummings was an early supporter of Barack Obama’s presidential bid in 2008.

Throughout his career, Cummings used his fiery voice to highlight the struggles and needs of inner-city residents. He was a firm believer in some much-debated approaches to help the poor and addicted, such as needle exchange programs as a way to reduce the spread of AIDS. Cummings was very popular in his district, where he was a key member of the community.

Cummings said in an interview with “60 Minutes” in January that he was one of the few members of Congress who lived in an inner city environment.

“I like to be among my constituents. Let me tell you something man, if I don’t do well in this block I’m in trouble. I mean, if you wanna take a poll, if I lost in this block I might as well go– I might as well stay home,” Cummings said in the interview.

Cummings was born on Jan. 18, 1951. In grade school, a counselor told Cummings he was too slow to learn and spoke poorly and he would never fulfill his dream of becoming a lawyer.

“I was devastated,” Cummings told The Associated Press in 1996, shortly before he won his seat in Congress. “My whole life changed. I became very determined.”

It steeled Cummings to prove that counselor wrong. He became not only a lawyer, but one of the most powerful orators in the Maryland House of Delegates, where he entered office in 1983. He rose to become House speaker pro tem, the first black delegate to hold the position. He would begin his comments slowly, developing his theme and raising the emotional heat until it became like a sermon from the pulpit.

Cummings was quick to note the differences between Congress and the Maryland General Assembly, which has long been controlled by Democrats.

“After coming from the state where, basically, you had a lot of people working together, it’s clear that the lines are drawn here,” Cummings said about a month after entering office in Washington in 1996.

Cummings chaired the Congressional Black Caucus from 2003 to 2004, employing a hard-charging, explore-every-option style to put the group in the national spotlight.

He cruised to big victories in the overwhelmingly Democratic district, which had given Maryland its first black congressman in 1970 when Parren Mitchell was elected.

Cummings addressed his recent health issues in the January interview with “60 Minutes.”

“Like I tell my constituents, “Don’t get it twisted. You know, I may– my knee may be hurtin’ a little bit, but my mind is clear. My mission is clear.” And I am prepared and able to do what I have to do. And I will do it to the very best of my ability, so help me God,” Cummings said.

This content was originally published here.

Spirit of the Entrepreneur: Valdosta Family Dentistry | Local News | valdostadailytimes.com

VALDOSTA — Being an entrepreneur isn’t always easy and everyone does it a little differently.

Some open online stores, while others open brick-and-mortar storefronts.

Some go all in and invest their lives into a new venture, while others start a new business as something to do on the side. Regardless of the type, entrepreneurs help drive the local economy.

Larry Black, owner and dentist at Valdosta Family Dentistry, didn’t begin his career in dentistry until he was in his mid-30s.

At 17, he left Valdosta and joined the Navy for six years.

He worked as an electronic technician doing satellite communications and cryptography.

After leaving the military as an employee, he worked as a civilian contractor for the Navy for six years doing similar work.

The work required Black to travel regularly, and he eventually decided he wanted to settle down.

“We traveled about 11 months out of the year,” he said. “We traveled anywhere the Navy was having trouble with communications equipment. I decided that I was ready to quit traveling and started back to school.”

Being from Valdosta, Black returned to attend Valdosta State University to earn a biology degree.

After three years of undergraduate work and a degree in hand, Black had been introduced to the world of dentistry through Dr. Greg Morris, he said.

So, Black attended the Medical College of Georgia for four years to to become a dentist.

By the time he attended MCG, he was the third oldest student in his cohort. Black said being a non-traditional student was beneficial to him.

“I was one of those people who could not have done and focused on school at 18,” he said. “Part of the reason I went into the Navy was I knew that about myself.

“When I came back from the Navy and started school, it was much easier for me having already had life experience and improved time-management skills. Knowing where I wanted to be and how to get there helped me jump through the hoops or check off the boxes to get there.

“I knew what I wanted and was wiling to work harder for it and put in the time.”

After graduation, Black came back to Valdosta in 2004 and opened his first office, Quitman Family Dentistry in Quitman.

“When I got out and looked at a place to set up my office, there was still plenty of room for more dentists in Valdosta, and having grown up here, I felt that it would be easier to start up a business in my hometown,” he said.

In 2009, Black opened an office in Valdosta.

