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32405	Bees are born fully grown.	The phrasing of the Snapple “real fact” and the above-displayed commercial led some viewers to believe that bees give live birth to fully grown adults. But this is not the case: Bees come from eggs and hatch as larvae, and while the majority of a bee’s growth occurs before it emerges from the pupa stage as an adult, that emergence is not commonly known as the “birth” of a bee.	false	Critter Country, bees, bees born fully grown, Bugs	Are bees born fully grown? This question has plagued Snapple drinkers since at least 2009, when “real fact” #775 was issued on the drink’s bottle caps: Renewed buzz about this “fact” was heard in May 2016 when a Snapple aired a television commercial based on this permise: However, this “fact” about bees being born fully grown is misleading. A bee goes through complete metamorphosis, transforming from an egg to a larva, to a pupa, and finally to a full-grown adult. This life cycle is not unique to bees: Many insects, including beetles, wasps, ants, butterflies, moths and flies undergo holometabolism, or complete metamorphism. In May 2015, biologist and photographer Anand Varma captured a time-lapse video showing the first 21 days of a bee’s life: After the queen bee lays a single egg in a cell of the comb, the worker bees feed the egg for a few days until it hatches into a larva. The larva continues to eat and grow until Day 10. Then, the worker bees cap the cell, and 11 days later an adult honeybee emerges. Varma was captivated by “this crazy transformation, from one nasty-looking grub thing into this crazy-looking insect.”
18545	Expanding Medicaid will worsen health care options for the most vulnerable among us in Texas.	"Cruz said that ""expanding Medicaid will worsen health care options for the most vulnerable among us in Texas."" Not only does this assertion make no logical sense -- some health coverage should always be an improvement over none -- but the evidence Cruz and others have pointed to also doesn’t back up his point. None of the studies make the argument Cruz does, and the small sample sizes of uninsured patients, combined with the challenge of defining the terms ""Medicaid"" and ""uninsured,"" pose serious questions about whether Cruz’s conclusion is valid. In fact, several authors of the papers we contacted disagreed with Cruz’s interpretation of their research. This sweeping generalization does not hold up."	false	National, Health Care, Medicaid, Poverty, Ted Cruz,	"Editor's note: After we published this report, the staff at Cruz's office gave us more information to consider. We considered that evidence in a separate report, but it did not change our initial findings or our ruling. Our original report remains below. Sen. Ted Cruz, the Texas Republican who is gaining a reputation for bold statements, is backing Texas Gov. Rick Perry’s decision to reject a major expansion of Medicaid, the health insurance program for the poor. Under the new health care law, states can get federal dollars to enroll their uninsured residents in Medicaid. Some politicians, including Cruz and Perry, argue that taking the federal money now leaves the state on the hook for long-term fiscal commitments it can’t afford. Cruz, though, has gone beyond arguing that the expansion is too expensive. He recently said it would also leave the uninsured worse off. ""Our friends who are saying they want health care do not realize that expanding Medicaid will worsen health care options for the most vulnerable among us in Texas,"" Cruz said at an event with Perry and others in the state capitol in Austin. This struck some observers as illogical: How could moving someone who’s uninsured onto the Medicaid rolls actually worsen someone’s health care options? When we checked with Cruz’s office, they referred us to a floor speech he gave on March 13, 2013. Here’s the relevant portion of that speech: ""The data demonstrates Medicaid beneficiaries face worse health outcomes than just about anybody else in the marketplace. In 2010, the Annals of Surgery issued a landmark study which examined the outcomes from nearly 900,000 individuals undergoing surgery from 2003 to 2007. ... Medicaid patients, when compared to people without health insurance, people who were uninsured, Medicaid patients were 13 percent more likely to die. They stayed in the hospital for 50 percent longer and cost 20 percent more. ""In 2011, Johns Hopkins did a study of patients undergoing lung transplantation. Their conclusions were very much the same. They found that Medicaid patients were 8.1 percent less likely to be alive 10 years after the transplant compared with those with private insurance and also compared to those without any insurance at all. Overall, the Johns Hopkins study found that Medicaid patients faced a 29-percent greater risk of death, and yet Obamacare is moving more and more of the economically disadvantaged onto Medicaid, which subjects them to those worse health care outcomes."" This is a line of argument that had appeared earlier in a number of conservative outlets, including a Wall Street Journal op-ed and a Manhattan Institute briefing paper. These analyses offered some additional studies with similar findings. Even though Cruz did not specifically mention these other studies, they have been cited so frequently in the debate that we will include them in our analysis. To start, we should note that even many critics of Cruz’s perspective acknowledge some concerns about the Medicaid expansion under the new health care law. First, most experts we contacted agreed that studies, including the two Cruz specifically cited, show that patients on Medicaid tend not to have health outcomes as positive as patients on private insurance (though they add that Medicaid is not necessarily the cause, since it’s hard to disentangle insurance status from socioeconomic and lifestyle factors). Second, experts acknowledge that Medicaid is not a perfect program and that various policy changes could make it more effective. And third, they say that adding millions of additional beneficiaries under the new health care law will impose additional strains on the program. That said, our examination of the medical papers, including interviews with some authors of the studies in question, suggests that Cruz has made too big a leap by arguing that an uninsured patient actually becomes worse off when they sign up for Medicaid. Here are a few of the reasons for caution: • The trends are more mixed than Cruz’s claim suggests. In many of the studies, uninsured patients did end up having better outcomes than Medicaid patients did, such as fewer complications and longer survival. But this trend isn’t universal. For instance, in one study, Medicaid patients had worse outcomes for clogged arteries but better outcomes for abdominal aortic aneurysms. • The authors of the studies do not make the argument Cruz does. Not one of the half-dozen studies we looked at articulated Cruz’s argument that someone will have a worse health outcome if they move from no insurance to Medicaid. The studies generally did not focus on comparing Medicaid patients to uninsured patients. Rather, they focused on the performance of Medicaid and uninsured patients collectively, compared to Medicare and private insurance on the other hand. In addition, most papers inserted extensive language urging caution about the limitations of their research. What Cruz and others have done is ""the worst kind of selective reading of the studies,"" said Michael A. Gaglia Jr., a professor at the University of Southern California’s Keck School of Medicine and the co-author of one of the papers. • The definition of ""uninsured"" in these studies is too fuzzy to be reliable. In these studies, the term ""uninsured"" doesn’t just refer to the popular image of someone who’s too economically strapped to afford health insurance. It can also include poor people getting free charity care from world-class hospitals, very wealthy patients who pay their own bills rather than carrying health insurance, and healthy young adults who gambled by not obtaining insurance but got sick anyway. Each of these patient groupings may have advantages in recovering more quickly, which could explain some of the the better outcomes among the uninsured. Meanwhile, the definition of Medicaid is also fuzzy because people can sign up for Medicaid after being diagnosed with a serious ailment at a hospital. The studies didn’t distinguish between patients who have been on Medicaid for years, people who were uninsured for years but suddenly signed up for Medicaid before receiving treatment, and those who remained uninsured all the way through treatment. • The number of both Medicaid patients and the uninsured who were studied was quite small. In many of the studies, private insurance and Medicare patients dominated the pool of those studied. (Medicare is the federal health insurance program for Americans over age 65; because it’s mandatory for seniors, it includes people of all income levels.) Typically, uninsured patients and those on Medicaid represented 3 percent to 5 percent of the individuals studied. Experts say it’s unwise to draw sweeping conclusions from small sample sizes. • The Annals of Surgery study Cruz cited has an important quirk in the results. The study looked at 11 types of surgery and found that in all 11, the outcomes were worse for Medicaid patients than for the uninsured. However, in 10 of those cases, patients on Medicare also had worse outcomes than the uninsured did. As Boston University health economist Austin Frakt has put it, ""Any theory to explain what’s going on in Medicaid had better explain Medicare, too."" • Other studies have shown a positive health benefit from joining Medicaid. A recent study in Oregon compares Medicaid enrollees who had been chosen by a lottery to uninsured residents who were not enrolled. The study indicated that the new Medicaid enrollees reported better health than those who remained uninsured, though the findings are preliminary. Our ruling Cruz said that ""expanding Medicaid will worsen health care options for the most vulnerable among us in Texas."" Not only does this assertion make no logical sense -- some health coverage should always be an improvement over none -- but the evidence Cruz and others have pointed to also doesn’t back up his point. None of the studies make the argument Cruz does, and the small sample sizes of uninsured patients, combined with the challenge of defining the terms ""Medicaid"" and ""uninsured,"" pose serious questions about whether Cruz’s conclusion is valid. In fact, several authors of the papers we contacted disagreed with Cruz’s interpretation of their research. This sweeping generalization does not hold up."
26226	Right now, China controls 80% of all ingredients and raw materials going into our generic prescription drugs.	The FDA does not track the volume of drug imports from outside the U.S. About 80% of active pharmaceutical ingredients come from overseas, but not just from China.	false	Health Care, Foreign Policy, Missouri, Vicky Hartzler,	"Earlier this month, Rep. Vicky Hartzler, R-Mo., co-signed a letter urging President Donald Trump to bring drug production back to the U.S. and out of China. She’s been a consistent voice against Chinese-made pharmaceutical ingredients, co-introducing a bill last year that would require the Department of Defense to only buy U.S.-made medicine. She later praised action by Trump in March. On March 18, Trump issued an executive order and invoked the Defense Production Act. The law allows the government greater control over private companies in the name of national defense. Enacted in 1950, the law has been used thousands of times each year for everything from missiles to body armor, for the U.S.-Mexico border wall. In some cases, it gives the government priority on an order, say, for face masks. The act allowed Trump to order General Motors to make ventilators. In a news release two days after Trump’s order, Hartzler said she supported the move and would keep pressing the administration to use the DPA authority ""to ensure medical ingredients and raw materials for medications are produced in the United States."" ""Right now, China controls 80% of all ingredients and raw materials going into our generic prescription drugs, allowing them the ability to cut off that supply chain in a moment of conflict,"" she wrote. We decided to look into it because 80% is a big chunk of our prescription drug ingredients. It’s a statistic that has come up in other places before, though in different ways. Last year, Senate Finance Chairman Chuck Grassley wrote that ""80% of (active pharmaceutical ingredients) are produced abroad, the majority in China and India."" More recently, in 2020, a similar statistic has come up in ABC News, AP News, The Hill and Fox News. The earliest use of the statistic we could find was from a 1998 report by the Government Accountability Office, but it didn’t say the ingredients all came from China. So, what’s right, and how applicable is the figure today? First, we’ll define the materials Hartzler referred to: Raw materials are chemical compounds that are used to make other parts of medicine. While they can be used for other things, such as for packaging, raw materials can be mixed to create ingredients for prescription drugs, ranging from binding ingredients to active pharmaceutical ingredients. Active pharmaceutical ingredients are then the active and primary parts of prescription drugs, allowing the drug to do what it needs to do. So, for example, a generic painkiller uses ibuprofen. The ibuprofen is what ends up stopping the pain, so it’s the active pharmaceutical ingredient, but other ingredients are used in the pill, too. Hartzler’s team directed us to the 2019 U.S.-China Economic Security Review Commission Report to Congress. The report says a ""substantial portion of U.S. generic drug imports"" is imported. So, of this substantial portion, how many ingredients and raw materials come from China? That 2019 report didn’t say. In a 2010 project from the NSD Bio Group to the U.S. China Economic and Security Review Commission, ""the U.S. imports an estimated 80% of the raw ingredients contained in both products manufactured, sold and consumed in this country."" The statistic, according to the report, was first generated by the Governmental Accountability Office in 1998. Does it mention what percentage of the raw ingredients come from China alone? No. It simply says that the raw ingredients are imported. Raw materials are a muddy area, too. The 2019 Review Commission Report gives many citations with an 80% figure, but only one refers to medicine-making active ingredients. Raw materials are mentioned in the report, but no statistics are given. And the report focuses on active pharmaceutical ingredients, not general ones. ""The United States sources 80% of its (active pharmaceutical ingredients) from overseas and a substantial portion of U.S. generic drug imports come either directly from China or from third countries like India that use (active pharmaceutical ingredients) sourced from China,"" the 2019 Review Commission Report says. So, a lot of generic drug imports are from China, but 80% of active ingredients are ""from overseas."" We can agree that most of the active ingredients come from China; even these places overseas sometimes import the active ingredients from there. The report even says that India ""relies on"" China for 80% of India’s active pharmaceutical ingredients. And how much does the U.S. rely on? Again, that’s hard to say. The FDA does not track the distribution of ingredients, and drug companies do not have to cite where the active ingredients in their drugs came from. In 2019, Janet Woodcock, M.D., the director of the Center for Drug Evaluation and Research , a branch of the FDA, testified about protecting the U.S. medical supply chains. Woodcock said the FDA does ""not know whether Chinese facilities are actually producing APIs, how much they are producing, or where the APIs they are producing are being distributed worldwide, including in the United States."" Woodcock said the FDA does ""not currently know whether (active pharmaceutical ingredient) manufacturing facilities are actually producing the drug, or in what volume."" This is because facilities do not have to report how many active pharmaceutical ingredients they are producing. Tracking active pharmaceutical ingredients can be tricky; a country can create these ingredients and export them for the production of the finished drug. According to the testimony, making active pharmaceutical ingredients in India makes it anywhere from 30% to 40% cheaper for U.S. companies. A product may stop in more than one place to create a finalized product. In the testimony, Woodcock provided a breakdown of where the active pharmaceutical ingredient facilities are that contribute to the U.S. pharmaceutical market. The number of registered facilities that make these ingredients in China ""more than doubled between 2010 and 2019."" By country, in 2019: Thirteen percent of the active pharmaceutical ingredient manufacturing facilities are from China. About 18% of these facilities are in India. And 28% are in the U.S. And in terms of prescription drugs, the World Health Organization lists 461 drugs as part of their Essential Medicine List, according to testimony. These meet the ""most important needs in a health system"" and include ""anesthetic, antibacterial, antidepressant, antiviral, cardiovascular, anti-diabetic, and gastrointestinal agents."" The percentages of facilities that make active pharmaceutical ingredients for these drugs are fairly similar to that of the general international ones. Fifteen percent of active pharmaceutical ingredients manufacturing facilities for these essential medicines are from China. The U.S. has about 21%. Again, in both the general and essential-medicine active pharmaceutical ingredient facilities, this does not indicate how many ingredients are produced. Regardless, the U.S. still has more facilities than China making these ingredients for the American market. The 2017 FDA at a Glance confirms, saying ""approximately 80% of active pharmaceutical ingredients manufacturers are located outside of the U.S."" Hartzler said, ""Right now, China controls 80% of all ingredients and raw materials going into our generic prescription drug."" While a large part may come from China, putting it all at 80% does not add up. The 2019 Commission Report and the testimony say 80% of active ingredients are from overseas. The government reports credit the figure for all imports of raw materials, and the GAO says active ingredients are made in more than 150 countries."
11598	Scalpel-Free Surgery Proves Safe, Effective for Treating Essential Tremor	This release reports the results of a randomized, multicenter, sham-controlled clinical trial testing the safety and efficacy of a new approach to controlling essential tremors in the elderly — magnetic resonance imaging (MRI)-guided focused ultrasound — to alter the thalamus in the brain and thus control tremors. The approach would be an alternative to the current procedure — deep-brain stimulation — which is more invasive. The study showed substantial improvement in a reduction of tremors for many patients at three-, six- and 12-months. But it also showed that about a third of the patients in the study experienced not insignificant adverse effects from the procedure. The release presents a glowing picture of the promise of this new approach while disregarding the caveats offered both in the journal paper and an accompanying editorial about the study. To see how a news outlet covered this new research, see our review of a STAT article. Like the news release, the STAT story didn’t provide us enough quantification of the benefits or mention a potentional conflict of interest between researchers and device manufacturers. But the STAT article picked up on some things the release missed, including more discussion of the harms observed in the study. Estimates are that essential tremors affect as many as 10 million Americans, many of whom are not helped by medications and who may not be candidates for the current surgical remedy — deep-brain stimulation. If proven safe and effective after long-term studies, this less invasive alternative would give patients and health care professionals more options for dealing with a condition that negatively affects the quality of life for many.	mixture	Academic medical center news release	The release mentions cost, saying, “Because the approach is so new, insurance plans will not yet cover the procedure, though that may change in the coming months. The cost at UVA has not yet been determined.” But the procedure is still neurosurgery which is inherently expensive. Readers might benefit from knowing the cost of the current alternative surgical approach to treating this condition, deep-brain stimulation. The fact that other language in the release does come close to marketing this procedure for the medical center is also troubling. We’ll give this release credit for including numerical data on patient improvement during the study: “they found that mean tremor scores improved by 47 percent at three months and 40 percent at 12 months. Participants reported major improvements in their quality of life. People who couldn’t feed themselves soup or cereal could again do so.” Unfortunately, it omits a host of other numerical data contained in the NEJM paper that places the patient improvement in a less-glowing perspective, issues like the reduction in improvement over time experienced by some patients and the extent of adverse effects (see below). It’s quantification data was based on relative rather than absolute improvements and it was not clear what those improvements meant functionally. The release could have described the range of the scale and given the actual tremor scores. This would have been more informative than describing a 47% reduction which could represent a very large or relatively small changedepending on what the baseline scores were. Had the release included some of the caveats pointed to in an editorial about the same study carried in the journal, readers would have a clearer picture of just how important this new procedure was. The release mentions harms in this statement: “The most commonly reported side effects were gait disturbances and numbness in the hand or face; in most instances, these side effects were temporary but some were permanent.” But that is by no means enough. More than a third of the patients in the study developed gait problems or numbness, or both, that in some cases persisted for 12 months. Others developed ataxia, unsteadiness and weakness that was persistent. The release seems to go overboard in downplaying these adverse effects and amplifying the positive outcomes. Releases should never cherry-pick the data from a study. The release mentions that this clinical trial was a randomized, multi-center, sham-controlled study with a small but reasonable number of patients, given the procedure involved. It provides specifics on the patient population and the scope of their disease, as well as an explanation of how improvements were determined. The release would have been improved with a description of how improvement (or lack thereof) was measured. The release does not appear to disease-monger. This release identifies the funders of the study but fails to point out that the principal investigator has a financial relationship with the manufacturer of the device used in the study. In addition, the published study notes that “Representatives of the manufacturer of the focused ultrasound system used in the study (InSightec) provided study oversight and technical support and obtained national regulatory permissions.” Allowing the device manufacturers to have “study oversight” suggests a potential for bias when most studies are obligated to keep a firewall between investigators and financial sponsors. The release never mentions the current alternative approaches used to treat essential tremors, either the pharmacological approach with drugs such as propranolol or primidone, or the neurosurgical approach of deep-brain stimulation. The release is clear in that the medical center is preparing to make the procedure available to qualified patients but it certainly is not available to the public at this time. It also mentions the uncertainty of insurance coverage. The release points out that the trial is “the most in-depth assessment yet of the safety and effectiveness” of this new approach to dealing with essential tremors. And since the procedure is less invasive than the standard surgical intervention now in use, it is certainly novel enough to warrant a news release. The release steps over the line several times in its use of hyperbole, beginning with the headline, “Scalpel-free surgery proves safe, effective for treating essential tremor,” that ignores the high proportion of adverse effects reported in the study and the limited time — 12 months — that the study covered. Saying a procedure is safe without long-term studies is an exaggeration. Further on, subheads refers to it as a “pioneering tremor trial” and “groundbreaking research.”
11175	Lilly buoyed by findings on Evista	This story reports the initial results of the Study of Tamoxifen and Raloxifene Trial (STAR) for estrogen-receptor positive women at high risk of developing breast cancer. This study was partially funded by Eli Lilly, though this is not mentioned, and the results here are presented as a financial boon for the company. There is less emphasis on the accuracy and interpretation of the trial from a women’s health perspective. There is also no attempt at corroboration with breast cancer researchers not affiliated with the trial: A lead investigator of the study (partially supported by Eli Lilly) and the president of science and technology at Eli Lilly are not unbiased sources. Costs were not mentioned. The story mentioned that 19,747 women were randomized to either raloxifene or tamoxifen and provides quantitative evidence of improved risk of blood clots or uterine cancers, however, both of those results were just shy of statistical significance, which is not mentioned in the article or in NCI press materials. (Source ACS: http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Raloxifene_as_Good_as_Tamoxifen_to_Prevent_Breast_Cancer.asp) In addition, raloxifene did not appear to raise the risk of cataracts, which tamoxifen does appear to do. That difference was statistically significant. The story didn’t mention this. The story mentions equivalent comparison with tamoxifen in preventing invasive breast cancer, however, tamoxifen protected women better from non-invasive breast cancer such as DCIS (ductal carcinoma in situ) and LCIS (lobular carcinoma in situ). And these conditions are being diagnosed much more frequently these days.	true		No mention of the cost of treatment for women outside clinical trials. Some quantitative benefit mentioned of taking hormone therapy for chemoprevention. Incomplete discussion of reduced rate of side effects in raloxifene group. Mentions harms of hormone therapy, such as an increased risk of blood clots and uterine cancers. Does not mention that raloxifene, like tamoxifen, has bothersome side effects such as hot flashes and vaginal discharge, which are reported as comparable and mild to moderate in the NCI press release of the initial results of this trial. Mentions that the STAR trial was a 5-year trial, but not that is was unblinded early (around year 4) due to positive side effect profile of raloxifene. Mentions that 19,747 women were randomized to either raloxifene or tamoxifen and provides quantitative evidence of improved risk of blood clots or uterine cancers, however, both of those results were just shy of statistical significance, which is not mentioned in the article or in NCI press materials. (Source ACS: http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Raloxifene_as_Good_as_Tamoxifen_to_Prevent_Breast_Cancer.asp) In addition, raloxifene did not appear to raise the risk of cataracts, which tamoxifen does appear to do. That difference was statistically significant. The story mentions equivalent comparison with tamoxifen in preventing invasive breast cancer, however, tamoxifen protected women better from non-invasive breast cancer such as DCIS (ductal carcinoma in situ) and LCIS (lobular carcinoma in situ). ” No evidence of disease mongering. Mentions that this drug is for post-menopausal women at higher than average lifetime risk of developing breast cancer. This study was partially funded by Eli Lilly. There is a a lot of Eli Lilly promotional information in this story. Of course, Indianapolis is the home of Eli Lilly. No attempt and independent corroboration with other breast cancer researchers. There was not much effort to get opinions on the study from outside sources. A lead investigator of the Eli Lilly-funded study and the president of science and technology at Eli Lilly are not unbiased sources. The story discusses the STAR trial, which compared current hormone treatment, tamoxifen, with raloxifene. It should be noted that the results here are initial findings after 4 years of raloxifene. The story could have done a better job in explaining that tamoxifen is usually taken for 5 years and there is much more long-term clinical data on safety and efficacy for this drug. It’s clear form the story that raloxifene is currently available for use in post-menopausal women to prevent osteoporosis. What isn’t clear is that use in chemoprevention would be an off-label use. This type of hormone therapy should be used in estrogen-receptor positive, post-menopausal women. Notes that use of Raloxifene (Evista) as chemoprevention is still in the clinical trial phase and that there are plans to file for FDA approval for use in preventing and treating breast cancer. Evista is already approved to prevent osteoporosis. We can’t judge if the story relied solely or largely on a news release. However, there is certainly a lot of Eli Lilly promotional information in this story. And Indianapolis is the home of Eli Lilly.
