Nearly two years after he’d been treated for kidney cancer and felt like he was in the clear, Chuck Stravin received the news that some nodules in both of his lungs were growing at an aggressive pace. When those were removed and biopsied, results confirmed that his kidney cancer had become metastatic. “Everything switched in that moment—the battle became completely different,” he recalls. “Before, we were focused on moving fast and being cancer-free, and then I had to flip a switch and slow down. I had to change my mindset, and I knew I couldn’t do that alone.” [time-brightcove not-tgx=”true”] When he was first diagnosed, Stravin had a few sessions with a social worker at the Dana-Farber Cancer Institute in Boston, where he was treated. But he knew that navigating metastatic kidney cancer would require a larger team to help him feel supported. “I’m a classic type A person who sees things as black and white,” he says. “But metastatic cancer is all shades of gray when it comes to how you respond emotionally. It’s hard to process that, especially on your own.” The American Cancer Society (ACS) estimates that about 82,000 new cases of kidney cancer are diagnosed each year. Around one-third of people affected will see their cancer spread to surrounding tissues or organs, which is called stage 4 or metastatic disease. The five-year survival rate fot these patients is around 15%, according to the ACS, though treatments and outlook are continually improving. Feelings of distress and isolation are common with kidney cancer, especially if it’s become metastatic. A 2018 study in Therapeutic Advances in Urology found that people with the disease experienced high levels of anxiety, pain, sadness, worry, and sleeping difficulties. Another study, published in a 2016 edition of the journal PLOS ONE, found that when kidney cancer patients experience psychological challenges, it can affect their immune systems and physiology. For instance, someone might report more chronic pain or catch colds more easily when they feel unsupported. That means getting the right resources isn’t just essential for mental balance; it could also improve symptoms to some degree. Here are tips from Stravin and other kidney-cancer specialists about how to find support and make the most of it. Identify what you needHaving lived with metastatic kidney cancer for six years, Stravin knows that what he needed in the beginning is not the same as the support he cultivates now. In the first few weeks, for example, he spent time talking with family, friends, his oncologist, and social workers about how to pivot away from constant anxiety. What he needed was to set meaningful goals—he chose “being able to see my daughters graduate from college” as the main one—and to focus on everyday joys that refreshed his optimism. That doesn’t mean it was easy, he adds, but it did give him a framework for making a huge mental turn. “I could tell that I needed to shift away from thinking about what’s next, always holding my breath before the next scan results, always wondering about clinical trials,” he says. “I never would have admitted back then that my cancer was incurable. That would have felt like giving up. But over time, I’ve come to see the enormous value in changing my focus.” Rather than just asking for support in general, Stravin has learned to be specific in what he needs. For example, sometimes he just wants to vent and needs a listener; other times he wants to pray and asks family to join him. Increasingly, he appreciates being able to joke around and laugh. “That’s the best remedy for coming to grips with this lousy situation,” he says. Taking some time to think deeply about what would be most nourishing for emotional health at the moment—with the understanding that tomorrow’s needs could be different—is very helpful when considering what type of support is best for right now, he suggests. Read More: Coping With the Side Effects of Kidney-Cancer Treatment Start with your doctorWhen Stravin’s daughter got married, his oncologist at Dana-Farber, Dr. Toni Choueiri, photobombed every group shot, and the family often jokes about their “bromance” and how they can talk for hours. Not every doctor-patient relationship will have that kind of chemistry, but it should have a deep foundation of trust that allows patients to be more open, Choueiri says. “In any specialty, the way a doctor and patient connect is important, but in oncology it’s especially crucial because patients are feeling very vulnerable,” he adds. “Your doctor should be your quarterback for care, and because of that, there needs to be a lot of confidence and communication.” When looking for support with metastatic kidney cancer, Choueiri suggests beginning with your oncologist, because that doctor will already have experience with what’s emotionally challenging for you. Your oncologist will also know what’s coming up in terms of important scans, family dynamics, clinical trial options, and side effects. All of these can be variables in helping you find the right kind of support, he says. Tap into your larger care teamSocial workers with oncology experience are essential for a care team, Choueiri says. These professionals “are trained to understand patient needs on multiple levels, and they can act as a bridge to other resources,” he adds. For example, social workers might connect a patient with a hospital system’s financial department, since paying for care can be a source of anxiety. Choueiri also suggests meeting with a psycho-oncologist, a specialist who can address the intersection of emotional, social, behavioral, and physical aspects of metastatic cancer. Meeting with a therapist, psychologist, or psychiatrist can help you talk through feelings about diagnosis, treatment, changing family relationships, concerns about the future, anxiety, or depressive symptoms. These mental-health professionals can provide the tools necessary to cope with stress and uncertainty. Sometimes, the support you need isn’t directly emotional but still affects your mental health, adds Dr. Jennifer Linehan, an associate professor of urologic oncology at the Saint John’s Cancer Institute in California. For example, having trouble sleeping or difficulty controlling pain can lessen one’s emotional resilience. In such cases, getting support would mean trying different treatment options that can provide rest and relief. Add virtual and in-person support to the mixWhether you’re feeling fatigue from a recent treatment, live too far from your cancer center for frequent visits, or just want to talk to a friend in the middle of the night, online support groups tend to be key for helping patients feel connected. These have come a long way in just the past five years, says Dr. David Nanus, a medical oncologist and specialist in genitourinary cancers at Weill Cornell Medicine in New York City. COVID-19 