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The number of measles cases recorded so far this year is already triple the 2023 total.According to the CDC, 188 measles cases have been reported.Experts attribute the trend to declining vaccination rates in the U.S. and a rise in measles cases worldwide. The number of measles cases recorded this year is more than triple the total from all of last year — with five months still to go. Read More
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We need comprehensive reform that addresses the entire ecosystem of fees, contracts and practices that have allowed PBMs to amass such unchecked power. Read More
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Humans have been afraid of sharks since long before “Jaws” and “The Meg” patrolled summer movie screens. Whether it’s the teeth or the lifeless eyes, something about them can just make your blood run cold. Marine biologists are quick to say this fear is way out of proportion. Lightning strikes and bear attacks are more common than shark bites, they say. Of the more than 500 species of shark, only a handful have ever attacked humans, and most bites in the United States can be traced to just four species. Read More
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As one of the physicians who recently expressed concern about President Joe Biden’s health and his likelihood of significant decline over the next four and a half years, I was relieved when he ended his reelection campaign—and also overwhelmingly sad. In essence, as people keep saying, he had his car keys and driver’s license taken away with the whole world watching. This evening as he gave a short speech from the White House about his accomplishments, his voice was weak, he stumbled occasionally over his prepared remarks, and his physical presence was diminished from what it once was. For months, I have wished that I could have Biden in my exam room, not as the president of the United States, but as a patient in my geriatrics clinic. Instead, watching from afar as he insisted on running, I wondered if his doctors were talking to him honestly about his concerning symptoms, and his disappointing odds of fulfilling the requirements of the office for another term. I hoped that if they were discussing his future, they were pointing out the advantages of taking charge in this situation, even when no available option was Biden’s ideal. But, given what they and the president said in public before he ended his campaign, I worried that little of this was happening. Despite the aging U.S. population, few clinicians are trained to care for aging bodies, much less to discuss the developmental stages of elderhood and identity-threatening realities of later life. In medicine, we use the term difficult conversations to refer to discussions of existential issues, particularly those with inherent uncertainty and ambiguity. They work best when the patient, perhaps in the presence of family or friends, shares their view of their own health and their hopes or concerns for their future, before—if they’re open to it—hearing a physician’s view and having a chance to explore the possibilities of the coming years in more depth. I might have asked the president what worries or scares him and what brings him joy and meaning, and worked to identify what his best- and worst-case scenarios would look like. Part of what was so excruciating about watching Biden hold on to his hope of winning a second term was seeing someone struggle to accept that their best-case scenario might be impossible. Variations of this situation play out daily in clinics and hospitals, and if you have a shred of empathy, it’s always heartbreaking. Yet few such difficult conversations—or the loud silences that too often take the place of these conversations—happen so publicly. Watching this one reminded me how unwelcome they are in American life, even in the offices of physicians delivering bad news. Admittedly, in denying the evident changes in how he walked, spoke, and looked, Biden contributed to the painful and public way that questions about his next four or five years of life were discussed. But his actions were of a piece with common age-denying choices and behaviors: Think of the gray hair diligently covered by many people over 50, the carefully cultivated older gym body, the graduation date dropped off a résumé, and the popular falsehood that “age is just a number.” These choices and statements are a response to a culture that views the diminishment of advanced age not as the natural progression for living organisms but as a personal failure. And people in this country do have reason to dread advanced old age. It can be deeply isolating, and many people end up warehoused and treated in ways that make little sense in a health-care system that hasn’t kept up with the numbers or needs of older adults. This election cycle in particular has inundated Americans with signals that “old” and “disabled” are categories no one should want to join. Magazine covers have shorthanded politicians’ old age and questions about their competence with images of walkers. In the past, Donald Trump has ridiculed a disabled reporter and refused to be seen in the company of wounded veterans. In March, he mocked Biden’s stutter, and his nephew claimed today in Time magazine that Trump said people with disabilities “should just die.” (Trump has not yet responded to this.) Pundits and politicians alike have simplified, distorted, disparaged, and lumped all people over age 70 into an inaccurate whole. Many octogenarians are cognitively and physically healthy, and the right person at Biden’s age might have made a fine candidate—as would a person who uses a walker or other assistive device, whatever their age. By staying in the race after he began to present such a concerning picture of health, Biden himself may have contributed to public conflations of old age and frailty. The driving analogy is apt: Most of us will need to retire from driving at some point, and it’s a much more positive experience for those who get to choose when to stop. Still, retiring from driving, work, or anything else can feel like that much harder a choice to make in a country where the Republican presidential nominee has used his considerable platform to suggest, repeatedly, that people who are old or not fully able-bodied are not worthy of our compassion or attention. Ironically, Trump is now the oldest candidate ever to be nominated for president. He has made a show of his relative robustness compared with Biden, a line of argument that puts him in a precarious position. Although he doesn’t appear frail, health records released during his presidency indicated that he was obese and had hypercholesterolemia and heart disease. And although he doesn’t drink alcohol or smoke, he eats a lot of fast food and seemingly doesn’t exercise beyond slow-paced golf games. It’s impossible to diagnose a person from afar, but his multiple instances of inaccurate recall and disjointed, tangential speech call into question his basic communication and leadership abilities, and raise the question of cognitive change beyond that of normal aging. If Trump came to my clinic, I would do the same physical and cognitive assessment on his as I would on Biden. I would also explore his interest in taking a healthier approach to aging given how his many risk factors increase his chance of adverse health events, functional loss, and death. I hope Trump’s doctors are having such conversations with their patient now. For Biden’s part, he now has to engage in another difficult—though also potentially exciting—conversation with himself and his family: What comes next? Clearly, after 81 years, most of his life is behind him. No one chooses how many years they have left. But with the privileges of free time and enough money, he can choose how to pursue his own health and happiness—to consider what matters most to him, what he enjoys most, and what he wants to do to avoid regrets when he comes to the end of his life. Most people do not become president, so most people are not going to move into old age with a list of regrets that could include stepping aside in a presidential election and, perhaps, watching their opponent triumph. They would not include wondering if, after all, they might have won, if their best-case scenario had indeed been possible. I hope Biden never has those thoughts. Instead, I’d like to see him take a new leadership role by choosing a different best-case scenario: one in which he demonstrates how to embrace the opportunities of advanced old age, even if they are as simple as reliably getting a full night’s sleep and spending time with his family. Read More
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Boar’s Head has recalled more than 207,000 pounds of deli meat, including liverwurst and ham products, because they may be contaminated with listeria bacteria. Read More
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England’s blood supplies are critically low following a cyber attack on a London pathology provider in June. The nation had less than two days’ worth of a universal type of blood that can be given to anyone as of Thursday. Read More
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Of all the reasons Kamala Harris is better equipped than Joe Biden to defeat Donald Trump in November—her relative youth, the fact that she’s a former prosecutor challenging a convicted felon—her biggest advantage may be her record on abortion. Harris served as the Biden administration’s de facto advocate for reproductive rights; it is her voice, not Biden’s, that’s been loudest in objecting to abortion bans and conservative efforts to curtail IVF and contraception. According to the White House, she is the only vice president to have paid an official visit to an abortion clinic. As a senator, she famously grilled the Supreme Court nominee Brett Kavanaugh on abortion, asking him, “Can you think of any laws that give the government the power to make decisions about the male body?” (He could not.) As California’s attorney general, Harris investigated the anti-abortion activists who pretended to be researchers from a biologics company and illegally recorded videos that were edited to suggest that Planned Parenthood sold fetal parts. (After Harris left the AG’s office for the Senate, her successor brought criminal charges, and Planned Parenthood eventually won more than $2 million in damages from a lawsuit against the activists.) It also doesn’t hurt that Harris is running against a notorious misogynist who selected for his running mate a man who said as recently as 2022 that he would support a nationwide abortion ban. In the tiny sliver of time in which she’s been the potential presidential nominee, Harris has already reenergized Democratic voters, especially abortion-rights advocates. Laudatory press statements have been issued by abortion-rights groups including Reproductive Freedom for All (formerly NARAL) and EMILY’s List, which is planning to donate millions to her campaign. If Harris is the nominee, Democrats will have the opportunity to make reproductive choice the leading issue of the 2024 campaign. And that might be enough to win. Since the Supreme Court, stacked with Trump-appointed justices, issued its ruling in Dobbs v. Jackson Women’s Health Organization in 2022, Americans’ support for abortion rights has soared to the highest levels since Gallup began measuring abortion attitudes, in 1995. Over the past two years, seven states, including solidly red ones, have asked their citizens to vote directly on laws either expanding or constricting abortion rights, and every single time, abortion rights have won. Only about one in 10 Americans think that abortion should be illegal in all circumstances—about as many as believe Jesus will return to Earth in their lifetime. So many voters are in favor of at least some abortion rights that Republican lawmakers across several states are trying to make it more difficult or even impossible for citizens to vote directly on ballot initiatives and constitutional amendments, even as they continue to push unpopular abortion bans through legislatures and the courts. [Read: The pro-life movement’s not-so-secret plan for Trump] Abortion bans have irrevocably altered the lives of untold American women, but they’ve been political gifts to Democrats—one of the few advantages the party has this year. Voters have clearly expressed their displeasure with the current state of the economy, the border, and public safety, all of which have dragged down Biden’s approval ratings. Polling from early July (before Biden dropped out) showed that Trump had more voters’ trust on the border, the economy, the war between Israel and Hamas, and crime and safety. But abortion was the issue for which Trump received the least trust, and Biden the most. And that’s polling on Joe Biden, a man who has been at best uncomfortable with and at worst hostile to abortion rights for most of his career. As a young senator, he groused that the Supreme Court had gone too far in Roe v. Wade. In the 1990s, he boasted about voting some 50 times against federal funding of abortions; in 2006, he said, “I do not view abortion as a choice and a right.” By 2012, Biden was emphasizing his support for a woman’s right to choose. As Barack Obama’s running mate, he maintained his belief that life begins at conception but said, “I just refuse to impose that on others.” And after the Supreme Court overturned Roe during his presidency, he called on Congress to codify that right. But he still takes pains to avoid even uttering the word abortion, skipping over it in his State of the Union address despite its inclusion in the prewritten text. His June 27 debate performance reached its nadir