“When I was working in Quitman Family Dentistry, myself and Dr. Eric Castor felt there would be a need for an emergency dental clinic in Valdosta,” he said. “We spent a year with this office as an emergency-only clinic.”

Based on customer requests, Black expanded to a full-service dentist office in 2010.

After being in practice for almost 15 years, he said the hardest part has been operating the business side.

“Running the business is probably the toughest part of what I do,” he said. “The toughest part for most dentists is we tend to be very technical. We enjoy working with our hands and working with people. And dental school prepares you for all the knowledge you need to do dentistry.

“The tough thing is they don’t prepare you to run a small business. When you come out of school and you have to learn about tax structure and accounting.”

Black said he leaned on his late wife, Dana Black, when he first opened his business.

“I got into it thinking you get out, put your sign on the door and you go to work,” he said.

While he worked with the clients, Dana learned how to run the business for him.

“She was a big part of why we were able to do what we did,” he said.

Dana passed in 2017.

As for advice for new or potential business owners, Black suggests taking a few years to learn about the selected industry. He also recommends utilizing the small business resources available.

“If you are going to open up your own business, understand that business,” he said. “Most people have an idea of what a business is but they haven’t worked in it before. They don’t have an idea of how it works. Take a few years and start from the bottom and work in a few positions.

“Then go and take some accounting classes and business classes either through (Wiregrass Georgia Technical College) or the (University of Georgia Small Business Development Center at Valdosta State University) that’s here in Valdosta because both of those guys helped me out after I got started.”

Valdosta Family Dentistry, 2935 N. Ashley St., Suite 130, is open open 8 a.m.-5 p.m. Monday, Wednesday and Friday. Quitman Family Dentistry is open Tuesday and Thursday. For more information, call (229) 333-8484.

Jason Smith is a reporter at The Valdosta Daily Times. He can be contacted at 229-244-3400 ext.1257.

This content was originally published here.

Avoiding red or processed meat doesn’t seem to give health benefits | New Scientist

Many health bodies have said in the past that people should limit their red meat intake

Owen Franken/Corbis Documentary/Getty

Owen Franken/Corbis Documentary/Getty

There are no health reasons to cut down on eating red or processed meat, according to a new review of the evidence. The claims, which contradict most existing dietary advice, come from a review of existing studies led by the Spanish and Polish Cochrane Centers, part of a global collaboration for assessing medical research.

Numerous health bodies have said for decades that we should limit our intake of red meat because it is high in saturated fat, thought to raise cholesterol levels and cause heart attacks. More recently, both red and processed meat have been linked with cancer.

In the latest review, though, the authors came to a different conclusion because they considered separately the two main kinds of research. The best evidence comes from randomised trials. In these, some participants are helped to change their diet in a certain way, such as eating less meat, and the rest aren’t. At the end, the health of the people in the two groups is compared.

But such trials are costly and hard to do. According to one estimate, only about 5 per cent of nutrition studies are large, good-quality randomised trials. It is much more common to do research that just observes what people choose to eat undirected. Known as observational studies, these are notoriously open to bias and can give misleading results.

Bradley Johnston of Dalhousie University in Halifax, Canada, and his colleagues first reviewed all previous observational studies looking at the health impact of eating red or processed meat. These pointed to a “very small” adverse effect on deaths, heart disease and cancer.

Then they separately reviewed the 12 randomised trials that have been done in this area, and found that there was little or no health benefit for people who cut down on eating these meats. Based on these findings, the authors conclude that people should “continue to eat their current levels of red and processed meat unless they felt inclined to change them themselves”. However, they added that some might want to change their diet because of animal welfare or environmental reasons.

“It may be time to stop producing observational research in this area,” Tiffany Doherty from Indiana University’s Pediatric and Adolescent Comparative Effectiveness Research team wrote in an accompanying editorial.

Duane Mellor, a spokesperson for the British Dietetic Association, says people shouldn’t take the advice as a green light to eat more red meat. “What it doesn’t say is that we can tear up the guidelines and start eating twice as much meat. But red meat three times a week is not a problem.”

Journal reference: Annals of Internal Medicine, DOI:

More on these topics:

This content was originally published here.

The Importance of Geriatric Dentistry

As you grow older, it’s important to keep up with your teeth. Perhaps you or your companions don’t see the need to go to the dentist, but the impact of good dentistry on your teeth and overall health is undeniable.

Here, we’ll explore all you should know about geriatric dentistry.

Why Do Older Adults Not Go to the Dentist?

