The recent return of polio has hit like something of an epidemiological thunderclap. It was in 1979 that polio was officially declared eradicated in the U.S.—an early step in a multi-generational effort to wipe out the disease around the world. On July 21, however, the New York State Department of Health announced a case of polio in an unvaccinated man in Rockland County, and since then, circulating poliovirus has been found in wastewater there and in neighboring Orange County, as well as in New York City. In London, the virus was also found in wastewater in February, and in Jerusalem, a case of the disease turned up that same month. The three cases, though seemingly isolated, point to a troubling trend—one that goes against more than three decades of progress in eradicating the disease. In 1988, polio was endemic in 125 countries and led to the death or paralysis of 350,000 people—mostly children—each year, according to the World Health Organization (WHO). But thanks to a massive vaccination push by the WHO, Rotary International, UNICEF, the U.S. Centers for Disease Control and Prevention (CDC), and more, polio is now endemic in just two countries—Afghanistan and Pakistan—which have seen only 18 cases between them so far this year. Polio, however, is creeping back, and health officials are now on the alert for what Paul Andino-Pavlovsky, a professor of microbiology and immunology at the University of California, San Francisco, calls a “silent epidemic” of the disease around the world. “This is just the tip of the iceberg,” he warns. Adds Yvonne Moldanado, a professor of global health and infectious disease at Stanford University School of Medicine, “The case we saw [in New York] was unusual but a red flag that we need to be on the lookout for potential outbreaks. We do run the risk of developing more cases of paralytic disease.” The bad news is that polio is stalking us anew. The good news is that just in the past year, a new vaccine has been added to the arsenal of existing polio vaccines—one that, properly deployed, could halt a new global outbreak of polio before it can get started. No matter what, the reappearance of the disease has raised a host of challenges—all of which need to be met if we’re to keep polio contained. What’s behind the current outbreak?Multiple factors have played a role in the return of polio—not the least of which is complacency, especially in the U.S. and other developed countries. When a majority of people alive have never encountered a case of a given disease, it’s easy to put it out of mind. “People don’t remember polio, they don’t see it,” says Ian Lipkin, professor of epidemiology at Columbia University’s Mailman School of Public Health. “There’s something about our species that just allows us to forget about the importance of these things.” That can lead to a slow erosion in vaccine compliance—something that the numbers bear out in the U.S. Nationwide, 92.6% of children are fully vaccinated against polio by age 2, according to the CDC. Broadly speaking, that’s an encouraging figure, but vaccination rates vary state to state and even county to county. In Oklahoma, for example, polio vaccination rates are just 79.5%, and in South Carolina, the figure is 80.3%. In the Rockland County zip code where the case of polio turned up in June, the vaccination rate stands at an alarmingly low 37.3%. The COVID-19 pandemic has also played a role in the return of the disease. “During the COVID era, families didn’t see their doctors or pediatricians as frequently as they normally would,” says Dr. William Schaffner, professor of infectious diseases at Vanderbilt University School of Medicine in Nashville, Tenn. “That has resulted in children falling behind in their routine vaccination schedules.” According to Moldanado, the fall-off has been minimal, with just a 1% decline in polio vaccination rates among children since the pandemic began. But when it comes to infectious diseases, even a single percent can matter a lot. “It translates to tens of thousands of kids who aren’t completely vaccinated,” Moldanado says, “and those children are at risk for diseases that really shouldn’t exist in well-resourced countries.” Read More: Polio Is Back. Here’s How to Keep Yourself Safe The vaccine paradoxThe irony of polio’s comeback is that the very vaccination campaign the CDC estimates has prevented 16 million cases of paralysis and 1.5 million deaths since 1988 is also partly responsible for the new resurgence. There are two kinds of polio vaccines. The first, known as the inactivated polio vaccine (IPV)—administered by injection—uses a killed virus to familiarize the body with the disease and prime it to recognize and attack a live virus if it ever encounters it. The other, known as the oral polio vaccine (OPV)—administered by mouth—uses an attenuated, or weakened, virus that can do the same job of priming the immune system, without actually causing the disease. The advantage of the OPV is that it’s easier and cheaper to administer, which is why it’s used in global eradication campaigns. The big disadvantage is that on rare occasions, the weakened vaccine can revert to its virulent strain. That can potentially lead to the disease in the person who received the vaccine, and even if it doesn’t, the reinvigorated virus is shed in feces, entering wastewater and potentially infecting other people. For that reason, the U.S. switched to the IPV exclusively in 2000—even though cases of viral reversion were exceedingly rare. “The crude estimate was one in 3 million doses of oral vaccine administered would lead to a case of polio in the U.S. before 2000,” Schaffner says. “It’s rare, but it’s not inconsequential.” Indeed it’s not. Genetic sequencing revealed that the virus that caused the recent cases in New York and Jerusalem and was found in wastewater in London was so-called circulating vaccine-derived poliovirus (cVDPV). So far this year, cVDPV has led to 535 other cases of polio in 18 other countries, according to the Global Polio Eradication Initiative (GPEI). But the IPV has its problems too—in addition to its comparative difficulty of administration. The OPV, since it’s taken orally, establishes what’s known as gut immunity. Assuming the person who receives the vaccine is not among the unlucky few in whom the virus reverts to its virulent form, there is no viral replication in the intestinal system and thus no virus shed in the feces. The IPV protects the recipient from ever contracting polio, but does not prevent intestinal replication and spread if that person ever picks up a cVDPV. Andino-Pavlovsky believes that sampling wastewater in any part of the world where the IPV is used would likely turn up some circulating vaccine-derived poliovirus that IPV recipients contracted, replicated, and shed, endangering unvaccinated people. “In Europe, in America, in Australia—every place where people are using the inactivated vaccine—it is likely,” he says. A new vaccineEven with the drawbacks to both vaccines, getting vaccinated is obviously better than not getting vaccinated, since all vaccine recipients are protected against contracting symptomatic polio. But the OPV and IPV do exist in a state of tension, with one producing vaccine-derived virus and the other contributing to its spread. For that reason, the WHO and other global health organizations call for an eventual switchover to the IPV exclusively—a move that would mean there would be no vaccine-derived virus to be picked up and shed at all. “We need to stop giving the live virus so it stops circulating,” says Moldanado. That, however, is not practical at the moment—not while there are still millions of babies and children who need vaccines in the developing world, where the IPV remains too pricey and skilled vaccinators who can administer injections are in far shorter supply than field workers who require little special training to administer drops to the mouth. As a stopgap, the WHO, the Bill and Melinda Gates Foundation, and the U.K.’s National Institute for Biological Standards and Control have come together to develop a new oral vaccine that is far more stable than previous versions, reducing the likelihood of the attenuated virus used in the drops ever reverting to its virulent state. Andino-Pavlovsky, who was part of the team that designed the vaccine, explains that it works by targeting the spot on the viral genome that is responsible for reversion to virulence. In existing OPVs, that part of the genome needs to go through just a single mutation to go from being harmless to dangerous. “What we basically did was modify this sequence,” he says, “so a single point mutation cannot cause reversion; a virus now has to go through four or five different changes before acquiring a more virulent phenotype. Basically, it’s a numbers game.” As Andino-Pavlovsky earlier described it to the journal Nature, “It’s like putting the virus in an evolutionary cage. The vaccine that contains that caged virus went into use at the end of 2021 and so far, Andino-Pavlovsky says, more than 180 million doses have been administered in 13 countries. “The new vaccine is as effective as the previous one in generating immunity,” he says, “[and is] able to stop the silent epidemic.” The goal, ultimately, is to drive polio over the cliff to extinction—as smallpox was in 1980—with a slow phase-out of all OPV, universal use of IPV, and the eradication of any form of poliovirus circulating anywhere in the world. The current return of the disease is a reminder that that job is not nearly done. Until it is, an old scourge will haunt us anew. from https://ift.tt/2szQqTE Check out https://takiaisfobia.blogspot.com/
