Current Events in June 2018

Kentucky has sued Walgreens for its role in the opioid epidemic, alleging that the pharmacy has been engaging in deceptive business practices in its large-scale shipment and sale of opioids at its Kentucky pharmacies for the past 10 years.

In a complaint filed Thursday, the state’s Attorney General Andy Beshear accused Walgreens of dispensing the drugs at “such an alarming rate and volume that there could be no legitimate medical purpose associated to their use.”

Beshear alleges that Walgreens’ 70 Kentucky pharmacies used “unlawful business practices” to fuel the epidemic in the state of Kentucky.

Accused of over-dispensing opioids

The lawsuit claims that for more than a decade, Walgreens filled "massive" and "suspicious" orders of opioids and failed to flag unusual orders or put a stop to the shipments. Beshear accuses the retailer of ignoring the deadly health crisis perpetuated by its practices for the purpose of making a profit.

Kentucky had 1,404 overdose deaths in 2016 and had the third highest drug overdose rate in 2015 behind West Virginia and New Hampshire, according to the complaint. Kentucky has the sixth-highest rate of opioid deaths in the country, according to data from the Centers for Disease Control and Prevention (CDC).  

“While Walgreens’ slogan was ‘at the corner of happy and healthy,’ they have significantly harmed the health of our families in fueling the opioid epidemic,” Beshear said in a statement. "While the pain of addiction and loss of a loved one may never heal, I want to make sure these billion dollar companies take responsibility and become a part of the solution."

Beshear wants Walgreens to stop "over-dispensing opioids" and "filling suspicious orders." The lawsuit also seeks damages and penalties, as well as an injunction.

Fighting the opioid epidemic

The lawsuit follows recent efforts made by companies to stem opioid misuse and abuse.

In January, Walmart introduced a way to safely destroy leftover opioids at home. Last month, the retailer pledged to propose a “solution” to the opioid crisis by implementing a new plan to restrict some opioid prescriptions to a seven-day supply with a maximum of 50 milligrams of morphine per day. CVS also started restricting first-time opioid prescriptions at seven days earlier this year.

Panera Bread’s grilled cheese sandwiches don’t come with peanut butter, but as a precaution, Elissa Russo says she advised a Massachusetts store that her daughter has a severe peanut allergy -- twice. She was ordering the meal online and had left warnings about her daughter’s allergy throughout the “comments” sections in the delivery portal.  

After the food arrived, Russo’s six-year-old took one bite into her grilled cheese and said it tasted funny. Her parents opened the sandwich and saw about two tablespoons of peanut butter inside. The girl was hospitalized and suffered post-traumatic stress from her near-death experience, her family said in 2016.

Now, the lawsuit that the Russos originally filed two years ago is set to head to a jury after a Massachusetts judge on Thursday rejected Panera Bread’s arguments that it should not be responsible for what happens at its franchise locations.

“A jury could find that a national chain was negligent based on how a franchise served a child with a food allergy,” the family's attorney told the Boston Globe on Friday.

Confused by order

The girl's father John Russo had said that the franchise manager initially blamed a confused worker with a language barrier for the mix-up, but Russo was unconvinced, noting that the word for “allergy” in both Spanish and Portuguese is the markedly similar “alergia.”

However, at a deposition last year, the worker who was reportedly responsible for making the sandwich said, through a Spanish translator, that she was “really confused” by the online order.

She admitted to putting peanut butter in the sandwich but portrayed it as a genuine mistake.

The Russo family is suing both the Panera Bread corporate chain and the owner of the franchise, PR Franchise Group, for negligence, assault and battery, and intentional or reckless infliction of emotional distress.

“This ought to be a warning bell to restaurants that it could be considered civil assault and battery to serve an allergen to someone who has a severe allergy,” the family’s attorney added to the Globe.

Fatal allergic reactions

Lawsuits accusing restaurants of poisoning patrons with food allergies typically don’t get very far if the judge presiding over the case buys the food industry's arguments that restaurant patrons are responsible for their own health.

