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Women’s Health: STD App, Hula, Lets Users Learn (And Alert People) About Their Status With A Tap

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Scientific American

By Dina Fine Maron

“I can’t tonight, I have chlamydia.” With those words Miranda, a character on the racy television series Sex and the City, doused her partner’s lust and reminded the TV audience of just how awkward conversations about sexually transmitted diseases can be.

Miranda’s admission aired 13 years ago, but the challenges of negotiating those conversations persist. More recently, the marketplace of ideas has churned out a bevvy of digital tools meant to help consumers anonymously inform past sex partners that they have been exposed to an STD (often via no-fun e-cards that carry the bad news) or to help people easily access their own test results—both for their own reference and to share with bedmates.

All told, about 10 such Web- or phone-based electronic services have come online, and more are in the works. To varying extents they all either help provide people with STD test results or allow them to anonymously inform partners of risk. Don’t Spread It, inSPOT and So They Can Know, for example, send anonymous exposure notifications to partners of infected individuals. And they have garnered the early approval of some health experts. (The San Francisco Department of Public Health was an early partner in developing inSpot almost a decade ago, easing STD diagnosis sharing among sex partners. Also, the Baltimore City Health Department is now working with the makers of So They Can Know to create their own portal to allow people to see their own STD test results online and separately inform at-risk partners of the need to be tested.) And services called Chexout and ChecMate allow health providers to securely upload test results, which are then shared privately with patients who subscribe.

A new free mobile app, the first of its kind, provides broader tools than the others, earning it praise from public health experts for promoting STD testing and awareness. The cutting-edge program, however, is also stoking some concerns about privacy, legality and what message its services send. It is called Hula, like the Hawaiian dance, because, its developers say, it helps “get you lei’d.” (Also, lest you forget, “horizontal hula” is slang for sex.) The app provides names, addresses and other information about local STD testing services, and collects the results in one place. To access your results or show them to others in a fairly light-hearted way, you go to a screen covered by the image of a closed zipper and unzip the image with your finger, gradually revealing the information underneath. Or, you can “friend” others to allow them to securely see the results via their digital devices. The app also lets users review STD testing centers with Yelp-like reviews about their experiences.

The app aims to address what its backers call a “broken system,” acting as the middleman between a user and the clinic by helping patients get their test results (when they otherwise may not) and interpreting them so patients can understand. With a user’s permission, labs upload raw results to Hula. Then a trained Hula employee taps the results into a set template so that it will be understandable. Instead of a syphilis test finding saying you are “nonreactive,” for instance, the app will say that the person is “negative” for syphilis. Because of understaffing at health clinics across the country, a de facto norm has been “no news is good news”—with clients either being explicitly told or assuming that if they do not hear about their results, there is nothing wrong. Yet positive results can fall through the cracks that way. An automatic app like this can ensure that results get to their destination. And Hula’s backers say they hope that the app will promote further testing, because it sends out reminders of the need for regular checkups.

Hula’s medical advisor, Jeffrey Klausner, says he sees the app as an important public health tool. The U.S. Centers for Disease Control estimates that a staggering 20 million new STDs are diagnosed in the U.S. every year, costing the U.S. health care system some $16 billion in medical costs annually. Right now, more than 110 million sexually transmitted infections are circulating among men and women across the nation. “When you are thinking about the millions of people in the U.S. who have infections and don’t know it, an effort that will promote easier screening and change the way people deal with test results is going to help,” he says. Klausner, a physician, was the former director of STD Prevention and Control Services at the San Francisco Department of Public Health and is a current professor of medicine and global health at the University of California, Los Angeles.

The CDC and public health officials also acknowledge the potential benefit of apps that make people more aware of the need to be tested for STDs and to share the outcome with sexual partners. Such actions are needed more than ever these days, the CDC notes, with people now looking to phone apps to seek sex partners. Mary McFarlane, a research behavioral scientist in the CDC’s Division of STD Prevention, predicts, too, that new mobile apps could help to reduce STD cases if they reduce the stigma of infection and of seeking sexual health care. But whether this type of app would provide the most accurate information and adequately protect patient privacy has yet to be determined, the CDC told Scientific American in an email.