36421	Colorado introduced a free birth control program, causing unplanned births and abortions to plummet, and saving millions of dollars.	Did Free Birth Control in Colorado Drop Unplanned Pregnancies by 40 Percent?	true	Fact Checks, Viral Content	On March 31 2019, a Facebook user shared a meme (archived here) about the purported effects of “free birth control” in the state of Colorado:Across an image of mountain scenery, the meme (watermarked by The Other 98%) read:COLORADO HAS OFFERED FREE BIRTH CONTROL FOR THE LAST 5 YEARS AND HAS SEEN:* UNINTENDED PREGNANCIES DROP BY 40% * ABORTION FALL BY 42% * MILLIONS IN PUBLIC HEALTH COVERAGE SAVEDSHARE IF YOU THINK WE NEED TO DO THIS WITH THE WHOLE COUNTRYAlthough the text described “the last 5 years,” the meme dated back to at least 2015, suggesting that it referred to a stretch between 2010 through 2015 or earlier. The meme made four claims about that time period, concluding with an opinion that the initiative ought to be implemented by other states:The source for the claims may have been a July 2015 New York Times article, published just before the earliest iteration of the meme we could find. It largely covered all four statistics mentioned in the meme, with some apparent inference in the meme:Over the past six years, Colorado has conducted one of the largest experiments with long-acting birth control. If teenagers and poor women were offered free intrauterine devices and implants that prevent pregnancy for years, state officials asked, would those women choose them?They did in a big way, and the results were startling. The birthrate among teenagers across the state plunged by 40 percent from 2009 to 2013, while their rate of abortions fell by 42 percent, according to the Colorado Department of Public Health and Environment. There was a similar decline in births for another group particularly vulnerable to unplanned pregnancies: unmarried women under 25 who have not finished high school. […]Proponents say the program is working. The state health department estimated that every dollar spent on the long-acting birth control initiative saved $5.85 for the state’s Medicaid program, which covers more than three-quarters of teenage pregnancies and births. Enrollment in the federal nutrition program for women with young children declined by nearly a quarter between 2010 and 2013.According to the New York Times article, the birthrate among teenagers dropped 40 percent — presumably the “unplanned” pregnancies mentioned in the meme. The rate of abortions dropped 42 percent in the same cohort, but it didn’t say what the drop in non-teenaged low-income women was by comparison. It also said that for every dollar spent on the program, the state’s Medicaid program saved $5.85 — but not what the overall number of births avoided or expenditures saved might be.However, a July 2014 CNN piece described the program’s effect as of that year, providing a timeframe for the start of the initiative as well as dollar amounts saved in a single year at the beginning of its implementation:Colorado’s teen birth rate dropped 40% between 2009 and 2013, the Colorado Department of Public Health and Environment announced this week [in 2014], in part due to a program that provides long-acting contraception to low-income women … In 2010 alone, Colorado saved $42 million on health care costs associated with teen births, thanks to the program, according to a press release from the governor’s office.A since-archived Colorado Department of Public Health & Environment press release from November 2017 reported that the initiative continued past 2015. It continued performing above expectations, and subsequent savings of $66.1 million to $69.6 million were cited for the years between 2009 and 2015:Colorado’s teen birth and abortion rates continue to plummet under a state health department family planning program that averted nearly $70 million in state and federal spending.“This is a good example of a smart and compassionate government program,” said Dr. Larry Wolk, executive director and chief medical officer of the Colorado Department of Public Health and Environment. “Not only did this initiative improve the health and well-being of thousands of Colorado women, it helped Colorado avoid the social and economic costs of unintended pregnancy.”From 2009 through 2016, the state birth rate fell 54 percent for women ages 15 to 19 and 30 percent for women ages 20 to 24. The state abortion rate declined 64 percent for women ages 15 to 19 and 41 percent for women ages 20 to 24. The number of teens giving birth for the second or third time dropped 63 percent during the same time period.An independent analysis by University of Colorado researchers concluded that the state health department’s family planning program was responsible for as much as two-thirds of the drop in births from 2009 through 2015, averting $66.1 million to $69.6 million in potential costs for four state and federal programs that provide health care, food and other assistance to low-income women and their infants.In other words, the meme’s claims actually understated the effects of Colorado’s free birth control program by 2019. The drop in teen births fell to 54 percent in subsequent years. The abortion rate also fell further, to 64 percent. And the 2017 update from Colorado’s health officials indicated that it estimated that $66.1 million to $69.6 million in expenditures related to unplanned pregnancies and births had been averted.
1687	Youth e-cigarette data prompts new calls to speed regulation.	Public health advocates are stepping up pressure on the U.S. government to quickly regulate and restrict access to e-cigarettes after new data showed use of the products tripled among high school and middle school children last year.	true	Health News	The figures released by the Centers for Disease Control and Prevention on Thursday raised concern among health officials who fear e-cigarettes will create a new generation of nicotine addicts who may eventually smoke conventional cigarettes. Cigarette smoking fell more than 25 percent over the same period. E-cigarette proponents said the data could indicate e-cigarettes are diverting young people away from conventional cigarettes, a view rejected by tobacco control advocates. [ID: nL2N0XD1UH] The Food and Drug Administration regulates cigarettes, roll-your-own tobacco and smokeless tobacco. It proposed extending its authority to e-cigarettes and hookah, among other products, nearly a year ago. FDA spokesman Michael Felberbaum said on Friday the agency is “moving forward expeditiously to finalize the rule.” Its goal is to release it in June. But the potential for delay is considerable. The agency received more than 135,000 public comments on the proposal and by law must review them all. The rule must also be reviewed by the Department of Health and Human Services and then by the White House’s Office of Management and Budget, which analyzes the potential economic consequences of proposed regulations. “This puts real pressure on every level of the administration to get this done,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids, referring to the CDC data. “It means business as usual won’t solve this rapidly growing public health problem.” OMB has not yet received the rule, according to its website. Once it does, it has 90 days to review it, though that can be extended. “There is always an opportunity for delay, but I think it will be much harder for the administration to exercise that opportunity now,” said David Dobbins, chief operating officer at the anti-tobacco group Legacy. “It’s up to the White House and HHS to make sure this regulation gets out as quickly as possible.” The proposed rule would ban the sale of e-cigarettes to people under the age of 18 and require FDA approval of new products. Public health advocates have also been pushing for a ban on flavored products, television advertising and internet sales, which they say attract children. The agency has said the rule would be the foundational first step in a range of potential future regulations. In the meantime, some states are moving to impose restrictions of their own. In February, Democratic Senator Barbara Boxer re-introduced proposed legislation that would allow the Federal Trade Commission to determine what constitutes marketing to children and would allow the FTC to work with states’ attorneys general to enforce bans. At least 43 states already have laws that restrict sales of e-cigarettes to minors and some are working to incorporate e-cigarettes into existing clean air acts that prohibit smoking in public places. “As long as the federal government doesn’t take uniform action, I think we will see action on a local level,” Dobbins said. “People can differ about the appropriateness of e-cigarettes for adults but I don’t think anyone disagrees on the appropriateness of giving them to children.”
37718	Rugby fans in New Zealand attended a live match on June 26 2020, because the country has successfully suppressed COVID-19.	A pair of viral Reddit posts — “New Zealand rugby game today as we have no COVID cases” and “New Zealand enjoying their rugby game with no Covid- 19 cases :)” — featured a photograph from an attendee at a June 26 2020 rugby match in Auckland, New Zealand. Overall, the claim is true with some very minor caveats — video highlights demonstrated that the match on that date involved massive crowds. Although New Zealand had at most two new cases the week of the match, the last instance of community transmission occurred in the country on or around May 1 2020. Although it was not true the image was New Zealand’s “first rugby game” (that was on the weekend of June 13 2020), the claim was accurate, and supported by myriad independent sources covering the match.	true	Fact Checks, Viral Content	On July 26 2020, a post to Reddit’s r/Damnthatsinteresting purportedly showed images from a rugby game in New Zealand on the same day, in a stadium full of fans — because the country has successfully suppressed COVID-19:New Zealand rugby game today as we have no COVID cases. from DamnthatsinterestingIterations and the Original Poster [OP]On r/pics, a similar thread was shared on the same day:New Zealand enjoying their rugby game with no Covid- 19 cases 🙂 from picsThe image originated on r/NewZealand, and it was initially shared by a Redditor apparently present at the match:Feeling lucky we get to do this! 🙂Chiefs vs Blues today from newzealandOn a different thread featuring the image, u/mistyillusions commented:Thanks for reposting without permission lolAnd:Hey! i recognise this photo–because i took it last night! lolWe spotted the image with one of the Reddit titles as a caption on Facebook:The MatchOn July 26 2020, the YouTube channel “SUPER RUGBY” published highlights in a video titled “Super Rugby Aotearoa \| Blues v Chiefs – Rd 7 Highlights,” with the following description:Super Rugby Aotearoa \| Blues v Chiefs – Rd 7 HighlightsThe Blues snapped their two-game losing streak on Sunday [July 26 2020], but not without a serious challenge from the still-winless Chiefs in Auckland.In those highlights, footage of a crowded stadium full of rugby fans was clearly visible, and regional outlets reported the event. Stills in the clip showed the crowd from numerous vantage points:Although it was difficult to specifically verify the image shared to Reddit by an attendee, footage from the event showed even larger portions of a crowded stadium.New Zealand ‘Has No COVID Cases’After u/mistyillusion’s photograph was crossposted (and apparently without their knowledge or permission) to other threads, titles often claimed that “New Zealand has no COVID cases,” and therefore were able to attend sporting events without masks or anxieties.According to Google’s COVID-19 dashboard, as of July 30 2020, the statement “New Zealand has no COVID cases” wasn’t precisely accurate. In fact, New Zealand appeared to have exactly one new reported case on that date:We moved the ticker back to July 26 2020, and for that date, there were zero new cases of coronavirus:Attempting to derive a percentage change from the zero new cases on July 26 2020 to the one new case on July 30 2020 yielded an interesting (and completely real) figure:We changed the metric from “new cases” to “deaths,” showing that on the deadliest day during the COVID-19 pandemic, four people in New Zealand died. The last COVID-19 death in New Zealand occurred on May 28 2020:We narrowed the results to the seven-day period up to and including July 30 2020:In that week, New Zealand hovered between zero and two new cases. Back on June 8 2020, the BBC reported that New Zealand “lifted almost all of its coronavirus restrictions after reporting no active cases in the country”:At midnight local time (12:00 GMT), all of New Zealand moved to level one, the lowest of a four-tier alert system.Under new rules, social distancing is not required and there are no limits on public gatherings, but borders remain closed to foreigners.New Zealand has reported no new Covid-19 cases for more than two weeks.Prime Minister Jacinda Ardern told reporters she did “a little dance” when she was told the country no longer had any active virus cases.“While we’re in a safer, stronger position, there’s still no easy path back to pre-Covid life, but the determination and focus we have had on our health response will now be vested in our economic rebuild,” Ms Ardern said.“While the job is not done, there is no denying this is a milestone. So can I finish with a very simple, ‘Thank you, New Zealand’.”Where New Zealand’s One or Two Cases OriginateNew Zealand reported between zero and two new cases the week of the rugby match — so how have they kept their numbers of new cases so low?On July 30 2020, a news outlet in New Zealand explained the source of the infections, and provided important context about the country’s management of the pandemic and case count:There is one new case of COVID-19 in New Zealand’s managed isolation and quarantine facilities, Director-General of Health Dr Ashley Bloomfield announced on [July 30 2020]. [July 30 2020]’s case is a woman in her 20s, who arrived in New Zealand from Ireland, via Dubai, on July 24 [2020]. She returned her positive result due to routine testing across the country’s managed isolation facilities. The woman, who was tested at around day three of her mandatory 14-day stay, had been completing her isolation period at the Rydges Hotel in Rotorua. She has since been transferred to Auckland’s quarantine facility.It brings New Zealand’s active case total to 24 and confirmed case total to 1210, the number reported to the World Health Organization. As of [July 30 2020] there have been no additional recoveries, although none of the current cases require hospital-level care.It has been 90 days since the last COVID-19 case was acquired locally from an unknown source, indicating there is no evidence of community transmission.On July 30 2020, New Zealand had few cases, not none. On that date, there were 24 active cases in New Zealand, and the most recent case of community transmission in New Zealand was on May 1 2020.New Zealand’s ‘First Rugby Match’ Since Effectively Eradicating the Novel CoronavirusThe rugby match in the photograph on Reddit was taken and shared on June 26 2020, and in one popular iteration was described as New Zealand’s “first” rugby match since the COVID-19 pandemic caused restrictions on events.That was inaccurate, as New Zealand’s first rugby match was reported by CBS News on June 14 2020:New Zealand welcomes back rugby with packed stadiums after country eradicates coronavirusNew Zealand became one of the first countries to welcome back fans to sporting events [on June 13 and 14 2020]. New Zealand was able to do so because of its success in eradicating the coronavirus.This past weekend [of June 13 and 14 2020], rugby made its return in New Zealand, with full crowds allowed to cheer on their favorite clubs in person. Going forward, fans will be allowed to attend games in an unrestricted fashion in New Zealand.TL;DRA pair of viral Reddit posts — “New Zealand rugby game today as we have no COVID cases” and “New Zealand enjoying their rugby game with no Covid- 19 cases :)” — featured a photograph from an attendee at a June 26 2020 rugby match in Auckland, New Zealand. Overall, the claim is true with some very minor caveats — video highlights demonstrated that the match on that date involved massive crowds. Although New Zealand had at most two new cases the week of the match, the last instance of community transmission occurred in the country on or around May 1 2020. Although it was not true the image was New Zealand’s “first rugby game” (that was on the weekend of June 13 2020), the claim was accurate, and supported by myriad independent sources covering the match.Comments
9427	Migraines plague millions, especially women. Now there's new hope	Getty Images The news peg of this Philadelphia Inquirer story (the “new hope” mentioned in the headline) is a clinical trial, published in the New England Journal of Medicine, for the monoclonal antibody drug, fremanezumab, which has shown promise in treating migraines. But, the story spends so little time discussing the new drug that it appears to write “around” the news, rather than writing “about” it. Readers, especially those dealing with this kind of pain, deserve comprehensive and quality information about anything dubbed a “new hope,” as this story does.	mixture	migraine	The cost of the drug is not discussed. Other media coverage of this new proposed drug, fremanezumab, sets its price as high as $8,500, although it’s not clear if that is for a year’s treatment or a single administration. The story only states that, “fremanezumab, an immunotherapy drug, has been found to reduce the number of days that chronic migraine sufferers experienced headaches.” This is not enough numerical information to help readers understand the scope of the benefits. By how much did it reduce the number of days? By 1? 5? 10? Similarly, this story doesn’t discuss harms. The story states that the study was a Phase III trial, but doesn’t explain what that is. Beyond that, there are no details–was it randomized? Controlled? How many people were enrolled? How long did it last? What were the key limitations? Migraines are a common cause of headaches, and can be tough to treat. However, we did want to note that the family anecdote in the story is an extreme case, and not necessarily representative of what most people with migraines experience. The story does include one statement by a physician not part of the research team. But it doesn’t point out that all of the researchers are either the employees of the pharmaceutical firm, Teva Pharmaceuticals, which makes the new drug, or they are consultants to dozens of other pharmaceutical firms. These ties should have been disclosed. The story does mention other current drugs and alternate approaches to treating patients with migraines so it gets a satisfactory in this category. However, most of these remedies are supported by poor or medium quality evidence and the article does not separate those that have more robust evidence and those that have been supported by tenuous or flawed evidence only. The story does state that, “Based on the promising phase III clinical trials, the drug could be available later next year.” The story makes it clear that this is the first drug (if approved) to be migraine-specific. The story does not appear to rely on a news release.
24576	"The health bill's plan for comparative effectiveness research ""would be used by the government to ration care."	here may seem something of a paradox because, as we note above,	false	National, Health Care, John Boehner,	"Many opponents of health care plans being considered by Congress have warned they would lead to government rationing of health care services. To which we say, yes they would. Health care is already rationed. Public and private plans have limited resources, and you can't just get any medical service you want anywhere at any time. That's rationing. It's a reality of health care today and would be under any of the plans being considered in Congress. And so we gave a to former Democratic National Committee chairman Howard Dean when he said the plans include no rationing. But that's not to say many of the claims of rationing by the Republican opponents are right. In fact, many of them are very misleading, or outright wrong. We've weighed in previously on former Alaska Gov. Sarah Palin's claim the bill would create ""death panels"" that will decide whether Grandma will get health care. It wouldn't. Here, we'll deal with another popular claim from Republican opponents of the plan: that government-sponsored research into medical care would be used to ration services. Most recently, the claim was made in a press release on the Web site for House Republican Leader John Boehner, R-Ohio, on Aug. 18, 2009. It states: ""The bill would establish a new tax on every health insurance policy to fund a government board that would be tasked with deciding which treatments are more cost-effective,"" the release states. ""The research findings would be used by the government to ration care."" The press release cites the part of the House bill that deals with establishing a Center for Comparative Effectiveness Research within the Agency for Healthcare Research. That's a bureaucratic way of saying the government would do studies to find out which medical treatments and medications work better than others, and which are most cost-effective. The idea is that this would help doctors and patients make better-informed decisions about the most effective treatment strategies. It's also expected to save money over time. A case for it was made on June 12, 2007, by Peter R. Orszag, then director of the Congressional Budget Office but now a member of the Obama administration, in an address to Congress: ""Hard evidence is often unavailable about which treatments work best for which patients or whether the added benefits of more-effective but more-expensive services are sufficient to warrant their added costs."" The findings, he said, suggest that better information about the costs and benefits of various treatments could substantially lower health care spending as well as ""yield better health outcomes from the resources devoted to health care."" Some opponents such as Boehner have argued that such research will lead to the government telling doctors what kinds of services or medications they can and cannot provide — rationing. Our ruling here may seem something of a paradox because, as we note above, Boehner would be right if he said there is rationing now and will be rationing in the future. But in this case, there actually are provisions in the bill about comparative research to make sure it is not used for rationing. Language in the House version of the health bill specifically states: ""Nothing in this section shall be construed to permit the Commission or the Center to mandate coverage, reimbursement, or other policies for any public or private payer."" And let's be clear, comparative effectiveness research has been done by the government for years and years. The Obama administration wants to greatly expand the amount of research. The economic stimulus package also included more funding for comparative effectiveness research. And the bill included a similar disclaimer that it would not mandate insurers to cover or reimburse one treatment or medication over another. ""We definitely need more information about how cost-effective certain things are,"" said Katherine Baicker, a health economics professor at Harvard University. People are understandably nervous that these studies could lead to rationing of certain services, she said, but as a researcher, ""It's hard for me to see how we can make better decisions without better information."" AARP, the leading advocate for seniors, has long been a strong supporter of such research. ""It boggles the mind"" said AARP spokesman Jim Dau, how comparative effectiveness research has been portrayed by opponents of the health care plan as government rationing of care. ""It's just good common sense,"" Dau said of the research. ""It's giving individuals and doctors better evidence-based research so that they can make better decisions."" Gail Wilensky, who ran the Medicare program under President George H.W. Bush in the early 1990s, is another big advocate of comparative effectiveness research. She views it as lobby-free information that can be used to empower patients. Wilensky envisions tiered co-payments based on the clinical appropriateness of various medical treatments. That's not rationing, she said. ""As we get more advanced, we'll be able to move toward more precision medicine, where we can authorize even very expensive treatments if we know they are going to work,"" she said. So, for example, she said, if someone with cancer has a biomarkers that indicates they would be likely to respond to the treatment, there would be a lower co-pay. ""We ought to be doing things better,"" Wilensky said. ""We need to spend smarter and treat more effectively,"" We think it's reasonable to conclude that some insurers may decide to use the government's research findings to determine what kinds of medical services it will cover, or at least which ones it will cover first. But we think it's a stretch to call giving patients better information about which treatments and drugs are most effective ""rationing."" In fact, given specific language in the bill to the contrary, we think it's outright wrong for Boehner to claim the research findings would be used by the government to ration care. Our friends at FactCheck.org came to the same conclusion in an item that walks through the evolution of comparative effectiveness research. So we find Boehner 's claim that comparative effectiveness research findings ""would be used by the government to ration care"" to be ."
10633	Electrical stimulation in the nose induces sense of smell in human subjects	The news release focuses on a recent paper regarding the use of electrodes in the nose to stimulate the brain and produce a sense of smell. The release is careful to highlight that this is only the earliest stage of research into developing a technology that might be able to restore a sense of smell to people with “smell loss” or anosmia — specifically for those who have lost the sense of smell due to nerve damage. The release misses the mark in describing benefits, harms and sources of funding. Proof-of-concept studies are interesting and important because they raise awareness of new possibilities. For people suffering from anosmia, the potential — however remote — for a technology that addresses their condition would be interesting indeed. But it’s important to highlight the limitations of such proof-of-concept research. This release doesn’t oversell the discovery, which is good. But if a condition is caused by nerve damage, and a prospective technological treatment involves attaching electrodes to what may be the relevant damaged nerves, one wonders just how much a study can tell you when it looks only at people whose nerves are not, in fact, damaged.	mixture	Hospital news release	Cost isn’t addressed, but we wouldn’t expect much here in regard to cost. The work is far too preliminary to attach a price tag, and the release highlights just how far off any relevant technology is from becoming a reality. Ideally, some discussion of cost, even in the most general terms (even if, for example, it were simply to say that it is far too early to estimate cost) would have been desirable. The release suggests that this is a “breakthrough for human patients.” None of the participants (incorrectly referred to as patients) in the study had lost their sense of smell, so none could have their sense of smell restored. The release notes that three of the five participants who underwent the experiment reported sensations of smell when their nerves were stimulated by electrodes. Importantly, the release neglects any qualification or description of the sensations. The manuscript notes the smells as “onion like,” ” fruity but bad,” “antiseptic like” and “sour.” Yes, electrical stimulation did create smells but creating de novo smells is hardly a benefit. Indeed the sensation of smells where none are present is referred to as olfactory hallucination. As with cost, it is far too early to create a laundry list of potential side effects associated with nerve stimulation to induce sensations of smell. However, there are things that could be said. For example, the study itself found that volunteers reported discomfort and occasional pain associated with the electrode stimulation. And the potential for inducing olfactory hallucination needs to be considered. Dysosmia may be less desirable than anosmia. The release notes the small sample size (five people), that all five participants had an intact sense of smell, and that only three of the people reported sensations of smell stemming from the electrode stimulation. That’s enough to earn it a satisfactory rating here. However, as noted above, it fails to answer what would appear to be a threshold question. If the work is held up as a proof of concept meriting additional research for the potential development of a prosthetic sense of smell; AND the proof of concept was done by using electrodes on nerves in a person’s nose; AND all of the volunteers in the proof-of-concept study had healthy nerves in their nose; BUT the people any prosthetic could be used on are people with nerve damage; then what, if anything, does this study tell us? Would the proof of concept even work in patients whose anosmia is caused by nerve damage? That seems like a fundamental question that needs to be answered before even exploring the feasibility of developing relevant technology, and it’s not addressed here. The release describes the potential effects of anosmia fairly accurately, consistent with a 2013 study on the consequences of the condition. It also puts the disease in context, describing how many people are estimated to be affected by smell loss. The release does not mention any sources of funding or potential conflicts of interest. To be clear, even if the work was internally funded and there are no conflicts of interest, that is worth noting. The release acknowledges previous work of “research colleagues” at the Virginia Commonwealth University but should have gone further in explaining that the researchers hold a patent for an olfactory implant system and have formed a company to develop the technology. The release notes that some cases of anosmia can be treated, but that there are no proven therapies for treating anosmia cases caused by nerve damage. The release also mentions preliminary work being done at another university aimed at developing a treatment for patients with anosmia caused by nerve damage (that work is also in its earliest stages). That earns it a satisfactory rating here. The release makes clear that a tremendous amount of work needs to be done before any relevant treatment technology might become available. The release makes clear that the researchers have, “for the first time, induced a sense of smell in humans by using electrodes in the nose to stimulate nerves in the olfactory bulb.” What they have not done, however, is shown whether that’s relevant for patients whose sense of smell is caused by nerve damage. The use of the word “breakthrough” is out of place in a summary of proof of concept work.
5697	Northam proposes $22M to improve maternal health outcomes.	Virginia Gov. Ralph Northam announced Monday that his budget proposal will include about $22 million for efforts to improve health outcomes for mothers and babies and reduce the racial disparity in the state’s maternal mortality rate.	true	Ralph Northam, Race and ethnicity, Health, General News, Virginia, Richmond, Medicaid	Part of the funding in the spending plan for the legislative session that begins in January would expand Medicaid coverage for new moms and increase home visits from care providers, said Northam, who was surrounded by advocates holding babies and young children as he spoke in Richmond. The plan also would fund access to long-term contraceptives for low-income patients and study the possibility of Medicaid reimbursement for doula services. “It is unacceptable that in this country and in our Commonwealth maternal mortality rates are on the rise,” he said. “This disparity is greatest among black women, who have a maternal mortality rate two times that of white women, regardless of education or income status.” Northam, a Democrat, established a new initiative in June intended to reduce the maternal mortality rate for black women. He said the budget proposals grew out of that work, which included a series of public input session held around the state. “Our goal is that every mother and every infant survive” to celebrate the baby’s first birthday together, said Northam, a pediatric neurologist. The governor’s budget includes nearly $4 million over two fiscal years to expand Medicaid coverage for women who are eligible only while they are pregnant. Coverage for those women currently extends 60 days from the end of a pregnancy. The additional funding would extend coverage until a year post-pregnancy and cover treatment for substance use disorders. State figures show the majority of pregnancy-associated deaths occurred more than 43 days from the end of the pregnancy and ensuring postpartum care would improve health outcomes, Northam said. The budget plan would allocate another $4 million to the state program that offers long-acting reversible contraception to low-income patients and $12.8 million to make home visit services eligible for Medicaid reimbursement. Northam said the plan also would call for the study of the best way to develop a Medicaid reimbursement model for doulas, who provide support to women and their partners during pregnancy, labor and the postpartum period. Aaliyah Samuel, a mother from northern Virginia who spoke after Northam’s announcement, said she was grateful for the steps he was taking. She said she experienced discrimination from health care professionals during the birth of her first son, who did not survive. “Unfortunately, my story is far too common among black women and women of color, not only here in Virginia but across the U.S.” she said. Governors’ budget proposals generally serve as a starting point for negotiations during the General Assembly session, which starts in January. The budget will be a top priority, and Northam’s plan will likely get a warmer reception than the one he put forward a year ago. During last month’s legislative elections, voters gave Democrats full control of the General Assembly for the first time in a generation. The governor is scheduled to make another budget announcement Tuesday at a child development center and is expected to share full details of his spending plan next week during a meeting of the House and Senate money committees.