But in several lawsuits in recent years, people suing restaurants have successfully convinced juries that they or their loved ones had taken extra steps to warn restaurant workers about their allergies, only to get burned anyway.

In Canada, a hunter said he was assured by his waitress that the cheesecake he wanted did not contain any nuts. His resulting allergic reaction cost the waitress and the local Travelodge $25,000 after a jury determined that the waitress hadn’t bothered to check an ingredients list in the kitchen indicating that the cheesecake contained walnuts.

And in the United Kingdom, a 38-year-old bar manager was found dead in his home, near a food container that had “no peanuts” written on it. The restaurant he ordered take-out from had switched from using almond powder to a cheaper, peanut-based nut mix in its Tikka Masala and did not tell consumers. Restaurant owner Mohammed Zaman was charged with manslaughter and sentenced to six years in prison in 2016 for the patron’s death.

Research has shown that food allergies are on the rise in children. Anecdotally, some parents of children with severe allergies have described facing snarky comments or worse from people who apparently don’t believe that their children’s allergies are real.

One study in the journal Pediatrics found that “bullying is common in food-allergic children.”

Insurance company Chubb has partnered with a startup called Sure to provide insurance coverage to users of ride-sharing apps Uber and Lyft, the Wall Street Journal reports.

Ride-sharing passengers in 38 states will be able to buy accident and death coverage on-demand through a smartphone app.

For $2.40 for a 24-hour period, a rider can get insurance that will cover $10,000 in medical costs and include a $100,000 death benefit for any accident or injuries he or she sustained while in the vehicle.

Adapting to new transportation trends

The on-demand insurance, which is being marketed under the name RideSafe, is part of an effort by insurance companies to create products and services for consumers who may be thinking of giving up their car in favor of increasing their use of ride-sharing services.

The “episodic” insurance aims to fill in any potential gaps in the liability insurance coverage currently provided by ride-hailing companies.

“There are many people, carriers and insurtech startups thinking of the implications of the ride-hailing world, the potential for gaps in insurance coverage and the opportunity to offer innovative new products,” Michael Halsband, a partner at law firm Drinker Biddle & Reath, told the WSJ.

The service works by connecting a rider’s Uber or Lyft account to the Sure Insurance app. Initial authorization of the coverage often takes less than 60 seconds, according to the company. Once coverage is authorized, the passenger’s ride is automatically insured.

Sure says on its website that future versions of its RideSafe offering will include coverage for passengers riding in autonomous cars, bicycles, and electric scooters used for ride-sharing.

The Centers for Disease Control and Prevention (CDC) released information on a salmonella outbreak that has affected 31 states. The culprit? Kellogg’s Honey Smacks cereal. 

On Thursday, the Kellogg’s company announced it would be voluntarily recalling 15.3 oz and 23 oz boxes of the cereal; it reports that no other cereals were affected by the infection.

According to the CDC, the illnesses from the outbreak started March 3 and lasted through May 28. Twenty-four people have been hospitalized, though no deaths have been reported. The majority of the outbreaks have occurred in Massachusetts, New York, California, and Pennsylvania.

Investigation of the outbreak

To find the source of the outbreak, CDC officials used epidemiological evidence, including patterns in the geographic distribution of illnesses, the time periods when people got sick, past outbreaks involving the same germ, foods or other exposures occurring more often in sick people than expected, and clusters of unrelated sick people who ate at the same restaurant, shopped at the same grocery store, or attended the same event.

Based on their findings, the Honey Smacks cereal was the likely cause of the infection. The CDC reported that 30 of the 39 people interviewed about the foods they ate in the week before getting sick all ate cold cereal, and 14 specifically reported eating Honey Smacks. Additionally, those who were sick reported eating Honey Smacks cereal more than any other cereal.

After the CDC and Food & Drug Administration (FDA) contacted Kellogg’s about the outbreak, the company immediately conducted their own investigation with the third-party manufacturer who produces Honey Smacks.