when he was asked an easy-win abortion question and responded by bungling the premise of Roe, struggling to rebuke a Trump fantasy about abortions “even after birth” (which do not exist), and saying that “the deal” with abortion was at least partly about “young women who are being raped by their in-laws.” When Florida banned abortions after six weeks of pregnancy, Biden gave a sprawling speech in Tampa in which he used the word abortion just twice and quickly moved on to other issues, according to a Politico analysis. When Harris appeared in Jacksonville for a Biden-campaign event the next week, she spoke almost exclusively about reproductive rights, and said abortion 15 times. Trump, like Biden, has proved malleable in his abortion politics, seesawing from “I’m very pro-choice” in 1999 to “I am pro-life” in 2011. In 2016, he said, “There has to be some form of punishment” for women who have abortions if the procedure ever became illegal (then quickly reversed his position), and he has more recently deemed himself “the most pro-life president in American history” and boasted that he “was able to kill Roe v. Wade.” But this year, public opinion has swung so hard against abortion restrictions that even Trump, who said in 2016 he was sure that voters would look the other way if he shot someone on Fifth Avenue, pushed his party to scale back its stated opposition to abortion in its 2024 platform. Trump didn’t mention abortion once during a record-length convention speech in which he found time to pontificate on Hannibal Lecter and a potential RNC in Venezuela. [Read: Suddenly Trump looks older and more deranged] That say-nothing strategy might have worked if the contest had remained between Trump and Biden. But instead, Harris seems poised for the nomination, and Trump picked a staunchly anti-abortion running mate in J. D. Vance. Although he started trying to soften his stance when he became Trump’s VP pick, Vance previously voiced support for a national ban on abortion (though he acknowledged that it was unlikely in the current political climate) and for state laws that outlaw the procedure without exceptions for rape or incest. Against these candidates, and with a single-issue advantage like this, talking about abortion nonstop is in Democrats’ best interests. Abortion is certainly not the only issue voters care about, or even the one they care about the most, so Harris would be remiss if she made it her campaign’s sole focus. Democrats have plenty of successes to tout from the Biden administration, including rescuing the post-COVID economy, investing big in infrastructure, and overseeing declining murder rates. But focusing on abortion and reproductive freedom offers Democrats a rare opportunity to pick up swing voters and turn out dedicated pro-abortion-rights Democrats. Forty-one percent of Republican and Republican-leaning voters, including more than a quarter of self-described conservative Republicans, say abortion should generally be legal, according to a Pew Research Center survey conducted in April. In a Wall Street Journal poll from March, 39 percent of suburban women in swing states chose abortion as their most important issue—more than any other option. And because many people seem to see abortion through the lens of health, family, and personal freedom, the issue dovetails quite neatly with Democrats’ other (limited) strengths: health-care access and protecting democracy from the threat of autocracy during a second Trump term. [Read: Can Harris reassemble Obama’s coalition?] A Democrat like Harris, who speaks forcefully and passionately about abortion rights, is an ideal foil for Trump and Vance. Her position is strong in a nation where anger over abortion bans remains vigorous. A candidate who can galvanize abortion-rights voters is exactly what Republicans fear and Democrats need. If Harris makes reproductive freedom a cornerstone of her campaign, she just may be the woman who finally breaks the presidential glass ceiling—and who keeps Democrats in the White House. Read More
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Life and relationship coach Rhea Williams stops by TODAY to share a 4-step plan for winning someone over, including being present, practicing authenticity and more. Read More
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For Americans retiring abroad, discover top retirement destinations around the world offering affordability, healthcare, quality of life, and beautiful surroundings. Read More
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This is an edition of The Weekly Planet, a newsletter that provides a guide for living through climate change. Sign up for it here. Last month, at the start of hurricane season, I invited my inner circle to a hurricane-preparation dinner. Over a supreme pizza and a bottle of wine, my girlfriend, our roommate, my best friend, and I discussed how we would evacuate together from New Orleans with our three dogs and three chickens. We talked about when we’d decide to leave (as soon as the storm hit Category 2) and where we’d go (it would depend on the direction of the storm, but we have friends in Texas and Georgia with whom we could stay). For decades, communities have relied on emergency-management agencies to tell them what to do during a disaster. But as our world warms, storms are intensifying more rapidly, making it much harder for cities to plan their responses. In an ideal world, emergency managers would have 72 hours to orchestrate a mandatory evacuation, but fast-moving storms give cities much less time to order people away. In the coming months and years, more people will need to decide either to evacuate—a process that is disruptive at best, and dangerous for vulnerable people at worst—or be prepared to stay home, in some cases without power for more than a week, and possibly without assistance from city officials. Fast-moving storms put emergency managers in a double bind: If they leave residents with too short a window to flee, they raise the risk of them getting trapped in their cars as the storm bears down. But calling for an unnecessary evacuation, where a storm ends up less intense than first feared, has its own dangers. During Hurricane Rita in 2005, for example, evacuees in Houston were short on fuel, water, and food, stuck in a traffic gridlock in high heat; the evacuation wound up killing more people than the storm itself. With less time to prepare for a storm’s arrival, coastal managers could turn to more targeted evacuations, focusing on the people directly in the path of storm surge. For residents who choose to stay, assistance from their city is not a given. In the days following Hurricane Ida, New Orleans city officials set up eight emergency resource centers where those in need could charge their devices, pick up food, and cool down. The city has since proposed a list of 15 potential Emergency Resource Centers, but the activation of these centers in an emergency isn’t guaranteed. Buildings could be damaged in the storm, and site availability would have to be determined accordingly. Ultimately, the messaging from the city has been that for the first 72 hours after a storm hits, those who stay are on their own. When I told Kim Johnston, a Queensland University of Technology professor, who has thought a lot about how communities collaborate during natural disasters in Australia, about my hurricane-preparation dinner, she quickly replied with useful advice. Johnston’s research has shown that community-led disaster preparation saves lives and speeds up recovery. She suggested moving the group chat to WhatsApp, as cell service could be limited during a disaster. Figuring out how to evacuate pets is also important, she noted. For us, that meant the dogs would need to be in a different car than the chickens. I was grateful for Johnston’s guidance, but also worried: How will those who have fewer resources or no support system manage? The problem extends far beyond New Orleans. Record-breaking ocean temperatures are expected to fuel more major hurricanes than usual this year, and research published in May found that the global mean rate of tropical-cyclone intensification has increased near coastal regions during the period from 1979 to 2020. One force that weakens hurricanes is vertical wind shear, how wind changes speed and direction with altitude. Climate change is reducing vertical wind shear in coastal areas, the climate and data scientist Karthik Balaguru, one of the authors of the study, told me. And that decrease means storms are more likely to intensify quickly just before they make landfall. We saw it happen earlier this month with Hurricane Beryl—a storm that forecasters said was unlike any they’d seen before, developing early in the season and undergoing two rapid intensifications before making landfall. New Orleans is, in some ways, better equipped for this challenge than other cities. Richard Chatman, the deputy director of the New Orleans Office of Homeland Security and Emergency Preparedness, first came to New Orleans in 2005 to help with emergency response after Hurricane Katrina. “This is a special place,” he said of New Orleans. “All the way down to the porch-neighbor mentality. People know each other.” Community groups are stepping up to fill disaster-preparedness gaps, hosting supply distributions and adding commercial-scale solar panels and batteries to local churches. Mary Delahoussaye, who works at the Split Second Foundation, a nonprofit dedicated to the wellness of people with disabilities, told me she’s reminding her clients not to treat city-assisted evacuation as their plan A and advising them on other options to get ready for the next storm. Planning smartly for one’s individual disaster response isn’t exactly a replicable strategy across cities and countries. But New Orleans’s lessons can apply to others who must rely on themselves to prepare: Neighbors should talk with one another openly and often about their just-in-case plans. People with disabilities should alert the national service Smart 911 about their particular needs. Have a plan for evacuating and a plan for staying. This list is not comprehensive, of course; it’s best to look out for specific guidance from local officials. A week after our hurricane dinner, my roommate and I ordered plywood sheets to protect the windows in our house in Gentilly from high-speed winds. I was home by myself when the wood was delivered and started pulling the sheets into my backyard one by one. My neighbor from across the street came over to help. “You shouldn’t have to do this alone,” he said. No one should have to do this alone, I thought. Read More
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More than a dozen vegetables including peppers, cucumbers and squash have been recalled due to possible contamination with listeria. The recall affects produce sold at select Walmart and Aldi stores, the U.S. Food and Drug Administration said in a news release Monday. It is an expansion of the Wiers Farm July 12 recall. Read More
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Discover the key factors to consider before deciding to retire overseas, including affordability, taxes, medical insurance, and residence requirements. Read More
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For as long as I can remember, I have bought into the gospel of fluoride, believing that my teeth would surely rot out of my head without its protection. So it felt a little bit illicit, recently, when I purchased a box of German fluoride-free kids’ toothpaste for my daughter. The toothpaste came in blue, understated packaging—no cartoon characters or candy flavors—which I associated with German practicality. And instead of fluoride, it contained an anticavity ingredient called hydroxyapatite, vouched for by several dental researchers I interviewed for this story. Could it be, I wondered as I clicked “Buy,” that toothpaste doesn’t need to contain fluoride after all? The scientific case for hydroxyapatite toothpaste is actually quite simple: Composed of calcium and phosphate, hydroxyapatite is the very mineral that primarily makes up our bones and teeth. Tooth enamel, the hard protective outer layer, is naturally about 96 percent hydroxyapatite. NASA researchers first patented an idea for repairing teeth with a hydroxyapatite precursor in the 1970s; nothing came of it then, but a Japanese company acquired the patent and eventually created a popular toothpaste called Apagard. Hydroxyapatite toothpaste has been approved for cavity prevention in Japan since 1993. It is also approved in Canada and endorsed by the Canadian Dental Association. And it’s sold in Europe, where the European Commission has deemed the ingredient safe in toothpaste. In the United States, however, fluoride still reigns supreme. You likely won’t find toothpaste containing hydroxyapatite at your corner drugstore. A few boutique hydroxyapatite-based brands have popped up, but they cannot market themselves for cavity prevention without FDA approval, a long and expensive process that no hydroxyapatite toothpaste has yet gone through. The American Dental Association (ADA), meanwhile, gives its Seal of Acceptance only to toothpastes that contain fluoride. Fluoride does work remarkably well: It is incorporated into the enamel structure of the tooth itself, forming a mineral crystal that is significantly more resistant to cavity-causing acid than the tooth’s natural material, according Bernhard Ganss, a scientist at the University of Toronto’s Faculty of Dentistry. “The dogma in dentistry has always been: Fluoride is a good thing.” The trouble with fluoride is that, at very high levels, it becomes a bad thing. Ingesting too much can lead to a condition called fluorosis, in which teeth become mottled in mild cases