Everyone on TikTok is bleary-eyed and anxious, it sometimes seems. The generations that dominate the app—Gen Z and Millennials—are also those most beleaguered by anxiety, which is closely tied to sleep disturbances. It’s little wonder, then, that supposed sleep aids—like tart cherry juice, brown noise, melatonin, and CBD—are constant fixtures on the social media platform. Now, the app’s wellness community has latched onto the latest supplement touted to heal both poor sleep and anxiety: magnesium glycinate, one of nearly a dozen over-the-counter supplements that can be used to boost the body’s levels of magnesium. Content creators insist that it helps them go to bed hours earlier than they usually do, eases insomnia, and lets them unwind at the end of the day. One nurse practitioner on the app called magnesium glycinate her “holy grail supplement.” So does it really work? What is magnesium?Magnesium, of course, isn’t new. It’s a mineral element that you already have in your body, thanks to foods like nuts, seeds, beans, and certain vegetable and dairy items. It works within the cells of multiple body systems to keep muscles, nerves, and other parts functioning properly. Someone trying to sell you supplements might tell you that as many as half of U.S. adults are magnesium-deficient, and while this is technically true, most of us still get enough to prevent any real noticeable effects, says Emily Tarleton, a registered dietitian and researcher at Northern Vermont University. Significant magnesium deficiencies are much less common and often come with symptoms like fatigue, weakness, and nausea. Some researchers, however, have also suggested that there could be connections between even mild magnesium deficiency and sleep disorders. In nature, magnesium is always found in combination with other elements, meaning that there are many ways to deliver it into the body. Magnesium products and supplements mirror this diversity of form. You can buy capsules (like magnesium citrate), beverage additives (like magnesium lactate), or salts, which include magnesium sulfate (aka Epsom salt) and are designed to deliver small amounts of the mineral through the skin. Magnesium glycinate is popular because it’s among the capsule forms that are the most bioavailable, meaning that a larger amount of the mineral can be used by the body. Do magnesium supplements improve mental health or sleep?Tarleton is one of the few researchers who have studied magnesium’s effect on depression in a randomized clinical trial, the gold standard for medication studies. In her 2017 study, she found that people who took 248 mg of elemental magnesium from magnesium chloride tablets each day reported improvements in feelings of depression over six weeks. The same year, a review of 18 small studies found that people who took various magnesium supplements reported improvements in symptoms of anxiety. In Tarleton’s study, “one of the other side effects was increased sleep,” she says. Though she hasn’t studied magnesium supplements’ effects directly on sleep, it makes sense to her that the mineral would work as a sleep aid, particularly in the more bioavailable forms like magnesium glycinate and magnesium chloride. “Magnesium plays a huge role in muscle contraction,” she says. “Athletes will sometimes use it for muscle cramping. So our theory is that the muscle relaxation side effect could help with sleep.” When sleep quality has appeared in magnesium supplementation research, it’s most often as a side effect. In studies where magnesium has been given to people with migraines, polycystic ovary syndrome (PCOS), and a few other health conditions, sleep improvements have sometimes been reported but are rarely formally tracked. A few studies have looked at magnesium supplements exclusively as an insomnia treatment, but they have all been too small and targeted to specific populations to draw conclusions from. One such study in 2012 included only elderly participants and had a sample size of only 46 people. Another more recent study from 2019 included magnesium as an insomnia treatment, but only as part of a supplement that also contained melatonin and vitamin B. In 2022, the authors of a review that analyzed all studies of magnesium as an insomnia treatment concluded that without more and longer-lasting research, no definitive link between magnesium and sleep could be drawn. Magnesium’s biggest starring role in the health world has long been for the treatment of migraines; certain formulas and strengths are made available via prescription to those who suffer from the attacks. Current theories about how magnesium works to alleviate these symptoms primarily suggest that magnesium gives the brain a sort of boost to resume normal function, including moderating the release of chemical signals and drawing healing factors into the area. While there’s no firm evidence that any of these processes would also apply to the sleep-addled mind, Tarleton says that it’s plausible. How to use magnesium safelyIf you want to try magnesium for sleep, relaxation, or any other reason, it’s important to make sure you actually know how much you’re taking. And because supplements aren’t regulated in the same way medications are, magnesium tablets may have other ingredients mixed in. “There are very few magnesium supplements that have been tested and verified in terms of knowing exactly what’s in them,” says Tarleton. She recommends always checking the bottle’s label to make sure the manufacturers have listed the amount of elemental magnesium (essentially, the volume of just the mineral itself) present in the pills. A health care professional is best suited to point you toward a good starting dosage—and weigh in on whether you should take magnesium at all, since supplements are not risk-free. “The big side effects of too much magnesium are diarrhea, upset stomach, and eventually nausea and throwing up,” says Tarleton. “Those are sort of the first signs” that you may be taking too much. Like any sleep aid, it’s also best to use magnesium supplements sparingly, since their effects can weaken over time, Tarleton says. And before you start popping supplements, consider revamping your sleep hygiene and habits. “It’s much easier to take a supplement than to try to really take a hard look at what the reasons are that you’re not sleeping well to begin with.” from https://ift.tt/VZQIk26 Check out https://takiaisfobia.blogspot.com/
