Category: Health

The “brazen and targeted” killing of Brian Thompson, CEO of UnitedHealthcare, outside a New York hotel, has shocked the nation. Thompson’s death has not only drawn attention to the tragic incident itself but has also ignited a wave of public anger toward the trillion-dollar health insurance industry. The murder has amplified ongoing frustrations with a system that many Americans believe is broken.

The phrase “prior authorisation,” central to insurance operations, has become a flashpoint of contention. This process allows insurers to evaluate and approve medical treatments before agreeing to cover them. Critics argue that such measures often lead to delays or outright denials of necessary care.

This sentiment was palpable during a July protest outside UnitedHealthcare’s Minnesota headquarters. Over 100 people from various states, including Maine, Texas, and West Virginia, gathered to decry the company’s policies and denial of claims. The demonstration, organised by the People’s Action Institute, resulted in the arrest of eleven protesters for blocking a road. According to Unai Montes-Irueste, the group’s media strategy director, many of those present had personal experiences with claim denials. “They are denied care, then they have to go through an appeals process that’s incredibly difficult to win,” Montes-Irueste explained.

This underlying frustration burst into the spotlight following Thompson’s murder. As the CEO of UnitedHealthcare, the insurance division of UnitedHealth Group, Thompson led the largest insurer in the U.S. While police are still searching for the suspect and the motive remains unclear, shell casings found at the crime scene bore words like “deny,” “defend,” and “depose”—terms critics associate with tactics insurers allegedly use to avoid payouts.

Online reactions to Thompson’s death revealed the deep-seated anger many feel toward the health insurance industry. A scan of Thompson’s LinkedIn profile showed comments from individuals frustrated with denied claims. One woman with stage 4 metastatic lung cancer wrote, “We’ve just left [UnitedHealthcare] because of all the denials for my meds. Every month there is a different reason for the denial.”

Thompson’s wife, Paulette Thompson, shared that he had received threats before the incident. “There had been some threats,” she told NBC. “Basically, I don’t know, a lack of [medical] coverage? I don’t know details. I just know that he said there were some people that had been threatening him.”

Philip Klein, a security expert who previously worked with Thompson, expressed shock over the lack of security during the executive’s New York trip. “There’s a lot of anger in the United States of America right now,” he remarked. Klein noted that corporate leaders often face threats stemming from public frustration over high costs and limited access. “Companies need to wake up and realise that their executives could be hunted down anywhere,” he added.

Following the shooting, politicians and industry officials expressed condolences. Michael Tuffin, president of the insurance industry organisation Ahip, called Thompson’s death a tragedy. “He was a devoted father, a good friend to many, and a refreshingly candid colleague and leader,” Tuffin said. UnitedHealth Group acknowledged the support it had received from “patients, consumers, health care professionals, associations, government officials, and other caring people.”

However, online commentary painted a contrasting picture. Many criticized insurance companies for claim denials and excessive costs. Some used dark humor, such as quipping “thoughts and prior authorisations,” a play on the common phrase “thoughts and prayers.” Others went as far as celebrating Thompson’s death, reflecting the depth of animosity toward the system. The outrage spanned the political spectrum, uniting left-wing activists, right-wing critics of corporate influence, and ordinary individuals sharing personal stories of denied care.

Montes-Irueste, while condemning the violence, acknowledged the widespread bitterness. “We have a balkanised and broken healthcare system,” he said, adding that the frustration stems from diverse experiences with a system that many feel is failing them.

Criticism of the insurance industry is not new. A recent Commonwealth Fund study revealed that 45% of insured working-age adults were billed for services they believed should have been covered. Additionally, 17% reported that their insurers denied coverage for doctor-recommended care. Less than half of those who suspected billing errors chose to contest them, highlighting the complexity and opacity of the system.

Sara Collins, a senior scholar at The Commonwealth Fund, described the U.S. healthcare system as both expensive and convoluted. “Just navigating and understanding how you get covered can be challenging for people,” she explained. While things might appear manageable when people are healthy, problems often arise when they require substantial medical care. Collins added, “We find high rates of people saying that their healthcare costs are unaffordable, across all insurance types, even Medicaid and Medicare. We truly have a medical debt crisis.”

The high costs of healthcare in the U.S. exacerbate these issues. Christine Eibner, a senior economist at the RAND Corporation, noted that average insurance premiums for a family hover around $25,000 annually, with out-of-pocket expenses often adding thousands more. “On top of that, people face out-of-pocket costs, which could easily be in the thousands of dollars,” she said.

UnitedHealthcare and other major insurers have faced lawsuits and investigations over their practices. Last year, UnitedHealthcare settled a case involving a chronically ill college student who amassed $800,000 in medical debt after his prescribed medications were denied. ProPublica, which covered the case, highlighted how the student struggled under the weight of the bills. The company is also contesting a class-action lawsuit accusing it of using artificial intelligence to prematurely terminate treatments.

Despite these controversies, many Americans still hold favorable views of their insurers. A survey by KFF found that while two-thirds blamed insurance companies for high healthcare costs, 81% rated their coverage as “excellent” or “good.”

Yet, the anger remains palpable, reflecting a broader dissatisfaction with a system that leaves many feeling vulnerable and neglected. As Tuffin defended the industry, calling his colleagues “mission-driven professionals working to make coverage and care as affordable as possible,” the divide between public perception and industry claims became starkly evident.

For now, the murder of Brian Thompson serves as a grim reminder of the tensions that exist within the U.S. healthcare system. Whether it leads to meaningful reforms or further entrenches the divide between insurers and the public remains to be seen.

In a significant move, British lawmakers granted preliminary approval to a bill that would allow terminally ill adults in England and Wales to seek assistance in ending their lives. The vote, which took place on Friday, followed an emotionally charged debate in Parliament that featured deeply personal stories of suffering and loss. The assisted dying bill passed with a 330-275 majority, signaling initial support but leaving further scrutiny and a final vote pending.

The debate lasted several hours and was marked by a level of decorum rarely seen in the House of Commons. Members of Parliament (MPs) discussed the ethical, religious, and legal ramifications of the proposed legislation with speeches delivered respectfully and without the usual interruptions. “Let’s be clear, we’re not talking about a choice between life or death, we are talking about giving dying people a choice about how to die,” said Kim Leadbeater, the Labour MP who sponsored the bill, as she introduced it to a packed chamber.

