Category: Health

Children whose families frequently use screens tend to have weaker vocabulary skills, with video games having the most detrimental effect on brain development, according to a recent study. The research, conducted by scientists from Estonia, underscores the negative influence of screen time on children’s language abilities.

In the study, more than 400 parents were surveyed regarding their own screen habits, their children’s screen use, and the children’s language development. The results, published in *Frontiers in Developmental Psychology*, highlight a clear correlation between high screen use by both parents and children and poorer language skills among the children.

Dr. Tiia Tulviste, the lead researcher from the University of Tartu, Estonia, emphasized the importance of face-to-face verbal interaction between parents and children, particularly during the early years of life. “The research shows that during the first years of life, the most influential factor is everyday dyadic face-to-face parent-child verbal interaction,” said Tulviste. The study involved surveying 421 children between the ages of two and a half and four years old. Parents were asked to estimate how much time family members spent using different types of screen devices daily. In addition, parents were required to complete a questionnaire that assessed their children’s language abilities, including vocabulary and grammar.

The researchers divided both the children and their parents into three groups based on their level of screen use: high, moderate, and low. The results showed that parents who spent a lot of time using screens had children who mirrored this behavior, indicating a strong influence of parental screen habits on children’s screen usage. Those children who used screens more frequently had lower scores in both grammar and vocabulary compared to those with less screen exposure.

One key takeaway from the study is that no form of screen time appeared to have a positive effect on children’s language skills. This was the case across the board, whether the screen time was spent on video games, watching videos, or any other screen-based activity.

However, Tulviste did point out that some types of screen use, such as reading ebooks or engaging in educational games, could provide valuable learning opportunities, particularly for older children. These activities, while not necessarily contributing to better language skills in younger children, may offer some potential for language development in later years. Still, the overall finding was clear: excessive screen time, especially in early childhood, is linked to weaker language abilities.

The most significant negative impact on children’s vocabulary development was found to come from video games. This was true regardless of whether it was the parents or the children themselves who were playing the games. “Using screens for video games had a notable negative effect on children’s language skills,” said Tulviste. This finding suggests that video gaming, in particular, might be a screen-based activity that warrants concern among parents and educators.

These findings contribute to the growing body of research that highlights the importance of limiting screen time for young children, particularly when it comes to activities that do not engage them in direct language-based interaction. Excessive screen time, especially in the form of video games, may hinder children’s opportunities for language learning during a critical period in their brain development.

Parents, researchers, and educators alike have been concerned for some time about the potential effects of rising screen use among children. With more children having access to devices such as smartphones, tablets, and gaming consoles, questions about how these technologies impact brain development have become more pressing. This study provides valuable insights into the relationship between screen time and language skills, a vital aspect of children’s cognitive development.

Although video games have often been marketed as a form of entertainment or even educational tool, this research underscores that they may not be beneficial for young children when it comes to language acquisition. Games, even those intended to be educational, often lack the direct interaction and rich language exposure needed for strong vocabulary development.

Moreover, the study raises broader questions about the role of screen-based activities in children’s overall learning and development. While there is growing awareness of the potential downsides of excessive screen use, especially in terms of language and social skills, many parents and educators continue to struggle with balancing technology’s role in children’s lives.

The screen habits of parents were also found to be highly influential in determining their children’s screen usage. In households where parents spent a significant amount of time on screens, children were more likely to do the same. This reinforces the idea that children’s screen habits are often modeled on the behavior of the adults around them.

The importance of face-to-face verbal interaction cannot be overstated, particularly during early childhood. Language development during this critical period is highly dependent on social interaction, including listening to and engaging in conversations with caregivers. These interactions provide children with the vocabulary, grammar, and communication skills necessary for later success in school and life.

While educational content on screens, such as ebooks or language-learning apps, may have some positive effects, they cannot replace the value of human interaction. This is why experts recommend that screen time, particularly for young children, be limited, and that parents focus instead on spending time talking, reading, and playing with their children.

Tulviste’s research contributes to a growing understanding of the potential risks associated with excessive screen time during early childhood. Her findings highlight the importance of parents being mindful of their own screen use, as well as their children’s, in order to support healthy language development.

This study serves as a reminder that while technology is a powerful tool, it is essential to manage its use carefully, particularly for young children. The early years of life are a critical period for brain development, and parents can play a crucial role in fostering their children’s language skills by prioritizing face-to-face interaction over screen-based activities.

Insulin resistance, a condition previously linked to numerous health issues, has now been associated with an increased risk of early death in women, as well as 31 different diseases, according to a new study. While the precise causes of insulin resistance remain unclear, experts believe that factors such as excessive weight and lack of physical activity play a significant role.

The study was led by Jing Wu and colleagues from the Department of Endocrinology at Shandong Provincial Hospital in China, who sought to investigate the wider impacts of insulin resistance. To do this, they turned to the UK Biobank, a large-scale health resource containing genetic, medical, and lifestyle data from over 500,000 individuals in the UK. This data provided a broad base for understanding how insulin resistance affects overall health.

One of the key elements used to measure insulin resistance in the study was the TyG index, which is based on participants’ blood sugar and fat levels, including cholesterol. The index offers a reliable way to estimate insulin resistance levels. According to the findings, the TyG index scores among participants ranged from 5.87 to 12.46 units, with an average score of 8.71 units.

The researchers observed a notable pattern: participants with higher TyG index scores tended to be men, older, less physically active, smokers, and more likely to be living with obesity. This group, with higher levels of insulin resistance at the start of the study, was linked to more adverse health outcomes. The findings were published in the journal *Diabetologia*.

By monitoring the health of participants over a median follow-up period of 13 years, the researchers discovered that insulin resistance was linked to a heightened risk of developing 31 different diseases. Of these, insulin resistance was directly associated with an increased likelihood of developing 26 conditions, including sleep disorders, bacterial infections, and pancreatitis. The researchers also found that the greater the degree of insulin resistance, the higher the risk of these diseases.

In terms of gender-specific findings, the study revealed a significant association between insulin resistance and all-cause mortality in women. The data showed that for every one-unit increase in insulin resistance, women had an 11% higher risk of dying during the study period. This was a striking finding, as no such link was observed for men.

The research also highlighted some of the specific diseases related to insulin resistance. For example, every one-unit increase in insulin resistance was associated with an 18% higher risk of developing sleep disorders. Additionally, the risk of bacterial infections rose by 8%, and the likelihood of developing pancreatitis increased by a significant 31% with each unit increase in insulin resistance.

One of the most important aspects of this study is its potential implications for public health. Insulin resistance, which was previously understood primarily as a precursor to conditions like diabetes and cardiovascular disease, may have far-reaching effects on a person’s overall health. The study’s findings suggest that individuals with insulin resistance are more likely to develop a wide range of conditions, many of which may not have been previously linked to insulin dysfunction.

“We have shown that by assessing the degree of insulin resistance, it is possible to identify individuals who are at risk of developing obesity, hypertension, heart disease, gout, sciatica, and some other diseases,” said Jing Wu, the lead researcher. This insight could prove crucial for early detection and intervention, potentially improving outcomes for individuals with high insulin resistance.

The connection between insulin resistance and early death in women also raises important questions about why this link exists for women but not for men. While the study did not delve into the reasons for this gender difference, it opens the door for further research to explore the biological or lifestyle factors that may influence this disparity.

The study’s findings also emphasize the importance of addressing insulin resistance through lifestyle changes, such as increasing physical activity and maintaining a healthy weight. Although the study did not specifically investigate interventions for reducing insulin resistance, it reinforces the idea that these factors could play a critical role in mitigating the risks associated with insulin resistance.

This new research highlights the extensive impact of insulin resistance on health, linking it not only to a wide range of diseases but also to an increased risk of early death in women. The findings underline the importance of monitoring insulin resistance as part of routine health assessments and suggest that greater attention should be paid to the condition, particularly in women, to prevent or delay the onset of related health issues. With further research and a focus on lifestyle interventions, there may be opportunities to reduce the burden of insulin resistance and improve health outcomes for many individuals.

A recent study has revealed a significant link between frequent mobile phone use and a higher risk of cardiovascular diseases, particularly in individuals who are smokers or have diabetes. This risk is compounded by additional factors such as poor sleep, psychological distress, and neuroticism, according to research findings published in the Canadian Journal of Cardiology on Wednesday.

The researchers emphasized that modern-day mobile phone use is a widespread habit, and its impact on public health requires careful consideration. “Mobile phone use is a ubiquitous exposure in modern society, so exploring its impact on health has significant public health value. However, whether mobile phone use is associated with the risk of cardiovascular diseases remains uncertain,” stated Dr. Yanjun Zhang, a researcher from the Division of Nephrology at Nanfang Hospital, Southern Medical University in Guangzhou, China.

The study utilized data from the UK Biobank, a large-scale prospective cohort study that included 444,027 participants. These individuals self-reported their mobile phone usage between 2006 and 2010 and had no prior history of cardiovascular diseases at the start of the study. Researchers defined regular mobile phone use as making or receiving at least one call per week. The goal of the study was to assess the potential connection between mobile phone usage and cardiovascular issues, which included acute stroke, coronary heart disease, atrial fibrillation, and heart failure.

Over the median follow-up period of 12.3 years, researchers tracked hospital admissions and mortality data to assess the occurrence of cardiovascular diseases. In addition to mobile phone use, the study examined lifestyle factors such as sleep patterns, psychological distress, and neuroticism, all of which could influence heart health.

The findings revealed a noteworthy association between frequent mobile phone use and a higher risk of developing cardiovascular conditions. More specifically, individuals who reported using their phones regularly showed an increased likelihood of suffering from heart-related problems. However, this risk was found to be even higher in people who smoked or had diabetes.

The study suggested that the chronic exposure to electromagnetic radiation emitted by mobile phones might play a role in this increased cardiovascular risk. “We found that sleep patterns, psychological distress, and neuroticism may be potential mechanisms of the association between mobile phone use and cardiovascular diseases. In addition, chronic exposure to radiation emitted from mobile phones could lead to oxidative stress and inflammatory response,” explained Xianhui Qin, a researcher also from Nanfang Hospital.

Oxidative stress occurs when there is an imbalance between free radicals and antioxidants in the body, leading to cellular damage. Prolonged exposure to mobile phone radiation has been proposed as a potential trigger for this imbalance, which in turn may contribute to cardiovascular problems. The inflammatory response caused by this stress could further exacerbate conditions such as heart disease, stroke, and atrial fibrillation.

