I’m Thinking About Suicide

Ever thought about suicide?

Many have.

And not all of them are depressed.

Some are epidemiologists – folks whose business it is to think about the source, causes, and prevention of disease. And then, other health professionals such as physicians, Nurses, psychologists, social workers, and others think about suicide – again, not as means to end their own lives, but for the sake of others. And yet Nurses and physicians also personally think about suicide, and often at rates greater than the average population.

I’ve thought about suicide.

I’ve thought about suicide many times.

In fact, I’m thinking about suicide as I write this entry.

But I’m not thinking about suicide as a means to end my own life.

I’m thinking about suicide because…

Advertisements

Apple Appeals to the “Help! I’ve fallen and I can’t get up!” Crowd

With it’s new Watch Series 4, Apple Computer of Cupertino, CA has signaled its intent to capitalize upon integrating electronics, health informatics, and aging.

With one fell swoop, Apple has exemplified and cemented the “Help! I’ve fallen and I can’t get up!” era.

Long thought of as a popular cultural icon, the phrase “I’ve fallen and I can’t get up!” entered American vernacular in 1989 and quickly became a comedic touchstone which endures to this day.

The LifeCall company advertised their medical alarm product on television, which was shown being worn as a pendant or brooch (primarily marketed toward women), and which could be activated by pushing a single button on the device which in turn, called the firm’s 24-7/365 operators in the event of the wearer’s immobility… presuming, of course, that they were fully alert, and capable of pressing a button.

By October 1990, LifeCall had patented the phrase “I’ve fallen and I can’t get up!” and with various minor modifications, as time progressed, by 2007, the phrase had become their legally official trademark.

Falls, of course, result many causes, not the least of which may be

Why does America need a Single Payer Healthcare option?

America and American industry, its entrepreneurship and ingenuity, needs a Single Payer Healthcare option for the same reason America’s military service members -and- their families have 100% all-expenses paid healthcare.

Why is that?

Because a sick military service member can neither train, nor fight, nor perform their mission (work/do their job), neither can they work/train if they’re worrying about their family – who’ll care for them, how they’ll get well, if they can pay for the care/treatment, etc.

Furthermore, it’s also a matter of National Security to provide 100% of all healthcare services at no cost to them because if they’re wondering how they’ll pay for healthcare, they might think of looking elsewhere for money, and thereby could become tempted to compromise security by divulging secrets, or working for an enemy.

Already, America is NOT the “healthiest” nation in the world, neither do we have the best healthcare nor healthcare system in the world. In fact, the overall performance or level of Americans’ national level of health, according to the latest research published in

Trump: Who Voted For, And Supports Him?

Formerly titled, “With Trump WYSIWYG: Who Voted For, And Supports Him?”

African leopard, Panthera pardus pardus, near Lake Panic, Kruger National Park, South Africa, 31 December 2013
Attribution 2.0 Generic (CC BY 2.0), Derek Keats, https://www.flickr.com/photos/93242958@N00/19448654130M

One either loves, or loathes, Donald Trump.

One does not simply “tolerate” him.

He is a divisive political figure.

He is starkly contrasted to former POTUS George W. Bush, who in a May 6, 1999 interview with David Horowitz of Salon magazine, famously said, “I’m a uniter, not a divider.”

Trump is a divider, not a uniter.

For Trump, e pluribus unum means nothing, even though we are the United States of America.

And for those who voted for him thinking he’d change, that he was merely spouting hollow campaign rhetoric, they might as well have asked a leopard to change it’s spots.

With Trump, WYSIWYG.

Specifically, I mean to refer to him in his executive Presidential capacity.