or structurally weak in more serious ones. The same can happen to bones. More controversially, high levels of fluoride in drinking water—higher than the level recommended in the U.S., but lower than the current EPA limit—have been linked to lower IQ in children. Toothpaste typically contains more than 1,000 times the fluoride recommended in drinking water. We use much less toothpaste than water, of course, and it’s not meant to be swallowed, but young children do not spit out toothpaste reliably. Hydroxyapatite is a way to sidestep the fluoride controversy. It offers the anticavity benefits of fluoride, but without the risks. Bennett Amaechi, a dentistry professor at the University of Texas Health Science Center at San Antonio, says he now recommends it to parents who have concerns about fluoride. He has collaborated with toothpaste manufacturers to study hydroxyapatite, but Felicitas Bidlack told me the same thing about its utility. Bidlack is not a dentist, but she is a tooth enamel researcher, recommended to me by the American Dental Association, which one could hardly accuse of being anti-fluoride. Yet for kids under 2 still learning not to swallow toothpaste, she would likely choose hydroxyapatite. “That’s what I would do as a mother,” she told me. Fluoride toothpaste is in a bit of catch-22, Bidlack added. Sweet candy flavors, bright colors, and glitter can make toothpaste enticing enough for kids to want to brush their teeth, but if it’s too enticing, kids might simply eat it. “If you provide fluoride with this good-tasting goo that they put in their mouths, there is definitely a risk of unintentional ingestion,” says Ganss, who has published papers on hydroxyapatite in collaboration with scientists from the Dr. Wolff Group, a German business that manufactures toothpaste. He went even further: For very young kids, “I would actually really stand up and say no fluoride, period.” I found these conversations clarifying, as they cut through the contradictory advice I’ve been given about fluoride for my 1-year-old. Toothpaste marketed to kids under 2 in the U.S. does not in fact contain fluoride (it usually contains a sugar alcohol called xylitol), and toothpastes that do contain fluoride are labeled as unsuitable for kids younger than 2 unless instructed by a doctor. But the American Academy of Pediatrics, whose guidelines our pediatrician repeated, says to use fluoride toothpaste as soon as the first tooth appears—though only a rice-size smear, which would limit exposure to fluoride. So is fluoride good or not? Is it safe or not? Wouldn’t it be nice not to deal with fluoride at all? Hydroxyapatite’s track record is not as long as fluoride’s, but the evidence so far looks good: In clinical trials that have followed kids or adults for six months to a year and a half—largely funded by toothpaste manufacturers—hydroxyapatite and fluoride have come out about equally protective against cavities. Hydroxyapatite is chemically not as resistant to cavity-causing acid as the mineral formed by fluoride, but Ganss says that daily brushing might replenish hydroxyapatite often enough that the real-world protection is the same. The mineral may also have some other benefits: In studies, hydroxyapatite has helped reduce tooth sensitivity and the amount of bacteria stuck to teeth. The one thing it cannot do is resolve the controversy over adding fluoride to drinking water, which is done as a public-health measure in most parts of the U.S. to prevent tooth decay. Hydroxyapatite can’t be put into drinking water, because it doesn’t dissolve at a neutral pH. “The tap water would be milky,” Ganss says. “It would probably clog all your pipes within a few days or so.” The researchers I spoke with thought fluoride still had its uses, particularly in treatments and toothpaste for adults who know not to swallow too much. Amaechi still brushes with the Colgate he’s used all his life, as he sees no reason for him, as an adult, to change his habits. But he does recommend hydroxyapatite in specific situations—for example, patients with dry mouth, he says, may particularly benefit from this formulation. Age 2 isn't some magic threshold at which the calculus regarding toothpaste in small children suddenly changes, of course. Canada, in fact, recommends holding off on fluoride for most kids until age 3; fluoride-free options for kids are now expanding in the U.S., even without FDA approval of hydroxyapatite. The German children’s toothpaste came only in boring white mint, but I found a number of brands in the U.S. already selling more tempting flavors, such as orange creamsicle and birthday cake. Read More
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The Food and Drug Administration said in a new alert Thursday that it has identified an additional cinnamon product sold in the U.S. that has been contaminated with lead. The ground cinnamon, sold as El Servidor and distributed by an Elmhurst, New York, company of the same name, joins a growing list of cinnamon products identified by the FDA to contain high levels of lead. Read More
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Centene reported second quarter profits of $1.1 billion as Obamacare enrollment and premium revenue helped overcome a big dip in Medicaid enrollment. Centene, which sells an array of government subsidized health insurance including Medicaid coverage and individual commercial insurance coverage under the Affordable Care Act known as Obamacare, said total managed care membership held steady at 28.47 million, compared to 28.41 million at the end of the second quarter of 2023. Read More
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When President Joe Biden announced on Sunday that he was ending his campaign for reelection, he took pains to describe his choice as one meant to serve the greater good. “I believe it is in the best interest of my party and the country,” he wrote in a statement. His decision seemed calculated to prioritize the health of the nation over his own self-interest—and, perhaps, above his own mental and physical well-being. When people choose to retire, it’s generally a positive experience, without a sizable effect on mental health. But stepping away from a high-powered job, whether toward full retirement or a substantial reduction in work, is fraught for many Americans. And it’s especially difficult for Biden’s demographic: highly educated men who have continued working far past 65, the average retirement age for men. “Particularly for college-educated men in professional positions, there’s this expectation that your work is part of your identity,” Sarah Damaske, who studies gender and labor at Pennsylvania State University, told me. Losing it can have serious consequences. Being president has almost certainly harmed Biden’s health, and he has demonstrated symptoms of significant cognitive and physical decline during his term. But exiting the presidency in January will pose new cognitive challenges. “When people are at the center of their universe through their job, we don’t have a storyline or a place in our society that is attractive enough to say, ‘Maybe I’ve had enough,’” says Joseph Coughlin, the founder and director of the MIT AgeLab. “You’re showing people the door with no direction.” That has implications for cognitive and emotional health. When a person starts to identify himself by the past tense—that he used to be a doctor, a teacher, or the president—he shifts his focus from his present and future to his past. Research shows that ruminating on the past can correlate with negative mental-health outcomes, including depression and a sense that one’s perspective and experiences are no longer relevant. Many Americans who stay in high-powered positions into their 70s, 80s, and beyond do so out of a warranted concern over who they would be without the job. S. K. Park, 88, a former psychiatrist and professor at the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences, never wanted to retire. But at 80, he told me, “I made up my mind to retire when I was still at the height of my cognitive ability. I was very conscious of not being a stubborn, obstinate old person.” At 84, 53 years after he started his job, Park left, figuring that he would turn to other interests: his children and grandson, calligraphy, hiking, and travel. But instead, “all of a sudden, life kind of stopped,” he said. Suddenly, he wasn’t sure how to spend his time or how he provided value to his community. Stepping away from work—which can provide an identity, a routine, a social network, and a purpose—is linked to several ill effects on health, especially for older adults. It has been linked to declines in verbal memory, the skill that allows you to recall spoken and written information, crucial for tasks like giving a presentation and communicating with clients. A 2020 meta-analysis found that 28 percent of retirees suffer from depression. By comparison, 2019 estimates from the Institute for Health Metrics and Evaluation suggest that, around the world, only 13.8 percent of adults age 60 or older experience any kind of mental disorder. [Read: There are exceptionally sharp octogenarians. Biden isn’t one.] Some doctors—a profession that notably skews older—are loath to retire precisely because they’re familiar with the medical literature. “I’m at least intellectually aware that in old age, people may fall into a state of despair,” Park said. “I’m trying hard not to fall into that hole.” Stephen Derbes, an 83-year-old rheumatologist at the LSU School of Medicine who still sees patients at the hospital, has no plans to retire. “I fear I would be very likely at risk of getting depressed if I just bailed out,” he told me. “As far as feelings of worth, that would be gone or at least diminished, since I wouldn’t have responsibilities.” The loss of a professional self-identity is particularly acute for men, who often have weaker ties and self-definition outside of the workplace. “For men, traditionally, there’s a total identification with work,” says Jack Maslow, an 82-year-old clinical therapist who runs a men’s group in Corte Madera, California, treating his patients as they adjust to the transition away from work. Beth C. Truesdale, a sociologist who studies retirement and aging at the W.E. Upjohn Institute for Employment Research, told me, “Women have often had to find other ways to create a sense of who they are, beyond what they do.” They are more likely to be caregivers, to maintain social relationships on behalf of their spouse or family, and to volunteer in their communities. And by retirement age, women are more likely to have already taken breaks from paid work. Gary Givler, a 77-year-old retired Episcopal deacon in Batavia, Ohio, sees the gendered struggle in the men’s group of retirees that he leads. For decades, Givler worked both as the vice president of an insurance company and as a deacon, with stints as a chaplain at a pediatric hospital and as a preacher. When he retired from his corporate job, in 2015, he started the men’s group at his church; he’s kept it up since his diaconal retirement, in 2023. Every Monday morning, the group of 15 men in their 70s and 80s—who retired from careers including engineering, teaching, and corporate leadership—meet at a local Panera Bread to talk about news, politics, and their lives. Yesterday, the conversation focused on Biden’s announcement: how he’d met the particular challenge of being pressured to end his campaign, and the courage it must have taken to publicly admit that he’s no longer the best candidate for the job. “The group thought that Joe did the right thing,” Givler said. But that didn’t change the men’s ambivalence about their own retirement. “A lot of them tell me they’d give anything to have a reason to put a shirt and tie on and go somewhere for an important meeting.” [Read: Joe Biden made the right choice] Retirement doesn’t have to be accompanied by decline. Mo Wang, a professor at the University of Florida who studies retirement and older workers, estimates that retirement has a significant positive effect on psychological well-being for 5 to 10 percent of people, largely those who worked very physically demanding jobs. But Wang has also found that retirement is linked to negative psychological effects for 20 to 25 percent of workers, at least temporarily. Other research has shown that people in full retirement tend to fare worse physically than those who keep up some kind of bridge employment or volunteering. The effect can become more dramatic as workers age, because a decades-long routine—the same weekly schedule, the same commute, the same colleagues—might help them perform daily tasks. “Their experience can compensate for cognitive decline, so they’re able to work much longer,” Wang told me. When they transition away from a professional routine, the adjustment can be a rude awakening. Many working-class Americans are pushed into early retirement because they can no longer manage a physically demanding job, such as construction or waitressing. Truesdale estimates that only 5 percent of Americans over 80 are still working. But that number is almost certain to rise. The oldest Baby Boomers are 78, and they’re generally working longer than their predecessors. The U.S. Bureau of Labor Statistics projects that adults age 65 and older will be 8.6 percent of the labor force in 2032, compared with 6.6 percent in 2022. “The aging population today, let alone those that are coming, have more formal education than at any time in history,” Coughlin told me. They’re also living longer than their forebears. Over the next decade, more Americans than ever will be placed in an unenviable position similar to Biden’s, facing a delayed retirement that’s likely to pose new health challenges. Whether he likes it or not, Biden has personified the ungainly challenge of reckoning with one’s work performance and stepping back from the job before one would like to. Now he has an opportunity to show millions of Americans navigating their 70s and 80s how to reckon with their limitations and maintain pride beyond the job. The best way to prepare for retirement at an older age, Wang said, is to make the transition gradual. At age 70, start to reduce your work hours and invest time in nonwork interests so that by 80, you have a strong identity beyond your professional work. For those leaving intense, identity-defining jobs, that process can include mentorship or an elder-statesman role. “Because Biden is transitioning from a very powerful role, it would be good for him to channel that energy to help the transition of power,” Wang said. [From the July 2019 issue: Your professional decline is coming (much) sooner than you think] Preparation, though, may not be enough to overcome the siren song of employment. Park missed his professional identity so much that this week, the 88-year-old went back to work, where he’ll resume supervising medical students. “I don’t think I should work until I die,” he told me. “I would quit myself if I go through what Biden seems to be going through.” But for now, he’s excited to get back to his career. When his current contract ends, he’ll be 89. “I will probably say that will be enough,” he said. “But never say never.” Read More
