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As authorities in Ohio try to pin down a motive for the weekend's second U.S. mass shooting and dig into the slain shooter's life, what they find might also help answer another big question looming over the tragedy: What, if anything, could have stopped it? Police say the gunman was wearing a mask and body armor when he shot and killed his younger sister and eight others after the pair had arrived together with a friend earlier Saturday evening at a popular entertainment district packed with people. (Seewer, Sewell and Minchillo, 8/5)

“Honestly, and I have to say unfortunately, because we have had so many of these incidences, there is a bevy of mayors who are able to give great advice and feedback,” Dayton Mayor Nan Whaley said during a Sunday afternoon briefing. “I think that’s quite frankly a little sad, if you think about it, that they’ve learned so much because all of their communities have gone through these terrible mass shootings.” She called the deaths in her city “completely preventable,” in an earlier phone interview with NBC’s “Meet the Press.” “We’re city No. 250,” she said. “How many more cities have to go through mass shootings before somebody does something to change the law?” (La Ganga, Etehad, Monetero and Hennessy-Fiske, 8/4)

Among the victims killed in the barrage of gunfire outside Ned Peppers, a popular spot in Dayton, Ohio, was the gunman’s sister, a 22-year-old college student described as “bubbly” and “outgoing.” Investigators had not determined on Sunday evening whether the gunman, armed with a military-style rifle and clad in protective armor, had specifically targeted his sister or anyone else in the crowd. (Stockman and Bogel-Burroughs, 8/4)

In El Paso, Texas, a lone gunman walked into a crowded Walmart Saturday morning, shooting with an AK-style semiautomatic rifle. Authorities were investigating the shooting, which killed 20 and injured 26 more, as a possible case of domestic terrorism and a hate crime because officials believe the suspect, a white man, was targeting Hispanics. He has been charged with capital murder. (Hobbs, Maher and Bauerlein, 8/5)

El Paso Police Sgt. Robert Gomez said police arrested the man without incident near the Walmart next to Interstate 10 on the east side of the city. Gomez did not identify the man, but CNN and other news outlets, citing multiple sources, have identified him as 21-year-old Patrick Crusius of Allen, north of Dallas — more than 650 miles from El Paso. Gomez said police don't believe there were other shooters — but he said they are still investigating. "This is unprecedented in El Paso," Gomez said.(Aguilar and Blanchard, 8/3)

In a country that has become nearly numb to men with guns opening fire in schools, at concerts and in churches, the back-to-back bursts of gun violence in less than 24 hours were enough to leave the public stunned and shaken. The shootings ground the 2020 presidential campaign to a halt, reignited a debate on gun control and called into question the increasingly angry words directed at immigrants on the southern border in recent weeks by right-wing pundits and President Trump. “It’s outrageous,” said Terrion Foster, who works in accounting and lives in Kansas City, Mo., where he was out shopping at a farmer’s market near downtown on Sunday afternoon. “It’s really sad because I feel like you can’t go anywhere and be safe. I’m 50 years old and I didn’t think I’d be alive to see some of the things that are going on today.” (Robertson, Bosman and Smith, 8/4)

The weekend’s violence rekindled an array of other national arguments: over gun rights, over pop culture, over social media and over what constitutes terrorism. Amid the overwhelming tragedy of the shootings, the El Paso incident drew special attention to the problem of lone-wolf shooters and whether they should be viewed as isolated actors — “sick people,” in the words of White House chief of staff Mick Mulvaney — or as part of a larger, ideologically driven movement. “These are not single shooters,” said Daniel Okrent, author of “The Guarded Gate,” a history of anti-immigrant bigotry in the United States. “They’re a mob with high-powered rifles, people who feel they’re part of something bigger. The technology has changed: A mob doesn’t have to get together in the street with torches anymore.” (Fisher, 8/4)

Prior to the mass shooting outside a Dayton bar that killed nine people, the Republican-ruled Ohio General Assembly had shown no appetite to consider legislation addressing gun violence. While lawmakers are moving on a bill to allow any law-abiding adult to carry a gun without a concealed-carry permit, no Republican-backed legislation to limit Ohioans’ access to guns has been introduced. Now, in the wake of what he called a “horrible day for Ohio,” first-year Gov. Mike DeWine said Sunday that “everything’s on the table” when it comes to potential changes in gun policy. (Ludlow, 8/4)

In the wake of Dayton's mass shooting Sunday, Ohio Gov. Mike DeWine was shouted down by a crowd of vigil attendees wanting action. As he took the stage in the Oregon District of Dayton, the location of Sunday's mass shooting, and commented on the size of the crowd gathered, he was met with chants. "Do something!" the crowd chanted over and over. (Knight and Balmert, 8/4)

More than a dozen years ago, pro-gun legislators -- fueled by the NRA and Buckeye Firearms Association – passed House Bill 347, which prohibited local governments from passing any regulations more restrictive than those passed by the Ohio legislature. The bill nullified ordinances already in effect in cities such as Cleveland, which had enacted a ban assault weapons. (MacDonald, 8/4)

Tears ran down the cheeks of some visitors to the Levitt Pavilion Dayton during Sunday afternoon’s vigil, as people sang songs and hymns and talked about the importance of uniting and helping the community heal. “We will not succumb to fear,” said Caleb Ingram, the executive director of Declare Worship Community. “I don’t want to hear people say, ‘Oh, we can’t go to Dayton anymore, we are afraid of what might happen. We can’t go to Levitt Pavilion anymore, we are afraid. We can’t got to the Oregon District anymore. We afraid.’ We are not going to give fear an opportunity.” (Frolik and Kelley, 8/4)