restrictions shut down many in-person support meetings, he says, and even though those have slowly returned, the breadth of online options developed in the interim have been a boon, Nanus says. “There are so many groups online now—the evolution has been very rapid in the last couple years in particular,” he says. “The advantage is that patients can meet people from all over the country or even the world, and they can feel a connection any time.” In addition to talking about emotional struggles, frustrations, and joys, these groups often share information about the latest research developments, Nanus says. They might track certain clinical trials or promising therapies that are working through the U.S. Food and Drug Administration approval process. Even if those treatments are years or decades away, being able to discuss them in a support group can be empowering, Nanus says. “A big part of metastatic kidney cancer is feeling a loss of control, and people can feel helpless because of that,” he adds. “When they can have a discussion with someone else in a similar situation and talk about potential progress, it absolutely makes them feel more involved in their care.” To find groups that might be appropriate, consider options such as those hosted by the Kidney Cancer Association, Smart Patients, and KCCure Kidney Cancer Patient Support Community. Also, ask your care team if there’s a virtual or in-person group that’s part of the care center. Many cancer centers have these groups, both for patients and caregivers, and may host cancer seminars as well, where you can meet other patients and learn about treatment options. Read More: 7 Myths About Kidney Cancer, Debunked Consider advocacy effortsOne way to broaden knowledge of available groups and resources is to become a voice for progress in cancer research and care, Stravin suggests. A few years ago, he became an active participant in KidneyCan, a nonprofit focused on education and advocacy, and now helps lead the New England delegation. That allows Stravin to connect with legislators and researchers, as well as other patients. The effort helps him feel like he’s contributing to greater awareness about kidney cancer, and supporting others while being supported himself. “I’ve developed relationships with other patients through KidneyCan, and we discuss the tough stuff together, like how to talk to your kids about the cancer progressing, or end-of-life decisions that should be made sooner rather than later,” Stravin says. “Also, being an advocate gives me a sense of purpose, which can sometimes be hard to have with metastatic cancer.” Combining all these resources—in-person support from his care team and family, advocacy efforts that drive his optimism, and virtual connections with his KidneyCan group—has helped Stravin navigate his cancer. “I think cancer still has a stigma attached to it, and I know it can be difficult to open up and talk about it,” he says. “But connecting with others and getting all these emotions out there is a huge part of dealing with the mental aspect of metastatic cancer.” from https://ift.tt/jYyutTV Check out https://takiaisfobia.blogspot.com/
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The abortion pill mifepristone has been on uncertain legal ground ever since a Texas judge ruled that the U.S. Food and Drug Administration (FDA)’s approval more than two decades ago should be suspended. After the Department of Justice appealed the decision and requested that the Supreme Court step in, the high court decided that mifepristone should remain available while courts continue to decide its legal fate in a potentially lengthy appeals process. With one abortion pill in legal limbo, experts are now worried about possible threats to the other one: misoprostol. The drug is FDA approved to treat ulcers and, when used with mifepristone, to induce abortion in the first trimester of pregnancy. Taking the pills together is more effective and linked to fewer side effects than using misoprostol alone. In many parts of the world, however, doctors use misoprostol alone for abortions. Health-care providers can still use misoprostol on its own for abortions or to manage miscarriages in what’s called “off-label” use, a common practice that allows them to prescribe any approved drug for purposes other than those for which they are indicated. [time-brightcove not-tgx=”true”] If mifepristone loses its status as an approved drug, or if its use is restricted, misoprostol could become the only option for medication abortion—and the next abortion battlefield. The unprecedented legal challenge to one abortion pill shows how the other might be similarly vulnerable. While misoprostol’s approval as an ulcer drug is unlikely to come under legal threat, its use in abortion might. If that happens, aggressive prosecutors might decide to criminally charge people who travel to other states to take the pill. (The same could also happen to people obtaining mifepristone should that drug become restricted.) “There are laws that can be used to go after people who have had self-managed abortions claiming that it’s fetal harm or child abuse,” says Liz Borkowski, managing director of the Jacobs Institute of Women’s Health at George Washington University. “That depends on prosecutors and how far out on a limb they want to go with this.” Just as plaintiffs brought a case against the FDA questioning the approval of mifepristone, parties could begin to challenge the FDA’s regulation of off-label use—not only for misoprostol, but for any drug, says Lawrence Gostin, director of the World Health Organization Collaborating Center on National and Global Health Law at Georgetown Law. “If the challenge to mifepristone is successful, it could open the floodgates to litigation against other drugs,” he says. For health-care providers, that would be devastating. “It’s extremely concerning when politics supersedes health decisions that are best left to the patient and provider relationship,” says Dr. Umair Shah, secretary of health for Washington state. “Today it’s mifepristone; tomorrow it could be vaccines, and then Narcan, and before we know it, it’s everything.” Read More: Abortion Rights Benefit People Who Want Kids, Too Though misoprostol is not currently being challenged, states in which abortion is legal are trying to pre-emptively protect it. Some Democratic governors—including in California and New York—are stockpiling the drug to preserve access to medication abortions. Having supplies of the drug on hand could avoid any potential restrictions, especially on shipping the medication between states, that could come. Officials in many states are also “making moves to say they won’t cooperate with investigations of providers and patients who use misoprostol,” says Borkowski. “A lot of states are stepping up and putting protections in place recognizing