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These days we're always looking for ways to cut the cost of medical care. One idea being tested that could save time and money is called "Integrated Care," which allows for patients to virtually connect with physicians.It might seem like just another phone call, in just another office, but when Richard Hughes-Findley's daughter was having an allergic reaction, a specially-designated space at his job allowed for her to be helped quickly."My wife called me and talking about my daughter having a allergic reaction," Hughes-Findley said. "So normally how that worked is I would rush home and try to get there and then usually we go to urgent care of the E.R. and try to figure out what was going on."Instead he got on a computer his employers set up, and in minutes, was connected to a doctor."They confirmed that we need to give her the Benadryl and then monitor it because she only had one zone that was reacting," Hughes-Findley said. "And that if it exploded or got worse then we could give her the IP pen and then take her to the ER."Hughes-Findley's daughter wasn't seen by a doctor in person, but her issue was solved. All without him having to leave his job."Once it subsided I went back to work," Hughes-Findley said.With just a few steps, Hughes-Findley can go from work to the Kaiser Permanente Integrated Care Room that's been set up at his job. There, he can connect with a doctor by chat, phone, or even video.The doctor can help employees take their temperature and even their blood pressure. They have access to all of the patient's medical records, so they can give a complete assessment and even make follow up appointment.Dr. Pierre Onda with Kaiser Permanente helped develop the pilot program to test a new concept in health care and said he believes this is the future of health care. His team has found virtual care can often be more efficient than in person treatment."There is maybe 50 to 60 percent of the problems that people are coming in can be addressed through that venue," Dr. Onda said. "So certainly not all of the problems but a significant portion of those problems can be managed."Other factors? Cost and convenience. Americans pay more for in person visits, and Onda says making it easier to connect with you doctor, makes it easier for your doctor to provide excellent care."To me this is just a way where I can extend the care and that I already do more conveniently for my patients," Dr. Onda said. 2477

There was a rare sight at San Diego City Hall on Tuesday.A local developer pitched a massive mixed-use complex with hundreds of homes to the council, in front of mostly empty seats. "Our focus has always been on creating a sense of place for the entire neighborhood," said builder Gary Levitt, of Sea Breeze Properties.Sea Breeze Properties plans to transform a 72-acre site just south of the 56 into hundreds of homes, plus offices, retail, and even a hotel and movie theater. The project, Merge 56, didn't get a single 'no' vote from multiple community planning groups.Some nearby residents even came to the meeting to support the project. But even with that backing, it still took five years just to get the council's unanimous vote of approval Tuesday.Levitt said the delays come from regulations, including environmental impact reports, and cost his company an extra million - about 15 percent of that in city processing fees.Councilman Scott Sherman said that is one reason we're in housing crisis. "At the end of the day all the prices get passed along to the consumer and the price of housing," Sherman said. Levitt said ideally it would take two years for a project to get approved. "It's a very expensive process and at the end of the day you're just playing with paper," he said. The project includes 242 new homes, condos, and apartments. Additionally, 47 of them will be affordable units. Two environmentalists did raise concerns about local impacts but the council didn't acknowledge them in their deliberation. Levitt's work, however, isn't done. He still has a number of permits to obtain. They're administrative, but he estimates it'll be about four months before he breaks ground.   1771

There's a renewed push to reform qualified immunity, a legal doctrine that protects police officers, along with some others, from civil lawsuits.In Congress, Sen. Justin Amash of Michigan proposed a bill to eliminate qualified immunity entirely. It has bipartisan support.Understanding why qualified immunity was established could help inform a vision for the future.Imagine a scenario where you're walking down the street and someone clearly violates your rights. The rule of law says they should be held accountable and you'd expect that they would. But can the same be said about police officers who violate a person’s rights?Qualified immunity protects public employees, like police officers, from being held personally liable for knowingly violating someone else’s rights, as long as the officer didn’t break any “clearly-established” laws in the process.Critics argue qualified immunity tilts the scales of justice and makes it hard to hold officers accountable for crimes they admit to committing.The legal path that led to qualified immunity started with the passage of the Civil Rights Act of 1871. Congress declared that every American has the right to sue any public employees who violate their rights.Then, in the late 1960s, a Supreme Court ruling would start morphing the concept into what we know today.It was 1967 when the court granted exceptions to police officers accused of violating rights if they acted in good faith and believed their actions were within the law. Another ruling, in 1982, shifted the burden entirely to the citizen, requiring they prove the officer’s actions broke a “clearly-established” right.That means presenting a case where the Supreme Court found an official guilty of the same “particular conduct” under the same “specific context” as is being alleged. Without it, the officer is protected from liability.The Supreme Court granted one exception for a particularly cruel case in 2002.In June 2020, the Court declined to take up a petition asking it to re-examine qualified immunity. The order was unsigned, and Justice Clarence Thomas was the only one to write a dissent.He wrote the “qualified immunity doctrine appears to stray from the statutory text.”Justice Thomas and Justice Sonia Sotomayor have urged the court to take up the doctrine multiple times in the past. In 2018, Justice Ruth Bader-Ginsburg joined in a dissent authored by Justice Sotomayor. It said that the way the Court previously ruled on qualified immunity had established “an absolute shield for law enforcement officers.” 2550