They were there to mourn those killed early Sunday morning outside a popular Dayton bar. One of victims was the sister of suspected shooter Connor Stephen Betts, 24, of Bellbrook, southeast of Dayton. Pastor Joel Burton with Simple Street Ministries directed the informal gathering, as dozens more filed in and around the concert venue, and started off with a simple message before leading the crowd in prayer. (Doyle, Woods, Sullivan, 8/4)

Many in the crowd were wearing "Dayton Strong" shirts and tanks, which were printed back when tornadoes swept through the area in May. "Unfortunately I need to wear it again because we have to be strong again," David Coon said. "We were strong when the tornadoes came through, when the KKK came to town, and we’ll stand up against this." (Bailey, 8/4)

More than 600 miles and a time zone away from El Paso, Hispanics in the Dallas area continued their Sunday routines after at least 20 people died  in an attack that has been blamed on anti-immigrant rage. But the massacre was never far from their minds. When Cristal Gonzalez heard about the mass shooting, she immediately texted her friends from El Paso who live near the Walmart where the shooting occurred. They were safe but spent hours in a lockdown. (Jimenez, Vizcaino and Mendez, 8/4)

El Paso is a border community unaccustomed to such large-scale acts of violence. And for many residents of El Paso — an epicenter of another of the nation's most divisive issues, immigration — the gruesome attack not only underscored the need to restrict access to high-caliber weapons like the one used by the alleged assailant, it also represented a clear and direct assault on the city's diversity and its standing as a welcoming community for migrants. (Montoya-Galvez, 8/5)

Neil deGrasse Tyson is facing backlash online after he tweeted about gun deaths over the weekend.In the tweet, the astrophysicist and author coolly referred to the mass shooting deaths in Ohio and Texas, suggesting they pale in comparison to deaths from other causes, namely illness and accidents. (Silverman, 8/5)

A tally of a mass shooting could be written in countless ways. The term is not a legal one — which means that definitions fluctuate. The Gun Violence Archive, a nonprofit that tallies gun violence in the United States, defines a mass shooting as four or more victims shot or killed. Some media outlets use three fatalities as a baseline for a mass shooting; others four. The topic is widely debated. (Miranda, 8/4)

A list of some of the deadliest mass shootings in the United States in the last two years. (8/4)

The shootings in Texas and Ohio that killed at least 29 people over the weekend left authorities searching for how to confront the challenges posed by mass violence and domestic terrorism, especially attacks driven by white-nationalist ideologies. Violence committed by white men inspired by an extremist ideology makes up a growing number of domestic terrorism cases, according to the Federal Bureau of Investigation. Of about 850 current domestic terrorism cases, 40% involve racially motivated violent extremism and a majority of those cases involve white supremacists, the FBI said. (Frosh, Elinson and Gurman, 8/4)

President Trump has relentlessly used his bully pulpit to decry Latino migration as “an invasion of our country.” He has demonized undocumented immigrants as “thugs” and “animals.” He has defended the detention of migrant children, hundreds of whom have been held in squalor. And he has warned that without a wall to prevent people from crossing the border from Mexico, America would no longer be America. “How do you stop these people? You can’t,” Trump lamented at a May rally in Panama City Beach, Fla. Someone in the crowd yelled back one idea: “Shoot them.” The audience of thousands cheered and Trump smiled. Shrugging off the suggestion, he quipped, “Only in the Panhandle can you get away with that statement.” (Rucker, 8/4)

The president made no mention of white supremacism on Sunday and focused instead on mental illness. He also didn't say anything about the critics laying blame at his feet, but appeared to allude to it by noting that “this has been going on for years. For years and years in our country.” He demurred when asked what his administration planned to do about the shootings. He said he would be making a statement on Monday morning, though Trump has always struggled with the role of a president who consoles the nation during tragedies like these. (Oprysko, 8/4)

“We are treating [the El Paso shooting] as a domestic terrorism case and we’re going to do what we do to terrorists in this country, which is deliver swift and certain justice,” said John F. Bash, the U.S. attorney for the Western District of Texas, at a news briefing. He said the possible charges — including hate crimes and firearms charges — could carry a death sentence. (Gowen, Berman, Craig and Natanson, 8/4)

The FBI insists it is fully engaged in combating the threat of violence from white supremacists, but some former federal officials charge that the government is still coming up short in the face of a strain of American terrorism that now seems resurgent. The weekend massacre at a Walmart and shopping center in El Paso has focused public debate once again on the issue, after federal prosecutors called it an act of domestic terrorism. (Barrett, 8/4)

Field offices will be actively working to identify threats similar to the attacks last week at local food festival in California, a Walmart in Texas, and an entertainment district in Ohio, the sources said. A command group at the bureau's Washington headquarters will oversee the effort, the sources said. The agency said it was concerned that US-based domestic violent extremists could become inspired by the attacks to "engage in similar acts of violence." (Maxouris, Campbell and Perez, 8/5)

The online message board 8chan, which has been linked to three mass shootings in 2019, will be terminated, Cloudfare announced late Sunday night, just hours after the site's founder called for its end. Cloudfare will cut off services for 8chan at midnight PDT, CEO Matthew Prince said in a statement, though he noted that another network provider could bring 8chan back online. That's what happened in 2017, when Cloudfare booted The Daily Stormer, a neo-Nazi message board. (Culver and Lam, 8/4)

In less than 24 hours on Saturday and Sunday, two mass shootings in El Paso, Texas, and Dayton, Ohio, have left at least 29 people dead. The back-to-back massacres are raising questions about the role of social media platforms in spreading content that promotes violence and white supremacist ideologies. Facebook, Twitter, and Youtube have been slow to take action against white supremacist users and posts on their platforms, but over the past year, they finally began taking a series of actions and implementing some policy changes that target this kind of content. It doesn’t seem to be working yet. (Ghaffary, Molla and Stewart, 8/4)

