Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.
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Question: - Frustration over limited time spent with patients. - Inordinate amounts of time inputting required data. - Side effects including high levels of stress. The patient? Herself. The remedy? “I did the research and found direct primary care,” said Anderson-Elder of Windsor. And in June she joined Dr. Frank Morgan at Balance Health in Greeley, a direct primary care clinic he founded four years ago in Greeley. Leaving her family practice at UCHealth Medical Clinic in Windsor after seven years wasn’t an easy decision, she said, but it was the right decision for her. Many physicians — from all specialties — share Anderson-Elder’s frustration and levels of stress incurred while working in insurance-based health care systems. In the 2018 Medscape National Physician and Depression Report, 42 percent of family physicians admitted to having burnout or depression, listing “too many bureaucratic tasks (charting, paperwork)” and “too many hours at work” as the leading factors in burnout. Although direct primary care has been around for some time, it is just now gaining a toehold with both physicians contemplating the switch to a different way of providing care and patients willing to give it a shot, so to speak. In 2017, there were more than 600 direct primary care clinics in the U.S., 10 percent of those in Colorado, according to the Colorado Independent. Anderson-Elder said in her research she found 1,000 out of the 80,000 family doctors practicing in the U.S. have gone the direct primary care route. DIRECT PRIMARY CARE What is direct primary care? And why the interest? First and foremost, the major difference is that direct primary care does not accept insurance. Patients instead pay a monthly membership fee that includes unlimited visits, calls and emails, along with many routine services and access to prescriptions and lab work at a reduced cost. For the physician, it means quality time spent with patients and no more time filling out paperwork to satisfy health insurance company regulations. What the monthly fee is varies from clinic to clinic. At Balance Health, it is $99 for adults, $180 for couples and $30 for children. Those who sign up for direct primary care are asked to sign an annual contract but can be released from it with 30 days’ notice, Anderson-Elder said. “We want to be accessible to our patients. We don’t want them to go to urgent care or ER if they don’t have to,” she said. And yes, that includes calls at 3 a.m., but if it can wait till morning, the patient is worked into that day’s schedule. Anderson-Elder typically sees eight to 17 patients per day, depending on whether it’s cold and flu season. And she spends as much time as needed with them. At her previous practice, she was limited to spending 15 to 20 minutes per patient. “People service their cars,” she said. “They should do the same thing with their bodies. You should be looked at and tuned up.” While most people think of going to the doctor only when they don’t feel well or need a physical for work or school, Anderson-Elder said she likes to see patients even when they feel healthy so she can check in on their well-being and talk about proper nutrition. “Oftentimes patients think they’re healthy, but then we do an exam and sometimes find things,” she said. Direct primary care works best when combined with a high-deductible health plan, Anderson-Elder said, for those times when unexpected surgeries are scheduled and for patients who suffer from chronic illnesses. But she said about one-third of her patients have no health insurance at all. She also noted direct primary care should not be confused with concierge medicine, which also provides direct access to providers for a flat fee but still bills insurance companies for services provided. Another key distinction between the two is direct primary care is mentioned in the Affordable Care Act as an acceptable option for receiving medical care without insurance, while concierge medicine is not, according to the American Academy of Family Physicians. And last year, Colorado Gov. John Hickenlooper signed Colorado HB17-1115, which establishes that direct primary health care can operate without regulation of the division of insurance. Windsor Republican Rep. Perry Buck was a primary sponsor of the bill. Patients at Balance Health also can tap into other healthy-living services for additional fees. Dr. Dana Morgan, a family care physician, specializes in bioidentical hormone replacement therapy. Balance Health also has a small fitness gym replete with trainers and classes. Wellness coaching also is offered. Leaving her practice in Windsor, though a hard decision, has been the right prescription for her, she said. “I no longer take paperwork home,” she said. “I’m happier and less stressed.” ___ Information from: The Tribune of Greeley, Co, http://greeleytribune.com

Answer: Windsor doctor joining direct primary care movement.