27910	Several actors have kicked the bucket in front of an audience.	‘Dimebag’ Darrell Abbott, formerly of the metal act Pantera, was shot by a jilted fan while performing with his new group, Damageplan.	true	Entertainment, died onstage, freakish fatalities, Radio & TV	Long part of the canon of contemporary lore is the tale of an unfortunate actor who expires on stage, his adoring audience unaware of his sudden deceasement because they think his collapse part of the show — while they clap and cheer at the brilliance of his death scene performance, unknown to them he is gasping his last. What follows is a quick romp through a growing list of those who died in the blaze of the footlights or on camera, or who were rumored to have met the Grim Reaper while treading the boards. At least one thespian death actually does match the legend (see if you can find it). Sports figures are not included in this compilation, even though a great many of them have expired while doing their thing as the public watched. This French playwright and actor-manager collapsed during the fourth performance of his newly penned Le Malade Imaginaire (The Hypochondriac). Overwhelmed by a coughing fit, he was carried to his home in the Rue de Richelieu, Paris, where he died. This Austrian conductor died in Munich at the age of 55 while conducting Act II of Wagner’s Tristan and Isolde. During a radio show (a round table discussion with four others on Hitlerism), Woolcott suffered a heart attack at 7:15 p.m. and died in hospital four hours later. Hundreds of people tuned into the show were unaware anything was amiss. Indeed, listeners reported that the writer, known for his incisive and sometimes stinging comments, seemed to have taken less than his usual part in the broadcast. Rhythm and blues recording star Johnny Ace died during a show he was giving in Houston, but did so offstage. During a five minute break, the singer was amusing himself with a game of Russian Roulette (one bullet in the chamber). He lost. Tyrone Power suffered a heart attack during the filming of a fencing scene in Solomon and Sheba in Madrid, Spain. He died only minutes after being loaded into an ambulance. As famed comedian Parkyakarkus, Harry Einstein expired while performing at a Friars Club roast for Lucille Ball and Desi Arnaz. He collapsed onto Milton Berle’s shoulder. Chief conductor at the Royal Concertgebouw in Amsterdam, van Beinum was taken ill after rehearsing the first two movements of a Brahms symphony, and died immediately after stepping off the podium aged 58. Just after he completed his second-act aria in Verdi’s La Forza del Destino (The Force of Destiny) at the New York’s Metropolitan Opera, Warren plunged face-forward onto the stage. The curtain was rung down, and it was announced a half hour later the singer had died of a massive stroke. This aviation pioneer and legendary movie stunt pilot died in Yuma, Arizona, during the filming of The Flight Of The Phoenix. As three motion picture cameras ground away, his plane hit a small sand dune, overturned and disintegrated. Though semi-retired from stunt work, Mantz was covering for his partner, Frank Tallman, who’d six weeks earlier broken his leg pushing his son’s go-cart. This famous actor and singer suffered a fatal stroke while performing onstage at the Doral Country Club in Miami at age 65. He died in hospital the next day. This 60-year-old conductor died at the National Theatre in Munich while leading Tristan and Isolde. While playing the lead in Macbeth at the Crawford Livingston Theatre in St. Paul, Minnesota, Ostroska dropped dead of a heart attack at the beginning of the second act. He was 32. This 70-year-old actor died onstage of a heart attack during a performance of 70 Girls 70 in Philadelphia. In a New York Times Magazine interview, this 72-year-old longevity guru announced, “I’m going to live to be 100, unless I’m run down by a sugar-crazed taxi driver.” A guest on the Dick Cavett Show the next day, while Cavett was discussing politics with journalist Pete Hamill, Rodale’s head dropped to his chest and he was heard to let out what sounded like a snore. “Are we boring you, Mr. Rodale?” asked Cavett. There was no response — Rodale was dead. The show was never broadcast. The lead guitarist of the Glasgow band Stone the Crows died after being electrocuted onstage at Swansea’s Top Rank Ballroom. Best known as “Granny” on TV’s Beverly Hillbillies, this spritely 71-year-old suffered a stroke while performing in the Broadway musical Pippin and died six weeks later. This 59-year-old expired of a heart attack while conducting Bach’s Come, Sweet Death at the Will Rogers High School in Tulsa. It was his first and last performance of that piece. After surprisingly opening her morning community affairs talk show with a newscast, this 30-year-old reporter announced, “In keeping with Channel 40’s policy of bringing you the latest in blood and guts and in living color, you are going to see another first — attempted suicide.” She then drew a revolver and shot herself in the head. Chubbuck expired 14 hours later in a hospital. Best known for his Carry On roles, the grand old man of dirty laughter collapsed onstage at the Sunderland Empire during a performance of The Mating Game and died in hospital shortly thereafter. He’d suffered a heart attack. This 83-year-old actor suffered a heart attack during a 25 November 1977 performance in Chicago of the musical Side By Side, causing him to slip into a coma from which he never recovered. This famed aerialist died at age 73 while attempting to walk a wire suspended 123 feet in the air between two hotels in San Juan, Puerto Rico. While attempting to film war destruction in Nicaragua, this ABC television news correspondent and his interpreter, Juan Espinosa, were executed by a National Guard soldier. Surviving members of the ABC crew managed to catch the murder on tape, and the footage was later shown on news broadcasts. This 48-year-old actor suffered a heart attack during a New York City performance of Peter Pan. In Hollywood’s most infamous on-set tragedy, Vic Morrow and two child actors in Twilight Zone, The Movie were killed when struck by a helicopter during the late-night filming of a mock Vietnam battle scene in Valencia, California. All exposed film was immediately seized, but some eventually made its way into the 1992 compilation film Death Scenes 2. Eight years after collapsing on stage during a performance and slipping into a coma, this singer died. He’d been felled in Cherry Hill, N.J. on 25 September 1975 while touring with Dick Clark’s touring rock-‘n’-roll revival. Though Wilson emerged from the coma a year later, treatment in medical facilities failed to restore his health. Known as the fez-wearing magician whose tricks always seemed to go wrong, this British comedian suffered a heart attack during a televised performance. Given the usual nature of his act, the audience took some time to realize that this really wasn’t part of it. He died later in hospital. This half of Britain’s Morecambe and Wise comedy team died in hospital the day after suffering a heart attack during a curtain call of a performance in Tewkesbury, Gloucestershire. He was 58 years old. Hexum died of a gunshot wound after he accidentally shot himself in the head with a .44-caliber magnum pistol loaded with blanks while on the set of the TV series Cover-Up. Wadding from the blank cartridge had been driven into his skull. Hexum was replaced in the series by Antony Hamilton, but the show didn’t last all that long, running only from 22 September 1984 to 6 July 1985 before being canceled. The Sankai Juku Dance Company of Toyko had been performing The Dance Of Birth And Death on the side of Seattle’s Mutual Life building when Takada’s rope broke and he plunged six stories to his death. The film of his demise was shown on the nightly news. Millions heard the final broadcast of this traffic reporter for WNBC radio in New York City as the helicopter she was in crashed into the Hudson River. She died on the way to the hospital. The pilot survived. This was Dornacker’s second helicopter crash that year. After singing several choruses of “Please Don’t Talk About Me When I’m Gone” during a performance of The Drunkard, this 60-year-old actress collapsed on stage for her scripted death scene and suffered an unscripted fatal heart attack. She was pronounced dead at the hospital. This Cincinnati reporter for radio station WKRC was killed along with the pilot in the crash of the station’s helicopter. She was not broadcasting at the time. This Pennsylvania state treasurer staged the best-known televised suicide. About to be sentenced on charges of conspiracy, mail fraud, perjury, and racketeering for taking a $300,000 kickback on a state computer contract, Dwyer convened a press conference in his office. While the film rolled, he handed out a twenty-page press statement, made a few remarks, then placed the barrel of a .357 revolver in his mouth and pulled the trigger. The tape was shown on the nightly news. While giving a comedy performance at the UC San Diego campus, Shawn fell and struck his head on the stage. The comedian lay there for nearly five minutes before the audience realized it was not part of his act and an ambulance was called. He died forty-five minutes later in hospital, apparently of a heart attack. This jazz saxophonist died of heart attack after collapsing onstage while giving a performance at Donte’s in North Hollywood. According to another member of the quartet, Marsh “just slipped off his stool.” He was pronounced dead at the hospital. Thrill seekers on “haunted hayride” in New Jersey got more of a thrill than they’d bargained for when it was discovered the teen playing the part of the hanged man was the real thing. The stunt had gone fatally wrong. This North Carolina 15-year-old who’d been staging a gallows scene at a Halloween party accidentally hanged himself when the noose somehow tightened. An amateur magician and resident of Fresno, California, Burrus came up with an escape stunt that would have done his idol Houdini proud — he’d be bound, confined in a plastic coffin, then buried under seven tons of soil and concrete. Handcuffed and chained, he was lowered into the hole. Assistants shoveled three feet of soil onto the casket, then a truck poured concrete into the hole. As they were topping up the cement, the level suddenly dropped eighteen inches. Fifteen minutes of excavating later, rescuers reached Burrus, but it was too late — he’d been crushed. Actor/comedian Redd Foxx underwent a heart attack on the set of The Royal Family, a new sitcom he was to appear in. Best known for his curmudgeonly role in Sanford and Son, this time it really was the big one, Elizabeth. A stunt gone wrong during the filming of The Crow cost the son of Bruce Lee his life. A blank fired from a .44 magnum revolver felled him. He died hours later in hospital. The metal tip of one of the dummy bullets had somehow pulled loose from its brass casing. When the dummies were unloaded and replaced with blanks, the metal tip remained behind in the gun’s cylinder. As soon as the blank went off, its explosive force propelled the dummy tip through the gun barrel — and into Lee’s body. Rumor to the contrary, footage of Lee’s fatal accident is not included in The Crow. While filming a segment for BBC’s 999 (a show which dramatically reconstructs real-life narrow escapes), this veteran stuntman died when his main parachute and two reserves failed to open. This popular radio host suffered a fatal heart attack while broadcasting popular music on WHLI in Garden City, Long Island. Though he was rushed to the hospital, he was pronounced dead on arrival. The song playing at the time of his heart attack was I’m in the Mood For Love. This drummer for the group Big Sugar died mid-number while performing in Waterloo, Iowa. He was 36. Better known as Country Dick Montana of the underground rock band The Beat Farmers, McLain expired on stage of a heart attack during a sold out performance at the Longhorn Saloon in Whistler, B.C. During the filming of a Mountain Dew commercial, this sky surfer’s parachute failed to open and he plunged to his death. Despite rumors to the contrary, though the finished commercial contains some footage of Harris, none comes from his final jump. This 63-year-old tenor died onstage at New York’s Metropolitan Opera immediately after delivering the line: “Too bad you can only live so long” in Janacek’s The Makropulos Case. It was the first performance and Versalle, who was playing the legal clerk Vitek alongside Jessye Norman, climbed a 20 ft ladder to file a legal brief, but had a heart attack and plunged to the ground. Janacek’s opera is about the secret of eternal life. While performing at Yokohama’s Blues Cafe, this 61-year-old rhythm and blues legend suffered a heart attack. He was pronounced dead upon arrival at the hospital. Performing at a Minneapolis fund raiser, Tiny Tim cut short his rendition of “Tiptoe Through The Tulips.” Turning to leave the stage, he was felled by a heart attack and was pronounced dead on arrival at the hospital. This 63-year-old British magician died on stage during a charity show in Sheffield, Yorks. Playing Judas in a Greek production of Jesus Christ Superstar, Wheeler’s performance was supposed to conclude with Judas hanging himself, a stunt he’d successfully negotiated 20 previous times. This time he forgot to fasten the rope to his safety harness. During a live show, this Brazilian radio presenter and local politician was shot dead by a gunman who burst into the studio. He was hit by 10 bullets fired from two revolvers. This professional wrestler lost his life when he fell from a height of 90 feet as he was being lowered into the ring for the “Over the Edge” sports entertainment event in Kansas City, Missouri. Lead singer of the Boston-based rock band Morphine, 47-year-old Mark Sandman collapsed on stage during a concert in Rome. He had suffered a heart attack and was pronounced dead in the ambulance on the way to the hospital. This jazz saxophonist and composer suffered a heart attack and collapsed after taping four songs that Friday evening for The Saturday Early Show on CBS. He died in hospital in New York City. While putting on a magic show for a group of hospital patients at Tokoroa Hospital in New Zealand, “Uncle Ron the Magician” collapsed and was pronounced dead 45 minutes later. The patients at first believed his crumpling onstage was part of the act. Another actor playing Judas mistakenly hanged himself in Camerata Nuova, a town 45 miles from Rome. Di Paolo’s death was captured on film by someone shooting a video of the outdoor play. This principal trumpet player with the Greater Trenton Symphony Orchestra collapsed of a heart attack on stage just after performing a solo and died in hospital. This 54-year-old conductor collapsed and died of a heart attack in Berlin while conducting perhaps the most emotionally charged scene in Verdi’s Aida. During the taping of the TV sitcom 8 Simple Rules for Dating My Teenage Daughter, the 54-year-old actor was stricken by a previously undiagnosed heart problem. He died in hospital later that night.
23872	Gov. Crist's veto also clears the way for taxpayer funding of abortion in Florida.	Expectations were high last year for three new migraine drugs hitting the market from Amgen Inc, Eli Lilly and Co and Teva Pharmaceutical Industries.	false	Abortion, Florida, Marco Rubio,	Priced around $7,000 each, the drugmakers called them “breakthrough” treatments designed to prevent migraines when taken year-round, and estimated that millions of patients could benefit. The U.S. Food & Drug Administration said Amgen’s Aimovig – the first of the three drugs approved – was an “important addition” to available treatments. But a small group of external medical experts who quietly advise U.S. health insurers on new drugs was not impressed, according to a private meeting held at UnitedHealth Group’s OptumRx offices in Chicago that was attended by Reuters. They concluded that all three medicines offered no clear benefit over drugs already on the market and that insurers could consider them optional when it came to health coverage. They advised putting limits into place on their use. While these experts do not discuss drug costs, their view of the clinical value of the new migraine drugs emboldened OptumRx, which manages prescription drug benefits, to demand steep discounts from the three manufacturers. Similar “pharmacy and therapeutics” (P&T) committees at rivals CVS Health Corp and Cigna Inc’s Express Scripts came to the same conclusion. The impact of their rulings will be on display on Tuesday, when Amgen, which co-markets the drug with Novartis AG, and Lilly report on their quarterly financial performance. When asked by Reuters about the OptumRx committee decision, the three drugmakers said the new therapies represent an important advance to patients who are not helped by existing treatments, or who have struggled to stay on their medications. They stress that for some patients, the new migraine drugs cut by half the number of days they experience headaches each month. These relatively unknown expert committees have been involved in drug coverage decisions for decades. Their identities are kept secret due to federal regulations aimed at preventing pharmaceutical industry interference. The committees make their decisions based on a drug’s clinical value, independent of cost, pharmacy benefit managers say. But their power has grown more recently with the consolidation of most of the U.S. pharmacy benefits business under OptumRx, CVS and Express Scripts. Taken together, their three advisory committees now guide drug coverage for more than 90 million Americans. P&T committees also hold sway over record numbers of novel and expensive medicines introduced into the U.S. market each year, more often with less evidence of effectiveness or safety than in the past. New drugs that may fall under their scrutiny in the next year include potentially life-saving therapies for spinal muscular atrophy and Duchenne muscular dystrophy as well as oral treatments for migraine, diabetes and multiple sclerosis. Their decisions have new consequences as the pharmacy benefits companies they advise are more likely to exclude a new treatment from coverage if it is deemed on par with existing therapies. Or they can demand discounts - or rebates - from drugmakers in exchange for the coverage. “If the committee says (a treatment) is no better than the existing drug, there is a very decent possibility that it might get a less preferred status or not be included” for reimbursement, said Jack Hoadley, a health policy expert at Georgetown University. OptumRx’s ability to call the shots on drug coverage for more than 30 million people make it a formidable negotiator for clients like Ben Johnson, a pharmacy director for a health plan in Utah that covers about 20,000 railroad union workers. Johnson once relied on his own P&T committee to determine whether a drug was effective and worth the price. Now he is often among the dozens of OptumRx clients and consultants invited to observe the quarterly P&T committee meetings in Chicago. Handing that role to OptumRx has tripled the value of rebates that his plan receives, Johnson said. FROM “BREAKTHROUGH” TO “OPTIONAL” Drugmakers say pharmacy benefit managers such as OptumRx are middlemen that take too great a cut of the discounts they negotiate and ultimately drive prices higher. U.S. Congress and President Donald Trump have taken up that criticism, and the administration has proposed banning rebates in government health programs unless benefits managers hand over the savings to patients. OptumRx, Express Scripts and CVS say that their method of reviewing a drug’s benefit and subsequent price negotiations has lowered prescription drug costs, and that 95 to 98 percent of the discounts they receive are passed on to their clients. In the case of the migraine drugs, Amgen, Lilly and Teva were quick to advertise the potential benefits directly to U.S. consumers once they were approved, months before the pharmacy benefits companies made decisions on how to cover the drugs. Television commercials from the drugmakers highlighted how some patients had their headache days cut in half, or more. The manufacturers offered the drugs to commercially insured migraine sufferers for free for up to a year or even longer to entice people to try them. Their primary competition is older, cheaper generic drugs. Migraines affect more than 39 million Americans, mostly women, and Amgen estimated 8 million could be candidates for the preventative therapies, which are delivered by injection every month or few months. Analysts forecast $4 billion in annual sales by 2026 in major global markets. OptumRx convened its advisory committee of a dozen doctors and pharmacists last November to review the new migraine drugs. These experts pointed to clinical trial data showing that patients taking the new drugs experienced an average of 1 to 2.5 fewer migraine days a month than those treated with a placebo, and said that was on par with existing therapies, though there were no clinical studies directly comparing the two groups of medicines. The committee acknowledged that some patients saw a much bigger benefit from the new drugs, but said the data did not show who might be helped the most. They questioned the limited safety data and the unknown long-term effects on the body. “Let’s be cautious and see how it all plays out, but we need to look at these studies with a jaundiced eye,” one of the members said. The committee’s verdict: All three drugs should be considered “optional” treatments that provide no unique benefit. OptumRx Chief Medical Officer Sumit Dutta said the decision, based on available clinical data, provided balance to the drugmakers’ claims. “There are plenty of examples of drugs that have a lot of enthusiasm in the beginning,” but that later turned out to be problematic, Dutta said. Because OptumRx could choose not to cover any of the new migraine drugs, it could push aggressively for discounts. On February 1, it began to cover Amgen’s Aimovig and Lilly’s Emgality. Teva’s Ajovy would only be covered if patients did not benefit from the other two drugs. Leerink biotech analyst Ami Fadia estimates manufacturer rebates on the drugs are as high as 50 percent. Amgen said 200,000 U.S. patients have been prescribed Aimovig, with about half of prescriptions being filled for free. Teva and Lilly have not provided figures on patient use. Teva said in February it expects 2019 sales for Ajovy of $150 million. For its part, Express Scripts estimates that only 128,000 of its covered patients will be good candidates for the new therapies, and has a program to closely manage who receives them. OptumRx and CVS declined to provide similar forecasts.
9442	‘Unbelievable’: Heart Stents Fail to Ease Chest Pain	This New York Times story describes startling news that a very common procedure–inserting a stent to open a blocked blood vessel–does not add benefit over medication in patients with angina. Angina is chest pain due to blocked heart arteries, and is common among people with heart disease. Sourcing is a strong point for this story: It features perspective from many American cardiologists who were shocked to learn of the negative results from this study. However, two important potential conflicts of interest among the sources were not disclosed. In addition, the story contains lots of helpful detail on the limitations of the study, the possibility that placebo effects are at play, and how medical practice may or may not change as a result. It also discussed the costs and potential harms of stenting procedures. That said, the story could have provided more information on what the study itself measured–and what, precisely, the results were. The Wall Street Journal story, which we also reviewed, was stronger on this point. Heart disease is still the leading killer of Americans so any news about treating aspects of heart disease, such as blocked arteries, is newsworthy. In addition, this story suggests that stenting — common, but expensive — is a prime example of over-treatment. Also the procedure carries some risk and may be causing complications if overused.	true	angina,heart disease,stent	The story says the procedure to insert stents costs from $11,000 to $41,000 in the U.S. The story makes clear there was no significant difference between a sham procedure or stent insertion, but it only describes the benefit as “less pain.” We would like to see how the pain was measured, some numbers on how much pain was reduced, and how many patients benefitted in each group. The story briefly mentions there are potential harms, including death. The story describes the study’s methods in some detail — the sham surgery of the control group, for instance — and mentions the size of the study and the characteristics of the subjects. It adds heft to the sense that this was a very good study with multiple reactions from expert sources — “humbling,” “unbelievable,” “impressive” and “very well conducted.” Importantly, it quotes one source describing a few desired measures that the study didn’t address, such as whether stents would be more effective in patients with more severe disease or who were studied for a longer period of time. The story could have done a better job of explicitly calling attention to the relatively small number of participants and the need for confirmatory follow-up studies. Heart disease is very common in our society and opening up blocked arteries is a common almost routine procedure. No disease mongering occurred in the article. We were pleased to see discussion from many experts, however, the story left out two important potential conflicts of interest. The story states that: Dr. William E. Boden, a cardiologist and professor of medicine at Boston University School of Medicine, called the results “unbelievable.” Readers should have been informed that Boden has received fees from Abbott, a major stent device maker. Also, the story states that: Dr. David Maron, a cardiologist at Stanford University, praised the new study as “very well conducted” but said that it left some questions unanswered. The participants had a profound blockage but only in one artery, he noted, and they were assessed after just six weeks. The story didn’t disclose that Dr. Maron is an “employee of and stockholder in Cardiovascular Services of America, which provides outpatient cardiac catheterization and computed tomography angiography services,” which was disclosed here. The story (and the study) suggest that medication can manage pain from blocked arteries. Stenting procedures are clearly widely available in the U.S. and across the world. What’s less clear, the story says, is whether guidelines or practice for stenting will change in the U.S.: “The idea that stenting relieves chest pain is so ingrained that some experts said they expect most doctors will continue with stenting, reasoning that the new research is just one study.” We thought this was an interesting point and are glad it was included. The many expressions of surprise by practicing cardiologists makes clear that the study offers a novel finding. The story did not rely on the news release.