The study also explored the impact of psychological and behavioral factors. Poor sleep quality, for instance, is known to negatively affect heart health by increasing the risk of high blood pressure, obesity, and type 2 diabetes—factors that are already established contributors to cardiovascular disease. The researchers found that individuals with disrupted sleep patterns were more likely to be frequent mobile phone users, suggesting a possible link between poor sleep and increased phone usage. Additionally, mobile phone usage, particularly late at night, could contribute to sleep disturbances, further heightening the risk of heart-related complications.

Psychological distress was another significant factor examined in the study. People experiencing high levels of stress or anxiety often engage in behaviors that may harm their heart health, such as smoking, overeating, or physical inactivity. The researchers noted that individuals who frequently use their phones for social media or communication may be more prone to psychological distress due to the constant connectivity and pressure to respond to messages or updates.

Neuroticism, a personality trait characterized by emotional instability and high levels of anxiety, was also found to be associated with frequent mobile phone use. The study highlighted that neurotic individuals might use their phones more often as a coping mechanism for stress or emotional distress. However, this constant phone use could inadvertently increase their risk of cardiovascular diseases by exacerbating their underlying psychological conditions.

The combination of these psychological and behavioral factors with chronic mobile phone use could create a dangerous cycle, increasing the overall risk of cardiovascular diseases. For individuals who already have pre-existing risk factors, such as smoking or diabetes, the situation becomes even more concerning.

Smoking, in particular, is a well-known contributor to cardiovascular disease, and the study found that smokers who regularly used mobile phones were at an even higher risk. Smoking causes damage to blood vessels, increases the risk of blood clots, and raises blood pressure, all of which contribute to heart disease. When combined with the potential oxidative stress from mobile phone radiation, the risk of heart problems becomes significantly amplified.

Diabetes was also identified as a risk-enhancing factor. People with diabetes are already at a higher risk for cardiovascular diseases due to complications such as high blood sugar levels and damage to blood vessels. The study found that frequent mobile phone users with diabetes had a higher likelihood of developing heart-related conditions compared to non-users.

The research team emphasized the need for further studies to fully understand the relationship between mobile phone use and cardiovascular disease risk. While the current study provides valuable insights, it does not conclusively prove a direct cause-and-effect relationship. Rather, it highlights the importance of considering multiple factors, such as lifestyle, psychological well-being, and pre-existing health conditions, when assessing cardiovascular health.

Future studies could focus on examining the long-term effects of mobile phone radiation exposure in greater detail, particularly with advancements in mobile technology and the increasing use of smartphones. Additionally, more research is needed to understand how sleep patterns, stress levels, and personality traits like neuroticism may interact with mobile phone use to influence heart health.

As mobile phone use continues to grow globally, public health officials and researchers must consider the potential implications for cardiovascular health. Educating individuals on the importance of moderating phone use, improving sleep quality, managing stress, and addressing smoking and diabetes as key health priorities could help reduce the risk of heart disease.

This study serves as an important step in exploring the potential health risks associated with mobile phone use. The findings suggest that regular mobile phone use, particularly among smokers and people with diabetes, may be linked to an increased risk of cardiovascular diseases. While more research is needed to provide definitive evidence, the study highlights the importance of considering multiple factors—such as poor sleep, psychological distress, and neuroticism—that may contribute to the connection between mobile phone use and heart health.

The U.S. Surgeon General, Dr. Vivek Murthy, issued a warning on Wednesday about the mental health impacts of parenting, highlighting that the role of being a parent can be both immensely rewarding and incredibly challenging. Dr. Murthy, who is a father himself, shared in a recent advisory that while he feels fortunate to experience the joys of parenthood, it remains the “toughest and most rewarding” job he has ever undertaken.

“The stresses parents and caregivers have today are being passed to children in direct and indirect ways, impacting families and communities across America,” Murthy stated in his advisory. He pointed out that many parents are feeling overwhelmed by the pressures they face, with a significant percentage admitting to feeling overburdened by stress. According to the advisory, 41 percent of parents confess to being so stressed on most days that they find it difficult to function, while 48 percent describe their stress levels as completely overwhelming.

Dr. Murthy emphasized that today’s parents are navigating a different set of challenges than those faced by previous generations. These challenges include the pervasive influence of social media, the rising youth mental health crisis, and what Murthy referred to as the “epidemic of loneliness,” which affects not only younger Americans but their parents as well. The surgeon general stressed that these modern-day challenges are having a profound impact on the mental well-being of both parents and children, contributing to a cycle of stress and anxiety within families.

To help alleviate these stresses, Murthy called for policy changes and the implementation of community programs designed to provide greater support to parents. Such measures could include making child care more affordable and ensuring that parents have the flexibility to take time off work to care for their sick children without financial strain. These changes, Murthy suggested, would help parents manage the various pressures they face, thereby improving the overall well-being of families.

Earlier in the year, Murthy also advocated for regulations requiring social media platforms to include warning labels about the potential mental health risks their content poses to children and young adults. This call to action is part of a broader effort to protect young people from the negative effects of social media, which has been linked to increased rates of anxiety, depression, and other mental health issues among youth.

“In my conversations with parents and caregivers across America, I have found guilt and shame have become pervasive, often leading them to hide their struggles, which perpetuates a vicious cycle where stress leads to guilt which leads to more stress,” Murthy explained. He noted that this cycle of stress and guilt can prevent parents from seeking the help and support they need, further exacerbating their mental health challenges.

Murthy also called for a shift in cultural norms around parenting to better support moms and dads in coping with the demands of raising children. He suggested that society needs to recognize the significant role that parenting plays in shaping future generations and to place a higher value on the health and well-being of parents.

“Raising children is sacred work. It should matter to all of us,” Murthy said. “And the health and well-being of those who are caring for our children should matter to us as well.”

By raising awareness about the mental health challenges associated with parenting, Dr. Murthy hopes to spark a national conversation about how best to support parents and caregivers. This includes not only policy changes and community programs but also a cultural shift in how society views and values the role of parents. The ultimate goal, according to Murthy, is to create a more supportive environment that recognizes the unique challenges of parenting and provides the resources and support parents need to thrive.

In his advisory, Dr. Murthy highlighted the importance of acknowledging the difficulties faced by parents and caregivers and the need for a more compassionate and supportive approach. He called on policymakers, community leaders, and society as a whole to take action to better support parents and to ensure that they have the tools and resources necessary to raise healthy, happy, and well-adjusted children.

The surgeon general’s advisory serves as a stark reminder of the mental health challenges faced by parents today and the need for a collective effort to address these issues. By recognizing the importance of supporting parents and caregivers, Dr. Murthy hopes to foster a more supportive and understanding environment for families across the United States.

Murthy’s message is clear: Parenting is not just a personal endeavor but a collective responsibility that requires the support and understanding of the entire community. By working together to address the challenges faced by parents and caregivers, society can help ensure that all children have the opportunity to grow up in a healthy, nurturing environment.The health and well-being of parents and caregivers, as Murthy emphasized, should be a priority for everyone, as it ultimately affects the future of society as a whole.

The World Health Organization (WHO) has declared mpox a global public health emergency for the second time in two years due to an outbreak that originated in the Democratic Republic of Congo (DRC) and has since spread to neighboring countries and beyond.

New cases of the virus have now been identified outside of Africa, in countries such as Thailand, the Philippines, Sweden, and Pakistan. Health authorities are raising alarms as many new cases in Africa involve a recently discovered, more lethal strain of the virus, known as clade 1b, which has also been confirmed in Thailand.

Mpox is a viral infection that spreads through close contact, including sexual contact. It presents with flu-like symptoms such as fever, chills, and muscle aches, along with pus-filled lesions. While the disease is generally mild, it can be fatal in some cases.

Two main types of mpox are identified by clades, with the current outbreak being attributed to clade 1. This strain seems to spread more easily and has a higher fatality rate compared to the clade 2 strain, which was prevalent in 2022. Clade 1 appears to disproportionately affect young people, with most fatalities occurring among children.

The rise in cases is primarily attributed to a new variant of clade 1, known as clade 1b, which is believed to be the main cause of the recent increase in cases, according to WHO. The organization noted that clade 1b is primarily transmitted from person to person, often through sexual contact. Although first identified in 2024, it likely emerged in the DRC around 2023.

“The outbreak associated with clade Ib in the DRC primarily affects adults and is spreading rapidly, sustained largely, but not exclusively, through transmission linked to sexual contact and amplified in networks associated with commercial sex and sex workers,” the WHO stated on August 19.

Aside from the DRC, clade 1b cases have been reported in Burundi, Kenya, Rwanda, Uganda, and Thailand. Clade 1 cases have also been found in the Central African Republic, the Republic of Congo, and Sweden. Meanwhile, the milder clade 2 has been identified in countries such as Cameroon, Côte d’Ivoire, Liberia, Nigeria, South Africa, the Philippines, and Pakistan.

The WHO’s declaration of a “public health emergency of international concern” is its highest level of alert and is aimed at speeding up international cooperation and public health measures to contain the disease.

“It’s clear that a coordinated international response is essential to stop these outbreaks and save lives,” said WHO Director-General Tedros Adhanom Ghebreyesus when the declaration was made on August 14. He further expressed concern over “the detection and rapid spread of a new clade of mpox in eastern DRC, its detection in neighboring countries that had not previously reported mpox, and the potential for further spread within Africa and beyond.”

Despite these concerns, Dr. Hans Kluge, the WHO’s regional director for Europe, emphasized last week that mpox should not be compared to Covid-19. In a statement released on Tuesday, Kluge dismissed parallels with the coronavirus pandemic and reassured that the risk to the general population remains low. “We can, and must, tackle mpox together — across regions and continents,” he stated.

In response to the outbreak, authorities are focusing on increasing vaccine availability, although access remains a significant challenge. The WHO is collaborating with countries and vaccine manufacturers to improve access for the nations most affected.

To date, the U.N. health agency has released $1.45 million in emergency funds and may release more in the near future. It has outlined an immediate funding requirement of $15 million for its response plan.

The Africa Centres for Disease Control and Prevention (Africa CDC) has partnered with the vaccine maker Bavarian Nordic to deliver vaccines. This partnership aims to provide 2 million doses this year and an additional 10 million doses by the end of 2025. Bavarian Nordic is also supplying vaccines to countries outside Africa and is seeking approval from the European Union’s drug regulator to extend the use of its mpox vaccine to teenagers.

The WHO’s efforts to contain the spread of mpox are focused on surveillance, public awareness, and enhancing the capacity of healthcare systems in affected regions. The agency urges countries to remain vigilant, ensure proper surveillance, and maintain strong collaboration with international health bodies to curb the further spread of the disease.

As concerns grow about a more severe variant of mpox spreading in Africa, infectious disease experts are cautiously optimistic that this strain may not spread as widely in the United States or cause as severe health impacts. The potential threat to the U.S. from this mpox subtype, known as clade I, could be minimized due to several factors, including immunity from previous vaccination and infection during the 2022 outbreak of a different variant, lack of viral circulation in wild animals, and better healthcare access and living standards.