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More people are ditching personal trainers and leaning towards technology for personalized workout plans. NBC News' Maya Eaglin has the pros and cons of using AI for workout plans. Read More
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Of all the news about bird flu, this month has brought some of the most concerning yet. Six people working on a chicken farm in Colorado have tested positive for the virus—the biggest human outbreak detected in the U.S. The country’s tally is now up to 11 since 2022, but that’s almost certainly a significant undercount considering the lack of routine testing. Since the current strain of bird flu, known as “highly pathogenic avian influenza H5N1,” began spreading around the world in late 2021, it has become something like a “super virus” in its spread among animals, Richard Webby, an influenza expert at St. Jude Children’s Research Hospital in Memphis, told me. Wild birds have been decimated, as have poultry farms: The virus has been detected in more than 100 million birds in 48 states. H5N1 has been around for longer than 25 years, but only recently has it regularly jumped to mammals, infecting cats, sea lions, and bears. In March, it was detected for the first time in American cattle and, since then, has already spread to 163 herds in 13 states. All of that would be worrying enough without reports of people also falling sick. Everyone who has tested positive in the U.S. has worked closely with farm animals, but each additional case makes the prospect of another human pandemic feel more real. “That’s absolutely the worst-case scenario,” Webby said. It’s a possibility, although not the likeliest one. For now, the virus seems poised to continue its current trajectory: circulating among wild birds, wreaking havoc on poultry farms, and spreading among cattle herds. That outcome wouldn’t be as catastrophic as a pandemic. But it’s still not one to look forward to. Even with the spate of farmworker infections, the threat of bird flu to humans is, at the moment, considered low. Researchers are keeping an eye out for two red flags. The bigger one would be the virus’s ability to spread between people. All of the people who have tested positive in the U.S. were infected by exposure to sick cows or poultry, and they have not seemed to pass the virus along to anyone else. Symptoms have generally been mild, including respiratory issues, though several people have developed serious cases of conjunctivitis, or pink eye. (No one in the U.S., or globally, has died from this variant of H5N1.) “There is no evidence at this point that this virus is going human to human, and therefore it really does not pose a threat to public health,” Jenna Guthmiller, an immunologist at the University of Colorado Anschutz School of Medicine, told me. The second warning sign is how the virus itself is changing. So far, H5N1 isn’t very good at getting into human cells and then replicating inside them, abilities that would enable the virus’s spread among people. But that may be changing. In a lab study, virus particles from infected cows showed signs that they were capable of binding to human receptors in the upper respiratory tract. The current strain of H5N1 has already mutated to infect mammals, and a few genetic changes could be all it takes for the virus to spread more efficiently to humans—or, worse, between them. “We’re at the highest risk of the virus” since the early 2000s, when a different strain of H5N1 led to numerous deadly human infections in East and Southeast Asia, Webby said. Not because the virus itself is necessarily more infectious but because it is spreading among so many different animals, and especially mammals—giving it more opportunities than ever to find a way to replicate in humans. But, again, despite all that transmission—all those chances for the virus to mutate into something that can reliably sicken humans—it hasn’t yet. That could “absolutely” continue to be the norm, David Topham, a flu expert at the University of Rochester Medical Center, told me. The status quo is still pretty troubling. New cases of bird flu keep popping up in herds across the country, raising fears that it might never be eradicated from cattle. The “most likely” scenario, Webby said, is that this virus will become endemic in birds and dairy cows—a constant presence, regularly causing outbreaks. Right now, infections in poultry tend to align with the migration of wild birds; if cows are constantly infected, chicken outbreaks could become more frequent. Nothing about endemicity would be good for humans. The consequences would be diminished, but not eliminated. Farmworkers may continue to periodically fall sick, Guthmiller said. The cost of regular animal outbreaks would be exorbitant. The USDA has already allocated more than $2 billion to address surges among poultry and livestock, which includes compensating farmers for animals that have been killed and eggs that have been destroyed to quell the spread. If the virus continues to regularly sicken cows, it will have even more opportunities to mutate in a way that could allow it to more easily infect humans. In infected cows, virus particles are mostly found in their udders; the virus is thought to spread between the animals through contaminated milking equipment. Research released last week, which has not yet been peer reviewed, indicates that cows can be infected by aerosolized virus; if they can spread the virus through their exhalations and sneezes, they could become infected merely by breathing the same air. H5N1 is restless—it will continue trying to infect new hosts. Given enough opportunities to mutate, the virus will do so. “It’s like playing the lottery,” Topham said. “We’re giving this virus a lot of tickets.” H5N1 may also be able to combine with flu viruses from different animals. If cows, chickens, and other animals—say, pigs, which aren’t affected by the current outbreak—on the same farm all have different versions of the flu, “that’s your mixing vessel right there,” Topham said. The H1N1 virus that caused the 2009 swine-flu outbreak, for example, was a mix of flu viruses from pigs, humans, and birds. There is one other possible future—the best-case scenario, which unfortunately is also the least likely. The virus possibly “could disappear,” Webby said. This would partly depend on eradicating it from cows, which he believes is plausible with human intervention and herd immunity. But eliminating the virus in birds—the main animals that get bird flu and spread it—is largely out of human control. H5N1 is particularly lethal in birds, with a mortality rate of up to 100 percent for some species; if it somehow kills enough of them, Guthmiller said, it very well could just fizzle out. “Dumb luck,” as Webby put it, might still prevail. But a supercharged bird virus with a taste for infecting mammals is not the kind of thing that should be left up to chance. It is fortunate that only 11 farmworkers have been infected—as far as we know. Tools to curtail the spread of bird flu are available, but they’re not being used, or used appropriately. Personal protective equipment is helpful when worn correctly, but doing so isn’t feasible when it involves wearing respirators and Tyvek suits in temperatures that reach 104 degrees Fahrenheit. Unlike many other countries, the U.S. does not vaccinate chickens against H5N1, in part because it’s expensive to do. And cost is also why only 60 farmworkers have been tested for bird flu, giving an imperfect window into the virus’s spread. “It’s going to be a lot more costly to deal with another pandemic than to deal with immunizing our farms,” Topham said. America’s response has been painfully shortsighted, and the country is paying the price: Had bird flu been kept in check earlier, it might never have made it into cows, and might never have developed the mutations that allow it to flirt so closely with human-to-human transmission. At this point, bird flu’s future has no good options—only one that’s bad, another that’s abysmal, and one that relies on nothing but dumb luck. Read More
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Members of the Australian women's water polo team contracted Covid-19 days before the Paris Summer Olympic Games. A look at the 2024 health protocols compared with 2021. Read More
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Today, for the third time in two years, President Joe Biden tested positive for COVID-19, the White House said. The president was in Las Vegas—attempting to convince voters, donors, and his fellow lawmakers that he is still the candidate best poised to defeat former President Donald Trump in November—when he fell ill with a runny nose and cough, according to a White House statement. He’s already taking the antiviral Paxlovid and will isolate at his home in Delaware. Since Biden’s first two COVID bouts—an initial case and a rebound shortly thereafter in 2022—much has changed for the president, and for the trajectory of the pandemic. Biden’s cognitive abilities have come under more intense scrutiny, especially following a debate with Trump last month in which the president demonstrated difficulty completing sentences and holding on to a train of thought. Reported rates of COVID infections, hospitalizations, and deaths have declined—thanks in large part to vaccination—and precautions have become ever more rare. Biden is vaccinated and has superb access to medical care. Chances are, he will be fine. Yet one basic fact remains unchanged: COVID is still capable of inflicting great damage, especially upon the elderly. In June, according to provisional CDC data, about four out of every 100,000 Americans over the age of 75 (or 0.004 percent) died with COVID-19. That’s a far cry from the staggering fatality rates of 2020 (roughly 0.17 percent for the same age group in April of that year), but still sizable in comparison with younger Americans’ risk. The June 2024 COVID death rate among 30-to-39-year-olds, for example, is two out of every 10 million. Hospitalizations tell a similar story for the elderly: Last month, more than 60 out of every 100,000 Americans over 75 were hospitalized with COVID. And according to the CDC, this is likely an undercount. Still, the risks of COVID seem to increase over even just a few years of life for the elderly. People 75 or older are currently 3.5 times as likely to be hospitalized and seven times as likely to die with COVID as people ages 65 to 74. And people in their 80s can accumulate health problems with startling speed. Heart disease, diabetes, kidney disease, cancer, and stroke—all maladies more likely to affect older people—increase a person’s chances of serious complications from COVID. Biden is as likely as any American of his age to come away from this infection with minimal long-term effects. So far, according to the White House’s statement, his symptoms are mild, he has no fever, and his blood-oxygen level is normal. He was first vaccinated against COVID in 2020 and has received several shots since, most recently in September. Vaccines are proven to mitigate the most serious risks of the disease, especially among the elderly. And should things take a turn, Biden, as president, has care teams and resources at his instant disposal. That said, as far as COVID is concerned, good for an 81-year-old is not reliably good. And COVID does not have to kill someone to have troubling, lasting effects. Even mild bouts of COVID can lead to symptoms that linger for weeks or years and range from inconvenient to debilitating. In a study published today, about 7.8 percent of patients infected since Omicron became the dominant variant in the United States developed long-term symptoms. Given current concerns about the president’s health and brainpower, any further deterioration is a sobering prospect. A report published by the National Academies of Science last month found that older Americans are especially at risk of cognitive impairment following a COVID infection. What would that mean for a man who has already shown signs of substantial decline—a man subjected to the rigors of one of the most demanding jobs on the planet during the most crucial political campaign of our lifetimes, who refuses to lift the burden of American democracy from his aging shoulders? Ten days ago—after Biden’s feeble debate performance, but before a gunman attempted to assassinate his opponent at a rally—the president made a perplexing statement. Addressing the crowd at a Pennsylvania campaign event, he declared, “I ended the pandemic.” The reality is that COVID continues to upend lives every day. Americans should be mindful that it could still upend elections, too. Lila Shroff contributed reporting. Read More
