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nrashkind

Cardiac injury among Covid-19 patients tied to higher risk of death - CNN - 0 views

shared by nrashkind on 29 Mar 20 - No Cached
  • Heart injury could be a common condition in patients hospitalized with Covid-19, according to a new study that also shows it's linked to a greater risk of death among those patients.
  • Cardiac injury, also referred to as myocardial injury, occurs when there is damage to the heart muscle, and such damage can occur when blood flow to the heart is reduced -- which is what causes a heart attack.
  • "An elevated troponin doesn't always mean a heart attack but it does mean myocardial injury or heart damage," said Dr. Erin Michos, the associate director of preventive cardiology at Johns Hopkins Medicine in Baltimore, who was not involved in the study.
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  • The data also revealed that the death rate was higher among patients with cardiac injury versus those without: 42 of the patients with cardiac injury, or 51.2%, died versus 15 of those without, or 4.5%.
  • Also, acute inflammatory responses due to an infection can lead to reduced blood flow in patients with preexisting cardiovascular diseases, the researchers noted. They wrote that "based on these lines of evidence, we hypothesize that an intense inflammatory response superimposed on preexisting cardiovascular disease may precipitate cardiac injury."Investigating inflammation
  • "Even though they're not dying from that cardiac injury, something about that biomarker is providing some prognostic value beyond other risk factors that were controlled, so it could still be important in terms of identifying high-risk patients that enter the hospital with Covid-19," Gump said.
  • To better understand that mechanism, Madjid said that he has looked to flu viruses.
  • The finding's in Wednesday's JAMA Cardiology paper "make a lot of sense," Kevin Heffernan, director of the Human Performance Laboratory at Syracuse University in New York, who was not involved in the study, wrote in an email on Wednesday.
  • A separate study published in the New England Journal of Medicine in 2018 found a significant association between respiratory infections, especially influenza, and acute heart attack, he said.
  • Inflammation appears to be the mechanism that best explains the association between cardiac injury and Covid-19, said Dr. Mohammad Madjid, a cardiologist and assistant professor at McGovern Medical School at UTHealth in Houston.
  • "To date, many patients with COVID-19 are still hospitalized in China and other countries, such as Italy and Iran.
  • Therefore, we should be ready for the reemergence of COVID-19 or other coronaviruses."
Javier E

