The U.S. Food and Drug Administration (FDA) just issued its first emergency use authorization for an at-home test that can tell users if they have either the flu, COVID-19, or both. The decision on Feb. 24 comes as more people become comfortable with the idea of testing themselves at home to get quick diagnoses for COVID-19. Public health officials have also increasingly warmed up to at-home testing during the COVID-19 pandemic. But with so many overlapping symptoms between COVID-19 and the flu, doctors and the public have used a COVID-19 rapid test to rule out a SARS-COV-2 infection. If it’s negative, they might assume symptoms are from influenza. Now you can understand what is causing your symptoms with more certainty. The FDA’s emergency use authorization for the test, made by Lucira, works in the same way as the at-home rapid antigen tests for COVID-19. People take the provided swab in the kit to swab their nose, then place the tip in a solution that provides results in about 30 minutes. The test is designed to pick up two types of influenza viruses, A and B, and SARS-CoV-2, the virus that causes COVID-19. The tests are expected to be rolled out soon, and are available without a prescription at the same locations where at-home COVID-19 tests are distributed. According to the data the FDA reviewed, the test correctly detected 90.1% of positive influenza A samples, 99.9% of negative influenza B, and 88.3% of positive COVID-19 samples. There are currently not enough cases of influenza B for the study, so the FDA is requiring Lucira to continue documenting the test’s ability to detect that type of flu once the test is available to the public. Knowing which virus you have can speed treatment—influenza and COVID-19 are caused by different kinds of viruses and therefore treated with different antiviral therapies. The FDA urges people to share their results with their health care provider, whether positive or negative, in order to receive the most appropriate treatment. If both tests are negative, then doctors can test for and treat other infectious diseases. The double test is an indication that health officials are reassured by the uptake and use of the COVID-19 self tests, which were the first for an infectious disease, and are willing to consider broadening the array of tests that people can administer on their own. Other home tests that combine flu, COVID-19 and even RSV—another infectious disease that primarily affects young children and the elderly—are also on the horizon. from https://ift.tt/mTaEBgG Check out https://takiaisfobia.blogspot.com/
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Addressing the nation during his State of the Union speech, President Joe Biden took aim at an injustice that touches the lives of most Americans—the absurdly high cost of prescription drugs. As the president laid out, the U.S. has the highest costs on drugs in the world. Biden vowed to take action, which will undoubtedly lead to the pharmaceutical industry’s lobbyists, lawyers, and paid-for allies doubling down on their frenzied efforts to derail newly enacted drug pricing reforms in order to protect the industry’s power and profits. As important as these pricing reforms are, they target only certain parts of the drug industry’s complex, profit-making puzzle. To fully grasp drugmakers’ vehement pushback on any attempts to reduce drug prices, it’s important to pull back the curtain on the industry’s ongoing anti-competitive practices to see what else is really at stake. Patent monopolies on 7 out of 10 of America’s top selling drugs should expire this decade. This means drugmakers stand to lose billions if—and when—lower-priced generic alternatives are allowed on the market. But unless America wises up to the industry’s under-the-table patent games, drugmakers will continue to have free rein to extend their patent protection, delay competition, and keep the cost of life-saving medicines sky high. Today, 1 in 4 Americans cannot afford to take their medications as prescribed. Too many seniors are having to ration their treatments to get by until their next social security check arrives. And contrary to what industry lobbyists argue, soaring drug prices are not the inevitable result of research and development costs to bring breakthrough drugs to market. It’s time to put this widely debunked excuse to bed. Read More: A New Alzheimer’s Drug Gave Patients Hope. Millions Can’t Get It At the root of our nation’s drug pricing crisis is the industry’s egregious abuse of a broken drug patent system. The U.S. patent system was originally designed to promote ingenuity and groundbreaking inventions by granting creators a limited monopoly period. When the system works as the Constitution intended, both industry and consumers benefit. Yet, somewhere along the way, drugmakers began manipulating the process to secure patents for simple tweaks to existing medicines, such as changing the way a drug is delivered or flavored. Big Pharma uses the patent system not to reward invention, but to block competition and extend lucrative monopolies. This isn’t invention—it’s legal gamesmanship designed to bend and distort the rules to put profits ahead of patients. Drugmakers have realized it’s far easier to extend patent monopolies on existing drugs to stem losses from expiring patents than it is to invest in and invent groundbreaking new treatments to save lives. For decades, drug companies have been given carte blanche to systemically game the system by quietly obtaining patent after frivolous patent—often referred to as “patent thickets”—on many blockbuster drugs. This wily maneuvering allows them to extend their monopolies far beyond the 20 years of patent protection intended by law and block lower-priced competitors from entering the market. It also gives them the power to extract multimillion-dollar settlements in litigation from companies with would-be generic or biosimilar products. A perfect poster child for undeserving patents is Regeneron’s product Eylea, which treats an eye condition known as macular degeneration that affects older adults. Eylea was approved by the U.S. Food and Drug Administration in 2011 and thanks to over 90 granted patents—including one for minor adjustments to its sterile packaging—the drug is unlikely to see any generic competitors for years to come. Today, the list price for a single dose of Eylea in the U.S. is over $1,800, while it costs roughly half that amount in the UK. A recent national report reveals that, on average, there are 140 patents filed and 74 patents granted on each of America’s 10 top-selling drugs. Sixty-six percent of these patent applications were filed after FDA approval – many for very minor product modifications. Accompanying the report is a new Drug Patent Book, which offers the first publicly accessible, user-friendly drug patent database underscoring drugmakers’ unrelenting abuse of the patent system. Each additional day of patent exclusivity can mean tens of millions of