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Research into the bird flu outbreaks on dairy farms describes how efficiently the virus has spread between cows and from cows to other mammals, including cats and a raccoon. Read More
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What if we could repair fundamental parts of our bodies? Gene therapy promises just that. It's like having a molecular mechanic that can fix or replace faulty genes, potentially curing diseases previously thought to be incurable. One area where gene therapy is making significant progress is in treating blood disorders. It offers hope to people with sickle cell disease or hemophilia. More recently, we have even seen success in implementing therapies directly in the body, a process known as in vivo gene editing. It's like performing microsurgery on your DNA while it's still inside you. This approach could open doors to treating many diseases with a single procedure. One study recognized and explored the potential of this in vivo therapy for blood disorders and diseases. The research paper published in Sciencediscusses a groundbreaking approach to altering hematopoietic stem cells within the body. Read More
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A large digital thermometer sits at the entrance to the gleaming mid-century-modern visitor center in Furnace Creek, California. When I arrived on Sunday afternoon, it was thronged with people with their phones out, taking pictures. A mood of anticipation hummed through the crowd. A few hours east of us, in Las Vegas, temperatures would rise to 120 degrees Fahrenheit, smashing that city’s record by three degrees. But news reports suggested that here in the heart of Death Valley National Park, the high could reach 130, matching the hottest-ever day reliably measured on Earth. At 1 p.m., the big thermometer was already flipping back and forth between 126 and 127. A ranger told us not to get excited, as the thermometer runs a degree or two hot. Our hopes were undimmed: There were still several hours to go before the day reached peak heat. In the meantime, a circus atmosphere was taking hold. I saw a man kneeling close to the ground, surrounded by a camera crew. I edged closer, thinking that he might have caught a scorpion or tarantula, and saw he had a frying pan instead. He was trying to cook a raw egg in the sun. When the clear and runny part turned white, he brayed at his doubters in triumph. People stood together in clusters, wearing floppy hats and neckerchiefs. I heard lots of French and German, and a bit of Dutch. Over the years, I’ve run into many Europeans in the big western parks. Europe has no great desert, and as a consequence, its people have become great pilgrims of arid expanses: seekers of heat, space, and light. A trio of Germans took pictures of themselves pointing to the temperature. I, too, was a tourist, and I, too, had retained a childish enthusiasm for superlatives. I wanted to experience world-record heat, not as a number in a headline, but with my body. I’d heard that Death Valley’s summers were becoming hotter, as they have been in many other places. I imagined my physical person as a kind of tuning fork for planetary change. At 3:18 p.m., the slightly overactive thermometer ticked up to 130; I later saw that, according to the National Weather Service, the temperature was only 129. I was no stranger to the scorching feel of a desert in high summer. My dad lived amid the red rock of Southern Utah for more than a decade, and I visited him in all seasons. I was just there a few weeks ago when temperatures reached 113. But 129 hits different. When you emerge into that kind of heat from an air-conditioned space, you feel its intensity before the door even closes behind you. It sets upon you from above. It is as though a clingy gargoyle made of flame has landed atop your head and neck. This gargoyle is a creature of pure desire. It wants only one thing, to bring you into thermal equilibrium with the desert. It goes for your soft spots first, reaching into the corners of your eyes, singeing your nostrils. After a few minutes pass, it tries to pull moisture straight through your skin. You feel its pinches and prickles on your forearms and calves. The breeze only makes things worse, by blasting apart the thin and fragile atmosphere of cooled air that millions of your pores produce by sweating. Your heart hammers faster and faster. Your cognition starts to blur. Only eight minutes in, I looked down at my phone. It had shut down entirely. I chose to view that as an act of solidarity. The next morning, I went for a ride with Nichole Andler, the park’s chief of interpretation. She helps visitors understand what they’re looking at, so they do more than gawk at the park’s spectacular geology. She’d sent me an email a few days earlier, “to set expectations.” We could be outside her vehicle only for 10 minutes at a time, it said. I’d rolled my eyes—I confessed this to her later—thinking that her caution was excessive, but my encounter with the heat the day before we met changed my mind. We drove along the eastern side of the valley in a white Jeep Grand Cherokee. A walkie-talkie in the center console occasionally piped up with bursts of static or number-coded reports called in by other rangers. She pointed to a hill covered in black volcanic rock. She said that in the 1970s, Carl Sagan had used its terrain to test-drive a prototype of a rover that later landed on Mars. Death Valley has also stood in for fictional planets. The Tatooine scenes in Star Wars were shot in the park because it was the kind of landscape that could have plausibly been scorched by two suns. We soon arrived at Badwater Basin, a playa wedged between two mountain ranges that shoot up straight from the valley floor. These mountains aren’t thickly forested like the Appalachians. They’re the stark, charcoal-and-brown peaks of the basin and range. The highest among them is 11,000 feet. A deep Ice Age lake once covered the valley, but after the planet warmed, it evaporated, leaving only trace minerals behind, mostly salt crystals. They lend the playa its distinctive white shimmer. At 282 feet below sea level, Badwater Basin is the lowest point in North America. There wasn’t a single cloud in the sky, not even a cirrus wisp or fading contrail. (The next day I did see a small cloud hovering over the valley’s edge, but it looked so out of place that I briefly wondered if it was a child’s lost balloon.) There isn’t much atmospheric cover, and July sunlight slams down into the valley, unimpeded, for 14 hours a day. The thick air near the bottom absorbs its heat, and rises, but not high enough to clear the mountains. Instead, the still-warm air settles back down to lower elevations and accumulates, an effect that Andler compared to that produced by a convection oven. On certain days, she said, the heat feels like it has drilled through her skin and muscle and into her bones. After a brief spell outside in 120-degree heat, rangers are advised to take anywhere from 15 to 45 minutes to cool down. They do everything they can to shorten these cool-down periods, in case they’re needed for a rescue or other urgent business. But they have to be careful: “Sometimes I get back into a hot Death Valley vehicle, turn the air-conditioning on, and start to feel refreshed, only to realize that my back is a completely different temperature than my front,” Andler said. (I pictured the gargoyle smirking at her in the rear-view mirror.) Death Valley allows its rangers to leave their parked cars running, so they are ready to serve as cooling chambers. The day before I arrived in Death Valley, the rangers had received a distress call from Badwater Basin. A group of six people had ridden motorcycles into the park and were showing signs of heat illness. “They were in the front country, and we knew their location, so rangers responded immediately,” Andler said. One of them was declared dead at the scene, not far from where Andler and I stood on the valley floor. Three others were brought to the visitor center for emergency medical attention, including one who was evacuated to a hospital in Vegas. The evacuation took extra time, because the air was too hot to send a helicopter into the park. “It’s tough when you’re on a motorcycle, because you’re exposed to the elements and you’re wearing heavy gear,” Andler said. “The only thing that I can assume is that they didn’t take enough time to cool down.” A sad silence passed between us. [Read: A new danger at America’s national parks] That night, I went to Zabriskie Point to watch the setting sun turn the valley’s wrinkled rock formations gold and pink. A crowd of extreme-heat tourists had assembled, but Andler’s story about the bikers made me feel less festive. After the sun went down, I drove back to Furnace Creek. Desert mice flitted across the road in my headlights. They were the only nonhuman mammals I’d seen apart from a coyote that padded through some sand dunes I visited at sunrise. It took two hours for Death Valley to darken. When the moon is full, the park’s salt flats take on an eerie glow, but that night the moon was just a thin crescent. It soon became so dark that I couldn’t see my own outstretched hand. One of the Milky Way’s starry arms arced from one horizon to another. I wanted to stargaze deep into the night, but could manage only half an hour: At 10:30 p.m., it was still 119 degrees on the valley floor. On my way out of the park early the next morning, I turned onto a private road. I passed a no trespassing sign and made my way onto Timbisha Shoshone land. At a small administrative office, I met with Mandi Campbell, a 50-year-old woman who serves as the tribe’s historic-preservation officer. We had just sat down to talk when an extreme-heat alert lit up both of our phones. I asked Campbell what the tribe made of all the people who come to the park just for the thrill of experiencing near-130-degree weather in person. “We think that they’re crazy,” she said. “We don’t understand why they do it. I have a police scanner at home, and it keeps going off. I keep hearing, ‘dehydration, dehydration, dehydration.’” Campbell is one of 25 tribe members who live in the Timbisha Shoshone’s ancestral homeland on the valley floor. Most have been here since birth. “This heat is nothing new to us,” she told me. “We know how to hunker down inside of our homes and try to stay cool.” Now that tribe members have air-conditioning, they live here year-round, but Campbell’s ancestors had the good sense to decamp to higher elevations during the hot months. They built a camp of summer homes on the shoulders of one of the park’s peaks centuries ago. “It’s 80 degrees up there right now,” Campbell said. “It’s nice.” The Timbisha Shoshone had been in Death Valley for more than 1,000 years when white settlers arrived during the Gold Rush. The environment proved difficult for the extractive industries. Less than a century later, the major mining company in the area pivoted to tourism. One of its executives lobbied Herbert Hoover to make Death Valley a national monument in 1933. Its first superintendent spoke openly about his desire to remove the Timbisha Shoshone. In 1957, after tribe members had left the valley floor for the summer, the park staff called in fire trucks, and ordered them to turn their hoses on the tribe’s adobe buildings. Many of their walls were reduced to mud. Only six remain, including three that house tribe members to this day. Despite this history, Campbell told me that she personally has a good relationship with the park, now that some of the tribe’s land has been returned. “We have to work together to protect this place,” she said. But she remains irked by the name Death Valley. “They called it that because they didn’t care for this place,” she said. “Their settlers weren’t making it here. But there is nothing dead about this valley. It is alive. There is plenty of food. My ancestors hunted bighorn sheep here. They hunted rabbits. They collected mesquite beans and ground them into flour to make bread. They knew where all the springs were. They had their trails, their ways. That’s how they were able to survive.” Campbell’s aunt, Pauline Esteves, was the driving force behind the tribe’s effort to reclaim its land from the U.S. government. She served as both chief activist and negotiator. I asked Campbell about her. I must have slipped into that subtle tone you use when you assume that someone is dead. “She is still alive,” Campbell said, almost in retort. “She will be 100 in December.” Esteves lives only a few houses away from the tribal office, as do two of the tribe’s other eldest elders. “They’re tougher than us,” Campbell said, and then she started to laugh. “When the electricity goes out in the summer, we are screaming to leave, but not the elders. All they want is a wet sheet to be put over them. They don’t want to go nowhere.” Read More
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Walmart is expanding its “autoimmune-focused” specialty pharmacy business to more than 30 locations across nine states as retailers beef up the more lucrative aspects of the prescription drug business. The nation’s largest retailer, which has long had traditional pharmacies in its stores, Thursday said it was opening 25 new autoimmune-focused “Specialty Pharmacies of the Community” across five states. Read More