The Dark Power of Fraternities - The Atlantic - 0 views

  • College fraternities—by which term of art I refer to the formerly all-white, now nominally integrated men’s “general” or “social” fraternities, and not the several other types of fraternities on American campuses (religious, ethnic, academic)—are as old, almost, as the republic.
  • While the system has produced its share of poets, aesthetes, and Henry James scholars, it is far more famous for its success in the powerhouse fraternity fields of business, law, and politics. An astonishing number of CEOs of Fortune 500 companies, congressmen and male senators, and American presidents have belonged to fraternities
  • They also have a long, dark history of violence against their own members and visitors to their houses, which makes them in many respects at odds with the core mission of college itself.
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  • A recent series of articles on fraternities by Bloomberg News’s David Glovin and John Hechinger notes that since 2005, more than 60 people—the majority of them students—have died in incidents linked to fraternities, a sobering number in itself, but one that is dwarfed by the numbers of serious injuries, assaults, and sexual crimes that regularly take place in these houses.
  • I have spent most of the past year looking deeply into the questions posed by these lawsuits, and more generally into the particular nature of fraternity life on the modern American campus
  • to answer the vexing question “why don’t colleges just get rid of their bad fraternities?”—the system, and its individual frats, have only grown in power and influence. Indeed, in many substantive ways, fraternities are now mightier than the colleges and universities that host them.
  • The entire multibillion-dollar, 2,000-campus American college system
  • the Kappa Alpha Society. Word of the group spread, and a new kind of college institution was founded, and with it a brand-new notion: that going to college could include some pleasure. It was the American age of societies, and this new type fit right in.
  • every moment of the experience is sweetened by the general understanding that with each kegger and rager, each lazy afternoon spent snoozing on the quad (a forgotten highlighter slowly drying out on the open pages of Introduction to Economics, a Coke Zero sweating beside it), they are actively engaged in the most significant act of self-improvement available to an American young person: college!
  • There are many thousands of American undergraduates whose economic futures (and those of their parents) would be far brighter if they knocked off some of their general-education requirements online, or at the local community college—for pennies on the dollar—before entering the Weimar Republic of traditional-college pricing. But college education, like weddings and funerals, tends to prompt irrational financial decision making,
  • depends overwhelmingly for its very existence on one resource: an ever-renewing supply of fee-paying undergraduates. It could never attract hundreds of thousands of them each year—many of them woefully unprepared for the experience, a staggering number (some 40 percent) destined never to get a degree, more than 60 percent of them saddled with student loans that they very well may carry with them to their deathbeds—if the experience were not accurately marketed as a blast.
  • When colleges tried to shut them down, fraternities asserted that any threat to men’s membership in the clubs constituted an infringement of their right to freedom of association. It was, at best, a legally delicate argument, but it was a symbolically potent one, and it has withstood through the years. The powerful and well-funded political-action committee that represents fraternities in Washington has fought successfully to ensure that freedom-of-association language is included in all higher-education reauthorization legislation, thus “disallowing public Universities the ability to ban fraternities.”
  • While the fraternities continued to exert their independence from the colleges with which they were affiliated, these same colleges started to develop an increasingly bedeviling kind of interdependence with the accursed societies
  • the fraternities involved themselves very deeply in the business of student housing, which provided tremendous financial savings to their host institutions, and allowed them to expand the number of students they could admit. Today, one in eight American students at four-year colleges lives in a Greek house
  • fraternities tie alumni to their colleges in a powerful and lucrative way. At least one study has affirmed what had long been assumed: that fraternity men tend to be generous to their alma maters. Furthermore, fraternities provide colleges with unlimited social programming of a kind that is highly attractive to legions of potential students
  • It is true that fraternity lawsuits tend to involve at least one, and often more, of the four horsemen of the student-life apocalypse, a set of factors that exist far beyond frat row
  • the binge-drinking epidemic, which anyone outside the problem has a hard time grasping as serious (everyone drinks in college!) and which anyone with knowledge of the current situation understands as a lurid and complicated disaster
  • The second is the issue of sexual assault of female undergraduates by their male peers, a subject of urgent importance but one that remains stubbornly difficult even to quantify
  • The third is the growing pervasiveness of violent hazing on campus
  • But it’s impossible to examine particular types of campus calamity and not find that a large number of them cluster at fraternity houses
  • the fourth is the fact that Boomers, who in their own days destroyed the doctrine of in loco parentis so that they could party in blissful, unsupervised freedom, have grown up into the helicopter parents of today
  • during the period of time under consideration, serious falls from fraternity houses on the two Palouse campuses far outnumbered those from other types of student residences, including privately owned apartments occupied by students. I began to view Amanda Andaverde’s situation in a new light.
  • Why are so many colleges allowing students to live and party in such unsafe locations? And why do the lawsuits against fraternities for this kind of serious injury and death—so predictable and so preventable—have such a hard time getting traction? The answers lie in the recent history of fraternities and the colleges and universities that host them.
  • This question is perhaps most elegantly expressed in the subtitle of Robert D. Bickel and Peter F. Lake’s authoritative 1999 book on the subject, The Rights and Responsibilities of the Modern University: Who Assumes the Risks of College Life?
  • The answer to this question has been steadily evolving ever since the 1960s, when dramatic changes took place on American campuses, changes that affected both a university’s ability to control student behavior and the status of fraternities in the undergraduate firmament. During this period of student unrest, the fraternities—long the unquestioned leaders in the area of sabotaging or ignoring the patriarchal control of school administrators—became the exact opposite: representatives of the very status quo the new activists sought to overthrow. Suddenly their beer bashes and sorority mixers, their panty raids and obsession with the big game, seemed impossibly reactionary when compared with the mind-altering drugs being sampled in off-campus apartments where sexual liberation was being born and the Little Red Book proved, if nothing else, a fantastic coaster for a leaky bong.
  • American colleges began to regard their students not as dependents whose private lives they must shape and monitor, but as adult consumers whose contract was solely for an education, not an upbringing. The doctrine of in loco parentis was abolished at school after school.
  • Through it all, fraternities—for so long the repositories of the most outrageous behavior—moldered, all but forgotten.
  • Animal House, released in 1978, at once predicted and to no small extent occasioned the roaring return of fraternity life that began in the early ’80s and that gave birth to today’s vital Greek scene
  • In this newly forming culture, the drugs and personal liberation of the ’60s would be paired with the self-serving materialism of the ’80s, all of which made partying for its own sake—and not as a philosophical adjunct to solving some complicated problem in Southeast Asia—a righteous activity for the pampered young collegian. Fraternity life was reborn with a vengeance.
  • These new members and their countless guests brought with them hard drugs, new and ever-developing sexual attitudes, and a stunningly high tolerance for squalor
  • Adult supervision was nowhere to be found. Colleges had little authority to intervene in what took place in the personal lives of its students visiting private property. Fraternities, eager to provide their members with the independence that is at the heart of the system—and responsive to members’ wish for the same level of freedom that non-Greek students enjoyed—had largely gotten rid of the live-in resident advisers who had once provided some sort of check on the brothers
  • , in 1984 Congress passed the National Minimum Drinking Age Act, with the ultimate result of raising the legal drinking age to 21 in all 50 states. This change moved college partying away from bars and college-sponsored events and toward private houses—an ideal situation for fraternities
  • lawsuits began to pour in.
  • Liability insurance became both ruinously expensive and increasingly difficult to obtain. The insurance industry ranked American fraternities as the sixth-worst insurance risk in the country—just ahead of toxic-waste-removal companies.
  • For fraternities to survive, they needed to do four separate but related things: take the task of acquiring insurance out of the hands of the local chapters and place it in the hands of the vast national organizations; develop procedures and policies that would transfer as much of their liability as possible to outside parties; find new and creative means of protecting their massive assets from juries; and—perhaps most important of all—find a way of indemnifying the national and local organizations from the dangerous and illegal behavior of some of their undergraduate members.
  • comprising a set of realities you should absolutely understand in detail if your son ever decides to join a fraternity.
  • you may think you belong to Tau Kappa Epsilon or Sigma Nu or Delta Tau Delta—but if you find yourself a part of life-changing litigation involving one of those outfits, what you really belong to is FIPG, because its risk-management policy (and your adherence to or violation of it) will determine your fate far more than the vows you made during your initiation ritual
  • the need to manage or transfer risk presented by alcohol is perhaps the most important factor in protecting the system’s longevity. Any plaintiff’s attorney worth his salt knows how to use relevant social-host and dramshop laws against a fraternity; to avoid this kind of liability, the fraternity needs to establish that the young men being charged were not acting within the scope of their status as fraternity members. Once they violated their frat’s alcohol policy, they parted company with the frat.
  • there are actually only two FIPG-approved means of serving drinks at a frat party. The first is to hire a third-party vendor who will sell drinks and to whom some liability—most significant, that of checking whether drinkers are of legal age—will be transferred. The second and far more common is to have a BYO event, in which the liability for each bottle of alcohol resides solely in the person who brought it.
  • these policies make it possible for fraternities to be the one industry in the country in which every aspect of serving alcohol can be monitored and managed by people who are legally too young to drink it.
  • But when the inevitable catastrophes do happen, that policy can come to seem more like a cynical hoax than a real-world solution to a serious problem.
  • Thanks in part to the guest/witness list, Larry can be cut loose, both from the expensive insurance he was required to help pay for (by dint of his dues) as a precondition of membership, and from any legal defense paid for by the organization. What will happen to Larry now?
  • “I’ve recovered millions and millions of dollars from homeowners’ policies,” a top fraternal plaintiff’s attorney told me. For that is how many of the claims against boys who violate the strict policies are paid: from their parents’ homeowners’ insurance
  • , the Fraternal Information and Programming Group’s chillingly comprehensive crisis-management plan was included in its manual for many years
  • the plan serves a dual purpose, at once benevolent and mercenary. The benevolent part is accomplished by the clear directive that injured parties are to receive immediate medical attention, and that all fraternity brothers who come into contact with the relevant emergency workers are to be completely forthright
  • “Until proven otherwise,” Fierberg told me in April of fraternities, “they all are very risky organizations for young people to be involved in.” He maintains that fraternities “are part of an industry that has tremendous risk and a tremendous history of rape, serious injury, and death, and the vast majority share common risk-management policies that are fundamentally flawed. Most of them are awash in alcohol. And most if not all of them are bereft of any meaningful adult supervision.”
  • the interests of the national organization and the individual members cleave sharply as this crisis-management plan is followed. Those questionnaires and honest accounts—submitted gratefully to the grown-ups who have arrived, the brothers believe, to help them—may return to haunt many of the brothers, providing possible cause for separating them from the fraternity, dropping them from the fraternity’s insurance, laying the blame on them as individuals and not on the fraternity as the sponsoring organization.
  • So here is the essential question: In the matter of these disasters, are fraternities acting in an ethical manner, requiring good behavior from their members and punishing them soundly for bad or even horrific decisions? Or are they keeping a cool distance from the mayhem, knowing full well that misbehavior occurs with regularity (“most events take place at night”) and doing nothing about it until the inevitable tragedy occurs, at which point they cajole members into incriminating themselves via a crisis-management plan presented as being in their favor?
  • I have had long and wide-ranging conversations with both men, in which each put forth his perspective on the situation.
  • the young men who typically rush so gratefully into the open arms of the representatives from their beloved national—an outfit to which they have pledged eternal allegiance—would be far better served by not talking to them at all, by walking away from the chapter house as quickly as possible and calling a lawyer.
  • The fraternity system, he argues, is “the largest industry in this country directly involved in the provision of alcohol to underage people.” The crisis-management plans reveal that in “the foreseeable future” there may be “the death or serious injury” of a healthy young person at a fraternity function.
  • His belief is that what’s tarnishing the reputation of the fraternities is the bad behavior of a very few members, who ignore all the risk-management training that is requisite for membership, who flout policies that could not be any more clear, and who are shocked when the response from the home office is not to help them cover their asses but to ensure that—perhaps for the first time in their lives—they are held 100 percent accountable for their actions.
  • The fraternity system, he argues, is “the largest industry in this country directly involved in the provision of alcohol to underage people.” The crisis-management plans reveal that in “the foreseeable future” there may be “the death or serious injury” of a healthy young person at a fraternity function.
  • His belief is that what’s tarnishing the reputation of the fraternities is the bad behavior of a very few members, who ignore all the risk-management training that is requisite for membership, who flout policies that could not be any more clear, and who are shocked when the response from the home office is not to help them cover their asses but to ensure that—perhaps for the first time in their lives—they are held 100 percent accountable for their actions.
  • Unspoken but inherent in this larger philosophy is the idea that it is in a young man’s nature to court danger and to behave in a foolhardy manner; the fraternity experience is intended to help tame the baser passions, to channel protean energies into productive endeavors such as service, sport, and career preparation.
  • In a sense, Fierberg, Smithhisler, and the powerful forces they each represent operate as a check and balance on the system. Personal-injury lawsuits bring the hated media attention and potential financial losses that motivate fraternities to improve. It would be a neat, almost a perfect, system, if the people wandering into it were not young, healthy college students with everything to lose.
  • In a sense, Fierberg, Smithhisler, and the powerful forces they each represent operate as a check and balance on the system. Personal-injury lawsuits bring the hated media attention and potential financial losses that motivate fraternities to improve. It would be a neat, almost a perfect, system, if the people wandering into it were not young, healthy college students with everything to lose.
  • Wesleyan is one of those places that has by now become so hard to get into that the mere fact of attendance is testament, in most cases, to a level of high-school preparation—combined with sheer academic ability—that exists among students at only a handful of top colleges in this country and that is almost without historical precedent.
  • Wesleyan is one of those places that has by now become so hard to get into that the mere fact of attendance is testament, in most cases, to a level of high-school preparation—combined with sheer academic ability—that exists among students at only a handful of top colleges in this country and that is almost without historical precedent.
  • This January, after publishing a withering series of reports on fraternity malfeasance, the editors of Bloomberg.com published an editorial with a surprising headline: “Abolish Fraternities.” It compared colleges and universities to companies, and fraternities to units that “don’t fit into their business model, fail to yield an adequate return or cause reputational harm.”
  • A college or university can choose, as Wesleyan did, to end its formal relationship with a troublesome fraternity, but—if that fiasco proves anything—keeping a fraternity at arm’s length can be more devastating to a university and its students than keeping it in the fold.
  • A college or university can choose, as Wesleyan did, to end its formal relationship with a troublesome fraternity, but—if that fiasco proves anything—keeping a fraternity at arm’s length can be more devastating to a university and its students than keeping it in the fold.
  • there is a Grand Canyon–size chasm between the official risk-management policies of the fraternities and the way life is actually lived in countless dangerous chapters.
  • When there is a common denominator among hundreds of such injuries and deaths, one that exists across all kinds of campuses, from private to public, prestigious to obscure, then it is more than newsworthy: it begins to approach a national scandal.
  • When there is a common denominator among hundreds of such injuries and deaths, one that exists across all kinds of campuses, from private to public, prestigious to obscure, then it is more than newsworthy: it begins to approach a national scandal.
Javier E

