NEW YORK — A germ that causes a rare and sometimes deadly disease—long thought to be confined to tropical climates—has been found in soil and water in the continental United States, U.S. health officials said Wednesday. The bacteria was found on the property of a Mississippi man who had come down with the disease, melioidosis. Officials don’t know how long it had been there, but they say it likely is occurring in other areas along the Gulf Coast. U.S. physicians should consider melioidosis even in patients who haven’t traveled to other countries, the Centers for Disease Control and Prevention said in a health alert. “Once it’s in the soil, it can be a health threat for people in the area,” said the CDC’s Julia Petras, who oversaw the investigation. The illness can start with a wide range of symptoms like fever, joint pain, and headaches. It’s treatable with the right antibiotics if it’s caught early, but it can lead to pneumonia, blood infections, and even death if not properly treated. About 12 cases are reported annually in the U.S. The vast majority have been in people who traveled to places where the bacteria is endemic, including certain regions of Australia, Thailand, and Central and South America. People can get the illness through direct contact with contaminated soil and water, especially if they have a cut on their hand or foot. It is also possible to inhale the bacteria. The bacteria may not bother healthy people. But it can be dangerous to those with diabetes, chronic kidney, or lung disease and weakened immune systems. Last year, four people came down with the disease even though none had traveled internationally. Officials blamed their illnesses on a contaminated aromatherapy spray imported from India. The new findings explain two Mississippi cases in men who hadn’t traveled internationally, officials said. One got melioidosis in 2020 and the other, who lives about 10 miles away, got it this year. Both have recovered. Health officials didn’t say exactly where in Mississippi the men live, but investigators took 109 soil and water samples from the area. The bacteria was found in three spots—two in soil and one in a puddle—on the property of the man who was sickened two years ago. Finding the bacteria in U.S. soil is significant, but not surprising. Investigators have long believed that local soil contamination was behind infections in Texas’s Atascosa County in 2004 and 2018, CDC officials said. from https://ift.tt/evJto2a Check out https://takiaisfobia.blogspot.com/
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GENEVA — The head of the World Health Organization on Wednesday advised men at risk of catching monkeypox to consider reducing their sexual partners “for the moment” following the U.N. health agency declaring the escalating outbreaks in multiple countries to be a global emergency. WHO Director-General Tedros Adhanom Ghebreyesus said 98% of the monkeypox cases detected since the outbreaks emerged in May have been among gay, bisexual and other men who have sex with men. He called for those at risk to take steps to protect themselves. “That means making safe choices for yourself and others, for men who have sex with men,” Tedros said. “This includes, for the moment, reducing your number of sexual partners.” Infectious individuals should isolate and avoid gatherings involving close, physical contact, while people should get contact details for any new sexual partners in case they need to follow up later, the WHO chief said. The U.S. Centers for Disease Control and Prevention has not suggested that men who have sex with men reduce their sexual partners, only that they avoid skin-to-skin contact with people who have a rash that could be monkeypox. Read More: The Best Way to Slow the Spread of Monkeypox WHO officials emphasized that monkeypox can infect anyone in close contact with a patient or their contaminated clothing or bedsheets. The U.N. health agency has warned that the disease could be more severe in vulnerable populations like children or pregnant women. To date, more than 19,000 cases have been reported in more than 75 countries; deaths have only been reported in Africa. More from TIME“We know very clearly that one of the main modes of exposure for this particular illness is through direct contact, close contact, skin to skin contact, possibly even face to face contact, exposure to droplets or virus that may be in the mouth,” Dr. Rosamund Lewis, WHO’s technical lead for monkeypox, said. Andy Seale, a WHO adviser on HIV, hepatitis and sexually transmitted infections, said experts have determined the current monkeypox outbreak is “clearly transmitted during sex,” but he said they have not yet concluded whether it’s a sexually transmitted infection. Dr. Hugh Adler, who treats monkeypox patients in the U.K., said monkeypox was being transmitted during sex and that sexual networks and anonymous sex with untraceable partners were facilitating its spread. Read More: Why It’s Way Harder to Get Tested for Monkeypox Than It Should Be “It’s just as likely that monkeypox was always capable of transmitting and presenting like this, but it hadn’t been formally reported or so widespread before,” he said. Last week, British authorities issued new guidance advising doctors that people with just one or two lesions might be infectious with monkeypox, potentially complicating efforts to stop transmission. The European Union’s health commissioner urged the bloc’s 27 member nations Wednesday to step up their efforts to tackle outbreaks in the EU, which she called “the epicenter of detected cases.” In a letter to European health ministers obtained by The Associated Press, EU Health Commissioner Stella Kyriakides called for a “reinforced, concerted and coordinated action.” “There is no time for complacency and we need to continue working together to control the outbreak,” she wrote. from https://ift.tt/vuJ49mZ Check out https://takiaisfobia.blogspot.com/ Washington — After weeks of delays, nearly 800,000 doses of the monkeypox vaccine will soon be available for distribution, U.S. health regulators said Wednesday. The announcement comes amid growing criticism that authorities have been too slow in deploying the vaccine, potentially missing the window to contain what could soon become an entrenched infectious disease. Nearly two weeks ago, the Food and Drug Administration said it had finished the necessary inspections at Bavarian Nordic’s facility in Denmark, where the company fills vials of the vaccine. The FDA said via Twitter on Wednesday that the certification had been finalized. The doses are already in the U.S. “so that they would be ready to be distributed once the manufacturing changes were approved,” the agency said. The U.S. already has sent more than 310,000 doses of the two-shot Jynneos vaccine to state and local health departments. But clinics in San Francisco, New York and other major cities say they still don’t have enough shots to meet demand. The head of the U.S. Department of Health and Human Services said Wednesday officials would announce more allocations on Thursday. Read More: Why It’s Way Harder to Get Tested for Monkeypox Than It Should Be Officials at the San Francisco Department of Health welcomed the news, saying they need many thousands more vaccine doses than the 7,800 they have received to date. “Without enough vaccine supply, we would have trouble fulfilling our basic duty of keeping our communities safe,” the agency said in a statement. Washington, D.C., officials said Wednesday they would join their counterparts in San Francisco, New York City and other cities who have stopped offering appointments for second vaccine doses due to short supplies. They said the single-dose strategy would allow them to “vaccinate more people at risk and slow the spread of monkeypox in the community more quickly.” The monkeypox virus mainly spreads through