dollars in revenue for a single drug: Revlimid and Keytruda, which treat cancer, earn $23.8 million and $26.8 million per day respectively; and Humira, which treats debilitating arthritis, was bringing in $47.5 million per day before the first competitor entered the market last week. Allowing Medicare to negotiate prices of some high cost drugs is an important step forward. But policymakers on both sides of the aisle must stop turning a blind eye to Big Pharma’s drug patenting schemes, which are having a profound impact on the health and pocketbooks of millions of American families. The way forward involves three long-overdue reforms to the U.S. patent system. First, Congress must work with the U.S. Patent and Trademark Office (USPTO) and the U.S Food and Drug Administration (FDA) to raise the bar for what gets patented and eliminate incentives for drugmakers to game the system by obtaining frivolous patents. Secondly, we need a much stronger balance of public and private interests within the overall patent system to ensure greater transparency and accountability. This can be accomplished by the USPTO becoming more accessible for public input, as well as placing more members of the public on its advisory committee. And finally, the process to challenge undeserved patents must be revamped to be less costly and convoluted to encourage wider input from the broader public—the patients and consumers who bear the burden of high drug prices. Once patents are granted, current rules make it very hard to challenge their validity and mitigate their harm. These reforms will go a long way to ensuring the U.S. patent system better serves the public. There is growing bi-partisan support in Congress to lower drug prices and enact long-overdue patent reforms. But Pharma is on the offensive trying to convince the public that patent reform would somehow stifle the invention of life-saving drugs. Congress must stand up to drugmakers’ deceptive, anti-competitive tactics and return the patent system to its original intent: an engine for breakthrough discoveries that benefit all Americans—not a vehicle to secure unprecedented profits for a few powerful corporations. from https://ift.tt/8Kfqksm Check out https://takiaisfobia.blogspot.com/ In 2018, I woke up on my birthday around 2 or 3 a.m. with a funny feeling in my left hand. It started as a slight itch on my thumb that quickly morphed into a different sensation—the feeling of the thumb beginning to swell, followed by the same feeling in my fingers and sections of my palm, until my hand was almost double its normal size. Later that morning, I visited an orthopedist I’d seen once or twice before for other reasons. He gave me a shot to prevent further swelling, and I went on my way. It was an unremarkable visit. Soon after, another strange thing happened: My hands began to feel like they were on fire—a painful and odd occurrence that I would soon come to know as the hallmark of Erythromelalgia—or “Man on Fire Syndrome.” James Baldwin famously said, “You think your pain and your heartbreak are unprecedented in the history of the world, but then you read.” Sometimes, though, your pain might really be unprecedented—so rare that no stories about it yet exist. In that case, you must be the teller of a story that renders your experience real. Only 1 in 100,000 people in the U.S. have reportedly been diagnosed with Erythromelalgia (or what many of those of us living with it prefer to call “EM”). A neurovascular illness, EM causes the blood vessels—meant to keep blood flowing and supply the body and its organs with nutrients and oxygen—to malfunction, leaving them unable to successfully undertake the process of normal narrowing (vasoconstriction) and widening (vasodilation) necessary for their most basic, crucial function—a breakdown that leads to the sensation of a self-immolating body. If I step outside for too long on a sunny day, if I get a little bit warm walking around, if I exercise or even mildly exert myself, if I wash my hands or my dishes, and sometimes, for no discernible reason at all, it happens: My hands turn a fuming shade of red, become tight with swelling, and begin burning. My face, my ears, and my feet all joined in at some point or another, too. When I use the word “burning,” I imagine that most readers interpret this to mean “hot,” as if the parts of my body are just very, very warm. But it is crucial here that you understand that I actually mean burning. Hand flares feel as if I am placing my hand on the burner of a stove and bring back memories of the sensation of sticking my hands in snow as a child and foolishly running them under hot water to warm them up. A flare in my ears feels as if someone is holding a lighter to my skin. Face flares feel as if I’ve gotten a terrible sunburn without any of the fun of having first been at the beach. When I feel the sensation in my feet, it is like walking across hot coals. And there are “hangovers” on days after flares—a sensation that I liken to rubbing one’s hands and feet in pink insulation or a tray of crushed glass. It is believed that there is a primary version of the illness caused by genetic factors and a secondary version related to underlying disorders like polycythemia vera and neuropathy, or autoimmune illnesses such as lupus and rheumatoid arthritis. Episodes can increase in frequency with time or remain unchanged over years or decades. For some, the condition can increase in severity rapidly and become disabling within months. Efforts to temper the burning of one’s body parts with water or ice can lead to severe infections and gangrene and further damage to blood vessels. There are stories of people who want to amputate their own limbs because of the unbearable severity of their pain or even worse—to end their own life. And there is currently no cure. To make matters worse, almost no one has heard of EM. The fact that it is so unknown can make the condition harder for those living with it to bear, leaving us strangers stranded alone in a very strange land. To date I have met only one doctor who was familiar with EM. In fact, it was not the orthopedist who first saw my body reacting to this condition but a specialist in misunderstood illnesses like Myalgic Encephalitis and Fibromyalgia, who serendipitously recognized my symptoms during a visit for other long-term chronic issues. Read More: What I Learned from the Generation of Disabled Activists Who Came After Me I know only two people living with EM like me. One, Kevin, a 55-year-old father and former educator who lives almost 2,000 miles away, met me on Twitter, where we both tweeted about life with EM. He quickly became a close friend. We text almost daily about our lives with EM, not only about how it has changed our lives, but also how it has changed us. We talk about the pain, flares, and the lack of treatments. We talk about how difficult it is to do just about everything. I talk about what it is like living with EM as a single woman with multiple