The El Paso shooting sent shock waves onto the campaign trail for next year's presidential election, with most Democratic candidates repeating calls for tighter gun control measures and some drawing connections to a resurgence in white nationalism and xenophobic politics in the United States. Several 2020 candidates said Trump was indirectly to blame."Donald Trump is responsible for this. He is responsible because he is stoking fears and hatred and bigotry," U.S. Senator Cory Booker said on CNN's "State of the Union." (Chiacu and Schroeder, 8/4)

Democratic presidential candidates expressed outrage Saturday that mass shootings have become chillingly common nationwide and blamed the National Rifle Association and its congressional allies after a gunman opened fire at a shopping area near the Texas-Mexico border. “It’s not just today, it has happened several times this week. It’s happened here in Las Vegas where some lunatic killed 50 some odd people,” Vermont Sen. Bernie Sanders said as he and 18 other White House hopefuls were in Nevada to address the nation’s largest public employees union. “All over the world, people are looking at the United States and wondering what is going on? What is the mental health situation in America, where time after time, after time, after time, we’re seeing indescribable horror.” (Price and Ronanye, 8/4)

The back-to-back mass shootings in Texas and Ohio—one of which authorities are investigating as a possible hate crime—thrust back into the national spotlight the debate over gun-control laws, which is likely to dominate the presidential campaign in coming days even as legislation faces steep odds of passing. Democrats on Sunday criticized Senate Republicans for opposing legislation they said would help prevent mass shootings and accused President Trump of using rhetoric that helped incite the violence. Republicans expressed outrage at the weekend shootings that killed 29 people but offered few signs of wavering on their opposition to new gun laws. (Ballhaus, Kiernan and Andrews, 8/4)

The immediate aftershocks of the shootings were felt by the three candidates whose home states were affected: Tim Ryan in Ohio, and Beto O’Rourke and Julián Castro in Texas. Struggling in the polls and unable to command significant coverage, all found themselves over the weekend the subject of intense media interest as they abandoned the campaign trail, canceled events and headed home amid a crush of national and local interest. The shootings also heightened the stakes for an upcoming gun violence forum for the Democratic candidates, all of whom blanketed television, radio and social media over the weekend to highlight their gun control plans, to call on the Republican-led Senate to come back from summer break to pass gun safety legislation, and to attack President Trump’s rhetoric on immigration. (Caputo and Siders, 8/4)

The political momentum in the gun control debate has shifted in the year leading up to this weekend’s mass shootings in El Paso and Dayton, Ohio, with gun control advocates taking a more empowered stance and the National Rifle Association consumed by internal power struggles. The major gun control organizations, propelled by funding from supporters like Michael R. Bloomberg, the former New York City mayor, and grass-roots networks across the country, have helped enact new laws — mostly in Democratic-controlled states — and, for the first time in 25 years, passed a significant gun control bill in the House. (Epstein, Astor and Hakim, 8/4)

Chicago's Mount Sinai Hospital temporarily stopped accepting patients Sunday morning because they were at capacity following a series of shootings, a hospital official said. The hospital went "on bypass" in the early morning, said Roberta Rakove, Senior VP for External Affairs. Hospitals use the term "on bypass" when they stop accepting ambulance runs and those ambulances are diverted to other trauma centers. Mount Sinai Hospital is one of five trauma centers in Chicago, according to Rakove. (Thompson, Ly and Joseph, 8/5)

About 1:20 a.m., a group of people were gathered in Douglas Park in the 2900 block of West Roosevelt Road when someone opened fire from a black Camaro, Chicago police said. A 21-year-old man was hit in the groin and taken to Mount Sinai Hospital in critical condition, police said. A woman, 25, was struck in the arm, leg and taken to the same hospital where her condition was stabilized. Another woman, 22, was also hit and taken to Mount Sinai, police said. Her condition was stabilized. A 20-year-old man and a woman, 19, were taken to Stroger Hospital, police said. The man was hit in the right side of the body and the woman was struck in the leg. Their conditions were stabilized. (8/4)

Seventy years ago, before Medicare existed to inspire "Medicare for All," a Democratic president wrestled with a challenge strikingly similar to what the party's White House hopefuls face today. Harry Truman, then in his fourth year of pressing for a national health insurance system, parried criticism of his approach in terms that a single-payer health care advocate might use in 2019. The plainspoken Missourian wrote in a 1949 message to Congress that his proposal "will not require doctors to become employees of the government" and that "patients will remain free to choose their own doctors." (8/5)

Democratic presidential candidates' tussle over health care reform continued Saturday as they pitched themselves to Nevada union members, with former Vice President Joe Biden declaring he's "against any Democrat who wants to get rid of Obamacare" and Sen. Kamala Harris saying no Democrat should be on the debate stage without a plan to cover everybody. They were among 19 candidates speaking at a forum held by the nation's largest public employees union in the state that will cast the first votes in the West in next year's primary. (Price and Ronayne, 8/3)

Another frequent topic was health care. The labor movement doesn’t have a unanimous view on the topic, an issue that has also divided the Democratic field. AFSCME supports a single-payer health-care system, and union leaders said they’re telling candidates they want to be part of any discussions about changing the current system. Warren, who supports Medicare-for-all, spoke directly to AFSCME’s desire to be part of the negotiations for a new system when she said: “As I see it, is the unions are at the table, nobody does anything without working people well represented.” (Linskey, 8/3)