And yet, strangely enough, he has coalesced support from diverse, divergent sub-groups within, and without the GOP. The importance of that feat cannot, and should not be underestimated, glossed over, or minimized, because understanding it is key to political success, especially for

11 Year Study Finds Opioid Deaths Down In Medical #Marijuana States

In an article entitled “Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010” published August 25, 2014 in the Journal of the American Medical Association, researcher and primary author, Dr. Marcus A. Bachhuber, MD, with the Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, 423 Guardian Dr, 1303-A Blockley Hall, Philadelphia, PA 19104 (marcus.bachhuber@gmail.com), and others concluded that, “The present study provides evidence that medical cannabis laws are associated with

#ALpolitics could STILL $ave money if they were to #ExpandMedicaid

Alabama, among other states, should have expanded Medicaid when they had the opportunity to do so, and with SIGNIFICANT REWARD! In other words, at the very first. Now, if any state decides to expand Medicaid, there’s little, if any, incentive, except that there will be some savings to the state, and benefit to their citizens, by having access to healthcare.

A sick workforce can’t survive.

The Centers for Disease Control and Prevention (CDC) continually tell America that the sickest, the fattest, the most diabetic, the most smokers, and cancer-ridden, are in the Southeast… which largely voted for Trump, and has been predominately GOP-voting for at least the past 25+/- years. And I write of Alabama in particular.

In a November 2012 brief entitled “An Economic Evaluation of Medicaid Expansion In Alabama under the Affordable Care Act” by Professors Drs. David J.Becker, Ph.D.and Michael A. Morrisey, Ph.D of the University of Alabama at Birmingham School of Public Health, Lister Hill Center for Health Policy, they presented the case for the numerous potential benefits of expanding Medicaid in Alabama, which was not merely an improvement in the overall quality of life for Alabamians, but significant economic benefit to the entire state.

Drs. Morrisey and Becker are Professor and Director, and Assistant Professor, respectively, at the University of Alabama at Birmingham School of Public Health, Lister Hill Center for Health Policy, and have researched and written extensively the subject. The University of Alabama at Birmingham is one of three independent, autonomous universities in the UofA System.

Then-Governor Dr. Robert Bentley, MD, a Republican, was forced to resign in shame in the midst of his second term after pleading guilty to charges of corruption and ethics violations, and refused to expand Medicaid in “Sweet Home.”

The Bureau of Labor Statistics has most recently shown that employment in the Healthcare sector is thriving nationwide. The figures below are from the BLS’ most recent report “THE EMPLOYMENT SITUATION — MARCH 2018,” and is expressed in thousands. The columns in order, are: Not Seasonally Adjusted, March 2017, January, February, March 2018, and Seasonally Adjusted for the same times, respectively. (ESTABLISHMENT DATA Table B-1. Employees on nonfarm payrolls by industry sector and selected industry detail)

Drs. Morrisey and Becker identified that had then-Governor Bentley expanded Medicaid, a Federal/State program that pays healthcare costs for the impoverished, the state could have not merely eked it’s way out of recession, but it would have propelled itself in rocket-like fashion, to a position of economic strength and stamina.

They cited a provision in the Patient Protection and Affordable Care Act (ACA) which provided incentive to states to expand Medicaid by offering a one-time bonus of paying for 100% of all costs in 2014, followed by nominal reductions each year thereafter. And if states chose to expand Medicaid, they would have paid LESS (a smaller percentage) even after all incentives expired. Medicaid is a Federal-State sharing program in which the states bear a certain portion, while the Federal Government picks up the remaining share.

They wrote in part, that “Under the ACA, Alabama would receive a significantly higher Federal Matching Assistance Percentage (FMAP) for the expansion population than the 68.5% it currently receives for the non ‐ expansion population. The ACA provides for a uniform FMAP to all states of 100% in 2014 ‐ 2016, 95% in 2017, 94% in 2018, 93% in 2019 and 90% in all years thereafter.”

Presently, because Alabama has chosen to NOT expand Medicaid under the provisions of the ACA, they are STILL paying MORE for Medicaid than if they would have expanded it… even now, in 2018. That’s because the OLD law, under which the state labors, requires Alabama (and other states that did not expand Medicaid) to pay 31.5%. If Alabama would EXPAND Medicaid even now, in 2018, they would pay only 10%.