that this is probably coming.” In the aftermath of the Texas judge’s ruling, for example, Washington state’s legislature passed a shield law that prohibits cooperation when Washington health-care professionals are charged with out-of-state criminal and civil cases related to abortion, which the governor is expected to sign into law. It also passed a law prohibiting copays for any abortion care, bolstering an existing state law that requires state plans to cover abortion services if they cover maternity care. Such protections are an extension of those that many Democratic governors passed by executive order after the Supreme Court overturned Roe v. Wade in 2022, protecting providers who perform medication abortions for people who travel from states where abortion is illegal. Even so, additional safety nets might be required to insulate misoprostol’s use in abortion. New York governor Kathy Hochul proposed legislation in New York that requires private insurance companies to cover misoprostol when it is used in abortion; she is also taking additional steps to protect doctors who prescribe misoprostol by discouraging higher malpractice rates for them. In Washington state, legislators passed a bill assuring that reproductive health-care services, including abortion, are recognized as part of health-care providers’ professional duties and not subject to any disciplinary measures under the state’s licensing regulations. The bill is awaiting the governor’s signature. While the legal fights continue, Shah’s biggest concern is for “the impact and precedent this sets for other kinds of medications,” he says. “We just don’t, as a nation, want to go back to letting politics get in the mix of health decisions.” from https://ift.tt/0YxVjE9 Check out https://takiaisfobia.blogspot.com/ North Dakota on Monday adopted one of the strictest anti-abortion laws in the country as Republican Gov. Doug Burgum signed legislation banning the procedure throughout pregnancy, with slim exceptions up to six weeks’ gestation. In those early weeks, abortion would be allowed only in cases of rape, incest or medical emergency, such as ectopic pregnancy. “This bill clarifies and refines existing state law…and reaffirms North Dakota as a pro-life state,” Burgum said in a statement. Last year’s U.S. Supreme Court ruling overturning the 1973 Roe vs. Wade decision that legalized abortion nationwide has triggered multiple state laws banning or restricting the procedure. Many were met with legal challenges. Currently, bans on abortion at all stages of pregnancy are in place in at least 13 states and on hold in others because of court injunctions. On the other side, Democratic governors in at least 20 states this year launched a network intended to strengthen abortion access in the wake of the U.S. Supreme Court decision that eliminated women’s constitutional right to end a pregnancy and shifted regulatory powers over the procedure to state governments. The North Dakota law is designed to take effect immediately, but last month the state Supreme Court ruled a previous ban is to remain blocked while a lawsuit over its constitutionality proceeds. Last week, lawmakers said they intended to pass the latest bill as a message to the state’s high court signaling that the people of North Dakota want to restrict abortion. Read More: Democratic States Are Stockpiling Abortion Pills to Preserve Access Supporters have said the measure signed Monday protects all human life, while opponents contend it will have dire consequences for women and girls. North Dakota no longer has any abortion clinics. Last summer, the state’s only facility, the Red River Women’s Clinic, shut its doors in Fargo and moved operations a short distance across the border to Moorhead, Minnesota, where abortion remains legal. The clinic’s owner is still pursuing a lawsuit challenging the constitutionality of North Dakota’s previous abortion ban. It’s expected that this new ban will also be the subject of legal challenges. Republican Sen. Janne Myrdal, of Edinburg, sponsored the latest state legislation. “North Dakota has always been pro-life and believed in valuing the moms and children both,” Myrdal said in an interview. “We’re pretty happy and grateful that the governor stands with that value.” Democratic Rep. Liz Conmy voted against the bill and said she had hoped Burgum would not sign it. “I don’t think women in North Dakota are going to accept this, and there will be action in the future to get our rights back,” Conmy said. “Our Legislature is overwhelmingly pro-pregnancy, but I think women in the state would like to make their own decisions.” from https://ift.tt/EtTxDHk Check out https://takiaisfobia.blogspot.com/ When his team decided to name the XBB.1.5 variant of COVID-19 “Kraken,” Ryan Gregory never imagined it would resonate the way that it did. It was an arbitrary nickname, meant to be an improvement on the confusing letter-and-number-salad system that led to official nomenclature like “XBB.1.5”—but certainly not designed to make the public think that this particular strain of COVID-19 was the most monstrous yet. “I always associated [the word] with the silly 1981 Clash of the Titans movie,” he says. “It’s cheesy in a way.” Gregory is an evolutionary biologist at Canada’s University of Guelph and the unofficial spokesperson for the small group of scientists fighting for clearer (and catchier) pandemic nomenclature. The team, which includes a science teacher from Indiana and academics across disciplines in Italy, Australia, and more, first assembled on Twitter. There, they’d been assigning creature-based nicknaming efforts for COVID-19 subvariants they deemed significant long they began receiving media coverage for Kraken; they’d named others Gryphon, Basilisk, and Minotaur, for example. But Kraken drew the first real attention to the project. And not all of that attention was positive. When the name caught on, some experts expressed concern that it could unnecessarily stoke fear because of its monstrous connotations. Meanwhile, the World Health Organization (WHO), which had led (and still does lead) the scientific discourse around COVID-19 nomenclature, remained conspicuously silent on the nickname in interviews at the time. “There was a lot of talk like, This is fear mongering, and it’s causing panic,” Gregory says. “And I’m like, ‘None of that happened.’ Meanwhile, the [WHO] was saying stuff like it’s the most transmissible variant ever. That’s scarier to me than this goofy mythological name.” Read more: Why New COVID-19 Variants Have Such Confusing Names Whether it was goofy or scary, the name Kraken stole enough attention to convince Gregory and his colleagues that maybe they would have been better off using more neutral names. So, on Feb. 13, the team debuted an updated system with an extensive user guide, which utilizes the names of constellations and other celestial objects rather than mythological creatures. And unlike in an ordered system like the Greek alphabet, Gregory is unlikely to run out of names. He’s got a long list, he says, of “stars, planets, moons, comments, galaxies…whatever.” It’s the citizen scientists’ second act, and how it goes could teach science communicators important lessons about what people want as they learn to live alongside COVID-19. The WHO’s initial plan, back in May 2021, was that major lineages of the virus would each get their own Greek letter. Alpha’s time in the spotlight gave way to Beta, and so on. But Omicron—the 13th named strain—never stopped spreading, and as it did, it branched out, with new mutated variants extending out like tree trunks from an original Omicron, most evolving even further into nearly indistinguishable subvariants. Using a method called Pango, which was developed by infectious-disease experts at the University of Oxford and the University of Edinburgh and formally adopted by international organizations in 2021, the agency quickly got into what Gregory calls “variant soup,” with each subvariant given a Dewey Decimal-like name with different letter and number elements that allow you to track its exact lineage. That’s how you end up with news stories about difficult-to-remember but important subvariants like XBB.1.16, which is currently gaining traction in the U.S. “It’s a very logical system,” says Gregory, but you have to know how to decode it. “The thing that concerns me a little bit is the World Health Organization is in this challenging position now where there are variants they want people to know about, but then they have to refer to technical names again.” “If people are going to be talking about it, in a non-technical context, it should have a nickname. That’s it for me,” he says. A virus, by any other name, is still as infectious, but you should at least be able to remember what it’s called. Read more: Why U.S. Experts Can’t Agree on the Origins of COVID-19 The common names developed by Gregory’s team fill in what many have identified as a gap left by a more technical system that those outside of science are unlikely to use. Initially the group assigned somewhat arbitrary names of mythological creatures to any variant designated by WHO as a “variant of concern” or a “variant of interest.” Their revised common naming system is getting more systematic, and includes new methods of epithet-based indexing. Gregory’s team has broken the alphabet into four sections—one for each of the three largest Omicron lineages, and one for viruses from smaller lineages. These groups are represented by the first letter of a subvariant’s common name. If a name begins with letters A through H, for example, it’s from the BA.2 lineage. Additionally, if a variant is a recombinant strain, meaning it was formed from the combination of two existing iterations, the name will have an R in it somewhere, says Gregory. Take the first variant the team nicknamed under the new system: XBB.1.16, or Arcturus. Because Arcturus starts with an A, it means it’s from the BA.2 lineage, and because it has an R in it, it’s a recombinant strain. Gregory believes that the new naming system is still doing the trick, even without the dramatic connotations of Krakens and Minotaurs. ”People are referring to Arcturus,” he says, “and presumably finding it helpful to talk about this particular variant.” Though Gregory believes it can easily work alongside and bolster Pango, the official groups that are seen as the authorities in such decision-making, such as the WHO and the U.S. Centers for Disease Control and Prevention, have yet to adopt the team’s new system or any of its terminology. Indeed, on Apr. 21, Maria Van Kerkhove, a WHO epidemiologist and the agency’s COVID-19 technical lead, tweeted at the end of a thread about XBB.1.16, “We are not using nicknames for these subvariants, and I would kindly encourage you not to. Please.” Gregory shared the tweet alongside an image showing “Arcturus” trending on Twitter. He has a point. Beyond Twitter, the nicknames are being used widely in the media and have even appeared in research papers and scientific journals. It’s a tug-of-war unlikely to end anytime soon, given how quickly the virus—and how people refer to it—continue to change. from https://ift.tt/qnVB8vR Check out https://takiaisfobia.blogspot.com/ The United States government has decided it is time to declare a formal end to the Covid-19 public health emergency. The end of the emergency is a time to reflect on what we have experienced and where we go from here. For over two years, I have led the Covid Crisis Group, a group of 34 experts originally formed with the goal of helping to lay the groundwork for an inevitable (we thought) National Covid Commission. We interviewed nearly 300 people. We organized task forces. We mapped out agendas. We shared insights across our different backgrounds and did a substantial amount of research. With an official inquiry nowhere in sight, our group felt we had to share what we have learned, in our just-published report, “Lessons from the Covid War.” The members of our group are angry. They are angry because they feel that good Americans, all over the country, were let down by ineffective institutions, a slow and uneven initial response, shoddy defenses, and inadequate leadership. We came away from many of our discussions consistently impressed with the ingenuity and dedication of people all over the country. That is why so many of us are so frustrated. Americans improvised to fight this war, usually doing the best they could. They had to struggle with systems that made success hard and failure easy. It is best to think of Covid as a war, the most expansive global struggle since the Second World War. The U.S. fought the Covid war without an army or a battle plan. We met a 21st century global emergency with structures fundamentally designed for 19th century problems, and it showed. Our scientific knowledge was unsurpassed. Thousands of people and organizations made heartrending, life-saving efforts. Americans spent more public money on the crisis than anyone. Yet the U.S. suffered many more casualties than any other affluent country, despite having the best access to remarkable vaccines. The Covid war shows how our wondrous scientific knowledge has run far, far ahead of the organized human ability to apply that knowledge in practice. If we want to avoid a repetition of the catastrophe of 2020-22, we cannot ignore that the Covid war revealed a collective national incompetence in governance. There is a common view that politics—a ‘Red response’ and a ‘Blue response’—were the main obstacle to protecting citizens, not competence and policy failures. It was more the other way around. Incompetence and policy failures, including the failure of federal executive