How the Religious Freedom Division Threatens LGBT Healthand Science

When Marci Bowers consults with her patients, no subject is off limits. A transgender ob/gyn and gynecologic surgeon in Burlingame, California, she knows how important it is that patients feel comfortable sharing their sexual orientation and gender identity with their doctor, trust and honesty being essential to providing the best medical care. But Bowers knows firsthand that the medical setting can be a challenging place for patients to be candid. That for LGBT people, it can even be dangerous.

"I know from talking with patients that they're often denied services, not just for surgery and hormone therapy, but basic medical care," Bowers says. "I've had patients show up in an emergency room who were denied treatment because they were transgender."

Experiences like these are what make the creation of a new "Conscience and Religious Freedom" division within the US Department of Health and Human Services so troubling. Announced last week by acting secretary of HHS Eric Hargan, the division's stated purpose is to protect health care providers who refuse to provide services that contradict their moral or religious beliefs—services that include, according to the division's new website, "abortion and assisted suicide."

But the division's loose language could leave room for physicians to provide substandard care to LGBT patients—or abstain from treating them altogether. Indeed, in a statement to WIRED, an HHS spokesperson said the department would not interpret prohibitions on sex discrimination in health care to cover gender identity, citing its adherence to a 2016 court order that excluded transgender people from certain anti-discrimination protections.

That's obviously bad for the health and wellbeing of LGBT people, who may feel less comfortable sharing their sexual orientation or gender identity going forward—but it's bad for science, medicine, and policy, as well.

At its core, the new HHS office threatens data and understanding. Collecting facts and figures on sexual orientation and gender identity fills valuable gaps in the medical community's comprehension of LGBT patients and their public health needs, and progress on that front has accelerated in recent years. "Gathering these details has tremendous potential to improve care for LGBT people," says psychologist Ed Callahan, who in 2015 helped orchestrate the addition of fields for sexual orientation and gender identity—aka "SO/GI"—to electronic health records at UC Davis, the first academic system in the country to do so. The more data doctors and policymakers have on LGBT people, the better they can understand the institutional hurdles, social challenges, and public health risks they face as sexual minorities.

The creation of the new HHS division is but the latest development in an ongoing battle over whether and how that data is collected. As of this year, the Office of the National Coordinator of Health Information Technology requires outpatient clinics to use software that collects SO/GI information if they receive federal incentive payments for using government-certified electronic health care records. The Bureau of Primary Health Care requires health centers to report the sexual orientation and gender identity of their patients. And the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services continue to encourage data collection on SO/GI.

"There’s actually been a lot of good work happening at the Veterans Health Administration," says Sean Cahill, director of health policy research at the Fenway Institute, a Boston-based center for research, training, and policy development on LGBT-related health issues. Since 2012, the VA has encouraged the collection of SO/GI data and issued directives that ensure respectful, equitable, culturally competent care for LGBT veterans. And by the end of Obama's presidency, the number of federal surveys and studies measuring sexual orientation had increased to 12, seven of which also measured gender identity or transgender status. "So the good news is that the shift to gathering these data has been underway for several years, and does continue," Cahill says.

But data collection has slowed under the Trump administration. In the past 13 months, surveys collecting data on participation in Older Americans Act-funded programs and Administration for Community Living-supported disability services have removed questions pertaining to sexual orientation and gender identity. In the same time span, numerous political maneuvers have sown uncertainty and distrust throughout the LGBT community. A July 2017 directive from President Trump attempted to ban transgender people from enlisting in the military, and in December policy analysts were presented with a list of banned words—including "transgender"—not to be used in official CDC budget documents.

In short: Under the Trump administration, the country is simultaneously collecting less data and promoting conditions that leave LGBT patients wary of their healthcare providers. "These patients already face significant obstacles to accessing medical care, and I fear implementation of these measures will only make these obstacles worse," says Stanley Vance, a pediatrician at University of California San Francisco and an expert in the care of gender nonconforming youth. "I also worry that these measures will be an institutionalized form of discrimination against patients who have been identified as a sexual minority or transgender who freely come out to their providers or through information previously entered in electronic medical records."