On Wednesday, the World Health Organization (WHO) reinstated mpox as a public health emergency of international concern due to a large outbreak of clade I in the Democratic Republic of Congo (DRC), which has spread to other African nations. Sweden reported the first case of clade I outside Africa on Thursday.

“It was only a matter of time before we saw this extend beyond the African continent,” said Dr. Boghuma Titanji, an infectious disease specialist at Emory University.

On Friday, Dr. Pamela Rendi-Wagner, director of the European Centre for Disease Prevention and Control, announced that the agency had raised the risk level of clade I to the general European population from “very low” to “low,” citing the close connections between Europe and Africa. “We must be prepared for more imported clade I cases,” she added.

The Centers for Disease Control and Prevention (CDC) confirmed on Friday that no cases of clade I have been reported in the U.S. so far.

Clade I is generally considered more transmissible and severe than clade II, the variant responsible for the global mpox outbreak that peaked in August 2022, which had a death rate of 0.2%. People with weakened immune systems, particularly those with untreated, advanced HIV, have been most at risk of severe disease, hospitalization, and death from clade II. The U.S. continues to see low-level transmission of clade II.

Anne Rimoin, an epidemiologist at the University of California, Los Angeles, and a leading mpox expert, emphasized the importance of context when comparing how mpox might behave in Western countries versus Africa. “I think we have to be very, very cautious about saying that this is more dangerous,” she said of clade I. “The data on the severity, associated mortality — all of that is scant. There are a lot of questions about whether or not the perceived severity might have more to do with the population that it’s spreading in, their immune system, the route of transmission, the infectious dose.”

On Thursday, the National Institutes of Health (NIH) reported that the antiviral TPOXX did not reduce clade I symptom duration in a DRC clinical trial. However, only 1.7% of participants died, compared to the typical clade I death rate of 3.6% or higher in the DRC. NIH experts credited better medical care provided to study participants for the lower death rate.

Epidemiologist Dr. Jennifer McQuiston, the lead for the CDC’s mpox clade I response, expressed hope that high-quality healthcare in the U.S. could help minimize deaths from the disease. Dr. Dan Barouch, a virologist at Harvard Medical School, acknowledged the possibility of clade I cases in the U.S. but stated, “The absolute risk in the U.S. is currently low, although we need to remain vigilant.”

The CDC first alerted doctors and healthcare providers in December to be on the lookout for clade I, updating the advisory on August 7. When U.S. clinics order testing for potential mpox cases, some testing centers can directly screen for the clade type, while others send samples to the CDC for analysis. All positive results must be reported to the CDC. Additionally, numerous sites across the country monitor wastewater for signs of the virus in local populations.

“We are more worried about clade I than we are about clade II,” McQuiston said, highlighting the CDC’s continued domestic vigilance.

The CDC recently reported that receiving both doses of the Jynneos vaccine appears to reduce the risk of mpox. The vaccine is expected to protect against both clades. Throughout the clade II outbreak, which is now at low levels, mpox has primarily spread through sexual contact between men. The CDC continues to urge men with multiple male partners to receive both doses of the Jynneos vaccine. However, only about one in four of those considered at high risk in the U.S. have been fully vaccinated.

In the DRC outbreak, clade I has spread significantly through sexual transmission among both gay men and female sex workers. Children have been particularly affected, accounting for two-thirds of the roughly 20,000 suspected cases and three-quarters of the 975 suspected deaths in the DRC since January 2023, according to the CDC.

There is speculation that recent mutations in the virus may have increased its transmissibility. Rimoin suggested that close physical contact, whether sexual or nonsexual household contact, likely remains necessary for transmission. In the DRC, people often live in much more cramped conditions compared to the U.S.

“We don’t hear reports of people getting it at the market,” McQuiston noted, adding that household spread might be occurring in the DRC due to family members caring for the sick without adequate protection and limited ability to isolate those who are infected.

The vaccine remains scarce in the DRC, while in the U.S., where supply is sufficient, household contacts of infected people can seek the vaccine prophylactically. In rural DRC, people also likely contract mpox from an unknown wild animal host, possibly a rodent. No animals in the U.S. are believed to carry the virus.

Dr. Jeffrey Klausner, an infectious disease expert at the University of Southern California, pointed out that differences in sexual behavior between gay men and heterosexuals in the U.S. might limit the spread of mpox among the broader American population. Unlike the general heterosexual population, gay and bisexual men include a smaller group whose behaviors could sustain an mpox outbreak outside of Africa, Klausner explained in a commentary published in The Lancet Microbe on August 7.

Klausner also argued that infectious disease researchers may have underestimated the rate of natural immunity from previous infections. For now, he believes that a combination of natural and vaccine-induced immunity is sufficient among those engaging in high-risk sexual behavior to largely prevent a substantial outbreak.

However, research suggests that natural immunity from the 2022 outbreak may wane over time, and mpox may mutate to evade these defenses. Additionally, the extent to which immunity from clade II will protect against clade I is still unknown, according to Dr. Chloe Orkin, an infectious disease expert at Queen Mary University of London.

Emory’s Titanji added a note of caution, saying of clade I, “I don’t want people to get into a complacency and think that we cannot see this in a heterosexual network” in the U.S.

The World Health Organization (WHO) has declared a public health emergency due to the rapid and deadly spread of a new strain of mpox in Africa. This is the second such declaration in three years, with the previous emergency having been lifted in May 2023. However, the current threat is considered to be much more severe.

“The detection and rapid spread of a new clade of mpox in eastern [Democratic Republic of the Congo], its detection in neighbouring countries that had not previously reported mpox, and the potential for further spread within Africa and beyond is very worrying,” WHO Director-General Tedros Adhanom Ghebreyesus said.

The Democratic Republic of the Congo (DRC) has been particularly hard-hit, reporting a record 15,600 mpox cases and 537 deaths. The outbreak has also affected 13 countries, including several that had never previously reported cases of the disease.

This outbreak is linked to a strain of mpox that descends from clade I, which is endemic to the DRC and the Republic of the Congo. Those most at risk from the current outbreak are women and children under the age of 15.

In response to the worsening situation, the U.S. Centers for Disease Control and Prevention (CDC) issued a health alert last week, urging both clinicians and the general public to remain vigilant for signs of the virus. The Africa Centers for Disease Control and Prevention also declared a “public health emergency of continental security” on Tuesday.

The U.S. Department of Health and Human Services has expressed its support for both the WHO and Africa CDC declarations. In a statement, the department emphasized the importance of international cooperation in addressing the outbreak. “The United States will continue to work closely with African governments, Africa CDC and WHO to ensure an effective response to the current outbreak and to protect the health and lives of people of the region,” the agency said.

As of now, no cases of this clade I mpox have been detected outside the affected African countries. However, the WHO’s declaration is intended to encourage other nations to prepare for a possible spread of the virus and to coordinate a response, including sharing resources like vaccines.

The declaration of a public health emergency by the WHO highlights the seriousness of the situation and the need for a coordinated global response. The rapid spread of this new strain of mpox in Africa, particularly in the DRC, underscores the potential for the virus to spread to other regions if not contained.

The WHO’s decision to declare a public health emergency is not taken lightly, as it is a rare and significant step that signals the need for immediate action. The last time the WHO declared an emergency over mpox, it was due to a less severe outbreak that was eventually brought under control. However, the current outbreak presents a much greater threat, both in terms of its rapid spread and its potential impact on vulnerable populations.

The situation in the DRC is particularly concerning, as the country has reported a record number of cases and deaths from mpox. The virus has spread to 13 countries in total, including some that had never previously reported mpox cases. This suggests that the outbreak is not confined to a specific region and has the potential to spread even further if not contained.

The WHO’s declaration is also a call to action for other countries to prepare for the possibility of the virus spreading beyond Africa. By coordinating a response and sharing resources like vaccines, countries can work together to prevent the virus from becoming a global threat.

The U.S. CDC’s health alert is another indication of the seriousness of the situation. The alert urges clinicians and the public to be on the lookout for signs of the virus and to take precautions to prevent its spread. This is particularly important in light of the fact that the current outbreak is linked to a strain of mpox that is endemic to the DRC and the Republic of the Congo.

The Africa CDC’s declaration of a “public health emergency of continental security” is another significant development, as it underscores the need for a coordinated response across the continent. The declaration highlights the potential for the virus to spread beyond Africa if not contained, and the importance of international cooperation in addressing the outbreak.

The U.S. government’s support for both the WHO and Africa CDC declarations is a positive sign that the international community is taking the outbreak seriously. By working closely with African governments and international organizations, the U.S. can help ensure an effective response to the outbreak and protect the health and lives of people in the region.

The current outbreak of mpox in Africa is a stark reminder of the importance of global health security and the need for a coordinated response to emerging infectious diseases. The WHO’s declaration of a public health emergency is a call to action for the international community to come together and address the outbreak before it becomes a global threat.

In the meantime, countries must remain vigilant and take steps to prepare for the possibility of the virus spreading beyond Africa. This includes monitoring for signs of the virus, sharing resources like vaccines, and coordinating a response to prevent the virus from becoming a global threat.

The rapid spread of the new mpox strain in Africa, particularly in the DRC, underscores the urgency of the situation and the need for immediate action. The international community must work together to contain the outbreak and prevent the virus from spreading further. The WHO’s declaration of a public health emergency is a critical step in this effort, and it is up to the global community to respond accordingly.

As the situation continues to evolve, it will be important for countries to stay informed and prepared for the possibility of the virus spreading beyond Africa. By working together and sharing resources, the international community can help ensure an effective response to the outbreak and protect the health and lives of people around the world.

The ongoing mpox outbreak in the Democratic Republic of the Congo (DRC) has prompted the World Health Organization (WHO) to once again declare it a public health emergency of international concern. This declaration mirrors a similar one made in 2022 when the virus began spreading to countries where it was not previously endemic. While wealthy Western nations managed to control the outbreak rapidly, African countries, including the DRC, received little assistance, leaving them at the heart of the epidemic.

Currently, infection rates in the DRC are on the rise, the virus is evolving, and the WHO has raised alarms again. Here’s what you need to know about the situation.

WHO’s Concern and Response

WHO Director-General Tedros Adhanom Ghebreyesus expressed serious concern about the outbreak, stating that everyone should be vigilant. The WHO intends to increase the distribution of diagnostics, treatments, and vaccines to the DRC. However, experts caution that it may take several months for these vaccines to reach the DRC and other affected African regions.