Governess Kay Ivey, also a Republican, who as Lt. Gov. assumed office following Bentley’s resignation after pleading guilty to corruption and ethics violation charges, has similarly expressed her reticence to expand Medicaid.

In 2016, Alabama spent $5,461,151,125 for Medicaid.

Noting that their “analysis does not consider potential savings from reduced spending on uncompensated care, mental health care and other services currently provided to the expansion population,” assuming the state expanded Medicaid and would pay “6.2% of program costs through 2020,” Drs. Morrisey and Becker projected three scenarios of a high, moderate, and low “take-up,” meaning enrollment into the program, and wrote that, “we estimate that the state of Alabama would be responsible for $771 million (6.2%) of the estimated $12.5 billion in new Medicaid program costs over the 2014 ‐ 2020 period,” and noted specifically, that “If more previously uninsured or privately insured individuals elect to enroll in Medicaid costs to the state and Federal government would rise. If take ‐ up were lower, the costs to the state and Federal government would fall.”

If Alabama had chosen to expand Medicaid in 2016 – the last year the Federal Government paid 100% of ALL COSTS of expansion – the state would have SAVED $5,461,151,125… the TOTAL cost of Medicaid. If Alabama were to expand Medicaid in 2018 (this year), they would pay only 6.2% of the costs, while the Federal Government would pay 93.8%. Using a high “take-up” scenario for 2018, Drs. Morrisey and Becker projected the state would pay $243,000,000… about 77.5% LESS than what it paid in 2016. A low “take-up” scenario for 2018 would be 46.48% lowered costs to the state.

The state has a peculiar and non-standard practice of having TWO budgets, the Education Trust Fund and General Fund budgets. Medicaid is paid from the General Fund budget, which is the smaller of the two, and receives “Taxes from over 40 sources are deposited into the GF, with the largest sources being the insurance company premium tax, interest on the Alabama Trust Fund and state deposits, oil and gas lease and production tax, cigarette tax, ad valorem tax, and Alabama Alcoholic Beverage Control Board profits,” and pays for and “supports state programs such as child development and protection, criminal justice, conservation efforts, economic development, public health and safety, mental health, Medicaid, legislative activities, and the court system.”

The much larger Education Trust Fund, receives revenue from “Ten tax sources are allocated to the ETF, the largest of which are the individual and corporate income tax, sales tax, utility tax, and use tax.” Revenues from the Education Trust Fund “support, maintenance and development of public education in Alabama, debt service and capital improvements relating to educational facilities, and other functions related to educating the state’s citizens. Programs and agencies supported by the ETF include K-12 education, public library services, performing and fine arts, various scholarship programs, the state’s education regulatory departments, and two- and four-year colleges and universities. Funding from the ETF is also provided to non-state agencies that provide educational services to the people of Alabama, including the arts, disease counseling and education, and youth development.”

Medicaid requires states to cover:
• Pregnant women up to at least 138% of the Federal Poverty Level (FPL) ($16,643 for an individual, $33,948 for a family of four in 2017)

• Preschool-age children up to at least 138% of the FPL ($16,643 for an individual, $33,948 for a family of four in 2017)

• School-age children up to at least 100% of the FPL ($12,060 for an individual, $24,600 for a family of four in 2017)

• Elderly and disabled individuals up to at least 75% of the FPL ($9,045 for an individual, $18,450 for a family of four in 2017)

• Working parents up to at least 28% of the FPL ($3,376 for an individual, $6,888 for a family of four in 2017)

Moreover, however, Alabama could have improved its economy by expanding Medicaid. In that same report, Drs. Morrisey and Becker considered three possible scenarios also based upon a high, moderate, and low “take-up” rate which showed that Alabama could have benefited between $2.331 billion and $33.529 billion in additional value added to the state’s economy from 2014-2020 (Low-to-High, inclusively and respectively).