Even when physicians don’t overtly discriminate against gay and transgender patients, negative health care experiences are routine. Many physicians simply don't think to consider a patient's SO/GI—information they can use to not only respect their patients, but screen them for family rejection, which studies show increases the risk for depression, suicide, and high-risk sexual behaviors. Failing to acknowledge a patient's SO/GI can compound the ill effects of social stigma and inaccessibility to care like hormone therapy or gender affirmation surgery. "Across the board, LGBT patients are the group least likely to come back for further care," Callahan says. "And that often happens because of ways they are dismissed as not existing."

Of course, the reality is that LGBT people do exist, they're entitled to equitable services and care, and they deserve to be counted—sometimes literally. "It really shouldn't be political, you know? It shouldn't be a partisan issue," Cahill says. "It's about science and data and providing quality care to all patients."

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To Study Violence After Gun Shows, Researchers Turn to An Unlikely Source

The Big Show Journal is no ordinary gun magazine. The print periodical, which appears on newsstands nationwide six times a year, is also, according to its website, "America’s most interesting gun and knife magazine" and "America’s most accurate and complete gun and knife show calendar." Gun enthusiasts may dispute the former claim—but the latter is less subjective than you might think.

In fact, The Big Show Journal might be the closest thing researchers have to a comprehensive record of gun shows in the US.

"There’s no readily compiled, publicly available database of where and when gun shows occur," says UC Berkeley epidemiologist Ellicott Matthay, who recently found herself in want of such a database. That includes the internet. When Matthay used the Wayback Machine to scour archived web pages for the dates and locations of past shows, she found gaps in the historical record; events she knew had happened were nowhere to be found. So she turned to trade magazines instead. The Big Show Journal, true to its claim, proved more comprehensive than competing publications like Gun List Magazine and Gun and Knife Show Calendar.

A state's gun laws, it seems, can be undermined by those of its neighbors.

Matthay needed that data to test a hypothesis about gun violence in America. Gun shows—of which the US sees about 4,000 per year—account for between 4 and 9 percent of firearm sales. As a public health researcher, Matthay knew that gun ownership increases the risk of suicide, homicide, and unintentional casualties in the home, and that firearms acquired from gun shows are disproportionately implicated in crimes. Matthay wanted to know if gun shows could lead to increased rates of gun violence, specifically in her home state of California. And the numbers she needed to find out were buried not in a government database, but in back issues of a big, glossy gun magazine.

But magazines are hard to mine for data. So Matthay set to work, scanning issues of The Big Show Journal published between 2005 and 2013 in the copy room at UC Berkeley's school of public health. She used optical character recognition software to convert the scans into alphanumeric data. Then she trained an algorithm to isolate the dates and locations of gun shows in California and neighboring Nevada, which shares the largest border with the state.

When Matthay was finished, she cross referenced her database with death records from the California Department of Public Health, along with ER and inpatient hospitalization records collected by the state. By comparing death and injury rates for the two weeks before and after each gun show, Matthay could see whether firearm casualties increased in nearby California areas in the wakes of California and Nevada gun shows.

Her hypothesis turned out to be half right: California gun shows did not appear to have a significant effect on local gun violence. But in regions near Nevada shows, rates of death and injury due to firearms spiked by 70 percent.

That staggering disparity could boil down to policy differences. California's gun laws are among the most stringent in the country. Nevada, in contrast, has some of the least restrictive—and no explicit regulations on gun shows. Data from the Bureau of Alcohol, Tobacco, Firearms and Explosives—which monitors where guns originate and where law enforcement recovers them—shows that firearms have a knack for flooding into states with tough gun laws from those without. (To cite just one example: Sixty percent of guns used to commit crimes in Chicago between 2009 and 2013 originated outside of Illinois.) A state's gun laws, it seems, can be undermined by those of its neighbors.

But that kind of inter-state analysis isn’t always possible. Many states—Nevada among them—don't require documentation of private gun sales.