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Did COVID Originally Leak From a Chinese Lab? Politics May Prevent Us Ever Knowing for Sure2/28/2023 China was quick to dispel reemergent COVID-19 “lab leak” theories following a Wall Street Journal report this weekend that the U.S. Department of Energy has concluded, with “low confidence,” that the virus behind the pandemic most likely originated in a Chinese laboratory. Mao Ning, spokesperson for China’s foreign affairs ministry, told reporters Monday that “certain parties” should “stop smearing China” and that the “lab leak” theory has already been authoritatively disproven. “The origins-tracing of SARS-CoV-2 is about science and should not be politicized,” said Mao. (The U.S. government is still investigating the origins of COVID-19, and both the FBI and the Energy Department have determined that a lab leak is the most likely source of the virus.) Researchers around the world have been endeavoring since the outbreak began in 2020 to determine the provenance of the virus. Knowing how the pandemic started, experts believe, can significantly aid the efforts to bring it to an end—and prevent future global pandemics. But three years and nearly seven million lives lost later, there’s still little certainty over whether the virus first naturally infected humans at a seafood market in Wuhan, as many scientists originally believed, or escaped a laboratory, as the Energy Department now reportedly believes based on undisclosed new intelligence. And at this point, agree that due to the charged atmosphere surrounding such investigations, we may never be sure. “The origin probe is so politicized,” says Yanzhong Huang, a global health expert at the Council on Foreign Relations, who notes that the revelation of the U.S. Energy Department report comes as U.S.-China tensions have risen in recent months. “It is just becoming increasingly difficult to find out what exactly caused the outbreak. I would say it’s almost impossible now, with all this delay, with the politicization of the issue.” At the beginning of the pandemic, Republicans in the U.S., most prominently former President Donald Trump, were quick to promote the lab leak theory, asserting that China was to blame for the outbreak. But while that suggestion initially seemed ideologically motivated to some—and aligned with a rise in anti-China rhetoric—there’s since been an increasing acknowledgement that the theory can’t be ruled out. “There is not a consensus right now in the U.S. government about exactly how COVID started,” National Security Council spokesman John Kirby said in a White House press briefing Monday. “The work is still ongoing. There hasn’t been a final conclusion arrived at here. And not everyone in the intelligence community or across the government necessarily has come to a consensus view here on how it started.” Add to that China’s reluctance to open up its facilities and cooperate with international investigators. The former head MI6, U.K. foreign intelligence service, speculated that any direct evidence that could point to a possible lab leak would have been destroyed by Chinese officials. Either way, there likely won’t ever be “smoking gun evidence,” says Huang. And that’s because China has also politicized its response. When the Australian government called for an independent probe into the virus’ origins in Wuhan in 2020, China retaliated by imposing trade sanctions on Australia’s exports. China claims its joint investigation with the World Health Organization in 2021 came to an “authoritative conclusion” against the lab leak theory, but the WHO itself says all hypotheses on COVID-19’s origin remain open. And when the WHO sought further investigations, China refused to cooperate. The problem, says Ayelet Berman, who leads the Global Health Law and Governance Program at National University of Singapore’s Center for International Law, is that in the existing political climate, China has nothing to gain from being more transparent. And that sets a dangerous precedent. Berman says that research on future outbreaks may be similarly hampered by origin countries’ fears of facing economic and social backlash. “All of the other outbreaks over the years—if you think about Zika, MERS-CoV, SARS-CoV-1, Ebola—there wasn’t really any problem to investigate the origin because the countries collaborated,” Berman said. That isn’t the case anymore. “It’s a big problem that needs to be addressed.” from https://ift.tt/jxEKy8P Check out https://takiaisfobia.blogspot.com/ News that the U.S. Department of Energy made a determination about the origins of COVID-19 has sparked new questions about the U.S. intelligence community’s investigation of the global pandemic that has killed an estimated 6.85 million people. The Energy Department, which runs multiple national laboratories, concluded with a low level of confidence that COVID-19 most likely emerged as a result of a leak from a laboratory in China, the Wall Street Journal reported on Sunday, citing anonymous sources. The Journal reported that the Energy Department’s new determination was classified. Previously, the agency was undecided on the cause of the pandemic. Eight agencies, plus the National Intelligence Council, have investigated the causes of the virus, according to a report summary from the Office of the Director of National Intelligence released in August 2021. The details of these investigations, including specific methods and sources used to make the determinations, and even the names of the agencies involved, remain hidden from public view. Based on what we do know from that report, the intelligence community remains divided on this issue. So far, two agencies believe the most likely cause of COVID-19 was a lab leak, at low and moderate confidence levels. Four agencies and the National Intelligence Council concluded with low confidence that COVID-19 emerged as a result of natural transmission