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When asked about Hula, public health departments have similarly been somewhat measured in their support. Susan Philip, chair of the board of directors of the National Coalition of STD Directors and director of the Disease Prevention and Control Branch of the Population Health Division at San Francisco’s public health department, called the model “interesting and provocative,” echoing CDC’s approval of efforts to improve contact with people who are at risk of STDs who may be more likely to use such apps. Still, legal concerns about turning over STD results to someone other than the patient prompted her city’s STD testing services to turn away patients’ requests to send test information to them via Hula—even though Hula facilitates filling out a Health Insurance Portability and Accountability Act form that gives clinics permission to share the data for each Hula user. “We are speaking with our city attorney about it and getting some clarifications. A lot of people are in the clarification stage,” Philip says.

Another concern that gives some public health experts pause is that a list of negative test results can give the test-taker and the individuals’ sex partners a false sense of security. Hula’s test data comes with time stamp, but even if the tests were fairly recent, they don’t necessarily mean the person is infection-free at the time they get the data. The individual could have unknowingly become infected after the test, could have taken a more recent test that was not reported to Hula or might have been tested in the period before an existing infection would show up in the results. Take HIV infection, for example: the immune system can take several months after viral exposure to make enough anti-HIV antibodies for the standard clinical HIV test to detect and indicate infection. Each time Hula posts results it warns users about such time-sensitive problems, states that a negative result does not guarantee a person is STD-free and urges people to “play safe.” But health officials still worry that some people may be misled by the initial impression that a tested person who is actually infectious is in the clear. “It’s an innovative concept and it’s targeting the right age, but my concern is it gives the suggestion that you are [STD-] negative,” says Patrick Chaulk, acting deputy commissioner for the Baltimore City Health Department Division of Disease Control.

“The message we want people to take is we definitely want people to get tested but not to take [good results] as a carte blanche to do anything they want,” he says. Baltimore has already recognized that it needs to improve its communication of STD results akin to Hula’s mission, admitting that to contact everyone who has taken a test is not easy. “We try to get ahold of everyone. We have about 33,000 tests a year in two clinics, so our priority is to contact everybody who has a positive test—gonorrhea, chlamydia, syphilis and HIV,” he says. Boosting users’ access to negative and positive results is why Baltimore’s health department is currently partnering with Sexual Health Innovations to build a Web site that will allow clinic users to access their test results by a laptop or a smartphone. So They Can Know is also helping the city to set up a text messaging or e-mail service that will send out the results that way, if users consent to such services. No STD clinic patient has yet asked about Hula, Chaulk says.

For its part, Hula is currently offering its services for free, although it hopes to eventually be able to turn a profit. Right now, its makers are looking for ways to expand the uses of the app to make further inroads into preventing STDs. It is working with the Los Angeles Unified School District to promote teaching teens about STD testing and safe sex, and teachers have the option to let students know that Hula is out there for those who are or will later become sexually active.

Hula is also hoping that it can help to reduce the risk of sex with people met through the proliferating location-based dating apps. Last month it announced that it was partnering with the gay sex app MISTER, which has a geolocator that helps men find other men by location. MISTER is currently publicizing the Hula service on its app and encouraging users to tap it to find local testing centers and obtain test results. MISTER is also encouraging users to link to Hula from within their profiles, making their test results available to online “friends.” Verified test results on gay sex apps would be a big change from current approaches, where it is common for individuals to self-report that they are HIV-free on their profiles. “In the not too distant future you’ll be able to see a badge on someone’s dating profile showing they’ve verified STD status by Hula,” says Hula founder and CEO, Ramin Bastani. “That can help you make better decisions about how you want to connect.”

But Carl Sandler, CEO of MISTER, says they are currently “proceeding carefully” about how to further integrate it into their app. “Verified results should be the start of a longer discussion, not a litmus test,” Sandler says. “I think in the future people will be more likely to ask for verified data, but that’s not something we’d require. There is too much prejudice and stigma against STDs and HIV, and verified data is only part of the safer sex equation.”

“When it comes to STD prevention, Hula is in no way a ‘silver bullet,’ and we never suggest that our users are STD-free,” Bastani says. “Like a condom, Hula is just another tool in your STD prevention toolbox. We feel the tools we provide are much better than the status quo—which is either self-reporting or not reporting at all. In our view, some information is much better than no information.”

Read More:  http://www.huffingtonpost.com/2013/11/21/std-app-hula_n_4317509.html?utm_hp_ref=womens-health

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Women’s News: 7 Things You Totes Need to Stop Saying if You’re Over 30 (Oops, There’s One of Them)

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Jennifer Ball

Mom, writer, teacher, lover of dirty martinis and yoga pants

A lot of us are guilty of it. Especially those of us with teens, or tweens, or kids of any age who watch kid-centric television shows or who spend a lot of time on Instagram.