Supporters of the bill argued that it would offer dignity and autonomy to terminally ill individuals while alleviating unnecessary suffering. Proponents emphasized that the legislation includes robust safeguards to prevent misuse, ensuring that vulnerable individuals are protected. The proposed law would apply only to adults over 18 with less than six months to live. Those requesting assistance would need to be mentally capable of making the decision and able to self-administer the prescribed medication. Additionally, two independent doctors and a High Court judge would need to approve each case.

Critics, however, expressed strong reservations about the bill. Concerns were raised about the potential for coercion, particularly among the elderly and disabled, who might feel pressured to end their lives to ease the financial or emotional burden on their families. Danny Kruger, one of the leading voices against the bill, warned that no amount of safeguards could fully protect vulnerable individuals. “We should not create a state suicide service,” he said.

Kruger also expressed disappointment at the bill’s preliminary approval but remained optimistic that it could still be blocked in the final vote. “I still think we can stop it,” he said, noting that some MPs who voted in favor may change their stance after further examination of the bill’s details.

The bill’s progression has sparked widespread public interest, with hundreds of people gathering outside Parliament as the debate unfolded. Demonstrators on both sides of the issue displayed their views through slogans and banners. Opponents held signs reading, “Kill the bill, not the ill,” and criticized the potential strain on the National Health Service (NHS). On the other side, supporters, many wearing pink hats, carried messages such as “You can’t cure death. Please make it fear-free” and “Giving me choice over my death.”

The emotional intensity of the debate was underscored by personal accounts shared by MPs and activists. Proponents highlighted stories of terminally ill individuals who endured immense suffering in their final months or resorted to secret suicides due to the current legal prohibition on assisted dying. Esther Rantzen, a well-known campaigner and broadcaster who is terminally ill with lung cancer, hailed the outcome as a step toward equality and compassion. “It’s wonderful. This gives people an equal choice,” she said. Rantzen previously stated that she had considered traveling to Switzerland, where assisted dying is legal for non-residents, to end her life.

Despite its passage in the Commons, the bill faces significant hurdles before becoming law. The government is expected to provide assessments in the coming months on how assisted dying would be funded and how it might affect the NHS, hospice care, and the judicial system. Prime Minister Keir Starmer has expressed support for the change but refrained from making a public statement before the vote. Divisions within political parties were evident, with members from all sides voting both for and against the measure. Health Secretary Wes Streeting and Justice Minister Shabana Mahmood were among those who opposed the bill, despite being part of the ruling Labour Party.

The legislation applies only to England and Wales, leaving Scotland and Northern Ireland unaffected. International comparisons were also highlighted during the debate, with MPs noting that other countries, including Australia, Belgium, Canada, and parts of the United States, have enacted similar laws. The regulations in these jurisdictions vary widely, with some permitting euthanasia, where a healthcare professional administers a lethal injection at the patient’s request.

For Joshua Cook, a 33-year-old living with Huntington’s disease, the bill represents progress toward a more compassionate society. “It’s a relief, it’s history,” Cook said after the vote. “Finally, we are getting towards having a society that shows love and compassion above the need to just keep people alive.”

The journey of this legislation is far from over. While Friday’s vote is a historic moment for advocates of assisted dying, it is only the first step in what promises to be a lengthy and contentious process. Both sides are prepared for further battles as the bill continues through Parliament.

Data from the Bureau of Labor Statistics highlights the significant yet relatively small portion of U.S. healthcare spending allocated to provider salaries. In total, healthcare providers collectively earn $966.99 billion, a substantial figure but still a fraction of the overall expenditures in the sector.

Physicians, numbering around one million in the United States, account for $262.33 billion of this total. This means their earnings represent just 7.3% of the $3.6 trillion spent on healthcare in 2019. While their role is critical to the system, their compensation is only a small portion of the immense financial resources channeled into healthcare annually.

A recent study has uncovered a potential reason behind graying hair: stem cells that get stuck in place and lose their ability to produce pigment. Published in the journal Nature by researchers from New York University’s Grossman School of Medicine, the study sheds light on how melanocyte stem cells (McSCs) contribute to hair color and why their dysfunction leads to gray hair.

The research primarily focused on McSCs, which play a pivotal role in producing pigment. Under normal circumstances, these stem cells move between different compartments within hair follicles. These compartments provide environments that allow McSCs to mature, acquire the proteins necessary to regenerate into pigment cells, and maintain hair color. What makes McSCs unique is their ability to shift between states of maturity as they travel between these compartments.

However, the study revealed that some McSCs get stuck in the hair follicle bulge compartment, preventing them from returning to the germ compartment. In the germ compartment, WNT proteins drive the regeneration of pigment cells. When McSCs remain immobile in the bulge, they lose their capacity to produce pigment, resulting in gray hair.

“It is the loss of chameleon-like function in melanocyte stem cells that may be responsible for graying and loss of hair color,” said Mayumi Ito, the study’s senior investigator and a professor in the Ronald O. Perelman Department of Dermatology and Department of Cell Biology at NYU Langone Health. “These findings suggest that melanocyte stem cell motility and reversible differentiation are key to keeping hair healthy and colored.”

The implications of the research suggest that if McSCs can continue moving freely or can be encouraged to move when stuck, it may be possible to maintain natural hair color indefinitely.

“Our study adds to our basic understanding of how melanocyte stem cells work to color hair,” explained Qi Sun, a postdoctoral fellow at NYU Langone Health and one of the study’s authors. “The newfound mechanisms raise the possibility that the same fixed positioning of melanocyte stem cells may exist in humans. If so, it presents a potential pathway for reversing or preventing the graying of human hair by helping jammed cells to move again between developing hair follicle compartments.”

The study also highlighted the difference between McSCs and the cells responsible for hair growth. According to Sun, even when pigment production ceases, hair growth can continue, albeit without color. As hair follicles age and undergo cycles of regrowth, an increasing number of McSCs become lodged in the follicle bulge, unable to regenerate pigment cells. Eventually, these stuck McSCs can account for approximately half of all the McSCs in a follicle bulge.

The research found that mobile McSCs retained their pigment-producing ability. However, over time, the requirements for McSC functionality become more challenging to meet, contributing to the appearance of gray hair as individuals age.

While stress is commonly linked to gray hair, separate research from Harvard indicates that stress accelerates hair follicle aging by increasing the regrowth cycle. This faster cycling ultimately speeds up the breakdown of McSC functionality, leading to earlier graying.

“For unknown reasons, the melanocyte stem cell system fails earlier than other adult stem cell populations, which leads to hair graying in most humans and mice,” the NYU study stated.