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Americans’ life expectancy continued to slide in 2021. According to provisional data from the National Center for Health Statistics released on Aug. 31, life expectancy dropped by 0.9 years in 2021, leading to a total decrease of about 2.7 years between 2019 and 2021—the largest two-year decline in a century. Once again, COVID-19 was the primary reason Americans died younger, accounting for 50% of the decline. However, other causes of death—including drug overdoses, heart disease, and liver disease—also surged, hinting at the devastating ripple effects the pandemic has had on society. The life expectancy for someone born in 2021 was 76.1 years, down from 77 years in 2020. The decline was greater for men than for women; the life expectancy for males was 73.2 years, down an entire year from 2020, and 79.1 for females, a 0.8 year loss. The drop in life expectancy wasn’t inevitable, especially after a highly effective COVID-19 vaccine became available, says Andrew Stokes, an assistant professor in the department of global health at Boston University School of Public Health. In fact, many wealthy countries—including much of western Europe—recovered in 2021 after experiencing declines in life expectancy in 2020—while some countries, like Australia, experienced no declines at all. “The U.S. is an outlier,” says Stokes. “In a highly functioning public health and health care system, one would expect rebounds due to widespread access to vaccines.” Without COVID-19 vaccinations, life expectancy could have dropped even further. About 1.1 million more people in the U.S. likely would have died from COVID-19 between Dec. 12, 2020 and Nov. 21, 2021, according to a Commonwealth Fund estimate. The virus also indirectly increased risk factors for other conditions, including by disrupting the health care system and people’s lives. In particular, researchers have warned that the pandemic put people at greater risk of dying from cardiovascular disease. COVID-19 has strained the U.S. health care system, leading to widespread understaffing, while patients delayed both routine doctors’ visits and trips to the hospital. More directly, SARS-CoV-2 infection can damage the heart, and is thought to have raised patients’ risk of dying. Substances like alcohol and drugs also posed a major health threat during the pandemic. Drug overdose deaths increased sharply, rising 15% to an estimated 107,622 deaths from 2020 to 2021, especially among Black, American Indian, and Alaska Native people. The increasing prevalence of illicit fentanyl, a highly potent synthetic opioid that was involved in about 66% of overdose deaths, is thought to be a major contributing factor. Researchers believe that the pandemic made substance use riskier by adding to isolation and worsening mental health, as well as disrupting patients’ access to treatment programs and health care. Among American Indians and Alaska Natives, chronic liver disease and cirrhosis—both of which can result from alcohol use—contributed to 18.6% of the decline in life expectancy. Black people, Hispanics, and native peoples experienced the greatest total declines in life expectancy from 2019 to 2021. The worst decline during both years was among American Indian and Alaska Natives: 1.9 years from 2020 to 2021, leading to a total decline of 6.6 years since 2019. However, in 2021, white people also saw a significant drop in life expectancy: one year. That’s compared to Black people (0.7 of a year) and Hispanics (0.1 of a year). This isn’t because conditions improved for Black and Hispanic communities, Stokes emphasizes; rather, it was because more white people died. COVID-19 caused 54.1% of the decline in white life expectancy. For the most part, says Stokes, this is because the Delta wave killed younger people and affected more rural areas—places with weaker health care systems, lower vaccination rates, and more white people, although the average age at death shifted older among white people during the Omicron wave. “I think it’s fair to say that at least part of the [U.S.’s] poor performance is due to the lackluster health care response and lack of uptake of vaccines,” says Stokes. “Things could have been different if we had had a more rigorous public health response.” from https://ift.tt/bh9cotI Check out https://takiaisfobia.blogspot.com/ WASHINGTON — The U.S. on Wednesday authorized its first update to COVID-19 vaccines, booster doses that target today’s most common omicron strain. Shots could begin within days. The move by the Food and Drug Administration tweaks the recipe of shots made by Pfizer and rival Moderna that already have saved millions of lives. The hope is that the modified boosters will blunt yet another winter surge. “You’ll see me at the front of the line,” FDA vaccine chief Dr. Peter Marks told The Associated Press shortly before his agency cleared the new doses. Until now, COVID-19 vaccines have targeted the original coronavirus strain, even as wildly different mutants emerged. The new U.S. boosters are combination, or “bivalent,” shots. They contain half that original vaccine recipe and half protection against the newest omicron versions, called BA.4 and BA.5, that are considered the most contagious yet. The combination aims to increase cross-protection against multiple variants. “It really provides the broadest opportunity for protection,” Pfizer vaccine chief Annaliesa Anderson told the AP. Read More: An N95 Is the Best Mask for Omicron. Here’s Why The updated boosters are only for people who have already had their primary vaccinations, using the original vaccines. Doses made by Pfizer and its partner BioNTech are for anyone 12 and older while Moderna’s updated shots are for adults — if it has been at least two months since their last primary vaccination or their latest booster. They’re not to be used for initial vaccinations. There’s one more step before a fall booster campaign begins: The Centers for Disease Control and Prevention must recommend who should get the additional shot. An influential CDC advisory panel will debate the evidence Thursday — including whether people at high risk from COVID-19 should go first. “As we head into fall and begin to spend more time indoors, we strongly encourage anyone who is eligible to consider receiving a booster dose with a bivalent COVID-19 vaccine to provide better protection against currently circulating variants,” FDA Commissioner Dr. Robert Califf said in a statement. The U.S. has purchased more than 170 million doses from the two companies. Pfizer said it could ship up to 15 million of those doses by the end of next week. The big question is whether people weary of vaccinations will roll up their sleeves again. Just half of vaccinated Americans got the first recommended booster dose, and only a third of those 50 and older who were urged to get a second booster did so. It’s time for U.S. authorities to better explain that the public should expect an updated COVID-19 vaccination every so often, just like getting a fall flu shot or a tetanus booster after stepping on a rusty nail, said University of Pennsylvania immunologist E. John Wherry. “We need to rebrand it in a societally normal-looking way,” rather than a panicked response to new mutants, Wherry said. “Give a clear, forward-looking set of expectations.” Here’s the rub: The original vaccines still offer strong protection against severe disease and death from COVID-19 for most generally healthy people, especially if they got that important first booster dose. It’s not clear just how much more benefit an updated booster will bring — beyond a temporary jump in antibodies capable of fending off an omicron infection. One reason: The FDA cleared the modifications ahead of studies in people, a step toward eventually handling COVID-19 vaccine updates more like yearly flu shots. First, FDA checked human studies of earlier Pfizer and Moderna attempts to update their vaccines — shots matching the omicron strain that struck last winter. That recipe change was safe, and substantially boosted antibodies targeting the earlier variant — better than another dose of the original vaccine — while adding a little protection against today’s genetically distinct BA.4 and BA.5 omicron versions. Read More: Need Another Reason to Exercise? It Could Protect You from COVID-19 But FDA ordered the companies to brew even more up-to-date doses that target those newest omicron mutants instead, sparking a race to roll out shots in less than three months. Rather than waiting a few more months for additional human studies of that recipe tweak, Marks said animal tests showed the latest update spurs “a very good immune response.” The hope, he said, is that a vaccine matched to currently spreading variants might do a better job fighting infection, not just serious illness, at least for a while. What’s next? Even as modified shots roll out, Moderna and Pfizer are conducting human studies to help assess their value, including how they hold up if a new mutant comes along. And for children, Pfizer plans to ask FDA to allow updated boosters for 5- to 11-year-olds in early October. It’s the first U.S. update to the COVID-19 vaccine recipe, an important but expected next step — like how flu vaccines get updated every year. And the U.S. isn’t alone. Britain recently decided to offer adults over 50 a different booster option from Moderna, a combo shot targeting that initial BA.1 omicron strain. European regulators are considering whether to authorize one or both of the updated formulas. AP Health Writer Matthew Perrone contributed to