What to do next

While this investigation is ongoing and the CDC will provide updates when more information is available, both Kellogg’s and the CDC are encouraging consumers to throw away any boxes of the cereal with the affected UPC codes/dates: 3800039103 or 3800014810 dated from June 14, 2018 through June 14, 2019.

Kellogg’s also urges customers to contact the company to receive a full refund for the cereal.

After moving to paper straws instead of plastic in its locations in the UK and Ireland, McDonald's says it plans to test the use of paper straws at select U.S. locations later this year.

In March, the global fast food chain announced the phase-out of plastic straws in Europe in an effort to reduce its contribution to plastic pollution. Last month, McDonald's restaurants in the UK and Ireland began replacing plastic straws with ones made from recycled paper. It now says 100 percent of restaurants there will be using paper straws by sometime next year.

In addition to U.S. restaurants, some McDonald's locations in France, Sweden, Norway, and Australia will begin testing the use of paper straws later this year.

“McDonald’s is committed to using our scale for good and working to find sustainable solutions for plastic straws globally,” said Francesca DeBiase Executive Vice President, Global Supply Chain and Sustainability. “In addition to the exciting news from the UK today, we are testing straw alternatives in other countries to provide the best experience for our customers. We hope this work will support industry wide change and bring sustainable solutions to scale.”

Single-use plastic common at fast food restaurants

Fast food restaurants, in general, are huge users of single-use plastic. In addition to straws, a meal at a fast food restaurant might be served on a plastic plate, with a plastic top, with plastic utensils, wrapped in plastic.

It's bad enough that plastic tossed into landfills never degrades, but billions of tons of plastic have ended up in the world's oceans over the years. Straws are but a small part of plastic pollution, but they have garnered most of the attention in recent months.

Malibu, Calif., and a few other cities, have already banned the use of plastic straws at restaurants. The New York City Council is currently considering a similar proposal.

For its part, McDonald's say it is committed to tackling the issue, beginning with straws.

Straws only by request

"In addition to testing alternative materials, in several markets including Malaysia, we will begin tests to offer straws upon request only," the company said in a release. "We are eager to learn from these tests around the world to develop solutions that are scalable across the globe."

The company has set a goal of sourcing 100 percent of its food packaging from renewable or recycled sources in all of its locations by 2025.

The Food and Drug Administration (FDA) is stepping up its efforts to counter the growing epidemic of opioid addiction by approving the first generic version of the treatment drug Suboxone (naloxone).

FDA Commissioner Scott Gottlieb says making the drug in generic form will ensure that it reaches more people who need it. The drug is in the form of a thin film that is placed under a patient's tongue.

“The FDA is also taking new steps to address the unfortunate stigma that’s sometimes associated with the use of opioid replacement therapy as a means to successfully treat addiction," Gottlieb said. "Patients addicted to opioids who are eventually treated for that addiction, and successfully transition onto medicines like buprenorphine, aren’t swapping one addiction for another, as is sometimes unfortunately said. They’re able to regain control of their lives and end all of the destructive outcomes that come with being addicted to opioids."

Last month, the FDA approved the first non-opioid therapy for the management of opioid withdrawal symptoms. The drug Lucemyra treats symptoms common to withdrawal from opioids, including vomiting, muscle aches, and agitation.

The drug does not specifically counter addiction, but it can be part of a longer-term treatment plan by making it easier to stop using the addictive drugs. In approving the drug, the agency said the fear of experiencing withdrawal symptoms often prevents people with an opioid addiction from getting help.

Medicated-assisted treatment

The FDA says the approval of Lucemyra, along with this latest drug approval, is part of a strategy called medicated-assisted treatment (MAT), combining approved medications like methadone, buprenorphine, or naltrexone with counseling and other behavioral therapies.

The agency says regular MAT using buprenorphine reduces opioid withdrawal symptoms and the desire to use opioids, cancelling out the cycle of highs and lows often associated with opioid misuse or abuse.