from animals to humans, and two have yet to make a determination. The names of the agencies were not included in the report and U.S. officials have declined to provide specifics when asked by reporters and lawmakers. “The President made trying to find the origins of COVID a priority when he came into office,” John Kirby, spokesman for the National Security Council, told reporters Monday at the White House. “He’s got a whole of government effort designed to do that. There is not a consensus right now in the U.S. government about exactly how COVID started. There is just not an intelligence community consensus.” The Energy Department news comes ahead of a Tuesday House Oversight Committee roundtable titled “Preparing For the Future By Learning From the Past: Examining COVID Policy Decisions.” House Oversight Committee chair James Comer told reporters on Monday that he would try to get the Energy Department’s assessment declassified and share it with the public, according to Axios. Here’s what we know about the divisions in the U.S. intelligence community over what caused COVID-19. The lab leak theoryAlongside the Department of Energy, the Federal Bureau of Investigation backs the lab leak theory, according to the Journal report and one from CNN, which TIME has not verified. The FBI did not comment directly on either outlet’s reporting. It is the only agency in the intelligence community that has made an assessment at a “moderate confidence” level, which indicates it is based on information credible enough to surpass a “low confidence” finding. The 2021 report summary revealed that one agency determined with moderate confidence that the virus found its way into the human population after “a laboratory-associated incident, probably involving experimentation, animal handling, or sampling by the Wuhan Institute of Virology.” The document did not name the agency. The natural transmission theoryThe National Intelligence Council and four agencies of the U.S. intelligence community, which have not been publicly named, determined that COVID-19 likely spread to humans through natural transmission from an animal, according to the report summary. All five of those bodies made their rulings with low confidence. Experts who back this theory base their conclusion on “China’s officials’ lack of foreknowledge,” as well as the historical precedent of new infectious diseases originating in animals. For example, the SARS outbreak from 2002 to 2004, which infected around 8,000 people and killed at least 774, was traced back to civets in southern China. That outbreak was caused by a coronavirus—the same family of pathogens that includes COVID-19. The disease that came to be known as COVID-19 was first acknowledged after the World Health Organization was informed of several cases of a mysterious viral pneumonia in the the central Chinese city of Wuhan. According to the WHO, Chinese authorities said that some of those initial patients worked in a seafood market there, about 40 minutes from the Wuhan Institute of Virology, which had long conducted research on coronaviruses. Still on the fenceAt the time the government report summary was released in 2021, there were three intelligence community agencies undecided between the lab leak and natural transmission hypotheses. According to the Journal’s recent reporting, one of those was the Department of Energy, which now supports the lab leak theory. The Journal and CNN have reported that the Central Intelligence Agency is one of the two remaining undecided groups, a fact TIME has not verified, while the other is still unknown. Why they’re dividedAccording to the 2021 report, the divisions between agencies largely stem from the importance experts at these agencies place on different pieces of intelligence and available scientific evidence—especially given the limited clinical samples and epidemiological data they have to work with. U.S. officials have accused China of covering up the severity of the outbreak early on during the pandemic. Even if the virus was naturally transmitted into the human population, the precedent set by older diseases indicates that it can take more than a decade to determine which species were probably responsible. Even then, they don’t know with 100% certainty. Furthermore, China does not appear to be cooperating with the WHO’s investigation. That means it’s unlikely we’ll ever know for sure how COVID-19 originated, and the division within the U.S. government is likely to persist. —With reporting by Brian Bennett from https://ift.tt/TLK1igb Check out https://takiaisfobia.blogspot.com/ The record-breaking heat Earth endured during the summer of 2022 will be repeated without a robust international effort to address climate change, a panel of scientists warned Monday. Heat-related deaths, wildfires, extreme rainfall, and persistent drought are expected to become increasingly severe as both ocean and atmospheric temperatures continue to rise, the experts said. Even if all greenhouse gas emissions ceased today, Earth will continue to warm for several decades. The presentation, “Earth Series Virtual: Blazing Temperatures, Broken Records,” featured a multidisciplinary panel of scientific experts from Columbia University. Radley Horton, a research professor at Columbia’s Lamont-Doherty Earth Observatory, stated that human-induced climate change has caused the global average atmospheric temperature to warm by about 2 degrees (1.1 degrees Celsius) in the last several decades. Read more: Why Extreme Heat Is So Bad for the Human Body “One of the key takeaways is that a little bit of change in global temperature has an enormous impact,” said Horton. Some of the main consequences include longer and more intense heat waves that are hitting increasingly larger areas. Additionally, Horton said, certain climate models have underestimated just how extreme certain events can be, such as the European heat wave of 2022 and the Pacific Northwest heat wave of 2021. “We are locked into a lot of additional climate hazards, there is no way around it,” said Horton. Diana Hernandez, Associate Professor of Sociomedical Sciences at the Columbia Mailman School of Public Health, is