How Title X change could affect family planning in US

Thomas Northcut/iStock/Thinkstock(WASHINGTON) -- President Donald Trump signed a bill into law today that could have far reaching effects on family planning services for many people in the U.S.

The rollback of the rule impacts how states dole out Title X funds, which provide low-income people and others access to family planning and related preventive health services.

States are supposed to award funding to providers based on their ability to provide services. However, some had changed the way Title X funds were given out and reduced the amount of funds available for centers that provided abortions.

The rule signed by President Obama last December made it difficult for states to continue to receive federal funds if they did not allocate Title X grants based on the quality and quantity of service providers, as originally intended.

Here's some background on Title X and what overturning this rule could mean.

What is Title X?

Title X of the Public Health Service Act was passed in 1970 by President Richard Nixon and provides funds to ensure access for family planning and related preventive health services for low-income or uninsured individuals, among others.

"Title X is the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services," according to the Health and Human Services website.

No Title X funds -- nor any federal funds -- can be used for abortion services specifically.

In 2015 more than 4 million individuals received services through nearly 4,000 health centers that are partially funded by Title X grants, according to the U.S. Department of Health and Human Services.

The Guttmacher Institute, which focuses on reproductive health policy, estimates that the unintended pregnancy rate would be 33 percent higher and the teen pregnancy rate would be 30 percent higher without contraceptive care provided by Title X centers. Moreover, the institute predicted the services provided by Title X centers have prevented "87,000 preterm or low-birth-weight births, 63,000 STIs and 2,000 cases of cervical cancer."

According to Planned Parenthood, Title X health centers provided 800,000 pap smears, 1 million breast exams and 6 million tests for sexually transmitted infections in 2015.

What was the rule passed by the Obama administration?

The Obama administration's rule was designed to reinforce the existing law and guarantee that states would not deny Title X funds to clinics for reasons other than subpar services, poor performance or noncompliance.

According to the 2016 rule, a number of states have taken actions to restrict Title X funding access to some providers "for reasons other than the provider's ability to provide Title X services."

How will changing this rule affect people?

Overturning the rule means that states will more likely be able to change funding or withhold Title X funds from clinics if they provide abortion. While it's not quite clear what the immediate effects will be, in the past, the number of people serviced by Title X providers diminished as states withheld coverage.

Kinsey Hasstedt, senior policy manager at the Guttmacher Institute, said states may think they have free reign to restrict funding now that the rule has been rolled back.

"States may be emboldened," Hasstedt said. They may think they are "entitled to deny Title X funding to Planned Parenthood and other safety net planning providers."

Hasstedt said Planned Parenthood and other providers have brought lawsuits against states for improperly withholding Title X funding.

"In reality it's not carte blanche for states to do this," she said. "Those funds should be going to whatever providers are best able to fit the need for contraceptive care."

According to the 2016 rule, services provided to patients in Texas had been drastically reduced after funding was cut.

"The combination of these actions decreased the Title X provider network from 48 to 36 providers, and the number of Title X clients served was reduced dramatically," according to the legislation. "Title X clients served decreased from 259,606 in 2011 to 166,538 in 2015."

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Mumps outbreak in Texas reaches 23-year high

jarun011/iStock/Thinkstock(HOUSTON) -- Texas health authorities are trying to combat a record-breaking outbreak of mumps that has swept through the state.

The Texas Department of State Health Services reported there have been 221 cases of mumps in the state this year, the highest number since 1994 when 234 cases were reported. College students in particular have been among the hardest hit by the virus, which spreads through close personal contact and can result in swollen glands, fever and headache.

"State, regional and local health departments are currently investigating multiple outbreaks throughout the state, including one involving possible exposures on South Padre Island, a popular spring break destination," the health department said in a statement.

Texas is just the latest state to be hit with a large mumps outbreak. Last year the U.S. had multiple outbreaks of the mumps resulting in 5,748 total reported cases. Comparatively there were just 229 cases in 2015. Washington state has 756 mumps cases since the start of an outbreak last October.

Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center, said unlike other outbreaks of diseases like measles, the recent mumps outbreaks appear to be occurring in populations with high vaccination rates.

"Although people are vaccinated, after about 15 years there is some waning of immunity and if you get a strong exposure that exposure can overcome that diminished protection and you'll get a case of mumps," said Schaffner.

People are usually immunized against mumps as children when they get two doses of the MMR (measles, mumps, rubella) vaccine.

Schaffner said college students are at particularly at risk since they live and go to school in close proximity to others. Additionally if they travel together for spring break, football games or other events the virus can spread from school to school.

"The college environment is such that it provides so many opportunities for close face to face exposure," he explained.

In a statement to ABC News last month, officials from the U.S. Centers for Disease Control and Prevention said the Advisory Committee on Immunization Practices (ACIP) plans to examine why mumps cases are increasing and determine if a third dose of the mumps vaccine during an outbreak could help prevent the virus from spreading.

"CDC is investigating the factors that may be contributing to the increase in cases, including that the vaccine prevents many but not all cases of mumps; the disease spreads more easily in crowded settings; and the possibility that the protective effect of the vaccine decreases over time," the CDC said.

Schaffner said in recent years epidemiologists have wondered if the virus has mutated enough that the current vaccines are not effective enough at providing protection. However he clarified it's far too early to know for sure.

"You can see minor variations and the question is, is that enough to evade the protection provided by this vaccine?" he said.

The CDC said last month that the vaccine continues to work well in children and pointed out that prior to the mumps vaccine there were approximately 186,000 cases of the virus annually in the U.S.

"Since the pre-vaccine era, there has been a more than 99% decrease in mumps cases in the United States," the CDC said.

The mumps virus is spread through close personal contact and through coughing, sneezing, or talking. While most people infected with the virus recover without serious complications, in rare cases the virus can cause swelling of the testes, the ovaries, the membrane surrounding the brain, and the brain itself.

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Your Body: High blood pressure during pregnancy

iStock/ThinkstockBy DR. JENNIFER ASHTON, ABC News Senior Medical Contributor

You’ve probably heard it a million times: Heart disease is a silent killer, and maintaining a healthy blood pressure is essential to a long life.

This is especially important for expectant moms since it can lead to preeclampsia and other complications. So here’s what you need to know:

During pregnancy, checking a patient's blood pressure is part of every prenatal visit. The number doctors look for generally is 140 over 90. When blood pressure goes above that number, there can be compromises to the mom and the baby, such as placental abruption or growth restriction of the fetus.

The best ways to keep your blood pressure at a normal range while pregnant are to avoid excess weight gain, limit salty food intake and stay active. If necessary, medication may be recommended.

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Nurse's elaborate dry-erase artwork brings cheer to his child patients

Cook Children's Medical Center(NEW YORK) -- This nurse’s drawings are bringing cheer to his young patients at Cook Children’s Medical Center in Fort Worth, Texas.

Edgar Palomo, 27, makes dry-erase artwork on the hematology/oncology floor to lighten the mood for the kids.

“I've always wanted to help people, which led me to nursing,” Palomo, who has been working at Cook Children’s for four years, wrote to ABC News. “I never wanted to pursue anything in art, so doing the drawings helps me to combine the two together in a positive and therapeutic manner.”

He said he’s been doing the drawings for the unit and patients for three years.

“As word of mouth goes around, it's gotten more frequent,” he explained of his elaborate creations. “I take requests from patients, families and staff. It can be a popular movie at the time or it might be something related to a holiday.”

Some of his drawings include famous characters from movies like Beauty and the Beast, The Wizard of Oz, Superman, A Charlie Brown Christmas and Winnie the Pooh.
Each drawing takes a few hours to complete, although Palomo said, “My job comes first.”

“I can usually only work on the drawings a little bit at a time when I have some free time,” he said. “And there is not always downtime. Therefore, a drawing can take one to two weeks, depending on how busy the unit is.”

Palomo is happy that his attempt to bring some cheerful color to the floor “can have such a positive impact on the kids.”

“Anything to bring a smile is worth doing,” he said.