Buprenorphine can also reduce the pleasurable effects of other opioids, making continued opioid abuse less attractive. The FDA cites Substance Abuse and Mental Health Services Administration data showing patients receiving MAT for treatment of their addiction are 50 percent less likely to suffer an early, preventable death.

The FDA said approval of generic versions of the drugs used in MAT therapies can lessen the cost and encourage the spread of MATs to counter the opioid crisis.

An official for the Securities and Exchange Commission (SEC) says the cryptocurrency Ether is not a security, a statement causing the digital coin's value to surge on trading platforms.

A cryptocurrency that is classified as a security, like stock in a company, would be subject to regulation by the SEC and other governmental bodies. Bitcoin has been labeled as a security, helping drag down its value -- along with most other digital coins -- so far in 2018.

William Hinman, head of the Division of Corporate Finance for the SEC, took part in the Yahoo All Markets Summit: Crypto conference in San Francisco on Thursday. At one point, he told the gathering that the SEC doesn't "see a lot of value" in categorizing Ether as a security.

"Ether is a coin that is evolving," Hinman said, pointing to the coin's decentralized and public network. He also noted there is no third party in the mix, expecting to bank a profit.

Decentralization appears to be a key. When a coin becomes widely held, the SEC is apparently less likely to view it as a security, the way it might view smaller coins, held by fewer investors.

Music to investors' ears

Hinman's statement was music to cryptocurrency investors' ears. Ether, backed by the company Ethereum, spiked nearly 9 percent on Hinman's statement, rising to more than $520 on CoinDesk. It's the second-largest cryptocurrency, after Bitcoin, with a market cap of more than $50 billion.

The coin is a major element of the Ethereum network, one of the emerging blockchain platforms providing both security and transparency in financial transactions.

After surging to dizzying heights in 2017, the values of all digital currencies have returned to earth this year. Taken together, digital currency values are down about 35 percent.

The SEC official's statement may give hope to executives at Ripple, who insist their digital coin XRP is not a security. Ripple is working on a network to facilitate faster and more secure transactions among banks and other financial institutions. XRP is used in that process.

Hinman said the SEC is not prepared to make any blanket assessment of cryptocurrencies in general, but it will review each on an individual basis.

On Thursday, the government reported a 0.8 percent increase in retail sales in May -- a figure that was much higher than anticipated. Perhaps even better, retail sales are up nearly six percent since last year.

The surges were seen at clothing stores, restaurants, and home improvement stores like Home Depot and Lowes.

The increase in spending last month was seen mostly at physical stores, as sales far outpaced what the government calls nonstore retailers -- a category that includes Amazon, catalog retailers, vending machines, newspaper delivery, and other online retailers.

Why the increase

Experts immediately pointed to the strong job market and economy as the two main reasons for increased spending. Currently, the unemployment rate is the lowest it’s been in almost two decades.

Though the year started off on a rocky note spending-wise, many believe the rough winter was behind the low spending in the early months of 2018.

Economists also pointed to the new tax laws playing a role in increased spending. Many Americans were waiting to see how the new tax cuts would play out, and once the cuts were passed, it was the green light to start spending.

Economic effects

Because of such strong sales numbers, economists at Barclays increased their forecast for the remainder of the year in terms of consumer spending. They now think the economy will expand at an annual rate of 3.5 percent -- up from their initial estimate of three percent.

However, it may be unlikely to think Americans will continue to spend at this rate. Though retail rates were up, savings rates were down, as that number dropped to 2.8 percent in April. Consumer spending may be increasing, but it’s increasing far faster than personal income.

It’s important to note the savings rate has only been below three percent three times since the 2008 financial crisis; one such time was this past November and December, though it quickly went up after the holiday shopping season.

This may cause retail sales rates to decrease soon, especially considering the Federal Reserve’s intent to continue raising interest rates throughout the year. Credit card rates are expected to be the most affected, followed up by home equity lines of credit, auto loan interest rates, and mortgage rates. The increase is the second of the year, and the seventh since the Fed began “normalizing” rates after years of keeping the discount rate at zero percent.