36297	Riots and war ended Japanese internment, slavery, and the Holocaust.	Did Riots and War End Japanese Internment, Slavery, and World War II?	mixture	Fact Checks, Viral Content	On July 16 2019, the Facebook page “Close the Camps” shared the following screenshot (archived here) of a Facebook post asserting that riots, rebellion, and war were necessary to put a stop to concentration camps, World War II, and slavery:The original post was published by Facebook user Rick Glass that same day. In full, it read:Do y’all know how Japanese internment ended? Riots. There was a huge riot in 1942 where police killed a guy, and a riot in 1943 after another internment death. That same year, the case went to the Supreme Court and they eventually pulled the plug.You know how Slavery ended? Riots. Uprisings. Rebellion. War.You know how the Holocaust ended? Riots. Uprisings. Rebellion. War.You know what didn’t stop any of these atrocities? Voting.Do you know what it will take to stop mass incarceration and child detention centers? Don’t kill the messenger.In the post, Glass points to three historical examples where “riots,” “war,” or general uprisings were responsible for an abrupt end to ongoing violations of civil and human rights — Japanese internment camps during World War II, slavery before the American Civil War, and the Holocaust.A notable coda not mentioned in the Facebook post was its implicit analogue to 2019 events — namely, anti-immigrant sentiment and the use of detainment camps based on presumed ethnicity or nationality. Another controversy involved the proposed inclusion of a “citizenship question” on the 2020 census.Until fairly recently in American history, the United States Census Bureau denied facilitating the internment of American citizenships in camps in the 1940s. But in 1943, the Bureau supplied census data to facilitate those detentions:Despite decades of denials, government records confirm that the U.S. Census Bureau provided the U.S. Secret Service with names and addresses of Japanese-Americans during World War II.The Census Bureau surveys the population every decade with detailed questionnaires but is barred by law from revealing data that could be linked to specific individuals. The Second War Powers Act of 1942 temporarily repealed that protection to assist in the roundup of Japanese-Americans for imprisonment in internment camps in California and six other states during the war. The Bureau previously has acknowledged that it provided neighborhood information on Japanese-Americans for that purpose, but it has maintained that it never provided “microdata,” meaning names and specific information about them, to other agencies.A new study of U.S. Department of Commerce documents now shows that the Census Bureau complied with an August 4, 1943, request by Treasury Secretary Henry Morgenthau for the names and locations of all people of Japanese ancestry in the Washington, D.C., area, according to historian Margo Anderson of the University of Wisconsin–Milwaukee and statistician William Seltzer of Fordham University in New York City. The records, however, do not indicate that the Bureau was asked for or divulged such information for Japanese-Americans in other parts of the country.The latter two examples (the Holocaust and slavery) were a bit more clear-cut than the third example of Japanese interment. U.S. President Abraham Lincoln issued the Emancipation Proclamation during the third year of the Civil War, but did not declare an end to slavery outright:President Abraham Lincoln issued the Emancipation Proclamation on January 1, 1863, as the nation approached its third year of bloody civil war. The proclamation declared “that all persons held as slaves” within the rebellious states “are, and henceforward shall be free.”Despite this expansive wording, the Emancipation Proclamation was limited in many ways. It applied only to states that had seceded from the United States, leaving slavery untouched in the loyal border states. It also expressly exempted parts of the Confederacy (the Southern secessionist states) that had already come under Northern control. Most important, the freedom it promised depended upon Union (United States) military victory.Although the Emancipation Proclamation did not end slavery in the nation, it captured the hearts and imagination of millions of Americans and fundamentally transformed the character of the war.Slavery was formally abolished with the ratification of the United States Constitution’s 13th Amendment in December 1865; Confederate troops and regiments began surrendering in April 1865 through November of that year, and President Andrew Johnson issued a Declaration formally recognizing an end to the South’s insurrection.The events of World War II and the liberation of the concentration camps of the Holocaust are similarly nuanced and spread out, but the catalyst for the end of the latter is reasonably described as the events of the former:In the spring of 1945, Allied forces, including millions of Americans serving in uniform, ended the Holocaust by militarily defeating Nazi Germany and its Axis collaborators.In the Facebook post’s first line, Glass says:Do y’all know how Japanese internment ended? Riots. There was a huge riot in 1942 where police killed a guy, and a riot in 1943 after another internment death. That same year, the case went to the Supreme Court and they eventually pulled the plug.Internment of American citizens of Japanese descent also took place against the backdrop of World War II, but the conclusion of that practice is less well-known than the actions that liberated various camps in Europe by Allied troops as the war drew to a close. The practice began not long after the bombing of Pearl Harbor on December 7 1941. Public opinion — strongly inflamed by editorial hysteria — led President Franklin Delano Roosevelt to sign an executive order in February 1942, relocating more than 100,000 people:The attack on Pearl Harbor also launched a rash of fear about national security, especially on the West Coast. In February 1942, just two months after Pearl Harbor, President Roosevelt as commander-in-chief, issued Executive Order 9066, which had the effect of relocating all persons of Japanese ancestry, both citizens and aliens, inland, outside of the Pacific military zone. The objectives of the order were to prevent espionage and to protect persons of Japanese descent from harm at the hands of Americans who had strong anti-Japanese attitudes.In Washington and Oregon, the eastern boundary of the military zone was an imaginary line along the rim of the Cascade Mountains; this line continued down the spine of California from north to south. From that line to the Pacific coast, the military restricted zones in those three states were defined.Roosevelt’s order affected 117,000 people of Japanese descent, two-thirds of whom were native-born citizens of the United States. The Issei were the first generation of Japanese in this country; the Nisei were the second generation, numbering 70,000 American citizens at the time of internment. Within weeks, all persons of Japanese ancestry–whether citizens or enemy aliens, young or old, rich or poor–were ordered to assembly centers near their homes. Soon they were sent to permanent relocation centers outside the restricted military zones.The well-documented riots broke out on more than one occasion during those years of internment, in response to unjust killings and poor living conditions in the camps:Violence occasionally occurred in centers. In Lordsburg, New Mexico, internees were delivered by trains and marched two miles at night to the camp.An elderly man attempted to flee and was shot and killed. After settling in, at least two men were shot and killed while trying to escape.On August 4, 1942, a riot broke out in the Santa Anita facility, the result of anger about insufficient rations and overcrowding. At Manzanar, California, tensions resulted in the beating of a Japanese American Citizens League member by six masked men. Fearing a riot, police tear-gassed crowds, and one man was killed by police.At the Topaz Relocation Center, a man was shot and killed by military police for going too near the perimeter. Two months later, a couple was shot at for the same reason.In 1943, a riot broke out at Tule Lake following an accidental death. Tear gas was dispersed, and martial law declared until agreements were reached.As the Facebook post correctly states, a Supreme Court case was pivotal in freeing those detained:After visiting an internment camp in 1942 and seeing the abysmal living conditions of the innocent Japanese-Americans, [American Civil Liberties Union lawyer James] Purcell was determined to bring a habeas corpus lawsuit against this unlawful detainment. Purcell eventually chose [detainee Mitsuye Endo] to be the case’s plaintiff as she was a U.S. citizen, had a brother in the army, and had never been to Japan. Although hesitant at first, Mitsuye ultimately chose to do it, stating many years later, “I agreed to do it at that moment, because they said it’s for the good of everybody, and so I said, well if that’s it, I’ll go ahead and do it.”On July 12, 1942 Purcell filled a petition challenging Japanese-American internment in federal district court in San Francisco. The court heard the case, but did not issue a ruling until July 1943, when the petition was denied without explanation. Soon after, the War Relocation Authorities offered to release Mitsuye in exchange for dropping her suit. She bravely declined and remained confined for years as her case progressed. In August of 1943, an appeal was sent to the Ninth Circuit Court of Appeals, but rather than issue a ruling himself, Judge William Denman sent the case directly to the Supreme Court in April 1944. On December 18, 1944, the Supreme Court unanimously ruled in favor of Mitsuye, stating that “the government cannot detain a citizen without charge when the government itself concedes she is loyal to the United States.”One day earlier, on December 17, 1944, the Roosevelt administration, having been alerted to the Court’s decision, issued Public Proclamation No. 21, which declared that Japanese-Americans could return to the West Coast in January 1945.Whether riots and instances of uprisings and unrest at the camps were beneficial to liberation efforts is not as clear as the other two instances. At the time, anti-Japanese editorializing in the news painted the riots as “Axis-related” activity:Due in part to the timing of the riot/uprising, many contemporaneous external accounts characterized it as a pro-Axis revolt commemorating the one-year anniversary of the attack on Pearl Harbor. It was part of a raft of negative publicity about the incarceration that led to Congressional investigations that put the WRA on the defensive. The event—along with similar unrest in other camps—influenced the WRA in developing and implementing a policy to identify and segregate the “disloyal” inmates and to encourage the “loyal” to leave the camps and “resettle” in communities outside the West Coast.Over the years, the riot/uprising has been analyzed numerous times by a range of scholars, and the varying interpretations of the event parallel the change in how the incarceration as a whole has come to be viewed.The Facebook post suggests that a riot in 1943 catalyzed the Supreme Court’s decision. However, the case in question — Ex parte Mitsuye Endo — was decided in December 1944, not 1943. In that ruling, a number of factors are cited as informing the Supreme Court’s decision, none of which are violence or riots in the camps. In a concurring opinion, one Justice of the time wrote:Moreover, the Court holds that Mitsuye Endo is entitled to an unconditional release by the War Relocation Authority. It appears that Miss Endo desires to return to Sacramento, California, from which Public Proclamations Nos. 7 and 11, as well as Civilian Exclusion Order No. 52, still exclude her. And it would seem to me that the ‘unconditional’ release to be given Miss Endo necessarily implies ‘the right to pass freely from state to state,’ including the right to move freely into California. If, as I believe, the military orders excluding her from California were invalid at the time they were issued, they are increasingly objectionable at this late date, when the threat of invasion of the Pacific Coast and the fears of sabotage and espionage have greatly diminished. For the Government to suggest under these circumstances that the presence of Japanese blood in a loyal American citizen might be enough to warrant her exclusion from a place where she would otherwise have a right to go is a position I cannot sanction.A second concurring opinion held that Endo’s rights had been squarely violated:I conclude, therefore, that the court is squarely faced with a serious constitutional question,-whether the relator’s detention violated the guarantees of the Bill of Rights of the federal Constitution and especially the guarantee of due process of law. There can be but one answer to that question. An admittedly loyal citizen has been deprived of her liberty for a period of years. Under the Constitution she should be free to come and go as she pleases. Instead, her liberty of motion and other innocent activities have been prohibited and conditioned. She should be discharged.In the post’s other two examples (the Holocaust and slavery), the decisive action taken was largely on the part of those with the ability to work from outside those conditions — resistance on the inside remains historically lauded, but action from the outside was necessary to liberate people. It appeared to be similar in the case of liberating Japanese-American prisoners, crystallized action coming in the form of a successful cause for legal action brought on behalf of a detainee with the dedication to see others freed despite her own unjust imprisonment, refusing the United States government’s offer to release her in order to make the lawsuit she brought moot.
6884	Elizabeth Smart says kidnapper being released still a threat.	Elizabeth Smart says a woman who helped kidnap her when she was 14 and stood by as she was sexually assaulted should be committed to a mental-health facility after she’s released from prison next week.	true	Health, Utah, North America, Elizabeth Smart, Salt Lake City, U.S. News	Smart said Thursday she was shocked to find out about Wanda Barzee’s prison release and she’s deeply concerned because the inmate hasn’t been cooperating with treatment. “She is a woman who had six children yet could co-conspire to kidnap a 14-year-old girl, and not only sit next to her while being raped but encourage her husband to continue to rape me,” Smart said. “So do I believe she’s dangerous? Yes.” Barzee is expected to be freed Wednesday after 15 years in custody, after Utah authorities said in a surprise announcement they had miscalculated the amount of time the 72-year-old woman should serve. Standing on the steps of the Utah state capitol, Smart, now 30, recalled some of the horrors she experienced when she was snatched from her home in 2002. She said Barzee “saw me as her slave. She called me her handmaiden. She never hesitated to let her displeasure with me be known.” The Utah Board of Pardons and Parole set a January 2024 release date in June, but her attorney questioned whether that took into account time she’d served in a federal prison. On Tuesday, the board decided that she had served her full sentence allowed under the law. Attorney Scott Williams has said Barzee has been diagnosed with several mental illnesses, but he’s not concerned about her being a danger to the community. Williams did not immediately return a message seeking comment Thursday. “I only found out shortly before everybody else,” said Smart, who is now a married mother and activist for victims’ rights. “And yes, it was a big shock. Only months ago, I was on my way to a parole hearing and was told she would never be let out before 2024.” Smart said she is taking unspecified steps to protect her family, but that she refuses to live in a “state of fear.” If Barzee had shown more clear signs of rehabilitation, she would likely feel differently about her release, she said. “I do believe in forgiveness. I am a Christian,” Smart said. She also urged authorities to reconsider the process for release decisions to put greater weight on potential threat along with time served. Smart was abducted from her Salt Lake City bedroom at knifepoint by street preacher Brian David Mitchell, who came in through an open kitchen window. The kidnapping triggered waves of fear around the country. The girl was found while walking with Barzee and Mitchell on a street in the suburb of Sandy, Utah, by people who recognized the couple from media reports. Mitchell is serving a life sentence after being convicted of kidnapping and raping Smart. He and Barzee were married at one point. Barzee was convicted of both state and federal crimes, and transferred to the Utah state prison in April 2016 after finishing a federal sentence in Texas. She will be under federal supervision for five years after her release from prison. If she violates the conditions of her release, which will include mental health treatment and an order not to contact Smart’s family, she could go back to prison, said Elizabeth Smart’s attorney Brett Tolman. He was previously the U.S. Attorney for Utah who prosecuted Mitchell. Barzee’s family could also request a possible civil commitment to a mental-health facility, if that’s warranted, Tolman said.
10362	Report: A bit more vitamin D is good, not too much	The story includes multiple voices that explain the rationale for the new recommendation, as well as comments from prominent experts who dissent with some of the committee’s recommendation. The story does not give readers any information about whether any of the experts quoted have potential financial or other conflicts of interest. This story does not deal with the costs of supplementation, which another story noted totals hundreds of millions of dollars a year of spending on vitamin D supplements alone. The story does a nice job of calling attention to recent examples of high hopes and later disappointment involving vitamin C, vitamin E and beta-carotene, thus helping readers put the current claims about vitamin D and calcium in perspective. People may want clear and final answers about nutrition and health, but the reality of health research is usually more complex and less conclusive. This story manages to summarize and explain the Institute of Medicine recommendations on vitamin D and calcium, while portraying some of the ongoing scientific debate.	true	Associated Press,Supplements	The story does not address costs. While the price of a supplement pill is typically just a few cents, this story would have been better if (like another story about this report that we reviewed) it had pointed out that Americans spend hundreds of millions of dollars every year on vitamin D supplements. This story reports that the Institute of Medicine committee concluded that typical consumption of vitamin D and calcium is adequate to support bone health, though the story does not define just what the term “bone health” means. The nature of the IOM report does not lend itself to quantifying potential benefits to bone health or other outcomes that were mentioned. The story does provide details about blood levels of vitamin D that are considered adequate by the IOM committee, as well as the higher levels advocated by some individual experts. The story also makes clear that the IOM committee concluded that evidence is lacking to claim that vitamin D or calcium produces other health benefits. This story does a good job of calling attention to kidney damage from excessive vitamin D and kidney stones caused by too much calcium. It also says that some studies have found other harms. This story does not do as good a job as some others in terms of explaining the process of evidence review and deliberation that the Institute of Medicine committee went through before issuing its report. However, readers are given a sense that the report is a consensus statement that attempts to sum up what is known about vitamin D and calcium. The story also refers to other reports and studies that provide context. The inclusion of comments from individual experts who dissent from some aspects of the IOM report accurately portray the active scientific debate on this topic. This story also does a nice job of pointing out recent examples in which hopes of vitamin benefits were dashed by careful experiments, thus helping to put into perspective the claims by individual scientists of hoped-for benefits of higher vitamin D consumption. The story clearly reports the Institute of Medicine committee conclusion that almost all Americans already consume enough vitamin D (and calcium) to support bone health. The comments from those who advocate broader use of supplements are labeled as individual opinions. There are multiple independent sources quoted in this story. This story could have provided readers with more background about the independent sources quoted; there is no mention of whether any of them have any potential conflicts. The story explains that there are alternatives to supplements, that vitamin D is included in foods (natural and fortified) and that vitamin D is produced in our skin when exposed to sunlight. The story refers to the availability of vitamin D in certain foods (natural and fortified), supplements, and that our skin produces vitamin D when exposed to sunlight. There is no claim of novelty. The story does not appear to rely on a news release.
10260	Test evaluates pregnancy, and it can deliver calm	"Preterm labor occurs in 8 to 10 percent of all births. Despite various strategies to reduce this percentage, it has remained relatively stable. Diagnosing preterm birth is difficult and has a high false-positive rate. As a result, many women are needlessly hospitalized, miss work or restrict their activies. The fetal fibronectin test could potentially reduce the need for hospitalizations by more accurately diagnosing preterm labor and providing peace of mind to women. The story perpetuates fear of preterm birth among asymptomatic women by focusing on only a small part of the preterm labor population and by not distinguishing the risk of preterm labor in asymptomatic versus symptomatic women. The test is really intended for and is only useful in symptomatic women, not as a screening test in women without symptoms. Furthermore, the story does not comment on the strength of the available evidence to support the use of the test. Specifically, the story does not comment on whether we know if the use of the test will result in better outcomes, such as reduced hospitalizations or prevention of preterm birth. The story does not quantify the benefits of the test. The simple question, how many hospitlizations could be prevented?, is not answered. Finally, the story does not really comment on the harms, or potential harms of the test. For example, the story could have commented on hte possible consequences of a false negative or false positive test result. Simply stating that ""no test is perfect"" is not sufficient."	mixture		"The story mentions the cost of the test and comments that most insurance companies cover it, however it is not clear if insurance companies will cover it in asymptomatic women. The story does not quantify the benefits of the test. How many hospitalizations could be prevented? The story does not really comment on the harms, or potential harms of the test. For example, the story could have commented on hte possible consequences of a false negative or false positive test result. Simply stating that ""no test is perfect"" is not sufficient. The story does not comment on the strength of the available evidence to support the use of the test. Specifically, the story does not comment on whether we know if the use of the test will result in better outcomes, such as reduced hospitalizations or prevention of preterm birth. The story perpetuates fear of preterm birth among asymptomatic women by focusing on only a small part of the preterm labor population and by not distinguishing the risk of preterm labor in asymptomatic versus symptomatic women. The test is really intended for and is only useful in symptomatic women, not as a screening test in women without symptoms. The story quotes multiple experts. The story mentions examination of the cervix as the alternative for diagnosing preterm labor but could have also mentioned ultrasonography. The story describes how widely available the test is. Clearly the test is not new. Because the story quotes mulitple experts, the reader can assume that the story does not rely on a press release as the sole source of information."
34787	"Students have developed a nail polish called ""Undercover Colors"" that can detect the presence of drugs linked to date rape."	The idea for a nail polish that could help detect the presence of date-rape drugs in drinks morphed into a different form of product.	mixture	Crime	In August 2014, interest in an in-development product called “Undercover Colors” swept the social web. According to the students who hatched the idea behind Undercover Colors, this nail polish formula would work to detect the presence of drugs commonly used to facilitate date rape. Undercover Colors maintained a Facebook page, on which the company’s social media team explained why the product was conceived and how it would work: While date rape drugs are often used to facilitate sexual assault, very little science exists for their detection. Our goal is to invent technologies that empower women to protect themselves from this heinous and quietly pervasive crime. For our first product, we are developing a nail polish that changes color when it comes in contact with date rape drugs such as Rohypnol, Xanax, and GHB. With our nail polish, any woman will be empowered to discreetly ensure her safety by simply stirring her drink with her finger. If her nail polish changes color, she’ll know that something is wrong. However, Undercover Colors didn’t demonstrate they had anything more tangible than a concept: we saw no evidence that the start-up had produced an effective prototype, and some critics maintained that the concept of such a drug-detecting fingernail polish wasn’t even a feasible one: While the media cheers, we suffer from a severe lack of any actual data on whether these testing kits function. A study of commercially available “date-rape” drug testing coasters found that they were unreliable — changing color for things like different brands of mineral water, taking an extremely long time for ketamine, and giving a false positive once milk was used. Another study of commercially available card testing kits found that in laboratory conditions, testers only correctly detected two out of three drugged samples. An interactive lesson at University at Buffalo found that the GHB test was only an acid test. Anything acidic: wines, fruit juices, would have caused it to turn positive. Compounding the issue, GHB also occurs naturally in wines. While the most frequently used drug in date rapes or DFSAs (drug facilitated sexual assaults) is alcohol, multiple studies found the most common substances were cannabis, cocaine, and MDMA. GHB and Rohypnol were found to be relatively rare. These tests focus their attention on three to four drugs, GHB (y-Hydroxybutyric acid), Rohypnol or “roofies” (flunitrazepam), Xanax (alprazolam), and Special K (ketamine). All of these drugs can weaken your resolve, and knock you out at a high enough dosage. Even if these kits worked and were 100% reliable, this is a losing battle. Wikipedia lists over 100 benzodiazepines like Xanax and Rohypnol including phenazepam (which can cause you to black out for days) and etizolam. Going beyond benzos adds hundreds more sedatives/hypnotics like Benadryl (diphenhydramine) and Unisom Sleep Tabs (doxylamine) which can be bought over the counter. The designer drug explosions means that there’s an entire galaxy of drugs that are just a molecular tweak away. Rapists watch TV and read the Huffington Post. They will know when these things come out and they’ll adapt accordingly. So pack up a 40-pound combined gas chromatograph and the mass spectrometer, and let’s drop in a Raman spectrometer as well to test every drink and then learn to read the results. But this too, is futile. The social media pages associated with the nail polish product have since been taken down, and the Undercover Colors website switched to promoting a product called SipChips: single-use, individually wrapped drug test kits that could be unobtrusively attached to key fobs or cellphones. The Undercover Colors FAQ explained why the company “moved away” from marketing a drug-detecting nail polish product: There are several reasons why the product has evolved — from the limitations with the chemistry of the nail polish format to consumer feedback throughout our development process. Consumers told us they wanted a format that was gender neutral, portable, discreet and accurate, and we believe the product we have today meets those needs. In December 2018, Undercover Colors announced the release of the SipChip product that took the place of the originally planned nail polish: Specializing in the evolution of lateral flow technology, Undercover Colors spent years creating the discreet device now known as SipChip™ which detects more of the drugs most commonly used to facilitate sexual assault – in over 100 beverages – than any other test on the market. If someone has suspicions about their beverage, just one drop of their drink on the SipChip™ can determine whether or not it is safe to drink. Similar to a pregnancy test, the lateral flow technology shows one line if the SipChip™ detects the presence of drugs, two if it does not. While interest in nail polish and chips that detect common drugs used in date rape was initially high, not everyone was pleased with the idea. Rape prevention advocates posited that the nail polish drug detection system was a form of tacit victim blaming, one which suggested the onus should be on potential victims to prevent rape, as feminist writer Jessica Valenti opined in a column for the Guardian: I’m appreciative that young men like want to curb sexual assault, but anything that puts the onus on women to “discreetly” keep from being raped misses the point. We should be trying to stop rape, not just individually avoid it. Prevention tips or products that focus on what women do or wear aren’t just ineffective, they leave room for victim-blaming when those steps aren’t taken. Didn’t wear your anti-rape underwear? Well what did you expect?
29	Bayer asks U.S. appeals court to reverse $25 million Roundup verdict.	Bayer AG on Monday said it has asked a U.S. federal appeals court to throw out a $25 million judgment it was ordered to pay to a California man who blamed the company’s Roundup weed killer for his cancer.	true	Health News	In a filing in the U.S. Court of Appeals for the 9th Circuit dated Friday, Bayer said the verdict defied regulatory findings and sound science, adding that the “speculative case” should never have made it before a jury. Bayer in a statement said it stood behind the safety of Roundup and its active ingredient glyphosate and planned to vigorously defend the more than 42,700 U.S. Roundup cancer lawsuits it faces. In its court filing, Bayer said the Hardeman appeal had the potential to shape how every subsequent Roundup case is litigated. The widely-used weed killer is made by Monsanto, which Bayer acquired last year for $63 billion. Bayer stock has lost about 23% in value since the first Roundup verdict for plaintiffs in August 2018. The case on appeal before the 9th Circuit involved the claims of Edwin Hardeman, which was the third Roundup case to go to trial in a U.S. court. A jury in March ordered Monsanto to pay $80 million in damages, saying Roundup had caused the man’s non-Hodgkin’s lymphoma. The trial court judge in July reduced that verdict to $25 million. Lawyers for Hardeman on Monday did not immediately respond to a request for comment on Bayer’s appeal. The lawyers during the trial argued Monsanto had failed to warn consumers of Roundup’s cancer risk and said the company concealed damaging evidence from public and regulatory view. Bayer rejects those allegations. The German company’s main appeal argument in Hardeman’s case centers on repeated findings by the U.S. Environmental Protection Agency that glyphosate is not a carcinogen and not a risk to public health when used in accordance with its current label. Bayer argued it would be impossible to comply with the Hardeman verdict, a lawsuit brought under state law, because any warning label would be in conflict with guidance from a federal agency. Some legal experts consider this preemption defense a “silver bullet” because it would stop claims across the board, but said the argument faced big hurdles on appeal. The company also said the trial judge had committed “a host of errors” by allowing jurors to hear unreliable expert testimony.