researching how certain vulnerabilities, such as medical conditions or access to energy, could be affected by changing climate domestically and internationally. The expected impacts include shade inequalities, urban heat islands, and inequitable access to energy-powered medical devices. “The climate is changing, and we are not adapted to be able to deal with it from a health perspective,” said Cecilia Sorensen, a physician and associate professor of Environmental Health Sciences at the Columbia University Medical Center. Sorensen noted that she and colleagues referred to summer as “trauma season” early in her career, even before she focused on the health impacts of climate change. “We used to get inundated with patients … people coming in with heart attacks and asthma exacerbations.” Read more: Climate Experts Are Testing New Ways To Reach the People Most Affected by Extreme Heat Despite the foreboding climate projections, the panelists expressed hope that considerable strides can be made to minimize future climate impacts related to extreme heat. Hernandez said a community-focused approach, especially with an emphasis on engagement that is inclusive, will be successful in implementing a wide range of climate adaptation strategies. Sorenson said one solution that can be implemented by hospitals is developing emergency room protocols to treat a large influx of patients suffering from heat stroke or related conditions during extreme weather. Improved communications are also needed to increase awareness about the medical risks of extreme heat and how impacts can be prevented, she said. “Within the problem lies the solution,” said Sorensen. ___ Associated Press climate and environmental coverage receives support from several private foundations. See more about AP’s climate initiative here. The AP is solely responsible for all content. from https://ift.tt/DsxzdIZ Check out https://takiaisfobia.blogspot.com/ Most TIME covers feature people already accustomed to the harsh glare of fame. Others depict those caught up in situations not of their own choosing. But occasionally, a regular person wanders unwittingly into the red border, because his or her life and the news briefly overlap. Such was the case in 2012 when Jamie Lynne Grumet and her son Aram appeared next to the question ARE YOU MOM ENOUGH? Grumet and her son were doing something they did every day, usually around nap time: nursing. Aram was 3, older (and taller) than most breastfeeding American kids, but Grumet, who was herself breastfed until she was 6, was an advocate of the attachment-parenting theories of Dr. Bill Sears—which include allowing kids to set their own weaning timelines, and which were the subject of the cover story. “Aram was getting sleepy, so he was just standing there nursing while they were kind of pulling my hair back,” recalls Grumet, of the moment photographer Martin Schoeller snapped a shot. “It wasn’t necessarily something we were posing for. It wasn’t something that was unnatural either. It was just how we were.” Read the original story: The Man Who Remade Motherhood The combination of the unconventional pose, Aram’s size, and the provocative cover line caused an uproar. “I saw it in the media before I got to see it on the cover,” says Grumet, who lives in California. “People who were awake before I was were sending videos of all the news outlets that were covering it.” She was shocked at how much attention it got, not all of it positive. “It’s just such an abnormal human experience, having this much attention on you, and it’s not necessarily healthy,” she says. “It was really interesting, but that the focus was on me was scary. I felt really vulnerable.” The cover had been the subject of considerable disagreement within TIME’s staff, with some calling it sensationalized and others saying it accurately captured the pressure mothers were under. Outside TIME’s walls, the cover was fodder for comedians, parenting experts, and a legion of letters to the editor. Thousands of people emailed Grumet, ranging from Dr. Sears to Alanis Morissette, who wrote the introduction and the foreword, respectively, for an attachment-parenting book Grumet wrote in 2019. After meeting other advocates at her media appearances, she became involved in clean-water and refugee causes, working in Europe, Asia, and sub-Saharan Africa. She traveled a lot, she thinks now, partly to prove a point—that attachment parenting didn’t lead to clingy kids. Her feelings about the cover have changed over the years. “I was worried at the time that it had done more damage than helped—but it didn’t,” she says. “Attachment parenting has been a lot more normalized the past 10 years, and so has breastfeeding.” As for Aram, now 14, he remembers little of the shoot, and almost none of the brouhaha that followed. He recalls his appearance on the Today show as “a room full of cameras.” The cover hangs on the wall of his bedroom alongside paintings by his grandmother. His friends don’t ask about it, but if they did, he’d be happy to explain. “I’m proud of it. I like it,” he says. “I just see myself and my mom. It makes me feel happy that my mom helped people, like, nurse their children in public, so they didn’t feel awkward or nervous.” from https://ift.tt/RJ6sAE5 Check out https://takiaisfobia.blogspot.com/ Hong Kong will stop requiring masks to be worn in public places from Wednesday, drawing to a close the prolonged Covid era that damaged its economy and standing in the world. Masks will no longer be needed outdoors, indoors or on public transport, Hong Kong leader John Lee told reporters on Tuesday. “From tomorrow we are completely returning to normalcy,” Lee said. “This year and the next year, we will focus on the economy and development.” Read More: Why Rapid COVID-19 Test Results Are Getting More Confusing The move comes as the government seeks to attract tourists and overseas workers to revitalize the finance hub. Next month will see Hong Kong host the biggest series of international events since often-violent protests in 2019 shut down much of the city, including a music festival, Art Basel and the Rugby Sevens tournament. Hong Kong had dropped most other pandemic