Understanding Mpox

Previously referred to as “monkeypox,” mpox is characterized by a rash of flat sores that develop into liquid-filled blisters, which can be itchy or painful. In addition to the rash, mpox can cause flu-like symptoms such as fever, headaches, body aches, swollen lymph nodes, chills, and overall fatigue. The majority of cases in the outbreak that began in 2022 have not been life-threatening. However, the disease can be fatal for individuals with compromised immune systems. Mpox spreads through close contact and has primarily affected men who have sex with men in the U.S. and Europe, where it has mainly spread within gay and bisexual communities.

Reasons for the Current Situation

There are several factors contributing to the current outbreak, according to Dr. Boghuma Titanji, an assistant professor in Emory University’s infectious disease department. More than 14,000 mpox cases have been reported in the DRC this year, surpassing the total number of cases for all of 2023. Tragically, over 524 people have died, including 240 children. According to the WHO and Save the Children, the infection is four times more deadly for children under the age of 15 than it is for adults.

Titanji notes that it remains unclear why the disease has become so lethal for children, but a variation or subclade of the virus, which has developed mutations making it more adept at human transmission, is suspected. This new subclade might also be responsible for the virus spreading across borders to other African countries, including Burundi, the Central African Republic, Kenya, and Rwanda. This situation led the Africa Centres for Disease Control and Prevention to declare a continent-wide public health emergency on August 13. However, Titanji points out that, so far, no cases of this new subclade have been detected outside of the African subregion.

Assessing the Risk of Mpox

For those outside Central Africa, the risk of contracting mpox has not increased. Although the Centers for Disease Control and Prevention (CDC) warned in May that the outbreak in the DRC poses a “global threat,” the agency still considers the overall risk to the general American public to be “very low.” For men who have sex with other men and have multiple partners, the risk is categorized as “low to moderate.” However, the CDC notes that this group could be at risk if the latest version of mpox reaches the U.S.

Even though the U.S. has an ample stockpile of vaccines and treatments for mpox, Dr. Titanji emphasizes the interconnectedness of the world today, stating, “We live in a very, very interconnected global village.” There are now outbreaks in 13 African countries. “These outbreaks are connected to the U.S. or Europe by just a couple of hours because it’s easy to get on a flight and travel,” Titanji explains. “If we don’t address problems when they’re still small and affecting a relatively confined geographic location, then we could potentially have to deal with it within our own shores.”

Implications of WHO’s Declaration for Africa

The practical implications of the WHO’s declaration remain uncertain, according to Titanji. “The global outbreak has been going on since 2022,” she points out, “and we still haven’t really seen containment of the outbreak in the African region.” She questions what will be different this time.

The WHO’s declaration is intended to act as a signal, emphasizing the gravity of the emergency in the hope that it will rally resources to the affected areas, thereby preventing the outbreak from spreading further. Ideally, this would mean that the international community would come together to provide funding, diagnostics, treatments, and vaccines to the DRC and other severely impacted African regions. However, Titanji recalls that in 2022, the declaration “did not necessarily translate to the tools needed to fight the outbreak in Africa.” She highlights that about 10% of mpox cases in the DRC remain unconfirmed due to a lack of diagnostic tools. Additionally, the vaccines and antiviral medications that were instrumental in controlling the outbreak in the U.S. are still in short supply in Africa.

During the press conference announcing the public health emergency declaration, the WHO estimated that an initial investment of $15 million would be required to fund surveillance, response, and preparedness measures. While the WHO has released $1.5 million toward this effort, they have called on donors to contribute additional funds to meet the necessary requirements.

The ongoing mental health crisis among children in the United States has become increasingly evident within schools, where students spend much of their time. In response, Google’s philanthropic branch is taking direct action by funding mental health projects in high schools through a classroom crowdfunding platform.

On Monday, Google.org announced a major initiative, flash funding all mental health-related projects listed on DonorsChoose, an online charity where public school teachers can request supplies. With an infusion of $10 million and the involvement of actress Selena Gomez, Google aims to make mindfulness a central focus as the new school year begins.

The COVID-19 pandemic has exacerbated issues like childhood depression, anxiety, and behavioral problems, prompting school districts to seek help from teachers in addressing these challenges. However, experts have noted that while awareness of mental health issues has grown, it has not been matched by a significant increase in philanthropic funding for mental health initiatives.

Google.org had previously pledged support for nonprofits working on children’s mental health and online safety. Monday’s announcement boosts this commitment to $25 million, including the provision of $500 vouchers for eligible DonorsChoose campaigns in the near future.

This move by Google comes amid growing criticism and legal action against Google-owned YouTube and other social media platforms, which have been accused of contributing to the mental health crisis among children by incorporating addictive features into their designs.

Justin Steele, Director for Google.org in America, emphasized that this initiative is part of Google’s effort to lead a crucial conversation and contribute positively to addressing the mental health crisis. He pointed out that searches for “teen mental health” have doubled over the past four years, highlighting the rising concern.

“Obviously, we want people to be able to take advantage of all the amazing things technology has to offer,” Steele stated. “But we also want them to be able to do it in a healthy and safe way.”

Google.org’s contributions include $6 million to DonorsChoose. Additionally, the company announced donations totaling $1.5 million to the Jed Foundation, the Steve Fund, and the Child Mind Institute—organizations that focus on the emotional wellbeing of young adults, people of color, and children, respectively. These groups will develop 30-minute training sessions to help educators manage new mental health challenges, with teachers earning $200 DonorsChoose credits upon completing the course.

Selena Gomez’s Rare Impact Fund, which seeks to increase funding in this underfunded area, will receive $1.25 million. Gomez, who has been open about her own bipolar diagnosis, stressed the importance of having supportive adults in teenagers’ lives.

In a blog post on Monday, Gomez wrote, “As young people find their way through the world, it’s crucial that they get guidance in building healthy, positive and productive mental health habits. Few people are in a better position to help do this than teachers.”

The urgency to address behavioral issues in schools was underscored by a recent report from the Centers for Disease Control and Prevention, which revealed that students are experiencing higher rates of bullying and school absences due to safety concerns compared to previous years.

Yes, there has been an uptick in funding for mental health initiatives, noted Mindful Philanthropy Executive Director Alyson Niemann, but she added that the financial support still falls short of meeting the elevated awareness and needs. One significant challenge, according to Niemann, is that donors are often uncertain about which solutions are effective. Nevertheless, school-based mental health support is one of the most promising strategies, as it is often the first place where students seek help and find trusted adults like teachers or coaches.

DonorsChoose CEO Alix Guerrier clarified that while teachers are not a replacement for mental health professionals, there has been a fourfold increase in the number of mental health-related requests from teachers on their platform over the last four years. These requests often include items like saucer chairs for a “calm corner” or meditative stuffed animals that aid in deep breathing exercises.

“There is no limit to teachers’ creativities,” Guerrier remarked.

Aileen Gendrano Adao, a high school English teacher in Los Angeles, has long prioritized mental health in her classroom. She begins her classes by asking students to ground themselves with three deep breaths and has decorated her classroom walls with posters that affirm students’ self-worth.

Adao appreciates the flexibility that DonorsChoose offers, allowing her to creatively engage with her students, especially when district funding falls short of meeting immediate needs. During the pandemic, when Asian Americans were facing racially motivated attacks, she used DonorsChoose to acquire graphic novels about Asian American identity for her students.

She hopes that this additional funding will inspire more educators to prioritize mental health in their classrooms.

“Schools are transforming in a way that’s needed and necessary to heal from post-pandemic chaos,” she said. “There’s an investment. People are seeing us and wanting us to be better and whole again.”

This comprehensive effort by Google.org and its partners reflects a broader recognition of the critical need to support the mental health of students. By providing resources and training for educators, they aim to create a more supportive and mindful educational environment for children facing unprecedented mental health challenges.

The Medicare physician payment system is becoming increasingly unsustainable, threatening the stability of both physicians and their patients. Despite years of advocacy for reform, physicians remain the only Medicare providers who do not receive an annual inflationary update. This lack of adjustment means that payment rates fall behind inflation, putting physicians at risk financially and making it difficult for them to manage rising medical costs. Without intervention, many physician practices may be forced to close, resulting in fewer options for all patients, not just those on Medicare, to receive high-quality care.

Reforming this system is urgently needed. Strong action from Congress is essential to establishing a fair and logical Medicare payment system that links compensation more closely to the quality of care provided. Such reforms would also eliminate the need for Congress to annually assess and prevent scheduled pay cuts. The Strengthening Medicare for Patients and Providers Act (H.R. 2474) proposes an annual inflationary update to Medicare physician payments, calculated using the Medicare Economic Index. Support for this bill from policymakers would help correct systemic flaws, protect physician practices, and ensure patients retain access to quality care.

Further reforms could also make the Medicare physician payment system more reflective of the current realities faced by medical practices. These changes could include revising the rules around budget neutrality calculations to prevent errors in future projections and reducing the financial and reporting burdens imposed by the Merit-based Incentive Payment System (MIPS). Additionally, reforms could encourage participation in alternative payment models (APMs), which reward providers for delivering high-quality, coordinated care.

There are several critical reasons why Congress needs to address this issue immediately:

Rising Practice Costs and Declining Physician Pay:

Since 2001, Medicare physician pay has fallen 29 percent behind inflation. During the same period, the cost of running a medical practice has increased by nearly 50 percent. This discrepancy has resulted in over two decades of stagnant payments in the face of rising costs.

Incorrect Assumptions Reduce Available Payment Funds:

When new services are added to the physician fee schedule, projections about the future workload of practices are made to comply with the Centers for Medicare & Medicaid Services (CMS) budget neutrality rules. However, these projections are often inaccurate, leading to billions of dollars being permanently removed from the payment pool.

Temporary Fixes Are Not Sustainable:

At the beginning of 2024, Medicare physicians faced a 3.37 percent payment cut. While Congress intervened to limit the reduction, they only managed to reverse 1.68 percent of the cut. This action left physicians struggling to manage practice costs and consumer prices. This reduction followed a 2 percent pay cut in 2023.

Ongoing Pay Cuts Limit Options for Medicare Patients:

The U.S. is already seeing delays in access to care and challenges in scheduling appointments. With a projected shortage of up to 86,000 physicians by 2036, Medicare patients cannot afford to lose more options for care.

All Americans Risk Losing Access to Quality Care Without Reform:

Without significant long-term changes, physicians will struggle to afford staff salaries, purchase new equipment, or invest in their practices. If Medicare physicians are forced to close their doors, all Americans, not just Medicare beneficiaries, will be at risk.

APM Development Has Stalled:

While both Congress and the physician community have advocated for APMs to enable better care delivery at lower costs, most physicians still lack the opportunity to participate in these models. This lack of participation deprives both patients and physicians of the advantages offered by innovative healthcare delivery systems.