4967	New, old drugs may offer fresh ways to fight heart disease.	Novel drugs may offer fresh ways to reduce heart risks beyond the usual medicines to lower cholesterol and blood pressure.	true	Heart disease, AP Top News, Health, Gene therapy, General News, Philadelphia, Business, Heart attack, Cholesterol, U.S. News	One new study found that heart attack survivors benefited from a medicine long used to treat gout. Several experimental drugs also showed early promise for interfering with heart-harmful genes without modifying the genes themselves — in one case, with treatment just twice a year. The research was featured at an American Heart Association conference ending Monday in Philadelphia. “There’s a lot of excitement” about the new gene-targeting medicines, especially because they seem to last so long, said Dr. Karol Watson, of the University of California, Los Angeles. Scientists have been exploring gene therapy — altering DNA — to attack the root cause of many diseases. The new drugs essentially accomplish the same thing without tampering with genes, said the University of Pennsylvania’s Dr. Daniel Rader, who has consulted for some makers of these drugs. The medicines work by silencing or blocking messages that genes give to cells to make proteins that can do harm, such as allowing cholesterol to accumulate. The first few of these “RNA-interference” drugs recently were approved for other conditions, and research is also targeting heart disease. Farthest along is inclisiran, tested in 1,561 people with heart disease from clogged arteries who still had high LDL, the bad form of cholesterol, despite taking standard drugs. They were given a shot of inclisiran or a dummy drug when they joined the study, three months later and then every six months. The drug lowered LDL by 56% without serious side effects. More testing will show whether it also lowers heart attacks and other problems, not just cholesterol. Inclisiran’s maker, The Medicines Company, plans to seek federal approval for it later this year. Two other RNA interference drugs aim at a different target — triglycerides, another fat in the blood that’s elevated in one quarter of Americans. Treatments include very low-fat diets, weight loss, fish oil and drugs, but doctors say more and better therapies are needed. Each RNA interference drug was tested at various doses in 40 people. A single shot lowered triglycerides by 30% to 67%, and the benefit lasted for at least four months. The studies were just intended to show safety; Arrowhead Pharmaceuticals is developing both drugs. Other research found new benefits from older drugs. AstraZeneca’s Farxiga, originally developed to treat diabetes, also lowered the risk of heart problems in heart failure patients who did not have diabetes. Among 2,605 of such patients treated for 18 months, about 9% of those on Farxiga had worsening heart failure or heart-related death versus nearly 13% of those not given the drug. That worked out to a 27% lower risk, without extra serious side effects. Surprising benefits also were seen in a Canadian study of the decades-old gout drug. The anti-inflammatory drug colchicine — sold as Colcrys, Mitigare and in generic form — was tested in 4,745 people who recently had a heart attack. After about two years, colchicine users had a 23% lower risk of suffering a new heart attack, heart-related death, stroke, cardiac arrest or urgent need for an artery-opening procedure compared with a group given dummy pills. The benefit came mostly from preventing strokes and artery-opening procedures, and some heart doctors would rather have seen more difference in heart attacks and deaths. Colchicine is being tested in several other studies, and more evidence is needed before using it routinely to lower heart risks, Dr. L. Kristin Newby of Duke University wrote in a commentary published with the study in the New England Journal of Medicine. Dr. Donald Lloyd-Jones, a Northwestern University cardiologist and program chief for the heart conference, was more supportive. “When you have a safe drug that’s easily available, it’s going to be hard to hold this one back,” he said. ___ Marilynn Marchione can be followed on Twitter at http://twitter.com/MMarchioneAP ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
3772	Officials list pot vape brands reported in US outbreak.	Health officials investigating a nationwide outbreak of vaping illnesses have listed, for the first time, the vape brands most commonly linked to hospitalizations.	true	AP Top News, Health, General News, Marijuana, Business, Vaping, U.S. News	Most of the nearly 2,300 people who suffered lung damage had vaped liquids that contain THC, the high-inducing part of marijuana. In a report released Friday, the U.S. Centers for Disease Control and Prevention listed the products most often cited by patients, noting that some of them said they vaped more than one. Dank Vapes was the brand used by 56% of the hospitalized patients nationwide. Dank is not a licensed product coming from one business, it is empty packaging that can be ordered from Chinese internet sites. Illicit vaping cartridge makers can buy the empty packages and then fill them with whatever they choose. Other product names at the top of the list from CDC were TKO (15%), Smart Cart (13%) and Rove (12%). “It’s not likely that a single brand is responsible for this outbreak,” said Brian King, a senior CDC official on the investigation. Some of the brands cited by the CDC are sold in states with legalized marijuana. But counterfeits of those legitimate brands have flooded the market around the country, forcing some to redesign their packaging. Bill Loucks, co-founder of TKO Products, said his company sells only to licensed dispensaries in California, but the company gets emails asking about TKO-branded cartridges purchased elsewhere. “If you bought them outside of California ... you are the proud owner of fakes,” Loucks said in an email. The CDC also said Friday that the worst of the outbreak may be over. Preliminary data indicates hospitalizations peaked in mid-September and have been declining since, officials said. Investigators want more data until they feel certain the outbreak is waning. If it is, there may be more than one reason, including growing public caution about vaping or perhaps a change in what cartridge makers are putting into them, King said. But cases are still coming in, with 2,291 reported this year — including 176 that joined the tally in late November. Every state has reported cases, and 25 states and the District of Columbia have reported a total of 48 deaths. Symptoms include trouble breathing, chest pain, fatigue and vomiting. About half the patients are people in their teens or early 20s. The outbreak appears to have started in March. CDC officials have gradually come to focus their investigation on black-market THC cartridges. An analysis of about 1,800 of the hospitalized patients found about 80% said they used at least one THC product. Last month, CDC officials said they had narrowed in on a culprit — a chemical compound called vitamin E acetate that has been commonly found in the lungs of sick patients and in the products they vaped. Vitamin E acetate is a thickening agent that’s been added to illicit THC vaping liquids. But it’s possible it also may have been added to vaping liquids containing CBD, another cannabis extract, King said. About 1% of the patients said they had vaped CBD products only. The agency is recommending that people do not use any electronic cigarettes or vaping products that contain THC, especially those obtained from friends, family members or black market dealers. However, 13% of patients said they vaped only nicotine. CDC officials are continuing to look at nicotine-containing vapes, and to advise caution about all types of vaping products until the investigation is concluded, King said. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
8388	France to shun strict discrimination by age in lockdown exit.	France will try to avoid setting different rules for older people and other forms of discrimination once the government starts easing its coronavirus confinement measures, the French President’s office said.	true	Health News	France’s lockdown to combat the outbreak, which like in Spain, Italy and many other European countries includes restrictions on store openings and people’s movements, will remain in place until at least May 11, President Emmanuel Macron said earlier this week. After that, schools and shops are set to reopen, though it is still unclear at what speed France will allow some businesses like hotels or cafes to restart, and whether it plans to lift home confinement recommendations for everyone at the same time. Macron’s latest announcements have sparked a backlash in recent days, after he said on Monday that older people, who are considered more vulnerable to the deadly virus, would be asked to stay at home for longer. Professor Jean-François Delfraissy, who heads the scientific council advising the government on the epidemic, also fuelled the debate after he proposed that confinement should continue for people aged 65 to 70 and above. “The President has followed the growing debate about the situation for elderly citizens after May 11,” the Elysee palace said in comments sent to Reuters on Saturday. “He does not want there to be any discrimination among citizens after May 11 in the context of a gradual easing of confinement measures, and will appeal to people’s individual responsibility.” The government is still likely to recommend that some people should stay at home for their own protection, however. “We will ask the most vulnerable people, older people, severely disabled people, and those who suffer from chronic illnesses, to remain in confinement even after May 11, at least in a first instance,” Macron said in his televised address on April 13. “I know it’s a major constraint ... But we’ll have to try to abide by this to protect you, it’s in your interest.” France’s registered death toll from coronavirus infections neared 19,000 on Friday, but most data provided further indications that the spread of the disease was slowing after the one-month-old national lockdown.
9468	PSA screening for prostate cancer saves lives after all, study says	This story about a new analysis of data on PSA screening includes many important details about the meaning of the study results. It points out harms of prostate cancer treatment and concerns about overdiagnosis and overtreatment. However, the cautionary statements are pushed down to the bottom half of the story. The headline and lead paragraphs include statements about screening saving lives, without telling readers about absolute risks or about limitations and uncertainties in the new analysis. By reporting a relative risk reduction of up to 32 percent–without also reporting that since fewer than 3 out of 100 men die of prostate cancer the absolute risk reduction is likely less than 1 percent–the story leaves readers with an inflated sense of how many lives might be saved by increased screening. Basically, this study adds very little to our current understanding of the benefits of prostate cancer screening–not much has changed (see our STAT News review to better understand why). Yet readers of this LA Times story are likely to come away with a different take.	mixture	prostate cancer	The story does not address the cost of the PSA test itself or of follow-up testing or treatment. The story reports only the study’s estimate of a relative risk reduction of 25 to 32 percent. This figure is meaningless without reporting the underlying absolute risk of dying from prostate cancer. The American Cancer Society states that “About 1 man in 39 will die of prostate cancer.” To put it another way, of every 100 men in the US, fewer than 3 will die of prostate cancer and more than 97 will die of something else. The study’s estimate of relative risk reduction might translate into fewer than 2 men dying of prostate cancer and more than 98 dying of something else. However, since many men are already screened with PSA tests, the actual reduction in deaths is likely to be smaller than that. For a more accurate way to capture the measured benefits, see STAT’s story. The story warns of overdiagnosis and overtreatment, and then specifically notes harms to “sexual function, urination and bowel movements.” The story also quotes an expert who notes that “the way screening has been implemented in the United States leaves much to be desired” and that the debate should be about “whether we can change our behavior so that it does more good than harm.” However, while the headline and lead paragraphs focus on the claim that PSA screening saves lives, the first mention of overdiagnosis and overtreatment does not appear until more than halfway into the story. The story does report at the top that this study is “a new analysis of existing clinical trial evidence.” It cites two big studies, PLCO and ERSPC, and recommendations based on them that were issued by the US Preventive Services Task Force. However, readers are not told specifically that this new analysis is based on data from those two specific studies, nor does it explain that the authors used a variety of methods to estimate the differences in death rates from prostate cancer based on screening practices used in these underlying studies, which involved a number of assumptions and simplifications. The story portrays the results of the analysis as far more clear-cut and definite than even the authors claim. See our STAT review for an example of a story that more accurately discussed the evidence. The story reports that a PSA test result is just the start of a decision-making process, and that many men reasonably choose to have little or no follow-up testing or treatment after a positive PSA result. As with the STAT News story, this one didn’t note the financial disclosures of the study authors, including the senior author, Ruth Etzioni, who disclosed she owns equity in a company developing medical imaging technology that it says could be applied in prostate cancer patients. Dr. Etzioni stated that she does not consider the equity ownership to be a conflict of interest, but considering that an increase in PSA screening would boost demand for more precise and less invasive follow-up testing, it appears that her company would benefit. While the story does quote an independent source, it would have been helpful to note that he consults for the medical industry. The study was funded by the National Cancer Institute. While that source does not raise any red flags, and the study stated that the funder had no role in the study, news stories are more informative when they note study funding. The story is all about the comparison of screening to not screening. It is clear that PSA screening is widely available. The story does not explain how or why this analysis of two trials is potentially more informative than the original separate studies themselves. There are original quotes in the story.
2294	Britain becomes first nation to legalize three-parent babies.	- Britain will become the first nation to legalize a “three-parent” IVF technique which doctors say can prevent some inherited incurable diseases but which critics fear will effectively lead to “designer babies”.	true	Health News	After more than three hours of debate, lawmakers in parliament’s upper house voted on Tuesday for a change in the law to allow the treatments, echoing a positive vote in the lower house earlier this month. The treatment, called mitochondrial transfer, is known as “three-parent” in vitro fertilization (IVF) because the babies, born from genetically modified embryos, would have DNA from a mother, a father and from a female donor. Although the techniques are still at the research stage in laboratories in Britain and the United States, experts say that now legal hurdles have been overcome, Britain’s first 3-parent baby could be born as early as 2016. Mitochondrial transfer involves intervening in the fertilization process to remove faulty mitochondrial DNA, which can cause inherited conditions such as heart problems, liver failure, brain disorders, blindness and muscular dystrophy. Mitochondria act as tiny energy-generating batteries inside cells, and around 1 in 6,000 babies around the world are born with serious mitochondrial disorders. Responding to the vote, Jeremy Farrar, director of the Wellcome Trust medical charity commended lawmakers for a “considered and compassionate decision”. “Families who know what it is like to care for a child with a devastating disease are the people best placed to decide whether mitochondrial donation is the right option,” he said. Mark Downs, chief executive of the Society of Biology, hailed “a great day for UK science” and said the landmark decision “will ensure mothers who carry faulty mitochondria can have healthy children free from the devastating conditions.” But Marcy Darnovsky, director of the campaign group The Center for Genetics and Society, called the move a “historic mistake” which turns children into biological experiments and will “forever alter the human germline”. “The techniques ... are relatively crude and will not in and of themselves create so-called designer babies,” she said. “However, they will result in children with DNA from three different people in every cell of their bodies, which will impact a large range of traits in unknowable ways and introduce genetic changes that will be passed down to future generations.”
9104	Specialists make breakthrough in the treatment of anal cancer	This news release summarizes a review of 65 randomized controlled trials and observational studies that included some 10,000 people with anal cancer. The analysis itself is important: it exposes the potential for misclassification of disease severity leading to over-treatment of many patients with radiation and chemotherapy, unnecessary side effects, and little or no improvement in outcomes for patients. But the release doesn’t include any of the weaknesses that enter in when results are based on data-mined meta-analysis of previously published studies. The headline touting a “breakthrough in the “treatment” of anal cancer and the almost complete absence of data leaves readers with misleading or confusing information about problems in diagnosing and treating a rare but deadly and difficult disease. Anal cancer, as noted above, is rare, about 8,200 new cases in the U.S. each year, compared to the 140,000 Americans diagnosed with colon cancer annually. But it can be lethal and treatments and their aftermath are often life-altering. News releases that claim that “specialists” have made a “breakthrough” in the treatment of the disease would be of high interest to those with the cancer or those at risk for it. When the claim is neither supported nor true, the public is ill-served. The study seems to imply that patients with lymph node positivity, or LNP, can be treated with less aggressive treatments, which is not shown in the data, but only implied in the results. Anal cancer that has spread to lymph nodes is associated with a lower chance of survival and is generally treated with radiotherapy.	mixture	anal cancer,University of Manchester	There is no actual “treatment breakthrough” in the data that needs a price tag. The implication is that less treatment is acceptable, which should cost less. The release could have made this point but we won’t penalize it for not doing so. The release states that the study “uncovered a phenomenon suggesting rates of lymph node spread are being overestimated, potentially leading to overtreatment of patients with chemo radiotherapy.” There are no data offered in support of that statement. It also makes the claim that “These findings will help us to better understand how anal cancer patients should be treated, ultimately improving survival rates and quality of life.” Again, there are no numbers provided showing how survival rates and quality of life can be improved with a change in treatment. The release should have attempted to put the main findings in meaningful context for lay readers. The release makes refers to the harm of over treatment and side effects, but never quantifies them. A quote from a patient refers to “joint pain and continence issues” suffered by some patients but it’s unclear which treatments were responsible. The release offers quotes praising “high profile results” that are likely to “play a vital part in improving patient care,” but offers no information about exactly what those results are, why they are so “vital” and what the research protocol involved. It quotes a patient (unclear if she was in the data set that was analyzed) about her treatment experience in very general terms. Further, there are serious limitations in meta-analyses that are never mentioned or discussed. The meta-analyisis included both randomized controlled trials and observational studies, some of which did not report overall survival. This would limit the reliability of the evidence. No mongering; anal cancer is a serous disorder. The release notes funding is from the Bowel Disease Research Foundation (BDRF). The only alternative the meta-analysis looked at was the difference between LNP and LNN (negative) anal cancer. It showed an association between LNP and lower survival. The release states that the study is likely to have an impact on treatment plans of future patients, but we never learn what that impact might precisely be, and what next steps might be taken by the oncology treatment community to use the findings and correct misleading statistics on diagnosis and treatment. The release is fairly clear that the meta-analysis has uncovered/confirmed that statistical misinformation can result from even the best intentioned efforts to improve diagnostic criteria and staging. It would have helped for the release to connect the dots and demonstrate what those data are and what their impact would have on various patients. Some of the language, including the headline and quotes, is overblown and unattributed. There is no “breakthrough in treatment” inherent in the study or the findings. And calling a finding a “unique phenomenon” without telling readers what, exactly, is the evidence for the phenomenon is unfortunate.
349	French court finds Bayer's Monsanto liable for farmer's sickness.	A French court has ruled that Monsanto was liable for the sickness of a farmer who inhaled one of its weedkillers, in another legal setback for the Bayer-owned business over health claims.	true	Health News	In the latest stage of a decade-long legal tussle, the appeals court in Lyon on Thursday found in favor of farmer Paul Francois’ claim that Monsanto’s Lasso weedkiller had made him sick and that the product’s labeling had been inadequate. Francois, 55, says he suffered neurological problems, including memory loss, fainting and headaches, after accidentally inhaling Lasso in 2004 while working on his farm. “Mr Francois justifiably concludes that the product, due to its inadequate labeling that did not respect applicable regulations, did not offer the level of safety he could legitimately expect,” the court said in its ruling. The latest verdict, however, did not determine compensation for the farmer, which will now be considered by another court in Lyon. Francois is seeking about 1 million euros ($1.1 million) in damages. Bayer, which acquired Monsanto in a $63 billion deal last year, said it was considering its legal options, including an appeal before France’s highest court. The German chemicals group added that crop-protection products “do not pose a risk for human health if they are used according to the terms of use set out in their regulatory approval”. Mr Francois had won rulings against Monsanto in 2012 and 2015 before France’s top court overturned the decisions and ordered the new hearing in Lyon. “We are all happy to have won but it came at a heavy price,” Francois told reporters in Paris. “It’s a big sigh of relief. It’s been 12 years of fighting, 12 years during which I had to put my whole life on hold.” Lasso was banned in France in 2007 after the product had been withdrawn in some other countries. It used a different active substance to glyphosate, the chemical contained in Monsanto’s best-selling weedkiller Roundup and the target of lawsuits in the United States over alleged cancer links. The company has been found liable in two trials in California brought by cancer sufferers who have been awarded tens of millions of dollars in damages. Bayer is appealing against those rulings. The legal troubles surrounding glyphosate have contributed to Bayer losing about 30 billion euros in market value since last August. The group’s chief executive on Thursday said it was “massively affected” by the litigation. After the announcement of the decision, Bayer’s shares extended a fall to trade about 1.5 percent down before recovering some of the losses. ($1 = 0.8874 euros)
29047	"An account describes Muslims' engaging in a ""dry run"" hijacking on AirTran Flight 297."	(Contrary to common belief, the fact that a replacement crew was used to complete the flight is not an indicator that the original flight crew refused to continue or felt the situation to be unsafe. When flights experience substantial delays in taking off, as Flight 297 did that day, that situation sometimes requires that the original crew be replaced because otherwise they would “time out” and exceed FAA limitations on maximum hours per working period.)	mixture	Politics, muslims	In mid-November 2009, a brief Associated Press news account reported an incident that had taken place on an AirTran Airways flight from Atlanta to Houston, one which resulted in the plane’s returning to the gate and departing 2½ hours late due to a passenger who would not shut off his cell phone when so directed by a flight attendant. A fuller article published by the Atlanta Journal-Constitution, who interviewed a woman seated directly behind the passenger in question, provided more detail: The passenger with the cell phone was part of a larger group (eleven others, plus an interpreter) seated throughout the plane; the passenger and the interpreter were asked to step off the plane (the other eleven members of the group also left the plane, although they eventually reboarded the same flight, while the passenger and the interpreter took a later flight); twelve other passengers also took up the airline’s offer to allow them to leave the plane and take a different flight; and a new crew eventually manned the flight when it finally departed. An AirTran spokesman said the issue was a simple matter of a passenger who would not turn off his cell phone when directed (a situation complicated by the passenger’s inability to speak English), requiring the flight to return to the gate: It’s unclear whether he was talking on the phone, snapping photos or texting, AirTran spokesman Christopher White said. But to airline officials and flight attendants, it didn’t matter. The Boeing 717 had pulled away from the gate, and the phone was on, White said. “Flight attendants were telling him, ‘Turn off the phone, turn off the phone,'” White said. “We can’t taxi with the cell phone on, and we certainly can’t take off,” White said. “Language barrier or not, you start to butt up against interfering with a flight crew.” Although the incident was reported to the Federal Aviation Administration (FAA), the Transportation Security Administration (TSA) said it would not follow up, as it was a customer service issue and not a security issue: “Passengers are required to follow instructions of the flight attendants,” regional FAA spokeswoman Kathleen Bergen said. AirTran reported the incident to the FAA, Bergen said. The federal Transportation Security Administration will not handle the incident, saying it is a customer-service issue between the passenger and the airline, a TSA spokesman said. The woman on the flight who was interviewed by the Journal-Constitution maintained that the passenger in question had a camera, not a cell phone, and that the incident was merely one of confusion involving a non-English speaking passenger which was blown out of proportion due to “poor communication”: The woman sitting behind the man said it wasn’t a phone at all, and feels the entire incident was the result of poor communication. “He was not talking on a cell phone, it was a camera,” said Nancy Deveikis of Marietta. “He was looking at pictures.” A flight attendant asked the man twice to turn off the device, Deveikis said. But it was clear the man did not speak English, she said. Although the man was traveling with others, the rest of the group was seated throughout the plane. When the man did not respond to the flight attendant, she took the camera from him, Deveikis said. “She grabbed it from his hand and basically said I’ll be holding this until you get off the plane,” Deveikis said. Deveikis said she never heard the one flight attendant use the word “phone” when speaking to the man. [Deveikis said] the whole incident, which scared other passengers who weren’t clear what was happening, could have easily been avoided. “Just one flight attendant snowed everyone into believing she had an irate passenger,” Deveikis said. Shortly after these events, a widely circulated account of the incident appeared on the Internet from Todd Petruna, who maintained that he was a passenger on the referenced flight and that what really took place was quite different than what was reported in the news. According to Petruna, Muslim passengers on the flight were potential terrorists who were making a “dry run” at hijacking an airliner: One week ago, I went to Ohio on business and to see my father. On Tuesday, November the 17th, I returned home. If you read the papers the 18th you may have seen a blurb where a AirTran flight was cancelled from Atlanta to Houston due to a man who refused to get off of his cell phone before takeoff. It was on Fox. This was NOT what happened. I was in 1st class coming home. 11 Muslim men got on the plane in full attire. 2 sat in 1st class and the rest peppered themselves throughout the plane all the way to the back. As the plane taxied to the runway the stewardesses gave the safety spiel we are all so familiar with. At that time, one of the men got on his cell and called one of his companions in the back and proceeded to talk on the phone in Arabic very loudly and very aggressively. This took the 1st stewardess out of the picture for she repeatedly told the man that cell phones were not permitted at the time. He ignored her as if she was not there. The 2nd man who answered the phone did the same and this took out the 2nd stewardess. In the back of the plane at this time, 2 younger Muslims, one in the back, isle, and one in front of him, window, began to show footage of a porno they had taped the night before, and were very loud about it. Now … they are only permitted to do this prior to Jihad. If a Muslim man goes into a strip club, he has to view the woman via mirror with his back to her. (don’t ask me … I don’t make the rules, but I’ve studied). The 3rd stewardess informed them that they were not to have electronic devices on at this time. To which one of the men said “shut up infidel dog!” She went to take the camcorder and he began to scream in her face in Arabic. At that exact moment, all 11 of them got up and started to walk the cabin. This is where I had had enough! I got up and started to the back where I heard a voice behind me from another Texan twice my size say “I got your back.” I grabbed the man who had been on the phone by the arm and said “you WILL go sit down or you Will be thrown from this plane!” As I “led” him around me to take his seat, the fellow Texan grabbed him by the back of his neck and his waist and headed out with him. I then grabbed the 2nd man and said, “You WILL do the same!” He protested but adrenaline was flowing now and he was going to go. As I escorted him forward the plane doors open and 3 TSA agents and 4 police officers entered. Me and my new Texan friend were told to cease and desist for they had this under control. I was happy to oblige actually. There was some commotion in the back, but within moments, all 11 were escorted off the plane. They then unloaded their luggage. We talked about the occurrence and were in disbelief that it had happen, when suddenly, the door open again and on walked all 11!! Stone faced, eyes front and robotic (the only way I can describe it). The stewardess from the back had been in tears and when she saw this, she was having NONE of it! Being that I was up front, I heard and saw the whole ordeal. She told the TSA agent there was NO WAY she was staying on the plane with these men. The agent told her they had searched them and were going to go through their luggage with a fine tooth comb and that they were allowed to proceed to Houston. The captain and co-captain came out and told the agent Ã¢? ?we and our crew will not fly this plane!Ã¢?Â After a word or two, the entire crew, luggage in tow, left the plane. 5 minutes later, the cabin door opened again and a whole new crew walked on. Again … this is where I had had enough!!! I got up and asked “What the hell is going on!?! ?” I was told to take my seat. They were sorry for the delay and I would be home shortly. I said “I’m getting off this plane”. The stewardess sternly told me that she could not allow me to get off. (now I’m mad!) I said “I am a grown man who bought this ticket, who’s time is mine with a family at home and I am going through that door, or I’m going through that door with you under my arm!! But I am going through that door! !” And I heard a voice behind me say “so am I”. Then everyone behind us started to get up and say the same. Within 2 minutes, I was walking off that plane where I was met with more agents who asked me to write a statement. I had 5 hours to kill at this point so why the hell not. Due to the amount of people who got off that flight, it was cancelled. I was supposed to be in Houston at 6pm. I got here at 12:30am. Look up the date. Flight 297 Atlanta to Houston. If this wasn’t a dry run, I don’t know what one is. They wanted to see how TSA would handle it, how the crew would handle it, and how the passengers would handle it. I’m telling this to you because I want you to know … The threat is real. I saw it with my own eyes … In anther account, a chaplain who was originally slated to fly on Flight 297 (but had arrived late and missed the initial boarding) reported that another passenger who left the plane before its eventual take-off told him that, as stated in Todd Petruna’s message, the incident involved more than the single passenger mentioned by AirTran representatives and news reports: 12 men of Middle Eastern appearance stood up and began dancing and singing in an Arabic dialect. They refused to be seated when directed to do so by the flight attendants. Then, the singing stopped and some of the men took out their cell phones and began taking pictures of the other individual passengers. Again, the men were ordered to be seated by the flight crew and refused while continuing to take their pictures. Next, the de-boarded passenger related that a few of the men gestured [using their fingers] as imaginary guns, indicating with their triggering action that they would shoot the people on the plane. However, none of the news accounts of the Flight 297 incident mentioned members of a passenger group screaming insults at the flight crew or being bodily ejected from the plane by other passengers. On 4 December 2009, AirTran issued a point-by-point rebuttal of the original account, maintaining (among other statements) that the members of the group in question were dressed just like other passengers (rather than in “Muslim attire”), that there were no reports of their screaming insults at crew members, that there were no reports of any of them standing up in a threatening manner, that there were no physical altercations between any passengers, that the group’s bags were not removed from the plane, that none of the group members was determined to pose a security threat, that there was no TSA agent on the plane, and that no passenger was refused permission to get off the plane: On November 17, 2009, AirTran flight 297 was scheduled to travel from Atlanta to Houston-Hobby. During taxi a passenger was non-compliant with Crew Members, using a cell phone and taking pictures. The flight taxied back to the gate and the passenger, who did not speak English, and his companion acting as his interpreter were asked to de-plane. They were met by customer service personnel and TSA. The passengers were allowed to re-board and continued on the flight after speaking with AirTran and TSA representatives. The flight was delayed by more than two hours. Since the flight and initial media reports, several blogs and Internet sites have recounted the incident as portrayed by a passenger originally scheduled for the flight. Below is that passenger’s account (unedited in any way including spelling and grammar), as reported on several blogs. Highlighted between the passenger’s account, are the factually accurate circumstances surrounding this incident. We bring this to your attention in order to dispel myths that are beginning to make the rounds in chat rooms, blogs and conspiracy theorists’ Web sites. AirTran 297 – Anatomy of an Urban Legend AirTran also issued a statement maintaining that Todd Petruna not actually a passenger on Flight 297: After conducting additional research into this situation, we have verified, according to flight manifests (legally binding documents) that the individual that allegedly created a first-hand account of events on-board AirTran Airways flight 297, a Theodore Petruna, was never actually on-board the flight. According to all available records, Mr. Petruna’s trip originated from Akron-Canton, Ohio (CAK) on AirTran flight 205. This flight arrived at the gate in Atlanta at 5:06 p.m. Eastern Standard Time. Flight 297, the flight which Mr. Petruna allegedly wrote a first-hand account of, originally pushed back from its gate in Atlanta at 4:40 p.m. EST, a full 26 minutes before flight 205 arrived at the gate in Atlanta, making this flight connection impossible. While Mr. Petruna was originally scheduled to begin his journey on AirTran flight 202 from CAK and connect to flight 297 in Atlanta he did not make that original flight. According to a Marietta Daily Journal reporter and Houston station KHOU-TV, the e-mail’s author acknowledged he had embellished his account but maintained that he was in fact on the flight: He admits that his description of the men’s attire was wrong, [that] he didn’t personally see anyone watching pornographic videos, [and that] he’d taken artistic license with a couple points, never imagining [his account] would travel beyond his circle of friends. AirTran [posted] the assertion that the disputed e-mail writer from Texas, according to “legally binding” flight manifests, wasn’t on the plane. The e-mail writer [said] AirTran is lying and he has his boarding pass. Another Flight 297 passenger interviewed by Atlanta television station WSB stated that although he did see a number of Middle Eastern passengers on the flight walking around, interacting with each other, and being uncooperative with the flight crew, and although he felt AirTran mishandled the incident (primarily by not communicating information about the situation to other passengers), none of the group in question was dancing, singing, taking pictures, or ended up being manhandled off the airplane by other passengers. He also stated that he talked to the pilots on the replacement crew, who reported they felt perfectly safe in flying the plane, and that he thought the claim the group of Middle Easterners were potential hijackers or terrorists to be “far-fetched.”