restrictions by earlier this year. People have been required to wear masks in all public places, including outdoors, from July 29, 2020. The rule is enforceable by fines of up to HK$10,000 ($1,275), with police regularly handing out HK$5,000 penalties on the spot for transgressors. Hong Kong was one of last places on Earth to mandate mask-wearing. At one stage, masks were required even when exercising. The rule increasingly jarred with Hong Kong’s push to move beyond the pandemic and lure visitors. As part of its Hello Hong Kong campaign, the city is giving away more than half a million airline tickets starting from Wednesday. Read More: The Bivalent Booster Protects Against New COVID-19 Variants, New Data Show Tourism numbers remain low. In January, passenger volumes at the Norman Foster-designed airport were a third of the level four years earlier. That compares with 77% for Singapore. The past three years of global isolation have weighed heavily on Hong Kong’s economy and reputation. The economy shrank 3.5% in 2022, contracting for the third time in four years. The population has fallen by a net 187,000 in the three years through 2022 as residents fled for other cities. --With assistance from Shirley Zhao from https://time.com/6258932/hong-kong-ends-mask-mandate-covid/ Check out https://takiaisfobia.blogspot.com/ Plenty of factors determine whether someone chooses to wear a mask at this stage of the pandemic: their health, their risk tolerance, where they are, who’s around them—and, according to a recent study, how attractive they think they are. The study, which was published in January in the journal Frontiers in Psychology, found that people who think they’re attractive tend to be disinclined to wear masks. That seems to be because people who think they’re good-looking don’t believe masks enhance their appearance, while the opposite may be true for people who don’t think they’re as attractive, the researchers concluded. (Several cultures even have slang terms for people who wear masks to look better or conceal their full faces, the authors note. In the U.S., it’s known as “mask fishing.”) For the study, a team of researchers in South Korea recruited U.S. adults to take several surveys. In the first, 244 people answered questions about their self-perceived attractiveness and how they thought wearing a mask affected their appearance. Then, researchers told the participants to imagine they had a job interview and asked whether they would wear a mask in the interview if they didn’t have to. “Individuals with higher self-perceived attractiveness were less likely to endorse the belief that mask-wearing enhances their perceived attractiveness, which further dampened their mask-wearing intention in job interviews,” the authors write. In other words, people who thought they were good-looking didn’t want to detract from their appearance by covering their face. Read More: How COVID-19 Changes the Heart—Even After the Virus Is Gone In another experiment, the researchers posed similar questions about masks and appearance to 442 people. They asked half the group to imagine they had a job interview (a relatively high-stakes situation) while the other half imagined they were walking a dog (a more mundane activity). Both groups were then asked if they would choose to wear a mask in their given scenario. They found that people were more likely to say they’d wear a mask if they thought it would make them look better, and that trend was more apparent in the high-stakes job interview scenario. This finding, the authors write, suggests that people’s masking decisions are at least partially based on how much they care about looking good in a given situation. The desire to appear attractive may even be as influential as the desire to stay healthy. In their surveys, the authors also asked people how much they feared COVID-19. People who thought masks made them look better were roughly as likely to cover up as those who were fearful of the virus. With COVID-19 mask mandates largely a thing of the past in the U.S., it’s important for researchers and public-health authorities to know why people are—or are not--continuing to wear them. Preventing disease is, of course, a major motivator. But so, it appears, is looking good. from https://ift.tt/7kOMcgH Check out https://takiaisfobia.blogspot.com/ You haven’t been feeling well lately. You’re more tired than usual, a bit sluggish. You wonder if there’s something wrong with your diet. Or maybe you’re anemic? You call your primary-care doctor’s office to schedule an appointment. They inform you the next available appointment is in three weeks. So, you wait. And then you wait some more. And then, when you arrive on the day of your appointment, you wait even more. You fill out the mountain of required paperwork, but the doctor still isn’t ready to see you. You flip through a magazine for a while, then scroll through your phone until you’re finally called. You wait a little longer in a scratchy paper gown, then talk to your physician—if you can call it talking, since she’s mostly staring at a computer screen—for all of 10 minutes before you’re back out in the lobby with a lab order to have your blood tested. [time-brightcove not-tgx=”true”] Then you call to set up your blood test, and the waiting process starts over. A few weeks after you get your results, a bill arrives in the mail. You’re charged hundreds of dollars for the blood work. The appointment was over in minutes, but your bank account will feel the effects for a long time. Going to the doctor may never be a fun experience, but surely it can be better than it is right now. In 2019, even before the COVID-19 pandemic rocked the foundations of health care, an Ipsos survey found that 43% of Americans were unsatisfied with their medical system, far more than the 22% of people in the U.K. and 26% of people in Canada who were unsatisfied with theirs. By 2022, three years into the pandemic, just 12% of U.S. adults said health care was handled “extremely” or “very” well in the U.S., according to a poll from the Associated Press–NORC Center for Public Affairs Research. Americans pay a premium for the care they rate so poorly. The