With Fears About Safety, Football Faces Uncertain Evolution - NYTimes.com - 0 views

  • Hall of Fame quarterback Terry Bradshaw said he believed that concern over head injuries would cause football to be eclipsed in popularity by soccer and other sports within 10 years.
  • “Football is really on the verge of a turning point here. We may see it in 15 years in pretty much the same place as boxing or ultimate fighting.” In other words, less a lucrative American colossus and more a niche sport beloved for its brutality.
  • there is a growing sentiment among those who love the sport and those who loathe it that football has come to a critical juncture.
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  • “Football is resting on this foundation of parental and cultural and masculinity-issued support that could be pushed to the background once people start to realize that taking the chance of brain damage isn’t worth proving that you’re a particular kind of man,” Coakley said. “We’re beginning to see the erosion of that support.”
  • He also advocated flag football as a worthy substitute for young players, who can learn rules and fundamentals in a controlled environment where the risk of head injury would be significantly diminished. He deflected the concern that children who start playing late are at a disadvantage, saying that talent is the ultimate determining factor.
  • “There’s plenty of ways to get exercise without risking not only head injuries, but the accompanying orthopedic problems that come with playing football.”
  • “It’s really a serious discussion and a secret fear that I think all of us feel. We’ve accepted the knees and the other ailments, but we really never thought about the deterioration of your brains as a result of concussions in football.”
  • If the suit goes to trial, he predicted, data that would be made public would prompt some parents to not allow their children to play football.
  • Entities from Pop Warner to high school could require parents to sign waivers preventing officials or the league itself from being sued.
Javier E