Janelle Fisher, 36, a licensed psychologist from Sacramento, is enthusiastic about single-payer health care. “Oh goodness, that should be a right,” she said. “Everyone should have access to health care that actually fits their needs and doesn’t leave them saddled with all this debt or having to file bankruptcy.” That said, Sanders’s Medicare for All isn’t her favorite version of it. “To be honest, Kamala Harris’s plan stood out to me,” she said. Fisher thought the California senator’s 10-year rollout was more realistic than Sanders’s four-year timetable. “At the end of the day, Medicare for All is such a huge, gargantuan plan to enact, and it’s not gonna happen overnight. But little by little, it can be something really fantastic.” (Kinery, 8/5)

The Trump administration is considering releasing its long-promised health-care plan in the fall as part of a campaign strategy to offer an alternative to Democratic candidates who back Medicare for All, according to people familiar with the discussions. White House officials are discussing unveiling the proposal during a September speech in which President Trump would seek to draw a contrast with Democrats while reassuring voters the administration is prepared if the courts abolish the Affordable Care Act. The timing of the speech could shift, officials said. (Armour and Restuccia, 8/3)

One of the nation’s largest public charities steered financial aid to patients of its two biggest corporate donors — the dialysis chains DaVita and Fresenius — while denying help to people who used smaller, unrelated clinics, in violation of anti-kickback laws, according to a federal whistle-blower lawsuit unsealed this week in Boston. The charity, the American Kidney Fund, helps patients who need dialysis by paying their health insurance premiums and other costs for treatment. But under a longstanding federal agreement intended to prevent illegal kickbacks, the charity is supposed to provide help based solely on a patient’s financial need, and not favor companies that donate to it. (Abelson and Thomas, 8/2)

According to the whistleblower complaint, which was first unsealed on Thursday after the U.S. Justice Department declined to intervene, most of the American Kidney Fund's money goes toward helping patients pay for dialysis treatment through grants. DaVita and Fresenius are among the organization's biggest donors. When the American Kidney Fund became pressed for donations, it began restricting grants to only patients whose dialysis providers contributed to the fund, according to the lawsuit, which was initially brought in 2016 by a former AKF employee of 12 years. DaVita and Fresenius pressured the AKF to do so, according to the complaint, which was first reported by Bloomberg Law. (Livingston, 8/2)

“The Department of Justice has looked at this matter and decided not to pursue any action against DaVita,” company spokeswoman Courtney Culpepper said in an email. “Unfortunately, some health insurers seeking to avoid high-cost patients may continue to try to challenge charitable premium assistance. We, in turn, will continue to defend our patients’ right to access such assistance.” (Tozzi, 8/2)

The children's lawyer was incensed. Her two tiny clients — one of them blind — had been in a shelter for three months, separated from their mother. The family had traveled from Mexico to the United States, reaching Nogales, Arizona, on March 1, 2018. Officials at the border found that the mother, Nadia Pulido, had "credible" reasons for seeking asylum from an ex-partner who, she says, beat her and stalked her after their relationship ended. (Ferriss, Kodjak and Phillips, 8/2)

A Florida detention camp that has housed thousands of undocumented migrant children is emptying out, federal officials said Saturday. Health and Human Services Department spokeswoman Evelyn Stauffer said in an email that all children who had been at the facility are now either with family members or at smaller state-licensed centers. The camp has housed about 14,300 undocumented children in total since March 2018, the largest such facility in the country. (8/3)

Medical charities and crowdfunding have long helped fill the gaps for Americans who lack health coverage. Now, Americans who have insurance are increasingly turning to charity as a lifeline, as a revolution in health insurance has driven up deductibles more than threefold over the last decade, forcing tens of millions of Americans to delay care and make difficult sacrifices to pay medical bills. (Levey, 8/4)

Medicare officials on Friday said it would increase reimbursements to hospitals for expensive new medical technologies, including a high-priced therapy used as a last-resort treatment for patients with blood cancers. The Centers for Medicare and Medicaid Services issued a final rule raising payments for new technologies from 50 percent to 65 percent of estimated costs. CMS Administrator Seema Verma said the step would promote access to potentially lifesaving treatments and reduce uncertainty about payments for a cancer immunotherapy known as CAR T-cell therapy, among other new therapies. (McGinley, 8/2)

The Centers for Medicare and Medicaid Services finalized a rule Friday that will boost payments for rural hospitals and innovative treatments under Medicare in 2020. The final rule is expected to increase hospitals’ pay by $3.8 billion, or 3 percent, next year. CMS originally proposed a $4.7 billion, or 3.7 percent, increase. (Clason, 8/2)

Starting Oct. 1, rural hospitals across the U.S. will get the wage index boost they have long begged for, the CMS' said in its final rule on inpatient prospective hospital payments for fiscal 2020. The agency's original proposal would have made this change by redistributing money from the top 25% of hospitals—such as politically heavyweight states like California and New York. In the final rule, the CMS will instead decrease payments across the board and cap any cut at 5%. (Luthi, 8/2)

The 13 quality improvement organizations that are part of CMS' Quality Innovation Network are halting operations and laying off staff as they wait for the agency to renew their multimillion-dollar contract. The $960 million contract, which ended in mid-July, wasn't renewed and won't be until sometime between September and November, according to a CMS memo to the organizations last month. The CMS didn't offer a reason in the memo for the delay in funding, but an agency spokeswoman said in an email to Modern Healthcare that some of the work performed by the quality improvement organizations for the expired five-year contract isn't ending until Oct. 16. (Castellucci, 8/2)

Missouri’s law would rank among the strictest in the nation, all but requiring anyone carrying a fetus diagnosed with Down syndrome or spina bifida or even fatal genetic abnormalities to carry that pregnancy to term. The other option would be to seek an abortion in a less restrictive state, including clinics in neighboring Overland Park or in Granite City, Illinois. (Adler, 8/4)

A Florida state senator wants voters to decide whether a male-dominated state legislature should be allowed to limit a woman's access to abortion. State Sen. Lauren Book filed a bill that calls for a constitutional amendment that would prohibit the Florida House of Representatives and Senate from voting on a bill that would affect access to abortions unless at least half of the members of the chamber are women. (Call, 8/3)