chronic illnesses. He tells me what it felt like when he had to stop working and about his first time using a wheelchair in public. I always feel better after talking with him. He tells me the same. And we talk about this too—about the value of friendship, mutual understanding, and empathy in the face of suffering, about the pricelessness of being able to share our stories. The subject that we talk about most often, though, is the shocking level of misunderstanding that we face on a regular basis. We are like aliens on a faraway planet. It is impossible for our family members, our friends, our therapists, and even our healthcare providers to understand what a life with EM is. And for those who are not close to us, it is completely unimaginable. Losing the ability to do things that one was previously able to do is a common human experience. Feeling as if one is burning alive is not. No one wants to believe that such a fate is possible. So, for many, it is easier to tell themselves that Kevin and I are simply lazy, weak, malingerers, liars, and weirdos. Some tell us directly. I would be lying if I said that I didn’t mind or ever find fault with this, but I still try not to blame others for misunderstanding. How can someone understand a thing that they didn’t even know exists? Erythromelalgia is only unimaginable until I tell you my story. And it is only unbearable if there is no one to listen. Chronically ill people need to be able to tell their stories—and to be believed. Along with many others living with such curious conditions, I have witnessed a perpetual, fundamental, cultural misunderstanding about why people like myself tell stories about our lives with these conditions. It isn’t to garner sympathy or to complain. It isn’t to offer one’s self up as a figure of inspiration. It is to be seen. If we are not seen, there can be no dialogue, and without dialogue there can be no progress—not in the way that we see and treat those who are suffering nor in the actual elimination of these devastating, life-shattering diseases. So this is the story of a person who goes barefoot as much as possible, even in winter. Long walks are now impossible for her. Playing tennis for hours in the summer sun as she had before is just a dream. She leans against doorways when stopping to have a conversation in order to avoid standing flat on her feet. She sometimes finds it difficult to hold up a pan filled with water, sometimes even something as small as a mug filled with coffee or tea. Cooking causes her hands to burn. So does vacuuming. Showers or a bit of sun turn her face into the bright red mask of a devil. She can still recall the day when it occurred to her that holding a baby would now, most likely, be out of the question. This is the story of a burning body with a yearning spirit and a churning mind, and, with any hope, it will be a story that starts conversations for cures. from https://ift.tt/1vsXIN0 Check out https://takiaisfobia.blogspot.com/ Life is arithmetic. There are only three certainties all of us face: you’re born, you live, and you die. How many years you get in that interval is something of a mortal crapshoot, but most people would agree on one thing: they’d like as many as possible. That fact is becoming more relevant than ever in the U.S., where aging Baby Boomers have now pushed the 65-and-over cohort to 56 million people, or 16.9% of the national population. By 2030, according to the U.S. Census Bureau, 20% of the population will be of retirement age. By 2034, seniors will outnumber children for the first time in U.S. history. That’s an awful lot of old people confronting the physical, cognitive, and emotional frailties that come with age, not to mention the cold reality that the older you get the closer you come to, well, the end of the line. There is an entire branch of psychology built around the geriatric mind, dealing not just with such clinical conditions as dementia, but also the simple business of fear of—and resistance to—aging. That resistance often takes its form in all manner of youth-preserving strategies such as cosmetic surgery (with 15.5 million procedures performed in the U.S. in 2020 according to industry reports); extreme sports like septuagenarian marathons; and magical thinking (Sixty is the new fifty!). But apart from fear of death—which, admittedly, is hard to get around—why exactly do Americans resist aging so much? It’s a privilege that is denied to too many, after all. And it comes with a raft of advantages like wisdom, respect, and for many, a comfortable retirement. So what is it exactly that makes us all so age-averse? For one thing, argues Sheldon Solomon, professor of psychology at Skidmore College, and, at 69, a Baby Boomer himself, America’s senior cohort comes from a uniquely privileged background, one that has left them with the feeling that the frailties that come with aging—and even death itself—are not inevitable rites of human passage, but somehow negotiable. “We are perhaps the most death-denying generation in human history, having grown up in surreal conditions of modernity,” he says. “Our parents knew wars and depression. We—at least most white people—saw the golden age of the American dream, the last generation of Americans certain to do better than our parents in a world that seemed to be on an inexorable road to progress. We hit golf balls on the moon and have DoorDash and so obviously the next step is eternal life.” That dream may be especially pronounced in one slice of the American demographic, but in fairness, aversion to death—and the dream of eternal life—is something writ deeply in the human psyche. Centuries of fables speak of immortality charms; Ponce de Leon, perhaps apocryphally, searched for the fountain of youth; religions promise eternal paradise after the brief passage of earthly life is done. In the 1980s, Thomas Pyszczynski, 68, professor of psychology at the University of Colorado, Colorado Springs, was part of a group of researchers who developed the terror management theory of facing death which, as its name implies, addresses the way we somehow get through our days knowing that somewhere at the end of the existential line lies the utter annihilation of the self. That’s a knowledge that other animals are spared, but it’s one that both haunts and animates our thinking. “We have this evolved imperative to stay alive,” says Pyszczynski. “So the awareness of death creates this potential for terror. As a result, we use the same intellectual abilities that make us aware of death to manage our fear of it.” Humans do that in one of two ways. The first is to cultivate a belief in literal immortality. “We detoxify death with the hope of living in an afterlife—like reincarnation,” Pyszczynski says. “Every culture has its own version of afterlife beliefs.” The other, less direct means is symbolic immortality. “That’s what people get by being part of something greater than themselves—something that will last forever, like having children or