U.S. spends more per capita on health care than any other developed country in the world but has subpar health outcomes. Average life expectancy is lower in the U.S. than in other wealthy nations, and about 60% of U.S. adults have a chronic disease. About 10% of the population doesn’t have health insurance. And the customer service sucks. U.S. patients are tired of waiting weeks or months for appointments that are over in minutes. They’re tired of high prices and surprise bills. They’re tired of providers who treat them like electronic health record entries, rather than people. That could dissuade them from getting medical care at all—and if that happens, America may get a whole lot sicker than it already is. Patients are, in a phrase, burned out. Primary care is supposed to be the bedrock of the U.S. medical system. In theory, patients get annual physicals so doctors can assess their overall health and detect any red flags (or refer them to specialists who can) before those warning signs become full-blown chronic disease. While experts debate whether everyone needs a checkup each year, studies show that on balance, patients who regularly see a physician tend to be healthier and live longer than those who don’t. Yet about a quarter of American adults don’t have a primary-care provider, and, as of 2021, almost 20% hadn’t seen any doctor during the past year. There are many barriers: it can take weeks to get an appointment, particularly in more rural areas where fewer doctors practice, and visits can be costly even for people with insurance. Research shows that during the past year, financial strain caused about 40% of U.S. adults to delay or go without medical care. Plus, people just don’t like going. A third of participants in one 2015 study said they had avoided going to the doctor because they found it unpleasant, citing factors like rude or inattentive providers, long wait times, and difficulty finding a convenient appointment. Many people also skipped appointments during the COVID-19 pandemic, largely because of office closures and fears of the virus—but one study found that people were more likely to forgo doctor’s visits during the pandemic if they’d had previous poor experiences with health care. People of color, women, and people who are overweight frequently report feeling mistreated by their doctors. Jen Russon, a 48-year-old English teacher and mother of two from Florida, says she can’t remember a single positive experience she’s had with a doctor. She struggles to square the $400 her family pays in monthly insurance costs with what she characterizes as a rushed and underwhelming care experience that pales in comparison with the attention her pets get at the veterinarian. “I wish we could see our vet instead, because they really spend a lot of time” with their patients, she says. Part of the problem may go back to the way doctors are trained, says Jennifer Taber, an associate professor of psychological sciences at Kent State University and a co-author of the 2015 study on doctor avoidance. U.S. medical schools do an excellent job of teaching students how to practice medicine. But, she argues, they aren’t always as good at preparing students to be doctors, with all the interpersonal complexity that entails. “Patients won’t necessarily want to go back to doctors they don’t like,” she says. Even small gestures, like making eye contact with or leaning toward a patient as they speak, can help build a strong rapport, Taber says. The pandemic certainly hasn’t improved bedside manner. It’s pushed nearly every element of medical care to the brink and prompted some providers to leave the profession entirely, worsening existing personnel shortages and contributing to an epidemic of physician burnout. According to one recent survey, 30% of U.S. physicians said they felt burned out in late 2022, and about as many said they’d considered leaving the profession in the previous six months. Physician burnout only adds to patient burnout, says Dr. Bengt Arnetz, a professor at the Michigan State University College of Human Medicine who researches how to improve primary care. “Providers feel stressed, burned out, less empathetic. A lot of times they don’t engage the patient, and the patient wants to be engaged,” Arnetz says. But these problems didn’t start with the pandemic, says Lori Knutson, executive director of the Whole Health Institute, a nonprofit focused on improving health care delivery. “We should all be honest,” she says, “about the fact that health care has been slowly imploding for a period of time.” It’s impossible to explain problems with U.S. health care without talking about insurance. U.S. patients pay more out of pocket for health care than people in other wealthy, developed countries, most of which offer some form of universal health coverage. The insurance system is also endlessly confusing, says Dr. Ateev Mehrotra, a professor of health care policy at Harvard Medical School. Doctors may not know how much the tests they’re recommending cost, particularly when every patient has a different type and level of coverage, so surprise bills are common—and so hard to understand that patients often have to spend hours on the phone seeking clarity from their insurance providers. One 2020 study estimated that dealing with insurance companies costs the U.S. more than $20 billion annually in lost productivity. How doctors get paid affects the patient experience too. Many health systems pay physicians based on how many appointments and procedures they squeeze in, which rewards lightning-fast visits over those that are “about the whole person and not just what’s wrong with them,” Knutson says. This system can also incentivize doctors to recommend tests and procedures that aren’t strictly necessary, which leads to extra costs and hassle for patients and added strain on the health care system. Here, too, insurance is part of the problem. Doctors in primary care or family medicine often make significantly less than specialists, in part because their services are reimbursed at lower rates. That dissuades some medical-school graduates—particularly those saddled with debts—from entering general medicine, which