The next phase of the research aims to determine how to restore mobility to McSCs once they become stuck. If successful, this could pave the way for treatments that reverse or prevent gray hair by ensuring McSCs remain functional and capable of producing pigment.

As Ito remarked, “These findings suggest a promising avenue for interventions that could one day prevent or even reverse the graying process, bringing hope to those seeking to maintain their natural hair color throughout life.”

Long before Bryan Johnson gained recognition for his relentless quest to reverse aging through biohacking—rigorous testing, strict diets, and an array of supplements—Valter Longo was deeply immersed in the study of longevity. A professor of gerontology and director of the USC Longevity Institute, Longo has long pursued the dream of living a robust life spanning 120 to 130 years. His mission reflects a rising interest in not just increasing life span—the total number of years lived—but enhancing health span, which refers to living free of disease and in good health.

The allure of longevity has often been associated with the Mediterranean lifestyle, celebrated for its emphasis on healthy eating, physical activity, and strong community ties. Italy, and particularly Sardinia, is a shining example. Sardinia is one of the original “Blue Zones,” a term coined to describe regions where people live significantly longer and healthier lives. This phenomenon was explored in Dan Buettner’s Netflix series, Living to 100, which examined the lifestyle habits of Sardinia’s residents.

However, Longo, who hails from Italy, reveals a concerning shift in his home country. “Almost nobody in Italy eats the Mediterranean diet anymore,” he observes. According to a profile of Longo in The New York Times, Italian youth are grappling with rising obesity rates due to the growing dominance of what Longo labels the “poisonous five P’s—pizza, pasta, protein, potatoes, and pane (bread).” He warns that if this dietary pattern continues, Italians might maintain long life spans but suffer from diminished health during those years.

To counteract this trend, Longo advocates a return to the traditional Mediterranean diet, which is rich in plant-based foods, nuts, and healthy fats. As the author of The Longevity Diet, Longo not only promotes this dietary approach but also offers practical guidance through recipes on his website. These include dishes such as sweet and sour sardines, stuffed artichokes, cabbage patties, and onions in walnut sauce—each designed with longevity in mind.

In addition to traditional dietary practices, Longo has introduced an innovative concept in the field of longevity: the fasting-mimicking diet, or “faux fasting.” This approach involves reducing food intake to simulate the effects of fasting without requiring complete abstinence from food. According to his website, this diet is characterized by low carbohydrates and protein while being high in fatty acids. “The Fasting Mimicking Diet patented recipe allows your body to remain in a fasting-like mode, which triggers a set of protectionist measures that the body has developed during natural selection,” his site explains. This state, he claims, enables the body to rejuvenate cells, enhance performance, and adapt to challenging conditions.

While research on intermittent fasting and related approaches has uncovered both benefits and limitations, the method’s enduring popularity highlights the extent to which individuals are willing to experiment to extend their lives. Longo’s fasting-mimicking diet is one of many strategies being explored in this field, yet it offers a compelling blend of traditional wisdom and modern science.

The story of Valter Longo serves as a reminder of the delicate balance between cultural heritage and modern dietary trends. While regions like Sardinia provide a blueprint for healthy living, Longo’s work underscores the importance of adapting these lessons to contemporary challenges. His dedication to longevity continues to inspire a global audience eager to not just live longer, but live better.

Time spares no one, as cognitive decline is a natural part of aging. However, new research offers hope by suggesting that a simple daily habit can rejuvenate brainpower, potentially making your mind function as if it were several years younger. This intriguing finding comes from a study published in the Annals of Behavioral Medicine by researchers at the Penn State College of Medicine.

Their study focuses on the benefits of “everyday movement”—ordinary physical activities that do not necessarily involve intense workouts. Actions like walking a dog, performing household chores, or light physical engagement seem to contribute to better cognitive function. According to the researchers, this everyday movement leads to an “improvement in cognitive processing speed equivalent to being four years younger.”

“You don’t have to go to the gym to experience all the potential benefits of physical activity,” said Jonathan Hakun, the study’s lead author and an assistant professor of neurology and psychology at Penn State College of Medicine. “All movement is important. Everyday movement counts as a source of accumulated physical activity that could be credited toward a healthy lifestyle and may have some direct impact on cognitive health.”

The Study’s Focus

This research stands out because, while previous studies have demonstrated that exercise benefits long-term brain health, this one emphasizes immediate cognitive benefits. Regular exercise has been linked to reducing mortality risk by as much as 27%, but the Penn State study sheds light on short-term effects.

Imagine walking your dog in the morning and experiencing faster cognitive processing later that day. As Hakun explained, “The idea here is that we can momentarily counteract [cognitive decline] through movement. It’s compelling. There’s the potential for a brief walk or a little extra movement to give you a boost.”

To test this idea, the researchers observed 204 middle-aged individuals, aged 40 to 65, all residing in the Bronx, New York. Over nine days, participants reported their physical activity six times daily and completed two brain games. These games measured working memory and cognitive processing speed. The findings were clear: after reporting any physical activity, participants exhibited noticeable improvements in cognitive processing speed.

Practical Takeaways

The implications of this study are especially relevant for those balancing busy schedules. Even simple adjustments to your daily routine, such as incorporating more physical movement, can yield cognitive benefits. Business leaders, for example, might consider walk-and-talk meetings or walking to a colleague’s desk instead of relying on video calls.

Hakun’s findings are not a replacement for traditional, vigorous exercise. Instead, they highlight how adding pleasant and straightforward activities to daily life can make a difference. As he put it, “We get slower as we age, both physically and cognitively.” However, even modest physical activity offers the potential for a noticeable boost in mental sharpness.

This study encourages us to appreciate the cumulative impact of small efforts, proving that even ordinary actions like walking the dog or tidying the house can contribute to a sharper mind.

The practice of forest bathing, rooted in mindfulness and meditation, involves immersing oneself in nature, often by walking through woodlands. Numerous studies highlight the health benefits of this experience, which can calm the mind and rejuvenate the body. This raises an intriguing question: could nature immersion become a formal therapeutic tool, prescribed by medical professionals to treat various health conditions?

Kathy Willis, a biodiversity professor at the University of Oxford, delves into this idea in her book Good Nature. Drawing on extensive evidence, she discusses not only the health benefits of nature but also presents quantitative data suggesting that doctors could incorporate nature into their treatment plans. Through her exploration of the sensory interactions between humans and the natural world, Willis uncovers the calming effects of touching wood, the enduring benefits of walking in pine forests, and the reasons why urban noise is particularly grating.