skin-on-skin contact, but it can also transmit through touching linens used by someone with the infection. The vast majority of cases reported have been in men who have sex with men, though health officials have stressed that anyone can catch the virus. People with monkeypox may experience fever, body aches, chills and fatigue. Many in the outbreak have developed zit-like bumps on many parts of the body. The sluggish federal response has drawn comparisons to the initial days of the COVID-19 outbreak, but experts had pointed out that the U.S. had one huge advantage: more than 1 million doses of vaccine in the strategic national stockpile. But it turned out U.S. officials had only about 2,000 doses on hand when the outbreak was first identified in May. Shipping and regulatory delays have meant only a portion of the rest were deployed. Read More: The Best Way to Slow the Spread of Monkeypox “There’s not enough doses,” said Dr. Perry Halkitis of Rutgers University. “I think with some quicker action on part of federal government we might not be in the situation we are now.” The doses previously shipped came from a separate facility in Denmark that already had FDA clearance. Another 786,000 doses made at a newly opened Bavarian Nordic facility were awaiting the U.S. certification announced Wednesday. The FDA requires inspections of all vaccine manufacturing plants to assure safety, sterility and consistency of production. U.S. officials announced orders this month for 5 million more doses, though most of those are not expected to arrive until next year. Officials have recommended the shots be given to people who know or suspect they were exposed to monkeypox in the previous two weeks. The Jynneos vaccine has never been widely used in response to an outbreak like this, and the government will track how well it’s working. from https://ift.tt/skAC0pf Check out https://takiaisfobia.blogspot.com/ Americans’ mental health tanked during the first year of the pandemic. More than 36% of U.S. adults experienced symptoms of anxiety or depression in August 2020, according to the U.S. Centers for Disease Control and Prevention. By January 2021, the number was above 40%. It’s not hard to see why. A novel and scary virus was spreading without vaccines to slow it. Cities and states were in various degrees of lockdown for much of 2020, with many people forgoing special occasions and visits with friends and family. Isolation and fear were widespread, and people had every reason to feel acutely stressed. But even as lockdowns lifted, people got vaccinated, and life resumed more of its normal rhythms, many people continued to feel…off. In an American Psychological Association survey published in October 2021, 75% of people said they’d recently experienced consequences of stress, including headaches, sleep issues, fatigue, and feeling overwhelmed. Now, more than two years into the pandemic, many people still haven’t bounced back. One reason could be “ambient stress”—or “stress that’s running in the background, below the level of consciousness,” says New York-based clinical psychologist Laurie Ferguson, who is director of education development at the Global Healthy Living Foundation, a nonprofit that supports people with chronic illnesses. “There’s something amiss, but we’re not registering it all the time,” Ferguson says. “We’re always just a little bit off balance. We kind of function at a level like everything’s fine and things are normal, when in fact, they’re not.” In a 1983 article published in the journal Environment and Behavior, researcher Joan Campbell described ambient stressors as those that are chronic and negative, cannot be substantively changed by an individual, usually do not cause immediate threats to life (but can be damaging over time), and are perceptible but often unnoticed. “Over the long run,” Campbell wrote, these stressors could affect “motivation, emotions, attention, [physical] health, and behavior.” Campbell cited examples like pollution and traffic noise, but it’s also an apt description of this stage of the pandemic. In March 2020, the pandemic was an in-your-face stressor—one that, at least for many people, felt urgent and all-consuming. Two years later, most people have adapted, to some degree. Most people are vaccinated, the news isn’t broadcasting the latest case counts 24/7, and life looks closer to 2019 than 2020. But, whether we’re conscious of it or not, we’re still bearing the psychic toll of two years of death, disease, upheaval, and uncertainty, as well as smaller disruptions like changes to our social or work lives, Ferguson says. Even ambient stress can have health consequences, as Campbell pointed out. Humans evolved to deal with short-term stressors, but we’re not as good at coping with chronic stress, explains Laura Grafe, an assistant professor of psychology at Bryn Mawr College. Chronic stress has been linked to conditions including high blood pressure, diabetes, sleep issues, and mental health and cognitive disorders. Constant stress can also compound the effects of other stressors. “Everything else just seems worse with the chronic stress of the pandemic going on in the background,” Grafe says. Ambient stress doesn’t have to zap all the joy from your life, though. In a 2021 study, Grafe and her co-authors examined how pandemic stress and coping strategies affected sleep. Her team found that a person’s sleep quality wasn’t necessarily dictated by their overall level of pandemic-related stress, but rather by how well they coped with that stress. That suggests stress, itself, isn’t necessarily the problem—it’s unmanaged stress. When stress becomes so routine that we stop acknowledging it, we’re less likely to manage it effectively. As Cambell wrote in 1983, “coping is most likely to occur when the stressor is still novel.” Halfway through 2022, many people have abandoned soothing hobbies like bread-baking, yoga, and knitting that they adopted in spring 2020. That’s why it’s important to develop sustainable coping strategies, says Niccole Nelson, a postdoctoral research associate in the University of Notre Dame’s psychology department who has also studied pandemic stress. “There’s no single coping strategy that is inherently good or bad,” Nelson says, but it’s often helpful to mentally reframe a stressor as less threatening. That’s difficult to do with something as serious as the pandemic, but Nelson suggests trying it on a smaller scale: finding ways to appreciate the positive aspects of working from home, for example. (Grafe suggests mindfulness exercises and cognitive behavioral therapy to cope with stress.) Giving your brain new stimuli can also help during a prolonged period of stress, Ferguson says. Even small changes, like eating something new for breakfast or taking a different route for your daily walk, can introduce some healthy novelty. Physical activity is also a tried-and-true stress reduction tactic, she adds. Simply noticing and naming your ambient stress can also go a long way, Ferguson says. “Even people who have gone ‘back to normal’ still have that ambient stress running, and they may not realize they’re a little more short-tempered, or they’re a little less hopeful,” she says. “It’s subtle, in many ways, and harder to notice” than full-blown pandemic stress, but just as important to manage. from https://ift.tt/r3xECHY Check out https://takiaisfobia.blogspot.com/ Napping, as well as sleeping too much or too little or having poor sleep patterns, appears to increase the risk for cardiovascular disease in older adults, new research shows. The study, published Tuesday in the Journal of the American Heart Association, adds to a growing body of evidence supporting sleep’s importance to good health. The American Heart Association recently added sleep duration to its checklist of health and lifestyle factors for cardiovascular health, known as Life’s