contributes to shortages in the medical fields patients are most likely to need on a regular basis. When there aren’t enough doctors to go around, appointments get scarcer and physicians become overworked, rushing from appointment to appointment and drowning in paperwork. Some simple solutions exist. In a study published in 2020, Arnetz and his colleagues analyzed what happened when one small medical clinic made minor tweaks to its operations, such as reassigning some of the main provider’s administrative duties to nurses or medical assistants and adding short team meetings to delegate tasks for the day. After two weeks, the clinic scored higher than a comparison clinic on measures of efficiency, contributing to better patient and provider satisfaction. Traditional medical offices could also take cues from the services patients are increasingly gravitating toward, says Pearl McElfish, who researches health services at the University of Arkansas for Medical Sciences. Patients who can afford it are flocking to startups offering perks like same-day appointments and flat-rate monthly memberships. And one 2018 study co-authored by Mehrotra found that visits to urgent-care clinics, where patients can walk in instead of waiting for weeks, increased by more than 100% from 2008 to 2015 among privately insured U.S. adults. (During roughly the same period, primary-care visits dropped 24%.) During the pandemic, urgent-care centers only became more popular—as did telehealth. “Currently [the traditional system] isn’t meeting the needs of many patients,” Mehrotra says. “Patients are voting with their feet and going to these other care sites.” The trouble with convenience-first medical care, however, is that it’s often issue-specific. If you go in to get a flu shot, you’ll get that vaccine and then be on your way. The clinician is unlikely to make sure you’re up to date on your other shots or perform recommended screenings—the kind of preventive care that can fend off bigger issues down the line. On the other hand, these newer options can “put pressure on existing providers to be a bit more patient-centric,” Mehrotra says. Traditional medical offices could make some changes right away, without waiting for big structural overhauls, he says. They could offer “walk-in only” hours to treat people without appointments, text patients when the doctor is ready to see them, and include clear explanations on bills so patients understand what they’re paying for. Even small shifts like these could make significant differences to patients. The stakes are high. Ashley, who is 35 and asked to use only her first name to protect her privacy, has a gene mutation that heightens her risk of breast cancer and is supposed to get an annual mammogram and two ultrasounds per year. But she has to move frequently for her job in academia and hasn’t had her tests done in four years because she got so fed up with the arduous process of finding new doctors, transferring medical records, and dealing with insurance every time she moves. “The barriers were enough that I just kept putting it off,” she says. Burned-out patients may retreat from the institutions that made them feel that way. Ashley says she’s considering a preventive double mastectomy—a surgery she may have needed anyway because of her genetic predisposition, but one made more appealing by her desire to stop dealing with “pain in the butt” medical appointments. Russon, from Florida, says she’s felt tempted to cancel her family’s insurance and go to the doctor only when absolutely necessary, though she’s never acted on the urge. Other patients, however, may walk away from the health care system entirely. It may not be the wisest or healthiest response, but it’s a human one. from https://ift.tt/oLE9kju Check out https://takiaisfobia.blogspot.com/ The COVID-related increase in Supplemental Nutrition Assistance Program (SNAP) benefits is coming to an end next month in 32 states, along with the District of Columbia, Guam and the U.S. Virgin Islands. More than 41 million Americans will be affected by the change, and many families are expected to receive at least $95 less per month, according to the research and policy think tank Center on Budget and Policy Priorities. Congress previously issued temporary increases to address food insecurity during the pandemic, when unemployment rates skyrocketed to a high of nearly 15% and more than 22 million jobs were lost. But the passage of the 2023 Consolidated Appropriations Act, which outlines appropriations to federal agencies during the year, ended emergency aid allotments after February 2023. Eighteen states—mostly Republican-led—have already dropped their additional allotments because they previously ended their emergency declarations. Research shows that emergency allotments helped keep 4.2 million people above the poverty line in the last quarter of 2021, mostly helping the Black and Latino population. The shift comes amid elevated rates of food inflation, with grocery staples like eggs up 138% higher than they were last year. Food banks that previously spoke to TIME have also reported increased need since the pandemic as they balance a higher demand for assistance and increased food prices that cause them to incur greater costs. “The things that I used to buy, I can’t afford now,” Mamie Wallace, 60, who relies on the Food Bank for New York City for supplemental grocery needs previously told TIME. “I didn’t notice [food inflation at first] because I had my freezer stocked up but since it’s been over a year now, things are starting to run out.” But even as research shows that 1 in ten Americans currently live in a food-insecure household, House Republicans are looking to cut food stamps even more and enact stricter work requirements for recipients in an effort to decrease the federal deficit. Conservative leaders, such as former director of the Office of Management and Budget Russell Vought, have vouched for broader cuts to social programs, including more than $400 billion in cuts to food stamps, according to the Washington Post. And in conservative-majority states like Iowa, state legislators introduced a new bill that would limit the