35379	President Trump gave a talk during the COVID-19 pandemic in which he remonstrated about showers and dishwashers not functioning properly due to low-flow standards.	Based on the way Trump talks about efficient lightbulbs, it seems his complaint is with compact fluorescent bulbs, which were the only low-energy bulbs widely available 10 years ago. But today, store shelves are full of LED bulbs with warmer-looking light and even longer life spans. Gleick suspects Trump’s toilet complaints are outdated as well, because low-flow toilet technology has come a long way in recent years.	true	Politics, COVID-19	On July 16, 2020, as the U.S. recorded its single highest number of COVID-19 cases since the coronavirus health crisis began, U.S. President Donald Trump spoke at an event held on the South Lawn of the White House, ostensibly on the subject of “Rolling Back Regulations to Help All Americans.” During his talk, according to a meme, Trump allegedly tackled the subject of energy-efficiency standards which have supposedly resulted in home appliances that do not function properly due to requirements aimed at conserving the amount of water and power they consume: This was an accurate reproduction of a portion of Trump’s talk, according to a White House transcript of the event: We’re bringing back consumer choice in home appliances so that you can buy washers and dryers, showerheads and faucets. So showerheads — you take a shower, the water doesn’t come out. You want to wash your hands, the water doesn’t come out. So what do you do? You just stand there longer or you take a shower longer? Because my hair — I don’t know about you, but it has to be perfect. Perfect. Dishwashers — you didn’t have any water, so you — the people that do the dishes — you press it, and it goes again, and you do it again and again. So you might as well give them the water because you’ll end up using less water. So we made it so dishwashers now have a lot more water. And in many places — in most places of the country, water is not a problem. They don’t know what to do with it. It’s called “rain.” They don’t have a problem. This was far from the first time the president had riffed on poorly functioning appliances. In December 2019, as Trump spoke in the Roosevelt Room of the White House amidst an impeachment inquiry, he digressed into railing about toilets and other bathroom fixtures that allegedly frustrate their users due to the use of low-flow technology. CNN reported: The President claimed Americans are flushing their toilets “10 times, 15 times, as opposed to once” and argued that they are having difficulty with washing their hands in what appeared to be a tangent about low-flow sinks and toilets. “We have a situation where we’re looking very strongly at sinks and showers and other elements of bathrooms where you turn the faucet on — and in areas where there’s tremendous amounts of water, where the water rushes out to sea because you could never handle it, and you don’t get any water,” the President said during a roundtable with small business leaders about deregulatory actions. “You turn on the faucet and you don’t get any water. They take a shower and water comes dripping out. Just dripping out, very quietly dripping out,” the President continued, lowering his voice as he spoke about the drips. “People are flushing toilets 10 times, 15 times, as opposed to once.” It wasn’t entirely clear what he was talking about, but it appeared to have to do with bathroom fixtures with low-flow appliances. He said the Environmental Protection Agency was looking into the issue on his suggestion. “They end up using more water. So (the) EPA is looking at that very strongly at my suggestion,” Trump said, though he did not give details on what suggestions, if any, he made. NPR quoted the Pacific Institute, a non-profit research institute with a focus on global and regional freshwater issues, as asserting that Trump’s statements did not comport with reality: Peter Gleick with the Pacific Institute in Oakland considers this all to be Trumpian nostalgia for a time when showers were strong, toilets used 4 gallons a flush and lightbulbs burned your hands when you touched them. Gleick said these newer household items are part of an “efficiency revolution,” doing the same tasks with less and halting the upward trajectory of water and energy consumption in America. And, yes, a dishwasher cycle takes longer, and incandescent bulbs are cheaper to buy upfront. But in the long run, “They’re much more expensive, because they use a huge amount of energy, which we pay for over time and they burn out 20 times faster,” Gleick said.
3196	House passes bills to expand medical marijuana.	The New Hampshire House approved a pair of bills Wednesday to make medical marijuana available to more patients, but a more expansive bill died in the Senate.	true	New Hampshire, Opioids, Medical marijuana, General News, Marijuana, Bills	The House voted to add insomnia and opioid use disorder to the list of qualifying conditions, though the latter would carry significant restrictions, including a requirement that certifying providers have specialized knowledge in addiction treatment. An earlier version of one of the bills also sought to add anxiety and Lyme disease to the list, but those provisions were removed. Meanwhile, the Senate voted Wednesday against making medical marijuana available for any condition for which treatment is determined to be necessary by a provider. The Senate also voted to further study a bill to legalize recreational marijuana, and there are several new bills on that topic coming up later this session.
33653	Dell Hospital will donate 15 cents towards the care of Maria, a raped child, every time a particular text message is forwarded.	If you want to make a difference in a sick child’s life, the best way is still the old-fashioned one: donate your money or your time, don’t passively share a worthless message.	false	Inboxer Rebellion, Medical Appeals	An entreaty to help save the life of a victimized child who had been raped by an AIDS-positive attacker began circulating as a cell phone text message in June 2010. At that time, the message being zinged from phone to phone represented the rapist being sought with a photograph of an African American male bearing gold teeth: This guy raped a five year old little girl. He ruined her life, she is alive & in the hospital can’t move and can never have children, or a normal life. This guy goes by different names he is in hiding & has AIDS. The girl came out positive. Please help us catch this animal. Every time this message is fwd the Dell Hospital will donate $.15 to Maria’s medication & treatment. Please don’t hesitate to fwd this. It could’ve been you’re daughter or sister. God bless. Thank you!. Forward this to as many people as possible. In October 2010, the hoax underwent a revival when it was circulated anew, that time accompanied by the photo of a Hispanic male sporting multiple tattoos. Since 2014, this Facebook post has been shared more than 77,000 times. A second post from 2016 has been shared more than 82,000 times with a different photograph: There was no such child: the whole thing was a leg-pull, said Dell Children’s Medical Center of Central Texas: A false text message has been circulating that describes an incident involving a 5-year old girl. The message states that every time you forward it to someone, Dell Children’s Medical Center will donate 15 cents to cover the child’s healthcare expenses. This message is spam and is in no way affiliated with Dell Children’s Medical Center or the Seton Family of Hospitals. If you receive this message, please delete it. As demonstrated so aptly by public efforts to provide relief to earthquake victims in Haiti, beneficences initiated by cell phone generally involve a tracking and billing mechanism that requires participants to text a specific short word or phrase to a particular (five-digit) number, not the willy-nilly forwarding of a explanatory narrative to as many people as possible. In 2009 we began to note that “Forward this message to help fund medical care for a sick or dying child” appeals were beginning to appear as cell phone text messages as well as being passed in e-mail. That trend continues into the present, with the “shot 14-year-old boy” just another iteration of the same basic hoax that falsely claims the American Cancer Society, the Make-A-Wish Foundation, or some other large entity will donate a predetermined amount of money every time a particular message is forwarded. Such leg-pulls have been circulating via e-mail since 1997. Typically, a large charity is named as the benefactor standing ready to direct monies towards the costs of medical care for the languishing child, but various corporations have also been fingered for this role in other iterations of the hoax, such as AOL and ZDNet in the Rachel Arlington leg pull (brain cancer sufferer in need of an operation) and McDonald’s and Pizza Hut in the Justin Mallory prank (epileptic in need of long-term care). Everyone wants to help sick children get better, and the thought of a little boy or girl suffering from some dread disease or infirmity because people couldn’t be bothered to forward a message tugs straight at the heartstrings. Problem is, hoaxsters know that, and they play upon these very human drives for their personal amusement. Once again, that is the case here: Well-intentioned forwarding does nothing towards helping a sick child; it does, however, make the day of some prankster.
2454	Use of sleeping pills highest among older Americans: CDC.	Older U.S. adults, particularly women, are more likely to use prescription sleep medications to try to get the minimum seven hours of sleep experts generally recommend, U.S. data released on Thursday showed.	true	Health News	Use of such pills, which include Sanofi SA’s Ambien and other similar drugs, was significantly higher for those in their 50s as well as age 80 and older, according to the findings from the Centers for Disease Control and Prevention. Overall about 8.6 million people, or 4 percent of U.S. adults reported recently using sleep medication, CDC’s National Center for Health Statistics said in a report. But data showed higher use among middle-aged adults ages 50 to 59 and the elderly. Six percent of those ages 50 to 59 said they had taken a prescription sleep pill in the last 30 days, and 7 percent of those age 80 and older reported such use. In between, the numbers dip slightly below 6 percent for those in their 60s and 70s. In comparison, just 2 percent of those aged 20-39 said they had recently taken a sleep aid. CDC researcher Yinong Chong said people in their 50s could have trouble sleeping because of work and family stress. “It gives the picture of a sandwiched group who has family, not only children but also probably elderly parents but still you’re likely to be in the workforce, so you get squeezed at both ends in terms of family responsibility and job responsibility,” she said. Sleep may improve when people retire before potential chronic health problems kick in and begin interfering with sleep, Chong said, adding more study is needed. The data also showed that 5 percent of women surveyed said they had recently taken a sleep aid compared to about 3 percent of male respondents, according to CDC’s report. Chong said it was not clear why women were more likely to use the drugs. While previous data have tracked prescriptions dispensed for sleep aids, the CDC said its study is the first based on a survey of actual use of such drugs. Researchers for the Atlanta-based health agency’s National Center for Health Statistics questioned a sampling of adults age 20 and older about whether they had used prescription sleep aids within the last 30 days and asked participants to show interviewers the prescription medication. “You get how many people are actually using them,” Chong said in an interview, noting that prescription data could include multiple prescriptions for one patient or prescriptions that are never filled or even used. “This is actual use.” Prescription sleep aids have become somewhat controversial because their effect can linger even after some patients wake up. The U.S. Food and Drug Administration has begun taking a closer look at sleep drugs, ordering lower-doses for Ambien and similar pills amid concerns that their active ingredient remained in patients’ blood the following morning at levels high enough to make driving and other activities dangerous. And just last month, the FDA rejected an experimental sleep drug from Merck & Co Inc, saying the proposed doses were not safe but that a lower-dose version might be acceptable. Not surprisingly, respondents to CDC’s study who said they slept five hours or less each night or those diagnosed with a sleep disorder were more likely to report using prescription aids. Additionally, more whites and people with higher levels of education also reported greater use, the agency said. Socioeconomic factors are likely behind those numbers, Chong said, since patients must be able to afford a doctor’s care and the medication. According to prescription data from IMS Health, Ambien and other versions of the drug zolpidem was ranked 15th among the most dispensed medications in the United States.
22639	"Twelve judges have thrown out legal challenges to the health care law because they rejected ""the notion that the health care law was unconstitutional."	"President Obama says 12 judges have rejected ""the notion that the health care law was unconstitutional"""	false	National, Health Care, Supreme Court, Barack Obama,	"Ever since a federal judge in Florida ruled the health care law unconstitutional, the White House has portrayed the opinion as an outlier made by an activist judge. Many other judges have come to a different conclusion, the argument goes. This was the tack President Barack Obama took in a pre-Super Bowl interview with Fox News' Bill O'Reilly, who asked about the recent Florida ruling. ""Well, I think the judge in Florida was wrong,"" Obama said. ""Keep in mind that we've had 12 judges said -- that just threw this case out -- the notion that the health care law was unconstitutional."" Obama's point was clear: The Florida case got the headlines, but courts are still overwhelmingly ruling with Obama on the key question of constitutionality. We asked the White House for some backup on the claim about the 12 dismissed cases, and they provided a list that we've appended to the bottom of this article. The White House is correct they were dismissed, but they were dismissed for procedural reasons, often because the judges concluded the plaintiffs either lacked proper standing or jurisdiction to bring the lawsuit. The judges did not opine on the merits of these cases, such as whether the law is constitutional. They dismissed the cases for a variety of reasons: in some, the argument was that the plaintiff's lacked standing because the individual mandate portion of the law (which requires people to have health insurance) had not yet kicked in. It goes into effect in 2014. In other cases, the judges said the plaintiffs lacked standing because they did not establish that they would be injured by the law. Besides the judges who dismissed 12 cases on procedural grounds, four judges have ruled on the merits of various cases challenging the health care law. Two ruled in favor of the administration and two against: Thomas Moore Law Center vs. Barack Hussein Obama On Oct. 7, 2010, U.S. District Judge George Steeh, a Bill Clinton appointee to the Eastern District of Michigan, ruled that Congress has the right to impose the individual mandate portion of the health care law under the Commerce Clause of the constitution. ""The health care market is unlike other markets,"" Steeh wrote. ""No one can guarantee his or her health, or ensure that he or she will never participate in the health care market ... ""In this case, the minimum coverage provision of the Health Care Reform Act contains two provisions aimed at the same goal,"" Steeh wrote. ""Congress intended to increase the number of insureds and decrease the cost of health insurance by requiring individuals to maintain minimum essential coverage or face a penalty for failing to do so. Because the 'penalty' is incidental to these purposes, plaintiffs' challenge to the constitutionality of the penalty as an improperly apportioned direct tax is without merit."" Score one for the constitutionality of the health care law. Liberty University vs. Timothy Geithner In an opinion handed down on Nov. 30, 2010, in the Western District of Virginia, U.S. District Judge Norman Moon, a Clinton appointee, also ruled the law constitutional under the Commerce Clause, the constitutional principle that allows the federal government to regulate commerce. ""I hold that there is a rational basis for Congress to conclude that individuals' decisions about how and when to pay for health care are activities that in the aggregate substantially affect the interstate health care market,"" Moon wrote. ""Nearly everyone will require health care services at some point in their lifetimes, and it is not always possible to predict when one will be afflicted by illness or injury and require care.… ""Far from 'inactivity,' by choosing to forgo insurance, Plaintiffs are making an economic decision to try to pay for health care services later, out of pocket, rather than now, through the purchase of insurance. As Congress found, the total incidence of these economic decisions has a substantial impact on the national market for health care by collectively shifting billions of dollars on to other market participants and driving up the prices of insurance policies."" So the first two decisions on the constitutional merits went Obama's way. But the next two did not. Commonwealth of Virgina vs. Kathleen Sebelius In a ruling filed on Dec. 13, 2010, U.S. District Judge Henry E. Hudson, a President George W. Bush appointee, wrote that ""despite laudable intentions of Congress in enacting a comprehensive transformative health care regime, the legislative process must still operate within constitutional bounds."" ""Neither the Supreme Court nor any federal circuit court of appeals has extended Commerce Clause powers to compel an individual to involuntarily enter the stream of commerce by purchasing a commodity in the private market,"" Hudson wrote. ""In doing so, the enactment of the Minimum Essential Coverage provision exceeds the Commerce Clause powers vested in Congress under Article I."" Hudson struck down the individual mandate, but upheld the rest of the law. State of Florida vs. United States Department of Health and Human Services This ruling made the biggest headlines. In a case brought by 26 states challenging the health care law, Senior U.S. District Judge Roger Vinson of Pensacola, Fla., a Ronald Reagan appointee, issued a sweeping ruling on Jan. 31., 2011, that the individual mandate is unconstitutional and so entwined with the rest of the law that the entire thing should be thrown out. ""In the final analysis, this Act has been analogized to a finely crafted watch, and that seems to fit. It has approximately 450 separate pieces, but one essential piece (the individual mandate) is defective and must be removed,"" Vinson wrote. ""It cannot function as originally designed. There are simply too many moving parts in the Act and too many provisions dependent (directly and indirectly) on the individual mandate and other health insurance provisions -- which, as noted, were the chief engines that drove the entire legislative effort -- for me to try and dissect out the proper from the improper, and the able-to-stand-alone from the unable-to-stand-alone. Such a quasi-legislative undertaking would be particularly inappropriate in light of the fact that any statute that might conceivably be left over after this analysis is complete would plainly not serve Congress' main purpose and primary objective in passing the Act. The statute is, after all, called ""The Patient Protection and Affordable Care Act,"" not ""The Abstinence Education and Bone Marrow Density Testing Act."" The Act, like a defectively designed watch, needs to be redesigned and reconstructed by the watchmaker."" There are other cases pending, as well as appeals on nearly all of the cases listed above. But here's the score so far: All sides agree that the issue will ultimately be decided by the Supreme Court. Back to Obama's statement, ""Keep in mind that we've had 12 judges said -- that just threw this case out -- the notion that the health care law was unconstitutional."" The president's statement ""very clearly implies the judges have said it's not unconstitutional,"" said legal commentator Stuart Taylor Jr. ""This is highly misleading White House spin. A ruling on standing is never a ruling on whether the underlying law is constitutional or not."" Avram Goldstein, a spokesman for Health Care for America Now, said the point is that despite all the media attention given to the Florida court decision, ""This one case is not the be-all and end-all."" The judges in the 12 cases listed by the White House may not have weighed in on the constitutionality issue, Golstein said, ""but if a judge throws it out for procedural reasons, you lost."" Kate Bedingfield, a spokeswoman for the White House, made a similar argument. ""Twelve lawsuits challenging the law's constitutionality have been dismissed,"" Bedingfield said. ""That’s a fact, and that is the point the president was making."" We disagree. Obama said the 12 judges dismissed the cases because they disagreed with the claim that the health care law was unconstitutional. They did not. They dismissed the cases because of procedural grounds. We find his claim . Appendix: 12 Cases Cited by the White House (PolitiFact added links to the cases and rulings that we could find online) Archer v. U.S. Senate, dismissed April 12, 2010 Baldwin v. Sebelius, dismissed Aug. 27, 2010 Burlsworth v. Holder, dismissed on Sept. 8, 29/8 Coalition for Parity Inc. v. Sebelius, dismissed on June 21, 2010 Fountain Hills Tea Party Patriots v. Sebelius, dismissed June 2, 2010 Mackenzie v. Shaheen (NH) - dismissed May 26, 2010 New Jersey Physicians v. Obama, dismissed Dec. 8, 2010 Schreeve v. Obama, dismissed Nov. 4. 2010 Sollars v. Reid, dismissed April 2, 2010 Taitz v. Obama, dismissed April 14, 2010 U.S. Citizens Association v. OMB, dismissed 8/2 Bryant v. Holder, dismissed Feb. 3, 2011"
8154	Canada's coronavirus death toll rises to 13 as repatriation efforts step up.	Canada’s death toll from the coronavirus rose to 13 on Saturday, and the country stepped up efforts to repatriate Canadians stranded overseas as Prime Minister Justin Trudeau called the situation “unprecedented, exceptional and very difficult.”	true	Health News	The government has tested around 83,000 people so far for COVID-19, the respiratory disease caused by the virus, Canada’s deputy chief public health officer Howard Njoo told reporters. There have been 1,099 confirmed cases. Canada has taken several measures to contain the fast-spreading virus, including closing its border with the United States, which came into effect on Friday night. Trudeau, who is himself in self-isolation after his wife tested positive for COVID-19, told reporters on Saturday the government is ramping up testing to detect as many cases as possible. “The ramping up of testing is increasing at a tremendous pace.... we are getting more equipment for testing. We recognize that broad scale testing is an essential tool in continuing to fight the spread of this disease,” Trudeau told reporters. There are around 5,000 ventilators across the country, Njoo said. He also said Canada is making efforts to bring home stranded citizens, and an Air Canada (AC.TO) plane is in the process of repatriating citizens from Morocco. He named Peru and Spain as two potential countries from which Canada was working with airlines to bring home stranded citizens. But Trudeau said the travel restriction put in place by many countries mean not every Canadian stuck overseas would be able to come home immediately. “We are going to ask people to stay safe, make smart choices and do the best they can in a situation that is unprecedented, exceptional and very difficult,” Trudeau said. Canada’s foreign minister François-Philippe Champagne estimated there are ten of thousands of Canadians overseas. Trudeau’s government has pledged C$27 billion ($18.6 billion) to help the economy amid the virus outbreak, which could blow out the fiscal deficit and lead to higher government borrowing by nearly 40%, according to Reuters calculations. “We have heard a wide range of estimates from economists and banks about how bad it is going to get. The only thing they seem to agree on is, it is going to get very bad. Fortunately, Canada is in an extremely strong fiscal position... and that gives us room to inject money into people’s pocket,” Trudeau added. Meanwhile, Canada’s decision to turn back asylum seekers who walk over the U.S.-Canada border has been criticized by advocates. “The government’s decision... ignores the recommendations of the World Health Organization and isn’t part of a sound pandemic management plan,” said Nazila Bettache, with the Caring for Social Justice Collective. She said asylum seekers will cross by other means that are less controlled and will not have access to proper safety measures, such as a 14-day quarantine.
9192	Phase III COMPASS study with Bayer’s Rivaroxaban in Patients with Coronary or Peripheral Artery Disease Shows Overwhelming Efficacy and Meets Primary Endpoint Early	This release touts the end of the biggest clinical trial to date on the drug Xarelto (rivaroxaban), used to prevent major adverse cardiac events such as heart attacks and strokes in people with coronary artery disease or peripheral artery disease. As we found with a recent release on the drug Repatha (which we also reviewed), this release does not provide findings from the study but instead acts more like a preview for the findings to be released at an upcoming scientific meeting. The release describes the study parameters (number enrolled, dosage, time frame, etc.) and discusses in clear detail the drug’s availability. But it left out potential harms from Xarelto and it also doesn’t cover the drug’s costs, talk about any of the specific benefits of the drug, or compare it to other treatments. In short, it’s like a Superbowl ad for the drug without the all the fast-talking caveats at the end. For a more general discussion of data-free drug announcements see Managing Editor Kevin Lomangino’s recent post on a “troubling PR trend.” Coronary artery and peripheral vascular disease are both common and will continue to become more common as the population lives longer. Medications to prevent new heart attacks or loss of limbs due to peripheral artery disease are always welcome (though prevention would be cheaper). Even when drug makers are required to disclose when it reaches “primary endpoints,” it’s to the benefit of investors, regulators, the medical community and hopeful patients to avoid hyping the results, emphasize study limitations, and highlight the lack of vetting by peers. That context is going missing in a number of announcements from big drug companies.	mixture	Bayer,rivaroxaban,Xarelto	There is no mention of costs in the release. That’s too bad because the drug costs about $375 for a 30-day supply. It’s worthwhile to let people know about costs. Many older people use their Medicare drug coverage to pay for the drug for the most common indication (atrial fibrillation), with a typical copay of $75 per month. For people on a fixed income, that cost is likely to be an important piece of information. There is no quantification of benefits in the release. Instead, it says, “A complete data analysis from this study is expected to be presented at an upcoming medical meeting in 2017.” Some preliminary data at minimum is necessary to assess the drug’s usefulness. Trials are often stopped early when they meet preset efficacy endpoints, even if the clinical differences are not earth shattering. Time will tell. There is no mention of harms in the release. An important harm associated with Xarelto is major bleeding, which cannot be easily reversed. In the case of atrial fibrillation, there are tools available to calculate the balance of benefit (from preventing blood clots stemming from the heart) and harm (major bleed). For newer drug indications, physicians would similarly like to know how to balance benefit and risk. The release explains that this is a “phase III” trial, which may mean something to reporters who watch clinical trials closely. It also explains that the company involved, Bayer, did the study working with the Public Health Research Institute. It gives the outlines of the study, explaining that “it has enrolled 27,402 patients from more than 600 sites across more than 30 countries worldwide. In the study, patients were randomized to receive either rivaroxaban 2.5 mg twice daily in addition to aspirin 100 mg once daily, rivaroxaban 5 mg twice daily alone, or aspirin 100 mg once daily alone.” As noted elsewhere in this review, we think the failure to mention the lack of vetting through independent peer review or publication is a very big omission. The release doesn’t engage in disease mongering. It provides context about the burden of different aspects of cardiovascular disease, with estimates that are in line with other published estimates. However, it doesn’t include sources for the estimates — something we encourage writers of both news stories and releases to incorporate. It is clear from the release that the study is being conducted by Bayer. The release does not compare alternatives. In this case, there are several medications available to prevent cardiac and peripheral events, including aspirin and Plavix. The release makes it clear that the drug being studied is available for prescription. It says, “Rivaroxaban is the most broadly indicated non-vitamin K antagonist oral anticoagulant (NOAC) and is marketed under the brand name Xarelto®. Xarelto is approved for seven indications, protecting patients across more venous and arterial thromboembolic (VAT) conditions than any other NOAC.” The release talks about the trial being the largest to date and about the “unmet need” in this area, and the fact that the trial reached a per-specified stopping point — all of which are strong news angles. We believe it’s out of bounds to claim “overwhelming efficacy” in the headline before any data have been provided to back up the claim. Even if they are required to make an announcement, it should be pro forma and avoid this kind of hype. It’s also not at all clear what “overwhelming efficacy” means here. Are they referring to the size of the risk reduction or to the statistical significance of the result? It’s possible, if not likely, that a very small risk reduction is being framed as “overwhelming” simply because the result is highly statistically significant. That doesn’t mean it’s especially meaningful for patients.