"If a gun originated in Pennsylvania, changed hands between private parties at a Nevada gun show, and resulted in a firearm death or injury in California, even if we were to trace it, we'd have no way of knowing it was ever in Nevada," Matthay says. What's more, ATF only tracks the provenance of guns recovered from crime scenes. But not all crimes involving guns result in injury or death. Conversely, not all firearm casualties—particularly unintended injuries—are logged as crimes.

So researchers like Matthay have to use trickier methods to understand the impact of firearms. "The biggest challenge, when it comes to understanding gun violence, is money—but the second biggest is data," says Frederick Rivara, an epidemiologist at the University of Washington and an expert on gun violence. The NRA's efforts to stymie gun research are extensive, palpable, and well documented: When a car kills somebody in the US, the details of the incident go into a massive government database. No such database exists for gun deaths. If you want to study firearms in this country—how they move, the way they're used, how often they murder and maim—you have to get creative. See: scanning old gun magazines by hand.

But with limited data comes limited information. Matthay's study didn't trace any guns, so it's unclear whether California's post-show spike in gun violence is tied to an inundation of Nevada firearms. (It could be due to an influx of ammunition, for example.) Neither did the study examine associations with firearm casualties in Nevada. (“We could do that,” Matthay says, for Nevada and neighbor states like Oregon and Arizona, “but we would need additional funding.”) Likewise, there's no telling if the link between gun shows and gun violence is causal. A randomized controlled trial—the gold standard of evidence in medical and epidemiological circles—could help isolate the signal. But researchers can't exactly go around exposing random populations to gun shows. "That would not be ethical," Matthay says, not to mention unfeasible.

Still, the study does paint a more nuanced picture of the relationship between gun shows and gun violence. By accounting for deaths and injuries ATF's data overlooks, Matthay's research points not only to the effectiveness of California's gun laws, but the pitfalls of porous borders—two valuable insights that policy makers can use to inform laws at the state and federal levels.

"That's our job as investigators—to see if those laws help or not and determine whether they should be more widespread, to reduce the total gun violence," Rivara says.

With the help of Congress, researchers like Matthay could do that job much more effectively. Until then, they'll make do with the data they have.

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D-IDs tech protects your privacy by confounding face recognition algorithms

D-IDs founders Eliran Kuta, Gil Perry, and Sella Blondheim

Unless you literally wear a mask all the time, it is almost impossible to completely avoid cameras and face recognition technology. Not only is this a privacy concern, but it also presents a potential liability for companies that need to protect personal data. D-ID, a startup currently taking part in Y Combinator, wants to solve the problem with tools that process images to make them unrecognizable to face recognition algorithms, but still look similar to the original picture.

D-ID (its name stands for de-identification) was founded last year by CEO Gil Perry, COO Sella Blondheim, and CTO Eliran Kuta. Perry and Blondheim met when both were in the Israeli Special Forces about a decade ago, while Kuta served in the Israeli Intelligence Corps. At that time, photo-sharing on social media was relatively new, but they already needed to be mindful of face recognition technology.

We couldnt share our photos and profiles over the web because of sensitive positions. Even after we finished our service, we couldnt share our photos when we traveled in South America, Perry says. We felt bad because we are very social and everyone was sharing photos, but we couldnt.

Perry and Blondheim realized that people in the security industry were also forbidden from sharing photos online. They started brainstorming ideas to protect pictures from face recognition tech and came up with a basic algorithm. After an interlude of a few years, during which each of them worked on separate startups, they regrouped, added Kuta to their team, and launched D-ID.

Finding a way to deal with face recognition technology has become even more imperative. ATMs that use face recognition technology have already been deployed in Macau and are being tested by border control agencies in several countries. In China, its even been used to identify jaywalkers.

We started thinking about it when only people who worked in security or the government were very aware of face recognition technology, says Perry. Now everyone needs to be aware of it. Streets today are covered by cameras, we all carry smartphones. We are being photographed all the time. When you combine all the cameras and face recognition technology, privacy is actually gone.

The growth of D-ID will also be driven by new data privacy regulations like the European Unions General Data Protection Regulation (GDPR), which will become enforceable in May 2018 and require companies to guard personal data, including biometric data, more stringently or risk heavy fines. D-ID claims that its technology is designed to be difficult for artificial intelligence to overcome. Perry declined to go into detail about how the startups algorithms accomplish that, but said its goal is to be the standard of image protection, protecting every photo containing biometric data that is shared online.