Sober homes are in the business of housing some of society’s most fragile people as they navigate the delicate stages of early recovery. But no one is watching. Anyone can open a sober home — just hang a sign on your door and start collecting rent. In this regulatory void, Cleggett and countless others have set up shop. Protected from prying eyes, Cleggett has opened one home in which, Boston officials say, clients are crammed into overcrowded, unsafe rooms, and another where clients say they were told by staff without medical licenses to stop taking psychiatric medications and, instead, to pray. Two people under his company’s watch have died. “It’s a legal loophole that costs lives,” said Quincy City Councilor Brian Palmucci, who wrote an ordinance attempting to require sober homes in Quincy to register with the city after receiving complaints about homes in his district. “We have these charlatans who are taking advantage of the opioid crisis to get rich.” (Allen, 8/3)

OxyContin maker Purdue Pharma on Friday sought to minimize its role both in the opioid addiction crisis and as a player in the painkiller industry as it asked a Massachusetts judge to dismiss a lawsuit from the state. The state alleges the company’s deceptive marketing of its drugs spawned the opioid epidemic in Massachusetts, but a lawyer for the company pushed back against that claim. (Joseph, 8/2)

Massachusetts took Purdue Pharma LP to task in a Boston courtroom Friday, blaming the opioid maker and the billionaire Sackler family that owns it for causing “thousands of people to suffer and many to die.” The state has proof Purdue targeted doctors to prescribe large volumes of high-dose pills to their patients, Assistant Attorney General Sydenham Alexander III told the court. (Lawrence, 8/2)

ARCOS was a secret database. The powerful interests who knew all about it — the drug industry and the federal government, specifically — wanted to maintain that secrecy. ARCOS, for Automation of Reports and Consolidated Orders System, was established by the Drug Enforcement Administration to track the manufacture and distribution of prescription drugs, including billions of opioid painkillers that have sparked a deadly epidemic. (Achenbach, 8/2)

The prescription opioid tsunami struck hardest in working-class communities in the Appalachian Mountains regions of West Virginia and Kentucky. But it also has taken a toll in Connecticut. Between 2012 and 2018, 5,175 people died of accidental drug overdoses here. (Hamm, 8/4)

At the height of the opioid epidemic, enough prescription painkillers were distributed to Minnesota pharmacies for every state resident to have 156 pills, according to new government data made available by the Washington Post. The 842 million pills distributed between 2006 and 2012 came as hundreds of Minnesotans died of opioid overdoses. (Collins, 8/5)

This summer, Heartland High School, Ohio’s first recovery school for teens overcoming addiction or substance abuse, finally opened its doors to students after three years of planning. The private school hosted two weeks of summer programming in July for a handful of students, including Alyssa, and will hold two more weeks in August, starting Monday. (Neese, 8/4)

Juli Engel was delighted when a neurologist recommended a PET scan to determine whether amyloid — the protein clumps associated with an increased risk of Alzheimer’s disease — was accumulating in her mother’s brain. “My internal response was, ‘Yay!’” said Ms. Engel, 65, a geriatric care manager in Austin, Tex., who has been making almost monthly trips to help her mother in Florida. “He’s using every tool to try to determine what’s going on.” (Span, 8/2)

The nation’s largest group of pediatricians warned this week that racism can have devastating long-term effects on children’s health. A policy statement from the American Academy of Pediatrics is the first it has issued to its members on the dangers of racism. Doctors involved in the report said the current political and cultural atmosphere makes the work more urgent. (Wan, 8/2)

Excessive alcohol consumption is not safe for a person at any age, but it is particularly dangerous for older adults. And according to a study published this week, about one in 10 older adults is considered a binge drinker. “Binge drinking, even episodically or infrequently, may negatively affect other health conditions by exacerbating disease, interacting with prescribed medications and complicating disease management,” said Dr. Benjamin Han, the lead author of the study that was published on Wednesday in the Journal of the American Geriatrics Society. (Rueb, 8/2)

In a time of climate change denial and vaccine resistance, scientists worry they are losing public trust. But it's just the opposite, a survey released Friday finds. Public trust of scientists is growing. It's on a par with our trust of the military and far above trust of clergy, politicians and journalists. The survey by the Pew Research Center finds 86% of those surveyed say they have a fair amount or a great deal of faith that scientists act in our best interests. And that's been trending higher — it was 76% in 2016. (Harris, 8/2)

After years of seeing her granddaughter in jeans that were too long and too loose, Karen Bowersox searched hard for brands that would work for the girl and others with Down syndrome. None existed. "There was nothing that fit them," said Bowersox, of suburban Cleveland. Convinced that "people with disabilities are a forgotten population in the world," Bowersox, an entrepreneur with "no clue" about the garment industry, spent four years creating Downs Designs pants, "shaped and sized" for children and adults with Down syndrome. (Groer, 8/3)

What began as the tragic death of a young football player at Garden City Community College in western Kansas is now a matter for the United States Congress. The bill filed Friday in the U.S. House would create a commission to prevent "exertional heatstroke deaths among high school and collegiate athletes"— the cause of death for 19-year-old Braeden Bradforth. (Zeff, 8/4)

When we smear on sunscreen, dermatologist Kanade Shinkai with the University of California San Francisco says, most of us don't think about it getting under our skin. "I think there was an assumption that these are things that we apply to our skin — they don't really get into our bloodstream," Shinkai says. (Neighmond and Neilson, 8/4)

The Benioff Children's Hospital at the University of California, San Francisco is a sleek new building with state-of-the-art facilities — a place where the sickest children go for leading-edge treatments. Which is why it might be surprising to find Robyn Adcock, who practices acupuncture and acupressure walking the halls. (Kodjak, 8/5)