In a recent interview with Live Science, Willis shared her motivation for studying the health impacts of nature, the physiological responses triggered by natural landscapes, and how incorporating plants into our homes can enhance well-being.

The Spark Behind the Research

Reflecting on her journey, Willis said her interest was sparked during a large intergovernmental project on ecosystem services. “I kept coming across this paper that really piqued my interest,” she recalled. It revealed that gallbladder surgery patients who could view trees from their hospital windows required fewer pain medications and recovered faster than those whose windows faced brick walls.

“The fascinating part was that it wasn’t about air quality or pollution,” she explained. “There was a direct relationship between what patients saw and their recovery rates. Something within their sense of sight was accelerating healing.” This observation led Willis to question the mechanisms behind such phenomena, marking the beginning of her research journey.

More Than Just a Feeling

The physical and mental effects of nature extend beyond simple enjoyment. Willis explored how various senses—sight, smell, hearing, and touch—interact with nature to produce tangible physiological changes. “It’s an automatic response,” she said. For instance, nature can lower adrenaline levels, improve heart rate variability, and even stabilize hormonal imbalances.

To persuade medical professionals of nature’s potential, Willis emphasized the need for measurable evidence. “You can’t just say you feel generally better,” she said. “You need quantitative data showing exactly what’s happening in the body.”

Green Spaces and Human Physiology

One striking revelation is how the color green impacts the body. “When you look at green, particularly green and white leaves, three pathways are activated,” Willis explained. The autonomic nervous system is affected, lowering heart rate and blood pressure. The endocrine system responds with changes such as reduced stress-indicating salivary amylase levels. Lastly, psychological markers reveal decreased anxiety and increased calmness.

This phenomenon may be evolutionary. Willis pointed to studies showing that people prefer mid-complexity fractal patterns, such as open landscapes dotted with trees, over angular urban horizons. “When shown images of different landscapes, people consistently choose open savanna-like vistas,” she said. Interestingly, even children from tropical rainforest regions who had never left their environment favored savanna landscapes in such studies.

Smells That Heal

The chapter on smell surprised Willis the most. She discovered that inhaling plant-derived volatile organic compounds (VOCs) has significant physiological effects. “When you breathe in a plant scent, those molecules cross your lung membranes and enter your bloodstream,” she explained.

Walking in a pine forest, for instance, increases blood levels of pinene, a compound that interacts with biochemical pathways similarly to certain prescription drugs. “There’s compelling evidence that breathing in VOCs from trees like cedar reduces adrenaline and elevates natural killer cells, which help fight cancers and viruses,” Willis noted.

A groundbreaking study published in Oncotarget highlighted this effect. People living near Cupressaceae forests were found to be healthier, with lower instances of autoimmune diseases. Additionally, participants who walked in such forests for five hours experienced elevated natural killer cells, an effect that persisted for seven days.

Artificial Plants: No Substitute for the Real Thing

Studies comparing artificial and real plants reveal that the benefits of nature cannot be replicated synthetically. Japanese schoolchildren exposed to real pansies for 10 minutes experienced lowered blood pressure and feelings of calm. However, polyester-based artificial plants provided no such benefits. “It’s not just about sight,” Willis clarified. “The subconscious impact of smell plays a huge role.”

Gut Health and Biodiversity

The influence of nature extends to the gut microbiome. Biodiverse environments can positively alter the gut and skin microbiomes, leading to reduced inflammatory markers in the blood. Willis cited a Finnish study involving nursery children who played in three types of playgrounds: concrete, artificial matting, and Boreal forest soil.

“After 28 days, children exposed to forest soil had a completely new gut microbiome and significantly reduced inflammatory markers,” she said. Similar benefits were observed in adults working in offices with green walls, showing that biodiversity in one’s environment directly affects bodily systems.

Bringing Nature Indoors

For those unable to venture outdoors, Willis offered practical advice on incorporating nature into daily life. Victorian-era homes, often filled with plants, serve as an inspiration. “Having live plants in your sitting room or study can make a difference,” she said. Even something as simple as placing a vase of roses on a desk has measurable effects.

“Studies show that even non-scented roses—white or yellow—can lower blood pressure,” she added. “Why not have a vase of roses on your desk? It’s a small step we can all take without waiting for a prescription.”

Nature as Medicine

Willis’s research underscores the profound impact of natural environments on human health. From lowering stress hormones to boosting immune cells, the evidence suggests that nature’s healing powers are rooted in complex physiological processes. By acknowledging and harnessing these benefits, we could transform healthcare, integrating nature-based therapies into traditional medical practices.

Her findings remind us of the importance of reconnecting with the natural world. Whether through a walk in the forest, a vase of flowers, or a well-placed houseplant, the path to well-being might be closer than we think. As Willis puts it, “Wherever we are, we should all really be heading towards the bushy edges.”

After years of repeated cuts to physician payments under Medicare, the system has reached a critical point, with a 2.8% reduction set to take effect on January 1. Many believe this highlights the system’s deep flaws. Thankfully, Congress appears to be addressing this challenge, recognizing the potential threat these cuts pose to the viability of physician practices and patient care.

On Tuesday, a bipartisan group of lawmakers introduced the Medicare Patient Access and Practice Stabilization Act of 2024, which aims to support struggling physician practices and improve patient access. Leading the effort are California Representatives Jimmy Panetta (D-CA-19), Ami Bera, M.D. (D-CA-6), and Raul Ruiz, M.D. (D-CA-25), joined by their Republican colleagues Greg Murphy, M.D. (R-NC), Mariannette Miller-Meeks, M.D. (R-IA), Larry Bucshon, M.D. (R-IN), Kim Schrier, M.D. (D-WA), and John Joyce (R-PA).

The California Medical Association (CMA) has expressed strong support for the bill, which seeks to halt the scheduled 2.8% Medicare payment cut in 2025. Additionally, it proposes a partial inflation update equivalent to 50% of the Medicare Economic Index (MEI) for one year in 2025 to offset rising practice costs. If passed, this would lead to a total 4.73% increase in Medicare physician payments for the year.

Urgent Need for Legislative Action

Time is running out for Congress to act on this critical issue. With the legislative calendar winding down and a “lame-duck” session anticipated after the upcoming elections, passing HR 10073 must become a priority. Advocacy groups like CMA are urging physicians and patients to contact their representatives and push for immediate support of the bill.