21169	If Rhode Island does a hybrid [retirement] plan we’ll be the first state in the nation to do this.’’	Gov. Lincoln Chafee says Rhode Island would be first state in U.S. to adopt hybrid retirement plan for public employees	false	Rhode Island, Pensions, Public Service, Retirement, Workers, Lincoln Chafee,	"If state lawmakers approve the Chafee administration’s plan to overhaul Rhode Island’s ailing public pension system, most state workers, teachers and many municipal employees will be enrolled in a so-called hybrid retirement plan. The hybrid plan that Governor Lincoln Chafee and General Treasurer Gina Raimondo have been touting would combine a smaller guaranteed monthly payout from a traditional pension with a variable payout based on the investment earnings of a 401(k)-style plan. While pitching their pension overhaul legislation to a joint meeting of the Senate and House Finance Committees Oct. 24, Chafee, an Independent, spoke at length about how the plan would address the state’s $9.4-billion pension shortfall. ""And also,’’ the governor said, ""somebody told me recently that if Rhode Island does a hybrid plan we’ll be the first state in the nation to do this.’’ The first in the nation? Chafee continued: ""And I think that’s in all of our interest to show the rest of the country that we can take on this challenge and share the ups and downs of the market with the employer and the employee. Right now, we the state, the employer, takes all the hit when the market goes down. And so I think the country will be looking at us . . . "" Rhode Island, of course, isn’t the only state to wrestle with pension problems. So we wondered: Would Rhode Island be the first in the nation to adopt a hybrid retirement plan? The facts A quick search of the Wall Street Journal’s archives turned up a story from July 10, 2010, entitled ""States Shift to Hybrid Pensions.’’ The article begins: ""State governments, one of the last bastions of guaranteed pensions, are increasingly taking a page from 401(k) plans that dominate the private sector.’’ Utah, Michigan, Oregon and Washington, the article states, all have some form of hybrid plan. Next, we called The National Association of State Retirement Administrators, a nonprofit membership organization whose members are directors of the nation’s public retirement systems. Keith Brainard, the association’s research director, provided us with a table that shows that seven states have some form of hybrid plan for public employees. They are: Georgia, Indiana, Michigan, Ohio, Oregon, Washington and Utah. (Michigan offers the hybrid plan only to school employees.) Their plans, like the one the Chafee administration has proposed for Rhode Island, share two features: a traditional pension with a guaranteed benefit, coupled with a 401(k)-style component that offers a payout tied to investment earnings. We called the governor’s office, and his spokeswoman, Christine Hunsinger, quickly responded that the governor had ""made a mistake."" Rhode Island, she conceded, would not be the first state to adopt a hybrid plan. OK, so the governor was wrong. Rhode Island didn’t come up with the idea first. But we still wondered what was happening elsewhere in the country. We contacted retirement administrators in other states to find out. At least two states -- Washington and Indiana -- have had hybrid retirement plans since the 1990s. During the 1990s stock-market boom, a legislative pension committee in Washington saw an opportunity to ""self-fund"" a portion of its retirement plan, said Dave Nelsen, legal and legislative services manager for the Washington State Department of Retirement Systems. The teachers union was the first to endorse the idea, he recalled, and in 1995, a bill ""sailed through the legislature"" to allow teachers to supplement their traditional pensions with something similar to a 401(k) plan. In 2002, the State of Washington passed its own bill to create a hybrid option for all new public employees. Indiana enacted legislation in 1998 to allow public employees to invest some of their retirement money in selected bonds and money market funds. (The hybrid plan proposed by the Chafee administration is similar to Indiana’s, said Brainard, of the National Association of State Retirement Administrators.) Ohio offered a hybrid plan to new state employees and those with less than five years of service in 2003. Oregon followed in 2004; Georgia in 2009; and Michigan (for school employees only) in 2010. Utah last year replaced its traditional defined benefit pensions with 401(k)-style plans for new state and municipal workers. The Chafee administration’s proposal could, however, set Rhode Island apart from other states in one respect, Brainard said: it would require not just new hires but also most existing employees (except judges, state police, correctional officers and municipal police and firefighters) to participate in the hybrid plan. In fact, Hunsinger told PolitiFact that was actually what the governor had been told would make Rhode Island ""the first in the nation."" But we’d caution the governor on that statement, too. We found that at least one other state -- Kansas -- has proposed doing the same. The ruling Governor Chafee was clearly wrong when he told state lawmakers that if they approve his administration’s pension reforms, Rhode Island would ""be the first state in the nation’’ to adopt a hybrid plan. These types of plans have been widely publicized in the national media and on the National Association of State Retirement Administrator’s web site, and our research found at least seven other states offer hybrid pension plans, some dating back to the 1990s. We rule his statement . (Get updates from PolitiFactRI on Twitter. To comment or offer your ruling, visit us on our PolitiFact Rhode Island Facebook page.)"
600	Twin Southern California wildfires menace Reagan Library, Getty Museum, homes.	A major wildfire threatened thousands of homes and the Ronald Reagan Presidential Library near Los Angeles on Wednesday as the fiercest Santa Ana winds yet lashed Southern California, forcing meteorologists to create new alert levels to warn of the danger.	true	Environment	The blaze erupted early on Wednesday morning in Simi Valley, northwest of Los Angeles in Ventura County, and by nightfall had charred 1,300 acres (526 hectares) as crews fought to protect the Reagan library and some 7,000 homes in the path of the flames. The Easy Fire, which forced 26,000 people to flee, broke out some 30 miles (48 km) from a separate conflagration burning in shrub-covered hills near the Getty Center museum that has displaced thousands of residents from some of the city’s most affluent neighborhoods. The Getty museum houses a collection that includes paintings by Van Gogh, Rembrandt and Manet, ancient Greek statues and an expansive array of manuscripts. The Reagan Library, Getty Center and Getty Villa in Malibu were all forced to close due to the flames and thick clouds of smoke, although all three facilities were said to be out of imminent danger by evening. “The dedication of our staff and the professionalism of our region’s first responders has been nothing short of heroic,” Getty president Jim Cuno said in a statement posted on the center’s website. The Santa Ana winds were blamed for a string of fire outbreaks across Southern California. In Riverside County, east of Los Angeles, a wind-driven brush fire swiftly blackened 250 acres (101 hectares), forcing the evacuation of hundreds of people from two mobile home parks and a nursing home, county fire spokesman Rob Roseen said. Weather conditions were at their worst, with fierce winds hurling burning embers through the air across bone-dry brush to ignite spot fires. “The fire outflanked us very rapidly today, pushed by those 40- to 50-mile-per-hour (40- to 80 km per hour) winds,” Ventura County Fire Department assistant chief Chad Cook told reporters. “We did experience gusts up to 65 miles per hour (105 kph) this morning, which made long-range spotting very, very dangerous.” He said erratic, high winds also forced intermittent grounding of firefighting aircraft through the day. The National Weather Service issued an unprecedented “extreme red flag” warning for wildfires in Los Angeles and Ventura counties ahead of two days of intense, dry wind gusts that were forecast to reach near-hurricane force. “I don’t know if I’ve ever seen us use this warning,” forecaster Marc Chenard said. “It’s pretty bad.” Statewide, the weather service issued alerts for “critical” or “extreme” fire hazards covering more than 34,000 square miles (88,000 square km), encompassing some 21 million people. Power was cut off to nearly 400,000 homes and businesses statewide on Wednesday as a precaution by the state’s largest utility, Pacific Gas and Electric Co, a unit of PG&E Corp (PCG.N), and other utilities. The so-called Easy fire in Simi Valley broke out just before dawn off a road named Easy Street, sending a wall of flames racing across scrub-covered slopes at the edge of the hilltop Reagan Library, which houses the late president’s archives and memorabilia. Pre-positioned strike teams of firefighters, backed by water-dropping helicopters and airplane tankers dumping payloads of fire retardant, swarmed the area as flames closed in on the library campus. “We’re surrounded. It’s a scary situation. But I’m sure they’ll get on top of it,” John Heubusch, the library’s executive director, said in an interview with KNX radio in Los Angeles during the firefight. “It’s as close as it gets.” By late morning, emergency crews had largely subdued flames, and the fire moved off in other directions. The blaze prompted public schools and at least five college campuses in the area to cancel classes for the day. Health authorities were handing out disposable air filter masks to members of the public at five cites around the county. On nearby ranches, residents in the protective face masks scrambled to coax nervous horses and other livestock into trailers to drive them to safety. “As long as we get up, get out of here, get the car moving, everything else can be replaced in theory so you know breathing at the end of the day is better than not breathing at the end of the day,” resident David Pollack told Reuters. The Santa Ana winds are a regional weather phenomenon that sends gusts westward off the desert to the east, through mountain passes toward the coast. They were forecast to reach sustained speeds of 50 to 70 mph (80 to 110 kph) on Wednesday and Thursday. Investigators say the Getty fire was likely caused by a broken tree branch blown into power lines during high winds on Monday morning. It spread, consuming 745 acres (300 hectares) by Wednesday morning, with about a quarter contained by firefighters. At least 12 homes have been destroyed. In northern California, firefighters struggled for a sixth day against the 76,000-acre (30,760-hectare) Kincade fire in Sonoma County’s wine country. That blaze has destroyed at least 189 homes and other structures but was listed as 30 percent contained on Wednesday. PG&E acknowledged last week that the Kincade fire started near a damaged transmission tower at about the time a live high-voltage line on that tower malfunctioned. The company filed for bankruptcy in January, citing $30 billion in potential liability from a series of deadly fires sparked by its equipment in 2017 and 2018. As many as 190,000 people were displaced at the height of the Kincade fire, but some evacuations have since been lifted.
22460	Secretly, unbeknownst to members of Congress, over $105 billion was hidden in the Obamacare legislation.	Michele Bachmann charges health care bill spent $105 billion 'secretly'	false	National, Federal Budget, Health Care, Michele Bachmann,	"Tea party favorite Michele Bachmann used a recent appearance on Meet the Press to attack the health care law for what she said was secret spending. ""It is shocking the revelations of all the money that's been spent,"" said Bachmann, R-Minn. ""There is a Congressional Research Service report that just was issued in February, and we discovered that secretly, unbeknownst to members of Congress, over $105 billion was hidden in the Obamacare legislation to fund the implementation of Obamacare. This is something that wasn't known."" Just in case you missed her point, she said the number ""$105 billion"" seven more times, and waved a sign that said ""$105,464,000,000."" Readers e-mailed us immediately, asking us to fact-check whether it was true. We contacted Bachmann’s office to ask where she got the number, but we didn’t get a response. So we turned to a February report from the Congressional Research Service titled, ""Appropriations and Fund Transfers in the Patient Protection and Affordable Care Act (PPACA)."" The $105 billion To explain the report’s findings, we should first tell you a little bit about how federal spending works when it comes to authorizations versus appropriations. Laws can either authorize money to be spent, appropriate money, or both authorize and appropriate. An authorization means it’s legally permissible to spend money on a particular program; an appropriation actually supplies the money. The real power lies in appropriation. House members like Bachmann had hoped to stop the new health care law by simply refusing to fund it with appropriations. What they’re finding out, though, is that doing so won’t shut the money spigot entirely, since the law already included some appropriations and transfers from other sources when it passed. The CRS report detailed the programs that received funding in the bill. (Fund transfers work a little differently than appropriations, but the important thing for analyzing Bachmann’s comment is that they both provided immediate funding.) The CRS report doesn’t add up all the numbers, but we did, and we got $104 billion -- very close to Bachmann’s number. A few programs are funded contingent on adjustments for inflation, so the grand total can vary a bit. The largest chunk of funding, $40 billion, went to the state Children’s Health Insurance Program, to fund it for 2014 and 2015. (Soon after President Barack Obama took office in 2009, Democrats approved funding through 2013.) A new Prevention and Public Health Fund -- a state-based effort aimed at preventing chronic disease -- got the second biggest chunk, $15 billion over 10 years. The Center for Medicare and Medicaid Innovation got $10 billion over 10 years to test payment and service-delivery models that might reduce health care spending and improve care. The ""shocking"" revelation But is that $105 billion a ""shocking"" revelation -- something that ""wasn’t known"" and passed ""secretly, unbeknownst to members of Congress""? Bachmann has a point if you look at the amount of media coverage the appropriations and transfers inspired. There was hardly any. Using a variety of terms to search the Nexis database, we found only one document that explained in any detail how the health care bill included appropriations and transfers -- a news release by the conservative Heritage Foundation that raised an alarm about abortion funding. The bill, Heritage said, would ""directly appropriate $7 billion over five years in operating funds for (federally qualified health centers) ... funds (that) would not need to be included in the annual appropriations bill for the Department of Labor and HHS."" But Bachmann didn’t say that the media failed to pay attention; she went further, charging that the provisions were passed ""secretly, unbeknownst to members of Congress."" We find that contention questionable. We poked around the versions of the health care law that were up for consideration and found older versions that included both appropriations and fund transfers, some of which made it to the final bill. The CRS report Bachmann cited may have compiled the appropriated funding information into an easy-to-understand format, but it’s not as if the spending was approved secretly. Steve Ellis of the nonpartisan Taxpayers for Common Sense said it was no secret: the Congressional Budget Office -- Congress’ nonpartisan budget-analysis agency -- extensively detailed the spending in the bill. ""I’m not saying that everybody knew everything that was in the health care bill, because it’s almost impossible to do that. But it was documented that the money was in there,"" Ellis said. ""Shame on them if they didn’t know that."" We asked experts in federal budgeting whether the health care bill’s use of appropriations in an authorizing bill was unusual. They said it was not. ""Congress has routinely provided appropriations in authorization bills, for multiple years of availability, and has also routinely transferred funds from one account to another,"" said Roy T. Meyers, a former CBO analyst and now a political scientist at the University of Maryland at Baltimore County. We should also note that versions of the health care law were posted to the Internet for 72 hours before a vote was held. That’s not a lot of time, but it’s far from a secret process, said Gabriela Schneider of the Sunlight Foundation, a nonprofit that urges greater government openness and transparency. ""At the time, we commended Congress for taking an unprecedented step and Speaker Pelosi for making sure every version of the health care bill was posted online 72 hours before consideration,"" she said. The process worked well, Schneider said, and House Republicans have subsequently adopted the 72-hour window. ""It's a bill -- the text is public!"" said Alec Vachon, a former Republican congressional staffer who’s now a health care consultant. ""Is Congresswoman Bachmann saying there are no House Republicans, members or staff, who can read a bill?"" One final point: Contrary to the implication of Bachmann’s comments, the spending provisions in the health care bill are not written in stone. ""Congress can always revisit the spending decisions, including entitlement and direct spending, of past Congresses,"" said Donald Wolfensberger, a former Republican aide to the House Rules Committee. Our conclusion Bachmann said that ""secretly, unbeknownst to members of Congress, over $105 billion was hidden in the Obamacare legislation."" She’s right that there’s about $105 billion of already approved spending in the health care bill that may be difficult to rescind. But that does not mean that the process was secret. While the pre-approved spending provisions didn’t attract media attention, they were in the plain language of the bill and did not vary dramatically from past congressional practice. And the bill was made public before the vote."
34091	Image shows an x-ray of a man with a fork in his urethra.	Rumor has it an image shows an x-ray of a fork stuck in a man's urethra.	true	Medical	The annals of emergency medicine provide numerous accounts of patients who have sought treatment for the removal of sizeable foreign objects from the rectum or urethra, items which sometimes ended up penetrating those openings by accident, but most commonly were deliberately inserted by patients seeking some form of sexual gratification. The list of items which doctors have documented removing from urethras and bladders includes a plethora of common household objects: telephone wire, pencils, toothbrushes, candles, balloons, hairpins, light bulbs, tweezers, thumb tacks, feathers, beans, foam sealant, shoelaces, animal bones, pipe stems, crochet needles, hair, and chewing gum. That list added another entry in August 2013, when the International Journal of Surgery Case Reports published an article entitled “An Unusual Urethral Foreign Body” authored by three Australian doctors from The Canberra Hospital’s Department of Urology. Example: [Collected on the Internet, August 2013] Is this real? A 70-year-old Canberra man came to an extraordinarily painful fork in the road when he presented to Canberra Hospital’s Emergency Department with a 10cm fork lodged in his penis. The doctors reported on the removal of a dining fork (“via forceps traction and copious lubrication”) from the urethra of a 70-year-old man, as shown in the x-ray displayed above: A 70-year-old man presented to the Emergency Department with macroscopic haematuria but no other urinary symptoms. Detailed history taking revealed he had self-inserted a 10cm steel dining fork into his urethra 12 hours prior, for autoerotic stimulation. On examination, the fork was not visible, but palpable within the penile urethra. Extraction of the foreign body via the urethral meatus was successful under general anaesthesia, with the aide of lignocaine gel and Rampley forceps. An open excision was not required. Urethrocystoscopy identified mucosal abrasions in the pendulous and bulbar urethra. A urethral catheter was not placed. The patient voided well and went home post-procedure. The authors also noted that men inserting objects into their urethras is a fairly uncommon phenomenon, and the use of a fork in such a scenario is rather rare: Self-inserted male urethral foreign bodies are rare emergencies that urological and general surgeons may face. Urethral foreign body insertions are an unusual practice in which any imaginable object is known to be implicated. In a series of 20 adult cases over 9 years, foreign body insertions into the lower urinary tract have a low incidence, with males 1.7 times more likely to commit the act than females. The mean age of individuals is 35.8 +/- 20.0 years. The practice manifests primarily during states of pathological masturbation, substance abuse and intoxication and as a result of psychological compounders. Autoerotic stimulation with the aid of self-inserted urethral foreign bodies has been existent since time immemorial and have presented an unusual but known presentation to Urologists. The presentation is however delayed owing to the fundamental emotion of embarrassment. Of those who seek medical attention, haematuria, dysuria, urinary frequency, strangury and urinary retention are the most common presenting features. Dire consequences such as fulminant sepsis and death ensue such behaviour in the event of delayed medical encounter. Despite the available literature on self-inserted urethral foreign bodies; the case we herein describe of a penile urethral fork is a rarity.
28544	"NASA had to relabel the size chart used for a condom-like urination contraption built into the Maximum Absorbency Garment space suit system because astronauts refused to choose the ""small"" size."	Given the differing accounts provided by Schweickart, Collins, and Dr. Flush, it is highly unlikely this name change was made on any official level at NASA. It does appear, however, that potty humor is alive and well in outer space.	mixture	Science	NASA may be known for its brilliant employees, technical advances, and lofty projects, but according to a persistent Internet rumor, its astronauts are not immune to penis envy: This rumor about urinary sleeve sizes stems from the “Space Suit” episode of Moon Machines, a 2008 Science Channel documentary miniseries documenting the engineering challenges of the Apollo space program. Donald Rethke, who earned the nickname “Dr. Flush” for his work on zero-gravity waste management, stated in the interview for the documentary the size chart for the urinary condoms attached to the Maximum Absorbency Garment space suit system had to be changed because astronauts refused to choose the “small” size: “Inside the urine collection assembly, which we call the pee pouch, is a one liter bag. And the attachment to the body was a condom with a hose on the end of it which allowed the urine to flow freely into the bag.” The condoms initially came in three different sizes: small, medium and large. But few astronauts, whatever their real dimensions, refused to accept that they were anything but large. “We changed the names to large, gigantic, and humongous.” While this humorous anecdote certainly has an element of truth to it, Dr. Flush embellished the story. Apollo 11 astronaut Michael Collins told a similar tale in his 2009 book Carrying the Fire: An Astronaut’s Journeys, but Collins reported the sizes were changed to “extra large,” “immense,” and “unbelievable.” More significantly, Collins suggested these “heroic terms” were merely informal references, not official designations: Then it’s time to don a triangular yellow plastic urine bag by inserting the penis into a rubber receiver built into one corner of it. There are three sizes of receivers (small, medium, large), which are always referred to in more heroic terms: extra large, immense, and unbelievable. Collins and Dr. Flush may disagree on what these new sizes were commonly called, but choosing the right condom size was indeed an issue that vexed the Apollo astronauts. Russell Schweickart, the Lunar Module Pilot on the 1969 Apollo 9 mission, said in an interview urinating in space was a little tricky: There’s always the possibility that in maneuvering around in a suit you can end up pulling off the condom, and there’s always — we have three sizes you know, small, medium and large — in diameter, and there’s always this little ego thing about which one you do pick. Of course the smart guy picks the right size, because it’s very important. But what happens is, if you get too small a size it effectively pinches off the flow and you just turn yellow because you can’t go; and if, on the other hand you’ve got an ego problem and you decide on a large when you should have a medium, what happens is you take your first leak and you end up with half of the urine outside the bag on you. And that’s the last time you make that mistake. So it’s a cute little trick there.
9804	Tiny electrical shocks to the brain enhance memory: study	This story does a bit better job than the other one we reviewed of describing electrical brain stimulation treatment as it is used in other types of patients, and pointing out that it is “very invasive.” Still, it could have been more specific about the inherent risks. Like the other story, it misses a chance to compare the results of this experiment to the size of the temporary memory boost provided by available drugs. The terrible effects of Alzheimer’s disease and the lack of effective treatments create desperate desires for new options. Stories that report on this line of research should emphasize the caveats and cautions in order to take into account the power of wishful thinking by families and friends of people with dementia.	true	Epilepsy	This line of research is so preliminary that we don’t think it’s necessary that stories report specific cost estimates. This story did include a comment about similar treatments being very expensive. The story is clear that this test was just a preliminary experiment to see if brain stimulation can have any memory effects in people. It notes that while researchers say it is worth exploring as a potential treatment for Alzheimer’s disease, there is no evidence yet that it provides such benefits. While this story (unlike the HealthDay story we reviewed) at least mentions that deep brain stimulation is “very invasive,” it should have listed at least some of the major risks of implanting electrodes into the brain connected to stimulation devices under a patient’s skin, including bleeding, strokes and infections. A recent study of deep brain stimulation (DBS) involving 99 Parkinson’s patients concluded that DBS “has an adverse effect on executive functions with implications for daily life of the patients and their relatives.” Almost 10% of those DBS patients had psychiatric events including a suicide attempt. The story includes several mentions of the preliminary nature of this work. It points out that there may be important differences between the epilepsy patients in this study and typical Alzheimer’s disease patients and that there is no proof this technique will work for patients with dementia. The story mentions the estimated number of people with Alzheimer’s disease in the United States and that their ranks are “swelling,” but it does not exaggerate the prevalence of the disease or the portion of the population that could potentially benefit if this line of research makes progress. The story quotes an independent source and includes a comment from an editorial that appears along with the research report in the New England Journal of Medicine. It does not refer to any conflicts of interest, but the authors reported no conflicts in the disclosure forms posted online by the journal. This story offers a bit more information about existing treatments than the other story we reviewed, but all it says is that available drugs cannot prevent Alzheimer’s disease from progressing. The story would have been better if it had given readers some sense of how the memory-enhancing effects of available drugs compare to the size and duration of the effects seen in this test of brain stimulation. The story describes how brain stimulation is now used to treat some patients with Parkinson’s disease and other disorders, while making clear that more research is needed before anyone will know if it offers any benefits to people with Alzheimer’s disease. As mentioned above, the story points out that this sort of technique is used to treat other problems. This story includes direct quotes from an interview with an author of the researcher report so it’s clear that it did not rely solely on a news release.