leadership, produced bad outcomes, flying blind, and resorting to blunt instruments. Those failures and tensions fed the toxic politics that further divided the country in a crisis rather than bringing it together. Poor communication aggravated the breakdown of public trust and confidence and undermined efforts to combat misinformation. The one great policy success, Operation Warp Speed, is not well understood. It didn’t score its main success in high science, in vaccine research and development. Pfizer’s R&D, for example, did not need or use Operation Warp Speed. A belated initiative improvised by career bureaucrats, outside experts, and administration gadflies, Operation Warp Speed was successful by managing biopharma acquisition like a national security enterprise, with advance purchase of promising vaccines and by managing manufacturing and distribution. We also show that this was a global war. Meeting it required global strategies and global coalitions at every stage—from prevention to warning to building and sharing countermeasures. National, ‘go it alone,’ approaches backfired both for people and for American business. Hurried global improvisations probably saved millions. Better preparation might have saved millions more. Even before the Covid war, it seemed fair to judge that the earlier American reputation for practical public problem-solving was tarnished. This pandemic crisis is so encompassing, has touched so many communities, that, as we understand it better, surely a teachable moment has arrived. Yet the policy agendas of both major American political parties appear almost entirely undisturbed by this pandemic. There is no momentum to recognize the failures or fix the system. Although several public health experts warned us about the usual cycle of “panic and neglect,” it still is astonishing to watch that cycle repeat once again, as we neglect lessons for not only for the next outbreak, but in our general competence to meet any great emergency One common denominator stands out to us that spans the political spectrum. Leaders have drifted into treating this pandemic as if it were an unavoidable natural catastrophe. This way of thinking risks not only failing to reform, but also failing to remember what actually happened. As the emergency comes to an end, the greatest danger is that we rush to move on, to forget. There is historical precedent for this: the 1918-19 influenza pandemic, one of the worst pandemics in history, was the subject of a book by Alfred Crosby titled America’s Forgotten Pandemic. Confronting bad governance with fatalistic apathy would be un-American. And it dishonors the memory of what and who we have lost—and are still losing. There will be other pandemics and other crises, possibly sooner than we can imagine. At present, the U.S. is no better prepared for those crises than it was in early 2020. The public emergency may be over. Its causes remain. from https://ift.tt/J6K8B5U Check out https://takiaisfobia.blogspot.com/ WASHINGTON — The Supreme Court on Friday preserved women’s access to a drug used in the most common method of abortion, rejecting lower-court restrictions while a lawsuit continues. The justices granted emergency requests from the Biden administration and New York-based Danco Laboratories, maker of the drug mifepristone. They are appealing a lower court ruling that would roll back Food and Drug Administration approval of mifepristone. The drug has been approved for use in the U.S. since 2000 and more than 5 million people have used it. Mifepristone is used in combination with a second drug, misoprostol, in more than half of all abortions in the U.S. The court’s action Friday almost certainly will leave access to mifepristone unchanged at least into next year, as appeals play out, including a potential appeal to the high court. The next stop for the case is at the New Orleans-based U.S. Court of Appeals for the 5th Circuit, which has set arguments in the case for May 17. Two of the nine justices — Samuel Alito, the author of last year’s decision overturning Roe v. Wade, and Clarence Thomas — voted to allow restrictions to take effect, and Alito issued a four-page dissent. No other justices commented on the court’s one-paragraph order, and the court did not release a full vote breakdown. President Joe Biden praised the high court for keeping mifepristone available while the court fight continues. “The stakes could not be higher for women across America. I will continue to fight politically-driven attacks on women’s health. But let’s be clear — the American people must continue to use their vote as their voice, and elect a Congress who will pass a law restoring the protections of Roe v. Wade,” Biden said in a statement. Alliance Defending Freedom, representing abortion opponents challenging the FDA’s approval of mifepristone, downplayed the court’s action. “As is common practice, the Supreme Court has decided to maintain the status quo that existed prior to our lawsuit while our challenge to the FDA’s illegal approval of chemical abortion drugs and its removal of critical safeguards for those drugs moves forward,” ADF lawyer Erik Baptist said in a statement. The justices weighed arguments that allowing restrictions contained in lower-court rulings to take effect would severely disrupt the availability of mifepristone. The Supreme Court had initially said it would decide by Wednesday whether the restrictions could take effect while the case continues. A one-sentence order signed by Alito on Wednesday gave the justices two additional days, without explanation. The challenge to mifepristone is the first abortion controversy to reach the nation’s highest court since its conservative majority overturned Roe v. Wade 10 months ago and allowed more than a dozen states to effectively ban abortion outright. In his majority opinion last June, Alito said one reason for overturning Roe was to remove federal courts from the abortion fight. “It is time to heed the Constitution and return the issue of abortion to the people’s elected representatives,” he wrote. But even with their court victory, abortion opponents returned to federal court with a new target: medication abortions, which make up more than half of all abortions in the United States. Women seeking to end their pregnancies in the first 10 weeks without more invasive surgical abortion can take mifepristone, along with misoprostol. The FDA has eased the terms of mifepristone’s use over the years, including allowing it to be sent through the mail in states that allow access. The abortion opponents filed suit in Texas in November, asserting that the FDA’s original approval of mifepristone 23 years ago and subsequent changes were flawed. They won a ruling on April 7 by U.S. District Judge Matthew Kacsmaryk, an appointee of former President Donald Trump, revoking FDA approval of mifepristone. The