“This is our last chance to ensure HR 10073 becomes part of the final year-end legislative package,” emphasized CMA representatives. They are calling on individuals to urge lawmakers to cosponsor the bill and help mitigate the impact of Medicare cuts.

Grassroots physician advocacy has already demonstrated its power. Recently, 233 bipartisan members of Congress signed a letter to House leadership, urging an end to Medicare payment cuts and requesting an inflation update before the year’s close. CMA is now asking for renewed efforts to ensure those same lawmakers back HR 10073 as cosponsors.

“Physician action makes a difference,” CMA emphasized, encouraging all healthcare professionals to rally behind the bill.

Building Toward Long-Term Reform

Although HR 10073 addresses Medicare physician payments for just 2025, it represents a critical first step in the broader effort to reform the system. The legislation provides temporary relief while opening the door for discussions about more comprehensive payment reforms in future sessions of Congress.

“This is an essential first step toward achieving our ultimate goal: long-term physician Medicare payment reform,” CMA leaders stated.

Lawmakers and medical associations are united in their assessment that the current system is unsustainable. “Everyone agrees the Medicare physician payment system is broken, and it’s time for Congress to do something about it,” advocates declared.

Take Action Now

To ensure the success of HR 10073, CMA and other advocacy groups are calling on physicians and patients to act swiftly. Contacting representatives, encouraging them to cosponsor the legislation, and raising public awareness are vital steps in securing its passage.

If successful, the Medicare Patient Access and Practice Stabilization Act will provide temporary stability for physician practices, ensuring better access to care for patients while paving the way for long-overdue reforms to the Medicare payment system.

New research led by experts from the University of Sydney and University College London has found that even a brief amount of physical activity—just five minutes per day—could significantly reduce blood pressure. Published on Thursday, the study indicates that adding daily activities like walking uphill or climbing stairs may play an impactful role in blood pressure management.

The study, conducted by the Prospective Physical Activity, Sitting, and Sleep (ProPASS) Consortium, examined how short bursts of movement can improve cardiovascular health. It suggests that swapping sedentary habits for only 20 to 27 minutes of exercise each day has a clinically relevant effect on blood pressure. According to Emmanuel Stamatakis, director of the ProPASS Consortium and joint senior author from the University of Sydney, “High blood pressure is one of the biggest health issues globally, but unlike some major causes of cardiovascular mortality, there may be relatively accessible ways to tackle the problem in addition to medication.”

Through an analysis of 14,761 volunteer data, the researchers found that minor daily changes, such as reducing time spent sitting, may yield substantial health benefits. The team projected that replacing prolonged inactivity with about 20 minutes of exercise each day could decrease the risk of cardiovascular disease by up to 28 percent.

The World Health Organization (WHO) has reported that 1.28 billion people worldwide aged 30 to 79 suffer from hypertension, defined as consistently high blood pressure, and nearly 46 percent of those affected are unaware of their condition.

New York, NY – World Vegan Vision recently held a successful event on October 19, 2024, at the Asa’mai Temple, spotlighting the vital connection between heart health and a plant-based lifestyle. The keynote speaker, renowned cardiologist Dr. Bimal Chhajer, captivated attendees with his insights on reversing heart disease through veganism.

The event drew an enthusiastic crowd eager to learn about the life-saving benefits of a vegan diet and how it can positively impact heart health. Dr. Chhajer shared key takeaways, including essential practices to manage and even reverse heart disease naturally. His approach emphasized cholesterol management, the elimination of oils in cooking, regular exercise, and stress reduction through yoga and meditation. The following are few critical insights from Dr. Chhajer’s presentation:

Cholesterol Management: Avoid all animal products to reduce cholesterol.

Zero-Oil Cooking: Exclude all oils to promote heart health.

Exercise: A daily 35-minute walk on an empty stomach significantly improves heart function.

Stress Management: Incorporate yoga and meditation to manage stress, a leading contributor to heart disease.

Blood Pressure Control: Maintain blood pressure at 120/80 mmHg by reducing salt intake.

Blood Sugar Monitoring: Keep fasting blood sugar under 100 mg/dL and HbA1c below 6.5%.

Triglyceride Reduction: Cut triglycerides to under 100 mg/dL (normal is <150 mg/dl) with plant-based foods and regular exercise.

Heart-Healthy Diet: Focus on high-fiber, antioxidant-rich foods, eliminating high-fat dairy and nuts.

Weight Management: Achieve a BMI below 24 through a whole-food, plant-based diet.

LDL Cholesterol Control: Keep LDL levels under 70 mg/dL for heart disease reversal. (normal is <100 mg/dl)

HDL Cholesterol: Boost HDL levels with regular exercise, targeting over 40 mg/dL. (normal is >40 mg/dl)

Natural Bypass Therapy: Explore EECP non-invasive cardiac therapy covered by Medicare.

Detox Therapy: Combined with a Zero-oil vegan diet, detox therapy like fasting aids in clearing blockages.

Angina Awareness: Learn to identify angina symptoms such as chest pain and discomfort.

Reversal of Heart Disease: A vegan diet paired with lifestyle changes can reverse severe heart disease.

We would like to clarify that the information we are sharing is not intended to serve as medical advice. Rather, our goal is to provide you with valuable insights and guidance on how to maintain and improve your heart health.

World Vegan Vision is dedicated to promoting the benefits of a vegan lifestyle for both personal health and environmental sustainability. We are grateful to all who attended and look forward to hosting more events aimed at educating and inspiring the community towards heart-healthy, compassionate living.

About Dr. Bimal Chhajer:

Dr. Chhajer is a respected figure in the field of Non-Invasive Cardiology, dedicated to combating heart disease through comprehensive, scientifically-backed lifestyle changes.

About World Vegan Vision:

World Vegan Vision is a 501(c)(3) nonprofit organization. The mission of World Vegan Vision is to increase public awareness about the 3 main aspects of Veganism – Health, Animal Rights & Environmental Conservation. The organization aims to organize activities to raise awareness about these issues.

The rapid increase in diabetes cases in India is being directly linked to the widespread consumption of deep-fried, baked, and grilled foods, which have become household staples across the country in recent years. These ultra-processed foods, easily found in every corner of India, are identified as a major cause behind the growing prevalence of diabetes, according to medical experts.

India now has an alarming 101 million people living with diabetes. A report by the Indian Council of Medical Research (ICMR) and the National Institute of Nutrition (NIN) reveals that more than 10 percent of the population between the ages of 5 and 19 are pre-diabetic, signaling the beginning stages of the condition.