Essential 8. It says adults should average seven to nine hours of sleep a night. “Good sleep behavior is essential to preserve cardiovascular health in middle-aged and older adults,” said lead author Weili Xu, a senior researcher at the Aging Research Center in the department of neurobiology, care sciences and society at the Karolinska Institute in Stockholm, Sweden. “We encourage people to keep nighttime sleeping between seven to nine hours and to avoid frequent or excessive napping.” Prior research has shown poor sleep may put people at higher risk for a range of chronic illnesses and conditions affecting heart and brain health. These include cardiovascular disease, dementia, diabetes, high blood pressure and obesity. According to the Centers for Disease Control and Prevention, nearly 35% of U.S. adults say they get less than seven hours of sleep, while 3.6% say they get 10 or more hours. Previous sleep duration studies show that sleeping too much or too little both may raise the risk for cardiovascular disease. But whether napping is good or bad has been unclear. Read More: Experts Can’t Agree on How Much Screen Time Is Too Much for Adults In the new study, researchers analyzed sleep patterns for 12,268 adults in the Swedish Twin Registry. Participants were an average of 70 years old at the start of the study, with no history of major cardiovascular events. A questionnaire was used to collect data on nighttime sleep duration; daytime napping; daytime sleepiness; the degree to which they considered themselves a night person or morning person, based on the time of day they considered themselves most alert; and symptoms of sleep disorders, such as snoring and insomnia. Participants were followed for up to 18 years to track whether they developed any major cardiovascular problems, including heart disease and stroke. People who reported sleeping between seven and nine hours each night were least likely to develop cardiovascular disease, a finding in keeping with prior research. Compared with that group, those who reported less than seven hours were 14% more likely to develop cardiovascular disease, and those who reported more than 10 hours were 10% more likely to develop cardiovascular disease. Compared with people who said they never napped, those who reported napping up to 30 minutes were 11% more likely to develop cardiovascular disease. The risk increased by 23% if naps lasted longer than 30 minutes. Overall, those who reported poor sleep patterns or other sleep issues – including insomnia, heavy snoring, getting too much or too little sleep, frequent daytime sleepiness and considering themselves a night person – had a 22% higher risk. Study participants who reported less than seven hours of sleep at night and napping more than 30 minutes each day had the highest risk for cardiovascular disease – 47% higher than those reporting the optimal amount of sleep and no naps. Read More: The U.S. Physician Shortage Is Only Going to Get Worse. Here Are Potential Solutions The jury is still out on whether naps affect cardiovascular risk across the lifespan, said Marie-Pierre St-Onge, center director for the Sleep Center of Excellence and an associate professor at Columbia University in New York City. She noted that the new research, which she was not involved in, was restricted to older adults. Rather than trying to recoup sleep time by napping, people should try to develop healthier sleep habits that allow them to get an optimal amount of sleep at night, St-Onge said. This includes making sure the sleep environment is not too hot or cold or too noisy. Reducing exposure to bright light before going to sleep, not eating too late at night, getting enough exercise during the day and eating a healthful diet also help. “Even if sleep is lost during the night, excessive napping is not suggested during the day,” Xu said. And, if people have persistent trouble getting enough sleep, they should consult a health care professional to figure out why, she said. from https://ift.tt/AWwDLPs Check out https://takiaisfobia.blogspot.com/ The federal government hopes a new website can help people and local governments beat the increasingly deadly heat of an ever-warming world. Days after nearly half the country — 154.6 million people — sweated through a blistering heat wave, which for the West, hasn’t quite finished, the Biden Administration Tuesday unveiled heat.gov, which includes maps, forecasts and health advice. The government can’t lower temperatures in the short-term, but it can shrink heat’s death toll, officials said. “July 2021 was the hottest month ever recorded on Earth and summers are getting hotter and deadlier,” said National Oceanic and Atmospheric Administration chief Rick Spinrad. “The annual average temperature of the contiguous U.S. has already warmed over the past few decades and is projected to rise by 5 to 9 degrees Fahrenheit (2.8 to 5 degrees Celsius) by the end of this century.” But officials said even though heat is the No. 1 weather killer, and warming is worsening, deaths can still be prevented. That’s the purpose of the website. “We don’t have to accept” heat deaths, Commerce Secretary Gina Raimondo said Tuesday. “This doesn’t have to be this way.” The new website is aimed both at local planners to help them decide whether it is too hot for road work, at farmers for planting and harvesting advice, and even “a mom trying to decide this summer: Is it safe for your kids to play outside or to go to summer camp?” Raimondo said. Pat Breysse, director of environmental health at the Centers for Disease Control and Prevention, said the predictions the new website offers can help authorities plan for extreme heat in advance and protect people who are most at risk, by setting up cooling centers and providing water, for example. “There’s a host of things that we can do with this advance warning from the data that NOAA provides us, particularly from a health standpoint,” Breysse said. He pointed to earlier efforts by Rhode Island, Maine, New Hampshire and Vermont to change weather service heat warnings to make them more effective for New England residents. The new website could be put to use immediately because record-breaking temperatures are forecast for Spokane, Washington, and Boise, Idaho — heat in the low to mid 100s, Spinrad said. The website follows other Biden Administration action on heat, including financial aid to help on air conditioning for low-income residents, grants to build new cooling centers, upcoming rules for workers outside in the heat and help for cities to cool urban heat islands with more tree cover. Calling climate change “an emergency,” but stopping short of invoking emergency measures, President Biden last week promised more action to fight global warming. Outside experts said the multi-agency website and action are overdue. “This is an important step for elevating the risks of heat,” said University of Georgia meteorology professor Marshall Shepherd, past president of the American Meteorological Society. “For too long, heat has been one of the deadliest weather hazards, but has languished from an urgency standpoint,” ignored by the public, media and decision-makers. Shepherd said people scamper inside at the threat of lightning or tornado, but exert themselves when the heat index is 100 or higher. North Carolina state climatologist Kathie Dello said, “extreme heat is one of our greatest challenges as a county and I’m glad to see the interagency cooperation.” It’s important that the website shows that heat isn’t just a problem for today “but in the future,” Dello said. Given warming trends, this summer with its widespread heat waves “is likely to be one of the coolest summers of the rest of our lives,” Raimondo said. “That’s a pretty scary thing.” —-- Wildeman reported from Hartford, Connecticut. from https://ift.tt/D1KPiIG Check out https://takiaisfobia.blogspot.com/ As the third year of the pandemic continues, doctors with disabilities are pushing the medical field to improve its treatment of disabled health professionals. An increasing number of people have Long Covid and need accommodations at work, and in the health care workforce, their ability to stay in their profession will be critical to helping patients also suffering from the little-understood condition. One in five American adults who has been infected with COVID-19 has some lingering symptoms that can be considered Long COVID, the Centers for Disease Control and Prevention found this spring. While symptoms vary widely, Long COVID can cause health problems including brain fog, fatigue, shortness of breath, and headaches that significantly affect people’s ability to function on a daily basis. The federal government is preparing to release two reports on Long COVID in August. These ongoing health issues were likely keeping 1.6 million Americans out of the workforce earlier this year, according to an estimate from Brookings in January, and that has almost certainly increased. Katie Bach, the economist behind that estimate, recently told Congress that it’s likely about 4 million people—or 2.4% of the U.S. employed population—have a reduced ability to work because of Long COVID. The impact on the health care workforce, experts say, could be devastating. “For those physicians and nurses that didn’t lose their lives to COVID,” says Lisa Meeks, a disability expert and assistant professor of family medicine at the University of Michigan School of Medicine, “they may very well lose their livelihood.” Meeks adds that the situation is especially dire given how many Americans with Long COVID may need care in the coming months and years. “We need these people in the workforce,” she says. Read More: You Could Have Long COVID and Not Even Know It While it’s not clear precisely how many health professionals will end up with Long COVID, a study published in the journal BMJ in 2020 found that health care workers were seven times as likely to have severe COVID-19 as those not in frontline jobs. Health care workers have also experienced intense burnout, depression, anxiety and other mental health issues during the pandemic, with turnover rates skyrocketing. A Morning Consult report last winter found that nearly one in five health care workers had quit their jobs during the pandemic, and now more than 2.7 million have left their jobs this year alone, according to the Bureau of Labor Statistics. That’s part of why Meeks and a growing movement of doctors, medical students, and other health care workers are trying to transform their profession to make it more inclusive of both doctors and patients with disabilities through a new group called DocsWithDisabilities launched on July 27. The initiative aims to change the culture, policies and practices of the medical field in ways that will increase the number of doctors with disabilities across the country. People involved with the initiative will conduct research about medical professionals with disabilities, work on curricula that could help medical students learn more about caring for disabled patients, and create policy recommendations on everything from physician licensure exam questions to how schools and hospitals handle training during COVID-19 surges and what accommodations they can provide to those with Long COVID. “We have this culture of perfectionism in our field,” says Dr. Cheri Blauwet, a sports medicine physician at Harvard Medical School and a former Paralympic wheelchair racer who has appeared on Meeks’ podcast highlighting doctors with disabilities. That can help clinicians strive to do their best work, she says, but it also “reduces our mental flexibility towards understanding that many people, inclusive of people with disabilities, can be excellent doctors when provided the right environment and the right accommodations in order to be successful.” ‘When providers are unwell, patients are unwell’The DocsWithDisabilities initiative, which started as a social media campaign in 2018 and then a podcast highlighting stories of disabled health care workers, will now include research groups, mentorship opportunities, policy recommendations and training for medical professionals on how to better include people with disabilities. Dr. Justin Bullock, a nephrology fellow at the University of Washington and a member of the initiative’s advisory board, says he would like to see hospitals and medical schools standardize how they handle accommodations for physicians with disabilities. Bullock has bipolar disorder and says he faced barriers in returning to his residency after he was hospitalized following a suicide attempt, but has felt supported at his current institution. “Doctors have mental illness and other illnesses because doctors are human,” he says. “The more stigmatizing and more traumatizing the systems are, the more harm we inflict on providers. And when providers are unwell, patients are unwell.” For Blauwet, she says using a wheelchair and having been a patient herself has made her a better doctor. “Anyone can read the books and learn the facts about physiology and disease processes and treatment,” she says, “but it’s much harder to teach people empathy.” Amy Addams, director of student affairs alignment and holistic review at the Association of American Medical Colleges (AAMC), says that when non-disabled medical students interact with peers who have disabilities, they can improve on this front too.
Very few physicians report having disabilities themselves, and studies have shown that doctors often carry misconceptions about disabled people, which can impact the care patients receive. Disabled Americans have expressed concerns about their treatment throughout the pandemic, particularly as much of the country has moved away from mask-wearing and other precautions. And now those with Long COVID are facing challenges in accessing treatment for their conditions.
In 2018, Meeks co-published a report with the AAMC that documented the experiences of students and doctors with disabilities in the medical field. While stories varied, it found that many still conceal their disabilities because they fear bias or stigma. The report also found that 2.7% of medical students disclosed a disability and received formal accommodations—a much smaller percentage than the average of about 11% for undergraduate programs. In 2019, Meeks and colleagues found that 4.6% of medical students disclosed a disability, and upcoming research for 2021 will show the number at 6.1%, she says. But while those numbers are increasing, Meeks has also found that people with disabilities disappear as they move forward in their medical careers. When people are asked whether they self-identify as having a disability, an AAMC survey found about 11% of medical students said they had a disability in 2020. Among residents, 7.5% identified as having a disability and just 3.1% of physicians said they had a disability in 2020, according to research published in JAMA Network Open. These findings were part of Meeks’ impetus for starting DocsWithDisabilities. “There is still such deep oppression and exclusion that we haven’t gotten a seat at the table, we haven’t gotten to the places where decisions are being made around inclusion and equity,” says Bonnielin Swenor, director of the Johns Hopkins Disability Health Research Center, who has frequently collaborated with Meeks on her research. Swenor has low vision and says she joined the disability community in her 20s, and Meeks found out she has an autoimmune disease as an adult after focusing her career on people with disabilities, so both women have been patients in situations where other medical professionals didn’t understand their experiences. They say they need more data. There’s little data on the prevalence of people with