D-ID serves three verticals: companies that need to protect images of their employees or customers, health management organizations, and government and security agencies that want to secure biometric data. It will launch a pilot program with cloud-based image management service Cloudinary to protect more than 14 billion media assets, Perry says.

Other companies that are developing ways to protect data from face recognition tech include ones that specialize in helping organizations comply with privacy regulations or offer data protection on a SaaS basis. Many of their tools work by making faces completely unrecognizable, but Perry says D-ID differentiates because their changes are much less detectable as possible, at least to the human eye. This element means that D-IDs tech can appeal to individuals who just want to protect photos they put online. Perry says a consumer app may be released if there is enough demand. D-IDs founders also say they welcome more competition because that means more companies are finding ways to help people protect their personal data.

Its an important point in time right now, with the progress of deep learning and every place being covered by cameras and regulators understand that, Perry says. More competitors are going to come and thats a good thing. we need to move fast in order to make an impact and we want to make as large an impact as possible in order to restore and protect privacy.

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IBM will use data science and tech to tackle the world’s biggest problems

IBM Watson's computer housing case.
Image: Andrew Spear for The Washington Post / Getty Images

IBM is channeling its science and tech expertise into tackling some of the world’s biggest problems.

On Wednesday, the tech giant announced the launch of Science for Social Good, a new program that partners IBM researchers with postdoctoral academic fellows and nonprofits to take on societal issues through data.

With the new initiative, IBM announced 12 projects planned for 2017. Each Science for Social Good project aligns with one or more of the 17 Sustainable Development Goals, the United Nations’ blueprint to address some of the globe’s biggest inequalities and threats by the year 2030.

Science for Social Good covers issues like improving emergency aid and combating the opioid crisis, and the projects all use data science, analytics, and artificial intelligence to develop solutions.

The projects chosen for this years Social Good program cover predicting new diseases, alleviating illiteracy and hunger, and helping people out of poverty.”

One project is called Emergency Food Best Practice: The Digital Experience, which plans to compile emergency food distribution best practices and share it with nonprofits through an interactive digital tool. IBM will partner with nonprofit St. John’s Bread & Life to develop the tool based on the nonprofit’s distribution model, which helps the organization seamlessly serve more than 2,500 meals each day in New York City.

Another project is called Overcoming Illiteracy, which will use AI to allow low-literate adults to “navigate the information-dense world with confidence.” The project hopes to decode complex texts (such as product descriptions and manuals), extract the basic message, and present it to users through visuals and simple spoken messages. While this project doesn’t solve the global literacy crisis, it will allow low-literate adults engage with text independently.

“The projects chosen for this years Social Good program cover an important range of topics including predicting new diseases, promoting innovation, alleviating illiteracy and hunger, and helping people out of poverty,” Arvind Krishna, director of IBM Research, said in a statement. “What unifies them all is that, at the core, they necessitate major advances in science and technology. Armed with the expertise of our partners and drawing on a wealth of new data, tools and experiences, Science for Social Good can offer new solutions to the problems our society is facing.”

IBM hopes the initiative will build off the success of the company’s noted supercomputer, Watson, which has helped address health care, education, and environmental challenges since its development.

Six pilot projects were conducted in 2016 in order to develop the Science for Social Good initiative. These projects covered a broad range of topics, such as health care, humanitarian relief, and global innovation.

A particularly successful project used machine learning techniques to better understand the spread of the Zika virus. Using complex data, the team developed a predictive model that identified which primate species should be targeted for Zika virus surveillance and management. The results of the project are now leading new testing in the field to help prevent the spread of the disease.

To learn more about current and past projects, visit the Science for Social Good website.

Read more: data rewards app gets Telefnica co-branding push

London basedPeople.iohas taken its first steps outside the UK, expandingits data sharing rewards platform into Germany where its launcheda co-branded version of the app with carrier o2 (called o2 Get), targeting the latters ~24 million customers.