A new study, published in the *International Journal of Food Sciences and Nutrition*, shows a direct correlation between the consumption of deep-fried, baked, and grilled foods and the onset of diabetes. These foods are rich in harmful compounds known as advanced glycation end products (AGEs), which are linked to inflammation and several chronic diseases, including diabetes.

“When we fry or grill foods, it results in oxidative stress, which promotes inflammation,” explained Dr. V Mohan, a leading diabetologist from the Madras Diabetes Research Foundation (MDRF) in Chennai. “Chronic inflammation is associated with not only diabetes but also hypertension, heart disease, and some types of cancer. Ultra-processed foods, especially those high in trans fats, are particularly damaging to our health,” Mohan added in an interview with IANS.

In addition to poor dietary habits, other factors like stress, lack of sleep, and air pollution are also exacerbating the diabetes crisis in India, according to health experts.

While foods high in dietary AGEs are shown to increase the risk of type 2 diabetes and inflammation, certain foods are classified as low in AGEs and can offer some protection against these conditions. Fruits, vegetables, legumes, oats, dairy products, eggs, fish, and tree nuts like almonds, walnuts, and cashews are considered low-AGE foods, making them beneficial for those looking to reduce their risk of diabetes.

“Our study showed that foods rich in dietary AGEs were closely linked to the development of type 2 diabetes and chronic inflammation,” Mohan said. “On the other hand, foods low in dietary AGEs seemed to offer a protective effect against diabetes.”

AGEs are formed through a process called glycation, where sugar molecules bond with proteins or fats in a non-enzymatic reaction. This process creates compounds that can lead to harmful inflammatory reactions in the body, contributing to the development of chronic diseases like diabetes.

In particular, deep-fried foods, especially popular street food in India, are often prepared with reheated oil. According to Dr. Mohan, this reheating process significantly increases the amount of trans fats in the food. “Reheated oil is loaded with trans fats, which are known to significantly increase the risk of heart disease and certain types of cancer,” Mohan explained.

However, the dangers aren’t limited to deep-fried foods. Even grilled or baked foods, which are often perceived as healthier alternatives, may pose serious health risks. Dr. Mithal, another prominent health expert, explained that grilling foods at high temperatures produces toxic compounds that can have harmful effects on the body.

“Many people believe that grilled food is healthier because it’s not fried, but that’s not always the case,” Mithal said. “Grilling exposes the food to extremely high temperatures, which leads to the formation of toxic aromatic carbons, some of which can be carcinogenic.”

Baked foods, often viewed as a healthier option, also come with potential risks. While baking eliminates the frying process, most baked goods are high in carbohydrates, which can also contribute to the diabetes epidemic. The study conducted by the MDRF found that excessive carbohydrate consumption, especially in the form of white rice or refined wheat (commonly known as maida), is a significant driver of diabetes in India.

“Excessive intake of carbohydrates, particularly from white rice or refined wheat, is a direct cause of the diabetes epidemic in India,” the MDRF study stated.

These findings suggest that common dietary habits in India, especially the reliance on fried, baked, and grilled foods, are contributing significantly to the rising number of diabetes cases in the country. The situation is further worsened by the availability and affordability of these ultra-processed foods, making them a staple in the diets of many Indian families.

As India continues to grapple with this growing diabetes crisis, experts emphasize the importance of dietary changes, including reducing the consumption of fried and ultra-processed foods and opting for healthier alternatives. Foods rich in fiber, low in trans fats, and free from harmful AGEs should be prioritized in daily meals to help combat the prevalence of diabetes.

New research reveals that exposure to certain “forever chemicals” may be disrupting the sleep quality of young adults, contributing to not only tiredness but also potential health risks. A study from the University of Southern California, recently published in *Environmental Advances*, found that individuals with elevated levels of four specific per- and polyfluoroalkyl substances (PFAS) in their blood experienced poorer sleep quality.

PFAS, often referred to as “forever chemicals” because they persist in the body and environment, may interfere with the function of a key gene involved in producing the hormone cortisol. Cortisol plays a crucial role in regulating sleep and wakefulness patterns, and disruptions to this hormone can affect sleep, the study authors noted.

“Because the body needs sleep every day, if PFAS might be interfering with your sleep, that may affect you more immediately than other chronic health issues,” said Shiwen (Sherlock) Li, lead author of the study and a postdoctoral researcher at USC’s Keck School of Medicine, in a statement.

There are thousands of types of PFAS, some of which are linked to illnesses like kidney cancer, testicular cancer, and thyroid disease. These chemicals are commonly found in firefighting foams, industrial waste, household products, cosmetics, and waterproof apparel.

Building upon previous knowledge that PFAS can disrupt hormones and the immune system, the USC researchers collected blood samples and sleep data from 144 participants aged 19 to 24. These young adults were part of the USC Children’s Health Study, a long-term research project studying the effects of pollutants on children.

The study was conducted in two phases. The first phase involved data collection from 136 participants between 2014 and 2018. The second phase, which took place between 2020 and 2022, reassessed 76 of these participants, while also including an additional eight individuals.

The researchers measured blood concentrations of seven PFAS compounds: PFOS, PFOA, PFHxS, PFHpS, PFPeS, PFNA, and PFDA. They then assessed the participants’ sleep duration based on self-reports and used validated tools to track sleep disturbances.

Of these seven chemicals, four—PFDA, PFHxS, PFOA, and PFOS—were significantly associated with poor sleep quality or shorter sleep duration, according to the findings.

Even though PFOA and PFOS are considered “legacy PFAS” and have largely been phased out of production, they remain widely present in the environment.

“It could be a matter of cumulative exposure over time,” Li explained. “What we measured in the blood is likely driven by exposure since birth, or even prenatal exposures.”

The study found that individuals with higher blood levels of PFDA, PFOA, and PFHxS had notably shorter sleep duration. Specifically, those with the highest levels of these compounds slept an average of 80 minutes less each night compared to those with the lowest levels.

Meanwhile, PFOS was linked to increased sleep disturbances and sleep-related impairments. Affected participants reported difficulty falling or staying asleep, trouble waking up, and feeling tired during the day.

The research team delved deeper to understand why these chemicals might be impacting sleep quality. They examined potential connections between PFAS exposure and genes associated with sleep disorders by utilizing toxicology databases that map relationships between chemicals, diseases, and changes in gene expression.