judge gave the Biden administration and Danco Laboratories a week to appeal and seek to keep his ruling on hold. Responding to a quick appeal, two more Trump appointees on the 5th U.S. Circuit Court of Appeals said the FDA’s original approval would stand for now. But Judges Andrew Oldham and Kurt Engelhardt said most of the rest of Kacsmaryk’s ruling could take effect while the case winds through federal courts. Their ruling would have effectively nullified changes made by the FDA starting in 2016, including extending from seven to 10 weeks of pregnancy when mifepristone can be safely used. The court also would have halted sending the drug in the mail or dispensing it as a generic, and patients who seek it would have had to make three in-person visits with a doctor. Women also might have been required to take a higher dosage of the drug than the FDA says is necessary. The administration and Danco have said that chaos would ensue if those restrictions were to take effect while the case proceeds. Potentially adding to the confusion, a federal judge in Washington has ordered the FDA to preserve access to mifepristone under the current rules in 17 Democratic-led states and the District of Columbia that filed a separate lawsuit. The Biden administration has said the rulings conflict and create an untenable situation for the FDA. Alito questioned the argument that chaos would result, saying the administration “has not dispelled doubts that it would even obey an unfavorable order in these cases.” And a new legal wrinkle threatened even more complications. GenBioPro, which makes the generic version of mifepristone, filed a lawsuit Wednesday to preemptively block the FDA from removing its drug from the market, in the event that the Supreme Court doesn’t intervene. The Supreme Court was only being asked to block the lower-court rulings through the end of the legal case. The appeals court has sped up its review, but there is no timetable for a ruling. Any appeal to the Supreme Court would follow within three months of a ruling, but with no deadline for the justices to decide whether to review the case. from https://ift.tt/tyjSdTU Check out https://takiaisfobia.blogspot.com/ The Supreme Court Will Soon Decide on Abortion Pill AccessIf It Meets Its Self-Imposed Deadline4/21/2023 The Supreme Court is facing a self-imposed Friday night deadline to decide whether women’s access to a widely used abortion pill will stay unchanged or be restricted while a legal challenge to its Food and Drug Administration approval goes on. The justices are weighing arguments that allowing restrictions contained in lower-court rulings to take effect would severely disrupt the availability of the drug, mifepristone, which is used in the most common abortion method in the United States. It has repeatedly been found to be safe and effective, and has been used by more than 5 million women in the U.S. since the FDA approved it in 2000. The Supreme Court had initially said it would decide by Wednesday whether the restrictions could take effect while the case continues. A one-sentence order signed by Justice Samuel Alito on Wednesday gave the justices two additional days, without explanation. The justices are scheduled to meet for a private conference Friday, where they could talk about the issue. The additional time could be part of an effort to craft an order that has broad support among the justices. Or one or more justices might be writing a separate opinion, and asked for a couple of extra days. The challenge to mifepristone, brought by abortion foes, is the first abortion controversy to reach the nation’s highest court since its conservative majority overturned Roe v. Wade 10 months ago and allowed more than a dozen states to effectively ban abortion outright. In his majority opinion, Alito said one reason for overturning Roe was to remove federal courts from the abortion fight. “It is time to heed the Constitution and return the issue of abortion to the people’s elected representatives,” he wrote. But even with their court victory, abortion opponents returned to federal court with a new target: medication abortions, which make up more than half of all abortions in the United States. Women seeking to end their pregnancies in the first 10 weeks without more invasive surgical abortion can take mifepristone, along with misoprostol. The FDA has eased the terms of mifepristone’s use over the years, including allowing it to be sent through the mail in states that allow access. The abortion opponents filed suit in Texas in November, asserting that FDA’s original approval of mifepristone 23 years ago and subsequent changes were flawed. They won a ruling on April 7 by U.S. District Judge Matthew Kacsmaryk, an appointee of former President Donald Trump, revoking FDA approval of mifepristone. The judge gave the Biden administration and New York-based Danco Laboratories, mifepristone’s maker, a week to appeal and seek to keep his ruling on hold. Responding to a quick appeal, two more Trump appointees on the 5th U.S. Circuit Court of Appeals said the FDA’s original approval would stand for now. But Judges Andrew Oldham and Kurt Englehardt said most of the rest of Kacsmaryk’s ruling could take effect while the case winds through federal courts. Their ruling would effectively nullify changes made by the FDA starting in 2016, including extending from seven to 10 weeks of pregnancy when mifepristone can be safely used. The court also said that the drug can’t be mailed or dispensed as a generic and that patients who seek it need to make three in-person visits with a doctor. Women also might be required to take a higher dosage of the drug than the FDA says is necessary. The administration and Danco have said that chaos will result if those restrictions take effect while the case proceeds. Potentially adding to the confusion, a federal judge in Washington has ordered the FDA to preserve access to mifepristone under the current rules in 17 Democratic-led states and the District of Columbia that filed a separate lawsuit. The Biden administration has said the rulings conflict and create an untenable situation for the FDA. And a new legal wrinkle threatens even more complications. GenBioPro, which makes the generic version of mifepristone, filed a lawsuit Wednesday to preemptively block the FDA from removing its drug from the market, in the event that the Supreme Court doesn’t intervene. For now, the Supreme Court is only being asked to block the lower-court rulings through the end of the legal case. But the administration and Danco have a fallback argument if the court doesn’t agree. They are asking the court to take up the challenge to mifepristone, hear arguments and decide the case by early summer. The court only rarely takes such a step before at least one appeals court has thoroughly examined the legal issues involved. The New Orleans-based 5th circuit already has ordered an accelerated schedule for hearing the case, with arguments set for May 17.