this report. from https://ift.tt/vm9YpDl Check out https://takiaisfobia.blogspot.com/ In the years following World War II, physicians in the U.S. and Europe noticed a surprising phenomenon: rates of heart attack and stroke fell dramatically in many places. Autopsies from this period also revealed reduced rates of atherosclerosis, which is a buildup of fatty arterial plaques that causes cardiovascular disease. At first, experts were perplexed. But as time passed, many concluded that wartime food deprivations and the forced shifts in people’s diets—namely, big reductions in the consumption of red meat and other animal products—contributed to the heart-health improvements. Later work, particularly the famous Framingham Heart Study, helped establish that blood cholesterol levels, driven in large part by a person’s diet, tended to overlap closely with cardiovascular disease. The idea that the foods a person eats could raise or lower their risks for unhealthy cholesterol levels and disease was, at first, a radical and controversial one. While there’s ongoing debate about the relationship between red meat and poor health, the links connecting diet, cholesterol, and cardiovascular disease are beyond doubt. Cholesterol is a waxy compound that your body uses primarily to make hormones and to firm up the walls of cells. “Our body needs some cholesterol for day-to-day functioning, but the amount our body needs is relatively small,” says Dr. Laurence Sperling, the founder and director of the Heart Disease Prevention Center at Emory University in Atlanta. Different parts of the body, including the brain and the blood, contain cholesterol. It’s the oversupply of cholesterol in the blood, specifically, that causes problems—specifically low-density lipoprotein (LDL), which is also known as “bad cholesterol. Too much LDL in the arteries can “form a fatty streak, which is the precursor of atherosclerotic plaque,” explains Dr. Francine Welty, a cardiologist at Beth Israel Deaconess Medical Center in Boston and former chair of the American Heart Association’s lipid committee. LDL, therefore, is the primary building block of arterial plaque. The two main diseases associated with clogged arteries—coronary artery disease and cerebrovascular disease—are both among the top three causes of death worldwide. More than 1 in 4 deaths are caused by one of these two conditions, and managing or lowering your blood cholesterol levels is a proven way to prevent these diseases. Sperling says ideal or “target” cholesterol levels vary depending on a person’s age, sex, and health status. But, optimally, you want to keep your LDL cholesterol below 70 mg/dL. While drugs can help people get there—and in some cases may be necessary—he says that non-pharmacological approaches are just as important. “Lifestyle and behavioral approaches are the foundation of cardiovascular prevention for all,” he says. Here, experts detail the most impactful lifestyle changes to make to lower your cholesterol. A proper diet, they all agree, tops the list. Read More: Only 7% of Americans Have Optimal Heart Health, Study Says How to eat to lower your cholesterolOne of the biggest trends in diet and nutrition advice is a movement away from talking about specific micronutrients and optimal daily servings of this or that food group. Instead, nutrition experts now talk a lot more about broad patterns of healthy eating. This means limiting certain foods while prioritizing others, rather than trying to hit narrow targets. “Something I tell a lot of my patients is that the Greek derivation of diet is diaeta, which means a way of life,” Sperling says. “Dieting shouldn’t be torture, or something you maintain for a month. It should be a meaningful and purposeful change you can extend throughout your life.” In this spirit, he says one of the most important changes you can make is to pack your meals with lots of fresh fruits, vegetables, nuts, and whole grains. Many of the most effective and evidence-backed cholesterol-lowering eating plans—like the Mediterranean diet—prioritize these foods, he says. Meanwhile, reducing your intake of animal products—especially red meat and processed dairy foods—is a move that research has repeatedly tied to cholesterol improvements. “I’ve run the lipid prevention clinic at my hospital for 31 years, and the first thing we tell people is to lower their intake of saturated fats,” Welty says. She mentions red meat, butter, and dairy as foods people should aim to cut down on—not eliminate necessarily, but reduce—if they want to improve their cholesterol. Many Americans consume saturated fats, from eggs and dairy products to red meat, with almost every meal. This sort of immoderation is a problem. “The Japanese have some of the lowest rates of cardiovascular disease in the world, and that may be because they eat much less red meat and saturated fat than we do in America,” Welty says. It’s worth noting that saturated fat is a controversial topic in nutrition research. Some experts have argued that saturated fats get blamed for health problems that are likely caused by processed meats, refined carbohydrates (like those found in sugary or packaged foods), and the trans fats in fast foods and some packaged snacks. Others have argued that if people avoid meat and dairy but end up eating more processed or refined carbs, that’s an unhealthy trade. On the other hand, experts generally agree that trading saturated fats for some of the healthy foods mentioned above—such as fruits, vegetables, and nuts—is a highly effective way to improve your cholesterol scores and heart health. “If you decrease the saturated fat in your diet, that’s one of the best ways to lower LDL,” Welty says. She adds that protein-rich soy-based products—from tofu to soy milks and yogurts—may also be good substitutes for meat, butter, milk, and other conventional saturated fat sources. “People in America are fixated on protein, but Americans don’t really like to eat soy products,” she says. This is unfortunate because research stretching back several decades has linked soy to improved heart health and lower blood cholesterol levels. “If you need to replace saturated fats with other proteins, soy would be a good option,” she says. Exchanging foods with hooves for foods with feathers or flippers is another good idea. “Replacing red meat and pork with fish and chicken is something we often recommend,” Welty says. In particular, fatty fish such as salmon, mackerel, and herring are heart-healthy choices. On the other hand, experts say fish oil—a popular health supplement—is not a helpful addition to your regimen. “Fish oil does not lower bad cholesterol,” says Dr. Leslie Cho, director of the Cleveland Clinic’s Women’s Cardiovascular Center. She says that some prescription fish oil supplements can help lower triglycerides, so doctors sometimes recommend them. But commercial fish oil supplements have been linked to an increased risk for abnormal heart rhythms and should be avoided. Last but not least, Cho says that getting plenty of fiber in your diet—something most Americans fail to do—is extremely important. “Fiber can bind to dietary cholesterol and eliminate it from the body,” she says. “We want you to aim for 25 grams of soluble fiber per day.” This is possible if you’re eating a lot of whole vegetables, fruits, and healthy whole grains like oatmeal or flaxseed. But supplements can also help you get there. Cho says ground psyllium seed—sold under the brand name Metamucil, and also in less-expensive (but identical) generic products—is a helpful source of soluble fiber that can reduce your LDL levels. Read More: What to Know About High Cholesterol in Kids Non-diet approaches to improving cholesterolWhile lowering your LDL scores should be your primary focus, improving your levels of high-density lipoprotein (HDL) cholesterol—also known as the “good” kind of cholesterol—is also important. “HDL sucks cholesterol from blood vessels like a vacuum,” Cho explains. Exercise is one way to pump up your HDL levels. “It can raise your good cholesterol and also lower triglycerides,” another type of blood fat linked with cardiovascular problems, Sperling says. However, when it comes to the best type of exercise for your cholesterol, the research is all over the place. One review of studies, published in 2020 in the journal Systematic Review, found that yoga has the strongest evidence in favor of its cholesterol-improving benefits. While many other types of exercise are undeniably good for your heart and vascular system—and some, like swimming and cycling, have been found to reduce cholesterol—more research is needed to determine which are the best at shifting cholesterol scores. Some of Sperling’s research has also examined the benefits of intermittent fasting on cholesterol levels. Intermittent fasting plans come in a lot of different forms, but one type (known as time-restricted eating) has generated a lot of promising research findings. Time-restricted feeding involves a daily fast, usually anywhere from 12 to 16 hours, while the rest of the day is open for normal eating. For example, you might eat lunch, dinner, and snacks between the hours of noon and 8 p.m. But the rest of the day, you avoid all caloric foods and beverages. Time-restricted eating has been linked to significant weight loss—which often improves cholesterol scores—as well as lower LDL and total cholesterol. There are other ways to improve your cholesterol naturally. But focusing on what and how you eat, as well as your exercise habits, is what experts say matter most. Don’t wait to startWhile the health problems associated with high