If the word “hospital” elicits a mental image of sterile rooms and hallways and dreary decor, think again. Modern hospitals have hit on a simple but effective way to foster even more healing: art. It’s a creative approach to an age-old need — and one that’s transforming not just the walls of modern hospitals but the atmosphere in which patients heal. In an engaging feature for Artnet, journalist Menachem Wecker dives into the world of hospital art. (Blakemore, 8/3)

Kaiser Health News: Superstar Athletes Popularize Unproven Stem Cell Procedures

Baseball superstar Max Scherzer — whose back injury has prevented him from pitching for the Washington Nationals since he last played  on July 25 — is the latest in a long list of professional athletes to embrace unproven stem cell injections in an attempt to accelerate their recovery. But many doctors and ethicists worry that pro athletes — who have played a key role in popularizing stem cells — are misleading the public into thinking that the costly, controversial shots are an accepted, approved treatment. (Szabo, 7/5)

Kaiser Health News: Kathy Brandt, A Hospice Expert Who Invited The World Into Her Own Last Days With Cancer, Dies

Kathy Brandt, a hospice industry leader who turned her own terminal cancer diagnosis into a public conversation about choices at the end of life, died Aug. 4. She was 54. Brandt’s death was announced on social media by her wife of nine years, Kimberly Acquaviva, 47, a professor of nursing and author of a book about hospice care for LGBTQ patients and families. “I wanted all of you to know that Kathy had a peaceful death and your love and support is what made that possible,” Acquaviva wrote in comments posted to Facebook. “Our family has felt your love and we can’t begin to tell you how much it’s meant to us.” (Aleccia, 7/5)

At least one million children and adults in the United States are allergic to sesame, an ingredient used in everything from hummus to snack bars, researchers reported on Friday. The finding indicates that sesame allergy is more prevalent than previously known, although still far less common than peanut allergy. But sesame is not among the allergens that the Food and Drug Administration requires manufacturers to list on food labels. (Athas, 8/2)

As the elderly man with an incurable cancer lay dying, he told his son he had only one regret. Rather than enjoying his last weeks of life with the people and places he loved, he had squandered them on drug treatments that consumed his days and made him miserable. Perhaps others can benefit from this man’s end-of-life insight. Too often, people with incurable cancers pursue therapy beyond any hope of benefit except perhaps to the pockets of Big Pharma. (Brody, 8/5)

The most recent effort to crush the largest measles outbreak in nearly three decades took place at a Brooklyn soccer field. As Latino players and fans showed up for a weekend tournament, Spanish-speaking health teams offered free vaccines to players and spectators, explaining the outbreak in predominantly Orthodox Jewish communities had spread in recent weeks and had sickened some Latino adults. “We know there’s a lot of adults who are unvaccinated,” said Paulo Pina, a doctor from NYU Langone Health who was part of the team. “It’s important that we vaccinate them, too, because this is New York: Everybody interacts with everybody.” (Sun, 8/2)

Kaiser Health News: The Real-Life Conversion Of A Former Anti-Vaxxer

Amid the contentious dispute over immunization requirements for children, Kelley Watson Snyder stands out: She has been both a recalcitrant skeptic and an ardent proponent of childhood vaccines. Snyder, a Monterey, Calif., mother of two, was a so-called anti-vaxxer for many years, adding her voice to those that rejected mandatory vaccinations for school-age children. She later realized she was wrong and in 2014 founded a pro-vaccination Facebook group called “Crunchy Front Range Pro-Vaxxers,” which she administers. It is an invitation-only site on which approximately 1,100 members exchange views and information. (Glionna, 7/5)

A Southern California hospital spent $72 million on a building designed to do two things after an earthquake: stay standing and stay open. But when a pair of strong earthquakes struck the region last month, the hospital couldn't use it. Structurally, the building was OK. But some broken pipes flooded a room of mechanical and electrical equipment, and water leaked into operating rooms and elevator shafts. The hospital in Ridgecrest, about 150 miles northeast of Los Angeles, had to evacuate the building as a precaution. (8/4)

Under expanded Medicaid – which covers anyone in the state making up to 138% of the federal poverty line, or $35,535 for a household of four – those who are deemed too infirm to conduct daily activities with ease are medically frail. The distinction has long been central: It used to determine what kind of health insurance Medicaid expansion recipients would receive. But under New Hampshire’s now-shuttered work requirement, it took on special importance: Those who were medically frail could suddenly become exempt. (Andrews and DeWitt, 8/3)

The Ohio Department of Medicaid is receiving $100 million to increase payments to mental health and addiction recovery providers, who say they have been financially struggling under changes made during the era of former Gov. John Kasich. The announcement was made official in an executive order signed this week by Gov. Mike DeWine. (Hancock, 8/2)

With the rise of Ebola in the Democratic Republic of Congo, Atlanta is once again at the center of containment efforts. The ongoing epidemic in the central African country has infected 2,659 people over the past year, killing more than 1,780, and is now the second-largest Ebola outbreak in history. (Oliviero, 8/2)

North Carolina's state health department is barred from allowing public funds to pay for conversion therapy for minors, a controversial practice aimed at changing young LGBT people's sexual orientations, under an order signed Friday by Gov. Roy Cooper. Advocacy groups praised the Democratic governor's executive order as a pioneering step to restrict the therapy in the U.S. South. (8/2)

Officials have declared a public health emergency over the rising number of hepatitis A cases in Florida, the latest part of the country dealing with outbreaks of the liver disease. Florida Surgeon General Scott Rivkees declared an emergency Thursday to allow the state to spend more on testing and treatment, saying Florida has had more than 2,000 cases since the beginning of the year compared with 548 all of last year. Most have been in central Florida, and health officials are still investigating the sources. (8/2)

