Monday, July 13

HEALTHCARE DATABASE & PATIENT PRIVACY

In our national edition, we have pointed out that the plan for a national health database would expose patients to illegal or improper prying by government (including law enforcement), potential employers or insurance companies. All they would need was the proper medical cover. Supporting this thesis is the note in the story below that "Mental health diagnoses, substance abuse treatment and HIV status are not included." If the system is truly secure, why should these be excluded? How can one be sure for whom the inquiring doctor is really working when the data is tapped? The fact that the exemption is noted indicates that it is already a concern.

Fierce Health IT - The state of Maine will soon go line with a statewide health records network connecting 15 hospitals, three clinics and the state's Center for Disease Control and Prevention. This puts the state second in line only to Delaware, whose system only exchanges laboratory data.

The two-year program, known as HealthInfoNet, attempts to prove that giving providers a real-time stream of electronic patient information can lower costs and improve quality of care. The state also expects to use the system to track outbreaks of infectious diseases such as the H1N1 swine flu, Lyme disease and tuberculosis.

The system already houses information on 400,000 Maine patients from affiliates of Eastern Maine Healthcare Systems, Central Maine Healthcare, Maine General Medical Centers and Maine Health. It also includes data from medical practices affiliated with Martin's Point Health Care in Portland.

Bangor Daily News - The primary goal is to allow a doctor in Portland, for example, to treat an unfamiliar patient from Presque Isle with ready access to that patient's updated medical information such as chronic illnesses, allergies, prescription medications, recent laboratory and imaging test results, surgeries and more.

Mental health diagnoses, substance abuse treatment and HIV status are not included.

Patient information from participating clinical sites was added to the HealthInfoNet system starting in December. The information is added and updated unless individual patients "opt out" - formally decline inclusion. Culver said information about HealthInfoNet - and how to opt out - continues to be provided in waiting rooms, at registration desks and in other patient areas.

"Our goal has been to make consumers aware, to provide them with enough facts to make a good decision about whether this is for them or not," Culver said. The decision to opt out can be exercised at any time, he added.

"If you wake up tomorrow and tell us you don't want to be in, we remove any clinical data that's already there and block any new data from going in," he said. About 2,000 Mainers have opted out of the system so far.

At the federal level, the Obama administration has dedicated $2 billion for state-level projects such as HealthInfoNet. . .

CLIMATE CHANGE'S TOLL ON MAINE'S SALT MARSHES

Science Daily - Global warming may exact a toll on salt marshes in New England, but new research shows that one key constituent of marshes may be especially endangered.

Pannes are waterlogged, low-oxygen zones of salt marshes. Despite the stresses associated with global warming, pannes are "plant diversity hotspots," according to Keryn Gedan, a graduate student and salt marsh expert at Brown University. At least a dozen species of plants known as forbs inhabit these natural depressions, Gedan said. . .

Gedan and her adviser, Mark Bertness, chair of the Ecology and Evolutionary Biology Department at Brown, decided to find out how global warming may affect pannes. In a series of experiments published in Ecology Letters, the pair subjected plots of forb pannes to air as much as 3.3 degrees Celsius (about 6 degrees Fahrenheit) warmer than the surrounding area.

They found that the plants in the test plots responded initially by growing more but then began a rapid die-off. As they died, they were replaced by a salt marsh grass, Spartina patens. At two sites - Nag Creek (Prudence Island, Rhode Island), and Little River (Maine) - the forbs covered less than 10 percent of the plot, from 50 percent originally, in tests that spanned the summer from 2004 to 2006. At the third site, Drakes Island (Maine), the forb pannes cover decreased from 50 percent of the plot to 44 percent (a 12-percent decline) in just the summer of 2007.

The researchers believe the forbs disappeared due to changes in the plant-water balance in the zone. What that means, Gedan explained, is the warmer air causes the forbs to take in more water, thus making the area less waterlogged and more hospitable to an invasion by Spartina patens, which prefers less water-soaked conditions.