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Toddler with 'childhood Alzheimer's' symptoms gets experimental treatment

Sara McGlocklin/ YORK) — When Marian McGlocklin was born, she weighed just over 5 pounds. Her parents thought she looked extra "delicate."

"She was having trouble gaining weight," Marian's mother Sara McGlocklin told ABC News. "We'd say she's so small and she's not very strong."

Initially, doctors tried to reassure her that Marian was normal, according to McGlocklin. But, eventually, as the infant failed to meet certain milestones they suspected something was wrong.

Last fall, doctors found that Marian's spleen was enlarged — a sign of a serious degenerative disease called Riemann-Pick disease, type C.

The disease is caused by an inherited gene mutation, which does not allow the body to properly break down cholesterol and other fats (lipids,) according to the U.S. National Library of Medicine (NLM). The cholesterol and other lipids start to accumulate to the point where they become toxic in the spleen, liver and brain. Eventually, this kills cells and causes symptoms like intellectual decline, learning difficulties, seizures, tremors, clumsiness and unsteady gait.

"What we think of as her being delicate is her low muscle tone," McGlocklin said.

It has been called "Childhood Alzheimer's" because of its degenerative effects on the brain, but McGlocklin said she thinks of the disease as far worse.

"I think the disease is even more shocking," she said. "It's a loss of every single skill you have."

Many children diagnosed with the condition at a young age may not survive to adulthood, according to the NLM.

Hearing the diagnosis was a shock for the McGlocklins.

"It was so devastating," McGlocklin told ABC News. "It was like the same feeling as when I found out my mom had cancer."

While Marian was originally diagnosed at Children's Hospital of Los Angeles, her doctors quickly looked for experimental treatments that could suppress the build up of lipids in the now 19 month old.

Eventually, after speaking with other families who have children with the disease, they found Dr. Elizabeth Berry-Kravis in Chicago, who is treating children for the disease with medication that has recently been FDA approved for rare pediatric diseases called VTS-270.

While the drug is not approved by the FDA for broader treatments, Marian was a candidate to receive the investigational drug as part of the FDA's "compassionate use" program. This allows people with severe or fatal illnesses, with no approved treatment, to use drugs in development in certain circumstances.

McGlocklin, along with her husband and two daughters, traveled to Chicago last week for Marian's first treatment. The drug is injected directly into Marian's spinal cord in the hopes that it will reach her brain to counteract the effects of the disease.

"It's like getting an epidural or a spinal tap," she explained. "They have a needle in her spine and they inject the medicine directly into her spinal fluid ... the theory is that the most possible will cross the blood brain barrier and gets into the brain."

While the family is hopeful, McGlocklin said that it has been difficult to acknowledge her daughter will need this invasive treatment every two weeks for the foreseeable future.

"I asked the doctor how long is it going to take?'" McGlocklin recalled. "The doctor said we don't know for Marian, she is the youngest person to receive the drug."

Dr. Elizabeth Berry-Kravis, who is treating Marian at Rush University Medical Center and the co-principal investigator of the drug study, said VTS-270 was discovered during tests on mice with Niemann–Pick disease, type C. VTS-270 was not the drug they were originally testing in studies; it was originally used as a way to dissolve the testing drug so it could be injected into the mice. However, researchers discovered that both the control mice and the sick mice were improving and VTS-270 was likely the reason. It then became the test drug and has gone on to win FDA approvals as an orphan drug and now a rare pediatric disorder drug — to treat Niemann-Pick disease.

Berry-Kravis added that starting Marian early on the drug could be helpful because treating patients before they develop symptoms can make a big difference.

"The idea of treating before symptoms is attractive from a neurological standpoint because once brain cells die, you can't get them back," she said. While still preliminary, she said early results from ongoing trials were promising.

The McGlocklin's are now back in their home in Monrovia, California, but will return to Chicago soon for more treatment. They hope to raise awareness about the disease by sharing Marian's story as she undergoes treatment. They are also raising funds for their travel and for further research into the disease.