Tony Bedikian, head of global markets at Citizens Bank, said increased rates could be a deterrent to shoppers, but consumers may not pull out so quickly if “the Fed doesn’t raise rates too quickly.” Additionally, Bedikian feels that “as long as [people] have jobs and wages are rising,” spending should remain at a steady rate.

Kellogg Company is recalling 15.3-oz., and 23-oz., packages of Kellogg’s Honey Smacks cereal that may be contaminated with Salmonella.

Kellogg has been contacted by the Food & Drug Administration and Centers for Disease Control regarding reported illnesses.

The following product, which was distributed in the U.S, Costa Rica, Guatemala, Mexico, the Caribbean, Guam, Tahiti and Saipan, is being recalled:

The BEST if Used By Date is on the top of the cereal box, and the UPC code is on the bottom.

What to do

Customers who purchased the recalled product should discard it and contact the company for a full refund.

Consumers seeking more information may contact the company at (800) 962-1413 Monday – Friday, from 9 a.m. to 6 p.m. (ET) and Saturday and Sunday from 10 a.m. – 4 p.m. (ET), or online at kelloggs.com/honeysmacksrecall.

Chrysler (FCA US LLC) is recalling 24 model year 2019 Jeep Cherokees equipped with 2.0L engines.

The vehicles' engines may be missing valve stem keepers, which can allow the valve to drop into the engine cylinder causing engine damage.

The engines may also have a reversed camshaft cap that can damage the camshaft bearing causing camshaft failure.

Cylinder damage or camshaft failure can cause the engine to stall, increasing the risk of a crash.

What to do

Chrysler will notify owners, and dealers will inspect and repair or replace the affected engine components, as necessary, free of charge.

The recall is expected to begin July 14, 2018.

Owners may contact Chrysler customer service at 1-800-853-1403. Chrysler's number for this recall is U52.

Southern California Toyota dealer Roger Hogan, who is refusing to sell over $1 million worth of Prius cars he says are unsafe to drive, recently met with federal regulators and a senator in hopes that they will open a new investigation into the auto company and the defect he describes as “sudden deceleration.”

Toyota in 2014 issued a recall on 800,000 of its Toyota Prius vehicles after consumers reported that the cars had suddenly stalled out on the road, a defect linked to the cars’ inverters burning out. To fix the problem, Toyota instructed dealerships to adjust the software in the cars’ computers.

But Hogan says that consumers continued to show up at his dealership with complaints that their vehicles suddenly stalled, even after their cars had been “fixed’ with the software adjustment. That’s because Toyota is avoiding replacing the cars’ inverters, the more expensive but correct remedy to repair the defect, as Hogan charges in a $100 million lawsuit he filed against Toyota.

Preparing for an investigation

At least one crash has been linked to a Prius that suddenly died on the road and numerous other drivers have come forward with frightening stories about driving on the highway when their cars stopped without warning. Hogan characterizes the problem as a “ticking time bomb.”

Earlier this month, Hogan met with the general counsel for the National Highway Traffic Safety Administration (NHTSA) and Sen. Jerry Moran (R-Kan), chairman of the Senate Commerce Subcommittee on Consumer Protection, in hopes of holding “Toyota accountable for a $14 billion consumer safety fraud,” he says.

“We met with NHTSA and with Senator Moran last week in DC, presented both with physical evidence of post remedy inverter failure that we have seen in our two dealerships in Southern California,” Hogan says in a statement to ConsumerAffairs. “NHTSA said they are in the process of preparing for a full investigation and Senator Moran let us know he is closely looking at hearings with the full Committee.”

Spokespeople for NHTSA and Moran have not yet returned inquiries about the meeting. Toyota has responded to Hogan’s safety warnings with a lengthy statement accusing him of having a professional grudge against the company.

A new international study suggests that higher than recommended levels of vitamin D could reduce the risk of developing colorectal cancer, a disease that kills more than 50,000 people a year. This finding was especially true for women.