creating works of art, or building buildings. We leave a mark that ensures the world—or at least our families—will remember us.” Americans are no different from others in leaning both on faith in an afterlife and producing good works in this one as a palliative for our fear of our own mortality. But as Solomon says, our culture—and particularly the Boomer segment—is pushing back against those old ways too. “I think we just never got out of the Disneyland idea that life was always going to get better,” he says. “It just was inconceivable that we would die so we’re trying to buy our way out of it—you know, have your head frozen; get out of my body and onto Google Cloud; just really hope that we get the pill that’s going to keep us around another couple of centuries.” For example, only 58% of Boomers aged 53 to 71 have written wills or other estate planning documents, according to the American Association of Retired Persons (AARP). What’s more, of the top 38 anti-aging start-up labs worldwide, 28 are in the U.S., reports the website MedicalStartups. Pyszczynski agrees that there is a particular anti-aging imperative in America. Traditional Asian cultures, for example, are inclined to venerate the elderly for their decades of acquired insight and wisdom. The U.S., a younger country with an equally young ethos, does not show the same respect. That’s especially true in politics, for example: witness the alternating hand-wringing and bomb throwing about whether President Joe Biden, at 80, is too old to serve now, much less seek another term. By contrast, the Dalai Lama, at 87, remains a revered figure in the Eastern world, with his advanced years seen as one of his great, transcendent strengths. “Our culture has always relied on the new,” Pyszczynski says, “on new discoveries and new ideas, whereas other cultures look back more at the elders and the ancients and see the world as fine the way it was many years ago.” Boomers have been a force multiplier in that rejection of the old and celebration of the new—and in some ways that comes from a disarmingly idealistic place. “There was the rebellion of the 60s,” says Pyszczynski. “There was the opposition to the Vietnam war, the push for desegregation, the sense that young people were going to make things better. The Who sang ‘Hope I die before I get old.’ I don’t think they would agree with that anymore.” Maybe not, but the exaltation of youth has stayed with the Boomer demo. “The values of being young that were so prominent when we were growing up makes it a little harder for us to age gracefully.” For example, 71% of Baby Boomers have failed to save adequately for retirement, according to MarketWatch—a stage in life that many Boomers may have felt they could put off indefinitely. Gracefully or not, of course, aging is happening—incrementally maybe, but inevitably. Death awaits inexorably at the end of the great arc of life. We can embrace that truth or flail against it. Too many Americans—especially those in the current senior cohort—are choosing the flail. Those who don’t, those who accept that dying will always be the table stakes of getting to live in the first place, will meet their end with a greater equanimity—and a greater sense of peace. from https://ift.tt/Ku6RVOH Check out https://takiaisfobia.blogspot.com/ The influenza vaccine has worked fairly well this season, preventing serious flu cases and hospitalizations across age groups, according to preliminary data released by the U.S. Centers for Disease Control and Prevention (CDC). Flu shot efficacy varies from year to year, since different strains of the virus circulate each flu season. Experts do their best to tailor the shots to the strains expected to spread, but it’s not always a perfect fit. In some years, flu shot efficacy doesn’t break 30%. So far, however, this season’s flu shots have been 71% effective at preventing symptomatic illness among children and 54% effective at preventing cases resulting in medical care among people younger than 65, according to a CDC report published Feb. 23 and based on data from Wisconsin. While those data are state-specific and based on a fairly small patient sample, the report notes that influenza strains circulating in Wisconsin tracked with those seen nationally. Read More: COVID-19 Rebound Can Happen Even Without Paxlovid The numbers also align with several preliminary national estimates released by the CDC on Feb. 22. Those data—drawn from three different flu-monitoring networks, which include research sites across the country—suggest this season’s shots have been roughly 50% and 70% effective at preventing influenza-related hospitalizations among adults younger than 65 and kids, respectively. Protection has been a bit lower among older adults and people who are immunocompromised, but still around 40% by some of the estimates. The current influenza season started early, with cases beginning to tick up in October and peaking in December. According to the CDC, this season’s circulating strains were a good match for those included in the annual flu shot, contributing to relatively high vaccine efficacy. As with COVID-19 vaccines, flu shots don’t entirely prevent people from getting sick with influenza. But, compared to those who are unvaccinated, vaccinated people who get infected typically experience milder symptoms and have lower risks of developing cases that require medical care or hospitalization—which is why public-health officials recommend annual flu shots for almost everyone in the U.S., regardless of exactly how well that season’s shot goes on to work. from https://ift.tt/W6IUxSd Check out https://takiaisfobia.blogspot.com/ One month before I got pregnant with my son, I was diagnosed with bipolar II disorder. My husband and I had been trying to conceive since our miscarriage the year prior. But we were supposed to have paused the baby-making to focus on finding a fix for my brain. When I told my therapist and my psychiatrist that I was pregnant, their faces fell. I would have to stop trying out medications and hope that the lowest possible dose of the safest possible antipsychotic would be enough to sustain my mental health through my pregnancy. While some pregnant people are able to stay on antidepressants, doctors said they were off-limits for me. In fact, Zoloft was what confirmed my suspected bipolar disorder when it launched me into “a mixed state”—simultaneous mania and depression. “I’m afraid I will lose my mind when the baby is born,” I told my therapist. “Well, that’s a valid fear,” she said. According to a study in Brain Sciences, a meta-analysis published in the American Journal of Psychiatry found that as many as 1 in 5 people with bipolar disorder who give birth experience a postnatal psychotic or manic episode. “What if I hurt him?” I asked. “The very fact that you’re asking this question means you’re more equipped than most parents to make sure you don’t hurt him,” she said. As my fetus grew from a pear to a coconut to a honeydew