"To receive the news that Marian had [Niemann–Pick disease, type C] and then learn not only is there a promising treatment, but she could get it within a few weeks ... it felt like a door was opening to save her life before she even got one dose of the treatment," McGlocklin said. "It was a massive wave of relief and felt like a huge turning point of hope for Marian's future."

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Conditions at DC VA hospital leave patients 'at unnecessary risk,' report finds

gpointstudio/iStock/Thinkstock(WASHINGTON) -- Sterile supplies kept in dirty facilities, crucial equipment left out of stock, $15 million worth of untracked materials and insufficient leadership in place to enact changes -- this perilous picture of inadequate medical care prompted the Department of Veterans Affairs’ internal watchdog to release a rare preliminary report Wednesday on a medical center serving more than 98,000 veterans in the nation’s capital.

The VA Office of the Inspector General found that conditions at the Washington, D.C., VA Medical Center have repeatedly put patients “at unnecessary risk” and are jeopardizing “a significant amount of assets of the Federal government,” according to the preliminary report.

While the OIG is continuing to survey conditions at the center, it released a preliminary report “given the exigent nature of the issues ... identified and the lack of confidence in VHA [Veterans Health Administration] adequately and timely fixing the root causes of these issues.”

The OIG has not yet identified any patients directly harmed by the conditions, but the inspection so far has identified several issues detailed in the report, including:

•  Supply shortages of important medical devices, including one March 15 case in which the center ran out of bloodlines for dialysis patients. The staff had to borrow bloodlines from a private hospital before administering dialysis.

•  Inadequate inventory management, leading to insufficient patient care. In June 2016, the report states, a surgeon used expired surgical equipment on a patient. In another case, prolonged use of expired sterilization tools meant nearly 400 items could have been incorrectly deemed sterile.

•  Dirty storage facilities for sterile supplies. The office surveyed 18 sterile storage areas that were dirty, and five were improperly doubling as offices or patient care spaces.

•  Organizational issues leaving $15 million worth of supplies unaccounted for. While this doesn’t mean the equipment is “necessarily missing,” the report states, it puts government assets in danger of going missing or unused.

•  Critical leadership vacancies that will make addressing these issues difficult. For example, the center has been without a permanent Associate Medical Center Director for nearly a year and a half.

In order to address these issues, the OIG recommended the center make several immediate changes, including implementing an “effective inventory management system” and ensuring that all necessary medical supplies are available.

This afternoon, the Department of Veterans Affairs responded to the report in a statement, thanking the OIG “for its quick work” reviewing the center and announced that the medical center director has been removed from his position. Dr. Charles Faselis has been named the acting medical center director for the D.C. VA Medical Center for the time being, according to the department.

The Department of Veterans Affairs also noted that it “considers this an urgent patient-safety issue” and that it is “conducting a swift and comprehensive review” into the findings. "If appropriate, additional disciplinary actions will be taken in accordance with the law," the statement concluded.

The OIG notified the VHA of the issues on March 30. The VHA has since established an incident command center and temporarily assigned staff to address the issues. But the report released today called these actions “short term and potentially insufficient.”

The OIG will release a final report with more recommendations when its inspection is complete.

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Dad runs Boston Marathon to honor unborn daughter with Down syndrome

Courtesy of Oliver and Kinnon Foley(BOSTON) --  A father's love for his unborn daughter has inspired a 26.2-mile run through the streets of Boston and has raised tens of thousands of dollars to benefit others with the same diagnosis.

Oliver and Kinnon Foley of Charlestown, Massachusetts, are less than a month away from the birth of their first child, a girl they named Tenley.

When Kinnon Foley was 11 weeks pregnant, they found out that their daughter would be born with Down syndrome.

"About six weeks after the diagnosis, the idea struck me — this would be my best opportunity to run a marathon," Oliver Foley told ABC News. "I learned the Massachusetts Down Syndrome Congress had one bib left. It felt like it was meant to be."

Down syndrome, also called trisomy 21, results when a person has three copies of the 21st chromosome. Typically people have two. The effects of the extra chromosome vary widely among people with Down syndrome, but it can cause developmental and physical challenges. Almost 1 in 800 babies in the U.S. is born with Down syndrome, according to research published in The American Journal of Medical Genetics.