from https://ift.tt/tUu6eg9 Check out https://takiaisfobia.blogspot.com/ NEW YORK — The longstanding racial gap in U.S. stroke death rates widened dramatically during the COVID-19 pandemic, government researchers said Thursday. Stroke death rates increased for both Black and white adults in 2020 and 2021, according to the Centers for Disease Control and Prevention study. But the difference between the two groups grew about 22%, compared with the five years before the pandemic. “Any health inequity that existed before seems to have been made larger during the pandemic,” said Dr. Bart Demaerschalk, a stroke researcher at the Mayo Clinic in Phoenix who was not involved in the new study. “This is another example of that.” During a stroke, something blocks or reduces blood flow to part of the brain or a blood vessel in the brain bursts. It can result in brain damage or long-term disability and is the nation’s fifth leading cause of death. Until about a decade ago, the U.S. stroke death rate was falling because of improved treatment and reduced smoking rates. The decline halted in 2013 at about 70 per 100,000 adults 35 and older. Experts think increases in obesity and related conditions finally offset some of things that had been driving stroke deaths down. It climbed the last few years, rising to nearly 77 in 2021. Black Americans have long had a higher stroke death rate than their white counterparts, a gap that was fairly steady for decades. In 2021, according to the new study, the Black stroke death rate rate for Americans aged 35 and older rose from about 101 per 100,000 before the pandemic to about 113. The white rate rose from about about 70 per 100,000 to 75. The difference between those two measures rose from 31 to 38, a 22% increase. The paper joins a growing number of studies that detected a disproportionately large increase in minority stroke death rates since the pandemic began. What drove the increases? Doctors say COVID-19 infection can raise the risk of stroke. This mainly happens in severe COVID-19 illness, and the problem is worse in people that already have partially blocked blood vessels because of other conditions. Patients with diabetes, high blood pressure, high cholesterol and a history of smoking seemed to be at highest risk, according to a study led by Demaerschalk that was published last year. But the virus probably wasn’t the only factor, Demaerschalk said. Obesity may have worsened, he said. People probably saw their doctors less often. And many were reluctant to go to a hospital when stroke symptoms developed — especially in the early days of the pandemic, when fear of catching the new virus may have surpassed concerns about stroke symptoms, he added. “Time is absolutely of the essence” in treating strokes, Demaerschalk said. So people were less likely to get medical care at the same time the risk of stroke was rising. And that “mismatch” may have been more pronounced for some Black people, because of lack of access of medical care and risk factors for COVID-19 and stroke, he said. from https://ift.tt/p2tW84m Check out https://takiaisfobia.blogspot.com/ In an Apr. 19 meeting, the vaccine committee of the U.S. Centers for Disease Control and Prevention (CDC) recommended that people ages 65 and older get a second bivalent mRNA booster. The panel also recommended additional boosters for people with weakened immune systems. As a result of the new recommendations, the bivalent booster, which targets both the original and Omicron BA.4/5 viruses, also becomes the only mRNA COVID-19 vaccine available in the U.S., replacing the original shots that targeted only the original SARS-CoV-2 virus and were used to immunize people with their primary series of shots. The updated guidelines are part of the CDC’s effort to streamline a confusing COVID-19 vaccine regimen. Currently, it includes different formulations of mRNA vaccines from both Pfizer-BioNTech and Moderna. Under the latest guidelines, these will now all target the same viral strain, differing only by dosage for different age groups. Annual COVID-19 boostersThe committee also supported simplifying the currently complicated vaccination timelines for most healthy Americans ages six and older with a booster once a year, similar to the annual flu shot. That means that most people’s next COVID-19 shot—likely a bivalent shot—would probably come in the fall. The U.S. Food and Drug Administration (FDA)’s vaccine committee will meet in June to decide which strain or strains should be included in that shot. While the specific formulation of the vaccine may change, it’s not likely that the simplified dosing schedule will change. The panel also allowed for some flexibility in the timing and frequency of the bivalent booster dose, especially for young children, older people, and people with weakened immune systems. For all of these groups, the committee supported giving doctors discretion in deciding whether additional doses—beyond the single booster recommended for most healthy people—should be used. Changes for kidsThe schedule remains slightly more complicated for younger children, since the two mRNA vaccine brands have varying doses based on age groups. For healthy children ages six months to four years, the committee’s updated recommendations advise at least two total doses, with at least one of them being a bivalent shot. Until now, children in this age group got two shots of Moderna’s original vaccine and a bivalent booster, while kids getting Pfizer-BioNTech received either two or three shots of the original, depending on their age, and a bivalent booster. Now, regardless of where they are in their primary vaccination series, the new recommendations could mean getting fewer total doses. For five year olds, the recommendations are slightly different, since Pfizer-BioNTech and Moderna used different age cutoffs for their studies. Five year olds getting Moderna shots now need at least two doses, with a least one of them being a bivalent shot. Five year olds getting Pfizer-BioNTech vaccine only need one dose of the bivalent shot. (To make the changes easier to understand, the CDC says it will publish charts on its website for parents and doctors detailing the new vaccination regimen for all young children.) These recommendations will remain in place until FDA and CDC experts meet again in June. from https://ift.tt/AgDB762 Check out https://takiaisfobia.blogspot.com/ Kate Hanselman’s home is like a shrine to hobbies past and present. There’s fencing gear from previous lessons, and two pairs of shoes she used during her love affair with rock climbing. “I find yarn everywhere because I love knitting, and I have a whole set of embroidery stuff,” she says. Plus: stacks of puzzles, her partner’s golf