cholesterol and clogged arteries often don’t show up until a person’s 50s or 60s, the underlying plaque build-up often begins decades earlier—in some cases, during a person’s 20s. Researchers have found that taking steps to lower your cholesterol earlier in life, before that plaque buildup gains momentum, could lead to three-fold reductions in cardiovascular disease compared to delaying these healthy changes until middle age. “The results of our study suggest that an effective primary prevention strategy may be to place greater emphasis on a healthy diet and regular exercise beginning early in life,” wrote the authors of a 2012 study in the Journal of the American College of Cardiology. Sperling agrees, and says you could think of cholesterol health as similar to an investment portfolio: the earlier you start, the greater the eventual profit. “You want to start in your 20s, not your 40s,” he says. Even if it’s too late to start early, the most important thing is to start. Cho says that changing diet and lifestyle to lower cholesterol can, for example, help those who have heart disease and are already taking cholesterol-lowering medications to avoid stronger drugs and the side-effects they may cause, such as joint pain and muscle spasms. “If you can make changes that prevent you from having to increase your dose, that’s a good thing,” she says. Read More: High Blood Pressure and Diabetes Are Linked. Here’s How to Reduce Your Risk for Both Cholesterol problems are one of the most common age-related risk factors for heart disease. While drugs can help, improving your eating and exercise habits can save your heart and vascular system from potentially life-threatening risks. from https://ift.tt/6UiwS2X Check out https://takiaisfobia.blogspot.com/ Chances are, you already know someone who’s an avid pickleball player. America’s fastest-growing sport—a cross between tennis, badminton, and ping-pong—can be played as either a singles or doubles game, though doubles is typically more popular. Points can only be accrued by the side that’s serving, and the winner is the first side to get to 11 points and be leading by at least two. Invented in 1965 in Bainbridge Island, Washington, pickleball has gained popularity during the pandemic, growing 14.8% between 2020 and 2021. According to the 2022 Sports & Fitness Industry report, more than half (52%) of core players—those who play eight or more times a year—are 55 or older, and almost a third (32.7%) are 65-plus. Jonathan Casper, an associate professor at North Carolina State University who has studied the benefits of pickleball for older adults, views it “as a public health tool in many ways, both for achieving physical activity and for getting the psychological and social benefits that are so important as we age.” Here’s why. It’s a low-impact way to get movingPart of pickleball’s appeal is that “while it does take coordination, and you have to be physically healthy to play,” it’s not that hard to learn, Casper says. And because the court is smaller than a tennis court, the net is lower, and you play with a plastic wiffle ball, “it doesn’t take too much out of your body,” says Arthur Kreiswirth, 80, a retired dentist in New Rochelle, N.Y., who started playing five years ago. “The running is in short sprints and the impact of smacking the ball is minimal, so it’s easier on the joints.” But pickleball is still a great workout. In a 2016 study published in Medicine & Science in Sports & Exercise, 12 middle-aged players burned 40% more calories during a 30-minute pickleball game than during 30 minutes of walking, increasing their heart rates to within the moderate-intensity exercise zone. A small six-week study of 15 people ages 40 to 85 who played an hour of pickleball three days a week showed improvements in cholesterol, blood pressure, and cardiorespiratory fitness. Plus, regular practice can help improve balance, which is important in preventing falls as you age. Because pickleball requires both hand-eye and foot coordination, says Casper, “your balance, your movement, and your coordination all get better as you play more.” It’s an avenue to socializationResearch has shown that social isolation is associated with an increased risk of dementia, depression, and premature death. Yet, without work or school-aged kids, it can be hard to make friends as an older adult. Enter pickleball, which Janet Niehaus, 68, a retired teacher in Easley, S.C., describes as “my socialization.” In the rotating group of 18 people she plays with twice a week, “we stand around and talk as much as we play.” In a recent study of 36 pickleball players over the age of 65, published in World Leisure Journal, those who maintained the social connections they’d made through the sport by continuing to play through the pandemic months of 2020 reported improved life satisfaction. Pickleball’s widening appeal—the average player’s age is 38, an almost three-year decrease from 2020—means you meet people you might not hang out with otherwise, says Erin McHugh, 70, author of Pickleball Is Life: The Complete Guide to Feeding Your Obsession. “As I grow older, I’m a big proponent of having friends of every age and different walks of life,” says McHugh, who plays daily with other devotees ranging from age 15 to 92. “It keeps you tuned in to what’s out there.” Courts have sprung up at community centers, YMCAs, and tennis clubs; search the Places 2 Play database to find a court nearby. And if you’ve got the space, you can even lay out your own pickleball court at home. It gives you something to get better atIn his research into the psychological connection between pickleball and older adults, Casper found that the competition inherent to pickleball—rare in other “senior-friendly” activities like walking or Zumba—was a major draw. When Kreiswirth started playing at 75, “I was paired with a 92-year-old, and he could stroke as well as anyone,” he says. “I thought, ‘Well, if he can do it, I can.’ It pumped me up to keep playing.” A 2018 study of 153 people who compete in pickleball tournaments found that playing pickleball is significantly related to a low level of depression in older adults. For retirees, pickleball can help restore a sense of purpose after leaving the working world, says Casper. “People start to form an identity as they play more and more,” he explains. “The fact that they’re able to continue to get better, that they’re able to compete and to have that satisfaction of winning contributes to their quality of life in many ways.” And when it comes to skill mastery, says McHugh, the sky’s the limit. “You can always improve at pickleball,” she says. “That’s so satisfying! How many things are going to be like that when you’re 70?” It keeps your brain sharpKathy Jaray, 70, who plays six times a week in Encinitas, Calif., says it’s not just the physical exercise that has her “pretty hooked,” it’s also the mental workout. “Some people could care less about strategy and just want to hit the ball, but for me, it makes for a more interesting game,” she says. While power and strength are helpful, “if you know the right placement, if you know where your opponents are positioned, if you have the right strategy, you can be just as good as—if not better than—those who are physically more superior and athletic than you,” Casper says. The confidence boost Kreiswirth gets from playing pickleball is huge. “It has helped me so much with my vision of myself,” he says. “Yes, I’m in good shape for an 80-year-old, but there is an end in sight, and I do not want to crawl to that end. Pickleball has given me a way to be active for a couple of hours, break a sweat, and feel really good about myself.” from https://ift.tt/7BQytA8 Check out https://takiaisfobia.blogspot.com/ While green tea has a long-standing reputation for health benefits, research has been much more mixed on black tea. One problem, says Maki Inoue-Choi, an epidemiologist at the National Cancer Institute, is that large observational studies on tea and mortality have focused on countries like Japan or China—places where green tea is more popular. To fill this gap, Inoue-Choi and her colleagues analyzed data in the United Kingdom, where black tea drinking is common. After surveying about 500,000 people and following them for a median of 11 years, the results, published Aug. 29 in the journal Annals of Internal Medicine, gave black tea a boost. Among the population of tea drinkers—89% of whom drank black tea, compared to 7% who drank green—drinking tea was associated with a modestly lower mortality risk for those who had two or more cups a day compared to non-drinkers. People who added milk or sugar also experienced the benefit, and the results remained consistent regardless of the tea’s temperature. The findings also indicate that tea drinkers had a lower risk of dying from cardiovascular disease, ischemic heart disease, and stroke than those who didn’t drink tea. While it’s difficult to say why people who drink tea may live longer, it’s not entirely a surprise. According to Inoue-Choi, tea is “very rich in bioactive compounds” that reduce stress and inflammation, including polyphenols and flavonoids. A 2020 study that used the same British database as the new research found that there’s an association between higher consumption of both black and green tea and biomarkers that predict cardiometabolic health, including lower cholesterol levels. Research has also suggested that tea can help lower blood pressure. Going forward, researchers should take a closer look at the connection between tea and cardiovascular disease, says Rob M. van Dam, professor of exercise and nutrition