Large-scale warfare occurred in Europe '1,000 years earlier than previously thought' | ... - 0 views

  • The earliest period of warfare in Europe might have occurred more than 1,000 years before what was previously thought to be the first large-scale conflict in the region
  • Reanalysis of more than 300 sets of skeletal remains uncovered in Spain – radiocarbon dated to between 5,400 and 5,000 years ago – indicates that conflicts took place long before powerful states formed in the region.
  • Researchers found there were substantially higher injury rates for the time, with 23% of the individuals showing evidence of skeletal injuries and 10% having unhealed injuries.
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  • The authors also found that 74% of the unhealed injuries and 70% of the healed injuries had occurred in adolescent or adult males, a significantly higher rate than in female individuals, and a difference not seen in other European neolithic mass-fatality sites.
  • The earliest such conflict in Europe was previously thought to have occurred during the bronze age, approximately 4,000 to 2,800 years ago.
  • The overall injury rate, the higher injury rate for males, the relatively high rate of healed injuries (suggesting that the conflict continued over several months) and the previously observed damage to the arrowheads led the authors to conclude that many of the individuals at the burial site were exposed to violence and might have been casualties of warfare.
Javier E

Pop Warner Football Limits Contact in Practices - NYTimes.com - 0 views

  • In response to growing concerns over head injuries in football, Pop Warner, the nation’s largest youth football organization, announced rule changes on Wednesday that will limit the amount of full-speed collisions and other contact allowed in practice.
  • The issue of brain injuries sustained on the football field has forced a reckoning at all levels of the sport in recent years. Pop Warner’s new rules, which will affect hundreds of thousands of youth football players, some as young as 5 years old, were seen as the latest acknowledgment that the nation’s most popular sport poses dangers to the long-term cognitive health of its athletes.
  • Under its new rules, effective for the coming season, which starts in August, contact will not be allowed for two-thirds of each practice — a move prompted by research showing that most of the hardest hits in youth football occur not in games, but in practice. The organization is also forbidding all drills that involve full-speed, head-on blocking and tackling that begins with players lined up more than three yards apart, as well as head-to-head contact.
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  • The group was persuaded to take its more drastic step when a study of second-grade football players published in February — which used data from sensors installed in helmets — showed that the average player sustained more than 100 head impacts during the course of about 10 practices and 5 games. Though most of those hits were moderate, some exceeded a force equivalent to a big hit in college football.
rachelramirez

Chip, Implanted in Brain, Helps Paralyzed Man Regain Control of Hand - The New York Times - 0 views

  • Chip, Implanted in Brain, Helps Paralyzed Man Regain Control of Hand
  • On Wednesday, doctors reported that Mr. Burkhart, 24, had regained control over his right hand and fingers, using technology that transmits his thoughts directly to his hand muscles and bypasses his spinal injury.
  • So in 2014, a surgical team at Ohio State operated. They used brain imaging to isolate the part of Mr. Burkhart’s brain that controls hand movements. The area is in what is known as the motor cortex, on the left side of his brain and just above the ear.
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  • After a year of training, Mr. Burkhart was able to pick up a bottle and pour the contents into a jar, and to pick up a straw and stir. The doctors, though delighted, said that more advances would be necessary to make the bypass system practical, affordable and less invasive, most likely through wireless technology
Javier E

Warning Labels on Helmets Combat Injury and Liability - NYTimes.com - 0 views

  • “They are saying to the public that you should buy our helmet, and they’re saying, if someone gets hurt, don’t blame us,” said Michael Kaplen, a lawyer who leads the New York State Traumatic Brain Injury Services Coordinating Council. “The selling of helmets is being done by the marketing department, and the label is made up by the legal department.”
anonymous

'Chaotic' Virginia Beach Shootings Leave 2 Dead, At Least 8 Others Wounded : NPR - 0 views

  • Two people are dead and at least eight others were wounded after multiple shootings near the oceanfront in Virginia Beach, Va., on Friday night.
  • Police officials say officers were on patrol in the city's resort area when they heard multiple gunshots at 11:22 p.m., according to a statement on Saturday. When they arrived to the scene, they found several victims suffering from gunshot wounds.
  • One woman died at the scene and at least eight people were transported to hospitals for their injuries. Authorities said the injuries ranged from "serious to life-threatening."
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  • One Virginia Beach police officer was also taken to a hospital for "minor injuries." The department's homicide unit is investigating what happened, but police say there are no suspects as of yet.
  • Authorities said an officer-involved shooting also took place on Saturday — just a few blocks from the shooting near the waterfront.
  • Department officials said a male suspect in this shooting died at the scene. Authorities said they believe the second shooting was related to the first, but did not provide details on how they are connected. The officer involved in the shooting has been placed on administrative leave pending an investigation, which police called standard procedure.
  • In addition to the shootings, a police officer was struck by a car and taken to the hospital with none life-threatening injuries.
  • The shootings in Virginia Beach follow mass shootings in the Atlanta area and in Boulder, Colo., this month, in which 18 people were killed in total. The Virginia Beach community also experienced a mass shooting in 2019, when a man killed 12 people and injured several others at a municipal building.
mimiterranova

The NFL Will Stop Assuming Racial Differences When Assessing Brain Injuries : NPR - 0 views