Healthcare Access in Rural and Underserved Areas Will Decline:

The annual cost of participating in MIPS is approximately $12,800 per physician. This cost is challenging for rural and small practices with limited resources to absorb. If Medicare physicians in these areas close, residents may struggle to find care at all.

A Rational Payment System Would Better Meet the Needs of Americans:

Reforming the current system would benefit both patients and physicians. It would provide financial stability and predictability, promote value-based care, and safeguard access to high-quality care. Additionally, it would allow practices of all sizes, in both rural and urban areas, to thrive.

Physicians have been pushing for reform for over a decade, but the system remains unchanged. The current situation has placed significant strain on the healthcare system, particularly for those on Medicare. As healthcare costs continue to rise, the lack of an inflationary update has put many practices at risk of closure, which in turn threatens the quality of care available to patients across the country.

One of the most significant issues is the failure to provide physicians with an annual inflationary adjustment. While other Medicare providers receive such updates, physicians are left behind, struggling to keep up with increasing costs. This gap between rising expenses and stagnant payments creates a precarious situation for many practices, especially smaller ones that lack the financial buffer to absorb these costs.

The Strengthening Medicare for Patients and Providers Act (H.R. 2474) offers a potential solution by proposing an annual update to Medicare physician payments based on the Medicare Economic Index. This adjustment would help align payments more closely with the realities of medical practice today, providing a much-needed lifeline for struggling physicians.

Moreover, addressing the systemic flaws that lead to inaccurate budget projections is crucial. When new services are added to the fee schedule, the assumptions made about future usage can lead to significant errors. These errors can result in billions of dollars being unnecessarily removed from the payment pool, exacerbating the financial challenges faced by physicians.

The temporary patches that have been applied to the payment system are no longer sustainable. At the start of 2024, physicians were confronted with a 3.37 percent payment cut. Although Congress intervened, they could only reverse a portion of the cut, leaving physicians unable to fully cover their rising costs. This situation is not new; it follows a similar reduction in 2023, highlighting the ongoing instability of the current system.

The continued decline in payment rates has broader implications for patient care. The U.S. is already grappling with delays in access to care, and with a projected shortage of up to 86,000 physicians by 2036, the situation could worsen significantly. Medicare patients, in particular, are at risk of having fewer options for care, which could lead to longer wait times and reduced access to the services they need.

Without comprehensive reform, all Americans stand to lose. Physicians will find it increasingly difficult to maintain their practices, particularly in rural and underserved areas where resources are already stretched thin. The high cost of participating in programs like MIPS further exacerbates these challenges, making it even harder for these practices to survive.

Reforming the payment system is not just about ensuring fair compensation for physicians; it is about protecting the healthcare infrastructure that millions of Americans rely on. A rational, stable payment system would support practices in providing high-quality care, encourage innovation through APMs, and ensure that patients, regardless of where they live, have access to the services they need.

Congress must act now to reform the Medicare physician payment system. The current system is unsustainable, and without change, both physicians and patients will continue to suffer. The Strengthening Medicare for Patients and Providers Act (H.R. 2474) and other proposed reforms offer a pathway to a more stable, equitable system that benefits everyone involved.

As retirement age nears, many physicians naturally begin to think about stepping down or reducing their workload. However, recent data from an AMA survey reveals a concerning trend: more than one-third of all physicians, including a significant number of younger or midcareer doctors, are considering leaving the profession or cutting back on their work hours. This trend raises alarms about the future stability of healthcare as experienced physicians contemplate early retirement or reduced workloads.

The American Medical Association (AMA) gathered over 12,400 responses from physicians across 31 states through the AMA Organizational Biopsy®, involving more than 80 health systems. The findings, exclusive to the AMA and not published elsewhere, reflect 2023 trends in six key areas: job satisfaction, job stress, burnout, intent to leave an organization, feeling valued by an organization, and total hours spent on work-related activities each week (referred to as “time spent”). These aggregated data aim to provide a national overview of organizational well-being and serve as a benchmark for other healthcare organizations, though the results are somewhat limited by the number of participating health systems.

From 2022 to 2023, 35.7% of doctors expressed a moderate interest in leaving their current jobs within the next two years or indicated they would like to or definitely would leave during that period, according to the national physician comparison report. Although this figure represents a slight decrease from 39.3% in 2022, the intent to leave remains highest among physicians who are 20 or more years out of training, at 40.8%. Part-time physicians also reported a high intention to leave, with 39.1% considering departure, compared to 34.9% of full-time physicians. Male physicians showed a slightly higher tendency to leave (35.9%) compared to female physicians (33.2%).

Specific specialties are more affected by this trend than others. Internal medicine physicians had the highest intent to leave at 39.1%, followed by family medicine at 37.3%, obstetrics and gynecology at 34%, hospitalist medicine at 32.9%, emergency medicine at 32.3%, and pediatrics at 30.2%. These figures highlight the growing dissatisfaction across a range of specialties, which could have significant implications for patient care and the healthcare system as a whole.

Furthermore, 35.9% of physicians surveyed stated they plan to reduce their work hours within the next 12 months, a slight decrease from 38.1% in 2022. The AMA, as a leader in promoting physician well-being, is actively working to reduce physician burnout by minimizing administrative burdens and offering practical solutions to help doctors rediscover the joy in their profession.

At Sanford Health in Sioux Falls, South Dakota, a member of the AMA Health System Program, the situation mirrors the national statistics, with 35.5% of physicians reporting an intention to leave within two years. Sanford Health is implementing several strategies to improve job satisfaction and reduce the number of physicians considering departure or reducing their work hours.

One of the key strategies Sanford Health has adopted is providing annual check-ins with physicians. Research shows a clear link between work overload and burnout or the intention to leave a job. Dr. Heather Spies, an obstetrician-gynecologist and physician director of clinician experience and well-being at Sanford Health, emphasized the importance of intentional and proactive conversations and investments in relationships between physicians and their leaders. “Why someone is considering leaving an organization can be complex—it may be different for everybody,” Dr. Spies explained.

To address this complexity, Sanford Health has instituted annual check-ins for physicians and other health professionals to meet with their department chair and directors individually, and offers additional opportunities to connect as needed. “Listening, understanding and building trusting relationships are essential to determining how best to help clinicians avoid burnout or alleviate it once it’s happened,” Dr. Spies noted. These conversations are crucial for early intervention if physicians are considering reducing their hours, leaving entirely, or retiring early.

Maintaining open communication is another critical component of Sanford Health’s approach. Solutions to physician dissatisfaction vary, and open communication helps leaders apply individualized solutions. This involves having deeper conversations to uncover the specific reasons why a physician may be considering leaving or reducing their work hours. “Is it because they are not able to keep up on their charts or their in-baskets? If it’s something operationally adjustable, then we could find ways to enhance teamwork within their clinic or their department,” Dr. Spies suggested. She added that tools like Epic signal data can help identify how much time physicians are spending on work-related tasks outside of regular hours, such as charting or managing their in-baskets. “If they’re high and their time spent outside of work on charting or the in-basket is an outlier, then we can talk to them about supporting them further with resources,” she said.

This data-driven approach allows Sanford Health to tailor solutions to individual physicians while also identifying broader trends that may impact multiple clinicians. “It’s really just looking at all the different things that they might need,” Dr. Spies explained. “Then the clinician and their leader can also work better together to have discussions on solutions—some of which may apply to and help other clinicians as well, and some of which may be more unique to a certain physician.”

At Sanford Health, the intent to leave is highest among physicians who are 20 years or more post-training, at 48.9%, and among obstetrician-gynecologists, at 46.1%. The upcoming Organizational Biopsy at Sanford Health aims to identify what physicians need to thrive in a high-stress, high-stakes environment. Previous data from Sanford Health’s Organizational Biopsy showed that “the highest turnover rate is in those first couple of years after joining a practice,” Dr. Spies mentioned.

In response, Sanford Health has heavily invested in new physician orientation and extended onboarding programs to ensure physicians feel integrated into the organization’s culture. These initiatives also help physicians adapt to the community where they live and connect them with mentors or coaches if needed. “Our goal with our clinician experience strategy is to continually look at ways to be intentional about assessing the needs of our clinicians so that if there is a need, we can try to be proactive and provide for that need rather than getting to the point where we’re retroactively trying to find out why people are leaving,” Dr. Spies said. She emphasized that data is a crucial part of understanding and addressing the well-being of clinicians at an organizational level, allowing Sanford Health to stay vigilant for red flags that might indicate potential issues.

“We want Sanford to be a place where clinicians come and a place where they retire,” Dr. Spies stated. “So, it’s really important to us that we’re looking at that whole career spectrum and what we can do in each phase of that spectrum to keep making it better.”

As leaders, Dr. Spies and her colleagues are committed to continuously finding ways to reduce administrative burdens and maintain a strong focus on patient care. They also strive to recognize clinicians for their hard work and to help them find joy in their profession. “We have to be ready as leaders in this work to pivot and keep finding ways to reduce administrative burdens and keep the focus on the care of the patient, keep finding ways to recognize clinicians for the great work they do and keep finding ways to help our colleagues have joy in their work,” she added.

Research by the US Food and Drug Administration (FDA) has discovered that sealed bottles of tattoo and permanent makeup ink, some marked as sterile, contain millions of potentially harmful bacteria.

“In light of our study results, we want to emphasize the importance of continuously monitoring these products to ensure the microbial safety of tattoo inks,” stated Seong-Jae (Peter) Kim, a microbiologist at the FDA’s National Center for Toxicological Research. Kim, the corresponding author of the report published on July 2 in the journal Applied and Environmental Microbiology, highlighted the significant findings of the study.

Tattoo ink is injected deep into the skin, creating an environment where some bacteria can thrive, potentially causing infections and serious injuries. Linda Katz, director of the FDA’s Office of Cosmetics and Colors, explained, “Pathogens or other harmful substances in these inks can travel from the injection site through the blood and lymphatic systems to other parts of the body.”

This systemic spread of bacteria can lead to severe, life-threatening complications such as endocarditis, an inflammation of the heart lining, and septic shock, the final and most severe stage of sepsis. The US Centers for Disease Control and Prevention (CDC) warn that if not treated quickly, “sepsis can rapidly lead to tissue damage, organ failure, and death.”

Common symptoms of tattoo ink infections include injection-site rashes, impetigo (a contagious bacterial skin infection), erysipelas (a bright red and tender skin rash), and cellulitis (a deep skin infection requiring antibiotic treatment). According to Katz, individuals with multiple or large tattoos are at a higher risk due to the increased likelihood of exposure to microorganisms. Permanent makeup, especially around the eye area, poses additional risks as microbes can enter the eye and cause infections.