Question: The alert urged Americans to seek medical help in the event they suffered any “unusual, unexplained physical symptoms or events, auditory or sensory phenomena, or other health concerns.” The alert comes as a U.S. medical team is screening more Americans who work at the Guangzhou consulate. A previous case in Guangzhou, disclosed last month, prompted the tests. The incidents have raised fears the unexplained issues that started in Cuba in 2016 have expanded to other countries. China says it has uncovered no information that could point to a cause. The most recent evacuations followed medical testing that revealed they might have been affected. State Department spokeswoman Heather Nauert said “a number of individuals” had been brought to the U.S. but didn’t say how many were affected or evacuated. Friday’s alert called for people to be attentive of symptoms including “dizziness, headaches, tinnitus, fatigue, cognitive issues, visual problems, ear complaints and hearing loss, and difficulty sleeping.” It urged them “not to attempt to locate the source of any unidentified auditory sensation. Instead, move to a different location.” The U.S. government has deemed the Cuba incidents “specific attacks” on American workers but hasn’t publicly identified a cause or culprit. Most of the incidents were accompanied by bizarre, unexplained sounds that initially led U.S. investigators to suspect a sonic attack. Asked about the latest incidents, Chinese Foreign Ministry spokeswoman Hua Chunying said Thursday that the U.S. had not formally raised the matter with Beijing. “If the U.S. makes formal contact with us, China will continue necessary investigations in an earnest and responsible manner and maintain close communication and cooperation with the U.S.,” Hua said at a regularly scheduled news conference. China earlier said it had looked into the case announced last month but came up with no clues about the cause of the symptoms. A U.S. official, who wasn’t authorized to discuss the situation publicly and requested anonymity, said the evacuated American government workers were being brought from China for testing to the University of Pennsylvania. That’s where doctors have been treating and studying patients previously evacuated from the U.S. Embassy in Havana. The preliminary findings of the medical reports on the 24 personnel affected in Cuba showed they had sensory and memory problems similar to the brain dysfunction seen with concussions. The Penn team said the patients from Cuba experienced persistent disability though rehabilitation therapy customized for them seemed to help. Canada in April also ordered families of diplomatic staff in Cuba to return home after mysterious health symptoms were detected in 10 Canadians stationed on the island. Canada said the 10 continued to show unexplained brain symptoms and that “medical information raised concerns for a new type of a possible acquired brain injury.” In testimony before the Senate Foreign Relations Committee last month about the first case in China, U.S. Secretary of State Mike Pompeo said China had “said all the right things and have demonstrated their willingness to help us identify the vector which led to this medical incident.” The China incidents affect one of the most important of the seven U.S. diplomatic outposts in the country. The Guangzhou consulate opened months after the establishment of diplomatic relations between Beijing and Washington in 1979 and moved to its new purpose-built facility in 2013. It serves four southern provinces with a combined population of more than 204 million and processes more than 1 million visa applications of all types annually. It is also the only U.S. diplomatic installation in China authorized to process immigrant visas and handle adoptions. People working in The Canton Place complex, a few kilometers (miles) from the consulate, said Thursday they were just hearing about the incidents, reflecting a lack of coverage in China’s entirely state-controlled media. Aled Williams, a British teacher at a kindergarten said Thursday that the reports sounded “sci-fi-ish.” “Hard to get my head around how it works,” he said. “Better watch myself.” Linda Chen, who runs a coffee shop in the area, said she was mystified as to why only certain people seemed to have been affected in an area known for its comfort and safety. “For me I feel it’s very strange. But I don’t feel that there’s something to be very afraid of because it’s probably a very special case,” Chen said. ___ Associated Press writer Josh Lederman in Washington, D.C. contributed to this report.

Answer: US Embassy in China sends new alert for mystery health issue.