The app isalso available to download via the App Store and Google Play, and o2 parent company Telefnica Germany will also be pushing the appsacross its fullmarketfootprint of 44M customers. The telcolinkfollows People.ioIn goingthrough the telcosWayra Germany accelerator last year. Theysay theyre the first Wayra-backed startup to launch a co-branded product with Telefnica.

By co-branding with o2 we benefit from a respected and well known consumer brand which gives us a fast track to scale; meaning we can focus on creating a great product experience that delivers on our vision to give peopleownership of their data, says co-founderNicholas Oliver.

Our decision to launch in Germany was driven by their strong, consumer-centric data privacy laws. This meant we were focussed on building a product that could meet even the most stringent data privacy laws with a view to further market expansion.

Oliver says the team isexpecting to get around250,000 downloads in the next 6 months in Germany; increasing to just under 1 million by the end of thefirst year.

The startup is apparently working with around a dozentelcos across 35 markets at this point although it remains to be seen how many of those conversations will turn into fully fledged co-branded app efforts.

In o2 Germanys case, People.ios philosophy around user data ownership clearly meshes with a Telefnica strategic push to give data back to usersaimed at fostering customer loyalty.

We first covered People.ioback in January 2016, when it had just launched a beta version in Shoreditch, giving locals the chance to share personal data in exchange for building up credits to redeem against digital serviceslike streaming music. Its since scaled out to be UK wide.

The core idea is to flip the notion that Internet users have topay to use free products by havingtheir personal data covertly and persistently harvested by these services. Instead, the platform aims to give people an incentive to share data willingly with it, for targeted ad purposes, rewarding them for sharing data with credits to redeem against different services (and by not sharing their data directly with others).

The app is broadly aimed at18 to 25 year olds for now, offeringa familiarTinder-style swipe interface for them torespond to questions about their likes and dislikes to start inputting personal data into the platform. They can also choose to connect other data sources, such as their email account, in order toshare more info with increased rewards for sharing more.

Advertisers are able totarget marketing messages at users via the platform, but the startup says users data is nevershared directly with third parties. And the further pledge is that users can delete their account at any point which immediately and permanently erases all their data.

Oliver describes the platformas a firewall for people, and reckons Europes incoming General Data Protection Regulation (GDPR) will have a serious impact on how thead tech industry operates regionally, because it gives consumers greatercontrol over how their data is used. The GDPR is due to come into force in May 2018, and includes tough penalties for compliance failures, changing the risks associated with collecting and processing EU citizens personal data.

While People.ios initial productpays data sharersfor viewing targeted ads typically redeemed againstgift cards for Amazon, Starbucks and iTunes, according toOliver, with an option to donate credits earned as cash to charity currently also in testing itswider vision is around expanding into paidservices of its own; utilizing users data to offer themthe ability to pay to enhance other digital services they use, without having to lose control of their information.

This might apply to health and fitness, connected home or even productivity apps and experiences, he explains. Our advertising feature(s) are really just phase one of a far bigger product vision. It provides us with a familiar consumer experience that allows us to develop the initial relationship with the user. From here, we can then educate them on the value associated to their data and demonstrate why taking ownership of it can benefit them; both financially and through enhanced digital experiences.

A brief example could be with a Spotify playlist. Having a playlist that dynamically changes your upcoming tracks based on your current context (at work, at home, going running, trying to relax) or mood (stressed, energetic, feel like partying). With wed just tell Spotify Nics at work or Nic is about to go running without sharing any of the data behind that insight. So that means Spotify can do what it does best, without ever needing access to your digital life.

When you consider the future of Conversational interfaces, like Amazon Echo, or chat bots; this type of functionality will become increasingly relevant, he adds.

At this still early stage, has around35,000 accounts activated sinceexiting beta in the UK, with around two-thirds of those characterizedas monthly actives.

On average, Oliver says users engage with the app between two to three times a week. Whilethe platform gets aroundhalf a million user interactions per month at this point.

He says the startup iscurrently raising investment to support continued momentum and growth into other key markets. Investors to date include Nick Robertson, founder of ASOS; Thomas Hegh, founder of Lovefilm; and Founders Factory, the accelerator founded by Brent Hoberman and backed by Guardian Media Group.