We start to talk like them. Words, phrases, the flotsam and jetsam of another generation’s vernacular seeps into ours and before you know it, we catch ourselves (or our friends) dropping these little beauties into everyday conversation, Facebook updates, blog posts and tweets.

Someone needs to step in now, and beg of us all: STOP IT. For the love of all things good and pure and age-appropriate, please stop.

Here are the things you need to stop saying if you are over the age of 30. Or if you have a mortgage, or a job that comes with benefits. Or if you have teens. Especially, if you have teens.

1. Totes. When used as an abbreviation for the word “totally,” of course. If someone approaches you on a rainy day and says “Hey, I love that cute, compact umbrella! What kind is it?” and you answer, “Totes!” it’s all good. But when you walk into the living room and announce, “Dinner is totes ready!” not so good. Please stop.

2. I know, right?? Last summer I spent a few weeks teaching preschool with a beautiful, tanned, Amazonian 20-something with a beach-volleyball player’s body. She was sweet, but answered everything with the words, “I know, right?” I’d walk into the classroom and say, “Holy crap is it hot out!” and Tall Tan One would say, “I know, right?” I’d say “Thank God it’s Friday!” and she’d look up from the Dora the Explorer puzzle she was working on and say, “I know, right?”

Yes, I do know. Right. Because I JUST SAID IT.

Now, despite my holier than thou approach to speaking, somehow this virus-like phrase started slipping out of my own mouth. I was horrified by the ease at which it popped out, usually in response to a friend’s innocent, middle-aged statement along the lines of “I’m so sick of peeing my pants.” Only I shortened it, and dropped the questioning inflection…and in my head it sounded more like a clipped, British, Colin Firth-ish “right, then” instead of the other way. My head was wrong. It still sounded lame.

3. Amazeballs And while we’re at it, let’s retire “amazing” for a while, too. “That pumpkin latte was amazeballs!” or “That meatloaf was amazing.” No. Nobody really needs to walk around saying the word “balls” except for gym teachers and coaches and boys between the ages of 7 and 15. And the word amazing has been stuck in my craw since my homegirl Nina Badzin wrote about how it’s being overused as a compliment. BECAUSE EVERYTHING ISN’T AMAZING. Sometimes it’s really good. Sometimes it’s yummy. Sometimes it’s just so-so. We have so many adjectives in the English language. Let’s dust some of the lesser-knowns off and use them for a while.

(And yes, oh the irony of the 47-year-old blogger using the word “homegirl”… I almost typed “home-skillet” which would have been even more sad. Amazingly so.)

4. Cray (Or Cray-Cray ). Crazy just sounds better. Or one of the ten million synonyms for crazy. I like a good “crazier than a shithouse rat” but I can’t say that when I’m surrounded by preschoolers. So I oftentimes use “whackadoo.” When I hear you say “cray” I think you were going to talk about Crayola crayons and had a brain freeze or else Robert Cray, who happens to be a pretty badass blues guitarist.

5. I Will Cut You/I Will Cut a Bitch No, you won’t. You’re sitting behind the wheel of a Honda Odyssey, you have groceries from Costco melting in the back and you’re in the parent pick-up line at school. You’re not a character inOrange is the New Black. You’re not going to be cutting anyone any time soon so please stop saying you will.

6. Adorbs Are you saying this with any sort of frequency at all? Are you 14 and talking about your BFF’s new Harry Styles iPhone case? If the answer to my first question was yes and the answer to my second question was no, then this word needs to stop coming out of your mouth.

7. Feels. As in, “This story hit me right in the feels” or “oh my feels!” or “so many feels”. You experienced an emotion. That photo session, the one where the guy’s wife passed away and he recreated their wedding photos with his toddler daughter? WE ALL CRIED. I cried like a tired baby on my couch for a good half hour. They caused feelings, not feels. See also: “I eat my feelings” vs. “I eat my feels”. Which one rolls off the tongue with more ease and less irony? No more feels. Please.

That’s all I’ve got. I was going to add that thing where people refer to cats as “kittehs” but that one is over now, right?

How about you? Any jargon that you wish would just go away forever? Or worse, that you find yourself saying out loud? Let me know. I’ll be over here eating these left-over holiday feels. They taste like snickerdoodles and ham, BTW.