  • The NFL on Wednesday pledged to halt the use of "race-norming" — which assumed Black players started out with lower cognitive function — in the $1 billion settlement of brain injury claims and review past scores for any potential race bias.
  • Wednesday's announcement comes after a pair of Black players filed a civil rights lawsuit over the practice, medical experts raised concerns and a group of NFL families last month dropped 50,000 petitions at the federal courthouse in Philadelphia — where the lawsuit had been thrown out by the judge overseeing the settlement.
  • Neuropsychologists will propose a new way of testing
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  • The binary race norms, when they are used in the testing, assume that Black patients start with worse cognitive function than whites and other non-Blacks. That makes it harder for them to show a deficit and qualify for an award
  • The awards so far have averaged $516,000 for the 379 players with early-stage dementia and $715,000 for the 207 players with moderate dementia. Retirees can also seek payouts for Alzheimer's disease and a few other diagnoses. The settlement ended thousands of lawsuits that accused the NFL of long hiding what it knew about the link between concussions and traumatic brain injury.
Javier E

The Moral Crisis of America's Doctors - The New York Times - 0 views

  • Some years ago, a psychiatrist named Wendy Dean read an article about a physician who died by suicide. Such deaths were distressingly common, she discovered. The suicide rate among doctors appeared to be even higher than the rate among active military members
  • Dean started asking the physicians she knew how they felt about their jobs, and many of them confided that they were struggling. Some complained that they didn’t have enough time to talk to their patients because they were too busy filling out electronic medical records. Others bemoaned having to fight with insurers about whether a person with a serious illness would be preapproved for medication. The doctors Dean surveyed were deeply committed to the medical profession. But many of them were frustrated and unhappy, she sensed, not because they were burned out from working too hard but because the health care system made it so difficult to care for their patients.
  • Doctors on the front lines of America’s profit-driven health care system were also susceptible to such wounds, Dean and Talbot submitted, as the demands of administrators, hospital executives and insurers forced them to stray from the ethical principles that were supposed to govern their profession. The pull of these forces left many doctors anguished and distraught, caught between the Hippocratic oath and “the realities of making a profit from people at their sickest and most vulnerable.”
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  • In July 2018, Dean published an essay with Simon G. Talbot, a plastic and reconstructive surgeon, that argued that many physicians were suffering from a condition known as moral injury. Military psychiatrists use the term to describe an emotional wound sustained when, in the course of fulfilling their duties, soldiers witnessed or committed acts — raiding a home, killing a noncombatant — that transgressed their core values.
  • By the time we met, the distress among medical professionals had reached alarming levels: One survey found that nearly one in five health care workers had quit their job since the start of the pandemic and that an additional 31 percent had considered leaving
  • the physicians I contacted were afraid to talk openly. “I have since reconsidered this and do not feel this is something I can do right now,” one doctor wrote to me. Another texted, “Will need to be anon.” Some sources I tried to reach had signed nondisclosure agreements that prohibited them from speaking to the media without permission. Others worried they could be disciplined or fired if they angered their employers, a concern that seems particularly well founded in the growing swath of the health care system that has been taken over by private-equity firms
  • Mona Masood, a psychiatrist who established a support line for doctors shortly after the pandemic began, recalls being struck by how clinicians reacted when she mentioned the term. “I remember all these physicians were like, Wow, that is what I was looking for,” she says. “This is it.”
  • I spent much of the previous few years reporting on moral injury, interviewing workers in menial occupations whose jobs were ethically compromising. I spoke to prison guards who patrolled the wards of violent
  • in recent years, despite the esteem associated with their profession, many physicians have found themselves subjected to practices more commonly associated with manual laborers in auto plants and Amazon warehouses, like having their productivity tracked on an hourly basis and being pressured by management to work faster.
  • it quickly went viral. Doctors and nurses started reaching out to Dean to tell her how much the article spoke to them. “It went everywhere,” Dean told me when I visited her last March in Carlisle, Pa., where she now lives
  • “I think a lot of doctors are feeling like something is troubling them, something deep in their core that they committed themselves to,” Dean says. She notes that the term moral injury was originally coined by the psychiatrist Jonathan Shay to describe the wound that forms when a person’s sense of what is right is betrayed by leaders in high-stakes situations. “Not only are clinicians feeling betrayed by their leadership,” she says, “but when they allow these barriers to get in the way, they are part of the betrayal. They’re the instruments of betrayal.”
Javier E

Study Bolsters Link Between Routine Hits to Head and Long-Term Brain Disease - NYTimes.com - 0 views

  • The growing evidence of a link between head trauma and long-term, degenerative brain disease was amplified in an extensive study of athletes, military veterans and others who absorbed repeated hits to the head
  • Of the group of 85 people, 80 percent (68 men) — nearly all of whom played sports — showed evidence of chronic traumatic encephalopathy, or C.T.E., a degenerative and incurable disease whose symptoms can include memory loss, depression and dementia.
  • Among the group found to have C.T.E., 50 were football players, including 33 who played in the N.F.L. Among them were stars like Dave Duerson, Cookie Gilchrist and John Mackey. Many of the players were linemen and running backs, positions that tend to have more contact with opponents.
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  • Researchers expected the details in the study to dispel doubts about the likelihood that many years of head trauma can lead to C.T.E. The growing connections between head trauma and contact sports, though, have led some nervous parents and coaches to assume that any concussion could lead to long-term impairment. Some doctors say that oversimplifies matters. Rather, the total amount of head trauma, including smaller subconcussive hits, as well as how they were treated, must be considered
Javier E

Gun Violence in America: The 13 Key Questions (With 13 Concise Answers) - Jonathan Stra... - 0 views