sciences at George Washington University’s Milken Institute School of Public Health, who did not participate in the study. One striking thing about the new research, he notes, is that there isn’t an association between increasing the dose of tea—the amount a person consumes—and decreased mortality after the person had consumed two or three cups. The exception, he said, is if you eliminate coffee drinkers, who may have made it harder to spot an association between increasing the amount of tea you drink and mortality because they had lower mortality during the study. Without the coffee drinkers, it became clearer that drinking tea was associated with a lower risk of dying of heart disease. “The association between tea consumption and cardiovascular mortality may be driving the association between tea consumption and all-cause mortality,” van Dam says. None of this is to say, however, that you should run to your kettle. The new research is based on an observational study—meaning that the evidence wasn’t gathered from an experiment, and the results were inferred by the researchers. The findings shouldn’t be used to make health decisions, and must be replicated in randomized clinical trials, experts say. Plus, the magnitude of the association between tea drinking and mortality was modest, which means it’s likely that another characteristic of people who drink tea could have led to this effect, says van Dam. For instance, people who drink tea might hypothetically have been less likely to consume soft drinks. As Inoue-Choi put it, the new findings should be reassuring to people who drink tea regularly. But “people shouldn’t change how many cups of tea to drink every day because of these results,” she says. from https://ift.tt/DFWVhaI Check out https://takiaisfobia.blogspot.com/ High blood pressure—also known as hypertension—and Type 2 diabetes are two of the most common medical conditions in the U.S. Unfortunately, they often occur together. Some research has found that 85% of middle-aged or older adults who have Type 2 diabetes also have hypertension, and both conditions elevate a person’s risk for heart disease, stroke, and kidney disease. These increased risks are significant, and in some cases grave. Researchers have found that people with Type 2 diabetes are up to four times more likely to develop cardiovascular disease than those who don’t have the condition. People with diabetes are also twice as likely to die of cardiovascular problems. The leaps in rates of stroke, kidney failure, and other deadly complications are also substantial for people who have both high blood pressure and diabetes. Why do these conditions so often show up in tandem? Experts are still trying to nail down the precise connections, but they say excess weight may play a part. Many people who have hypertension and Type 2 diabetes also have obesity, and this “triumvirate,” as some researchers have termed it, is associated with metabolic and endocrine problems that overlap and promote disease. “Obesity seems to be fertile soil for both,” says Dr. Srinivasan Beddhu, a professor of internal medicine at the University of Utah School of Medicine. Also, the sheer commonness of hypertension all but ensures that most people with Type 2 diabetes will end up with both diseases. Roughly half of all U.S. adults have hypertension, and that percentage goes up with age. “It can develop as early as [ages] 30 to 42, but in most cases, by the time you’re in your 50s, it’s there,” says Dr. George Bakris, a professor of medicine at the University of Chicago. Although hypertension often precedes Type 2 diabetes, Bakris says, diabetes is increasingly common in young adults and even children. It’s more important than ever to keep an eye out for both conditions, perhaps especially if you’re overweight or obese. Here, experts explain how high blood pressure and Type 2 diabetes cause trouble in combination, as well as how to manage the conditions and reduce their associated risks. Read More: These New Developments Could Make Living With Type 2 Diabetes More Manageable Understanding the connectionEvery time a heart beats, it sends blood out into the body via the circulatory system. In between beats, the heart fills with blood. A person’s blood pressure refers to two different but related measurements of this cycle. The first, known as systolic blood pressure, is the pressure inside the arteries when the heart beats and pumps out blood. The second measurement, known as diastolic blood pressure, is the pressure inside the arteries when the heart is resting and filling with blood. These two numbers are usually presented together, and they almost always rise and fall in unison. In the U.S., blood-pressure scores higher than 130/80 mm Hg are considered hypertensive. Bakris says hypertension is often called a “silent killer” because it may cause no symptoms. Even when a person’s blood pressure is dangerously high, the symptoms that develop are so common and nonspecific—meaning they turn up for all sorts of reasons—that you may not connect them with high blood pressure. Dizziness, headaches, and blurry vision are among these nonspecific symptoms. By the time they set in, a person’s blood pressure may have been elevated—and doing damage—for several years. What sort of damage? High blood pressure can stretch or injure your arteries in ways that raise your risk for heart disease, arterial disease, stroke, and other cardiovascular complications. High blood pressure also increases stress on the kidneys and some other organs. Type 2 diabetes is a medical condition defined by high blood-sugar levels. These high levels are caused by problems related to insulin, which is a hormone that signals to the body’s cells that they need to absorb blood sugar. In people with Type 2 diabetes, the cells become “resistant” to insulin, meaning they do not properly absorb blood sugar. As with hypertension, the early symptoms of Type 2 diabetes—frequent urination, blurry vision, dramatic hunger spikes—may not raise immediate red flags. If someone isn’t staying on top of their doctor’s appointments, they may not be aware that one or both of these conditions is present. How do these conditions combine in ways that contribute to health problems? “Both affect the small blood vessels,” says Dr. Mattias Brunstrom, a hypertension specialist and physician researcher at Umea University in Sweden. “Diabetes affects the vessels in ways that make them stiffer, and high blood pressure impairs their function.” This stacking of arterial damage helps explain why the combination of the two conditions is associated with cardiovascular problems, including higher rates of heart disease and stroke. At the same time, both hypertension and Type 2 diabetes may also promote higher-than-normal levels of blood sugar. Elevated blood sugar can damage the cells of the kidneys (as well as the heart and blood vessels). Kidney disease—and ultimately kidney failure—is a common complication among people with both of these conditions. “If you have [systolic] blood pressure consistently above 180, within 12 to 15 years, you will be on dialysis,” Bakris says, referring to a medical procedure that removes, filters, and returns the blood to someone whose kidneys are no longer up to it. Elevated blood sugar caused by Type 2 diabetes further damages kidney cells, and increases the odds that the kidneys will struggle or fail to perform their job. Although cardiovascular and renal problems are two of the most common complications, hypertension and Type 2 diabetes can cause or contribute to a wide range of health problems—from dementia to blindness. “Both affect the vasculature, which can impair the health of any organ system,” Brunstrom says. Fortunately, there are effective ways to manage both conditions and therefore reduce all of these health risks. Read More: The Truth About Fasting and Type 2 Diabetes What you can doAs is the case with most common health conditions, experts say that a combination of lifestyle changes and prescription drugs are often an effective one-two punch for people with both hypertension and Type 2 diabetes. “First, I would say that lifestyle changes are the basics of all disease management,” Brunstrom says. He re-emphasizes the strong associations linking hypertension and Type 2 diabetes to obesity, and the role excess weight plays in exacerbating many health complications. “Obesity or overweight is a huge driver of both these conditions, so weight management would be very crucial,” he says. “Diet, exercise—any way you can get your weight down is good.” Even if you’re not losing weight, exercise is still beneficial. “It increases circulation around the body and improves function of the small vessels, which might get [blood] pressure down,” he says. “It might also improve the sensitivity to insulin and reduce glucose.” That’s all good stuff. Even short of sweaty exercise sessions, spending less time sitting or in a sedentary position—walking, for example, or doing chores around the house on your feet—may be helpful. When it comes to eating, Brunstrom highlights the DASH diet, which is endorsed by the National Heart, Lung, and Blood Institute for the management of hypertension. (DASH stands for “dietary approaches to stop hypertension.”) The DASH diet involves limiting your intake of saturated fats, which are common in red meat and fatty dairy products, and also cutting down on your intake of salt and sugary foods and drinks. Meanwhile, the DASH diet recommends eating lots of fruits and vegetables. Other experts endorse these eating habits. “I always tell my patients to eat healthy, which means more fruits