melon, I studied news clip after news clip about mothers dealing with postpartum psychosis who were eventually pushed to do unthinkable harm to their children or to themselves. In addition to painting our nursery and mastering the swaddle in our infant-care courses, I tested my husband regularly with worst-case scenarios: “If I so much as joke about wanting to throw the baby out the window, what do you do?” Read More: About That Horrific Birth Scene on ‘Fleishman Is in Trouble’ My therapist promised I would be monitored carefully—by her, by my psychiatrist, by my husband. But once the baby was born, it was impossible for anyone to watch me all the time so I was alone with him for so many hours each day. And I was not OK. On top of my bipolar II diagnosis, I had been diagnosed with complex PTSD (CPTSD) from years of physical and emotional abuse as a child. It manifested mostly in the form of daily flashbacks, nightmares, and inarticulable fear. I screamed in panic, for example, when my son was 6 weeks old, and my husband climbed a step stool to install a ceiling light. Sobbing, I begged him to come down as my concerned in-laws tried to reason with me. When I proved inconsolable, my 71-year-old father-in-law eventually installed the light by himself because my brain couldn’t handle the remote possibility that my baby’s father might fall off that fourth step and die. But sometimes, the CPTSD showed up as intrusive thoughts. This baby is completely helpless, the thoughts would say. You could crush the life out of him. If you dropped him now, you could kill him. I was terrified of my power. Terrified that being a “good mom” wasn’t an automatic reaction. It was a choice. I couldn’t stop thinking: “the distance between him alive and him dead / is how well I am.” Of course, I would never intentionally hurt my son. I love my child. To the moon and back, just like the best of them. But when I read about Lindsay Clancy, the Massachusetts mother accused of murdering her three children, my first thought, as horrified as I am by her alleged crimes, was not “How could a mother do such a thing?” It was instead: “That could’ve been me. Thank God that wasn’t me.” More from TIME[video id=JNDyTl2n autostart="viewable"]Read More: ‘Of Course She’s Not O.K.’ The Conversation That Changed How I Thought About Early Motherhood I thought childbirth was supposed to flip on the switch of sacrificial, maternal love, but I have lost count how many mom friends have admitted they were disappointed not to have had that magical moment when the baby was placed in their arms after labor and delivery. Hormones fritzing, body reeling from the bludgeon of pregnancy and childbirth, many of us were shellshocked. It turns out that “What am I supposed to do with this now?” is a more common reaction to holding your newborn for the first time than I thought. Having a safe space to confess my most disturbing thoughts and sort out what is and isn’t “a common reaction” is what ultimately helped me most during those trying months. In addition to my mental-health team, I was fortunate to have two close friends, former roommates, who gave birth to their first babies around the same time as I did. One of them made us take the postpartum-depression quiz at least once a month. We could joke with each other about wanting to run away, which made us better equipped to stay. Still, during that excruciating first year, I fantasized about dying or leaving more times than I admitted even to my best friends. But I had the good fate of avoiding postpartum psychosis. The worst thing I did was leave the apartment once with the baby still inside. I didn’t go far. I stood outside our building and stared up into the baby’s bedroom window. And with the Nest camera feed of him sleeping in his crib open on my phone, I smoked half a pack of years-old cigarettes I’d found in a sweater drawer and cried. When I texted the group thread and told them what I’d done, the other moms said they were glad I got some air. They were glad I came back home. Read More: How I Lost Myself to Motherhood The idea of harming our own children is probably one of the worst scenarios imaginable to the healthy human parent brain. And the idea that it’s possible not to have control over our own brain while we commit harm is even more alarming. Our instinct here is to distance ourselves from this possibility. We want to believe this could never happen to us. But while we may feel safer this way, “othering” people with mental illnesses only increases our susceptibility to this danger. It perpetuates the false idea that mental-health help is something only some people require when what we actually need is more access to mental-health care. For everyone. It’s true that people with preexisting mental illnesses are more likely to experience postpartum psychosis, but it’s also true that 1 in 5 Americans experiences mental illness every year. That’s a whole lot of moms. When our kids were toddlers done with breastfeeding, one of my happiest, most “well-adjusted” mom friends with no history of mental illness and a very loving family of origin confided that she thought every mom experienced suicidal ideations during milk letdown. When the other moms and I looked bewildered, she told us about her experience with dysphoric milk ejection reflex (D-MER), which she described as the feeling of Harry Potter-esque dementors descending down upon her every single time she breastfed or pumped. Her mood would plummet just before her milk released, then the momentary depression would vanish after a few minutes of torture. There is so much that moms don’t talk openly about. Sometimes we stay silent because we, like my friend, assume our suffering is so normal that it’s not something we’re allowed to complain about. Other times, we stay silent because we worry no one else is struggling and that our suffering might make us appear unfit to parent. Either way, our silence comes from shame. And we are ashamed because of continued stigmas against mothers with mental illnesses, against mothers with histories of trauma, or against the average struggling mom and especially the average struggling BIPOC mom. When I considered whether to have a second child, I did a deep dive into maternal-mental-health studies before making the difficult choice to stick with one. One 2019 Australian study published in the Journal of Marriage and Family found that while maternal mental health decreases after the first baby, it eventually finds its way back up. But after two babies, it’s much more likely for maternal mental health to go down and stay down. I have nearly every privilege in the book. A loving, supportive, hands-on spouse. The kind who can be a solo parent when I have a bad day. Plus money to pay for regular visits with both my out-of-network therapist and my psychiatrist, and to afford my medication. And still, I’m not so sure I have the hardware to be able to handle two kids, let alone three. This is not to say it’s impossible. I happen