  • There were 8,583 homicides by firearms in 2011, out of 12,664 homicides total, according to the FBI. This means that more than two-thirds of homicides involve a firearm
  • Gun violence also affects more than its victims. In areas where it is prevalent, just the threat of violence makes neighborhoods poorer. It's very difficult to quantify the total harm caused by gun violence, but by asking many people how much they would pay to avoid this threat -- a technique called contingent valuation -- researchers have estimated a cost to American society of $100 billion dollars.
  • 19,392 of 38,264 suicides in 2010 involved a gun (50%), according to the CDC.
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  • There were 606 firearm-related accidents in the same year -- about 5% of the number of intentional gun deaths.
  • There are about 310 million guns in the country. About 40% of households have them, a fraction that has been slowly declining over the last few decades, down from about 50% in the 1960s.
  • gun ownership has gotten much more concentrated among fewer households: if you own one gun, you probably own several
  • The most comprehensive public list of U.S. mass shootings is the spreadsheet of 62 incidents from 1982-2012, compiled by Mother Jones. Their list shows:
  • Mass shootings happen all over the country. Killers used a semi-automatic handgun in 75% of incidents, which is about the same percentage as the 72% in overall gun violence. Killers used an assault weapon in 40% of incidents. This is much higher than overall assault weapon use in crimes, estimated at less than 2%. The guns were obtained legally in 79% of mass shootings. Many of the shooters showed signs of mental illness, but in only two cases was there a prior diagnosis. There were no cases where an armed civilian fired back.
  • they account for only a small fraction of gun violence in the United States.
  • It's also possible that gun ownership is a deterrent to crime, because criminals must consider the possibility that their intended victim is armed.
  • . In 2010, different researchers re-examined Lott's work, the NRC report, and additional data up through 2006, and reaffirmed that there is no evidence that right-to-carry laws reduce crime.
  • The most comprehensive estimate is that a 10% reduction in U.S. households with guns would result in a 3% reduction in homicides.
  • current federal gun regulation (see above) contains an enormous loophole: While businesses that deal in guns are required to keep records and run background checks, guns can be transferred between private citizens without any record. This makes straw purchases easy.
  • There's abundant evidence that under the current system, guns flow easily between legal and illegal markets.
  • guns are used to commit a crime about 10 times as often as they are used for self-defense.
  • Won't criminals kill with other weapons if they don't have guns? The crux of this question is whether most homicides are planned, or whether killers more often confront their victims with no clear intention. In the second case, adding a gun could result in a fatal shooting that would otherwise have been avoided.
  • In 1968, Franklin Zimring examined cases of knife assaults versus gun assaults in Chicago. The gun attacks were five times more deadly
  • Here are some approaches that don't seem to work, at least not by themselves, or in the ways they've been tried so far: Stiffer prison sentences for gun crimes. Gun buy-backs: In a country with one gun per person, getting a few thousand guns off the street in each city may not mean very much. Safe storage laws and public safety campaigns.
  • We don't really have good enough evidence to evaluate these strategies: Background checks, such as the Brady Act requires. Bans on specific weapons types, such as the expired 1994 assault weapons ban or the handgun bans in various cities.
  • These policies do actually seem to reduce gun violence, at least somewhat or in some cases: More intensive probation strategies: increased contact with police, probation officers and social workers. Changes in policing strategies, such increased patrols in hot spots. Programs featuring cooperation between law enforcement, community leaders, and researchers, such as Project Safe Neighborhoods.
  • Removing legal restrictions that prevent the Centers for Disease Control and other agencies from tracking and researching gun violence is also a sensible idea, and follows a long history of calls from scientists (see: what don't we know).
  • We lack some of the most basic information we need to have a sensible gun policy debate, partially because researchers have been prevented by law from collecting it. The 2004 National Research Council report discussed above identified several key types of missing data: systematic reporting of individual gun incidents and injuries, gun ownership at the local level, and detailed information on the operation of firearms markets. We don't even have reliable data on the number of homicides in each county.
  • Centers for Disease Control, the main U.S. agency that tracks and studies American injuries and death, has been effectively prevented from studying gun violence, due to a law passed by Congress in 1996.
  • anonymized hospital reporting systems are the main ways we know about many other types of injuries, but the Affordable Care Act prevents doctors from gathering information about their patients' gun use. A 2011 law restricts gun violence research at the National Institutes of Health. The legal language prevents these agencies from using any money "to advocate or promote gun control."
Javier E

NFL Concussions Mega-Lawsuit Claims League Hid Brain Injury Links From Players - 0 views

  • NEW YORK — Scores of lawsuits involving thousands of former players touched by concussions and brain injuries have been consolidated into one master complaint, setting up a massive and potentially costly case for the NFL.
  • "The NFL, like the sport of boxing, was aware of the health risks associated with repetitive blows producing sub-concussive and concussive results and the fact that some members of the NFL player population were at significant risk of developing long-term brain damage and cognitive decline as a result," the complaint charges. "Despite its knowledge and controlling role in governing player conduct on and off the field, the NFL turned a blind eye to the risk and failed to warn and/or impose safety regulations governing this well-recognized health and safety problem."
Javier E

Brain Trauma Extends to the Soccer Field - NYTimes.com - 0 views

  • C.T.E. is believed to be caused by repetitive hits to the head — even subconcussive ones barely noted. Once considered unique to boxers, it has been diagnosed over the past decade in dozens of deceased football players and several hockey players. In December, it was found for the first time in a baseball player.
  • “The brain is a very delicate organ, and it probably can withstand some injury, but the whole issue of repeated injury is a very different circumstance,” he said. “When it’s moving, it’s moving with its 200 billion brain cells. And those cells are being, in some way, mechanically deformed, some more than others,
  • Bigler said he would not recommend that players, especially young ones, routinely head the ball. The brain is not fully developed until about age 25, he said, making it more susceptible to injury.
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  • ome youth soccer organizations have warned against practicing heading until players reach a certain age, usually between 10 and 14. Some scientists believe those ages are somewhat arbitrary
  • The cold, hard reality is that the data don’t exist to address that question,”
  • ipton said Wednesday that there was probably a reasonable threshold below which heading might cause few problems. “Above some level, heading is probably not good for anyone,”
  • In hindsight, Grange’s family said that he showed symptoms of C.T.E. beginning in high school. He struggled to balance a checkbook. He did not understand the repercussions of failing classes.
anonymous