They concluded that, using the intermediate, or moderate “take-up” scenario, “we project that a coverage expansion would reduce the state’s uninsured population by approximately 232,000 individuals while generating $20 billion in new economic activity and a $935 million increase in net state tax revenues.”

Again, that does NOT include the savings from eliminating uncompensated care.

Bottom line?

It would STILL be exceedingly wise for Alabama to expand Medicaid.

Why I Advocate 100% Marijuana Legalization

Let there be NO MISTAKE: Based upon a preponderance of scientific evidence, logic, reason, and numerous substantiating rationales, I openly advocate for, and am a proponent of the 100% full and total legalization of marijuana (aka cannabis) for adult recreational, and medical use.

And as a triple-degree, BSN-prepared Registered Nurse, Nationally Certified EMT, State Certified Volunteer Firefighter, and First Responder, I am a long-time Licensed Healthcare Professional, and presently possess, and have possessed unblemished active licenses to practice in numerous states, and internationally.

While I have “worn other hats” in Nursing, the bulk of my professional healthcare career has been in Critical Care. Working in Critical Care is the type of stressful job in which one keeps the Grim Reaper at bay by the hour. And I have been fortunate to have worked at some of the nation’s, and world’s premiere, and leading healthcare research institutions. It is research that drives much of such care, to ensure the best possible outcomes for the individuals for whom we care. Thus, keeping abreast of current research findings on many topics within, and without Critical Care, healthcare, and public policy related to healthcare in general, is a special interest and forté of mine.

As well, I am also a United States

National Academies #Marijuana Findings @theNASEM

Many have heard or read about United States Attorney General Jeff Sessions’ ignorant remark about marijuana, and many of us have heard or read numerous claims about cannabis, ranging from “it cures cancer” to “it makes you hungry,” and almost everything between. But if you want to make an effective argument for or against anything, you need facts. And the following information from the National Academies of Sciences, Engineering, and Medicine is THE MOST authoritative, up-to-date volume on the subject of cannabis. You would be wise to cite this research when you lobby your local, state or national legislator to legalize (or not) marijuana. (I am a legalization proponent & advocate for the 100% legalization, regulation, and taxation of adult recreational & prescriptive medical use of marijuana.)

Now, with the 2017 release of “The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research” by the Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda, Board on Population Health and Public Health Practice Health and Medicine Division, A Report of the National Academies of Science, we have one of THE MOST to-date conclusive pieces of EVIDENCE for/against cannabis consumption, either medically, and/or recreationally. It is AUTHORITATIVE, and unbiased. Bear in mind, this is findings of SCIENTIFIC MEDICAL RESEARCH.

An independent examination of the report was carried out in accordance with institutional procedures and all review comments were carefully considered. A committee of experts was convened to conduct a comprehensive review of the literature regarding the health effects of using cannabis and/or its constituents that had appeared since the publication of the 1999 IOM (Institute of Medicine) report.

From their review, the committee arrived at nearly 100 different research conclusions related to cannabis or cannabinoid use and health.

Committee members formulated four recommendations to address research gaps, improve research quality, improve surveillance capacity, and address research barriers.

Categories, including subtopics, are as follows:

Therapeutic effects
• Chronic pain; cancer, chemotherapy-induced nausea/vomiting; anorexia and weight loss; irritable bowel syndrome; epilepsy; spasticity related to multiple sclerosis or spinal cord injury; Tourette syndrome; amyotrophic lateral sclerosis; Huntington’s disease; Parkinson’s disease; dystonia; dementia; glaucoma; traumatic brain injury; addiction; anxiety; depression; sleep disorders; post-traumatic stress disorder; schizophrenia and other psychoses

Cancer
• Lung cancer; head and neck cancer; testicular cancer; esophageal cancer; other cancer