"The forbs basically engineer themselves out of their habitat by making it more favorable for their competitor," said Gedan, the paper's lead author.

In New England, pannes range from Connecticut, where they make up less than 10 percent of a salt marsh's area, to Maine, where they can comprise some 40 percent of the salt marsh ecosystem, according to Gedan.

THE RETURN OF JOHN CACOULIDIS

Tux Turkel, Portland Press Herald - The new owner of the Portland Press Herald properties in Portland said that he hopes to build a 1 million-square-foot office complex downtown if Boston insurance companies he's talking with decide to expand to the city. Construction would take roughly four years after government approvals are in hand, said John Cacoulidis, president of Grand Metro Builders of New York Corp., which is based in Jericho, N.Y. Cacoulidis' comments came moments after he completed his purchase of the Press Herald properties from Maine Today Media Inc., the newspaper's new owner. The developer said last month that he wanted to build a 30-story tower at 385 Congress St., the site of the Press Herald's former printing plant. The 2.3-acre site holds an unoccupied building and a parking lot. . .

Cacoulidis has been heavily involved in Portland's real estate scene, with mixed results. In 2001, he presented plans for a hotel and convention center on a 22-acre parcel he acquired at Spring Point in South Portland. The project called for twin 35-story towers and a 300-foot-high cable-car system to take passengers across Portland Harbor. He was unable to get city permits for that project, or permits for a scaled-down version presented to city officials in 2003. . .

Mark Peters, Portland Press Herald, 2004 - In his mind, John Cacoulidis returns to Greece each year. The New York developer can easily afford to fly to the country he left five decades ago, but his constant need to work, build and earn prevents him from going. "There are opportunities every day if you are willing to work," Cacoulidis said. . .

When he bought a nine-story office building in downtown Portland last June, he paid $13.5 million - in cash, he said.

His American dream, however, has been viewed by some in southern Maine as a local nightmare.

This conflict was clear last week when a Canadian energy company announced it wants to build the state's first liquefied natural gas terminal on an island Cacoulidis owns in Casco Bay. The proposal drew the ire of residents of Casco Bay islands, who immediately raised concerns about the safety, environmental impact and aesthetics of an LNG project. Some directed their anger at Cacoulidis, accusing him of trying to make a profit at their expense.

Three years ago, he got similarly negative reaction when he proposed twin 41-story hotel towers on South Portland's waterfront. He also has created tension with Cumberland by pushing to have Hope Island secede from the town to cut his tax bill.

Greg Boulos, a partner in CB Richard Ellis/The Boulos Company, who is Cacoulidis' real estate representative locally, described his client as "a lightning rod for controversy."

Cacoulidis came to Maine in 1993 after reading an ad in a New York newspaper for Hope Island. Two hours after seeing the island, he bought it for $1.3 million. In the last decade, he has created a private world on the 89 acres of rock and trees off the coast of Cumberland.

The island now includes a road network, artificial lakes, a stable with 14 stalls, a chapel, tea room, helicopter pad and mansion. Cacoulidis lives on the island part time, splitting his time between Maine and Long Island, New York. . .

Cacoulidis said he is confused at times that he does not get more of a welcome in Maine, because he sees his projects as a way to stimulate the economy and bring jobs to a state struggling with job growth. . .

Al Diamon, Portland Phoenic, 2004 - Cacoulidis, a wealthy New York developer, first came to public attention in Maine in 2002, when he proposed building twin 640-foot towers on the South Portland waterfront as part of a hotel/convention center/hospital complex that would be connected to Portland by cable cars across the harbor. Development officials had to take him aside and explain the project was, um, eccentric.

Next Cacoulidis and his wife complained about the property taxes they paid for their private island off Cumberland. When town officials were less than sympathetic, Cacoulidis asked the Legislature to allow the island to secede and form its own municipality, population: two. The bill was killed after being referred to the Joint Standing Committee on Eccentricities. . .