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Last Thursday was not a good day for Joe Biden. During the president’s shaky and at times incoherent debate performance, he appeared weaker and frailer in real time than the American public had ever seen. Friday appears to have been a much better day. At a campaign rally in North Carolina, clips of which his campaign distributed online, the president seemed like an entirely different man. Lively and invigorated, he spoke with a ferocity that had eluded him on the debate stage. Both his supporters and detractors have turned this yo-yoing into a talking point that has come up frequently in the days since the debate: The president has good days and bad days. Biden himself has said that he “didn’t have my best debate night,” and his press secretary spun the performance as the result of a cold rather than “an episode.” Indeed, earlier this year, at the State of the Union, Biden appeared much more lucid. Many people have pointed to Biden’s inconsistencies as indicative of something more serious, and the challenge—perhaps the insurmountable challenge for the White House—is that it is unclear which version of Biden will show up next. The president is slated to appear in an interview with ABC’s George Stephanopoulos on Friday, and as The New York Times reported earlier today, Biden understands that another bad performance may doom his candidacy. There are many reasons a person could swing between good days and bad days. Some of them are benign. Some of them are threatening a presidency. At 81, some cognitive unevenness is to be expected. It’s also to be expected for Donald Trump, who is 78. The brain slows down as a person gets older, Steven P. Woods, a psychology professor at the University of Houston, told me. Learning and remembering don’t come as easily as they used to. Flubbing a word here or there is one thing. But executive functioning—higher-order processes that enable planning and cognitive flexibility—tends to decline too. As a result, cognition becomes less consistent. The notion of good versus bad days falls under a scientific category encompassing spontaneous changes in attention and consciousness: cognitive fluctuations. As people get older, they may experience more frequent and more significant fluctuations than before. Parts of the brain involved in learning and complex functions can shrink, and communication among certain neurons can break down. The big question, Woods said, is “what happens when fluctuations become abnormal?” What constitutes unusual cognitive variability depends entirely on the person’s overall health. A brief decline in energy or focus isn’t, on its own, a cause for concern, Woods said. Needing the occasional nap would not by itself render someone unfit for the nation’s highest office. But it could be a problem if accompanied by consistent cognitive shifts, significant medical changes, or impairments to daily life. “If you have a fluctuation where you’re no longer able to manage your day-to-day, even for a period of time, that would be abnormal to me,” Jeremy Pruzin, a cognitive-behavioral neurologist at Banner Alzheimer’s Institute, told me. Not all fluctuations caused by aging are that severe. But age is a risk factor for conditions that can worsen fluctuations, such as dementia and neurodegenerative diseases. Brain trauma, certain infectious diseases, and mood disorders are also associated with those changes. Fluctuation can take place within days, not just between them: Sundowning, largely associated with Alzheimer’s disease, refers to cognitive issues that arise in the late afternoon and early evening. A bad day can be part of a constellation of symptoms. In people with Parkinson’s disease, for example, cognitive fluctuations can accompany a soft voice, a shuffling gait, an inability to move fluidly, and a decrease in facial expression, Pruzin said. Cognitive fluctuations are also the cardinal feature of Lewy body disease, a type of dementia. According to Pruzin, people with this illness can “seem rather out of it for periods of time, then seemingly back to or close to normal within the course of hours or a day.” Biden has not reported having any of these ailments. After an annual physical in February, the president’s doctor said he was “fit for duty,” though Biden was not administered a cognitive test. But after last week, it’s entirely understandable that many Americans are asking whether something more serious is wrong with the president. Biden’s cognitive variability isn’t necessarily a sign of illness, or even old age. “We all experience good days and bad days,” regardless of age, Alexandra Fiocco, a psychology professor at Toronto Metropolitan University, told me. People misplace their coffee cups, forget the names of their colleagues, stare blankly at laptops. Nobody can be “on” all the time. Fluctuations are just part of “normal human cognition,” Woods said. External factors, such as lack of sleep, low physical activity, high stress, and certain prescription medications, can play a role. The effects of a spoiled tuna sandwich or a bad breakup can easily derail cognition. Some people naturally experience more fluctuations than others—psychologists call this “intra-individual variability”—owing to many variables, including differences in biology and brain pathology. Unfortunately for voters, there are more questions than answers about what caused Biden’s bad night. You can’t gauge cognitive variability based on a few media appearances, or even a prolonged debate. Usually, doing so requires a battery of tests and long-term observation. There is a tendency to assume that older adults have dementia when less dire factors, such as lack of sleep and dehydration, may be at play, Fiocco told me. It takes the whole picture “to determine whether somebody’s just having a bad day, or if this dramatic bad day is part of a broader syndrome related to a disease,” Pruzin noted. The public’s skepticism about Biden’s health is understandable. U.S. presidents have a record of keeping Americans in the dark about their health woes. See also: Grover Cleveland, Woodrow Wilson, and Franklin D. Roosevelt. Certainly, it’s possible that Biden didn’t get enough sleep, was especially stressed, or was impaired by a cold, as his team said last Thursday. But that possibility can coexist with another: He is just old. Read More
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Traveling overseas for procedures and treatments, known as medical tourism, is a growing trend as Americans look for ways to save on medical bills. NBC’s Vicky Nguyen breaks down what you need to know before booking a ticket. Read More
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Recent studies have repeatedly indicated a growing surge in rates of colon cancer in young individuals. A ground-breaking study published a few years ago in the Journal of the National Cancer Institute found that individuals born between the years of 1981 to 1996 faced nearly twice the risk of colorectal cancer in comparison with those born in the 1950s. A more recent study also found that for patients younger than 50 years of age, the incidence of colon cancer has increased by nearly 2% for tumors in the colon and the rectum. Additional large cohort studies since then have continued to find similar patterns. In fact, the emerging research finally convinced the U.S. Preventative Services Task Force, an organization which provides healthcare screening guidelines and recommendations, to change its recommendation for individuals to begin undergoing colon cancer screening at the age of 45, rather than the previously recommended age of 50. Read More
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Several years ago, in my work as a palliative-care doctor, I cared for a man in his 60s who had been mostly healthy before he was diagnosed with stomach cancer. After three different treatments had failed him, his oncologist and I told him that a fourth treatment might buy him a few weeks at best. “Send me back to Boston,” he said immediately. He wanted to smell the Atlantic, see his childhood home. He made it there, dying a week later. My patient died on his own terms: He was comfortable, fully informed about his worsening cancer, and able to decide where he wanted to die, whom he wanted to be with. This is the type of proverbial “good death” that our medical system is slowly learning to strive for—but not necessarily for younger people. In the hospital room next to this man was a young mother who, like me, was in her 30s. We bonded over our love of ’90s music and the Southern California beaches where we’d built sandcastles as children and stayed out late as teenagers. She, too, was dying of Stage 4 stomach cancer; I first met her when her oncology team asked if I could help manage her pain and nausea. She would rest her hands on her protruding belly, swollen with fluid and gas because cancer blocked her bowels; she couldn’t eat, so medications and liquid nutrition dripped through a large catheter threaded up a blood vessel in her arm and into her heart. Like her older neighbor, she had been through many different treatments, which had failed. Yet when she asked her oncologist how much time the next medication might buy her, I remember him telling her that he didn’t have a crystal ball while encouraging her to stay positive: She had made it through other harsh treatments, and she still had promising options. Her husband reminded her that she had a lot to live for. Conversations like this one are happening every day: An unprecedented number of young Americans are dying of cancers typically found in older people, with diagnoses rising most rapidly among those in their 30s. Millennials born in 1990—at the peak of the generation—are twice as likely to develop colon cancer as Baby Boomers born in 1950. Younger adults are being diagnosed with cancers at more advanced stages, and may suffer from more aggressive tumors than older adults. In my work caring for these patients, I have seen the ways their age influences how their medical teams and families view them, the choices about treatment we hope they will make, the silence we maintain around their mortality. Their youth can become a justification to pursue physically devastating and at times ineffective treatment; the unspoken assumption is that they want to extend their life as long as possible, regardless of its quality. My patient knew that her cancer was incurable, that every time one treatment stopped working, the next one was likely to be harsher and less effective. Though she had once found consolation in the possibility of more treatment, she now feared that it might worsen her struggle to make it through each day. Yet even as her cancer grew, both her doctors and her family hesitated to talk with her about the inevitability of her death, and what she wanted the rest of her life to look like. [Read: The meaning of silence in conversations about death] Younger adults face unique stressors when they are diagnosed with cancer: They might worry about whether they will be able to have children or see their children grow up. They may not have stable health insurance or be able to finish school. And they must face sudden uncertainty and grief while watching their peers move forward in their jobs and relationships. Physicians’ efforts to be sensitive to this constellation of losses by delaying emotionally charged conversations may be well intentioned, but that instinct hurts younger patients in a different way, by depriving them of information and choices offered more easily to older patients. And young patients want information about their prognosis and the opportunity to share how they’d like to be cared for at the end of their life. Without these discussions, many suffer through situations they wanted to avoid, such as dying in the ICU instead of at home, and physicians may overtreat younger people with harsher and sometimes unproven therapy strategies not offered as readily to older patients. Those treatments help even younger people survive only marginally longer. My patient’s oncologist believed that her body and healthy organs could endure toxic therapies; the question of whether she could endure, let alone enjoy, the life she was living came a distant second. Just because the majority of her organs still worked didn’t mean that she’d want more treatment, or that more treatment would help her to live the life she wanted. [Listen: How to live when you’re in pain] Still, her family wanted her to have every possible chance, even though she struggled to play with her son, who mostly saw her sick or asleep. “A chance for what?” she asked me, gesturing at her bruised arms and a bin filled with vomit. She craved freedom from hospitals and chemotherapy suites. She didn’t know if she was allowed to want that. Physicians’ own understandable feelings sometimes delay these discussions. Abby Rosenberg, a pediatric oncologist at Boston Children’s Hospital, has spoken about how physicians sometimes avoid starting distressing conversations because “we love our patients and don’t want to cause them pain or harm,” only to find that this “delay tactic ends up causing more distress down the road.” Many doctors feel a profound sense of guilt and failure when they cannot save a young patient’s life. Yet age cannot stop the advance of Stage 4 cancer or change the fact that, at some point, treatment no longer works. Merely acknowledging that my patient was dying felt transgressive. But when an octogenarian is dying, there is often an unspoken—and sometimes spoken—sentiment that they have led a full life, that death is both natural and expected, somehow less devastating and easier to address. [From the October 2014 issue: Why I hope to die at 75] But what is a full