Eleven Wisconsin teenagers and young adults have been hospitalized with severe lung damage that has been linked to vaping, and seven other cases are under investigation, state health officials said Friday. Counties with confirmed cases now include Door, Racine, Walworth, Dodge, Waukesha and Winnebago, officials with the state Department of Health Services said. (Spicuzza, 8/2)

State regulators Friday announced swift approval of plans by a medical device sterilizing company to implement pollution-reduction changes at its Smyrna facility. Sterigenics said earlier this week that it had just submitted an application for a permit for the proposed facility changes. (Boodman and Miller, 8/2)

Bastrop, Caldwell and Fayette counties are among 15 rural counties the university will be helping to build a framework of services for homeless individuals, which are more often seen in cities. Specifically, the university has received $400,000 from the Health and Human Services Commission — thanks to Senate Bill 1849, which was passed in 2017 — to help construct Healthy Community Collaborative programs for counties with populations under 100,000. (Mulder, 8/2)

Gov. Chris Sununu signed a bill Friday aimed at preventing youth suicides by requiring training for teachers and students. Suicide is among the leading causes of death for young people, according to the Centers for Disease Control and Prevention, and has become more common in New Hampshire over the past 20 years. The bill signed into law Friday directs local school districts to develop policies to prevent suicide, assess students at risk of suicide and respond to student suicide, as well as to provide training about youth suicide to staff and students. The bill passed with bipartisan support, and Sununu signed it into law Friday. (Albertson-Grove, 8/2)

That need has cities across the country wrestling with a major public health challenge: how to provide sanitation to growing populations of unsheltered people. San Francisco is staffing public toilets to serve homeless people. Washington, D.C., is conducting pilot programs to increase access to public toilets. (Spitzer, 8/3)

An unusual setup for the sale of a computer program — created by LSU employees and worth an estimated $50 million — put the daughter of an LSU Board of Supervisors member on both the board of the company contracted to make the sale and the university-affiliated nonprofit issuing the contract. It was an arrangement LSU President F. King Alexander says he knew nothing about. (Ballard, 8/3)

The state board that oversees Iowa’s medical cannabis industry has declined adding any new conditions to the list of approved uses in Iowa. The Medical Cannabidiol Board denied petitions to approve illnesses such as anxiety and schizophrenia at its meeting Friday. A decision whether to approve post-traumatic stress disorder was delayed until November. (Gerlock, 8/2)

If one of the perpetrators of this weekend’s two mass shootings had adhered to the ideology of radical Islam, the resources of the American government and its international allies would mobilize without delay. ...No American would settle for “thoughts and prayers” as a counterterrorism strategy. No American would accept laying the blame for such an attack on video games, like the Texas lieutenant governor, Dan Patrick, did in an interview on Sunday when discussing the mass shooting in El Paso that took 20 lives and left 27 people wounded. (8/4)

El Paso was an act of terrorism, but one that should drive us to cast fear aside and reinforce the fundamental principles and values of this country.  To preserve our values, we must first live by them. That means we need to combat terrorism, whether it be foreign or domestic. It also means that we need to take clear and convincing steps and act with urgency to stop mass shootings in on our communities.  (8/5)

The two mass shootings this weekend have inflamed a gun-control debate that never seems to go away and never seems to get resolved. In the span of less than 24 hours, El Paso, Texas, and Dayton, Ohio, joined a morbid parade of American cities and towns—places such as Littleton, Colorado; Virginia Beach, Virginia; San Bernardino, California; Las Vegas; and Pittsburgh—as sites of tragic, mass shootings. In the not quite eight months of 2019, there have been seven such attacks. After each one, political leaders of all stripes send their thoughts and prayers to the families of the victims, and Democrats and Republicans offer radically different responses. (Austin Sarat and Jonathan Obert, 8/4)

When one side proposes ways that human beings might begin to solve a deadly problem while the other side leaves it up to God, you know which side is right. When one side proposes solution after solution to contain gun violence — and offers compromise after compromise to get something done — while the other side blocks action every time, you know which side is right. When the president of the United States and his most incendiary media allies fuel hatred of those who are not white while his opponents say we should stand in solidarity with one another, you know which side is right. (E.J. Dionne Jr., 8/4)

Based on the increase in the U.S. population, there are now some one million people with serious mental illness living among the general population who, 60 years ago, would have been treated in state mental hospitals. Multiple studies have reported that, at any given time, between 40% and 50% of them are receiving no treatment for their mental illness. With the best of intentions and the worst of planning, America has emptied out its public psychiatric hospitals without ensuring that the released patients would receive the necessary treatment to control their symptoms. What did we think would happen? (E. Fuller Torrey, 8/4)

The motive of Saturday’s mass shooting in El Paso which left 20 people dead has not yet been confirmed by law enforcement. There is reason to believe, however, that before opening fire the shooting suspect published a short screed disparaging immigrants to the United States and warning of an “invasion” of Hispanics. That term is one that Trump himself has used to describe migrants seeking entry to the United States from Mexico. Trump has repeatedly hinted at meeting migrants with violence. In May, someone at one of Trump’s rallies in Florida replied to his rhetorical question about how the arrival of migrants could be stopped by saying they should be shot. Trump made light of the comment: “That’s only in the Panhandle you can get away with that statement.” (Philip Bump, 8/4)

His supporters may be correct that Mr. Trump’s opponents will not reciprocate by pushing back against the irrational elements on the left. But a President has a special role in the American system even if our politics has elevated the Presidency more than it should. Either Mr. Trump restrains his rhetoric or he will pay a consequential political price. Joe Biden’s theme of a return to “decency” and “normalcy” will resonate with even millions of Trump voters if Mr. Trump doesn’t change. (8/5)