The new study pooled data from 17 previous studies on the subject and involved more than 12,000 participants from Asia, Europe, and the United States. It was conducted by researchers from the American Cancer Society and about 20 other health groups.

The researchers found that people who had lower levels of vitamin D than recommended had a 31 percent higher risk of colorectal cancer during a follow-up period. On the other hand, participants with vitamin D levels that were above the guidelines currently recommended for bone health had a 22 percent lower risk, the researchers said.

“Our study shows that having higher levels above bone-health ones are associated with lower colorectal cancer,” said Stephanie Smith-Warner, a Harvard epidemiologist and one of the study’s senior authors.

Twenty-two percent lower risk

Although it was an observational study and does not prove cause and effect, the research showed that participants who had vitamin D levels that were higher than the recommended levels had a 22 percent lower risk of colorectal cancer.

The study authors stressed that consumers shouldn’t go overboard on vitamin D intake in light of the study’s findings, since taking too much vitamin D can cause kidney stones and other adverse health effects. More research is needed to determine whether vitamin D supplements should be used to prevent colorectal cancer.

In an interview with the Washington Post, JoAnn Manson, chief of the division of preventive medicine at Brigham and Women’s Hospital in Boston, urged consumers to “err on the side of moderate intake” until more information is available.

Current dietary guidelines suggest that most adults get at least 600 international units (IU) of vitamin D a day. Health experts say the best way to get vitamin D is by eating foods and beverages that are rich in the vitamin -- such as fatty fish, milk, and cheese -- since sun exposure raises the risk of skin cancer.

The study has been published in the Journal of the National Cancer Institute.

Earlier this week, Comcast announced that it’s ending its practice of throttling heavy internet users that are clogging the network.

The company’s congestion management system had been in place for a decade prior to the announcement. However, it had been “essentially inactive for more than a year,” Comcast told the Verge.

“As reflected in a June 11, 2018 update to our Xfinity Internet Broadband Disclosures, the congestion management system that was initially deployed in 2008 has been deactivated,” Comcast said in a statement.

“As our network technologies and usage of the network continue to evolve, we reserve the right to implement a new congestion management system if necessary in the performance of reasonable network management and in order to maintain a good broadband internet access service experience for our customers, and will provide updates here as well as other locations if a new system is implemented.”

Throttling no longer necessary

Comcast says congestion isn’t as burdensome to its servers and modems as it used to be, so it’s no longer necessary to throttle speeds to slow down heavy internet users.

Users should be aware that although the company has disabled its throttling system, it will still maintain data caps and charges for overages in 27 states.

Comcast made its announcement the same day net neutrality regulations were officially repealed. Under the new Restoring Internet Freedom Order, companies may have more freedom to block, speed up, or slow down access to specific online services, or offer premium internet speeds at premium cost.

At the same time net neutrality rules were rolled back, the Federal Communications Commission (FCC) also updated its transparency rules. Comcast likely made its announcement in an effort to comply with the new rules.

On Thursday, Verizon released a pricer, third-tier unlimited data plan entitled “aboveunlimited.” The new plan joins “gounlimited” and “beyondlimited,” both of which vary in terms of what they offer customers.

Unlimited data plans have experienced a great deal of evolution over the years. Last year, Verizon broke its unlimited plans into two options for customers, and it ultimately comes down to cost. Now, the company has introduced a third plan into the mix.

“It’s very simple,” said Ronan Dunne, president of Verizon Wireless. “We’re confident people will enjoy the choice.”

What “aboveunlimited” looks like

The “aboveunlimited” plan appears to be designed for users who use a ton of data.

The plan includes unlimited data for high-definition videos for up to 75 GB of data before Verizon intervenes, as well as 20 GB of mobile hotspot data at LTE speeds, five “TravelPasses” that offer one day of international data usage per month, and 500 GB of Verizon Cloud service. Prices range from $60 to $95 per line.

With an additional unlimited plan, Verizon is now allowing customers to mix and match between three different tiers for different phone lines on family plans. Under the current system, all lines must be on the same plan. Customers are free to switch back and forth between the tiers as they see necessary, and existing customers can also make the change.