The Foleys first connected with the organization soon after Tenley's diagnosis. They were referred by "every doctor and geneticist" to the MDSC first-call program, which connects parents new to a Down syndrome diagnosis, whether pre- or postnatal, with families that had similar experiences.

"You can ask any questions at all," Kinnon Foley said. "It's completely nonjudgy and an incredible resource."

Oliver Foley's original fundraising goal was $15,000, something he called "aggressive but achievable." With the marathon five days away, he has raised more than $62,000 through MDSC's Crowdrise page, surpassing his goal by more than 300 percent.

There's another person Oliver Foley will honor during his run: his wife's late uncle Chris McCall, who also had Down syndrome. He died in 2012 at the age of 65.

"I was very close to him," Kinnon Foley said. "He was the most wonderful, loving, kind person. He brought incredible joy to his siblings and profoundly affected my mom and dad's lives." She added that the couple's family members and friends are "incredibly excited" about meeting Tenley.

The Foleys said the world has changed dramatically for a person with Down syndrome since her uncle was born. "It was unusual that my grandparents would take him home and raise him. But they became huge advocates for people with D.S., and in many ways, Chris paved the way for Tenley."

Dr. Brian Skotko, a medical geneticist and an assistant professor at Harvard Medical School, runs the Down syndrome clinic at Massachusetts General Hospital. "People with Down syndrome are achieving previously unimagined successes, thanks in part to advances in medical care and innovation," he told ABC News.

"However, I think that most of the remaining barriers come not from medical limitations but from social ones. Until our schools, communities and workplaces become fully inclusive, our work is not complete," he added.

Oliver Foley is far from the only person running the prestigious race to honor someone with Down syndrome. Matthew Gousie will run for his 1-year-old daughter, Cecelia, also benefiting the MDSC. Emily Anderson will run for her infant daughter, Andie, benefiting Massachusetts General Hospital's Down syndrome program. All these runners have far exceeded their fundraising goals.

"By running the Boston Marathon, Oliver Foley and Emily Anderson are demonstrating, step by step, that the best is still yet to come for everyone with Down syndrome and those who love them," said Skotko.

"As parents, we want her to feel like she can achieve anything," Oliver Foley said when asked what his hopes are for his unborn daughter. "We know she'll change people's perceptions about what it means to have Down syndrome."

Kinnon Foley said, "What we want for her is nothing different than what any parent wants for any child. We want her to feel happy and loved by her community."

And the date Tenley is due to make her arrival? May 3, her great-uncle Chris' birthday.

Copyright © 2017, ABC Radio. All rights reserved.


Doctor delivers 'baseball team' with 3 sets of triplets in 6 weeks

iStock/Thinkstock(ST.LOUIS) --  A doctor in St. Louis delivered three sets of triplets within six weeks of each other—something his medical center is referring to as their resident "baseball team." Dr. Michael Paul of Missouri Baptist Medical Center said delivering that many triplets so close together is certainly a rarity.

“Having three over a six week period of time pushes the limits of what we expect,” Paul told ABC News. “We usually have about one set every three months and have four or five sets in a year.”

Though triplets in general typically involve higher-risk pregnancies, all nine of these children were born healthy, Paul said.

“[The deliveries] went completely perfectly well,” he said. “They had extremely good conditions at birth.”

Not only did Paul successfully deliver all nine children, he also helped the children’s mothers connect during their pregnancies. Jessica Kennedy, Kristen McCloy and Jeri Wright bonded over their special pregnancies after meeting each other through Paul.

 “It was so nice to have someone to speak to, to know what they’re going through and to make sure your worries and concerns were not the end of the world,” Kennedy, who gave birth to Reed, Knox and Finn on November 11, told ABC News.

McCloy, who gave birth to Lucas, Emalyn and Colton on November 26, agreed, adding that the nurses at Missouri Baptist Medical Center encouraged the three mothers to find support in each other. McCloy and Wright were neighbors in the hospital while still pregnant, and Kennedy, who had previously met Wright, would come visit the two mothers even following the births of her children.