John Swierk, an assistant professor of chemistry at Binghamton University, noted, “We know that contamination in tattoo inks is a common occurrence. Part of the problem is that there is no agreed upon, industry-standard method for sterilizing inks. Our work and the current study really highlight the need for good, standardized manufacturing processes across the tattoo ink industry.”

The tattoo industry is working with regulatory bodies to comply with safety standards. Selina Medina, director of research at the Alliance of Professional Tattooists, stated, “Manufacturers are investing in advanced sterilization technologies and formulation advancements to improve their production environments to reduce the risk of contamination. This includes using clean rooms and enhanced quality control processes to mitigate against problems like this.”

The latest study examined 75 samples of sealed tattoo and permanent makeup ink from 14 US manufacturers. Researchers found that 26 samples from 10 manufacturers, or 35% of the sample set, had some degree of bacterial contamination. While most samples had bacterial counts of less than 250 CFUs (colony-forming units) per gram, a few contained bacterial counts as high as 105, or 100,000 bacteria per gram.

Earlier FDA studies found that 35% of unopened and sealed inks from US manufacturers had bacterial counts as high as 108 CFU, or 100 million bacteria per gram. Infectious disease expert Dr. Robert Schooley emphasized that the bacterial level in materials injected into the skin should be zero. “The level of bacteria in materials that are injected into the skin or that come into contact with abraded or injured skin should be ‘none detected,’” said Schooley.

Schooley also noted that tattooing has been associated with the transmission of viral infections like hepatitis C, hepatitis B, and HIV. He added, “These (infections) were not studied in the FDA manuscript, but the fact that so many of the inks failed bacterial sterility tests suggests that other organisms like viruses and fungi also can slip through the cracks.”

Many certified tattoo artists are aware of the contamination risks and take steps to avoid them. Medina emphasized, “Transparency with clients is vital. Artists should communicate openly about the steps they take to ensure ink safety and address any concerns clients may have.”

Some artists conduct their own testing or require proof of testing from suppliers, including microbial testing for potential contamination. Tattoo artists can also resterilize inks before application using an autoclave, a machine that uses steam to apply high pressure and temperature to eliminate bacteria.

The way ink is handled during tattooing is crucial. For instance, using the same gloves to touch a client and the ink bottle can lead to contamination. Artists should ensure ink bottles are tightly sealed when not in use and stored in cool, dry places away from direct sunlight to minimize contamination risks.

Experts advocate for regulations requiring testing and certification of tattoo and permanent makeup inks before they are marketed. Swierk mentioned, “Tattoo inks are in the process of being regulated due to the Modernization of Cosmetics Regulation Act (MoCRA) of 2022, but much of that law dealing with tattoo inks has yet to be implemented.”

“We anticipate that MoCRA will be phased in over the next few years and that will represent the first serious regulation of tattoo inks in the US. Most of this will focus on good manufacturing processes and safety substantiation.”

In June 2023, the FDA released draft guidance for the tattoo industry, detailing how manufacturers should conduct quality control measures, including sterilization.

The U.S. government has committed $176 million to Moderna for the accelerated development of a pandemic influenza vaccine targeting bird flu, federal officials announced Tuesday. This funding reflects growing concerns about the spread of bird flu to dairy cows across the country.

Moderna is currently in the early stages of testing a bird flu vaccine utilizing the same mRNA technology that facilitated the swift creation and distribution of COVID-19 vaccines. The U.S. Department of Health and Human Services (HHS) is providing this new funding to support the ongoing development of the vaccine, potentially leading to a late-stage trial next year, provided that initial study results are promising.

Importantly, HHS officials have highlighted that the project is designed to be adaptable, allowing a swift pivot to address other forms of influenza should a different threat arise, rather than the current focus on the H5N1 strain of bird flu.

The funding is being provided through the Biomedical Advanced Research and Development Authority (BARDA), a program dedicated to the development of medical treatments for potential pandemics.

The H5N1 virus, which was detected earlier this year in dairy cows, has now spread to more than 135 herds across 12 states. To date, three people have been infected, all of whom experienced only mild symptoms. Federal health officials emphasize that the overall risk to the general population remains low.

The U.S. government’s investment in Moderna is a proactive measure to combat potential pandemic threats. By leveraging mRNA technology, which proved effective against COVID-19, and ensuring flexibility in targeting various forms of influenza, this initiative aims to bolster national preparedness against future influenza outbreaks.

A recent cohort study investigated the disparity in unprofessional behavior reports among physicians across various specialties, as perceived by their coworkers. Involving 35,120 physicians, the study discovered that 9.1% had at least one report from a coworker describing unprofessional behavior.

Key Findings

Surgeons were the most frequently reported group, with 13.8% having at least one report, whereasnonsurgeonnonproceduralists had the lowest rate at 5.6%. Emergency medicine physicians and nonsurgeon proceduralists exhibited unprofessional behavior at rates of 10.9% and 12%, respectively. Physicians specializing in pediatrics were notably less likely to receive reports compared to their nonpediatric counterparts, especially among nonsurgeonnonproceduralists (3.6% vs. 6.0%).

The primary types of unprofessional behavior reported were issues with clear and respectful communication, followed by lapses in professional responsibility, competent medical care, and integrity.

Study Design

This retrospective cohort study, published in JAMA Network Open, utilized data from the Coworker Concern Observation Reporting System (CORS), administered by the Vanderbilt Center for Patient and Professional Advocacy, covering January 2018 to December 2022. Reports were categorized into clear and respectful communication, professional responsibility, competent medical care, and integrity. The study employed logistic regression to calculate the odds of any CORS report, adjusting for specialty, region, academic practice status, and pediatric specialty status.

The cohort included 18,288 nonsurgeonnonproceduralists, 1,876 emergency medicine physicians, 6,743 nonsurgeon proceduralists, and 8,213 surgeons. Notably, surgeons had the smallest proportion of pediatric-focused practitioners (5.5%). The largest proportion of the cohort practiced in academic settings, reflecting the distribution of CORS sites.

Detailed Results

Out of the 35,120 physicians in the cohort, 3,179 (9.1%) had at least one CORS report. The incidence of reports varied significantly by specialty: nonsurgeonnonproceduralists (5.6%), emergency medicine physicians (10.9%), nonsurgeon proceduralists (12.0%), and surgeons (13.8%). Nonsurgeonnonproceduralists were significantly less likely to be reported compared to all other specialties combined (5.6% vs. 12.8%).

Pediatric-focused physicians were less likely to receive a CORS report than nonpediatric-focused physicians (6.8% vs. 9.4%). Specifically, pediatric-focused nonsurgeonnonproceduralists had fewer reports compared to their nonpediatric counterparts (3.6% vs. 6.0%).

In a multivariable logistic regression model, controlling for physician and practice site characteristics, all specialty types had significantly higher odds of receiving at least one coworker concern report compared to nonsurgeonnonproceduralists. The adjusted odds ratios (OR) were: emergency medicine physicians (adjusted OR, 1.91; 95% CI, 1.63-2.24), nonsurgeon proceduralists (adjusted OR, 2.34; 95% CI, 2.12-2.57), and surgeons (adjusted OR, 2.75; 95% CI, 2.51-3.01) (P < .001). Pediatric-focused physicians were significantly less likely to have a coworker concern report than those with a nonpediatric focus (adjusted OR, 0.69; 95% CI, 0.61-0.78; P < .001).

The predominant types of CORS reports across all specialties involved issues with clear and respectful communication, followed by professional responsibility. Reports concerning professional integrity were the least common.

Implications

“Because unprofessional behaviors are associated with patient complications, malpractice claims, and well-being concerns, monitoring concerning behavior and especially those physicians with repeated reports provides important opportunities for physicians and leaders to support professionalism, which increases the chance of health care organizations meeting their clinical, cultural, and other performance goals,” the study researchers concluded.

A complete list of disclosures from the researchers is available in the study.

According to new research published in the Lancet Global Health, half of the adult population in India does not meet the World Health Organisation’s (WHO) guidelines for adequate physical activity. The study highlights that more women (57%) than men (42%) are physically inactive. Alarmingly, the prevalence of insufficient physical activity among Indian adults has escalated dramatically from 22.3% in 2000 to 49.4% in 2022.

If this trend continues unchecked, by 2030, 60% of the Indian population could be unfit and at increased risk of diseases associated with insufficient physical activity.

Importance of the Study

The WHO advises that all adults should engage in at least 150 to 300 minutes of moderate aerobic activity per week, or an equivalent amount of vigorous activity. Insufficient physical activity is defined as failing to achieve 150 minutes of moderate-intensity activity, 75 minutes of vigorous-intensity activity, or a combination of both each week. According to the WHO, physical inactivity significantly raises the risk of cardiovascular diseases like heart attacks and strokes, Type 2 diabetes, dementia, and cancers of the breast and colon.

India ranks 12th highest in terms of insufficient physical activity among 195 countries. Globally, nearly one-third (31%) of adults—approximately 1.8 billion people—did not meet the recommended levels of physical activity in 2022. Dr. Rüdiger Krech, Director of Health Promotion at WHO, explained, “This is because of many factors, including changes in work patterns (move towards more sedentary work), changes in the environment, convenient transportation modes and changes in leisure time activities (that is more screen-based/sedentary activities).”

The highest rates of physical inactivity were found in the high-income Asia-Pacific region (48%) and South Asia (45%). Other regions showed levels of inactivity ranging from 28% in high-income Western countries to 14% in Oceania.

Why Should Indians Be Concerned?

Indians are genetically predisposed to developing non-communicable diseases like heart disease and diabetes about a decade earlier than others. Dr. K Srinath Reddy, a public health expert and leading cardiologist, noted, “Lack of physical activity means that you are just aggravating your existing risk factors. The WHO goals were set to reduce risk of heart disease, diabetes, obesity and some types of cancer while improving mental health and a stronger immune system.”

He added, “Delayed urbanisation and industrialisation in some parts of the world have led to a sedentary and comfortable lifestyle, particularly South Asia (including India).”

Overcoming a Sedentary Lifestyle

Maitreyi Bokil, a Pune-based nutritionist and exercise physiologist, believes the biggest obstacle to fitness is the mental barrier that views exercise as just another chore in a busy day. She advises starting with enjoyable physical activities, such as watering plants or doing household chores. “Once you do that regularly, take the next step by finding a friend to go for a walk or join a community club. Having a pet is a great way to break a sedentary lifestyle,” she says.

For people with comorbidities, she recommends seeking medical advice on the frequency, intensity, and type of physical activity based on their endurance levels. Regarding diet, Bokil advocates for a rainbow-colored diet. “Everyone is aware of the importance of protein, carbohydrates, and fat, but we don’t realize the importance of micronutrients like vitamins and minerals. They make sure we get the energy out of carbs, protein, and fat. In addition, they help us fight inflammation caused due to erratic lifestyles. So everyone should focus on at least two vegetables (one cooked, one raw) for each meal and two whole fruits in a day,” she advises.