They identified more than 600 possible candidate genes and narrowed down their focus to seven that appeared to be activated by PFAS exposure and were also associated with sleep regulation.

One of the genes, HSD11B1, is involved in producing cortisol. The hormone plays an essential role in controlling sleep and wakefulness rhythms. Disruptions to the expression of the protein encoded by this gene could lead to altered cortisol levels, which, in turn, could affect sleep, according to the study.

“If the expression of the protein encoded by HSD11B1 is disrupted, that means that cortisol levels could also be disrupted,” Li said. “That, in turn, affects sleep.”

Another gene of interest was cathepsin B, which produces enzymes that are precursors to amyloid beta proteins. These proteins are commonly found in the brains of Alzheimer’s patients. High levels of cathepsin B have previously been linked to cognitive decline in Alzheimer’s disease, which itself has been associated with sleep deficits, the researchers explained.

The findings are significant because they suggest that PFAS exposure may contribute to broader health consequences through its impact on sleep. The team plans to continue exploring the effects of forever chemicals on children’s sleep as part of a larger National Institutes of Health initiative.

“Sleep quality is an issue that affects almost everybody, so the impact of PFAS on sleep may have policy implications,” Li added.

This research underscores the potential public health concern related to PFAS exposure and its effects on sleep, especially in young adults. As these chemicals continue to persist in the environment, the findings highlight the need for further studies and possibly regulatory changes to address the presence of PFAS in everyday products.

In an unconventional self-experiment, Harvard medical student Dr. Nick Norwitz set out to study the effects of consuming a massive quantity of eggs on cholesterol levels. Over the course of a month, Norwitz ate an astounding 720 eggs – averaging 24 eggs per day – to test how such a diet would impact his cholesterol, particularly his LDL (low-density lipoprotein), commonly referred to as “bad” cholesterol. Surprisingly, instead of seeing an increase, Norwitz observed that his LDL levels dropped by nearly 20 percent by the end of the month.

Before beginning his egg-heavy experiment, Norwitz hypothesized that consuming 60 dozen eggs would not elevate his LDL cholesterol levels. His normal diet was a mixed, standard American-style one, during which his LDL levels hovered around 90 mg per deciliter. Norwitz had since switched to a ketogenic diet, a high-fat, low-carb eating style. The primary goal of his experiment was to observe how drastically increasing dietary cholesterol intake would affect his cholesterol markers.

Norwitz detailed his findings in a video on YouTube, explaining that his dietary cholesterol intake skyrocketed during the month. He estimated his total cholesterol intake at around 133,200 milligrams, with his intake of dietary cholesterol increasing more than fivefold. Despite this, Norwitz noted a 2 percent drop in his LDL levels after the first week of consuming 24 eggs a day. By the end of the experiment, his LDL levels had fallen by a total of 18 percent.

For those unfamiliar with cholesterol metrics, LDL cholesterol is often seen as a marker for heart disease risk. However, some studies suggest that the relationship between dietary cholesterol and blood cholesterol levels may not be as direct as once believed. For instance, according to Healthline, research has shown that consuming eggs – up to two per day or half a cup – does not appear to raise cholesterol levels in healthy individuals. Furthermore, even individuals with health conditions like diabetes who consume six to twelve eggs per week do not seem to experience adverse effects on their cholesterol levels or heart disease risk factors. Instead, egg consumption is linked to an increase in HDL (high-density lipoprotein) or “good” cholesterol.

Norwitz’s self-study contributes to the ongoing debate about cholesterol and diet, particularly in the context of low-carb and ketogenic diets. “In lean, insulin-sensitive people who go on low carbohydrate diets, especially ketogenic diets, it’s common for LDL levels to rise as part of a lipid triad,” Norwitz explained. The lipid triad consists of elevated LDL cholesterol, elevated HDL cholesterol, and low triglycerides, forming what he called “a metabolic signature of an extreme shift from carb-burning to fat-burning.” This shift is particularly notable in people on ketogenic diets, which prioritize fat as the primary energy source over carbohydrates.

Despite Norwitz’s massive intake of cholesterol over the month, his cholesterol levels defied conventional expectations. In addition to his LDL decrease, Norwitz mentioned that adding carbohydrates back into his diet during the final two weeks led to further dramatic changes. As a “lean, mass hyper-responder,” Norwitz’s body showed extreme sensitivity to his diet. Adding carbs, including fruits like blueberries, bananas, and strawberries, helped lower his LDL further. Although he didn’t fully reverse his metabolic response, Norwitz said the addition of carbs “dominated over the insane amounts of cholesterol I was consuming,” leading to a noticeable shift in his cholesterol markers.

Norwitz consumed around 60 grams of net carbohydrates per day in the final two weeks. This wasn’t enough to fully negate his ketogenic state, but it was sufficient to bring him in and out of ketosis – the metabolic state in which the body burns fat instead of carbohydrates for energy. Despite this ebb and flow in ketosis, Norwitz continued to consume high levels of dietary cholesterol. His daily intake of saturated fats reached about 75 grams, which amounts to roughly 100 calories, and he consumed about 5,000 milligrams of dietary cholesterol per day. This is far beyond the American Heart Association’s recommendation that no more than 6 percent of daily calories should come from saturated fat.

The outcome of Norwitz’s extreme experiment raises questions about conventional advice on cholesterol and diet. Typically, people are warned to limit dietary cholesterol and saturated fat to prevent heart disease. However, Norwitz’s experience suggests that the relationship between cholesterol intake and blood cholesterol levels may be more complex, particularly in people following specific diets like keto.

Norwitz acknowledged that his month-long egg diet was “crazy,” but he was motivated by more than curiosity about his own cholesterol. He hoped that his experiment would spark “intellectual provocation” regarding extreme dietary messaging often seen on social media. Referring to his experiment as “legit-bait,” Norwitz admitted that the bizarre nature of his diet was designed to attract attention. By sharing his experience, Norwitz aimed to encourage more researchers to investigate the nuances of metabolic health and cholesterol.

Beyond the eye-catching nature of his experiment, Norwitz emphasized that the results shed light on the importance of context in dietary studies. While some people may be able to handle large amounts of dietary cholesterol without negative consequences, others may not react in the same way. His findings suggest that individual factors, such as body composition and metabolic state, play a significant role in how dietary cholesterol is processed.

Ultimately, Norwitz’s self-experiment is a reminder that dietary science is constantly evolving. What works for one person may not work for another, and extreme dietary changes can lead to unexpected results. While eating 24 eggs a day may not be advisable for most people, Norwitz’s findings contribute to the ongoing dialogue about cholesterol, diet, and health.