European markets are a priority, thanks to the pro-privacy regulatory environment, butOliver says the team ishoping to expand into the first non-EU market by the end of the year. The US is certainly a market that were keeping an eye on, he adds.

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Avocado Nutrition: Whether you're focusing on the USDA's food scale or the latest diet book that was just released, you will see that different people have different ideas about what proper nutrition is. Before you form an opinion one way or the other, here are some simple nutrition tips you should read – what is avocado good for.

Benefits of Avocado: If you are traveling to a high-altitude destination, don't take medication that might mask the effects of altitude sickness. Instead, drink plenty of water to mitigate the symptoms. Masking them might mean you don't realize the danger until it's already too late; it's better to just deal with that headache for a few hours instead – hass avocado nutrition.

Avocado Nutrition Facts: Include more fiber in your diet. Fiber causes your body to expel wastes so that nothing harmful has a chance to sit for long inside of you. By eating more fiber, you are helping keep your colon in top condition by pushing out harmful waste at a quicker rate – avocado nutrition data.

Health Benefits of Avocado: To have a healthy body we need to keep track of what we eat. There is a very popular saying that goes to say that you are what you eat. That is entirely true, therefore it is important to limit the consumption of processed food and take in more organic foods – nutrition in avocado.

Avocado Health Benefits: Don't deprive yourself of your favorite foods entirely, but substitute healthier renditions when possible. You need to learn about the foods you're currently eating, the alternatives, and how to make healthier choices. Restaurants are starting to provide nutritional information on the foods they serve, so this has made it easier to do – why are avocados good for you.

Are Avocados Good for You: Write down and collect healthy recipes. Cook books are expensive and seldom have much useful information. Make your own instead. Buy a pack of index cards and use them to copy down any healthy recipes you try and enjoy. Replace all those high calorie, unhealthy recipes you had been saving with the new ones – avocado nutrition info.

Avocado Oil Benefits: When you are craving a glass of fruit juice, you should consider having a small piece of fresh fruit instead. This will curb your craving and it will also keep you full for much longer. If you must drink fruit juice, try to drink a diet or 100 percent natural version – avocado benefits for men.

Is Avocado Good for You: A great tip for living a healthier lifestyle is to eat a healthy breakfast. Breakfast is essential because if you start the day off right, you are more likely to continue to eat right throughout the day. Eat a muffin, a couple eggs and some fresh fruit. Avoid foods rich in sugar and calories, such as, pancakes with syrup – avocado oil health benefits.

Benefits of Eating Avocado: We eat vegetables both cooked and raw. Which is better? Raw vegetables have their advocates. But current studies show that most vegetables have higher nutritional value and are more digestible when cooked. Carrots and cabbage are tasty eaten raw, but many vegetables are palatable only when cooked. Steaming is the best method to retain food value – avocado seed benefits.

Nutrition Facts Avocado: Try to get more calcium and vitamin C into your body. Calcium helps your bones to become stronger and a you get older, bones tend to become more brittle. Calcium will help reverse that. Vitamin C can help fight off infections and colds by helping your white blood cells – avocado benefits for skin.

Benefit of Avocado: Vegetables are one of the cornerstones of proper nutrition. To be sure that your daily vitamin and nutrient requirements are met, eat a wide variety of vegetables in as many colors as you can throughout the day. For instance, try eating green broccoli, red peppers and orange carrots to vary the types of vitamins that your body is getting. Aim for eating at least three servings of vegetables each day – avocado health.

Benefits of Avocado Oil: Rice is one of the most convenient foods that you can have, as it is very easy to make & goes with a wide variety of foods. Instead of white rice, choose brown rice, as it is healthier for your body and contains a lower level of fat content upon consumption – why is avocado good for you.

Nutrition Avocado: There are more than a few competing ideas about what proper nutrition is. However, you don't really have to subscribe to any of them. As long as you're eating a balanced & nutritious diet, preferably with the help of the tips you've learned from this article, you'll be well on your way to proper nutrition – what are avocados good for.

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