As for starting exercise at any age, Bokil cites research indicating that muscle gains can be made throughout life. “New neuro-muscle connections can be made at any age,” she says.

Gender Disparity in Physical Activity

Dr. Reddy noted that several studies within India have also shown low levels of physical activity among women, who often mistakenly believe that household chores constitute sufficient exercise. Cultural barriers also contribute to this inactivity, especially among middle-aged urban women. Indian women are faring worse than their counterparts in Bangladesh, Bhutan, and Nepal, according to the study.

Dr. Fiona Bull, head of the WHO unit for physical activity, and epidemiologist Dr. Tessa Strain, attributed these figures to women bearing a larger share of home duties. “These combined with their caregiver role provide women lesser opportunities to prioritize themselves; they don’t have time and feel tired,” they said.

This comprehensive study underscores the urgent need for India to address its rising levels of physical inactivity. With a significant portion of the population at risk of developing serious health conditions, promoting a more active lifestyle through awareness and accessible initiatives is crucial.

The National Board of Physicians and Surgeons (NBPAS) commends the recent announcement made by the Federal Trade Commission (FTC), the Department of Justice (DOJ), and the Department of Health and Human Services (HHS) regarding their collaborative initiative to seek public input on anti-competitive and monopolistic practices within the healthcare sector.

Back in September, NBPAS formally approached the FTC seeking relief from what it perceives as an attempt by the American Board of Medical Specialties (ABMS) and its affiliated boards to utilize their monopolistic authority to exclude or eradicate competitors from the market for continuing certification. Of significant concern is the refusal of other segments of the medical community to engage with NBPAS, particularly given their shared board memberships and close economic ties to ABMS.

According to NBPAS, the existence of a monopoly that stifles competition not only burdens physicians but also inflates healthcare costs for consumers and exacerbates the ongoing physician shortage. Despite providing physicians with a more streamlined, less cumbersome, and cost-effective path for continuous board certification over the span of eight years, NBPAS has struggled to gain substantial traction in the market due to perceived obstacles to competition and unfair trade practices.

NBPAS founder and president, Dr. Paul Teirstein, emphasizes the importance of physicians affected by ABMS Maintenance of Certification (MOC) to voice their grievances. He asserts, “We urge every physician who has been harmed by ABMS MOC to speak now, speak loudly, and spread the word to every physician you know.” Dr. Teirstein expresses gratitude that the FTC, DOJ, and HHS are providing a platform for physicians and the public to express their concerns through the FTC’s new submission portal.

Dr. Teirstein underscores that the issue transcends NBPAS, stating, “At the end of the day, this is not about NBPAS.” He asserts that no single entity should wield unchecked authority over the lives and careers of physicians, as it ultimately impacts patient care. Taking a principled stance, NBPAS is proud to lead the charge on behalf of practicing physicians and future generations.

NBPAS emerged as a response to the demand for a continuous certification pathway founded on practice-relevant and specialty-specific Continuing Medical Education (CME). It adheres to national accreditation standards for hospitals and health plans and presently certifies over 13,000 physicians across more than two hundred institutions, including hospitals, academic medical centers, telemedicine firms, major insurers, and the Veterans Health Administration (VHA) system. NBPAS’ continuous board certification program aims to alleviate physician burnout and address the physician shortage by offering an evidence-driven, clinically relevant certification pathway.

Nobel Prize-winning molecular biologist Venki Ramakrishnan sat down with ABC News Live to discuss the science and ethics of extending the human lifespan.  In his new book, “Why We Die: The New Science of Aging and the Quest for Immortality,” Ramakrishnan explains why we may not want to lengthen our lives much longer.

Ramakrishnan’s thought-provoking argument is that a society where people lived for hundreds of years could potentially become stagnant, as it would consist of the same group of people living longer, raising important questions about societal dynamics and progress.

He discussed the cycle of life and why we die.

ABC NEWS LIVE: If you think it might be wonderful to live forever, you may want to hear what a Nobel Prize-winning molecular biologist has to say that could change your mind. Venki Ramakrishnan has examined the latest science, weighed the possibilities and researched the ethical cause of lengthening our lifespans in his new book, ‘Why We Die The New Science of Aging and the Quest for Immortality.’ Doctor, thank you so much for joining us.

ABC NEWS LIVE: So humans now live twice as long as we did 150 years ago. But you raise some, some caveats to why we may not want to lengthen our lives that much longer. Why is that?

RAMAKRISHNAN: Well, I think a society where everybody lived indefinitely or very long time, say, hundreds of years would be a very different society. It would be quite stagnant. It’d be the same group of people just living longer and longer.

You wouldn’t have that turnover between generations. You know, maybe new ideas, things like that. But I think that’s still in the realm of science fiction. I think biology is looking at the causes of aging, and that’s allowing us to tackle some of these causes. But most of the focus is how to live healthily for longer, because all developed societies are living longer lives.

So we’re having more and more older people well past retirement. And we want to see how can we keep older people healthy and productive, you know, and energetic and and actually lively. So I think a lot of biology is trying to understand those causes so we don’t suffer some of the debilitating consequences of aging.

ABC NEWS LIVE: Explain why it is that sometimes our biological age doesn’t match our chronological age.

RAMAKRISHNAN: That’s because aging you can think of as an accumulation of damage as over time. And we have very sophisticated repair mechanisms, and we have ways to deal with the problems of old age, of the accumulation of damage, accumulation of garbage in the cells. We have recycling mechanisms and all those things break down. And the rate at which they break down is different for different people.

ABC NEWS LIVE: Explain the new research, though, that talks about how there are certain blood markers that indicate why people age faster than others, and we could say this is separate from drinking and smoking or lack of sleep.

RAMAKRISHNAN: Yeah. So blood — there are different markers for aging. So some markers are on our DNA. Our DNA acquires marks called epigenetic marks as we age. And that changes the pattern with which we express different genes.

So it changes how our biology works. There are also markers in our blood. And this was found because when they connected an old animal with a young animal and allowed them to exchange their blood supply, the old animal benefited from the young blood. And that suggested these things in younger blood that deteriorate or don’t exist or have changed in older blood. And people are trying to find what those markers are.

ABC NEWS LIVE: Let’s say in the next few decades, we’re able to come up with cure for, for cancer, high blood pressure, diabetes. What’s the best-case scenario, do you think, for the longevity of human life?

RAMAKRISHNAN: So someone did a calculation. And if we eliminated some of the major causes of fatality today, like the things you mentioned, you would only gain about 15 years. But what biologists think is if you tackle the underlying causes of aging, then you could really, expect to, live a longer and healthier life.

ABC NEWS LIVE: Really fascinating. Doctor, we thank you so much for joining us. Want to let our viewers know “Why We die? The New Science of Aging and the Quest for Immortality” is now available wherever books are sold.

An analysis of cost data within the South Mississippi system’s Accountable Care Organization (ACO) uncovered that care administered by nonphysician providers managing their own patient panels was pricier than care delivered by physicians. This revelation prompted leaders at Hattiesburg Clinic to revamp the clinic’s care model and publish their discoveries. Initially employing 26 physician assistants (PAs) and nurse practitioners (NPs) in 2005, the clinic now boasts 118 such providers. Alongside certified registered nurse anesthetists and optometrists, these 186 nonphysician providers constitute what is termed as advanced practice providers (APPs) at the clinic.

According to a study titled “Targeting Value-based Care with Physician-led Care Teams,” published in the Journal of the Mississippi State Medical Association, Hattiesburg Clinic made strategic decisions over the past 15 years to expand their care teams by integrating advanced practice providers, primarily due to shortages in primary care physicians. The study highlights, “Focusing specifically on primary care, because our shortage of physicians there was so dire—due to retirements, massive panel sizes and lack of medical students entering primary care residencies—we allowed APPs to function with separate primary care panels, side by side with their collaborating physicians.”

However, upon retrospect and analysis of extensive internal data, encompassing cost data from over 33,000 Medicare-enrolled patients, the findings were consistent and unequivocal: the integration of advanced practice providers with independent panels under physician supervision fell short of meeting primary care objectives in providing patients with an equivalent value-based experience.

Hattiesburg Clinic, a private multispecialty clinic with over 300 physicians, holds membership in the AMA Health System Program. Its ACO earned the top rank in quality within its cohort in 2016 and 2017 among 471 other participants and has garnered recognition from the Centers for Medicare & Medicaid Services (CMS) for delivering high-quality care at a low cost.

According to CMS cost data spanning from 2017 to 2019, for Medicare patients excluding those with end-stage renal disease or in nursing homes, per-member, per-month spending was $43 higher for patients under the care of nonphysician primary health professionals compared to physicians. This contrast could translate to an annual increase of $10.3 million in expenditure if all patients were overseen by APPs. Following risk-adjustment for patient complexity, the disparity amounted to $119 per member, per month, equating to an annual difference of $28.5 million.

Dr. Bryan N. Batson, an internist and CEO of Hattiesburg Clinic, a co-author of the study, stated, “We didn’t set out to do a scientific study per se. This was really an observational experience that used data to help us drive decision-making going forward.” He added, “This was us looking in the mirror to say: As we’re becoming more advanced in value-based care, how do we do it better?”

Initially, upon receiving the initial CMS reports on care costs, the focus was on identifying the highest-cost physicians and collaborating with them to curtail spending. Dr. Batson mentioned, “When we got the claims data for the first time, one of the first things we did was to look at who our highest-cost providers were.” He further expressed surprise at the stark disparities in costs between physicians and advanced practice providers at the high-cost end of the spectrum.

Further analysis revealed that the additional costs were attributed to a combination of factors, including increased test ordering, more specialist referrals, and heightened emergency department utilization. Dr. John M. Fitzpatrick, a nephrologist and president of Hattiesburg Clinic, noted that “four of the five top highest-cost providers were nurse practitioners,” prompting a comprehensive analysis of the entire population and leading to the findings presented in the study.

Patients whose primary care provider (PCP) was a nonphysician exhibited higher rates of emergency department visits compared to those without a PCP. Moreover, physicians outperformed nonphysicians on nine out of ten quality measures, particularly excelling in flu and pneumococcal vaccination rates, despite these being considered manageable by nonphysician staff. Physicians also attained higher average patient satisfaction scores across six domains measured by Press Ganey.

Acknowledging the invaluable contribution of nurse practitioners and physician assistants to the care team, the study emphasized that they should not operate independently based on a wealth of information and experiences in collaborative relationships with physicians.