Question: Sunflower County Corner Heather Burton told The Associated Press a 32-year-old male prisoner died before noon Thursday at the Mississippi State Penitentiary at Parchman. Burton said the inmate, whom she declined to identify pending notification of relatives, had multiple stab wounds. Sunflower County Sheriff James Haywood said other inmates were injured. Deputies from multiple counties and state agencies responded to the sprawling and isolated Parchman prison, Haywood said. Inmates in a different unit than the one where the stabbing occurred set their cell block on fire, the sheriff said, speaking by cell phone from the prison. Haywood said the fire was put out and the inmates were under control. “Everybody is up here and everything is calm and cool right now,” he said. Mississippi Department of Corrections spokeswoman Grace Simmons Fisher later said nobody was hurt by the small fire that was set by an inmate, and no structural damage occurred. She said inmates were evacuated while the fire was extinguished, then moved back in. Earlier in the week, prisons statewide were put under lockdown after what the department called a “major disturbance” Sunday at the South Mississippi Correctional Institution in Greene County. Inmate Terrandance Dobbins, 40, was killed and two others were hurt. On Tuesday evening at Parchman, 25-year-old inmate Walter Gates died and several others were injured during a fight among prisoners. The fight broke out in one unit and spread to others around the prison, Burton told news outlets. Burton said Gates, who had a 2015 burglary conviction, received multiple stab wounds. Then one inmate was killed and two were injured in a fight early Thursday at Chickasaw County Regional Correctional Facility, a county-run facility that holds state inmates. “We had it under control in three minutes,” Chickasaw County Sheriff Jim Meyers told The Associated Press. Meyers identified the dead inmate as 26-year-old Gregory Emary,  of Hernando, serving a 16-year sentence for burglary. Another inmate was in intensive care after surgery at a Tupelo hospital, Meyers said, and a third was at another hospital with cuts to the head. The lockdown means inmates can’t go outside, make phone calls or receive visitors. Authorities said the ban on visitors will extend at least through the weekend. “All available resources are being used to address disturbances occurring around the state,” the statement said. The violence came even as U.S. District Judge William Barbour ruled Tuesday that while conditions may have previously been poor at East Mississippi Correctional Facility near Meridian, there’s no longer any evidence that the privately run prison is violating inmates’ rights. A lawsuit suit filed in 2013 alleged that inmates were being systematically denied health care and mental health care, were in danger of violence from guards and other prisoners, and were forced into long stretches in solitary confinement, where cells were often dark and where inmates often set fires. “While plaintiffs and their expert witnesses argue that environment and healthcare services at the prison could and should be better, those arguments do not establish that the conditions under which they are currently housed, as a class, are cruel and unusual,” Barbour wrote in his ruling. The judge wrote that he believed that conditions had improved after former Corrections Commissioner Christopher Epps resigned in November 2014. Epps was later convicted of taking more than $1.4 million in bribes. One of those who pleaded guilty to bribing Epps was Dr. Carl Reddix, whose company previously had a contract to provide medical and mental health care at East Mississippi. Barbour said that the bribes “likely affected the quality of care that was being provided to prisoners as well as other conditions at the facility.” The lawsuit was brought on behalf of inmates by the American Civil Liberties Union and the Southern Poverty Law Center. Neither group, nor the state, immediately commented Thursday on the ruling. The Corrections spokeswoman Fisher didn’t comment directly on the ruling but wrote in an email that “linking the ruling to what is going on now is plainly unfair.” Expert witnesses testified that care at the prison, which holds male inmates who mostly have been diagnosed with mental illness, was substandard. But Barbour ruled the experts’ opinions didn’t reach the “very high bar” needed to prove that state officials were deliberately indifferent to inmates’ needs. He wrote the state had improved health care, mental health care, staffing and the physical conditions at the prison during the course of the lawsuit. Mississippi Corrections Commissioner Pelicia Hall announced Tuesday that she will resign in mid-January to take a private sector job signaling incoming Gov. Tate Reeves won’t retain her upon taking office Jan. 14. ___ Jeff Amy reported from Atlanta.

Answer:
4th death in Mississippi prisons; judge says other prison OK.