With retirement, spending time with family, and other life events in full swing, it can be difficult to prioritize your oral health.

Here are some specific reasons why seniors don’t visit the dentist:

  • Cost: Seniors don’t have workplace insurance coverage. Programs like Medicaid offer limited coverage for dental procedures. Some seniors don’t view paying out-of-pocket as a realistic option.
  • Misinformation: Some seniors believe that they don’t need to go to the dentist because they don’t have teeth. This is simply not true. At a visit, you can be fitted for dentures and get exams to screen for signs of oral cancer.

How Your Oral Health Affects You

Your oral health is important in so many ways. Some of the top reasons include:

Contributing to Your Bodily Health

Your oral health doesn’t just benefit your teeth and gums. Poor oral health can lead to:

  • Diabetes
  • Heart disease
  • Pneumonia

Neglecting to visit a dentist can lead to specific oral issues like:

  • An uneven jawbone
  • Root decay
  • Darkened or otherwise discolored teeth
  • Gum disease

Giving You Confidence

There is an aesthetic appeal to good oral health.

A white, aligned smile is self-assuring. It can help you feel confident and allow you to more fully enjoy social interactions.

Ceramic crowns, veneers, and other types of cosmetic dentistry from Calgary, for example, all help seniors smile with confidence. More standard services, like teeth whitening and cleaning, help preserve your smile for life.

How to Go on a Budget

If the cost of going to the dentist is daunting, use these tips for going to the dentist on a budget.

Limit Unnecessary Visits

At home, be sure to care for your teeth. Take these preventative measures:

  • Brush twice daily
  • Floss daily
  • If you have extra-sensitive teeth, use a gentle toothpaste.
  • Avoid foods that may cause tooth damage, like hard candy or acidic fruits

Even though skipping out on visits may save you money temporarily, it isn’t a financially-savvy habit. Attending regular visits prevents the need for costly treatments down the road.

Review Your Options

Look up different dental offices around you. They will vary in price based on the services they offer and the areas where they operate. Consider driving to a nearby area with a lower cost of living. The extra minutes it takes to drive to a different location can save you money, especially on costly procedures.

Look for Coupons

Some offices offer special coupons or deals for new customers. Look actively on saving sites like Groupon or browse your local newspaper.

Go to a Dental Hygienist

In many areas, you can see a dental hygienist without a dentist present. These types of visits are significantly less expensive than regular office visits. Be sure to research the regulations in your area. Some areas restrict what a hygienist can treat.

Ask for a Discount

If you’ve been going to the same office for years, consider asking for a discount. Most dental offices are willing to negotiate a price, especially on a costly procedure. Do so before you receive treatment. You can also request treatment to be performed in different stages. This way, you have time in-between visits to save money to pay for your treatment.

Visit Your Dentist!

Managing your oral health as a senior can be intimidating. As with other adults, seniors should have their teeth cleaned twice a year. You should also get X-rays at least once a year to ensure there are no underlying problems with your teeth or gums.

Take command of your oral health as a senior!

The post The Importance of Geriatric Dentistry appeared first on LivingBetter50.

This content was originally published here.

Americans Spent More on Taxes in 2018 Than on Food, Clothing and Health Care Combined

A grocery shopper in Los Angeles on July 24, 2019. (Photo by Mark RALSTON/AFP/Getty Images)

Americans on average spent more on taxes in 2018 than they did on the basic necessities of food, clothing and health care combined, according to the Bureau of Labor Statistics Consumer Expenditure Survey.

The survey’s recently published Table R-1 for 2018 lists the average “detailed expenditures” of what the BLS calls “consumer units.”

“Consumer units,” says BLS, “include families, single persons living alone or sharing a household with others but who are financially independent, or two or more persons living together who share major expenses.”

In 2018, according to Table R-1, American consumer units spent an average of $9,031.93 on federal income taxes; $5,023.73 on Social Security taxes (which the table calls “deductions”); $2,284.62 on state and local income taxes; $2,199.80 on property taxes; and $77.85 on what BLS calls “other taxes.”

The combined payments the average American consumer unit made for these five categories of taxes was $18,617.93.

At the same time the average American consumer unit was paying these taxes, it was spending $7,923.19 on food; $4,968.44 on health care; and $1,866.48 on “apparel and services.”

These combined expenditures equaled $14,758.11.