disabilities among other health professions such as nurses, pharmacists, and dentists, for example. And data about medical students’ and doctors’ experiences during the pandemic is still being collected. After seeing how people with disabilities have been treated during the COVID-19 pandemic, Democratic Sen. Tammy Duckworth of Illinois recently got the Government Accountability Office to agree to study health care access for disabled Americans, including examining how many people with disabilities exist in the health care workforce and what kind of training doctors receive about treating disabled patients. Read More: Tim Kaine Refuses to Let Long COVID Be an Afterthought Also partially in response to the stress that health care providers experienced during the pandemic, medical schools have started to focus more on addressing mental health issues, says Addams. The AAMC has worked with Meeks on her research and is encouraging its members to take more steps to embrace students with disabilities. Dr. Peter Poullos, a clinical associate professor of radiology at Stanford University who became paralyzed after a biking accident in 2003 and co-hosts the DocsWithDisabilities podcast, says that the goal of the new group is to improve health care not just for people with disabilities, but for everyone. He has seen this work through a group on disability inclusion and equity he runs at Stanford, and wants other schools and hospital systems to have similar resources. “We’re trying to envision a future that is built with the idea that people with disabilities are here,” he says. “We should just assume that they are present and include them in the planning and the construction of a system where that doesn’t look at them as a problem, but as an opportunity.” from https://ift.tt/8kMS3Cj Check out https://takiaisfobia.blogspot.com/ Last week, we were told the President of the United States has COVID-19, but it wasn’t a big deal, as White House press secretary Karine Jean-Pierre told the media: “We knew this was going to happen. At some point, everyone is going to get COVID.” Leana Wen, the former health commissioner of Baltimore, chimed in in the Washington Post endorsing Jean-Pierre’s fatalism, adding: “Another key lesson is that it’s inevitable that everyone—even the president of the United States—will be exposed to the coronavirus[…]COVID-19 is a manageable disease for almost everyone, so long as they use the tools available to them.” Manageable. Except we have daily deaths hovering around 400 per day, making the U.S. the worldwide leader in COVID-19 associated mortality in absolute terms, with only a few real competitors among nations of our size and wealth if we look at it per capita or in terms of excess deaths per capita as well. In addition, we’ve had about 40,000 people hospitalized, about 4600 in intensive care over the past week or so. And this is on top of what Boston University’s Jacob Bor calls our “missing Americans,” those we have lost to early death compared to other rich nations. Bor and his team estimate that if U.S. age-specific mortality rates had equaled those of other wealthy nations we would have saved 626,353 in 2019 before COVID-19 struck. In 2021, there were 1,092,293 “Missing Americans” in the midst of the pandemic. So much winning. One has to wonder what the hell is going on. When did it become aspirational as a nation, to reach for the top slot in COVID-19 mortality, to ignore the fact that we are losing hundreds of thousands of Americans yearly to early death even before the pandemic and that our life expectancy ranks in the 30s or 40s compared to other nations, and we’re expected to drop down into the 60s by 2040. In fact, the manic insistence that we “get back to normal” from the White House on down, that we have the tools to manage the pandemic, that public health is now a matter of “you-do-you” in terms of mitigation efforts (wear a mask if you want to, but don’t if you don’t!) is part of the problem. You see we have a wonderful healthcare system in the U.S., the best money can buy, and we spend more on it than any other nation as well, even as our life expectancy as just described should make us think hard about the return on investment we’re getting. What we don’t have are two key ingredients needed to raise us up to a healthier state of affairs. First, we simply don’t have what we need to keep us healthy—a robust set of social protections like our peer nations, which strongly determine our risk for getting ill and getting better in the first place. You may think it’s the biomedical innovations of the past century that save the most lives, often it’s much simpler than that: having a roof over your head, food to eat, a good job. It’s no coincidence that those who are better off do better in terms of health as they purchase what we call the social determinants of health at a premium. Second, for all the money we spend on healthcare, we spend a fraction of that on public health, with estimates between 1.5 to 2.5 cents spent on public health for each dollar on healthcare. For the past two years, people have been frustrated by the public health response to COVID-19, but with these facts in mind, perhaps we can agree that the expectations here have been like asking a 30-year-old used car to perform like a Ferrari just out of the showroom. With a public health system under-funded, under-staffed keeping America healthy is almost impossible to do. And what the current response to COVID-19 in the U.S. tells me is that things are not likely to get better. While the White House and its surrogates trumpet “we have the tools” to combat the pandemic, they ignore the fact that in the U.S., access to these tools is not guaranteed and once again your personal resources determine your fate. The most vociferous of these commentators, like the New York Times’ David Leonhardt, even castigate those trying to keep themselves and those they love safe as barriers to getting back to normal. While the U.S. President and these well-known individuals have access to everything they need, too many Americans are on their own. This is policy set from privilege. The only thing wrong right now for them is that we are not getting back to normal fast enough. The rest of 2022 offers us more deaths and hospitalizations, millions of new infections with some riding them out because they have what they need to do that, some struggling as even a minor infection sends their households in to chaos and some sadly saddled with long COVID, which most of our policymakers are trying their hardest to ignore. Meanwhile in the background are the ghosts, the missing Americans that Jacob Bor has brought out into the light as much as America would like to bury them, their memories, our shame. We have no interest in combating this pandemic any longer, nor do we really show any ambition in American competitiveness in saving lives overall. We are happy to live with death. It’s the American way of life. from https://ift.tt/dbOVGql Check out https://takiaisfobia.blogspot.com/ As the heat index topped 100 degrees in Johnson County on Saturday, dozens of canvassers fanned out over affluent suburbs to knock on strangers’ doors and talk about an emotional, fraught, and, in many cases, very personal issue: the Kansas constitution. The state’s voters are being asked to amend its constitution to explicitly say that it does not contain a right to abortion. The ballot measure, which was first proposed in 2020, is intended to undo a 2019 Kansas Supreme Court ruling that found that right was implicitly part of the state’s governing document. The Aug. 2 vote will mark the first time the issue of abortion has been on the ballot since the U.S. Supreme Court overturned the federal constitutional right to an abortion in Dobbs v. Jackson Women’s Health Organization. It also represents a new frontier in the fight over abortion access: the battle over state constitutions. Rachel Sussman, the vice president of state policy and advocacy at Planned Parenthood, tells TIME that for the foreseeable future, access to abortion is going to play out “singularly” at the state level. “That is going to be amending state constitutions, pushing state statutory protections for abortion, and going to the ballot and bringing some of these issues directly to the public,” she says. While canvassers with Students for Life of America—an anti-abortion group coordinating with the Value Them Both coalition supporting the amendment—were encouraging residents to vote for the ballot measure on Saturday, abortion rights canvassers with Kansans for Constitutional Freedom were urging its rejection. Both sides expect the Kansas race to be close: a statewide poll conducted by co/efficient this month found that 43% of Kansans said they plan to vote “no” while 47% said they plan to vote “yes.” Millions of dollars have poured into the race, with national abortion rights groups backing the “no” side and Catholic dioceses and churches funding efforts to vote “yes.” While the campaigns were underway before Roe v. Wade fell, advocates on both sides tell TIME that the decision has given their efforts heightened urgency. On Saturday, 72-year-old Carolyn Sullivan told a canvasser she was voting “no” because she remembered a time before Roe and feared returning to it. “I’m Catholic. I’m not sure I could ever have an abortion myself. But that’s not the issue,” she said. “The government should not be telling me what I’m doing with my medical needs.” That same afternoon, Joe Mayer, 78, told canvassers that his Catholic faith compelled him to vote “yes.” “Our church recommends we do that,” he said. “It is the right thing to do.” Due to its location, loss of abortion access in Kansas would impact far more than just Kansans. With Roe gone, near-total abortion bans in neighboring states such as Oklahoma, Missouri, Arkansas, and Texas went into effect, meaning more people than ever are now driving hours to reach the handful of abortion clinics in Kansas. On July 22, TIME spoke with five women who sought abortions at the Planned Parenthood in Overland Park who said they had driven from other states to access the procedure. Cynthia, 31, who withheld her last name out concerns for her privacy, said she had driven five hours from Tulsa, Okla. to receive an abortion. A mother of two, the first of whom she had at age 18, she said she was in the process of building a business and did not feel prepared to have another child. She had not heard about the Kansas ballot measure, and was alarmed to hear its potential ramifications. “Right now,” she said, “Kansas has been the hope for people like me.” Ramifications across the MidwestKansas is a conservative state where registered Republicans greatly outnumber Democrats, and in presidential elections, voters strongly favor the GOP. But at the state level, its politics are more complex. Democrats have been just as likely as Republicans to hold the governorship in recent decades and the majority of the current justices on the state Supreme Court were appointed by Democrats. Over the last 20 years, Republican state lawmakers have passed many restrictions on abortion, including a 24-hour waiting period, parental consent for minors, and strict limits on when private and public insurance can cover the procedure. But partly because of the 2019 court ruling, Kansas still allows abortions up to 22 weeks of pregnancy, making it an unlikely outpost of access in the Midwest. Kansans’ views on abortion are nuanced, too. A 2021 survey from Fort Hays State University found that 31% of respondents viewed abortion as murder and 40% said they believed life began at conception. But more than 60% said they disagreed with abortion being completely illegal in Kansas and 51% said the Kansas government should not place any regulations on when women could get abortions. Even before Roe fell, people from other states were coming to Kansas to get abortions. After the COVID-19 outbreak in 2020, Kansas was one of the few states in the area that allowed clinics to remain open during lockdown. Then, in September 2021, Texas banned most abortions after around six weeks of pregnancy. Oklahoma enacted a similar bill in May 2022, and by the end of June, abortion was no longer a constitutionally protected right nationwide. Ashley Brink, the clinic director of the Trust Women abortion clinic in Wichita, says that starting with the Texas law last September, the number of out-of-state patients to her clinic doubled. In June, 172 of the clinic’s 272 patients seeking abortions were from out of state. One 28-year-old woman, who declined to be identified out of concern for her privacy, said she had driven from Tulsa, Okla. to terminate her pregnancy at the clinic in Overland Park. She said her doctor told her she needed to because she could not get her stomach and thyroid cancer properly treated while pregnant. In her home state, abortion is now banned except for instances rape, incest, and “medical emergency” in which abortion is necessary to save the pregnant person’s life. She told TIME that her condition did not allow her to access the procedure there, and she couldn’t get an appointment at the closer clinic in Wichita. Republican state Rep. Susan Humphries, who supports the amendment, describes the state’s current role in the country’s abortion post-Roe landscape as “an anathema to the citizens of Kansas, that we would be a destination for abortion.” Jaylem Durosseau, a strategic partnerships advisor with Students for Life of America, says that the influx of out-of-state patients has raised the stakes for the ballot measure, and his canvassers are excited about the possibility of making an even larger impact on limiting abortions. The epicenter of the fightIn many ways, abortion rights advocates are heading into the Kansas ballot measure vote at a disadvantage. The Aug. 2 vote coincides with the state’s Republican and Democratic primaries, where Republicans typically show up in larger numbers. “Republicans start out as the heavy favorites in any election on the primary ballot,” says Neal Allen, a political science professor at Wichita State University. “A primary in the first weekend in August is the worst time to get strong voter turnout. You have many people who are on vacation, students are not in school … and Kansas, like many states, has made it more difficult to register voters.” Turnout in Kansas primaries has historically been about half as high as general elections. More Republicans tend to participate in primaries, as they more frequently have contested races. Kansans must be registered with a party to vote in a partisan primary, meaning the large share of voters who are unaffiliated are likely not used to voting in primaries and may not even know they can vote for the ballot measure. The state’s voters are 44% Republican, 26% Democratic and 29% unaffiliated. Abortion has been a major issue in Kansas politics for years, and many Kansans already have firm beliefs on the issue. So advocacy groups are more focused on turning out their voters than changing minds. KCF has raised $6.54 million since the beginning of the year, with help from national groups like Planned Parenthood, the ACLU and the progressive Sixteen Thirty Fund, while the Value Them Both Association has raised $4.69 million, largely from the Archdiocese of Kansas City, the Catholic Diocese of Wichita and other religious groups. The overturning of Roe has supercharged efforts on both sides. Voter registration surged 1,000% on June 24, the day of the ruling. KCF says they raised almost $100,000 that day and went from 50 volunteer canvassers per week to 500 volunteers the week after, while Students for Life of America says their volunteers in the state have more than doubled since May, when