life? How does anyone know that a young person hasn’t lived fully, or that an older person has? Helping people find that satisfaction requires doctors to ask what that means to their patients. Their answers reflect who they are, what matters to them, and what they will make of their remaining time. These are important conversations to have with every patient: Plenty of people of all ages are still offered aggressive treatment as a matter of course, or end up facing death under circumstances they might not have desired. As the number of younger people with cancer continues to rise, physicians who embrace their duty to have truthful, compassionate conversations with all patients can help each person make choices that reflect their singular humanity. I, too, struggled to see past my patient’s age. It was simpler to talk about mixtapes we’d made in high school than the reality of her illness. But as she became sicker, I understood that avoiding that reality was protecting only me, and that my silence could deprive her of moments for grace with her family. Doctoring well required learning the difference between my distress and my patient’s, how focusing on my emotions limited my ability to understand hers. Knowing how to start a conversation about death with someone in their 20s or 30s can be difficult. Voicing My Choices, an advance-care-planning guide developed for young patients, offers gentle questions that may be useful in early discussions. In addition to posing routine questions about treatment choices and identifying a surrogate decision maker, the document prompts a health-care provider to ask how a person prefers to be comforted, how they would like to be supported when feeling lonely, how they may wish to be remembered, what they want to be forgiven for or forgive others for. These questions illuminate who a patient is and what they value—information that can shape their choices regardless of their age or diagnosis. Understanding the person who is making decisions helps families and physicians find greater peace in accepting that person’s choices, whether they opt for the most aggressive medical treatments until they die or interventions that minimize their suffering. [Read: Where end-of-life care falls short] When her oncologist and I met with my patient next, she demanded to know what the point of more treatment was. Whatever choice she made, her oncologist told her, she probably had weeks to live. Her face relaxed. Just like my patient from Boston, she seemed relieved to hear aloud what at some level she already knew. She didn’t want more treatment, and she and her family, craving privacy, weren’t emotionally prepared for her to enter home hospice, which would bring medical professionals through their doors regularly. She opted, for the moment, only to continue medication to ease her nausea and pain; she’d come back to hospital for any other needs. Before she left, she shared with me what she was looking forward to. Lemonade, even if she vomited. Sleeping in her own bed. Searching for stars outside her window with her son, even if, amid the winter’s haze, they saw just a few. Read More
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People who test positive for Covid don’t need to isolate for five days, according to recent guidance from the Centers for Disease Control and Prevention. Read More
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Adults in many parts of the U.K. face waits of up to eight years to be assessed for a behavioral disorder, a BBC investigation has found. Freedom of information requests revealed some 200,000 people were waiting for attention deficit hyperactivity disorder assessments across two dozen public providers. Read More
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This article was featured in the One Story to Read Today newsletter. Sign up for it here. Times are tough for omnivores. By now, you’ve heard all the reasons to eat less meat: your health, the planet, the animals. All that might be true, but for many meat-eaters, vegetables aren’t always delicious on their own. Pitiful are the collards without the ham hock, the peppers without the sausage, the snap peas without the shrimp. In my family’s universe, meat is the sun around which vegetables, beans, and grains revolve. Take it away, and dinner descends into chaos. As the cook of the family, I’m constantly trying to find ways to reduce our meat consumption. But the mouths I feed, mine included, still crave the taste of meat. Eating less meat and more vegetables can be really difficult—in part because the current meat replacements are so lacking. Do you really crave tempeh? Or a black-bean burger? Yet a solution might already await in your refrigerator—an ingredient that’s easily as savory and satisfying as meat. Toothsome and funky, rich with umami, it makes up for meat’s absence, and then some. If there’s one thing that can turn meat-eaters into plant-lovers, it’s cheese. Adding cheese to vegetables is kitchen sorcery. A dusting of Parmesan transforms humble pasta with beans into a filling Italian dinner; slices of grilled Halloumi turn a plate of greens into lunch. In one viral recipe, a slab of feta is baked with tomatoes and garlic to create a luscious pasta sauce. The natural order of a meal: restored. For generations, cooks have used cheese to entice people to eat their vegetables. In other words, cheese is a meat replacement, even though an Italian nonna may not call it that. Cheese can help address the issues posed by meat and its imitators. Although plant-based meat is an improvement on some of these fronts, drawbacks related to taste, cost, and nutrition remain. As declining demand suggests, it’s far from perfect. Lab-grown meat that is theoretically identical to meat is still a long way off. Tofu is, well, tofu—healthy and minimally harmful for the planet, but most appetizing when slathered in oily, salty sauce. In these regards, cheese isn’t perfect, either. But it’s better than meat. Yes, even in terms of health. The long-held belief that cheese is bad for you has been complicated by research—it turns out to depend on what you’d eat instead. Cheese has a bad rap because of its high saturated-fat content. Dietary guidelines warn that saturated fat causes weight gain, which in turn raises the risk of heart disease, diabetes, and other health conditions. All of that is true. Yet perplexingly, large studies show no relationship between cheese consumption and weight gain. In some studies, for reasons that have yet to be explained, eating cheese is even linked to lower weight. Meat isn’t uniformly bad for you; red and processed types seem to be the worst offenders. And cheese comes out looking even better when it’s specifically eaten as an alternative. The effect of substituting just 1.8 ounces of red or processed meat a day with an ounce of cheese could decrease the incidence of diabetes by 8.8 percent, according to one modeling study. “If you consume a lot of meat, then replacing some of it with cheese is likely better for your health,” Daniel Ibsen, a nutrition professor at Aarhus University, in Denmark, who led that study, told me. Part of the explanation is that some beneficial elements of cheese, such as good fatty acids and probiotic bacteria, may compensate for its unhealthy qualities. But the main reason is likely that red and processed meats are just so bad for you that replacing them with virtually any other protein source is probably better. Then there is the climate concern. Cheese—especially hard varieties, which require more milk to produce—is unquestionably tough on the planet. The fact that it comes from cows is not great. It has the fourth-highest emissions among major protein sources, after beef, lamb, and farmed crustaceans. Producing 1.7 ounces of cheese emits the same amount of carbon dioxide as charging 356 smartphones using conventional power sources. But here’s the catch: Cheese is typically consumed in far smaller serving sizes than meat. Most of us don’t regularly down a steak-size hunk of Gouda for dinner or substitute a wheel of Camembert for a burger patty. Americans ate nearly 42 pounds of cheese per capita in 2022, a record-breaking amount—yet meat consumption has hovered around 250 pounds annually for the past two decades. A little cheese goes a long way. Cheese is not a one-to-one meat replacement but rather a way to make plant-based dishes more exciting without missing the meat. This principle has shaped dinner at my house. When plant-based dishes seem too plain, too spartan, too veggie, I think about how to incorporate a bit of cheese. Humdrum asparagus? Lay it down on a bed of labneh. Cheerless lentils? Invigorate them with goat cheese. The dish that might single-handedly turn my family into vegetarians is a northern-Indian dish called saag paneer, in which spiced puréed spinach envelops cubes of squishy, salty, chewy paneer cheese. It’s essentially a meat stew, only the meat is cheese. Switching from a meat-centered diet to one based on cheese should not be the end goal. Whether cheese is “healthy” depends on who’s eating it: A person concerned about diabetes might benefit from using it in lieu of red meat, but not someone worried about cardiovascular risk, Ibsen said. Cheese doesn’t come cheap—and if you are lactose intolerant, this isn’t for you. Cheese isn’t the new meat—rather, it’s the bridge to a meatless future, one where calls to enjoy vegetables on their own aren’t annoying, because omnivores are all a little more creative about what a satisfying meal can be. Cauliflower can be seared like steak, mushrooms shredded like chicken, crushed walnuts sautéed like ground chuck. But discovering the joys of meatless cooking takes time. For now, a sprinkling of cheese won’t hurt. Read More
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Twice-yearly shots used to treat AIDS were 100% effective in preventing new infections in women, according to study results that experts are calling "stunning." Read More
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How does Synchron's new OpenAI ChatGPT integration impact commercial brain-computer interface (BCI) markets? I spoke with Founder & CEO Tom Oxley to find out. Read More
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This article was originally published by Undark Magazine. For more than a decade, in blog posts and scientific papers and public talks, the psychologist Hal Herzog has questioned whether owning pets makes people happier and healthier. It is a lonely quest, convincing people that puppies and kittens may not actually be terrific for their physical and mental health. “When I talk to people about this,” Herzog told me, “nobody believes me.” A prominent professor at a major public university once described him as “a super curmudgeon” who is, in effect, “trying to prove that apple pie causes cancer.” As a teenager in New Jersey in the 1960s, Herzog kept dogs and cats, as well as an iguana, a duck, and a boa constrictor. Now a professor emeritus at Western Carolina University, he insists that he’s not out to smear anyone’s furry friends. In a 2012 blog post questioning the so-called pet effect, Herzog included a photo of his cat, Tilly. “She makes my life better,” he wrote. “Please Don’t Blame The Messenger!” Plenty of people believe that there’s something salubrious about caring for a pet, similar to eating veggies or exercising regularly. But, Herzog argues, the scientific evidence that pets can consistently make people healthier is, at best, inconclusive—and, at worst, has been used to mislead the American public. Few experts say that Herzog is exactly wrong—at least about the science. Over the past 30 or so years, researchers have published many studies exploring a link between pet ownership and a range of hypothesized benefits, including improved heart health, longer life spans, and lower rates of anxiety and depression. The results have been mixed. Studies sometimes fail to find any robust link between pets and well-being, and some even find evidence of harm. In many cases, the studies simply can’t determine whether pets cause the observed effect or are simply correlated with it. Where Herzog and some other experts have concerns is with the way those mixed results have been packaged and sold to the public. Tied up in that critique are pointed questions about the role of industry money on the development of the field—a trend that happens across scientific endeavors, particularly those that don’t garner much attention from federal agencies, philanthropies, and other funding sources. The pet-care industry has invested millions of dollars in human-animal-interaction research, mostly since the late 2000s. Feel-good findings have been trumpeted by industry press releases and, in turn, have dominated news coverage. At times, industry figures have even framed pet ownership as a kind of public-health intervention. “Everybody should quit smoking. Everybody should go to the gym. Everybody should eat more fruits and vegetables. And everyone should own a pet,” Steven Feldman, the president of the industry-funded Human Animal Bond Research Institute (HABRI), said in a 2015 podcast interview. The problem with that kind of argument, Herzog and other experts say, is that it gets ahead of the evidence (also, not every person is equipped to care for a pet). “Most studies,” Herzog says, “do not show the pattern of results that the pet-products industry claims.” It seems safe to say that most people don’t get a dog in order to marginally lower their odds of developing heart disease. Research on the health benefits of pets falls into a strange family of science that measures the practical health outcomes of things people typically do for decidedly nonpractical reasons, such as get married and have children. [Read: Pets