and vegetables, less red meat, fewer high-carbohydrate foods,” says the University of Utah’s Beddhu. Recently, some researchers have examined the benefits of intermittent fasting plans for the management of Type 2 diabetes. These approaches involve limiting or eliminating all caloric intake for an extended period of time—usually 16 hours or longer. There’s evidence that they may be beneficial. They also appear to be safe for people with early or mild disease. “But if you have diabetes and are on medications, these diets can wreak havoc,” Bakris says. “If you want to try that, you need the help of a physician or accredited diabetes dietitian.” Weight-loss surgery may be a treatment option worth considering. Recent research shows that bariatric surgery has helped both young people and adults get better control of their diabetes and hypertension. In some cases, especially those involving teenagers, weight-loss surgery has removed the need for medications or even eliminated the diseases entirely. Apart from surgery and lifestyle interventions, experts agree that prescription medications are almost always necessary to manage these diseases. “You can reduce your pill burden if you’re really good on the lifestyle side—so eating right, reducing sodium intake, exercising regularly,” Bakris says. “But even on the low end, most people with diabetes and hypertension are going to require four to six medications.” Others agree that pills are pretty much unavoidable. “I always compare [taking] them to doing your taxes or brushing your teeth,” says Dr. Tom Brouwer, a cardiology resident and researcher at Amsterdam University Medical Centres in the Netherlands. “It’s not fun, but you need to do it.” In the U.S., medical guidelines recommend that doctors aim to get people with both hypertension and diabetes down to blood-pressure scores below 130/80 mm Hg. There’s some ongoing debate about whether targeting even lower numbers would be beneficial. Brouwer has conducted research in this area, and he says that in many cases he’s a proponent of aiming for a systolic BP of 120. “If a patient tolerates it, I tend to try to lower their blood pressure all the way to 120,” he says. There are many different drugs used to treat people with both hypertension and Type 2 diabetes. But two of the most popular options are angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, both of which help relax the arteries and so assist blood flow. Apart from being effective for hypertension, these drugs also help protect the kidneys. Diuretics (drugs that increase urination), as well as beta blockers and calcium channel blockers, are all common treatments. Read More: People With Diabetes Are More Vulnerable to Heart Disease. How to Reduce the Risk “With these three drugs, an overwhelming majority of patients get to the target blood pressure,” Brouwer says. For those at risk for hypertension, diabetes, or both, experts say that all the lifestyle measures above—a good diet, exercise, and maintaining a healthy weight—are among the best ways to lower your risks. By following your doctors’ drug recommendations and trying to live a healthier life, you can protect yourself from serious complications. “I tell patients: you can help yourself,” Bakris says. “But you have to put in the effort.” from https://ift.tt/IAW8Ohn Check out https://takiaisfobia.blogspot.com/ Derrick Morton was skeptical about working for Kaiser Permanente’s Bernard J. Tyson School of Medicine. The Pasadena, Calif., school hadn’t yet opened to students when he was offered a job in early 2020, and it felt risky to work for such a new institution. But Morton, who is Black, was eventually sold by the medical school’s mission: to train doctors with a strong focus on diversity, equity, and inclusion and to dismantle health disparities. After a short time as an assistant professor of biomedical science, however, Morton says it became clear that the reality didn’t live up to his “great expectations.” In a lawsuit filed Aug. 22, Morton alleges that Kaiser’s medical school discriminates against Black faculty, fostering a culture of “anti-Black animus” that is “so pervasive and chilling that [Morton] and his Black colleagues could not associate with each other or with Black students for fear of being blacklisted and rendered professionally non-viable.” At least a dozen times between October 2020 and July 2021, Morton alleges that he complained to supervisors that Black employees were being discriminated against and treated unfairly, including through demotions, discipline, and efforts to “silence” those who spoke out. Morton claims that he personally experienced similar issues—including being appointed to a diversity, equity, and inclusion advisory committee that, he says, was stripped of authority and effectively made secondary to an outside consultant. Morton claims that the toxic work environment at Kaiser caused him to develop panic attacks and insomnia, and to seek out therapy for the first time in his life. A spokesperson for the medical school said they were “surprised” by Morton’s complaint and “strongly disagree with the allegations and characterization of events” within it, but declined to provide further comment on the lawsuit because litigation is ongoing. The spokesperson stressed that “addressing equity, inclusion, and diversity in medical education and health care is one of our primary objectives at the Kaiser Permanente Bernard J. Tyson School of Medicine.” They noted that the school recruits a diverse body of students and faculty; that anti-racism is woven throughout its curriculum; and that Black faculty members hold many leadership and committee positions at the school. Morton isn’t the first ex-faculty member to sue Kaiser’s medical school. Last year, former instructor Dr. Aysha Khoury filed a complaint against the school, alleging that she’d been suspended and ultimately terminated—without warning or a satisfying explanation—after leading a classroom discussion on racism in medicine, drawing on her own experiences as a Black woman and physician. Prior to that incident, Khoury alleges she endured microaggressions related to her gender and race, including extra scrutiny and supervision of her work and being reprimanded for failing to greet a white male colleague. Khoury tells TIME she hopes her lawsuit will ensure that “nothing like what I experienced happens to another faculty member.” Both Khoury and Morton are seeking monetary damages as well as policy changes to prevent future discriminatory behavior. In June, the National Labor Relations Board (NLRB), a federal agency that protects fair labor practices, filed a complaint on Khoury’s behalf. School representatives declined to comment on Khoury’s complaint and time at the school, citing ongoing litigation. Kaiser’s lawyers filed a motion for summary judgment in August, arguing that Khoury had not proven she faced racial or gender discrimination and that her case falls exclusively under the NLRB’s jurisdiction. In interviews with TIME, more than half a dozen current and former faculty members said they consider racism to be a systemic problem at the new medical school despite its progressive veneer. And Kaiser isn’t alone. U.S. medical schools both new and old are struggling to live up to their stated goals around diversity and inclusion and cast off the long history of racism embedded in U.S. health care—problems too deeply entrenched for a few well-placed buzzwords to fix. One of the guiding values of Kaiser’s medical school is “advocating for change in medical education, the profession, and the healthcare system”—a proclamation that underscores how deep-seated issues of racism and inequity are in American medicine. Centuries ago, enslaved Black people were forced into medical research, at times withstanding procedures without proper pain medication so that white doctors could learn about the human body. Modern medicine was “built on bodies that were Black, enslaved, had no autonomy, were abused and misused,” says Dr. Rachel Bervell, who runs the Black ObGyn Project, an initiative dedicated to anti-racism in medicine. That mistreatment didn’t end with slavery. During the infamous Tuskegee study, which began in the 1930s, researchers withheld syphilis treatment from hundreds of Black men so they could see what the disease did to the human body over time. And well into the 1900s, it wasn’t uncommon for doctors to perform procedures, particularly on patients of color, without informed consent, as in the well-known case of Henrietta Lacks, a Black woman whose cancerous cervical tissue was taken without her knowledge during a medical visit in 1951, and later formed the basis for lucrative biomedical research projects. Those are only two of many examples, and they’re not ancient history. Even today, studies show that people of color in the U.S. experience poorer health care than white Americans. That’s particularly true when they’re treated by doctors of a different race—which is likely, since 56% of practicing physicians in the U.S. are white. A white coat isn’t a shield against racism, either. Many physicians of color report experiencing racism from patients and colleagues, studies show, and almost a quarter of medical students who identified as an underrepresented minority say they experienced race-based discrimination during medical school, according to one 2020 study of 27,500 graduates. About 4% of medical students who experience recurrent discrimination or mistreatment ultimately leave medical school, according to 2022 research—and students of color are disproportionately likely to fall in that category. Inequality is