MAINE NOTES

Lyme disease is up 72% in Maine between 2007 and 2008 with over 900 cases. This follows a 52% increase in 2007 says the state Center for Disease Control & Prevention.

WABI - The owner of a topless coffee shop that burned down wants permission to build a replacement shop. Donald Crabtree owns the Grand View Topless Coffee Shop in Vassalboro. It was destroyed in an arson fire last month.

Lynne Williams, former State Chair of the Maine Green Independent Party, and a Bar Harbor attorney, will formally declare her candidacy for Governor on July 15 in Portland and Bangor. Williams will hold a press conference at the Portland Public Market, Monument Square, Portland, at 11 am. She will then travel to Bangor and will hold a 4 p.m. press conference at Nonesuch Farm, a B & B and working farm, located at 59 Hudson Road, in Bangor.

New Agenda - Williams favors wind energy farms in urban areas but opposes them in rural areas. She believes that wind farms actually do more damage to the wildlife and the ecosystem than intended. Her strongest opponent has been the company First Wind. . . She believes the decentralization of power and giving the communities and individuals more independence control over their lives; this independence will lead to both economically and ecologically sound choices.

As of June, Maine foreclosures were up 13% over January with the biggest increase in Portland, Bangor and Westbrook. Foreclosures decline slightly in Auburn and Sanford.

Two Maine builders of classic yachts

Peaks Island now has a taxi

Trout Unlimited Camp

Dealing with mosquitoes

PS: DON'T TRY THIS AT HOME

So far as we know, female horseshoe crabs are as wild in Maine as in Delaware

Louisa Jonas, NPR - On the Delaware Bay shore, there's a swinging party that's been taking place for millions of years.

If you're a female horseshoe crab, then it's your night. You'll swim to shore, meet a special someone and he'll clasp onto the back of your shell. You and he will crawl onto the beach together, where you'll spawn at high tide under the light of the full moon.

But the mate attached to your shell is not your only tryst. On this night, you will mate with up to 13 males, all at the same time. Thousands of horseshoe crabs will pile on top of one another, glistening shells covering the beach for miles.

"We just love the whole phenomena of how once a year, for a season, they do this incredible mating on the beach," Keith Rutter says. "I don't know how anybody can watch this and not get excited about nature and science and how things work in the world."

Rutter and his family didn't travel from Silver Spring, Md., to Delaware's Pickering Beach just to watch the orgy. They came here to count.

The Delaware Bay shore is the site of the largest horseshoe crab spawning in the world, but in the 1990s the horseshoe crab population in the bay plummeted. So on this night, at the world's epicenter of horseshoe crab sex, volunteers in headlamps and waders will tally up the amorous crabs.

Horseshoe crabs are weird, like armadillos of the sea. Their shells look like armored helmets and their tails resemble swords. And then there are the eyes. They have 10 of them - including one on that spiked tail that helps them tell time. Their strange design is time-tested; they haven't evolved much for more than 400 million years. We're talking before the dinosaurs - before flying insects, even.

Scientists call horseshoe crabs living fossils. Master generalists, they've survived asteroids, volcanoes and ice ages. But on the beach, there's no such thing as safe sex. About 10 percent of crabs die upside down when they can't right themselves during spawning. . .

In one sitting, each female lays about 4,000 tiny green eggs that look like clumps of pesto in the sand. In a few weeks, only the luckiest of eggs will hatch and billions of eraser-sized horseshoe crab babies will wash into the bay.

Recent surveys suggest that the horseshoe crab population may be stabilizing, and everyone here hopes this latest count will show an increase in spawning. The crabs themselves are certainly doing what they can; even after the tide recedes, a few determined, solitary males patrol the beach, still scanning the deserted sand for a mate.

MORE EXOTIC CREATURE SEX

Having recently covered the sex life of porcupines and horseshoe crabs, we can't avoid including Ogden Nash's analysis of turtles:

The turtle lives twixt plated decks
Which practically conceals its sex.
I think it clever of the turtle
In such a fix to be so fertile