RALEIGH, N.C. -- Some doctors in North Carolina are voicing their support for legislation to cut red tape for Advanced Practice Registered Nurses (APRNs).

More than 20 states and the District of Columbia already grant licensed APRNs full practice authority, meaning they don't need to pay a doctor to supervise them.

The SAVE Act, introduced in North Carolina this year, would remove supervision requirements.

Dr. Elizabeth Golding, medical director for palliative care services at Cone Health, said there wouldn't be enough palliative medical care available in the state without APRNs, and believes supervision requirements, which often cost APRNs thousands of dollars, are a hindrance to patients' getting high-quality care.

"They really do nothing to improve the quality of care, and in my opinion are really, in truth, unnecessary and are just costly administrative hoops," Golding argued.

While individual physicians are speaking out, the North Carolina Medical Society has repeatedly opposed allowing APRNs to practice independently, arguing eliminating doctor supervision would increase safety risks for patients.

Dr. William Long, a primary care and geriatric physician in Charlotte, explained supervision requirements do not require doctors and APRNs work closely together. Long added some supervising physicians live hours away, or even in another state, from their collaborating APRN.

"I just don't think that's the spirit of what the law is," Long contended. "I think the law should be modified so that after a certain period of time, and pick your number, two years, three years, whatever, those individuals are very competent in the scope of practice that they're in."

Dr. Jessica Cannon, a retired OB/GYN physician in Wilmington, pointed out full-practice APRNs could help more North Carolina women have healthy pregnancies and healthy babies, especially in rural counties.

"We know that in states where certified nurse midwives have independent practices, that the outcomes are known to be just as safe as traditional OB/GYN outcomes, and in many cases, they have superior outcomes," Cannon observed.

Research shows APRN midwives lower risks for women and babies. Compared with obstetricians, midwifery care has led to much lower intervention rates and reduced the odds of Cesarean delivery by 30% for women having their first baby.

With costs growing, health care is set to be a major theme in Olympia this year.

Sam Hatzenbeler, health policy associate for the Economic Opportunity Institute, said state lawmakers have made progress, but care is still becoming increasingly unaffordable.

Hatzenbeler pointed out some Washingtonians have to make tough decisions.

"They're forced to choose between getting needed medical care and buying food, putting food on the table, paying rent, paying their car bill," Hatzenbeler outlined. "People shouldn't be forced to choose between these necessary pieces of being a human."

Across the U.S., the average worker's premium contribution has increased almost 300% over the past two decades. And Americans spend more than $1,500 each year on prescription drugs.

To tackle drug prices, state lawmakers hope to establish the Prescription Drug Affordability Board. Lawmakers approved a similar board in 2020, but Gov. Jay Inslee vetoed it because of its price tag. The Senate version of the bill had a public hearing this week.

Another measure, Senate Bill 5688, would give the attorney general oversight to ensure market consolidations don't result in increased cost.

Hatzenbeler noted the attorney general also would ensure care is not restricted.

"For example, some Catholic mergers and acquisitions have resulted in reduced access to reproductive care, gender-affirming care, end-of-life care, things like that," Hatzenbeler explained. "We want to make sure that consolidations don't result in this diminishing of care."

The bill includes a health equity assessment as well. It had a public hearing this week.

Hatzenbeler added another important provision to her organization is in the budget, and would increase funding for health care to immigrants. She reported 105,000 immigrants in the state lack health care.

Hatzenbeler emphasized low-income people, people of color and front-line workers in particular have shouldered a disproportionate impact from the pandemic.

"We have an opportunity this session to correct some of those long-standing inequities," Hatzenbeler asserted. "And make sure that health care is not only more affordable and higher quality for those people who are disproportionately impacted, but for all of us."

Excessive screen time can cause a host of negative side effects in kids, but as some Indiana schools go virtual because of the omicron variant, prolonged interaction with technology can be unavoidable.

Dr. Derek Sprunger, a professor of clinical ophthalmology in the Indiana University School of Medicine's Ophthalmology Department, said parents still can still use several methods to moderate their kids' screen time. He advised limiting kids' exposure to non-education-related technology.

"I don't say eliminate, but cut back," he said, "and there's no exact amount of time that you should or shouldn't be doing this, but if you're doing a lot through school, more than typical, cut back on your outside-of-school time, like gaming and things like that."

Sprunger said excessive screen time can cause several short-term health effects, including eye fatigue, blurred vision and headaches. According to the Mayo Clinic, it also can lead to irregular sleep and impaired academic performance.

In addition to those side effects, Sprunger added that overusing technology also can advance long-term nearsightedness.

"This is a more permanent thing," he said. "The things we talked about earlier, if you cut usage of your screen time, that will reverse. Once you induce nearsightedness, that can be a more permanent problem."

Dr. Scott Edmonds, chief eye-care officer at United Healthcare, recommended the "20-20-20" rule, breaking up screen time to limit eye strain: For every 20 minutes folks spend staring at a computer, he said, they should take 20 seconds to observe something at least 20 feet away.

"That break takes you away from the blue light, lets your pupil go to its normal size, lets your muscles in your eye relax, lets your focusing muscle relax," he said. "All that, every 20 minutes, will really help you be more comfortable with screen time."

In a September report from the Pew Research Center, about 70% of parents said their children are spending more time in front of screens than they did pre-pandemic.

More than 2.5 million Americans stutter at some point in their lives, and a Michigan researcher is among those learning more about the genetics of stuttering.

There is no known cure for it, but experts say newly identified genes associated with stuttering can help them find out if there are links to other conditions or possible treatments.

Shelly Jo Kraft, who directs the Behavior, Speech and Genetics lab at Wayne State University, said the new genes are helping researchers learn more about the factors that contribute to stuttering, or protect people from risk.

"We've known stuttering is inherited for a long time," she said, "but there's been a lot of community misinformation about stuttering, a lot of stigma, a lot of misconception about why someone stutters."

She said having more information about how the genes operate that lead people to stutter can help push back against those misconceptions - to show that stuttering isn't a personality trait, or caused by a traumatic event.

In addition to learning more about the genetics of stuttering, Kraft said, the research is showing that the condition is much more prevalent than once thought. At least 5% to 6% of children and 1% of adults experience stuttering, but she said that may be an undercount.

"A lot of children do stutter for a transient amount of time during childhood," she said, "and with the help of therapy, with the help of their parents and natural things that parents do in response to stuttering, the stuttering goes away."

Kraft, who has collected DNA samples from roughly 1,800 people who stutter from 250 families globally, has partnered with a research lab at Vanderbilt University to expand their reach to a worldwide repository of DNA information.