a leaked draft opinion signaled the decision to come. As with many elections, the race could be determined in the suburbs. Both sides are particularly focused on Johnson County, which is just southwest of Kansas City and the most populous in Kansas. Joe Biden won Johnson County in 2020 by 8 points, even as Donald Trump won the whole state by 14. In their messaging, the campaigns are each trying to frame the ballot measure as a way to let voters decide the future of abortion in the state. The anti-abortion advocates in favor of the amendment say they merely want to reverse the state Supreme Court’s decision while abortion rights groups argue the amendment would open the door for state lawmakers to completely ban abortion. Democratic pollster Celinda Lake says her data shows that independent and even some Republican women voters are motivated by the idea of lawmakers “going too far.” While Republicans in Kansas have publicly refrained from sharing their plans if the amendment passes, the Kansas Reflector published leaked audio on July 15 of state sen. Mark Steffen, a Republican, who said that if the amendment passed, the state legislature would be able to pass new laws “with my goal of life starting at conception.” (The senator did not respond to a request for comment.) Similar fights are now set to play out around the country. Without a federal right to abortion, the procedure’s legality rests on each state’s varied political landscape. In places like Kansas, Montana, and Florida, where state courts have previously ruled the state constitutions protect the right to abortion, abortion rights supporters have found themselves defending those decisions from anti-abortion advocates who want to reverse the rulings or amend the documents. In other states, including Michigan, Vermont, and California, abortion rights supporters have launched proactive campaigns to enshrine the right in the state’s constitution. Before Roe was overturned, four states approved ballot measures like the one in Kansas and state courts had established state constitutional protections in a handful of other places, but in most states, there’s no definitive ruling on what the state constitution means for abortion, says Elisabeth Smith, director of state policy and advocacy at the Center for Reproductive Rights. “Until there’s a determination from the state supreme court,” she says, “it is an open question.” A preview of what’s to comeIn the new post-Roe landscape, advocates see the need for a “layered” fight, says J.J. Straight, deputy director of the ACLU’s liberty division, looking for ways to bolster abortion access through state houses, governors’ mansions, state constitutions, and state supreme courts. In Michigan, Planned Parenthood and Gov. Gretchen Whitmer have each challenged the state’s 91-year-old abortion ban in court seeking to establish a state constitutional right to abortion. But after the Supreme Court overturned Roe, the campaign for a ballot measure to enshrine the right to abortion in the state’s constitution saw a massive surge in signatures. “These efforts are crucial to the fight for protecting access to abortion moving forward,” says Sussman of Planned Parenthood. “There needs to be more of them, and over time, a thoughtful and strategic nationwide effort to use state constitutions and ballot efforts to protect access.” In some states, including Michigan and Kansas, these fights will also involve the elections for the state supreme courts. Conservative groups have historically spent significantly more on state supreme court elections than liberals have, and the 2019-2020 cycle was the most expensive cycle yet, according to a report from the Brennan Center for Justice. State supreme court elections also haven’t typically received as much attention as other statewide races, says Douglas Keith, counsel at the Brennan Center and co-author of the report. But the courts’ role in redistricting, voting rights, and now abortion, is changing that, with liberal groups looking to engage in court fights in North Carolina, Ohio, Montana, Michigan and Kansas. “What’s different now is that the U.S. Supreme Court is signaling a general withdrawal from the court’s role of protecting rights,” Keith says. “It’s clear that this is not just one issue that the state supreme courts are going to play a prominent role in. They may in fact become the primary venue for protecting individual rights.” In Kansas, six of the state’s seven supreme court justices are up for retention elections in November, including three who were on the court for the 2019 abortion decision. So far, local groups on both sides of the abortion debate are focusing their energies on the ballot measure rather than the court races. But Kansas has seen intense battles over its Supreme Court justices in the past, and if the constitutional amendment fails, the Court will maintain a crucial role in deciding the future of abortion policy in the state. “I would be surprised if there was not a significant effort to unseat justices in this year’s retention election,” says Keith. In the meantime, the future of abortion access hangs in limbo in Kansas, as well as for millions of people in neighboring states. Brenna Keener, 24, drove to the Overland Park clinic last week from Blue Springs, Mo. She described a brutal year that involved four surgeries to treat her Crohn’s disease. When she found out she was pregnant, she felt her body could not handle a pregnancy and she was not in a position to care for a baby on her own. With abortion almost completely banned in her home state, she drove to Kansas. She’s closely watching the ballot measure race, apprehensive that it might pass. “Where was I going to go? I didn’t have anyone … I can’t emotionally, physically, and financially take care of anyone but me right now,” she said. “I could not imagine this not being an option for women at all.” from https://ift.tt/2Be6cfs Check out https://takiaisfobia.blogspot.com/ Online shopping is more than a hobby for those who get a thrill out of traversing the biggest mall in the world: the internet. It’s also a sport. How else to explain Monica Corcoran Harel’s reaction to the news that there’s a flash sale at one of her favorite online stores? “I get very, very excited and incredibly competitive,” she says, hitting refresh over and over to land the best deal. If a family member happens to enter the room while she’s hovered over her computer, “I’m like, ‘flash sale! I have a flash sale!’” In other words: do not disturb. Corcoran Harel, 53, who lives in the Los Angeles area and runs Pretty Ripe, a lifestyle newsletter for women over 40, has been shopping online for years. She relishes the ability to visit dozens of shops at once, comparing prices before clicking “buy now,” and the promise of quick delivery, all without stepping out of her house. Online shopping is “beyond intoxicating,” she says. “I’m probably partially responsible for the downfall of brick-and-mortar stores.” But what exactly makes these orders feel so good? Experts explain the psychology behind online shopping—along with tips on how to show restraint if your virtual cart is overflowing. Online shopping increased during the pandemicOnline shopping transformed from novelty to normality years ago: Amazon launched nearly three decades ago, in 1995, as an online bookseller, and now reports that customers buy around 7,400 products per minute from its U.S. sellers. But the pandemic shifted consumer habits in a way that favored buying even basic necessities like toilet paper online. According to the Annual Retail Trade Survey, e-commerce sales increased by $244 billion—or 43%—in 2020, jumping from $571 billion in 2019 to $815 billion in 2020. That surge was at least partially driven by a desire to avoid indoor venues. But experts say it could also have to do with self-soothing behaviors. Research has long