Driven by data insights, Hattiesburg Clinic revamped its care model, ensuring that all patients consult with a physician as their primary care provider and no patient exclusively sees a nonphysician. Dr. Batson elaborated, “We had a one-year transition period leading up to that, so that the nurse practitioners could tell their patients that beginning Jan. 1, 2021, you’re going to have alternating visits with me and my supervising physician, but your PCP will officially be the physician.”

Telemedicine has played a pivotal role in facilitating the implementation of the new care-team model, enhancing healthcare delivery in rural settings. Dr. Batson highlighted, “It really changes the way that we’re able to deliver health care in a rural setting—in a positive way—such that a clinic may be able to be staffed some days with an APP, some days with a physician, but in those days that the APP is the lead there, there’s the availability of telemedicine to support more advanced health care delivery.”

The American Medical Association (AMA) asserts that patients deserve care led by physicians, advocating against scope-of-practice expansions that jeopardize patient safety. Dr. Fitzpatrick emphasized the importance of credible, Mississippi-based data in influencing legislative decisions, noting the commendable efforts of legislators in prioritizing patient well-being while devising strategies to reduce healthcare costs.

Both doctors expressed optimism that their experience would encourage other ACOs to conduct similar analyses, potentially stimulating discussions with other organizations nationwide or attracting the attention of CMS.

“We would encourage other organizations to look at their data—like we did—to help them refine their care teams in ways that can improve health care,” Dr. Batson concluded. “That’s what this was all about: trying to improve health care of our patients and for the system.”

The Supreme Court declared on Wednesday its refusal to accept the “unconditional and unqualified” apologies tendered by Yoga guru Baba Ramdev and Patanjali Ayurved Managing Director Acharya Balkrishna. This apology came in response to contempt of court notices issued by the court, following a lawsuit by the Indian Medical Association (IMA). The IMA accused them of publishing misleading advertisements, claiming cures for certain diseases, and criticizing the allopathy branch of medicine.

A bench consisting of Justices Hima Kohli and Ahsanuddin Amanullah had previously expressed dissatisfaction with the apology affidavits submitted by Ramdev and Balkrishna. They were given an opportunity to provide better responses to the show cause notices. These notices were issued due to alleged violations of an undertaking given to the court on November 21, 2023, pledging not to make “casual statements claiming medicinal efficacy or against any system of medicine”.

The court expressed displeasure over a press conference held by Ramdev on November 22, 2023, in Haridwar, and an advertisement released by the company on December 4, 2023, which were seen as violations of the undertaking made on November 21, 2023.

Subsequently, fresh affidavits were filed on April 6, offering unqualified and unconditional apologies. However, Justice Kohli stated, “We do not accept these affidavits. We decline to accept or condone it. We consider it a wilful and deliberate violation of the order.” The court criticized the respondents’ actions as a deliberate breach of the undertaking, despite repeatedly emphasizing their apologies in the affidavits.

In its order, the court remarked, “Having regard to the entire history of the matter, and the past conduct of the respondents, we have expressed our reservations about accepting the latest affidavit filed by them.” The bench scheduled another hearing for April 16.

The court also found fault with an application submitted by the duo during the previous hearing, seeking exemption from appearing in court due to international travel. It was noted that the affidavits were sworn a day before the air tickets were issued, leading the court to believe the respondents were attempting to avoid personal appearance.

The court stated, “It is now been stated in the affidavit filed by the proposed contemnors that admittedly the tickets were issued on a date after the affidavit was sworn…Fact remains that on the date, the affidavits were shown, there was no such ticket in existence (at the time the affidavits were sworn). And therefore, the assumption is the respondents were trying to wriggle out of their personal appearance before this court, which is most acceptable.”

Furthermore, the court reprimanded the state of Uttarakhand for failing to take action against Patanjali and its subsidiary Divya Pharmacy for advertisements promising cures for diseases. The court requested affidavits from officials who had held the post of Joint Director of the State Licensing Authority in Haridwar between 2018 and the present, to explain their actions to address this issue.

The unexpected announcement from Catherine, Princess of Wales, regarding her initiation of chemotherapy for cancer treatment came as a surprise to many. In the wake of this news, major newspapers in Britain expressed concern on their front pages. The Times reassured its readers with the headline, “Princess reveals her cancer and says: I’m going to be OK.” Similarly, the FT Weekend chose the headline, “Kate puts end to speculation,” while The Sun tabloid conveyed a message of solidarity to the princess with, “KATE, YOU ARE NOT ALONE.”

In an emotional video statement released a day prior, the 42-year-old princess opened up about her battle with cancer after weeks of intense scrutiny regarding her health. Despite her usual nervousness in front of cameras, the princess bravely shared her story in her own words, filmed simply on a bench against a backdrop of spring foliage.

Acknowledging the challenging weeks she has faced, the princess addressed ongoing interest in her health, particularly following reports of a potential breach of her medical privacy by hospital staff where she underwent treatment in January. This development followed a surge of unfounded conspiracy theories, fueled by speculation surrounding her surgery in January, her husband Prince William’s absence from a memorial event, and her admission of editing a family photo for Mother’s Day.

The revelation about her health sheds new light on recent events and prompts questions about the transparency of the royal family regarding her condition. This period of uncertainty adds to the challenges faced by the monarchy, with two senior members now indisposed, leaving Prince William and Queen Camilla to take on additional responsibilities.

The diagnosis of cancer for the future Queen follows King Charles III’s own health struggles, disclosed earlier in February, further straining the monarchy. Kate’s condition, especially given her youth, contrasts sharply with her image as a symbol of health and perfection since marrying into the royal family in 2011.

Kate’s vulnerability underscores her humanity, challenging perceptions of her as a flawless public figure. Despite her previous portrayal as a steadfast member of the royal family, her battle with cancer serves as a poignant reminder of her humanity.

The prime minister’s statement reflects widespread sentiments of support for the princess, condemning media scrutiny and advocating for her privacy and well-being. While Kate was expected to resume official duties after Easter, her return will be delayed pending medical clearance, with any appearances likely to be spontaneous.

The lack of detailed updates from Kensington Palace underscores the family’s desire for privacy as they navigate this challenging time. The public’s access to Kate’s video message serves as the most comprehensive update on her health, in exchange for respecting the family’s need for space.

Prince William’s continued public engagements aim to reassure the nation amidst the upheaval, while prioritizing his family’s well-being. In her video message, Kate emphasized the importance of maintaining normalcy for their children, suggesting a desire for privacy amidst media attention.

The timing of the announcement, after the Easter holidays, highlights the couple’s consideration for their children’s routines. Despite her ordeal, Kate remains resolute in her focus on recovery, while also calling for understanding and privacy from the public.

Navigating the delicate balance between media coverage and privacy presents a challenge, particularly with international attention. While some online speculation persists, Kate’s message has prompted an outpouring of support, potentially reshaping public discourse around royal figures and confronting baseless conspiracy theories.

In the face of adversity, Kate’s openness about her health journey offers a chance for reflection on the impact of media scrutiny and the importance of empathy and understanding in the public sphere.

Following her father’s passing five years ago, Nirmala Chetty, now professionally known as Dr. Sahila, a medical practitioner based in New Jersey, faced a challenging health journey, grappling with bipolar depression and thyroid issues, among other ailments. Despite seeking relief in various hospitals, she found no solace.

However, delving into her Hindu and Indian heritage, Sahila discovered what she describes as a transformative solution. Today, she proudly asserts being “pill-free, disease-free, and stress-free,” attributing her well-being to the scientific efficacy of chakra healing.

Expressing her lament over the diminished faith in this ancient practice, Sahila, who operates her own clinic named Wellness with Sahila, remarked, “It’s very sad that, you know, such a beautiful and crucial concept is lost today because people don’t have faith in it.”

Critics have often derided chakra healing as pseudoscience, noting its exploitation by self-professed healers who charge exorbitant fees. Common perceptions associate chakras with energy centers in the body, correlated with colors and shapes representing emotions and meanings.

Yet, amidst skepticism, proponents of chakra healing, buoyed by the growing acceptance of Indian-origin practices like yoga in the West, endeavor to dispel misconceptions and assert the scientific grounding of their methods.

Reflecting on this evolution, Maetreyii Ma Nolan, a spiritual instructor in California, elucidated, “As Indian thought has come to the West, it’s gone through various incarnations, first as a spiritual tradition, and then as asana, or yoga posture tradition.”

Chakra healing, an ancient Hindu doctrine, posits that chakras—Sanskrit for “wheels”—align with specific nerve endings and internal organs. The body comprises seven chakras, prominently featuring the “third eye” at the forehead, often adorned with a bindi in Hindu culture.

According to Sahila and fellow practitioners, blockages in these chakras can manifest as emotional, physical, and spiritual maladies. For instance, an imbalance in the muladhara chakra, linked with identity and situated at the base of the spine, may result in depression, anxiety, or narcissism if not rectified. Similarly, issues with the svadhisthana chakra, situated in the lower abdomen and associated with women’s health, can affect childbirth.

Addressing these blockages, Sahila advocates surrendering the ego and embracing a journey of “sadhana”—a daily regimen of yoga and meditation targeting each chakra and its corresponding natural element.

While Western medicine often dismisses chakra healing as alternative or new-age, Sahila contends, “there’s a science to it, and if you understand the science to it, then the flow just automatically happens.”

Offering a testimony to the compatibility of chakra healing and Western medical practices, Hina Mehta, a neuroscience fellow at the National Institute of Health, revealed her initial hesitance as a scientist to explore Eastern healing. However, she emphasized the non-mutually exclusive nature of Hindu philosophy and Western science.

Mehta highlighted the direct correlation between chakras and the body’s hormone-producing glands, asserting that yogis and gurus have long mastered the art of channeling energy to these glands through specific yoga postures and hand movements.

For Lata Nigam, who underwent a significant lifestyle change following a breast cancer diagnosis, chakra healing provided a deeper understanding of her internal struggles. While acknowledging Sahila’s impact on her life, Nigam stressed the importance of personal commitment to the healing process.

Critics attribute the skepticism surrounding chakra healing to Western misinterpretations of Hindu healing concepts. Maetreyii Ma Nolan, blending psychology with Tantric philosophy, leads a community in California dedicated to meditation and self-discovery.

Evan Rofheart, another advocate of chakra healing, dismisses the necessity of subscribing to Hindu doctrines, underscoring personal experiences of divine energy transfer as foundational to his practice.

Nevertheless, proponents like Sahila emphasize the scientific underpinnings of chakra healing, citing correspondences between the seven chakras and cosmic and human realities. Sahila’s personal experiences with chakra healing, particularly the opening of her throat chakra, have reinforced her belief in its efficacy.

Sahila posits that widespread recognition of the authentic science behind chakra healing could significantly benefit society, fostering profound personal growth and well-being.