to know several mothers with well-controlled mental illnesses who parent their multiple children with enviable grace. But when I see a mother falter—or worse, do harm—I see a mother whose pain and illness outweighed the resources she had to manage that pain and that illness. The circumstances don’t excuse harmful behavior, but they do, at the very least, put the behavior within our own realm of human possibility. Most of all, they expose how ill-equipped we are to support and care for mothers who find themselves in that unique hell, which the rest of us escaped by sheer luck of the draw. If you or someone you know may be experiencing a mental-health crisis or contemplating suicide, call or text 988. In emergencies, call 911, or seek care from a local hospital or mental-health provider. from https://ift.tt/7HmMzO9 Check out https://takiaisfobia.blogspot.com/ With COVID-19 infections becoming more common, experts have recently urged doctors to prescribe the antiviral drug Paxlovid more than they have been to minimize patients’ symptoms and reduce the chance that they’ll develop severe disease. The drug is authorized for people at higher risk of developing severe COVID-19, including those who are older and people with underlying health conditions. But many patients who have taken Paxlovid have reported developing rebound infections shortly after: testing positive again for the virus after first supposedly clearing the infection and testing negative. Studies have documented that the repeat positive tests are due to the same virus that caused the original infection returning again, rather than a new infection. In 2022, the U.S. Centers for Disease Control and Prevention advised physicians about the potential for rebound infections; the agency continues to recommend the drug for those at high risk of severe COVID-19 disease, but warned doctors to be aware of rebound since people could be contagious when their infection returned. So-called “Paxlovid rebound” has raised questions about how common rebound infections are, both with and without Paxlovid. Pfizer, Paxlovid’s manufacturer, found in its own study of the drug that rebound occurs in about 1.7% of Paxlovid patients, which is slightly lower than what they found in the untreated, placebo group. Larger studies have not yet established how often rebound occurs in people who are infected and not treated. But a new study published in the Annals of Internal Medicine sheds some light on the question, reporting on how likely rebound infections are without taking an antiviral. “When I heard reports of people telling me they were getting better [on Paxlovid] and then got worse again, there was always a question in my mind about whether this happens during the natural COVID-19 infection recovery period,” says Dr. Jonathan Li, associate professor of medicine at Harvard Medical School and Brigham and Women’s Hospital and author of the study. “Only by understanding what happens in untreated infections can we interpret the data we are getting from patients receiving Paxlovid.” In the trial—which was part of a larger network of trials testing various antiviral treatments for people with mild-to-moderate COVID-19—Li tracked the symptoms and viral levels, measured by weekly nasal swabs, of about 560 people who received a placebo over the course of their infection. Everyone swabbed at the start of the study and at two, three, and four weeks later. They also kept a daily log of symptoms, including fever, headaches, and coughs. About 26% of these untreated people reported that their symptoms returned around 11 days after their onset, and 31% had higher virus levels after they had initially dropped. Overall, 3% of people reported both a return of symptoms and a higher viral load during the month-long study period. (All scenarios indicate infection rebound.) “Those results tell us that symptom improvement is not a linear process but, in fact, waxes and wanes over time,” says Li. “It’s also very rarely associated with high-level viral rebound. Even without Paxlovid…patients will have symptom rebound, and potentially viral rebound as well. We have to be careful when saying Paxlovid will cause a significant side effect of rebound, when we still just don’t know.” Read More: A One-Shot COVID-19 Treatment Shows Promise Various studies and anecdotal data have found vastly different rates of rebound among both Paxlovid users and untreated people. Anecdotal reports, for instance, suggest a much higher rate of rebound among people who take Paxlovid than the Pfizer study did. But variations between all of this research, including the threshold of viral load that the researchers set to record virus levels, could account for the differences. One advantage of the current study, says Li, is that the patients were swabbed every week—but the small number of positive rebound samples also means it’s hard to draw any definitive conclusions about the incidence of rebound. So how should the results be interpreted? Li says it’s most important to remember the reason why people take Paxlovid. “The reason we recommend Paxlovid is not to prevent rebound [infections] but to prevent hospitalization and death,” he says. “When I counsel my patients, I tell them that the clinical trial [that the U.S. Food and Drug Administration reviewed to authorize Paxlovid] showed 90% protection from hospitalization and death despite any viral rebound after treatment. We need to keep our eyes on the prize.” Scientists are also looking into whether Paxlovid can help reduce the risk of Long COVID, though that research is still early and conclusions can’t yet be drawn. Rebound infections are not unusual with viruses, and researchers are learning more about why this particular virus bounces back after waning and how extensive the repeat infections are. One possibility, related to way Paxlovid works, is that the recommended five days of pills may not be enough to properly suppress the virus, so it comes back when the medication stops. Another theory is that in response to the immune system, the virus may be moving to different parts of the body and finding new cells to infect, causing surges in virus levels and the return of symptoms. “We need more intensive data looking at both those taking Paxlovid and those who are not, to better understand what’s going on,” says Li. Deciding who might benefit from Paxlovid should come after a detailed discussion between doctor and patient, Li says. “I counsel patients depending on their overall risk,” he says. “Risk factors like age do not lead to dichotomous ‘yes-no’ answers; it’s a continuous spectrum.” Data from his study should help in those discussions, to better balance the risks and benefits of the treatment for individual patients. More studies are also needed to clarify the cycle of rebound, since people who test positive again after testing negative can still spread the virus to others. from https://ift.tt/vCzg6kE Check out https://takiaisfobia.blogspot.com/ Over the past three