In the last week, more than 30 people have died in three separate mass shootings in Gilroy, El Paso and Dayton, Ohio. We believe that analyzing and understanding data about who commits such massacres can help prevent more lives being lost. For two years, we’ve been studying the life histories of mass shooters in the United States for a project funded by the National Institute of Justice, the research arm of the U.S. Department of Justice. We’ve built a database dating back to 1966 of every mass shooter who shot and killed four or more people in a public place, and every shooting incident at schools, workplaces, and places of worship since 1999. We’ve interviewed incarcerated perpetrators and their families, shooting survivors and first responders. We’ve read media and social media, manifestos, suicide notes, trial transcripts and medical records. (Peterson and Densley, 8/4)

Sadly, we in the news media know just how to do it. When a mass shooting happens, even when it happens twice in a 24-hour period — even when the death toll soars into the dozens — we reflexively spring into action. We describe the horror of what happened, we profile the shooter, we tell about the victims’ lives, we get reaction from public officials. It’s difficult, gut-wrenching work for those journalists who are on the scene. And then there’s the next one. And the next one. (Margaret Sullivan, 8/4)

What is most horrifying about the killings in El Paso, Texas, where a man openly carrying a rifle strolled into a Walmart in a shopping mall and opened fire, killing at least 20 people and wounding another 40, is not that they happened. Nor even that they reflect a circumstance of American life that has become so mundane that politicians can pull a premasticated statement of “thoughts and prayers” out of their files and post it on Twitter even before the blood has dried. (Michael Hiltzik, 8/4)

Last week's Democratic presidential debates underscored health care as a defining policy division among the candidates. On one side, many of those who argue for radical change would tell you, are Democrats who want to preserve a status quo in which private companies suck profits out of sick and vulnerable people. Their alternative is killing off the insurance companies and providing universal, high-quality, government-controlled care. The description is simplistic. The Democratic field is unanimous in its desire to provide universal coverage; the candidates just disagree on how to get there. (8/4)

One afternoon about a year ago, just as the Senate began considering Brett Kavanaugh’s nomination to the Supreme Court, I logged on to Day Night Healthcare, an online pharmacy based in India, and ordered a pack of abortion pills. A few hours later, I got a call from a Day Night customer-service agent with a warning. If my credit-card company called to ask about the purchase, “tell them you approve the charge, but don’t say what it’s for,” the man advised. “If they ask, say it’s gym equipment, or something like that.” (Farhad Manjoo, 8/3)

Could an emerging technology reshape the battle lines in the abortion debate? Since Roe v. Wade was decided in 1973, that fight has been defined by the interlocking, absolute values of choice and life: For some, a woman’s right to choose trumps any claim to a right to life by the fetus; for others, it’s the reverse. But what if we could separate those two — what if a woman’s choice to terminate a pregnancy no longer meant terminating the fetus itself? (Zoltan Istvan, 8/3)

The physician burnout crisis that has spilled into the public conversation might actually be a blessing in disguise. Patients are now hearing about the struggles their physicians face, but doctors have silently been battling burnout all along. Patients may not realize that physicians care deeply and that our system is harming them as well. Ideally this might provide an opportunity to drive a patient-provider relationship closer towards a partnership. (Lara K. Ronan, 8/3)

Sickle cell disease affects about 100,000 Americans, most of them African-Americans. There are few treatments for it, and experts say not enough is being done to prevent complications. Just recently, the Centers for Medicare and Medicaid Services declined to put in quality measures that might help monitor care improvements. There is also a question about what role race and wealth play in how much attention and funding the disease receives. (Aaron E. Carroll, 8/5)

I glanced down and saw a pink rash on my upper left chest. At first, I thought it was insect bites — I had been walking outdoors more often once spring arrived. A few days later, the rash looked like small red pimples filled with liquid and had started to itch. I sprayed the rash with calamine, which felt soothing at first. But a few hours later, I felt I was being stung over and over again and I knew something was wrong. I made an appointment with my doctor for that afternoon. (Christine Lehmann, 8/3)

Early one Saturday, I headed to a “sugar detox” seminar at my gym. I didn’t expect it to be a hot ticket, but when I opened the classroom door every seat was taken. One was filled by “Grandma Teresa,” as she introduced herself, who had brought along her two granddaughters, ages 11 and 13, because “sugar is really bad and I want them to learn as much as they can when they are still young.” The other participants, all women from their 30s to 70s, said they wanted to curb their sugar intake for a variety of reasons — to ease a health struggle; to lose weight; or to reduce their risk of diabetes, heart disease, cancer and dementia. (Steven Petrow, 8/4)

During my training to become a primary care physician, the importance of preventive cancer screening was ingrained in me. The idea of catching cancer at an early stage so we can better treat it made intuitive sense. But as I’ve learned over the years, the simplicity of this concept can obscure its limitations and make it difficult to persuade older or sick individuals that screening can do them more harm than good. (Nancy L. Schoenborn, 8/5)

It’s Monday morning, and I’m the attending physician starting a week of inpatient hospital medicine. My patient list includes a man who at age 91 has outlived his siblings, his first and second wives and all of his peers. After seven decades of smoking, his lungs are failing; he carries a diagnosis of “severe emphysema.” The sign-out note from the previous doctor reads, “Daughter and son-in-law from out of town, we met multiple times last week to discuss goals of care.” (Amy Cowan, 8/4)

By pursuing “waivers” – flexibility in how Georgia administers Medicaid as well as the subsidies for care under the Affordable Care Act – he can make both programs work better and lower prices for Georgians. ...A waiver to help these Georgians could include a new state reinsurance program that subsidizes our sickest neighbors directly. (Kyle Wingfield, 8/3)