First Dogs Major And Champ Biden Return To White House : NPR - 0 views

  • First dogs Champ and Major Biden are back in Washington, D.C., after spending part of the month in Delaware, where Major underwent remedial training after causing a "minor injury" at the White House.
  • Michael LaRosa, spokesman for first lady Jill Biden, confirmed to NPR on Wednesday morning that the dogs are at the White House, but did not specify when they returned. One of the family's two German shepherds can be seen on an Executive Residence balcony in a photo snapped by Reuters correspondent Jeff Mason on Monday night.White House press secretary Jen Psaki told reporters on Wednesday that Champ and Major joined the first family at Camp David over the weekend, and returned to the White House on Sunday. She said it "will not be uncommon" for the dogs — and their owners — to go back and forth to Delaware.
  • The news comes a week after President Biden defended Major in an interview with ABC's Good Morning America, calling the 3-year-old a "sweet dog" who was just startled by an unfamiliar person in his new home.
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  • Psaki said earlier this month that Major "reacted in a way that resulted in a minor injury" to the unnamed individual, with NBC News reporting that he nipped the hand of a Secret Service agent. She said that both dogs had been sent to the Bidens' home in Wilmington, Del., as part of a previously planned visit while the first lady was traveling.
  • Major got some remedial training while he was there, according to Biden, who stressed that the rescue dog is still adjusting to his new environment.
  • The Bidens fostered and then adopted Major from the Delaware Humane Association — where his litter of six puppies was dropped off in poor condition after ingesting an unknown toxic substance — in 2018. According to the shelter, Biden was looking for a companion for Champ, who is now 12 years old. Major is, famously, the first dog to go from a shelter to the White House — a historic journey that now also includes a brief detour to the dog house.
xaviermcelderry

Is Quarantine Giving You Headaches, Back Pain, and More? - The Atlantic - 0 views

  • One morning in May, I rolled out of bed to find that my hip flexors were at it again. Dragging my rolled-up yoga mat to the middle of the floor to arrange my body into the now-familiar contortion—one leg straight back, the other forward and bent against the floor, then switch—I tried to piece together what was going on. Like most Americans, I hadn’t been on an airplane since February. I had been sitting at home virtually all the time, a situation of relative comfort and incredible luck. But in the weeks that followed, I folded my body into pigeon pose again and again, with minimal returns. As I lost hip flexibility, I also gained other problems, which accumulated over the next several months—low-grade headaches, sore shoulders, a stiff neck, dry skin.Recommended ReadingHow Your Laptop Ruined Your LifeAmanda MullAfter the Pandemic, the Office Dress Code Should Never Come BackAmanda MullAmericans Got Tired of Looking Bad on ZoomAmanda MullRecommended ReadingHow Your Laptop Ruined Your LifeAmanda MullArticleRecirc_itemMedia__1z
  • And people aren’t just working in more challenging physical circumstances; they’re also spending more time doing it. “In the office, people work for eight or nine hours, but now they find themselves working 10 or 12 hours at home just because there’s no commute time,” Natalia Ruiz, a physical therapist at NYU Langone Orthopedic Center, told me of her patients. “Expectations of productivity have increased because you’re working from home.” In her practice, she’s seen more complaints of back and neck pain, but also more “repetitive strain” injuries such as carpal tunnel syndrome, tendinitis in the hands and forearms, and pinched nerves in the elbows.
  • For people who aren’t of working age, the orthopedic concerns are a little different. Elderly people, who are at the highest risk from the virus itself, have also experienced some of the worst physical consequences of isolation. “The elderly are not taking their walks and are getting weaker in their legs,” Singh said. “They are losing confidence in their gait, which causes further weakness, and they enter a vicious cycle.” Many people have sharply reduced their exercise this year as gyms have closed, or they fear catching the coronavirus at those that have reopened, but for younger adults, who are generally more physically fit and less prone to injury, regaining some movement in creative ways is easier, and novel, unsupervised exercise is less risky (although Singh noted that he has seen some injuries from people who have used their new Pelotons vigorously but incorrectly).
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  • Even for people who spent their workdays indoors and on a computer before the pandemic, the routine of going into work—the process of getting dressed, going outside, getting in a car or boarding a train, interacting with co-workers, attending a meeting or two, and maybe going to happy hour afterward—likely provided enough variation and visual novelty to head off some of the vision problems people are having now.
  • The pandemic also seems to be causing a litany of skin and hair issues, according to research provided by the American Academy of Dermatology, some of which has not yet been published and has yet to be peer-reviewed.
Javier E

Ban College Football? Breaking Down a Debate - NYTimes.com - 0 views

  • Two prominent writers argued for banning college football on Tuesday night at New York University’s Skirball Center as part of the Intelligence Squared U.S. Debates series. Their opponents were two journalists, who also happened to be former players.
  • Before hearing the arguments, audience members were asked their opinion, and 16 percent were for the resolution to ban college football; 53 percent were against. At the end of the night, 53 percent were for it and 39 percent against. The undecided vote had plunged from 31 percent to 8 percent.
  • Gladwell was not amenable to modifications, calling the idea that brain injuries could be minimized by better helmets or medical care “a fantasy.”“I’ve seen pictures of the brain scans of people with C.T.E.,” he said, referring to a trauma-induced disease, “and it looks like someone drove a truck across their brain.”
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  • said he had “grave concerns” about concussions, but also denied the problem was as widespread or severe as Gladwell implied. Citing a study from the University of North Carolina, he said there were more direct fatalities in lacrosse, water polo and baseball than football, so why not ban those sports?
Javier E

Pop Warner Football Rules Limiting Contact Raise New Questions - NYTimes.com - 0 views

  • he future of youth football may be determined by research that continues to redefine what the sport considers safe.
  • “The N.F.L.’s bore the brunt of this in terms of P.R., but how do we know that it’s not the adolescent exposure?”
  • But with a number of studies now detailing football’s link to brain injuries, some parents may conclude that playing the sport is not worth the risk to their children.
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  • research has shown that the damage from concussions can be cumulative, and that the brains of younger athletes may be particularly susceptible.
  • Research has been difficult to quantify, Duma said, because “no one knows how many times or how hard players have been hit.” Until recently, it was common to hide or minimize concussions.
  • if the country’s largest youth football organization were to outlaw all contact and go to a flag-football approach, about 90 to 95 percent of the players would leave and find tackle football elsewhere. He also predicted they would sustain concussions in other sports.
Javier E

