Issue No. 117

July 5, 2016

 


 
Freedom. 
A word that means so much to so many. It's what all Americans celebrate this month. 
 
Chances are we all probably know someone who has served in the armed forces. This month, it's not about what these brave men and women did or didn't do while serving their "volunteered" tour, rather, it is about the weight of willingness a veteran has laid on the line to secure our freedoms that is worthy of our thanks. 
 
We trust that you had a wonderful and safe Independence Day holiday. We hope that as the days have passed, you have paused to remember those and their stories that have afforded us our freedoms. We hope that celebrating freedom and honoring the heroes in the Armed Forces who wake every morning to defend our freedoms continues today, tomorrow and the day after...

When presented with the opportunity, say thank you. 
 
Celebrating Independence. Celebrating Freedom.
 
   
Healthcare in the News

   
HHS Announces Major Initiative to Help Small Practices Prepare for Quality Payment Program


Courtesy - HHS.gov


Over the last few weeks, the Department of Health and Human Services (HHS) has made several important announcements related to the Quality Payment Program, which has been proposed to implement the new, bipartisan law changing how Medicare pays clinicians, known as the Medicare Access and CHIP Reauthorization Act of 2015, or MACRA. We are announcing $20 million to fund on-the-ground training and education for Medicare clinicians in individual or small group practices of 15 clinicians or fewer. 

These funds will help provide hands-on training tailored to small practices, especially those that practice in historically under-resourced areas including rural areas, health professional shortage areas, and medically underserved areas. 

"Doctors and health care providers in small and rural practices are critical to our goal of building a health care system that works for everyone," said Secretary Burwell. "Supporting local health care providers with the resources and information necessary for them to provide quality care is a top priority for this administration."

As required by MACRA, HHS will continue to award $20 million each year over the next five years, providing $100 million in total to help small practices successfully participate in the Quality Payment Program. In order to receive funding, organizations must demonstrate their ability to strategically provide customized training to clinicians. And, most importantly, these organizations will provide education and consultation about the Quality Payment Program at no cost to the clinician or their practice.

"The bipartisan MACRA legislation gave us the tools to improve Medicare and make it modern and sustainable by improving the incentives for and lowering the burden on clinicians," said Dr. Patrick Conway, acting principal deputy administrator and chief medical officer for the Centers for Medicare & Medicaid Services. "Real change must start from the ground up, and the announcement recognizes this reality by  getting doctors the resources they need to provide better, smarter care."

Organizations receiving the funding would support small practices by helping them think through what they need to be successful under the Quality Payment Program, such as what quality measures and/or electronic health record (EHR) may be appropriate for their practices' needs. Organizations would also train clinicians about the new clinical practice improvement activities and how these new activities could fit into their practices' workflow, or help practices evaluate their options for joining an Alternative Payment Model. 

"Providing these tools to help physicians and other clinicians in small practices navigate new programs is key to making sure they are able to focus on what is most important: the needs of their patients," said B. Vindell Washington MD, MHCM, FACEP, principal deputy national coordinator. "As with the Office of the National Coordinator for Health IT's funding for Regional Extension Centers, this assistance will help health care providers leverage health information technology to enhance their practices and the care they deliver."

 
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Agriculture News
  
Texas Tech Mosquito Expert Breaks Down Risk 
of Zika Virus

Courtesy  - Alyssa Goard, KAMC-TV
Concerns are mounting internationally over the Zika virus, which spread recently through travelers and mosquitoes in Central America. 

"It's a scary virus, it ranks right up there with Dengue fever and Chikungunya virus," explained, Steve Presley, Ph.D., who runs Texas Tech's mosquito research program through the Institute of Environmental and Human Health.

Presley has been researching mosquitoes for three decades and currently helps monitor Lubbock's mosquito populations for the city.  While mosquito season hasn't started yet in Lubbock, Presley has been following the virus' spread with concern.

"The number of children born with birth defects and microcephaly is increasing, especially in Brazil especially where Zika virus is running rampant," Presley said. 
He believes the Zika virus is yet another emerging disease as a result of what he calls less "broad spectrum mosquito control."