Norwitz’s egg-centric experiment serves as an example of how unconventional methods can provoke deeper conversations about nutrition and health. By challenging the assumptions about dietary cholesterol, his experiment may pave the way for further research on how different diets affect metabolic markers. In a field where nutrition advice can often be contradictory, Norwitz’s experiment underscores the need for more nuanced understanding and study of the relationship between diet and cholesterol.

Though Norwitz’s findings are unlikely to result in widespread recommendations to consume 24 eggs a day, his experiment adds another layer of complexity to our understanding of dietary cholesterol and its role in overall health.

The United States spends more on health care than any other high-income nation, yet Americans face higher rates of illness and premature death while struggling to afford essential medical services, according to a new report from The Commonwealth Fund. The independent research group’s report, released on Thursday, underscores that despite the high financial investment in health care, Americans have poorer health outcomes compared to their peers in other high-income countries.

In comparison with nine other wealthy nations, the U.S. ranked last overall, marked by lower life expectancy and higher rates of disease and death. This stark reality stands despite the fact that the country outspends all others on health care. Australia, the Netherlands, and the United Kingdom emerged as the top three performing countries in the report.

“This report reveals that our health system is continuing to lag far behind other nations when it comes to meeting our citizens’ basic health care needs. The US spends more on health care than any other country, and Americans are sicker, die younger and struggle to afford essential health care. We spend the most and get the least for our investment,” said Dr. Joseph Betancourt, president of The Commonwealth Fund, during a news briefing.

Betancourt, a primary care physician, emphasized the personal impact of these system failings. “As a primary care doctor, I see the human toll of these shortcomings in our system on a daily basis. I have patients who need medications they can’t afford. I spend time going back and forth with insurance companies who have denied care I know my patients need, and I see older patients who arrive sicker than they should because they’ve spent the majority of their lives uninsured,” he added.

According to Betancourt, the report provides a valuable “blueprint for health leaders and policymakers on how the US can achieve more equitable, affordable care for all Americans.”

Top Performers and Struggles of US Healthcare

The Commonwealth Fund’s analysis compared the health systems of ten countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom, and the United States. These countries were evaluated across five key areas: access to care, the health care process, administrative efficiency, equity, and health outcomes, using data from the World Health Organization, OECD, Our World in Data, and other international surveys.

The highest-ranking nations in these five areas were Australia, the Netherlands, and the United Kingdom, with Australia taking the top spot. On the other hand, the U.S. ranked last in multiple domains, including access to care and health outcomes, reflecting significant issues in the system’s ability to provide timely and affordable health services.

The U.S. was highlighted as having the shortest life expectancy and the highest rates of avoidable deaths among the ten nations analyzed. The study also found that the U.S. recorded the most excess deaths related to the Covid-19 pandemic for individuals under the age of 75.

Equity was another area where the U.S. struggled, ranking ninth. This indicates that disparities based on income and background continue to be a major issue in accessing and receiving health care services. The country also ranked ninth in administrative efficiency, with numerous complaints about problems related to insurance approvals and billing processes.

“Administrative requirements can cost time and money for patients and doctors,” noted Reginald Williams II, vice president of international health policy at The Commonwealth Fund. He explained that many countries have simplified their health insurance systems through standardization and regulation. “For example, other countries apply standardized payments to all physicians for services, and do that on a regional basis, so that doctors know what they’ll be paid, and patients know what portion they’ll be responsible for,” he said. This makes their systems “much simpler.”

While the U.S. ranked poorly in several domains, the report did find that the country performed well in the care process domain, indicating that the quality of care delivered in some aspects is high. However, these gains were not enough to counterbalance the overall poor performance in other critical areas.

A Clear Outlier in Health System Performance

The U.S. stood as an outlier in the analysis, with researchers emphasizing that while all countries had areas where they could learn from one another, the gap between the U.S. and the other nations was particularly stark. The other nine countries shared universal health coverage systems, where copayments for services are minimal, which enhances both accessibility and affordability.

“A lot of the lagging performance of the United States’ health care system has to do with access to care and equity of care, both of which are heavily influenced by the availability and quality of insurance,” said Dr. David Blumenthal, former president of The Commonwealth Fund.

Blumenthal highlighted that, despite historic lows, approximately 20 million Americans remain uninsured, around 7-8% of the population. “It also lacks in terms of the ability of lower-income people to get access to basic services,” he said, reflecting the broader issue of access disparity.

Another key issue noted in the report was that despite similar health care spending levels in the other countries studied, the U.S. spends far more but delivers worse results. This inefficiency in spending, alongside the inequities in access, marks the U.S. as unique among its peers.

Improving US Health Care

The report calls for several reforms to improve the state of the U.S. health care system. These include expanding insurance coverage, reducing disparities in care, and simplifying the insurance system to minimize the administrative burden on both patients and providers.

Additionally, researchers argue that the U.S. must invest in addressing the social determinants of health, such as poverty, homelessness, and substance abuse, all of which contribute to poor health outcomes. “It’s important for the United States to invest in interventions outside of health care to address the social drivers of health: poverty, homelessness, hunger, discrimination, gun violence, substance use,” said Williams.

A stronger primary care system could also be key to improving health outcomes in the U.S. In the Netherlands, for instance, primary care physicians are required to offer after-hours coverage, ensuring that patients can access their doctor 24/7. Blumenthal noted that this system could significantly reduce the reliance on emergency rooms for after-hours care in the U.S., which is currently a major contributor to high health care costs and administrative complexity.

Impact of Political Choices on Healthcare

The future direction of U.S. health care is likely to be influenced by the upcoming presidential election, according to Blumenthal. “The American electorate makes choices about which direction to move in, and that is very much an issue in this election,” he said. Policies aimed at expanding insurance coverage could move the country closer to the standards seen in other high-income nations.

A similar report from The Commonwealth Fund last year revealed that the U.S. had the highest rates of avoidable deaths, maternal and infant mortality, while also spending the most on health care.

Dr. Georges Benjamin, executive director of the American Public Health Association, who was not involved in the reports, remarked last year, “We’re not getting the best value for our health care dollar.”

Benjamin outlined three areas for improvement: expanding universal access, increasing focus on primary care prevention, and investing in societal support systems. “They spend their money on providing upfront support for their citizens. We spend our money on sick care,” Benjamin said.

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.