This post originally appeared on Jennifer’s blog, The Happy Hausfrau.

Read More:  http://www.huffingtonpost.com/jennifer-ball/7-things-you-totes-need-to-stop-saying-if-youre-over-30_b_4375298.html?utm_hp_ref=women&ir=Women?utm_hp_ref=women&ir=Women

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Women’s News: U.S. Ranks Near Bottom Among Advanced Nations In Efficiency Of Health Care Spending

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The Huffington Post  |  By 

While the great health care debate continues across the nation, a new study shows our struggles for health care go far beyond just the quarrels in Washington.

Researchers at McGill University and the UCLA Fielding School of Public Health analyzed the efficacy of health care systems across the world and found the U.S. ranks 22nd out of 27 high income nations when it comes to increasing life expectancy.

The analysis, published in the American Journal of Public Health , defined health efficiency by the increase in life expectancy relative to health care dollars spent. In the U.S., every additional $100 spent on health care increased patient life expectancy by around half a month, while in the most efficient nations life expectancy grew by over four months with the same cost. Germany topped off the list of most efficient nations, followed by Switzerland and Italy, while Luxembourg and Greece fell at the bottom.

The inefficiency of U.S. spending is particularly staggering, although not necessarily surprising, given that in 2009, publicly-financed health care expenses reached $1.14 trillion, up from $646 billion in 2001. It’s one of the top countries when it comes to health care spending by capita in the world, trumped only by Switzerland.

But there’s more.

“While there are large differences in the efficiency of health spending across countries, men have experienced greater life expectancy gains than women per health dollar spent within nearly every country,” study author Douglas Barthold said in a release.

When it comes to increasing female life expectancy, the U.S. ranking dropped down further to 25th place while it fared slightly better for men’s health care efficiency at 18th place. Troublingly, women pay $1 billion more than men annually in insurance costs according to one report.

The findings raise several questions on how a more advanced nation can have such an inefficient health care system and why there is such a substantial gender disparity. But the key to a more efficient system could be treating it as a health care system rather than a “sick care” system, Huffington Post blogger Susan Blumental wrote. “Costs are compounded by preventable chronic illness… tobacco use, obesity and lack of physical activity — have overwhelmed the American health care system,” Blumenthal wrote.

Researchers say the findings warrant further research on the gender disparities and the lack of investment in preventive medicine.

Read More:  http://www.huffingtonpost.com/2013/12/12/us-health-care-efficiency_n_4430101.html?utm_hp_ref=womens-health

Women’s News: 19 Stages Of New Year’s Eve Planning Anxiety

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The Huffington Post  |  By 

Deciding how to spend New Year’s Eve is usually a gigantic production. Not only is it the most overhyped “party night” of the year — just staying in is, apparently, not an option — but everyone has a different idea of what makes an “epic” night. Whether it’s paying way too much money to go to a club, raging at a warehouse party in a predictably sketchy part of town, or packing into Times Square or its equivalent to watch something fall from the sky, figuring out how to just have a good time on New Year’s can be shockingly difficult.

Here are the 19 stages of New Year’s Eve planning anxiety:

1. The conversation first comes up at brunch in November, which is just way too early. And, unfortunately, the opinions being tossed around aren’t quite your scene. 

2. “I heard about this awesome dance party!”

3. “Ooh let’s go to a fancy hotel!”

4. “What about a gala? Something black tie?”

5. It’s shaping up to be an expensive night.

6. One where you’ll have to wear heels and stand in a line.

7. But resistance is futile at this point, so you nod and play along.

8. Fast-forward to mid-December, where everyone starts panicking about having a set plan before people peel off for the holidays.

9. But when the previous suggestions are re-hashed, you’re not having it. 

10. Your only requirement for the evening? This:

11. The email chain your friend started about the night is now 102 messages long.

12. You browse Facebook to get away from it all.

13. But what’s this on your sidebar? An invite you somehow missed?

14. A New Year’s house party? Friends of friends are welcome?

15. Hallelujah!

16. All that’s left is getting ready for the night itself. Grab your shiniest dress.

17. Dig out your best playlist.

18. Dismiss all suggestions that your plans aren’t “fun” enough.

19. And enjoy!

Read More:  http://www.huffingtonpost.com/2013/12/27/new-years-eve-planning-anxiety_n_4468064.html?utm_hp_ref=women&ir=Women?utm_hp_ref=women&ir=Women

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