really can be like human family] At the same time, there’s evidence—much of it anecdotal—that at least some people are cognizant of the potential health benefits when choosing to get a pet. And the idea makes intuitive sense to many people, who say that their animals are good for their well-being. Concurrently, hospitals and nonprofits have rolled out programs that aim to use therapy dogs and support animals to improve people’s mental health. James Serpell began studying the pet effect in the early 1980s, as a young animal-behavior researcher. At the time, spending on pets was rising in the United States. But there was little research on people’s relationships with their animals. “Why are we doing this?” Serpell wondered. “What’s it all about?” In an influential 1991 paper comparing non–pet owners with people who had recently adopted an animal, he supplied crucial data suggesting that new pet owners experienced a measurable reduction in minor health problems. New dog owners also pursued more physical activity, compared with people who had cats or no pets at all. In the decades since, researchers have published many studies comparing pet owners and non–pet owners. The results are mixed, sometimes pointing toward health benefits, and sometimes not. Some of that data may reflect the realities of human-animal relationships—which, like any kind of relationship, can vary for all sorts of reasons. “It doesn’t mean that my lived experience or anyone else’s lived experience is wrong,” says Megan Mueller, a human-animal-interaction expert at Tufts University. “What it means is that it’s different for different people.” For some people, she says, having a pet can bring on stressors. The caretaking responsibilities may be too taxing; the pet may exacerbate family tensions or trigger allergies; the owner may be unable to afford pet food or veterinary care. The results, some experts say, are also muddied by issues with research methods. The problem is that there are differences between the people who choose to own pets and the people who don’t. “What happens is, we try to compare people with pets to people without pets, and then we say, ‘People with pets have X, Y, and Z differences.’ It actually is a really invalid way of approaching the research question,” says Kerri Rodriguez, who directs the Human-Animal Bond Lab at the University of Arizona. A study finding that pet owners are more likely to be depressed, for example, may be picking up on a real connection. But it could just be that people already experiencing depression are likelier to get pets. [Read: Cats are not medicine] Today, Rodriguez mostly studies service animals, especially for veterans at risk for PTSD. In this context, it’s possible to conduct randomized trials—for example, randomly choosing who will get a support animal now, and who will go on a waitlist to get a companion animal later. Some research on service dogs—including a recent controlled, but not randomized, trial that Rodriguez was involved with—has shown clear benefits. How much those benefits apply to typical pet owners, experts say, is unclear. And it’s hampered by researchers’ inability to conduct randomized trials. (“You can’t randomize people to pet ownership,” Rodriguez says.) Rodriguez says she’s interested in studies that track the association between human-pet relationships and health over time, checking in with people again and again and collecting larger amounts of data. One such study, for example, found a slower rate of decline in cognitive function among older pet owners. Serpell, after his 1991 study, largely moved on to other research questions. “I basically concluded that this type of research was too difficult,” he says. “And even if you did it, the results you would get would always be questionable.” These doubts have not deterred interest in the field from the companies that lead the pet industry, which is today valued globally at more than $300 billion. Almost from the start, the quest to understand the health effects of pets has been entangled with industry money. Serpell’s earliest work was funded by what is now known as the Waltham Petcare Science Institute, a division of Mars, which owns a portfolio of pet-food and veterinary-care brands in addition to its famous candy business. “There was no other source of funding, really,” recalls Serpell, who’s now an emeritus professor at the University of Pennsylvania. “Nobody else was willing to put money into this field.” In 2008, Mars entered into a partnership with the National Institutes of Health in order to spur more research into the relationship between human-animal interactions. In the first year, the pet-product provider ponied up $250,000, while the federal government supplied $1.75 million. (The NIH partnership ended in 2022, although Mars continues to underwrite research on pets and human health.) In 2010, a group of pet-industry heavyweights launched HABRI. Key funders have included Petco, Nestlé Purina PetCare, and Zoetis, a veterinary-pharmaceuticals firm. “Pets and animals make the world a better place, and we’re going to use science to prove it,” Feldman, HABRI’s president, said in a 2014 talk at a conference for pet bloggers. The nonprofit has spent more than $3 million funding research on human-animal interactions. Companies also directly fund university research: One prominent research group at the University of Arizona—separate from Rodriguez’s lab—includes a sponsor page on its website featuring the logos of Nestlé Purina, Waltham, the veterinary drugmaker Elanco, and other pet-product companies. “Funding from the pet industry has transformed the field, and without it, we would not have the science that we have,” Mueller says. (Like Serpell and Rodriguez, Mueller has received industry funding for some of her research.) Did that funding shape the field’s findings? “I think it has largely been done in a really ethical way,” Mueller says. She and Rodriguez both say they have never felt pressure to produce a particular result. Waltham, when it entered the partnership with NIH, gave up the right to select who would get the funding. Industry-funded studies have found—and published—results that suggest little benefit from pets. “I really think that the field has done a good job of publishing a lot of findings that are maybe not what people would expect,” Mueller says. Herzog says he has seen little evidence that industry money has changed the science. Mostly, he says, “they’ve funded pretty good studies.” But there are ways that industry funding can change the field. “It’s always been a source of great ambivalence, I think, for everybody involved,” Serpell says. “You try and work around it, by getting whoever funds the work to stay off your back and let you do the work, and if they don’t like the results, that probably means the next time you apply to them for funding, you won’t get it.” Funding can shape the questions that a field asks—or avoids. “Industry-funded studies tend to produce results that favor the sponsor’s interest,” says Marion Nestle, an emeritus professor at New York University who has spent decades studying corporate influence on science. Sponsors influence what gets studied, Nestle says, and they select for studies that they think will produce positive results. And, she says, research suggests that sponsorship can shape the way results are interpreted—often without researchers being aware of the influence at all. Controlling the focus of the research can also steer scientists away from certain topics entirely. “For obvious reasons, these companies don’t wish to draw attention to the darker side of the human-pet relationship,” Serpell says, referring to research areas such as dog bites. In a recent Zoom interview, Feldman told me that funders “can tell us what kind of things they’re hoping to see,” and the organization will try to accommodate those requests: “But then, once the process of funding a project begins, there’s absolutely no influence there whatsoever.” [Read: Too many people own dogs] HABRI embraces negative results, or those that don’t show a clear effect from pet ownership, and not just positive findings, Feldman said. But, he acknowledged, they may choose to emphasize positive results. “We try and be very true to the science, but if we take a slightly more optimistic view as to the body of work than researchers who take a different perspective, I think that helps generate a lot of positive behavior in the real world.” Herzog, Feldman suggested, was making a name for himself with naysaying—in ways that, perhaps, sometimes defy common sense. A 2021 HABRI survey found that nearly nine in 10 pet owners report that their pets benefit their mental health. “I kind of think pet owners might be onto something,” Feldman said. Herzog agrees that having a pet can have real benefits. At the end of a recent conversation, he reflected on his cat, Tilly, who died in 2022. She used to watch TV with him in the evenings, and she would curl up on a rocking chair in his basement office while he worked. The benefits of their relationship, Herzog said, were real but perhaps hard to measure—among the intangible qualities that are difficult to capture on research surveys. “If you’d asked me, ‘Did Tilly improve the quality of your life?,’ I’d say ‘Absolutely,’” he said. “My health? Nah.” Read More
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Dermatologist and TODAY contributor Dr. Michelle Henry stops by Studio 1A to share ways to care for your skin during the summer, including how to keep your nails hydrated, how to treat blisters from a sunburn, and more. Read More
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Although previous research found greater levels of lean muscle mass may decrease the risk of neurodegeneration, this study suggests having greater muscle strength may be more important than muscle quantity. Read More
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Pharmacy benefit managers, the middlemen who negotiate drug prices for millions of Americans, were grilled at a congressional hearing. Executives of the three biggest companies pushed back against allegations of patient exploitation. NBC News' Erin McLaughlin reports. Read More
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Cows from Texas likely infected healthy cows in Ohio and probably spread the virus to cats, a racoon and wild birds on farms through their milk, scientists said, raising fears the virus may be changing to better infect mammals like humans. Read More
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A Washington state woman who got tuberculosis and was arrested after refusing to isolate or take medication has been cured, health officials announced. Read More
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“If our team members feel that they're simply cogs in a corporate machine, I guarantee you they will deliver care in that manner and patients will feel the same way.” — Mike Oshiki, MD, MS, FAAFP, FACHE, president of Riverside Regional Medical Center and Acute Care Division for Riverside Health System Read More
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Democratic and Republican lawmakers found common ground with one another during an oversight committee hearing Tuesday, blaming executives from three major pharmacy middlemen groups for the sky-high prescription drug prices in the United States. Read More
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British regulators have approved anti-obesity drug Wegovy to prevent serious cardiovascular problems in some overweight and obese patients. The U.K.’s Medicines and Healthcare Regulatory Agency gave the green light to Novo Nordisk’s blockbuster semaglutide injection following the results of a major international trial. Read More
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Humanitarian groups and public health leaders around the world are extremely worried that polio may be spreading in Gaza, after tests found the virus in wastewater samples. Read More
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Playing Dungeons & Dragons provides social connection, a creative outlet, and a sense of control that benefits their mental health, according to new research. Read More
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If you have wide feet, you’re probably familiar with the feeling of sneakers pinching or feeling too tight around the side of your feet. But having wide feet shouldn’t stop you from having your Cinderella moment. You may just need to focus on sneakers that have a wide width to find the perfect running or walking shoe. “The right shoe will feel comfortable, provide adequate space for your toes to move freely, and support your foot’s natural shape and alignment,” says Dr. Isaac Tabari, a board-certified foot and ankle doctor and owner of the NYC Podiatry Center of Excellence. Thankfully, there are plenty of sneaker brands — like New Balance, Hoka and Brooks — that make shoes specifically for people with wide feet. I interviewed podiatrists about what to look for when shopping for the best women’s wide sneakers for running and walking. I included their picks along with highly-rated options and NBC Select staff recommendations that come in wide widths. Read More
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By the time Henry Ford introduced the Model T in 1908, the automotive industry had been around for 15 years, and competition was fierce, with approximately 200 manufacturers. Just 20 years later, automotive sales had increased by ~10X, but the number of manufacturers had dropped to 24. Read More
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An Iowa law banning most abortions will take effect Monday. It prohibits abortions after a fetal heartbeat is detected — around six weeks into pregnancy. Read More