baked into the very structure of modern medical education. In the early 1900s, the Carnegie Foundation commissioned education expert Abraham Flexner to assess the state of U.S. medical schools. Inspired by the German model for educating doctors, which pushed for the advancement of research and biomedical science, Flexner recommended shutting down schools with subpar facilities or underperforming research programs. Almost 100 medical schools closed in the wake of his review, including five of the seven dedicated to educating Black students. The Association of American Medical Colleges (AAMC) has since acknowledged the harm caused by the Flexner report, but its influence on medical education is still felt today—perhaps most painfully in the shortage of Black physicians in the U.S., who make up just 5% of the doctor workforce. Closed Black medical schools could have trained approximately 35,000 additional Black physicians by 2019, one study found. Many of medicine’s forefathers held racist beliefs that bled into medical training—like the idea that race itself predisposes people to certain ailments, or the false belief that people of color feel less pain than white people. So-called “race-based medicine” has been discredited in recent years, and the AAMC recently introduced new tools for teaching and assessing competency in diversity, equity, and inclusion—but in many cases, the damage has been done. Kaiser’s medical school aimed to address many of these long-standing problems. When it announced in February 2019 that it would soon start accepting applications for its first class, it was explicit about its mission: to train “diverse physicians to serve the needs of society.” It would offer free tuition to the first five graduating classes, in order to attract the right students regardless of their ability to pay. It sounded like “a little slice of utopia,” says a current faculty member who asked to go unnamed for fear of retaliation. But for some faculty of color, working at the school has not lived up to the promise. In 2017, Kaiser hired Victoria Richards, a pharmacologist with experience in medical school curriculum development who has since left the school, to help shape its academic programming before it opened. At first, she says, the school’s ethos seemed to match its stated mission. But very quickly, Richards perceived the school’s focus shifting toward becoming an elite research institution—just like other prestigious medical schools—and the diversity initiatives started to seem like distant priorities. “I became disillusioned and disappointed,” she says, “particularly as the dean was hired and brought in.” That dean was Dr. Mark Schuster, a lauded pediatrician and former Harvard Medical School professor. At least on paper, Schuster shares the school’s values. An article he co-authored about the school’s founding, published in the journal Academic Medicine in 2020, uses the acronym “EID”—for equity, inclusion, and diversity—49 times. But as Richards saw it, Schuster brought with him what she calls a “Harvard mentality”—one that seemed to value prestige and traditional trappings of academic success above values Kaiser’s medical school claimed to hold sacred, such as training community-oriented physicians who could help eliminate socioeconomic disparities in health. Kaiser representatives did not make Schuster available for an interview. But Dr. Lindia Willies-Jacobo, the school’s senior associate dean for admissions and equity, inclusion, and diversity, insists the administration’s commitment to those values has never wavered. “It’s work, and we are doing the work,” she says. “As a Black woman…I will boldly say that I have never before worked at a school that was, in fact, as diverse as our school.” Khoury, however, has a different perspective. She says that none of the 50 students in each of Kaiser’s first two classes came from a historically Black college or university (HBCU). And in Richards’ opinion, instead of looking for well-rounded students from diverse backgrounds, Schuster and his team appeared to prioritize applicants with excellent test scores--a metric that notoriously favors white, higher-income students—who would make the school look good as it got off the ground. (Willies-Jacobo strongly disagrees with the notion that applicants were not evaluated holistically, and says some HBCU graduates were admitted but chose not to attend. Fourteen percent of students in Kaiser’s first class identified as Black, higher than the 2020 national number of 9.5%.) A former employee with knowledge of the school’s internal demographic data also says Kaiser had difficulty retaining faculty and staff of color across roles. (From 2017 to 2021, 11 of 13 voluntary faculty resignations came from people of color, according to Khoury’s legal complaint.) But unflattering data about retention were never distributed throughout the school, says the former employee. “Any data that ran contrary to the narrative [the dean] was trying to create, he would dismiss,” the former staffer says. Indeed, a current faculty member, who asked to go unnamed to avoid retaliation, says the leadership team created an “unsafe environment to even just ask difficult questions.” Those who critique decisions made by leadership risk professional consequences, including removal from committees and being passed over for promotions, several current and former faculty members say. Those themes are echoed in Khoury’s legal complaint, which cites an email sent to administrators by a faculty member of color who argued the school’s commitment to anti-racism was superficial. “We are a racist institution, we are upholding the system of white supremacy that is at the core of our nation, but we do not have to be,” the faculty member wrote, according to an excerpt included in the complaint. Willies-Jacobo declined to comment on other people’s statements about how they perceive the school, but strongly defended Kaiser’s commitment to diversity, equity, and inclusion. She says that members of the leadership team take diversity, equity, and inclusion training sessions and have held “listening sessions” where students, staff, and faculty can share feedback. Tensions boiled over when Khoury was abruptly suspended, with little explanation, in the summer of 2020. “Here I am thinking that I have the permission to be all of who I am, and that that is appreciated,” Khoury says, looking back on the experience. “And for them to not even speak to me is so disabling, traumatic. It strips you of any identity.” The incident was also traumatic for the wider Kaiser community. More than 90% of the first-year class signed a petition demanding Khoury’s reinstatement, according to a tweet from the account StudentsofKP, which describes itself as a group of students from the school’s class of 2024. Her case also sent ripples of fear through a faculty already on edge, some of her colleagues say. If an instructor could be suspended for leading a discussion about racism in medicine—at a school that had encouraged her to do just that—what else could be considered a fireable offense? In the aftermath of Khoury’s departure, several Black students reached out to Morton and another teacher of color to talk about what had happened, Morton recalls. “‘We don’t think we can meet with you,’” he told them. “‘They may fire us.’” Morton’s legal complaint also alleges that a member of Kaiser’s leadership team implied in a meeting with Morton that his students could face consequences if they protested Khoury’s departure. Morton subsequently advised his students of color to partner with white students if they wanted to speak out against perceived racism on campus, believing the school to be more receptive to the white students’ concerns, the complaint says. Less than a year after Khoury’s suspension, Morton took a job at another university and didn’t look back—despite a significant pay cut. The “culture and overt racism” at Kaiser, he says, “made it such that I couldn’t stay.” Kaiser’s medical school opened in 2020, when racial issues were top of mind for the entire country. It had no history to overcome, no statues to tear down or buildings to rename. Yet to many, it’s still coming up short. It’s far from the only medical school struggling to tackle issues of systemic racism and inequality. Schools both new and old are learning that breaking the mold created by centuries of medical racism is easier said than done. “We’re all cut from the same cloth,” a current Kaiser employee says of U.S. medical schools. “We just had the hubris and arrogance to claim that we could be different.” In late 2021, Dr. Princess Dennar, who formerly ran a medical residency program at Tulane University, settled a lawsuit in which she alleged the school discriminated against doctors of color. A representative from Tulane said they could not comment on the lawsuit, but said Tulane has “embarked on a school-wide cultural change that places equity, diversity and inclusion at the center of our recruitment, training, teaching, research, operations and care.” Dennar says she could not talk about her time at Tulane, but overall says she has never seen a medical institution totally overcome its racist foundations. “Medicine is a racialized system,” she says, and those historical roots keep inequities in place. “I would be hard-pressed to believe that there is an institution that exists today—if they still practice the same things they’ve been taught and built upon—that is absolved from having any forms of racism.” But some schools—particularly those founded relatively recently—are trying. Charles Collier, an assistant dean at