Cardiometabolic risk
• Acute myocardial infarction; stroke; metabolic dysregulation, metabolic syndrome, prediabetes, and diabetes mellitus

Respiratory disease
• Pulmonary function; chronic obstructive pulmonary disorder; respiratory symptoms (including chronic bronchitis); asthma

Immunity
• Immune function; infectious disease

Injury and death
• All-cause mortality; occupational injury; motor vehicle crash; overdose injury and death

Prenatal, perinatal, and postnatal exposure to cannabis
• Pregnancy complications for the mother; fetal growth and development; neonatal conditions; later outcomes for the infant

Psychosocial
• Cognition (learning, memory, attention, intelligence); academic achievement and educational outcomes; employment and income; social relation- ships and other social roles

Mental health
• Schizophrenia and other psychoses; bipolar disorders, depression; suicide; anxiety; post-traumatic stress disorder

Problem cannabis use
• Cannabis use disorder

Cannabis use and abuse of other substances
• Abuse of other substances

Weight Of Evidence Categories for Conclusions are ranked High-to-Low-and-None as Substantial, Moderate, Limited Evidence, and No or Insufficient Evidence to Support the Association for therapeutic effects, and other health effects.

Here are: 
Conclusions—Therapeutic Effects of Cannabis and Cannabinoids

There is conclusive or substantial evidence that cannabis or cannabinoids are effective:
• For

Members of Congress: Virtual American Royalty… At Taxpayer Expense

Members of Congress as virtual royalty,
have raised their pay 9 times over 9 years,
but raised Minimum Wage only 3 times in 18 years.
While Congress now pays themselves almost
3x the Median Household Income,
since 2000,
Inflation has totaled 37.4%.
And with 72% subsidies, Employer Contributions,
and other
luxurious perks unavailable to the Average Citizen,
including full Retirement Vestment after 5 years,
and 72% subsidy for Healthcare Insurance in Retirement,
their Healthcare is practically free.
And you’re paying for it.
But yours is not.
And you’re paying for it, too!

Members first received $6 a day in 1789, today they get $174,000 annually, in addition to phenomenal perks, health insurance, and retirement… all at taxpayer expense.

Presently, Congress also gets:

Why All Christians Should Support Abortion Rights

I support abortion rights for women. Here’s why.

Freedom, Liberty, and Independence.

And, I’m Catholic.

I have a cousin who

Charles Manson And Mental Health

“The murders were probably the most bizarre in the recorded annals of American crime. I’ve often said that if these murders had never happened and someone had written a novel, with the same set of facts and circumstances, you’d probably put it down after a couple of pages. Because to be good fiction, as I understand it — unless it’s science fiction — it’s got to be somewhat believable, and this is just too far out.”

– Vincent Bugliosi (1934-2015), Los Angeles County District Attorney, Chief Prosecutor in the Charles Manson trial, to NPR in 2009

Some years ago, during Mental Health Clinical Rotations, I was impressed with the insidious nature of severe mental health problems, which often masquerade as mere quirks, eccentricities, or peculiarities of character. In that sense, I think Southerners are more adept at denial of mental health problems than others in regions throughout the United States. We often laugh and joke about “Old Spinster Miss So-And-So,” “the Crazy Cat Lady,” or “Old Man Mozz” who for years has lived by himself.

And yet sometimes, we’re shocked at what we do NOT see, which when given opportunities to see “behind the scenes,” observation provides confirmation and undeniable proof-positive of mental health problems.

I recall in particular some time ago in which a friend and his wife had

How To Resolve Gun Sickness & Disease

Firearm fascination has gotten to the point of ridiculousness, to the extent that it’s much like a paraphilia. It’s no longer merely “disturbing,” its downright dangerous, and blatantly irresponsible. As Healthcare professionals, we research & examine the scope, extent, and exact nature of the problem, then make a diagnosis, and formulate a plan of treatment to either ameliorate the symptoms, or cure the disease. It presumes, of course, that the patient will cooperate with the plan, and follow the course of treatment.