So, the $14,758.11 that the average American consumer unit paid for food, clothing and health care was $3,859.82 less than the $18,617.93 it paid in federal, state and local income taxes, property taxes, Social Security taxes and “other taxes.”

I asked the BLS to confirm these numbers, which it did while noting that the “Pensions and Social Security” section of its Table R-1 included four other types of payments (that many people are not required to make or that do not go to the government) in addition to the average of $5,023.73 in Social Security taxes that 77.21% of respondents reported paying.

“You asked us to verify the amounts for the total taxes and expenditures on food, apparel/services, and healthcare,” said BLS. “Based on table R-1 for 2018, your definition for food, apparel, and healthcare matches the BLS definition and the total dollars. Your dollar amounts for federal, state, and local income taxes and for property taxes are correct, as is the amount for Social Security deductions. For the combined pension amount [$6,830.71] that we publish however, in addition to the $5,023.73 for Social Security, there is an additional amount for government retirement deductions [$135.11], railroad retirement deductions [$2.85], private pension deductions [$608.22], and non-payroll deposits for pensions [$1,060.79].”

That Americans are forced to pay more for government than they pay for food, clothing and health care combined has become an enduring fact of life.

A review of the BLS Table R-1s for the last six years on record shows that in every one of those years, the average American consumer unit paid more in taxes than it paid for food, clothing and health care combined.

In 2013, the average American consumer unit paid a combined $13,327.22 for the same five categories of taxes cited above for 2018, while paying a combined $11,836.80 for food, clothing and health care.

In 2014, the average American consumer unit paid $14,664.13 for those same taxes and $12,834.34 for those same necessities.

In 2015, it was $15,548.36 versus $13,210.83. In 2016, it was $17,153.30 versus $13,617.60. And, in 2017, it was $16,750.20 versus $14,489.54.

Even when all the numbers for the last six years are converted into constant December 2018 dollars (using the BLS inflation calculator), the largest annual margin between the amount paid in taxes and the amount paid for food, clothing and health care was last year’s $3,859.82.

The margin was so great last year that you can add the $3,225.55 Table R-1 says the average consumer unit paid for entertainment to the $14,758.11 it paid for food, clothing and health care, and the combined $17,983.66 is still less than the $18,617.93 it paid for the five categories of taxes.

You get a similar result if you add the combined $2,903.50 that the average consumer unit paid in 2018 for electricity ($1,496.14) and telephone services ($1,407.36).

Yes, Americans on average paid more in taxes last year than they paid for food, clothing, health care, electricity and telephone services combined.

Was the government you got worth it?

(Terence P. Jeffrey is the editor in chief of CNSNews.com.)

This content was originally published here.

PROFILES IN SUCCESS: Cavanaugh takes hoops lessons into his work as an orthodontist

As Robert Cavanaugh walked through the Old Town Banquet Hall in Valparaiso last month, the former Valparaiso High School and Valparaiso University basketball player was struck by the amount of meaningful relationships he’d made with people in the room over the years.

Cavanaugh was one of 10 individuals inducted into the Valparaiso High School Hall of Fame on Jan. 20, and while he had two tables of supporters, Cavanaugh spent plenty of time floating around the room.

Joe Otis was holding court on one side of the room, telling old basketball stories. Mike Jones and Scott Anselm traded stories while forming a unique bond with Cavanaugh with the three having played for both the Vikings and the Crusaders. Former coach Bob Punter told a tale or two before introducing Cavanaugh to the audience.

The honor of getting inducted into the Hall meant a lot to Cavanaugh, an orthodontist with Cavanaugh & Nondorf Orthodontics, but the people is what he’ll remember.

“(Getting inducted) was kind of humbling,” Cavanaugh said. “The best part of it was going to the event and seeing all these people that were such a big part of my life. The evening itself was really neat because of getting to spend time with so many different people.”

Cavanaugh knows a lot of people simply because he is as ingrained in the Valparaiso community as one can be. He and his wife, Heather, have five children that have come up through the Valparaiso school system, the same system that produced Cavanaugh before he graduated in 1990.

Cavanaugh spent his first three seasons at VHS playing basketball under Skip Collins. The 1988-89 team won a sectional championship before falling in the regional. Collins gave way to Punter and Cavanaugh for his first taste of a different coaching philosophy.

“Skip was very regimented, very organized and very detailed,” Cavanaugh said. “Punter let us go a little bit more. We scored a lot more points going up and down the floor, but we gave up a little bit more, too.”