Three different storm systems are threatening different parts of the United States and the Caribbean this weekend.Hanna becomes hurricane as it bears down on TexasHurricane Hanna made landfall on Texas’ Padre Island Saturday afternoon. The National Hurricane Center says the storm made landfall about 15 miles north of Port Mansfield with maximum winds of 90 mph.Hurricane #Hanna made landfall on Padre Island, Texas at 5 PM CDT with maximum sustained winds of 90 mph. Visit https://t.co/tW4KeFW0gB for details. pic.twitter.com/yIT12pXwjp— National Hurricane Center (@NHC_Atlantic) July 25, 2020 Hanna was upgraded to a hurricane Saturday morning as it moved toward the Texas coast, becoming the first hurricane of the Atlantic's 2020 season.Meteorologists say the biggest concern from Hanna is expected to be flash flooding. Up to a foot of rain and storm surge up to 5 feet is forecast for some areas.Local officials on Saturday asked residents to stay home and ride out the storm, but to also be mindful of the coronavirus pandemic.Officials said Friday that they were confident they'd be able to cope with the one-two punch of the storm and the state's surge in COVID-19 cases.Hurricane Douglas bears down on HawaiiHurricane Douglas in the Pacific Ocean is presenting new challenges to officials in Hawaii who are long accustomed to tropical storms.Meteorologists say Douglas should weaken by the time it hits Hawaii with strong winds, heavy rainfall and dangerous surf beginning Saturday night.Honolulu authorities are preparing extra shelter space so people can maintain physical distance from others during the COVID-19 pandemic.Evacuees at Honolulu shelters will have their temperatures taken. Those with high temperatures or with a travel or exposure history will either be isolated at that shelter or taken to a different site. Officials are also reminding residents to make sure they have masks and hand sanitizers in their emergency supply kits.President Donald Trump issued an emergency declaration for Hawaii on Saturday because of Douglas, directing federal assistance to supplement state and local response efforts.The National Weather Service on Saturday issued a hurricane warning for the island of Oahu, where the state’s largest city, Honolulu, is located.Hurricane #Douglas Advisory 22: Hurricane Douglas Continues to Move West-Northwest Toward Hawaii. Hurricane Warning Issued For Oahu. https://t.co/mbw53QNBXE— NHC Eastern Pacific (@NHC_Pacific) July 25, 2020 Maximum sustained winds decreased to about 90 mph by midday Saturday, making Douglas a Category 1 hurricane. The storm is expected to be near the main Hawaiian islands late Saturday and move over the state Sunday and Monday.Tropical Storm Gonzalo to move through CaribbeanTropical Storm Gonzalo is still on track to move across the southern Windward Islands later Saturday.Tropical Storm #Gonzalo Advisory 15A: Heavy Rain From Gonzalo Nearing Trinidad and Tobago. https://t.co/VqHn0u1vgc— National Hurricane Center (@NHC_Atlantic) July 25, 2020 Gonzalo is forecast to bring 1 to 3 inches of rain, with isolated totals of 5 inches.A tropical storm warning was in effect for Tobago and Grenada and its dependencies.The storm was expected to dissipate by Sunday night or Monday, forecasters said. 3284

Their youthful brains were developing normally, with no signs of developmental, psychological or neurological problems. None had ever had a concussion. But by the end of a single football season, 24 children between the ages of 9 and 18 who had more frequent impacts to the head showed signs of damage to brain development, new research says."Repetitive head impact exposure may have a cumulative effect in the rapidly developing brains of youth and high school football players," said study co-author Gowtham Krishnan Murugesan, a radiology research assistant at UT Southwestern Medical Center in Dallas, adding that the results mirror other recent findings.The study outfitted 60 youth and high school football players who had no history of head trauma or developmental issues with a head impact telemetry system that measures the magnitude, location and direction of impacts to the head. The researchers were not looking at whether the impact resulted in a concussion, only that impact occurred.The children were sorted into two categories: high cumulative head impact players (24) and low cumulative head impact players (36).Before beginning to play, each child had a resting state functional scan, known as an fMRI; the scans were repeated at the end of football season. The researchers were trying to see how exposure to repetitive hits affects the normal "pruning" process in the brain that occurs during adolescence."Pruning is an essential part of brain development," Murugesan said, comparing the process to how a tree needs to have dead or unneeded branches cut to keep it healthy and allow it to grow."Disruption in normal pruning has been shown to be related to weaker connections between different parts of the brain," he said.After comparing the functional MRI results to the player's level of impact, the researchers found that youth in the high-impact group had damage to their brains' pruning process after one season."Our study has found a significant decrease in gray matter pruning in the frontal default mode network, which is involved in higher cognitive functions, such as the planning and controlling of social behaviors, " Murugesan said.Although the "teenage years are a critical time for brain development, brain remodeling or synaptic pruning, this was a short-term study and did not follow the players longitudinally over several years. We don't really know the full application," said Dr. Julian Bailes, director of neurosurgery and co-director of the NorthShore University HealthSystem Neurological Institute, who was not involved in the research.Weill Cornell neurologist Dr. Richard Isaacson, who was also not involved in the study, called the research "early" and said the results don't necessarily "translate to a clinical or cognitive outcome." More research is needed to see whether the decline in brain pruning permanently affected the child's cognitive function or whether the brain's natural plasticity allowed it to repair itself."I would call this a pilot study," Isaacson said. "The call to action would be that we need more robust longitudinal studies with a pre- and a post-assessment of more than brain imaging. The study should also measure cognitive and neurological function and look for changes."As we learn more about the issue, Isaacson said, parents should do everything they can to limit contact in sports, "especially in practice before games, where studies show the majority of contact occurs." 3464