Quinnipiac University’s Frank H. Netter MD School of Medicine, has run a program that supports students from underrepresented backgrounds on their paths to medical school since 2012, two years after the school was founded. Collier says it was forward-thinking for the school to have such a program, especially a decade ago, but admits there have been “peaks and valleys” in its implementation. He says he has faced resistance from colleagues who don’t see why minoritized students need more support than other prospective applicants—though that pushback melted away after the uprising that followed George Floyd’s murder in 2020, he notes. (In a statement, Dean Dr. Phillip Boiselle said the program has always had full institutional support.) Collier says there’s been sustained momentum since 2020, and the school recently hired an inaugural associate dean for equity, inclusion, and diversity—a promising sign, he says. Frank Netter isn’t perfect, but Collier believes it is doing a better job at confronting inequality than most U.S. medical schools. That’s in large part, he says, because its students are motivated to effect change, forcing administrators to listen. Student pressure, he says, was the “catalyst” for hiring the new associate dean for equity, inclusion, and diversity. Boiselle agrees that student feedback has been “especially vital” in shaping Netter’s approach to diversity, equity, and inclusion, a process that he says will continue into the school’s second decade. Similar battles are playing out at older schools, which have considerably more history to overcome. Harvard has been publicly reckoning with its historical ties to slavery, and that’s an ongoing process, says Dr. Joan Reede, dean for diversity and community partnership at Harvard Medical School. “Everyone acknowledges that we are not at the end of uncovering,” she says. Still, Reede notes that Harvard Medical School has been engaged in diversity, equity, and inclusion efforts for more than 50 years, dating back to when a former dean in 1968 created a committee meant to help diversify the student body. LaShyra Nolen, president of Harvard Medical School’s 2023 graduating class, says Harvard’s medical students and residents are widely committed to equity and anti-racism, but it can be hard to inspire the same enthusiasm from veteran figures in medicine. She points to a recent book written by Dr. Stanley Goldfarb, a former dean at the University of Pennsylvania’s medical school, called Take Two Aspirin and Call Me By My Pronouns: Why Turning Doctors Into Social Justice Warriors Is Destroying American Medicine, which she describes as specifically mocking her anti-racism advocacy. “As we’re making strides,” Nolen says, “we still have this old guard” that is resistant to change. Nolen has been encouraged that Harvard now accepts EID work for senior thesis projects and factors it into faculty promotion assessments. Previously, she says, EID was often considered a “volunteer” commitment, rather than academically rigorous work. That gets at a systemic problem. The medical education system relies heavily on standardized tests and other similarly one-dimensional performance metrics. Even though a growing number of undergraduate colleges are deemphasizing standardized test scores in part because of research suggesting they reinforce racist and culturally biased admissions processes, many medical schools continue to use them. Schools that try to do things differently—prioritizing hands-on learning over exams, accepting students with other valuable medical skills but not-so-great scores—risk producing doctors who can’t compare, at least on paper, to their competitors’ graduates. Several current and former Kaiser medical school employees say the numbers-focused system partially explains what they see as the institution’s failure to live up to its anti-racism goals. The school is so new that it is still going through the process of accreditation, through which institutions must prove they meet the necessary standards for granting degrees. Since that process is crucial to the school’s future, current and former faculty members say leadership is making every effort to present an impressive facade to outsiders—even if it means glossing over internal culture and equity issues that don’t show up on an evaluator’s spreadsheet. As of August, Kaiser has been granted preliminary accreditation by the Liaison Committee on Medical Education. It was also recently included on U.S. News & World Report’s list of the most diverse medical schools in the U.S. Willies-Jacobo acknowledges that the pressures of accreditation “are real.” But “having said that,” she continues, “I would say that we have pushed, and will continue to push, boundaries.” Pushing boundaries within an existing system doesn’t go far enough, Dennar says. The entire health care system was built upon racist foundations, and she’d like to see a similarly ground-up approach to remaking it. Starting in medical schools, and continuing all the way through the current health care workforce, Dennar wants more emphasis on holistic patient care, better understanding of how race and health intersect, and stronger connections between clinicians and the communities they treat. She’s optimistic, but not delusional: “We have a lot of bandages being put on wounds, and the wound is still festering,” she says. Despite everything, Khoury still wants Kaiser’s medical school to live up to its ideals; she believes the school, as described on paper, should and could exist. With “some significant humility, accountability, introspection, and dedication to anti-racism,” she thinks it can get there. Changes to the way it deals with racism on campus and commitment to transparency and academic freedom would be good places to start, she says. But Khoury knows that work takes energy and dedication, and she fears that both may be in short supply at Kaiser. If efforts fall short, she’s afraid others will be lured to the school for the same reasons she was, only to be disappointed. “There’s a part of me that would rather them just change their mission,” she says. “That might be easier to do.” from https://ift.tt/GsbFK8q Check out https://takiaisfobia.blogspot.com/ Out-of-body and other mystical experiences can be life-changing, and research suggests they can even make people less afraid of dying. But such experiences are rare, and tend to occur accidentally and in the most extreme circumstances—such as at the brink of death. There might be another way to mimic the near-death experience: scientists have identified striking parallels between these experiences and the effects of psychedelic drugs. According to a new survey conducted by researchers at Johns Hopkins Medicine, published Aug. 24 in the journal PLOS ONE, people’s attitudes about death change after both a psychedelic drug experience and a non-drug-related out-of-body experience. The researchers split more than 3,000 participants into two groups: those who had previously had an extraordinary non-drug experience, and those who had used a psychedelic drug: psilocybin (found in magic mushrooms), lysergic acid diethylamide (LSD), ayahuasca, or N,N-dimethyltryptamine (DMT). They found that about 90% of people in both groups were less afraid of death than they had been before their experiences. These findings build upon previous research showing that psychedelics, especially when combined with therapy, can relieve anxiety about the end of life. That includes a 2016 randomized clinical trial that found that psilocybin lessened depression and anxiety among 51 patients with life-threatening cancer. Co-author Roland Griffiths, a professor in the departments of psychiatry and neurosciences at the Johns Hopkins University School of Medicine, is hopeful that psychedelics could one day be used to help anyone who’s struggling with the fear of death. Treatment “could significantly reduce suffering in individuals with or without a life-threatening illness,” he says, including by lessening the emotional pain some people feel at the end of their lives, such as depression, anxiety, and isolation. Evidence suggests that psychedelics can affect the brain, including by promoting neuroplasticity, which refers to its ability to modify, change, and adapt. It’s harder to determine how near-death experiences impact the brain. However, both experiences—nearly dying and taking psychedelics—can be profound. About half of each group in the new study said that they’d encountered something they might call “God”—48% among the non-drug group, and 56% among people who’d used psychedelics. In the non-drug group, 85% said the experience was in the top five most meaningful of their lives, compared to 75% of the psychedelic group. The study isn’t a perfect representation of the range of what happens when people take psychedelics or have an unusual non-drug experience. For instance, the study authors point out that the participants were mostly white and American. They also opted to join the survey, which means they might have been especially motivated to share their experiences. Plus, there are signs that at least some people could be negatively affected by these experiences; about 1 in 20 people in each group said that they were more afraid of death afterwards. The next step is additional scientific research, says Griffiths, including broad surveys of the general population. For now, however, the new findings add hope that while death will always be inevitable, suffering at the end doesn’t need to be. from https://ift.tt/rXvIFp6 Check out https://takiaisfobia.blogspot.com/ |
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