Children and Guns - The Hidden Toll - NYTimes.com - 0 views

  • A New York Times review of hundreds of child firearm deaths found that accidental shootings occurred roughly twice as often as the records indicate, because of idiosyncrasies in how such deaths are classified by the authorities.
  • The National Rifle Association cited the lower official numbers this year in a fact sheet opposing “safe storage” laws, saying children were more likely to be killed by falls, poisoning or environmental factors — an incorrect assertion if the actual number of accidental firearm deaths is significantly higher.
  • The rifle association’s lobbying arm recently posted on its Web site a claim that adult criminals who mishandle firearms — as opposed to law-abiding gun owners — are responsible for most fatal accidents involving children. But The Times’s review found that a vast majority of cases revolved around children’s access to firearms, with the shooting either self-inflicted or done by another child.
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  • In all but a handful of instances, the shooter was male. Boys also accounted for more than 80 percent of the victims.
  • The Times sought to identify every accidental firearm death of a child age 14 and under in Georgia, Minnesota, North Carolina and Ohio dating to 1999, and in California to 2007. Records were also obtained from several county medical examiners’ offices in Florida, Illinois and Texas.
  • Even in accidental shootings where criminals were in some way involved, they usually were not the ones pulling the trigger. Rather, they — like many law-abiding adults in these cases — simply left a gun unsecured.
  • Another important aspect of firearm accidents is that a vast majority of victims do not die. Tracking these injuries nationally, however, is arguably just as problematic as tallying fatalities, according to public health researchers. In fact, national figures often cited from the Centers for Disease Control and Prevention’s Web site are an estimate, projected from a sampling taken from hospital emergency departments. Nevertheless, in 2011, the most recent year with available data, the agency estimated that there were 847 unintentional nonfatal firearm injuries among children 14 and under.
  • More concrete are actual counts of emergency department visits, which are available in a small number of states. In North Carolina, for instance, there were more than 120 such visits for nonfatal gun accidents among children 17 and under in 2010, the most recent year for which data is available.
  • While about 60 percent of the accidental firearm deaths identified by The Times involved handguns as opposed to long guns, that number was much higher — more than 85 percent — when the victims were very young, under the age of 6. In fact, the average handgun victim was several years younger than long gun victims: between 7 and 8, compared with almost 11.
  • Over all, the largest number of deaths came at the upper end of the age range, with ages 13 and 14 being most common — not necessarily surprising, given that parents generally allow adolescents greater access to guns. But the third-most common age was 3 (tied with 12), a particularly vulnerable age, when children are curious and old enough to manipulate a firearm but ignorant of the dangers.
  • About half of the accidents took place inside the child’s home. A third, however, occurred at the house of a friend or a relative, pointing to a potential vulnerability if safe-storage laws apply only to households with children, as in North Carolina.
  • In four of the five states — California, Georgia, North Carolina and Ohio — The Times identified roughly twice as many accidental killings as were tallied in the corresponding federal data.
  • But Taurus backed out within a few months, citing competing priorities, and the project fell apart. Charles Vehlow, Metal Storm’s chief executive at the time, said that while he did not know exactly what pressures Taurus faced, there was a general wariness of smart-gun efforts among manufacturers and pro-gun groups. “There was no question that the N.R.A. was very sensitive and was aware of what we were doing,” he said.
  • Under the Centers for Disease Control and Prevention figures, in fact, gun accidents were the ninth-leading cause of unintentional deaths among children ages 1 to 14 in 2010. (The agency reported 62 such killings that year.) If the actual numbers are, in fact, roughly double, however, gun accidents would rise into the top five or six.
  • The rifle association and its allies also often note that studies on the impact of safe-storage laws have found mixed results. But those studies are based on the flawed government statistics. “When we’re evaluating child access laws, we’re using total trash data,
  • A safe-storage bill was introduced in the Ohio legislature in February, prompted by a shooting that killed three students at a high school in suburban Cleveland. But the measure, which would prohibit storing a firearm in a residence in a place readily accessible to a child, has encountered skepticism from the Republicans who control the legislature. “The tenor was, somebody breaks in, do I have time enough to get to my gun?” said State Representative Bill Patmon, a Democrat who introduced the bill.
  • The N.R.A. has long argued that better education is the key to preventing gun accidents, citing its Eddie Eagle GunSafe program, which teaches children as young as 3 that if they see a gun, they should “stop, don’t touch, leave the area and tell an adult.” The association, which did not respond to a request for comment, says its program has reached more than 26 million children in all 50 states and should be credited for the deep decline in accidental gun deaths shown in federal statistics dating to the mid-1980s.
  • Beyond the unreliability of the federal data, public health experts have disputed the N.R.A.’s claims, pointing to other potential explanations for the decline, including improvements in emergency medical care, along with data showing fewer households with firearms. They also highlight research indicating that admonishing children to stay away from guns is often ineffective.
  • As part of Dr. Kellermann’s study, researchers watched through a one-way mirror as pairs of boys ages 8 to 12 were left alone in an examination room at a clinic in Atlanta. Unknown to the children, an inoperative .38-caliber handgun was concealed in a cabinet drawer.
  • Playing and exploring over the next 15 minutes, one boy after another — three-quarters of the 64 children — found the gun. Two-thirds handled it, and one-third actually pulled the trigger. Just one child went to tell an adult about the gun, and he was teased by his peers for it. More than 90 percent of the boys said they had had some gun safety instruction.
  • Other research has found that simply having a firearm in the household is correlated with an increased risk of accidental shooting death. In one study, published in 2003 in the journal Accident Analysis and Prevention, the risk was more than three times as high for one gun, and almost four times as high for more than one.
  • requiring, or even encouraging, efforts to introduce “smart gun” technology remains unpopular with the gun lobby, which has worked to undermine such research and attempts to regulate firearms as a dangerous consumer product.
  • In state after state and often with considerable success, gun rights groups have cited the federal numbers as proof that the problem is nearly inconsequential and that storage laws are unnecessary. Gun Owners of America says on its Web site that children are “130 percent more likely to die from choking on their dinner” than from accidental shootings.
  • The Colt’s Manufacturing Company and Smith & Wesson experienced a backlash against their own smart-gun programs, which were abandoned amid financial problems caused, in part, by boycotts from gun groups and others in the industry. So unpopular was the whole smart-gun concept that Colt’s Manufacturing later could not even find a buyer for its patents, said Carlton Chen, a former lawyer for the company.
  • Gun rights lobbyists have also helped keep firearms and ammunition beyond the reach of the Consumer Product Safety Commission, which has the power to regulate other products that are dangerous to children. The N.R.A. argues that the commission would provide a back door for gun control advocates to restrict the manufacture of firearms. Proponents of regulation say guns pose too great a hazard to exclude them from scrutiny.
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