In this present “gun nut” scenario in which we find ourselves suffering, the NRA has bent over backwards to

Here’s Why, Despite Seeming Political Appearances, We Are Closer To Single Payer #Healthcare Than Many Imagine

In a recent exchange online dialogue with friends – some, whom to the casual observer would be diametrically opposed on many policy ideas – I was, once again, pleased to note that, despite the SEEMING APPEARANCE of differences, we share SIGNIFICANT common ground.

In fact, I have found that to be quite true with many, that when we move past the vitriolic venomous sport of castigating political candidates, and speak in respectful tones, patiently explaining the whys and wherefores of potential policy, we share many common bonds, and similar ideas.

For example, in response to a recent post of the story published by Pro Publica – Pressure Mounts on Insurance Companies to Consider Their Role in Opioid Epidemic – (https://www.propublica.org/article/pressure-mounts-on-insurance-companies-to-consider-their-role-in-opioid-epidemic) written by Charles Ornstein Oct. 19, 6:47 p.m. EDT – I enjoyed reading the following remarks, made toward the conclusion of the online dialogue:

Person A (Physician): “It is a shame our country can’t have

Helping Comes First

 When Saint Pius of Pietrelcina (1887-1968) — Padre Pio as he’s widely known — decided he wanted to build a free hospital for the poor up the road from his friary, he started with a piece of land and a few friends and supporters. Four years later, in 1956, he had one of the most modern hospitals in Europe. Since the padre’s death in 1968, the facility, which

Can American Health Insurance Be Repaired?

Naysayers to the “public option,” or “single payer” health insurance plan claim that it’s “socialized medicine.” You know… much like what Military Service Members  – and their families – in the Army, Air Force, Navy and Marines have access to. And to be certain, the health insurance “money grab” came through Richard Nixon‘s signature on a bill written by  Massachusetts’ U.S. Senator Edward Kennedy… the Health Maintenance Organization Act of 1973.

Before that law was passed, it was ILLEGAL to profit from delivery of healthcare services. Now, we have avariciously rapacious Wall-Street masters slave driving the people for more and more and more and more profit. The greedy, never-ending quest for profits has quickly deteriorated the American healthcare delivery system, which was once a marvel of the world. Now, according to the World Health Organization 2000 report of its 191 member nations health systems, the United States ranked 37th in efficiency worldwide, while France, Italy, San Marino, Andorra, and Malta round out the top five most efficient nations for delivery of healthcare services. Japan ranks 10th, while the United Kingdom is 18th, and Canada is 30th. The United States is sandwiched in between Costa Rica, and Slovenia, respectively.

Truth be told – and it’s sad to say – there are probably as many corrupt Democrats as there are corrupt Republicans, neither of whom have the people’s best interests at heart, or in mind. Such ones’ solitary concern is with their own wallet, and how they can profit privately at taxpayer expense. That includes graft through directing contracts and business toward friends’ business interests.

Look at

Advice For Lovers Everywhere

Have you ever, in a passionate moment, had your ear gently kissed by the lips of your lover? The sensation of tenderly soft and warm skin brushed up against the lobe of your ear, or even a light flicker of the tip of the tongue anywhere on the ear is to many, sensuously delightful, and highly erotic.

For some, it’s enough to send shivers down your spine! Your entire body quivers with passionate delight!