The 1989-90 Vikings also won a sectional title and Cavanaugh learned a life lesson in watching Collins, and then Punter, that he has taken with him to his orthodontics practice.

“You can see there’s ways to look at different approaches,” Cavanaugh said. “Now as a business owner, being in charge of 10 to 12 staff members, you can see that they’re all different. The coach has to decide what everyone is good at. Watching (Collins and Punter), there’s not only one way to do something, there’s positives and negatives.”

Cavanaugh set the IHSAA record for consecutive free throws at 72 his senior year and he made 102 out of 104 attempts from the charity stripe. Despite scoring 18.5 points per game and leading the Vikings in assists, Cavanaugh wasn’t highly recruited out of high school and it wasn’t until he had a stroke of good fortune that he found his landing spot.

“(Second-year Valparaiso University coach) Homer Drew called me and told me that he really liked me, but also wanted to tell me that he wasn’t going to recruit me because they didn’t need a guard,” Cavanaugh said. “The season ends and two of their guards leave. Homer called me and immediately offered me a scholarship. I was lucky how the opportunity came about.”

Cavanaugh started all four years for the Crusaders and has made a profound impact on the Valparaiso record book. He finished his career with the highest 3-point percentage at the time and now ranks No. 6 in program history. Cavanaugh is joined in the top 10 by Bryce Drew, Casey Schmidt and Mike Jones, all Valparaiso High graduates. Cavanaugh also ranks among the program’s best in assists and free throw percentage.

More important than individual statistics was the ascent of the team when Cavanaugh played for the Crusaders. Valparaiso won five games in each of his first two seasons before breaking through for 12 wins in 1992-93. The following year the Crusaders won 20 games, a mark they’d hit in eight of the next nine seasons.

“We were starting to see the hard work paying off,” Cavanaugh said. “It was about setting goals higher, having persistence. Those first couple years when you’re not winning, it’s hard. People are hanging their heads, but once you start winning, it changes your whole feeling.”

While basketball was a passions for Cavanaugh, so was dentistry. His father, Tom, worked in the field for 40 years and Rob gotten bitten by the bug at an early age. After graduating from Valparaiso, Cavanaugh completed his dental studies at the Indiana University of Dentistry in 1998 and then graduated from NOVA Southeastern University in Fort Lauderdale with orthodontic specialty education in 2001. Cavanaugh became board certified by the American Board of Orthodontics in 2005.

“During some of those summers (when I was younger), I worked for my dad in his office,” Cavanaugh said. “I started making some appliances. My grandfather was a general dentist and I had the opportunity to visit some of the other dentists in town.”

Dentistry is certainly a family business as far as Cavanaugh is concerned. His partner, Matt Nondorf, is the same way as his father, sister and wife also work in the field. Just as dentistry brings Cavanaugh and his family together, so does flying. Tom was a longtime flight instructor and Rob’s brother Brad owns Air One, an aerial photography business.

“During my sophomore year at VU I got my pilots license,” Cavanaugh said. “My dad was a flight instructor and was honored by the FAA with the Wright Brothers Award for 50 years of no accidents. Hanging out at the airport with all the guys, it’s something I’ve always had an interest in.”

Cavanaugh has built a successful business career, but the itch to compete is still there. He cures it with weekly basketball games and by coaching his children. While basketball has always come natural to him, Cavanaugh is finding a new love with following his children in cross country. While dentistry and sports don’t quite go hand in hand, Cavanaugh has found a balance between the two that is rooted in more life lessons he learned back at Valparaiso High.

“The big thing going into dental school was to remember time management and being able to multitask,” Cavanaugh said. “Learning how to deal with failures, how to make mistakes and to be persistent.”

This content was originally published here.

Veterans Affairs To Share Veterans’ Health Information Without Consent

Thousands of veterans were alarmed to learn VA is quietly rolling out is plan to automatically share veterans’ health information with third parties without written consent.

You got that right. Thanks to the VA MISSION Act, VA will now automatically enroll, or opt-in, all veterans into a health information sharing system with numerous government agencies and private organizations after September 30, 2019, unless you object in writing on a paper form.

Veterans must submit the VA Form 10-0484 in person or by mail to their local VA Release of Information office by of September 30, 2019, if they do not want to be “automatically enrolled” into the eHealth Exchange managed by The Sequoia Project.