"There's a whole number of factors, that influence that: reduced use of pesticides, or reduced vigilance, and more open borders, and more people coming into the country from places where these diseases occur," Presley said.

According to the Centers for Disease Control no U.S. mosquitoes are known to have transmitted cases of  the Zika virus to humans. However, the CDC notes that there have been cases of people contracting the virus while traveling and bringing that virus into the U.S. 

Dallas County Health and Human Services recently confirmed it's first case of the Zika virus acquired through sexual transmission. DCHHS said that the patient with the Zika virus was infected after sexual contact with an individual who returned from a country where Zika is present.

The virus can also be contracted by mosquito bites and the World Health Organization said that limiting human exposure to mosquito bites will be an important part of curbing the virus. 

People with the virus can see symptoms such as rashes, fever and, joint pain; not unlike the symptoms of other mosquito transmitted diseases. While the illness usually has mild symptoms which typically last up to a week, there is greater concern over how Zika may impact children born to mothers who contract the virus. 

Margaret Chan, Director-General of the Worth Health Organization, declared that the recent cluster of microcepahly and neurological disorders reported in Brazil, and in 2014 in French Polynesia constitute a Public Health Emergency of International Concern. The WHO is calling for enhanced surveillance for microcephaly and the Zika virus itself. It is "strongly suspected" that Zika virus is tied to these neurological disorders, the WHO said. 

Back in Lubbock, Steve Presley is now making plans to have his lab trap and test Lubbock mosquitoes for the Zika virus once mosquito season begins.  He added that his lab may even consider scanning human samples for the virus. 

Presley said that if the South Plains was uninhabited, it wouldn't be an ideal location for mosquitoes, but because humans have settled there and brought with them tall trees,  lawns, and playa lakes,  vector-carrying mosquitoes have grown accustomed to the microclimate around Lubbock. 

He doesn't expect that the Zika virus will become established around Lubbock because of the climate in the region, but acknowledges that it is possible for Zika to come to Lubbock through travelers. 

Presley explained that the types of mosquitoes which carry the Zika virus-- aedes albopictus andaedes aegypti-- are found in Lubbock,  but require different trapping and control measures than the type of mosquitoes Lubbock currently treats for.

"Because [the Zika virus] goes from mosquitoes to humans and back to mosquitoes, people who actually have the virus, are the reservoirs for the virus.  If they come into town with the virus, you need to protect them and keep mosquitoes from feeding on them, picking up the virus, and moving the virus into the community," Presley said. "That's one of the reasons Zika virus is more of concern  because it becomes established in an area much more quickly than West Nile virus where you have to have an intermediate host--a bird."

Presley has always advocated for repelling and avoiding mosquitoes, but with Zika virus in focus he hopes the public takes mosquito bite prevention especially seriously. 

"I anticipate there will need to be an increased vigilance on the individual person's account to make sure they don't have species breeding in their backyard," Presley said. 

Presley said Zika-spreading mosquitoes are "day-biters" who breed in small amounts of standing water. He explained that  the public will have to be vigilant about their mosquito protection all day and dump out standing water near their homes.  

Presley's biggest concern with Zika when it comes to West Texas is that individuals and public agencies are used to preventing mosquitoes at dawn and dusk, not throughout the entire day. 

Presley has been discussing Zika virus and how to prevent it in with Lubbock's Vector Control and Health Department. 

Jaime Coy with the City of Lubbock's Vector Control said the city plans on meeting with Dr. Presley to format a more comprehensive plan for how to address Zika virus. 
But overall, Coy said, because there are no mosquitoes yet this year, it is too early to tell if mosquitoes in Lubbock this season will be impacted by Zika virus.
Lubbock's Health Department is on alert for the virus as well. Katherine Wells, the City of Lubbock's director of Public Health said she receives state and federal information about the Zika virus several times a week now. 

"The department of State Health Services is working on additional guidelines and fact sheets for the public [regarding Zika virus]," Wells explained.
She reiterates that there are no known cases of the Zika virus in Lubbock. 

Wells encourages people who have recently traveled to countries where the Zika virus is present to take precautions. 