“You very quickly feel isolated [in the hospital],” McCloy said. “Without that support between the nurses and the other moms, it definitely would’ve made it a much longer and rougher road.”

 Wright, who was the last to give birth on December 16, said the emotional support the mothers offered each other was incredibly important in their journeys.

“We really bonded over similar circumstances,” Wright, mom to Finn, Beckett and Oliver, said. “When you’re in that much of an emotional struggle and physical struggle you bond with people who are going through the same thing. Only they truly get it.”

Paul said the camaraderie between the mothers has been beneficial to their experiences.

“It becomes a club,” he said.

The three mothers said they have remained friends and stayed in touch with Paul. The nine babies were even part of a baseball-themed photo shoot, which has been posted to the hospital's website. The shoot was inspired by the city's obsession with baseball and the fact that nine players take the field at a time.

“We talked periodically over the course of the pregnancies…about how it was a unique experience and we needed to do something to highlight it,” Paul said.

All of the mothers thanked Paul for making their journey smoother both in and out of the delivery room.

“Dr. Paul is the reason we all made it with a happy ending. Even though we are all triplet moms, he treated us all as individuals,” Wright said. “I can’t speak highly enough about him.”

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Nancy Kerrigan talks eating disorder she developed after 1994 attack: 'I didn't realize what I was doing'

ABC/Eric McCandless(NEW YORK) --  Olympian and Dancing With The Stars contestant Nancy Kerrigan revealed she developed an eating disorder following the attack she suffered in 1994. In an interview with People magazine, the figure skater said she felt like everything was "really out of control."

"I would avoid food because it was something I could do. I felt like I could control that and nothing else," she said. "I don't know why, but that seemed like an accomplishment."

Kerrigan came under massive scrutiny after the incident, in which she was clubbed in the knee, an attack organized by a skating rival's ex-husband. Though her injury didn't affect her next bout at the Olympics, it did affect her in other ways.

"I didn't realize what I was doing," she said. "I lost a whole bunch of weight before competing because I was working out for hours."

The National Eating Disorder Association estimates that in the United States, 20 million women and 10 million men suffer from a "clinically significant eating disorder" at some point in their lives.

 Kerrigan, 47, also said she would try to alter her appearance to disguise that her body was changing.

"I just started shrinking," she said. "I'd put on makeup differently to sort of hide that I was wasting away. Strangers would say, 'Oh, that's not enough food on your plate.'"

Though the struggle began to affect her energy levels, she said her manager, Jerry Solomon, would sit with her while she ate and encourage her to "Just eat two more bites." She said that with Solomon's help, "it slowly became easier and easier."

One of the final straws came when Kerrigan noticed her son developing similar eating habits.

"I saw my son doing the same thing," she said. "He was like, 'No, no, no. I'm not hungry. I'm fine. I'm fine.' I was like, 'Oh. Give me a piece of that pizza. I better eat that because he's watching me and watching what I'm doing. I'm doing that again.' I'm so thankful for a logical brain because it could've gone such a different route."

Now, Kerrigan is producing a documentary called "Why Don't You Lose 5 Pounds" which highlights the prevalence of eating disorders in athletes.

“I think a lot of times people see it as something they can control," she said. "But frankly, the eating disorder starts to control you.”

Copyright © 2017, ABC Radio. All rights reserved.


Your Body: Early menstruation and stroke risk

iStock/ThinkstockBy DR. JENNIFER ASHTON, ABC News Senior Medical Contributor

Girls who got their first period before the age of 13 were 1.8 times more likely to suffer a stroke later in life than girls who got their periods at age 15, a Japanese study published in the journal Neuroepidemiology found.

Further studies are definitely needed to prove cause and effect, but here’s my take on age of menstruation:

For white, American girls, the average age of their first period is 12, while for African American girls it's 11. Many factors go into this age but awareness of the association, and the pros and cons that come with the age of first period is important.

Outcomes like how tall you are, your risk for breast cancer and now, possibly, your risk of stroke can all be related to how old you were when you got your first period.

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