Sound absurd? Here is what VA wrote in its Virtual Lifetime Electronic
Record (VLER) FAQ:

All Veterans who have not previously signed form 10-0484 as of September 30, 2019 will be automatically enrolled, but have the option to opt out.

Let me say that a third way in case I have not been clear.

VA will automatically share your health information with third parties without your written consent unless you opt-out in writing or submit a revocation in writing submitted in person or by US mail. You cannot submit your opt-out or revocation electronically.

How ironic, right?

In the name of technology, VA is about to force veterans into an electronic data sharing system without consent. The only way to prevent this violation is to present your objection on an agency mandated form ON PAPER by hand or snail mail by Monday. How old school.

And we are just learning about the deadline now.

In order to opt-out or revoke consent, there are a couple of forms you need to consider, noted above… but you only have until Monday to figure it out.

Curiously, the VA Form 10-10164 opt-out that is not technically an official form until October 2019 based on the available form.

One could argue that submitting the 10-10164 before September 30 may still result in a veteran’s automatic opt-in and then opt-out since the form may lack legal effect until October 2019.

So, the forms you can use to opt-out or revoke consent:

How do you get the form to VA? Can I send it on eBenefits or
fax it to Janesville Evidence Intake Center?

No. The agency requires that you either hand deliver the
signed form or mail it to the local Release of Information office at your VA Medical
Center by Monday.

No revocations will be processed after September 30, 2019. I
hope VA will not auto-opt-in veterans who submit the new form before the
deadline.

Either way, if you fail to take action by September 30, your
health information will be shared with the eHealth Exchange managed by The Sequoia
Project.

Good luck.

Once health information is shared, it cannot be unshared as
best I can tell from the information available including the old form.

This means meaning you lose control of your data. While you can possibly opt-out at a later date, whatever is shared is out there in the great and mysterious cloud for whatever hacker to access however and whenever they choose.

Who may get access?

The eHealth Exchange is a massive data-sharing system between federal agencies and private organizations in all 50 states that was originally controlled by the Department of Health and Human Services.

A nonprofit called The Sequoia Project took over management of the eHealth Exchange for “maintenance.” Many VA contractors and vendors are on the Board of Sequoia including Cerner and Mitre Corporation.

VA reassures us everything is safe. Right. Kind of like all
the times our data was illegally shared or hacked within the existing system?

“Rest assured. Your health information is safe and secure as it moves from VA to participating community care providers,” promises VA.

Believe them? We don’t, either.

We Drove To Minneapolis VA To Investigate

On Thursday, colleague Brian Lewis and I went to Minneapolis VA Medical Center immediately after reviewing what I describe below to confront agency officials about the highly questionable timing of the notice.

The Facebook Live video contains our initial impressions, which later evolved after we spoke with local officials and conducted an additional deep dive. Veterans who do not revoke consent/opt-out by September 30 will be enrolled automatically per the VLER FAQ.

We learned some inside baseball by asking around about it
and inspecting the facility. But, many of the VA officials we spoke with were
generally unaware of what VA Central Office was rolling out.

Our local Release of Information booth at Minneapolis VA did not have any of the forms available for veterans seeking to opt-out or revoke their previous consent. The attendant seemed to think her boss might bring some forms up sometime Friday or Monday since a few veterans were asking about it.

Fantastic.

Btw, you may have noticed my reference to “booth” about our ROI. In order to speak with someone at ROI, Minneapolis VA leadership decided to move the ROI intake to the open lobby area where anyone and everyone can hear about what you are asking about regarding your private health information.

So much for privacy when trying to get your private health
records.

For newbies reading this, Brian and I are veterans rights attorneys in the Minneapolis Metro who are well-known, but not well-loved, by VA officials locally and nationally.

I will explain the forms in a bit.

Back In The Day When Consent Was In Writing… And It Mattered

For years, VA was required secure informed consent from veterans prior to the sharing of health information. Whether you were a veteran trying to get care in the community or allow your attorney access to a claims file, you were required to provide VA with a release of information granting consent to share the date.

If you wanted to give VA your genomic information so they
could share it with private researching organizations for God knows whatever
reason, specifically the Million Veteran Program, you had to sign a form
granting permission.

If you wanted to opt in to allow your community care provider to use the health exchange to access your electronic health records, you need to sign the VA Form 10-0485. If you wanted to revoke that access, you needed to sign and submit the VA Form 10-0484.