years, COVID-19 has directly touched every aspect of our society, including children. Although less severe in children than adults, COVID-19 is now the fifth-leading cause of disease-related death among those under 19 years old. Yet, as the pandemic and its direct effects on children are easing, there are other concerns that the medical community must contend with—a problem, in large part, due to the spillover effects of misinformation and politics on pediatrics. Today we are seeing long-established norms of basic pediatric practice being discredited and ignored, and a concerning rise in vaccine and pediatric misinformation. In 2019 alone, childhood vaccinations prevented more than 24 million cases of vaccine-preventable diseases in the U.S. But over the course of the COVID-19 pandemic, the anti-vaccine movement has greatly escalated its generalized anti-pediatric vaccine attacks. This misinformation spread is having real consequences for the public: The number of parents who believe that they should be able to decide not to immunize their school-age children, even if being unvaccinated creates health risk for other children, nearly doubled between 2019 and 2022, to about 30%. Read More: We Still Don’t Know What Works Best to Slow the Spread Of COVID-19 It is worrisome that rates of vaccination for young children in some areas of the U.S. have now fallen below levels needed for population immunity. In January 2023, an outbreak of measles in Ohio in more than 80 under-vaccinated children resulted in nearly 40% of them being hospitalized. In the past, there would have been public outrage if this occurred. But in 2023, the public response to the outbreak was muted. Rather than recognizing the established pediatric wisdom that consistently speaks in evidence-based support of immunization, we are now seeing widespread legislative attempts to roll back school vaccine requirements and escalating social media attacks aimed at experts in pediatric infectious disease who advocate for childhood vaccines. We’re also seeing prominent pediatricians removed from important state positions in Tennessee and Florida, for vaccine-related issues. There has been similar political backlash against pediatric care for children with gender dysphoria, with a flurry of false information mischaracterizing the care that these children receive. Although such children may see specialists for some aspects of their health care, pediatricians also care for these children in the primary care setting, and also understand the special mental health challenges and complex care needed for these patients. To the concern of many, across the U.S., there are numerous legislative bills against supporting pediatric transgender care, irrespective of the wishes of parents and children. These political restrictions of transgender care are causing great concern in the pediatric community, and undermine the pediatrician-patient-family relationship. These legislative efforts also ignore the collective voice of the established pediatric medical community. In 21 states, hospitals and health care providers participating in pediatric transgender care have recently been threatened or harassed, in part due to right-wing groups spreading false information. Bomb threats made against children’s hospitals for providing pediatric transgender care not only disrupt such care but disrupt general hospital operations, as well. A different, but somewhat related dynamic is at play in the ongoing battles about access to abortion, where attempts to restrict such access is often coupled with efforts to restrict reproductive health education, and birth control access by teenagers. The backlash against sex-education in schools is associated with disinformation too. These political actions are causing pediatric and other care providers to make a choice: either work in parts of the U.S. where such restrictions are not in teenagers’ best interests, or leave, abandoning the geographical area. This is happening at a time when the pediatric health care workforce is already decreasing. Fewer medical school graduates are going into pediatrics or other forms of primary care than just a few years ago, and the rate of retirement among established providers is increasing. Soon, we will be facing worsening pediatric workforce shortages—especially in many regions of the U.S. where residents struggle to get effective health care and are more likely to be impacted by sexual health legislation. Irrespective of whether we agree or disagree with new legislation and political influence on pediatrics, we need to ask ourselves: Are we comfortable with the sort of threats and actions that are now being taken against pediatricians simply for advocating for longstanding core practices? Why are we listening to orchestrated campaigns of false facts related to pediatric care rather than mainstream pediatric organizations? We all need to consider what the long-term consequences will be when we stop listening to the professionals with decades of education, training, and experience who care for the 73 million children in this country. It also begs one more, vital question we all need to put to ourselves: When a parent or guardian brings a child to their pediatrician for medical care and guidance, who do we want to decide their treatment—their licensed health care providers or politicians? from https://ift.tt/VdZt96R Check out https://takiaisfobia.blogspot.com/ EPA Takes Over Cleanup of Toxic Ohio Train Derailment With Norfolk Southern to Foot the Bill2/21/2023 EAST PALESTINE, Ohio (AP) — Federal environmental regulators on Tuesday took charge of the cleanup from the East Palestine, Ohio train derailment and chemical burn and ordered Norfolk Southern to foot the bill. The Environmental Protection Agency told Norfolk Southern to take all available measures to clean up contaminated air and water, and also said the company would be required to reimburse the federal government for a new program to provide cleaning services for impacted residents and businesses. The EPA warned Norfolk Southern that if failed to comply with its order, the agency would perform the work itself and seek triple damages from the company. “The Norfolk Southern train derailment has upended the lives of East Palestine families, and EPA’s order will ensure the company is held accountable for jeopardizing the health and safety of this community,” EPA Administrator Michael S. Regan said in a statement ahead of a planned news conference with the governors of Ohio and Pennsylvania. “Let me be clear: Norfolk Southern will pay for cleaning up the mess they created and for the trauma they’ve inflicted on this community,” he said. “In no way shape or form will Norfolk Southern get off the hook for the mess they created,” Regan said at the press conference. He added that he knows the order “cannot undo the nightmare that families in this town have been living with, but it will begin to deliver much needed comfort for the pain that Norfolk Southern