suggested that retail therapy can actually be therapeutic. A study published in the Journal of Consumer Psychology in 2014, for example, indicates that making purchases helps people feel instantly happier—and also fights lingering sadness. One reason, the study authors speculate, is that making purchase decisions confers a sense of personal control and autonomy. Another study, published in Psychology & Marketing in 2011, found that going shopping leads to “lasting positive impacts on mood,” and is not associated with feelings of regret or guilt about spontaneous purchases. Shopping is, in many ways, motivated by emotion, says Jorge Barraza, program director and assistant professor in the online master of science in applied psychology program at the University of Southern California. “When we’re sad, when we’re stressed, we’re more likely to engage in this kind of behavior,” he says. In some cases, he notes, the spark of joy a fancy new dress or gadget triggers might not last, especially if the buyer knows they’re mismanaging their money. “That boost in mood might be transitory, if you’re spending more than you can afford, but at least temporarily it does appear to restore a sense of control, and reduce any residual sadness that people might be experiencing.” Why online shopping makes people so happyIn many ways, online shopping catapults the pleasure of in-person shopping to a different, almost overwhelming stratosphere. “It’s psychologically so powerful,” says Joshua Klapow, a psychologist and adjunct associate professor of public health at the University of Alabama at Birmingham. (He’s also the new owner of three inflatable pool floats, a collapsible whisk, two jars of almond butter, and 50 pounds of bird seed, all of which he ordered online.) Compared to shopping in person, “it’s a much more gratifying experience overall, because there’s less friction, less barriers, less behavioral cost, more specificity, and more choice,” he says. Plus, “the shopping is totally tailored to us. We can shop quickly or slowly.” Part of the reason why online shopping is so appealing is convenience. When we go shopping in-person, Klapow points out, we have to walk or drive or figure out some other way of getting there, and then we have to stride through aisle after aisle to locate what we’re looking for. Even at stores that offer contactless pay, there’s some effort required to make a transaction: swiping a credit card or Apple Pay on your phone, for example. Then, a shopper needs to travel back home. “For a lot of people, these incredibly minor inconveniences just start picking away at the overall perceived value of the purchase,” he says. In addition to being easier, online shopping delivers the satisfaction of accuracy. If Klapow heads to a big-box store, he might not find the shirt he’s looking for in the right size or color. If he’s shopping online, he’s more likely to snag exactly what he wants with far less hassle. Doing so is a form of immediate gratification, which we’re all wired to crave, says Joseph Kable, a cognitive neuroscience researcher at the University of Pennsylvania. “This is a tendency that’s universal among people and is shared across much of the animal world,” he says. “People and other animals tend to discount outcomes in the future, relative to outcomes that are immediate. This means we prefer to have good things as soon as possible, and to postpone bad things as far as possible in the future.” Interestingly, online shopping is also associated with another, more delayed type of gratification: anticipation for the order’s arrival. Awaiting something exciting is “like Christmas every day,” Klapow says, likening the ability to track a package to monitoring Santa’s whereabouts on Christmas Eve. That resonates with Corcoran Harel, who works from home and enjoys looking out the window to see if a package has arrived. “I’m vigilant about getting my packages,” she says. “I’m so excited to rip it open and try something on—and the knowledge that you can return something easily just makes it better.” What to do if you think you have a problemResearchers define compulsive buying as “a preoccupation with buying and shopping, frequent buying episodes, or overpowering urges to buy that are experienced as irresistible and senseless.” There’s no one-size-fits-all answer to whether your online shopping habit is problematic, Barraza says, but it’s generally a good idea to ask yourself if your purchases are interfering with your quality of life. Compulsive buying disorder (or any other type of shopping addiction) is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM). However, it’s been recognized for more than a century: the German psychiatrist Emil Kraepelin is credited with first describing the disorder in 1915, calling it “oniomania”—the Greek word “onios” means “for sale,” and “mania” was interpreted as “insanity.” As the authors of a 2012 article in Advances in Psychiatric Treatment point out, experts continue to debate whether shopping addiction is “a valid mental illness or a leisure activity that individuals use to manage their emotions or express their self-identity.” In a study published in 2014 in the Journal of Behavioral Addictions, researchers presented several factors that might predispose someone to developing an online shopping addiction, including having low self-esteem, low self-control, a negative emotional state, a penchant for anonymity , and an internet diet that includes exposure to lots of graphics and pop-up messages. Another research article, published in 2017 in Frontiers in Psychology, focused on developing a scale that could measure online shopping addiction. According to the authors, six elements are required to meet the definition of addictive behaviors, including salience (which means online shopping would be the most important activity in the person’s life); mood modification, like feeling a buzz after placing an order; conflict, perhaps with family members; and relapse, or resuming the behavior after trying to stop. In those cases, a person addicted to online shopping might benefit from working with a professional and undergoing cognitive behavioral therapy, Klapow says. Concerns about shopping addiction and over-spending are especially relevant now, as inflation hits its highest peak in the U.S. in four decades. Klapow recommends focusing on making intentional decisions about what to buy. “There’s nothing wrong with saying, ‘I want this, so I’m going to get it,’ but we do need to be careful that we’re not calling all our wants ‘needs,’” he says. Here are a few tips if you’re concerned about over-spending online: Before checking out, review each item in your online cart and ask yourself: “Do I want this, or do I need it?” Klapow instructs his clients to do this cognitive exercise, and it can be helpful, he says. “It forces you to kind of look in the mirror, and you’d be amazed at how many items you end up putting back or saving for later.” Attach a helpful Post-it note to your computer screen. This is one of Klapow’s favorite ways of modifying the environment to resist the siren call of e-commerce. Write your monthly budget in big letters on the sticky note, or a message directing yourself to check the total cost before clicking “buy now.” The visual reminder can help ground you when you’re caught up in the excitement of a new find. Don’t store your credit card information online. Lots of people store information for multiple credit cards online, expediting the ability to make a purchase. Ideally, you wouldn’t store even a single card, Klapow says—”not from a safety standpoint, but from an impulse standpoint.” Having to manually input your payment details requires an extra minute to breathe and perhaps reevaluate the purchase. from https://ift.tt/1kS3GEb Check out https://takiaisfobia.blogspot.com/ |
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