There’s Gold In Those Records, Boys And Girls

To me, and millions of other veterans, this process seems
straightforward, but VA officials, university researchers, and private industry
really wanted more access to more veteran data since our electronic health records
comprise one of the most valuable datasets in the history of the world to date.

Yes, there is an incredible monetary value within the database containing all of our electronic health information, and private industry would profit handsomely from various marketing, advertising, and health solutions that could be developed by simply accessing our records.

Now, that access to our records comes at a cost. For at
least the past eight years, standard HIPAA requirements to de-identify records
no longer provide the security previously believed. Companies like Facebook
readily work to hack HIPAA protections using algorithms to connect HIPAA de-identified
data with a person’s Facebook profile using various markers including data like
that given by veterans to the Million Veteran Program, for example.

That data can then provide the backbone of entirely new research and advertising arm of companies like Facebook and Google to connect pharmaceutical ads with individuals who may be interested in the newest and greatest pill for anxiety or erectile dysfunction.

VA Throws Off The Heavy Yoke Of Privacy

Fortunately for business partners, researchers, and anyone
else who wants to access our data but not be troubled with difficult privacy
laws, VA will no longer have its research potential hamstrung by sentimental
laws like the Privacy Act or HIPAA.

Veterans can thank Congress and its passage of the VA MISSION
Act for allowing automatic access to all veterans’ health information by third
party community care providers and “partners.”

One of my readers alerted me to a change in protocol yesterday
starting with a PDF flyer circulating at VA.

That flyer, called the Veteran Notification Flyer, informs veterans of the five things we “need to know” about the VA’s new implementation of the health information mandate. I included this below in italics verbatim from the agency’s flyer.

You may be thinking, ‘Well, at least VA thought to give you
notice.’

Not exactly. I have not received any notice yet. However,
many veterans are writing in starting yesterday with notice letters that VA was
transitioning veterans into a new and brave system of data sharing.

The flyer was created September 11, 2019, informing veterans that in 20 days the process was flipping on its head where we need to opt-out after automatically being opted-in.

5 Things You Need To Know About Health Information
Sharing

If you are a little unclear about how to be sure no one
receives the health information, you are in good company. A lot of readers and
agency officials were unclear of exactly what is going on, and multiple dates
are floating around within VA’s own notices.

One page reads, “VA will begin opting all Veterans into
health information sharing, beginning January 2010.” Another page
reads, “VA Systems will begin opting all Veterans into health information
sharing, beginning January 2020.”

So, when did or will VA start the sharing of our health information
without consent?

An intranet notice to VA employees indicated the actual
process of sharing will start on or about November 18, 2019.

The VLER FAQ sheet probably provides the best advice
specific to veterans who do not want their data shared in the electronic system:

All Veterans who have not previously signed form 10-0484 as of September 30, 2019 will be automatically enrolled, but have the option to opt out. Beginning late 2019, a VA patient’s information will be shared with any community providers that also provide health care services for the shared patient.

“Revocation forms will not be processed after September 30,
2019. However, if you submit VA Form 10-0484, before September 30, your
preference will remain honored and no further action is needed by you.”

This language suggests the form must be submitted before
September 30, because the agency will stop processing them after September 30.

But how to do you revoke the consent that you never granted?

What is also important is the language difference between
the two forms.

Old VA Form 10-0484 vs New VA Form 10-10164

Let’s start with the new form, VA Form 10-10164. Basically,
the form says the agency cannot share your health information unless treatment
is required for an emergency:

So, the opt-out is not absolute. The form also indicates the
opt-in means all your health information can be shared for treatment.

What about your mental health records? How will VA protect
that data? Could that data also be shared with DHS or other organizations for
their own purposes?

The VA Form 10-0484 handles the issues differently.

First, it addresses that the signer revokes their previous
consent. Obviously, most of us never consented to this program. So, by signing
this 0484, can you preemptively revoke?

That is a question for your local Release of Information
Official.

The old form provides the following list about revocation
that I think is far clearer about what is at stake. Here is the list from VA in
italics:

One of the differences that jumped out at me in the old form was the promise that VA “will no longer share any of my individually-identifiable health information”. It did not qualify that revocation by stating the information will be shared in an emergency.

However, the revocation qualifies the health information by calling it “individually-identifiable health information” demonstrating the agency will share your information so long is it is de-identified. As noted above, merely adhering to HIPAA is no longer sufficient to protect your identity or other information that can be traced right back to you with today’s computing power.