Presley also recommended that women who are pregnant avoid traveling to countries where the Zika virus is found in mosquitoes. 

"[The Zika virus] is serious and it's something to take seriously, it's not something to panic about, it just needs to be thought out or addressed to control it," Presley said. 


 
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 Healthful Hint
  
 July is UV Safety Month
Do You Know Your UV IQ?
 
The skin is the body's largest organ. It protects against heat, sunlight, injury, and infection. 
Yet, some of us don't consider the 
necessity of protecting our skin.

It's just smart to take good care of your skin.

The need to protect your skin from the sun has become very clear over the years, supported by several studies linking overexposure to the sun with skin cancer.

The harmful ultraviolet rays from both the sun and indoor tanning "sunlamps" can cause many other complications besides skin cancer - such as eye problems, a weakened immune system, age spots, wrinkles, and leathery skin.

 
How to protect your skin
There are simple, everyday steps you can take to safeguard your skin from the harmful effects of UV radiation from the sun.
  • Wear proper clothing Wearing clothing that will protect your skin from the harmful ultraviolet (UV) rays is very important. Protective clothing are long-sleeved shirts and pants are good examples. Also, remember to protect your head and eyes with a hat and UV-resistant sunglasses. You can fall victim to sun damage on a cloudy day as well as in the winter, so dress accordingly all year round.
  • Avoid the burn Sunburns significantly increase one's lifetime risk of developing skin cancer. It is especially important that children be kept from sunburns as well.
  • Go for the shade Stay out of the sun, if possible, between the peak burning hours, which, according to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), are between 10 a.m. and 4 p.m. You can head for the shade, or make your own shade with protective clothing - including a broad-brimmed hat, for example.
  • Use extra caution when near reflective surfaces, like water, snow, and sand Water, snow, sand, even the windows of a building can reflect the damaging rays of the sun. That can increase your chance of sunburn, even if you're in what you consider a shady spot.
  • Use extra caution when at higher altitudes You can experience more UV exposure at higher altitudes, because there is less atmosphere to absorb UV radiation.
  • Apply broad-spectrum sunscreen Generously apply broad-spectrum sunscreen to cover all exposed skin. The "broad spectrum" variety protects against overexposure to ultraviolet A (UVA) and ultraviolet B (UVB) rays. The FDA recommends using sunscreens that are not only broad spectrum, but that also have a sun protection factor (SPF) value of at least 15 for protection against sun-induced skin problems.
  • Re-apply broad-spectrum sunscreen throughout the day Even if a sunscreen is labeled as "water-resistant," it must be reapplied throughout the day, especially after sweating or swimming. To be safe, apply sunscreen at a rate of one ounce every two hours. Depending on how much of the body needs coverage, a full-day (six-hour) outing could require one whole tube of sunscreen.
When to protect your skin
UV rays are their strongest from 10 am to 4 pm Seek shade during those times to ensure the least amount of harmful UV radiation exposure. When applying sunscreen be sure to reapply to all exposed skin at least 20 minutes before going outside. Reapply sunscreen every two hours, even on cloudy days, and after swimming or sweating.
 
Protecting your eyes
UV rays can also penetrate the structures of your eyes and cause cell damage. According to the CDC, some of the more common sun-related vision problems include cataracts, macular degeneration, and pterygium (non-cancerous growth of the conjunctiva that can obstruct vision).
  • Wear a wide-brimmed hat To protect your vision, wear a wide-brimmed hat that keeps your face and eyes shaded from the sun at most angles.
  • Wear wrap-around style sunglasses with 99 or higher UV block. Effective sunglasses should block glare, block 99 to 100% of UV rays, and have a wraparound shape to protect eyes from most angles.
Using the UV index
When planning your outdoor activities, you can decide how much sun protection you need by checking the Environmental Protection Agency's (EPA) UV index. This index measures the daily intensity of UV rays from the sun on a scale of 1 to 11. A low UV index requires minimal protection, whereas a high UV index requires maximum protection.


 

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Texas Cotton Ginners' Association
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United Cotton Growers
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Next Issue:  July 19 , 2016 
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