“When I introduced the Verizon unlimited plan back in February of last year, it was a real reset of the market and a game changer,” Dunne said. “And we said at the time we would continue to evolve and expand that portfolio to broaden out the match with customers.”

According to Dunne, “aboveunlimited” is geared towards “the person who wants it all.”

With the announcement of the new plan, Verizon also reduced its charge per line for all three tiers of unlimited plans as a customer adds more lines. For example, with the “aboveunlimited” plan, customers will pay $90 per month per line for two lines, $70 with three lines, and $60 with four lines.

Market trends

Verizon didn’t enter the unlimited data market until last February, though other carriers had offered customers unlimited data for some time. When first released, Verizon only offered one unlimited plan. It later expanded to a cheaper, though more restrictive, tier in August.

At the time of the first unlimited plan release, Verizon was struggling with losing customers. Before unlimited data, Verizon lost a net of 398,000 regular monthly phone customers -- the most it had ever lost in a quarter. In adding the unlimited plan, though one that was pricier than competitors like Sprint and T-Mobile, the company regained 109,000 monthly customers.

However, the release of this latest unlimited plan comes at a better time for the company. Verizon reported having added 260,000 regular monthly subscribers in the first quarter.

Despite the positive news, Verizon decided to raise prices of this latest unlimited plan at a time when other cell phone providers are looking to keep customers -- for cheaper. Last week, Sprint introduced a plan that would cost just $15 a month -- with a promise to never go up. T-Mobile offers free Netflix and AT&T throws in HBO with an unlimited plan. However, Verizon is steadfast in its belief that customers are paying for a higher quality provider.

“There’s been a very positive, consistent trend in the performance of Verizon Wireless over the last few quarters,” Dunne said. “I think it’s fair to say objectively based on our performance since some of our competitors changed their offerings, we’ve not seen any increase in our churn... and we’ve continued to see high levels of customer engagement and satisfaction.”

Instagram announced that users will now be able to purchase things directly from brands’ stories. The new feature allows companies to add a shopping bag icon to their Instagram stories; when users click on the tagged items, they’ll immediately be brought to the company’s website to make a purchase.

With over 300 million Instagram users currently taking advantage of the app’s story feature, the ease of the new click-and-shop feature will eliminate having to search for items users see on the platform. With one click, they’ll be able to make a purchase.

The new feature is free to use, though it is only available to businesses -- not individual sellers -- and companies can’t currently sell through a third-party retailer. Adidas, Louis Vuitton, and Aritizia are expected to be the first brands to use the feature with their customers when it officially launches, with more companies being added into the fold in the coming weeks.

“Stories are so impactful as a content format for a variety of reasons due to the in-the-moment, ephemeral feel of the content from a consumer’s perspective,” said Kamiu Lee, CEO of the influencer marketing platform Activate. “This format created urgency and exclusivity for would-be shoppers -- a key tactic for brands and retailers alike to increase conversion.”

Instagram’s rising popularity

According to a recent study by the Pew Research Center, Instagram is the second most popular social media platform among U.S. teens between 13 and 17. Seventy-two percent of respondents say they use Instagram -- behind only YouTube, and more than the 69 percent that used Snapchat.

However, users of Instagram see the benefits of the app beyond just sharing pictures with friends and family. According to Instagram’s COO Marne Levine, almost 80 percent of users choose to connect with companies and brands so they can shop and gain brand awareness.

“People are looking to follow businesses on the platform -- there are 200 million Instagrammers who visit a business profile every day,” Levine said. “Two-thirds of those are non-followers, someone who is looking around wanting to learn about new businesses. If businesses are looking for customers, they are here.”

Recent Instagram shopping experience

Before this update to the app, companies on Instagram could link to certain items in their stories, but customers couldn’t purchase them directly. Now, Instagram is stepping up its e-commerce participation, and companies will have the most direct route to engage customers in buying their products.