What About Health Information Already Shared

The old 10-0484 says the information “already exchanged”
will continue to the used despite revocation meaning once the information is
out there, it is out there.

The health information being passed between VA and its
community care providers is supposedly shared in “guidance” with the Health
Insurance Portability Accountability Act (HIPAA) regulations.

Do we have enough information to make informed decisions?
Does VA seem to give a rip about our informed consent?

I plan to update this post as more information comes out. You may want to check back from time to time.

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This content was originally published here.

BYU students promote women in dentistry

From left to right: Lauren Olsen, Eliza Butcher, Nadia Valentin, Kendra Law, Tessa Hadley, Cyerra Davis and Haram Kim smile at the opening social of the BYU Women in Dentistry committee last week. (Ty Mullen)

Recent BYU graduate Lauren Olsen wanted to be a dentist since she was 4 years old, but while at BYU, her advisor influenced her to pursue a different career path. She ended up graduating in 2018 with a degree in public health.

“He looked at me and was like ‘You know, if you’re a dentist, you’ll have a really hard time being a mom,’” Olsen said, describing the conversation that led her to change majors. “I left and just cried a lot.”

Lauren Olsen dressed as a dentist with her father. Olsen said she knew she wanted to be a dentist at a very young age. (Lauren Olsen)

Olsen said a public health internship in Cambodia helped her realize she needed to return to her roots and study dentistry. While there, she met a young girl with an infected tooth and a swollen face who couldn’t speak. There were no dentists available in the area to assist her.

“I was flying home the next day and thought ‘I didn’t do anything for her,’ and it’s one of my biggest regrets,” Olsen said. “When I got home, I started having a lot of little experiences that reminded me that I wanted to be a dentist all along.”

Olsen said once she got home, she asked family members if they knew any women in dentistry. She eventually learned about Jennifer Klonkle, who is a mother and works one day out of the week as a dentist in Arizona.

Dentists like Klonkle inspired Olsen to find a way to share their stories with other aspiring female dentists.

“If only other girls at BYU could see this,” Olsen said. “I know these nice, normal, smart girls are dentists and moms and whatever they want to be.”

Despite the small number of female dentists in Utah, Olsen established the Women in Dentistry committee at BYU to inform others that there are women who have successfully forged a career in dentistry.

Only four percent of dentists in Utah are women, while 28.9 percent of dentists are female nationwide, according to a 2017 study by the Utah Medical Education Council.

Women in Dentistry president Kendra Law said the group has grown from six to about 30 members. Law said she believes the numbers have increased because of the committee’s support for students who would otherwise be discouraged from a career in dentistry.

“It just helps to have this support group of women who are all trying to reach the same goal,” Law said. “Even when some people are saying, ‘No, you can’t do it,’ we can turn to each other, and we have a good network of people supporting and pushing us to all reach the same dream.”

The first six members of the Women in Dentistry club (from left): Alejandra Garcia, Lauren Olsen, Tess Hadley, Emily Coenen, Kendra Law and Emma Kohl. Club president Kendra Law said the number of members has grown since then. (Lauren Olsen)

The Women in Dentistry committee volunteers for organizations like Community Health Connect to help youth from low-income Utah County families receive the dental care they need. Members of the committee participate in a fluoride varnish program where they check children’s teeth and refer severe cases to dentists who offer dental care free of charge.

“They get a chance to see and understand that there are kids that really don’t have a toothbrush or can’t take care of themselves,” said Julie Francis, Dental Assistant Program Coordinator of Mountainland Technical College. “They get that feeling to help people and become more involved in the community.”

Olsen said she is expanding the Women in Dentistry committee to reach female dental assistants who are juniors and seniors in high school.

“Ninety percent of the high school students we talked to signed up to learn more,” Olsen said.  “It taught me when you teach young girls about their potential, they want to do big things.”

Olsen is now completing prerequisites at UVU so she can apply for dental school next summer. She is also creating a website where young women can observe the examples of female dentists who have successfully balanced their career and other interests.

“So that there will never be a girl again who comes to BYU and gets told ‘No, you can’t be a mom and a dentist. You can’t be a Young Women’s president and a dentist,’” Olsen said. “We’ll have a database of interviews showing that you can and that women all over the country are doing it.”

For updates about BYU Women in Dentistry club meetings, follow them on Facebook and Instagram.

This content was originally published here.