types of food recipients could purchase. The proposal would not allow people to purchase white grains—meaning they could only buy 100% whole wheat bread and pasta—, baked beans, fresh meat, or sliced cheese, among other limits. Other SNAP waivers will be affected soon after the federal public health emergency ends on May 11. This includes SNAP temporary student exemptions, which permitted certain students who were enrolled at least half-time for their higher education degree to receive food stamps. They will lose aid in June, according to the U.S. Department of Agriculture (USDA), though some may still be eligible if they meet the regular student exemption guidelines, which can include working at least 20 hours a week, caring for a child or not being able to work. Under the emergency allotments, the government also temporarily paused the time limits on SNAP benefits able-bodied adults under the age of 50 who do not have dependents and are not pregnant could receive. Adults will now return to the previous standard, which said that they could not receive food stamps for more than 3 months within a 3-year period unless they met certain work guidelines. from https://ift.tt/jGih3Ju Check out https://takiaisfobia.blogspot.com/ WASHINGTON — The Biden administration moved Friday to require patients see a doctor in person before getting attention deficit disorder medication or addictive painkillers, toughening access to the drugs against the backdrop of a deepening opioid crisis. The proposal could overhaul the way millions of Americans get some prescriptions after three years of relying on telehealth for doctor’s appointments by computer or phone during the pandemic. The Drug Enforcement Administration said late Friday it plans to reinstate once longstanding federal requirements for powerful drugs that were waived once COVID-19 hit, enabling doctors to write millions of prescriptions for drugs such as OxyContin or Adderall without ever meeting patients in person. Patients will need to see a doctor in person at least once to get an initial prescription for drugs that the federal government says have the the most potential to be abused — Vicodin, OxyContin, Adderall and Ritalin, for example. Refills could be prescribed over telehealth appointments. The agency will also clamp down on how doctors can prescribe other, less addictive drugs to patients they’ve never physically met. Substances like codeine, taken to alleviate pain or coughing, Xanax, used to treat anxiety, Ambien, a sleep aid, and buprenorphine, a narcotic used to treat opioid addiction, can be prescribed over telehealth for an initial 30-day dose. Patients would need to see a doctor at least once in person to get a refill. Patients will still be able to get common prescriptions like antibiotics, skin creams, birth control and insulin prescribed through telehealth visits. The new rule seeks to keep expanded access to telehealth that’s important for patients like those in rural areas while also balancing safety, an approach DEA Administrator Anne Milgram referred to as “expansion of telemedicine with guardrails.” The ease with each Americans have accessed certain medications during the pandemic has helped many get needed treatment, but concerns have also mounted that some companies may take advantage of the lax rules and be overprescribing medications to people who don’t need them, said David Herzberg, a historian of drugs at the University of Buffalo. “Both sides of this tension have really good points,” said Herzberg. “You don’t want barriers in the way of getting people prescriptions they need. But anytime you remove those barriers it’s also an opportunity for profit seekers to exploit the lax rules and sell the medicines to people who may not need them.” U.S. overdose deaths hit a record in 2021, about three-quarters of those from opioids during a crisis that was first spun into the making by drug makers, pharmacies and doctors that pushed the drugs to patients decades ago. But the grim toll from synthetic opioids like fentanyl far outstripped deaths related to prescription drugs that year, according to Centers for Disease Control Data. Fentanyl is increasingly appearing on the illicit market, pressed into fake prescription pills or mixed into other drugs. The proposed rules deliver a major blow to a booming telehealth industry, with tech startups launching in recent years to treat and prescribe medications for mental health or attention deficit disorders. The industry has largely benefitted from the reprieve on in-person visits for drugs brought on by the pandemic, although some national retailers stopped filling drug orders generated by some telehealth apps over the last year. The DEA has grown increasingly concerned over the last two years that some of those startup telehealth companies are improperly prescribing addictive substances like opioids or attention deficit disorder medication, putting patients in danger, a DEA official told The Associated Press on Friday. The official said the agency plans to have the new rule in place before the COVID-19 public health emergency expires on May 11, which will effectively end the loosened rules. That could mean people who may seeking treatment from a doctor who is hundreds of miles away need to start developing plans for in-person visits with their doctors now, pointed out Boston-based attorney Jeremy Sherer, who represents telehealth companies. Patients will have six months to visit their doctor in person when the regulation is enacted. “Providers and their patients need to know what that treatment is going to look like moving forward and whether, once the public health emergency ends in May, if they’re going to need to figure out a way to have a visit in person before continuing treatment, and that can be a real challenge,” he said. Many states have already moved to restore limitations for telehealth care across state lines. By October, nearly 40 states and Washington, D.C., had ended emergency declarations that made it easier for doctors to see patients in other states. from https://ift.tt/t2ouVhU Check out https://takiaisfobia.blogspot.com/ |
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