“Instagram shopping has been an added bonus to our online shopping strategy with no added tech expense,” said Alex Faherty, co-founder of New York City-based clothing line Faherty Brand. “We can leverage Instagram’s organic lifestyle vibe while still offering an easy, highly efficient shopping experience.”

The U.S. is facing growing healthcare shortages, particularly in rural areas. A complicating issue is there are fewer and fewer primary care providers.

Research from the University of Delaware suggests one answer is the enlistment of more highly skilled nurse practitioners (NPs), who tend to choose primary care as a field at a much higher rate than doctors. There are currently some 248,000 nurse practitioners in the U.S., and about 87 percent are trained in primary care.

Hilary Barnes, an assistant professor in the College of Health Sciences’ School of Nursing at the University of Delaware, says primary care is important, particularly in underserved areas, because it is often the first point of contact with the healthcare system.

First point of contact

Primary care providers conduct screenings for major health conditions, such as diabetes and heart disease, and help patients manage those conditions. Barnes says that as primary care physicians retire, they aren't being replaced at a fast enough rate.

Barnes' research finds that NPs are increasingly being tapped for a primary healthcare role, accounting for about 25 percent of healthcare providers in rural areas, a 43.2 percent increase overall from 2008 to 2016.

However, some states limit what they do. In these states, laws specifically bar NPs from serving as primary care providers and require them to be supervised by a physician.

“Some states are very restrictive,” Barnes said. “An NP has to maintain written agreements with a physician to practice and prescribe medication. In the most extreme examples, the law states that an NP must talk about every patient with a physician. Or that the physician has to sign for prescriptions.”

Restrictions vary by state

The level of restrictions varies from state to state. Barnes says Pennsylvania is among the most restrictive, requiring an NP to have a collaborative agreement with a physician. If there is no physician in the town, Barnes says an NP is unlikely to practice there.

Some states, such as New Jersey, give an NP more autonomy to practice but still require a relationship with a physician in order to prescribe medication.

“Without prescriptive authority, you are limited on the services that you can provide to patients,” Barnes said.

Since 2015, Delaware has given nurse practitioners full autonomy to practice medicine without being supervised by a physician. Barnes says states with more NP-friendly laws tend to attract more nurse practitioners.

Typical education requirements to become a nurse practitioner include a bachelor's degree in nursing, experience as a registered nurse, and a graduate degree in nursing.

Twitter announced on Wednesday that it’s rolling out changes to its platform intended to make it easier for users to discover relevant breaking news, events, and stories.

Users will soon see personalized breaking news and live events at the top of their timelines, eliminating the need to follow hashtags or search for certain accounts in order to get relevant news and stories.

“We’ve been working to change how you discover all the information around news, events, and stories, and today, we’re sharing a few steps forward,” Twitter said in a blog post. “It’ll be easier to find and follow the big events and stories you care about in your timeline, notifications, and Explore.”

Personalized news and event notifications

In the coming weeks, Twitter users will be given the option to receive notifications about breaking news that is relevant to their interests.

Twitter says it’s experimenting with sending notifications to users based on their interests, which the site will determine based on accounts followed and what a user tweets about. Users who would rather not receive push notifications for personalized breaking news can toggle off these notifications in the recommendations section of Twitter’s settings.

Redesigned Explore tab

Additionally, the Explore section of Twitter will soon be organized by topic instead of content type.

“We heard from you that Explore would be easier to navigate if it was organized by topic instead of content type (video, articles, etc). We’re now experimenting with topic tabs in Explore so it’s easier to see what’s happening in news and entertainment, and what’s most relevant to you,” Twitter said.

Twitter has also started organizing Moments -- the feature that aggregates world news -- into a vertical display like the Twitter timeline, rather than a horizontal orientation.

The changes will roll out gradually to iOS and Android users in the U.S. in the coming weeks and months, but Twitter has already launched its change to Moments just in time for World Cup festivities. A specialized version of this feature will be available for sports, which will have video at the top and a live-updating score.