Of course, such a moment is nothing like

A Common Calling To Care

St. Louis King of France with a Page, El Greco

 Two men quite unlike each other, both saints, and both revered for similar reasons: Their concrete love for the poor. In the mid-13th century, Saint Louis (1214–1270) embraced the way of Saint Francis of Assisi and cared for the poor even as King Louis IX of France. It is said that Louis had over 100 guests from among the poor to eat with him daily. He also established hospitals and houses of healing for lepers and the sick. Saint Joseph Calasanz (1557–1648) in the mid-16th century saw that the need to educate poor children was so important that he gave up a career in

Government–Mandated Waste Drives Up Prescription Drug Co$t$

 

Just Like Food “Expiration” Dates, Drug “Expiration” Dates Are Also Fake… And It’s Co$ting You BIGTIME

Hospitals and pharmacies are required to toss expired drugs, no matter how expensive or vital. Meanwhile the FDA has long known that many remain safe and potent for years longer.

The box of prescription drugs had been forgotten in a back closet of a retail pharmacy for so long that some of the pills predated the 1969 moon landing. Most were 30 to 40 years past their expiration dates – possibly toxic, probably worthless.
But to Lee Cantrell, who helps run the California Poison Control System, the cache was an opportunity to answer an enduring question about the actual shelf life of drugs: Could these drugs from the bell-bottom era still be potent?

Cantrell called Roy Gerona, a University of California, San Francisco, researcher who specializes in analyzing chemicals. Gerona had grown up in the Philippines, and had seen people recover from sickness by taking expired drugs with no apparent ill effects.

“This was very cool,” Gerona says. “Who gets the chance of analyzing drugs that have been in storage for more than 30 years?”

Pharmacist and Toxicologist Lee Cantrell tested medicines that had been “expired” for decades. Most of them were still potent enough to be on shelves today. (Lee Huffaker for ProPublica)

The age of the drugs might have been bizarre, but the question the researchers wanted to answer wasn’t.

Pharmacies across the country in major medical centers and in neighborhood strip malls routinely toss out tons of scarce and potentially valuable prescription drugs when they hit their expiration dates.

Gerona and Cantrell, a pharmacist and toxicologist, knew that the term “expiration date” was a misnomer. The dates on drug labels are simply

Your Child May Not Truly Be Allergic To Penicillin

Reported penicillin allergies in children usually inconsistent with true allergy

Jul 3, 2017

Clinical Essentials from Pediatrics

Takeaway
• Parent-reported penicillin allergy symptoms in children presenting to the emergency department (ED) are likely inconsistent with true, immunoglobulin E-mediated allergy when evaluated by the 3-tier penicillin allergy questionnaire.

• Data demonstrate that the true incidence of penicillin allergy is 0.004%-0.015%.

Why this matters
• Because of time constraints and invasiveness associated with standard allergy testing, an allergy pediatric questionnaire may optimize first-line penicillin use in children presenting with the ED with parent-reported penicillin allergies.

• Data suggest that the majority of reported pediatric penicillin allergy symptoms (eg, maculopapular rash, hives, vomiting, diarrhea) are actually low risk for true allergy.

Study design
• This study evaluated 597 children between the ages of

Mobile Alabama MD & Medical Practice Settle Medicare, Medicaid & TRICARE Fraud Claims

The Department of Justice, United States Attorney’s Office, Southern District, announced that Mobile, Alabama physician Dr. James Matthew Crumb, MD (AL license number MD.24535, AL Controlled Substances Certificate ACSC.245, National Provider Identifier: 1629079793 ) a Physical Medicine and Rehabilitative physician who currently practices as Mobility Metabolism and Wellness (MMW), and a local neurosurgeon group Coastal Neurological Institute, P.C. (CNI), 3280 Dauphin Street, Suite A, Mobile, AL 36606-4060, (NPI:1740212174), have collectively paid $1.4 million to settle allegations that they violated the False Claims Act (“FCA”) by engaging in fraudulent schemes to maximize payment from the Medicare, Medicaid, and TRICARE health care programs.

In late December 2015, the United States Attorney’s Office filed a civil lawsuit against Defendants CNI, Crumb, and MMW, on behalf of the Department of Health and Human Services and the Department of Defense, alleging that the Defendants knowingly billed federal health care programs for