has caused.” The agency said it would release more details on the cleanup service for residents and businesses this week. The EPA said its order marks the end of the “emergency” phase of the derailment and the beginning of long-term remediation phase in the East Palestine area. Ohio Gov. Mike DeWine on Tuesday also acknowledged the community’s concern that it will be left to handle the aftermath on its own once the news cameras leave and public attention turns elsewhere, and he assured residents that won’t be the case. Separately, Transportation Secretary Pete Buttigieg announced a package of reforms Tuesday, calling on railroad operators to take immediate steps to improve safety, such as accelerating the planned upgrade of tank cars. Some 50 freight cars derailed on the outskirts of East Palestine, near the Pennsylvania state line, prompting persistent environmental and health concerns. The derailment prompted an evacuation as fears grew about a potential explosion of smoldering wreckage. Officials seeking to avoid the danger of an uncontrolled blast chose to intentionally release and burn toxic vinyl chloride from five rail cars, sending flames and black smoke again billowing high into the sky. That left left people questioning the potential health impacts for residents in the area and beyond, even as authorities maintained they were doing their best to protect people. ___ Rubinkam reported from northeastern Pennsylvania. from https://ift.tt/4ESI5pA Check out https://takiaisfobia.blogspot.com/ Often derided and the topic of many a teacher’s report card comment daydreaming, or mind-wandering, is generally seen as an undesirable activity, especially among school-age children from whom the education system demands unrelenting focus. “Monica likes to daydream,” notes home to my Mom would read. “I do wonder what she is thinking about.” And yet, on average, we daydream nearly 47% of our waking hours. If our brain spends nearly half of our awake time doing it, there is probably a good reason why. The term “daydreaming” was coined by Julien Varendonck in 1921 in his book The Psychology of Day-Dreams (with a foreword by Sigmund Freud, so sort-of a big deal). While Varendonck and Freud saw benefits to daydreaming, the past 20 years have yielded research that portrays daydreaming as “a cognitive control failure,” with some researchers out of Harvard recently declaring “a wandering mind is not a happy mind.” An exception to that opinion was one held by the late eminent psychologist Jerome Singer, who spent most of his professional life researching daydreaming (he preferred the term to “mind-wandering”). Singer identified three types of daydreaming, and while two can have negative impacts, one is quite beneficial. The first is “guilty dysphoric” or fear-of-the-future daydreaming, when we either think about the past, perseverating on a negative experience (like reliving a tough phone call over and over), or we catastrophize the future (like imagining failing spectacularly at an upcoming work presentation). Then there is “poor attentional control,” where a person struggles to focus on a particular thought or task, particularly troublesome for those with attention deficits. These two kinds of daydreaming don’t have identifiable benefits. But the third type, “positive constructive daydreaming (PCD),” where we cast our mind forward and imagine future possibilities in a creative, positive way, can be quite beneficial. Helpful for planning and creativity, PCD is the bridge that links our internal observations with the forecasting required for future exploration. Read More: How to Stop Catastrophic Thinking at Bedtime Philosophers have long stressed the importance of the type of inner reflection associated with PCD. Most of the enlightenment philosophers like Diderot, Locke, and Kant believed it was inward reflection, not external drivers, that empowered humanity to direct their own lives and lead themselves. In his 1690 work, An Essay Concerning Human Understanding, John Locke ponders the term “consciousness,” describing it as the “perception of what passes in a man’s own mind.” For Locke, consciousness was “inseparable from thinking” and represented an integral awareness of the working of our own mind. To him, open observation of our internal consciousness paved the way for curious exploration of our external world. The part of our brain most often associated with daydreaming is called the “default mode network” (DMN). The term “default mode” refers to the part of our brain associated with our resting state and is responsible for our ability to reflect on our own consciousness and internal narrative. The DMN is an anti-correlational system active during contemplation like daydreaming and quiet when our working memory becomes engaged. The DMN is also something of a hub, with lots of connections running through it that impact a host of other activity patterns. But more interesting and somewhat mysterious, the DMN is responsible for much of our abstract conceptual thought—the introspective, self-referential kind that separates us from primates—and it recalls and constructs social scenarios to help us make meaning of our life. While the DMN can become disrupted during cognitive decline, such as dementia, PCD can actually thicken the cerebral cortex, or what’s known as our brain’s gray matter, the thinning of which is associated with the cognitive decline of aging. While this link isn’t fully understood yet, we know that a well-functioning default mode network—where we cast our mind’s eye forward in time or reflect on our past experience (as in positive constructive daydreaming)—plays a pivotal role in our healthy mental functioning, in areas like memory consolidation, planning, and impulse control. Despite the benefits, we are conditioning daydreaming out of our kids—and in turn, out of our adult lives as well. Daydreaming is strongly discouraged in the majority of traditional learning environments, Most schools dwell so much on an assumption of high attentional demand that they’ve failed to balance the potential benefit of PCD’s “constructive internal reflection.” When we consider that daydreaming is a hallmark of ADD/ADHD, one has to question if neurodivergent children are being labeled as “underachievers” or “troublemakers” for simply engaging in an activity we all do with frequency, but one that doesn’t fit within the rigid strictures of the modern education system. Rather than demonizing daydreaming, we should protect it, nurture it, honor it—if not for the raft of physiological and psychological benefits, then for the potential societal benefits. People who daydream are more reflective, have a deeper sense of compassion, and show more moral decision-making. And ultimately, children who are more reflective, compassionate, and moral grow up to be the adults who build a more just society. from https://ift.tt/msEBLxP Check out https://takiaisfobia.blogspot.com/ |
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