clubs, and equipment from his flying lessons. “Our house is like a full hobby station,” she says with a laugh. Challenging, fun, and engaging hobbies have the power to make us happier and healthier, says Hanselman, a psychiatric mental health nurse practitioner with the counseling practice Thriveworks. Such pursuits help us grow in creative, physical, or intellectual ways, and can boost self-esteem. Plus, they often foster connection with others. Research suggests that hobbies lead to better physical health, more sleep, lower stress, greater life satisfaction, a larger social network, and improved work performance. “Hobbies live in the pleasure world, not necessarily the mastery world,” Hanselman says. “We’re not trying to impress the board, we’re not going for a paycheck, there’s no ulterior motive. Hobbies are like dessert—and as a baker myself, dessert is the most important part.” That resonates with Chris Johnson, who does woodworking, rides motorcycles, gardens, cooks, and runs in his free time. He’s accepted that he’ll never be a master surfer, but that doesn’t dampen his enjoyment of riding the waves. And he’s so taken with beekeeping that 20,000 Italian honey bees now live in his backyard. “I really love learning and figuring things out, and developing an understanding of how things tick,” says Johnson, 35, who lives in Carolina Beach, N.C. His hobbies tend to evolve out of curiosity, boredom, or need. Take the bees: After moving into a new home with a barren yard, he was concerned about a lack of pollinators, so he planted a garden and became a beekeeper. “If you derive joy from your hobby—it doesn’t matter if it’s a board game or beekeeping—I’m confident it will make you a better person in every aspect of your life,” he says. But where do you start? We asked experts to share strategies for discovering the hobbies you don’t yet know you’ll love. Ask yourself how you want to feelHobbies present an escape—they can help us get out of our head and calm down, says Matthew J. Zawadzki, an associate professor of health psychology at the University of California, Merced, who has researched the connection between leisure and well-being. He suggests asking yourself how you want an activity to make you feel: Mentally engaged? Distracted? Relaxed? Socially connected? It can also be helpful to consider what your life is missing, like creativity or physical activity, and allow that to guide your choices. “Recognize that you have different needs at different moments, and that’s OK,” he says. There’s no such thing as one perfect hobby. Start smallDon’t invest a ton of time and money in a new hobby immediately. Ease in to figure out if it’s right for you, advises Rebecca Weiler, a licensed professional mental health counselor who specializes in career counseling: “You can always do more later.” If you’re wondering if paintballing might be a good fit, join an outing or two with a local Meetup group. Or sign up for a one-time pottery class, rather than a set of eight. It’s also smart to resist the pressure to over-commit. Hanselman enjoyed learning to fence, but the next step was competing, and she didn’t want to do that, so she stopped. “You spend enough of your day pushing yourself,” she says. “Hobbies are supposed to be fun.” Be openKeeping an open mind and not dismissing potential hobbies—even if they seem out of your wheelhouse—is key, says Katina Bajaj, a clinical psychology researcher and co-founder of Daydreamers, a company that aims to help adults tap into their imagination, creativity, and curiosity. She and her husband recently went hiking in San Francisco, where they live, and someone handed them a pamphlet of plants to look for along the trail, like miner’s lettuce. Instead of tossing it, they paid attention—and have now embraced foraging as a new hobby. “We’re wired as humans to be curious and open, but in a very burned-out world, we forget that,” she says. “It’s the first thing to go.” So next time someone hands you a flyer, or invites you to tag along to an event, seize the opportunity. It could introduce you to something you never guessed you’d love. Take a trip back in timeWhen you were a kid, what did you want to be when you grew up? The answer could point you toward an appealing hobby, Weiler says. “If you wanted to be a major league player, what can you do now that fulfills that urge for you?” she asks. Joining a softball team or coaching neighborhood kids could help reignite a long-dormant passion. The nostalgia doesn’t have to stop there. Revisit activities you loved when you were young, Bajaj suggests, like drawing pictures, putting together model kits, collecting things, or building clay figures. Doing so “is a really helpful place to start, and it allows you to feel comfortable,” she says. Childhood delights can easily evolve into adult hobbies. Go “back to school”Consider auditing a class at a local university or signing up for a lesson to learn more about a potential hobby, Weiler advises. You’ve always dreamed of writing a novel? Enroll in a fiction-writing program. Fascinated by family history? Take a genealogy class. There’s no need to spend lots of money: Plenty of e-courses are available for free or for a nominal price. Check out resources like Coursera, Udemy, Open Yale Courses, and MIT Open Courseware. Take an assessmentLots of colleges offer career assessments that can help students determine what to major in and how to navigate their professional lives. You can also use these tools to glean insights about potential hobbies, especially for those “starting from square one,” Weiler says. If you’re a college graduate, connect with your university’s alumni center; sometimes, she notes, they make these assessments available for free. Or, you can pay a career counselor for access to one. Keep a listHanselman and her partner keep a running list on their fridge of all the things that strike them as interesting. “Maybe a month from now I’ll be like, ‘Butterfly garden. Why did I think that was a good idea?’ Or it might be just the right time for it,” she says. Log potential interests as they come to you, and you’ll have no shortage of options to explore when you’re ready. Remove guilt from the equationZawadzki’s research indicates that when people feel guilty about spending time on leisure activities, they experience increased symptoms of depression and anxiety. “Give yourself permission to do something that you like,” he urges—and keep in mind that if a hobby makes you healthier and happier, everyone around you will benefit. Think of discovering new hobbies as an adventure that will add fulfilling new dimensions to your life, and enjoy the process. “I sneakily suspect that we have more leisure and hobbies in us than we realize,” he says. from https://ift.tt/QhoPGMm Check out https://takiaisfobia.blogspot.com/ |
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