34508	Donald Trump owns a stake in Energy Transfer Partners (the builders of the Dakota Access Pipeline) as well as Phillips 66, an affiliated company.	What's true: Trump spokeswoman Hope Hicks said that he had sold the small number of his remaining shares in Energy Transfer Partners as of mid-2016. What's undetermined: Whether Trump sold shares for both ETP and Phillips 66.	unproven	Politics Legal, blind trust, dapl, donald trump	After the 8 November 2016 election of Donald Trump, and amidst the backdrop of ongoing protests at the Standing Rock Indian Reservation, rumors circulated that the President-elect owned a stake in the Dakota Access Pipeline. On 29 November 2016 the blog Gothamist published a piece about Trump’s stock in the pipeline’s parent company, Energy Transfer Partners: Donald Trump, who the American public somehow recently elected to be president, owns stock in at least one of the companies behind the contested Dakota Access oil pipeline, a piece of infrastructure across stolen Native American land, completion of which the Obama administration has provisionally blocked. Financial disclosure forms filed by Trump in May show that he owned between $15,000 and $50,000 in stock in the Texas company Energy Transfer Partners, which is building the pipeline. The project has drawn protesters from more than 300 indigenous tribes from across the Americas, as well as non-native demonstrators such as the Bronx woman at risk of losing her arm from what activists have described as a police-thrown concussion grenade. A disclosure made a year earlier showed that Trump owned between $500,000 and $1 million in Energy Transfer Partners stock at that time. On 25 November 2016, CBS reported that additional stock owned by Trump exacerbated the conflict: Trump’s 2016 federal disclosure forms show he owned between $15,000 and $50,000 in stock in Texas-based Energy Transfer Partners. That’s down from between $500,000 and $1 million a year earlier. Trump also owns between $100,000 and $250,000 in Phillips 66, which has a one-quarter share of Dakota Access. While Trump’s stake in the pipeline company is modest compared with his other assets, ethics experts say it’s among dozens of potential conflicts that could be resolved by placing his investments in a blind trust, a step Trump has resisted … The 1,200-mile pipeline would carry oil across four states to a shipping point in Illinois. The project has been held up while the Army Corps of Engineers consults with the Standing Rock Sioux, who believe the project could harm the tribe’s drinking water and Native American cultural sites. Most stories published in November 2016 cited financial disclosure forms filed in May 2016, well before Trump’s Republican Party nomination and general election win. Both ETP (page 37) and Phillips 66 (page 43) were found in a 92-page long disclosure report published by CNN on 22 July 2015. On 19 May 2016, ABC scrutinized contents of a subsequent disclosure form; Trump announced that the document was filed on 17 May 2016. (ETP was again mentioned on page 37, and Phillips 66 on page 48.) ABC’s report made note of the fact that Trump’s stake in various companies did not appear to prevent him from criticizing them or their subsidiaries on the campaign trail, and speculated that such assets would be placed in a blind trust should he be elected. Interests in energy were noted, but ETP was not mentioned by name: Trump Has Invested in Several Companies He Says He Doesn’t Like: The report also shows investments by Trump in companies like Apple and Amazon, as well as the parent company of Oreo — all of which he has attacked on the campaign trail. Like any wealthy investor, Trump holds large stakes in sectors that are often the topic of big political disputes, like energy and health care. He has hundreds of thousands of dollars tied up in energy companies like Exxon, Phillips 66 and NextEra Energy. He’s also invested in biopharmaceutical companies like Celgene and technology companies like Gilead Sciences, Microsoft and Google. None of these investments are uncommon, but they highlight why some candidates turn their financial interests over to blind trusts once in office. Energy and healthcare are two industries particularly dependent on government contracts and grants, and they’re perennial campaign issues. Trump also reported at least $15,000 of income off an asset with the province of Quebec. He also reports having more than $100,000 invested in gold. It appears that a stake in ETP or Phillips 66 was just one of many that required attention prior to Trump’s January 2017 inauguration. On 25 November 2016, Trump spokeswoman Hope Hicks addressed the claim with a general statement about handling potential business conflicts: A spokeswoman for Trump, Hope Hicks, provided a statement about conflicts of interest to The Associated Press on Friday: “We are in the process of vetting various structures with the goal of the immediate transfer of management of The Trump Organization and its portfolio of businesses to Donald Jr., Ivanka and Eric Trump as well as a team of highly skilled executives. This is a top priority at the organization and the structure that is ultimately selected will comply with all applicable rules and regulations.” However, on 22 November 2016, Hicks maintained that Trump had sold off his ETP shares months before: President-elect Donald Trump sold off his shares of Energy Transfer Partners, the owner of the $3.7 billion Dakota Access pipeline that has become the focus of protests by Native American and environmental groups, according to his spokeswoman Hope Hicks. Trump’s share, which in a May 2015 disclosure was listed at between $500,000 and $1 million, had fallen to less than $50,000 by the time he sold it in the summer of 2016, according to a disclosure earlier this year. The sale would eliminate one possible conflict of interest for Trump, who has vowed to speed up permits for oil and gas pipelines in order to spur more oil and gas development in the United States. The shares were one of innumerable financial interests marked to go into a blind trust. Hicks also affirmed a “goal of the immediate transfer of management of The Trump Organization and its portfolio of businesses to Donald Jr., Ivanka and Eric Trump as well as a team of highly skilled executives.” Although she maintained that Trump intended to transfer all business interests to family members or executives, she also said that ETP was unequivocally not one of those interests.
5664	Ebola responders on ‘lockdown’ after Congo city’s unrest.	Ebola responders are on lockdown in the eastern Congo city of Beni after angry residents attacked a United Nations base to protest repeated rebel assaults, the World Health Organization said Tuesday. At least four protesters were killed, a local official said.	true	AP Top News, Health, General News, Africa, International News, United Nations, Ebola virus	Every day that health workers don’t have full access to Ebola-affected areas is a “tragedy” that prolongs the second-worst Ebola outbreak in history, WHO director-general Tedros Adhanom Ghebreyesus said on Twitter. No one in the city could be vaccinated against Ebola on Monday, WHO said. The U.N. health agency previously could trace more than 90% of contacts of infected people in Beni but now that figure is just 17%, U.N. spokesman Stephane Dujarric said. Almost 50 “non-critical” WHO staffers were evacuated to the city of Goma while 71 remain, spokesman Christian Lindmeier said. He said the violence is not directed at WHO or the Ebola response at large. Instead, Beni residents are outraged that rebels continue to carry out deadly attacks despite the presence of U.N. peacekeepers and Congolese forces. Some demand that the U.N. mission act or leave. The bodies of four young protesters were found near the U.N. base after Monday’s attack, Kumbu Ngoma with Beni’s military court told The Associated Press on Tuesday. Investigations continued into the cause of their deaths. Six Congolese soldiers were wounded by gunfire near the base, Ngoma added. Congo’s President Felix Tshisekedi after an emergency meeting Monday decided to allow joint operations between Congolese and U.N. forces in Beni following the protests that also burned the town hall. Congo’s military early this month declared a new offensive against Allied Democratic Forces rebels who have killed hundreds of civilians and security forces over the past few years in the mineral-rich northeast. After the U.N. mission in recent days was accused of inaction, it said it could not carry out operations unilaterally in a region where Congo’s military is already active, and that it cannot participate in Congolese military operations without being invited. Any unrest in the region where numerous rebel groups are active hurts crucial efforts to contain the Ebola outbreak. The number of reported cases has been dropping, with zero cases recorded on several days this month. Congo’s president, heartened by the trend, said earlier this month he hoped that the outbreak could be ended “completely by the end of the year.” However, WHO says 42 days without new Ebola cases must pass since the last possible exposure to a confirmed case for an outbreak to be declared over. More than 3,100 Ebola cases have been confirmed since this outbreak was declared in August 2018, including more than 2,100 deaths. WHO has called the trend in the declining number of cases encouraging but said the recent days of protests in Beni and surrounding areas are of “grave concern.” ___ Associated Press writers Jamey Keaten in Geneva and Edith M. Lederer at the United Nations contributed. ___ Follow Africa news at https://twitter.com/AP_Africa
10130	Topical Gel Catches Up With Pills for Relief	This story about topical gels that contain pain relief medication similar to ibuprofen makes a strong showing when examined point-by-point. Nevertheless, readers may end up with a skewed impression because of the personal anecdote and opinion that open and close the story. The headline and lead, as well as the last words of a story, can carry a lot of weight. The meat of the story includes a comprehensive overview of the medical evidence, but then there are phrases such as, “She raved about the stuff” and “for immediate relief of my tennis-related muscle pull, the cream was handy and helpful.” All the careful statements of fact in the body of the story may well be drowned out by the personal comments.	true		"The story says that the average copayment for a month’s supply of some of the topical NSAID medications is around $30. It would have been nice to include the cost of comparable oral medications. Although the story explains the available evidence comparing topical NSAIDs to oral pain relievers, highlights the limited number of direct comparisons, and carefully states the general consensus of experts, all of this solid reporting is undermined by a focus on personal anecdotal evidence over quantifiable benefits. Indeed, the reporter claims one medication provided immediate relief, a statement at odds with clinical trials that conclude that it usually takes hours for patients to feel the pain-relief effects of topical NSAIDs. The story summarizes the reported side effects of topical NSAIDS. What’s more, the reporter points out that the potential risks in people who have other health problems or are taking other drugs have not been well studied. That insight is something we see too rarely. The story refers to a number of clinical trials and systematic reviews of the evidence. It highlights areas where evidence is lacking or inconclusive. It would have been helpful to point out that in placebo-controlled trials, almost as many people who received the placebo reported pain relief as did those who got the active medication. The story could have mentioned that the systematic review it referred to was published by the Cochrane Collaboration and also the sources of the other clinical trial reports, so that interested readers could more easily locate the original articles. The story does not exaggerate the common pains these drugs are intended to treat, but the personal anecdotes and opinions highlighted at the beginning and ending of the story are unrepresentative of the typical experiences reported by participants in clinical trials and create a powerful impression that is at odds with the evidence. The story includes quotes from several experts and points out that two of them have accepted consulting fees or research support from pharmaceutical companies. The essence of this story is an attempt to compare topical NSAIDs with pills and other pain treatments. As noted above, though, the story does not mention that most people with minor pains feel better after awhile even if they don’t take any pain relief medication. It also should have mentioned that the difference between placebo and active treatment groups in the clinical trials is often slim. The story reports that only three topical NSAIDs (nonsteroidal anti-inflammatory drugs) are approved for sale with a prescription in the United States, while several brands are sold over the counter in Europe. Part of the focus of the story is that NSAIDS have been around for a long time but only recently are being given a more serious scientific reassessment. As the story says, ""But a number of new controlled trials and meta-analyses like Dr. Moore’s suggest that topical Nsaids are as effective as their oral counterparts for treating osteoarthritis in the knee and hand as well as musculoskeletal injuries like soreness and tendinitis."" The story includes several experts and mentions multiple studies."
3066	Search warrants target illegal Southern California pot grows.	More than 15,000 marijuana plants were eradicated and six people were arrested during raids on illegal grows in Southern California, authorities said Tuesday.	true	San Diego, General News, Marijuana, Environment, Arrests, California, Riverside, United States	Thirteen search warrants involving marijuana cultivation were served Monday by Riverside County sheriff’s deputies and state Department of Fish and Wildlife personnel in the unincorporated Aguanga area. In addition to the eradicated plants, 2,356 pounds of processed marijuana and 14 firearms were seized, the Sheriff″s Department said. One of the grows was using an extremely toxic pesticide that is banned in the United States, the department noted. “Marijuana cultivation negatively impacts the environment in many ways including diminishing and poisoning the water table and pesticides adversely affecting the health of neighboring residents,” the department said. Aguanga is about 55 miles (88.5 kilometers) north of San Diego.
5333	Kasich, Gee group to push opioid settlement toward hospitals.	West Virginia University President Gordon Gee and former Ohio Gov. John Kasich are creating a nonprofit that will fight to steer cash from any national opioid settlement to hospitals, rather than to local and state governments already sparring for control of the dollars.	true	John Kasich, AP Top News, State governments, Opioids, Gordon Gee, Health, General News, Politics, Epidemics, West Virginia, Ohio, Education, U.S. News	Gee and Kasich say Citizens for Effective Opioid Treatment, a 501(c)4 organization announced Thursday, will educate policymakers and the public about the negative impact the opioid epidemic has had on health care infrastructure and advance health-related research solutions to the crisis. “It’s an educational effort,” Gee said. “We want to help people understand that this is a crisis and that the caregivers — the hospitals, in particular — are really leading the charge in order to be able to both give care and solve the problem.” The duo’s plan is the latest move in a tug-of-war over what to do with the potential billions that could flow from a national opioid settlement with drugmakers and distributors, if one is reached. Some individual settlements with counties and states have already been reached and larger pharmaceutical companies could yet cut deals as the clock ticks toward the first trial, which is set for October. Local governments are asking the Cleveland-based federal judge who is overseeing the majority of more than 2,000 lawsuits over the toll of opioids to let them distribute money among themselves. They say being able to negotiate as a group on behalf of all or most local governments would make it possible to reach a deal with the industry. They argue the crisis has hit local governments especially hard as they’ve needed to spend more on police, jails and other programs. Most state attorneys general oppose that plan, saying the states would be in the best position to dole out money to local governments and to create larger scale prevention and treatment programs. Both Gee and Kasich said their nonprofit isn’t intended as an attack on local governments. But Kasich, who was criticized as governor for cuts to the state’s local government fund, said large sums of undedicated money can tend to migrate. “I’m not here to kind of tell the attorney generals what to do. If they can get a settlement and these communities can be reimbursed, good for them,” he said. “But I don’t want the money to go to fill potholes or to fill a budget gap or something like that. I want the money to go to the people who are on the front lines, because they are right up against the wall.” Gee and Kasich developed a relationship when Kasich was Ohio’s governor, beginning in 2011, and Gee was president of Ohio State University. Gee — himself a prolific fundraiser — said he enlisted Kasich’s help with the nonprofit for his political acumen. Gee called Kasich “a rainmaker and a door opener” who “knows everyone.” Under IRS rules, the new tax-exempt nonprofit — which can raise unlimited amounts and not disclose its donors to the public — must “primarily” engage in social welfare and helping the community, meaning at least half its budget has to go to activities such as education rather than to political lobbying. Gee said a companion entity is planned whose collections can be spent more freely. Hospitals in West Virginia, including one system separately chaired by Gee, sued some of the largest makers of the powerful painkillers in April, seeking monetary damages to cover the costs of the crisis. The epidemic has spread to include street drugs, such as heroin and illegal fentanyl. The U.S. Centers for Disease Control and Prevention says opioids were involved in more than 47,000 deaths in both 2017 and 2018. Gee said hospitals have had to cope with front-line health care costs, the space requirements of patients unable to go home, the associated medical needs of children and newborns and added workload and security costs. He said the nonprofit will solicit private donations to spread its message. Kasich said he will speak out publicly, write op-eds and appear in videos. The idea of having a private foundation handle at least some of any money from an opioid settlement isn’t new. A group of public health groups including the Public Health Advocacy Institute at Boston’s Northeastern University filed papers in court in May calling for such an entity. The group said one of the successes from a 1998 national tobacco settlement was the $1.7 billion that went to such a group and helped reduce youth smoking. But this approach makes some people bristle. Earlier this year, OxyContin maker Purdue Pharma and members of the Sackler family, which owns it, agreed to a $270 million settlement with the state of Oklahoma. Much of that money went to a research and treatment center at Oklahoma State University. Some lawmakers complained that they, rather than the state attorney general, should have gotten to decide what to do with the settlement. In July, a group of state lawmakers in West Virginia asked their state’s attorney general for control of a $37 million opioid settlement with the drug distributor McKesson, arguing they were the ones best suited to assure the money went to treatment programs rather than administrative costs. Attorney General Patrick Morrisey responded in a statement that it’s important to “attack the drug epidemic holistically.” ___ Associated Press Writer Geoff Mulvihill contributed to this report from Cherry Hill, New Jersey.
8566	U.S. nurses who can't get tested fear they are spreading COVID-19.	In New York City, an intensive care nurse treated patients for three days after she started displaying symptoms of COVID-19 - but couldn’t get a test from her hospital. In Georgia, a nurse was denied a test after treating an infected patient who died.	true	Health News	In Michigan, one of the few hospital systems conducting widespread staff testing found that more than 700 workers were infected with the coronavirus - more than a quarter of those tested. More than a month after the pandemic hit the United States, the persistent test shortages mean that health workers are treating patients while experiencing mild symptoms that could signal they are infected themselves, according to Reuters interviews with 13 nurses and 2 doctors who described testing shortages at their hospitals. Many medical centers are testing only the workers with the most severe symptoms, according to the frontline workers and hospital officials. As a result, nurses and doctors risk infecting patients, colleagues and their families without knowing they are carrying the virus, medical experts say. The New York City nurse works at Mount Sinai Hospital, a major institution in the national epicenter of the pandemic. Her nausea, upset stomach and low-grade fever did not qualify her to get a test in late March, she told Reuters on condition of anonymity. She continued to work because her fever - at 100.2 degrees Fahrenheit (37.9 Celsius) - was just below the threshold set by the U.S. Centers for Disease Control and Prevention for sending health workers home. But she had the virus, an infection she confirmed when she took it upon herself to get tested at a private clinic, she said. “I knew something wasn’t right,” the nurse said, “but I didn’t really think I had it.” A hospital spokesman declined to comment on the nurse’s case but said that mildly symptomatic employees could now get tested. Mount Sinai Hospital’s chief medical officer, Vicki LoPachin, told staff on April 4 that the hospital would increase testing of employees with symptoms of the virus starting on Tuesday. New York City is home of the nation’s worst coronavirus outbreak, with about 78,000 cases and 3,600 deaths as of Wednesday morning. Nationwide, the number of infections has surpassed 400,000, with nearly 13,000 deaths. (For an interactive graphic tracking the virus, see tmsnrt.rs/2XjOZil ) The continued test shortages - even for the workers most at risk - is “scandalous” and a serious threat to the patients they treat, said Dr. Art Caplan, a professor of bioethics at the NYU Grossman School of Medicine. “It’s obvious that we should be testing healthcare workers, just as points of infectivity,” Caplan said. On Monday, the U.S. Health and Human Services Inspector General’s Office published a survey of 323 hospitals that found the shortages left the facilities unable to effectively test staff and patients, who frequently waited more than seven days for results because of delays at outside laboratories. In March, the U.S. Food and Drug Administration gave states permission to approve their own tests to avoid federal regulatory delays. It also approved the first rapid coronavirus diagnostic test, manufactured by Cepheid, which the company says can detect the virus in about 45 minutes without sending samples to an outside laboratory. The FDA did not immediately respond to requests for comment on Wednesday about federal efforts to further address the persistent national test shortages. While some hospitals have announced plans to test more employees in recent days due to increased capacity, the inconsistency across states has created a patchwork of testing protocols based on the supplies available. NYC Health + Hospitals, the corporation that operates the city’s 11 public hospitals, said last week they would have the capacity to test all employees - regardless of symptoms - by April 22. In Georgia, where the nurse told Reuters she was denied testing after treating a dying patient, the state health department said it is giving priority to healthcare workers at new drive-through test sites. The workers, however, must be evaluated and recommended for testing by a doctor. The CDC advises that healthcare facilities should prioritize giving their limited tests to hospitalized patients and symptomatic healthcare workers, specifically those experiencing fever, cough and shortness of breath. All other healthcare workers should receive tests “as resources allow,” according to the CDC’s website. In Michigan - a leader among states in establishing testing programs that deliver quick results - more than 700 staff in the Henry Ford Health hospital system have tested positive out of some 2,500 employees tested since March 12, chief clinical officer Adnan Munkarah said on April 6. While the infected workers represent just 2% of the system’s overall staff, the high percentage of positive tests in the initial round signals that further testing could reveal many more infections. The Henry Ford system did not immediately respond to a request for comment Wednesday. Until rapid testing is widely available, hospitals face a dilemma: Do they test staff with mild symptoms and keep them home for days as they await results? Or do they keep mildly ill - but desperately needed - staff at work to treat the rush of patients? “It’s a different kind of triage,” said Caplan, the bioethics professor. “It’s precaution versus, ‘I need staff.’” Rapid testing of all hospital employees could possibly decimate the workforce by revealing asymptomatic infected workers, several healthcare workers told Reuters. But it would also protect colleagues, patients and family members. “It’s scary to come home and not know if you’re bringing it home to your family,” said Sydnie Boylan, a nurse at Hollywood Presbyterian Medical Center in Los Angeles. She went to work in late March with a headache and sore throat, but no fever, after she had been exposed to a coronavirus patient while not wearing sufficient protective gear. Those symptoms did not qualify for testing at her hospital. Boylan said the hospital told her to quarantine at home for 14 days because of her exposure to the patient. The headache and sore throat persisted for six days, she said. Asked about Boylan’s case, Hollywood Presbyterian Medical Center’s head of clinical operations Jamie Chang said in a statement the hospital is testing as many staff and patients as possible with limited supplies. He said the hospital follows the Los Angeles County Health Department guidelines for testing, which recommend prioritizing patients with a cough, fever and difficulty breathing. “Despite the severe shortage in testing capacity available to the hospital, Chang said, “all HPMC staff have access to the same COVID-19 testing that we offer to our patients.” Boylan said she had been tested at a drive-through site. She is still waiting on the results.
8041	Turkey adopts 'voluntary' stay-at-home quarantine.	President Tayyip Erdogan called on Friday for a “voluntary quarantine” in which Turks stay at home except for shopping or basic needs to stem a surge of coronavirus cases, which jumped by a third in a day to 5,698 with 92 dead.	true	Health News	“If we don’t want these measures to reach a further stage, we must abide by the voluntary quarantine rules verbatim. What does this voluntary quarantine mean? It means do not leave your house,” Erdogan told a press conference late on Friday. The rate of infections in Turkey has outstripped most other countries in the last two weeks with 2,069 more cases in the last 24 hours, the country’s health minister said earlier on Friday in calling for wider measures to contain the outbreak. Erdogan also announced an end to all international flights, and said pandemic councils will be formed in Turkey’s 30 biggest cities to take additional precautions if necessary. “By taking care of social distancing at home and at work, by not using public transportation unless necessary, by not leaving the house apart from fundamental shopping needs, by taking care of our cleanliness, it is mandatory that we increase the effectiveness of these measures,” he added. Turkey’s government says it is not disclosing the location of cases to prevent the risk of increasing transmission rates by encouraging people to move from areas with high rates to places where there are no or few cases. Ramping up measures against the outbreak, Turkey also limited intercity bus travel and banned walks and fishing along the seashore and beaches, as well as jogging in forests and parks on weekends. Local governors could decide to extend the decision to week days, Interior Minister Suleyman Soylu told an interview on NTV news channel. One town and four villages in Turkey’s Black Sea province of Rize have been quarantined over the coronavirus outbreak, the local mayor said on Friday, marking the country’s first case of a lockdown.
3779	"Bipartisan Medicare drug bill gets makeover to lower copays."	A bipartisan Senate bill to curb prescription drug costs for Medicare recipients got a makeover Friday to lower copays and make it easier for seniors to budget for their expenses.	true	Seniors, Ron Wyden, Health, General News, Legislation, Politics, Prescription drug benefits, Impeachments, Prescription drug costs, Business, Prescription drugs, Chuck Grassley, Medicare, Bills, Nancy Pelosi, Donald Trump	The updated legislation unveiled by Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., would lower the standard copay to 20% from the current 25% for seniors enrolled in Medicare’s Part D prescription drug benefit. It also introduces a feature that would let Medicare enrollees spread out their copays in monthly installments. Because of the current design of the system, seniors taking very expensive drugs can face unmanageable out-of-pocket costs in the first couple of months of any year. The bipartisan Senate bill has the support of President Donald Trump, but it’s unclear if any significant drug pricing legislation can pass a Congress polarized by impeachment. In the House, Speaker Nancy Pelosi plans to bring her own, more ambitious bill to a floor vote next week. The California Democrat’s legislation would empower Medicare to negotiate prices with drug companies and plow the savings back into expanded dental, vision and hearing benefits for seniors. But congressional Republicans are opposed to the government negotiating drug prices. Trump, who supported the idea as a candidate, has since dropped it. And Senate Majority Leader Mitch McConnell, R-Ky, is reluctant to bring the bipartisan Grassley-Wyden bill to the floor. It could trigger Democratic amendments designed to create political headaches for Republicans on other issues, such as protecting people with pre-existing medical conditions. In terms of policy ideas, there’s considerable overlap between the Senate bill and parts of Pelosi’s plan. Both would cap out-of-pocket costs for Medicare beneficiaries and require drugmakers to pay rebates to the government if they hike prices above inflation. But the political challenges may be impossible to overcome. The Grassley-Wyden bill would limit out-of-pocket medication costs faced by seniors to $3,100, starting in 2022. Currently there is no limit, and some Medicare recipients dealing with serious illness face copays rivaling a mortgage payment. In a statement late Friday, the White House said “President Donald J. Trump applauds the work of Chairman Grassley and Ranking Member Wyden to lower prescription drug costs and further improve their bipartisan legislation, such as adding a provision to limit monthly out-of-pocket spending for seniors with chronic high costs. The White House called on Congress “to act now to give Americans the relief they need by sending bipartisan drug pricing reform to the President’s desk this year.” Supporters of the Senate bill are hoping a deal can still be had, and that major prescription drug legislation can be incorporated in a budget bill expected early next year. The pharmaceutical industry opposes both the Senate and House bills and has poured millions of dollars into a lobbying battle to block them.
8424	Africa may see millions of coronavirus cases, tentative WHO forecast shows.	Coronavirus cases in Africa could shoot up from thousands now to 10 million within three to six months according to very provisional modelling, a regional World Health Organization (WHO) official said on Thursday.	true	Health News	But Michel Yao, head of emergency operations for WHO Africa, said that was a tentative projection which could change and noted worst-case predictions for the Ebola outbreak had not come true because people changed behaviour in time. “This is still to be fine-tuned,” he told a media teleconference. “It’s difficult to make a long-term estimation because the context changes too much and also public health measures when they are fully implemented, they can actually have an impact.” The world’s poorest continent has seen more than 17,000 confirmed cases of the COVID-19 disease and about 900 deaths so far - relatively little compared to some other regions. But there are fears that could balloon and overwhelm shaky health services. “We are concerned that the virus continues to spread geographically, within countries,” said Matshidiso Moeti, director for WHO’s Africa region, which comprises 46 sub-Saharan nations and Algeria. “The numbers continue to increase every day.” Infections in South Africa, which has the highest number of cases, have slowed after it began a strict lockdown, but other nations - like Burkina Faso, the Democratic Republic of the Congo and Algeria - have seen higher than average fatalities. The WHO is working with authorities there to improve patient care and reduce fatalities, Moeti said. She warned that President Donald Trump’s withdrawal of U.S. funding for the WHO could harm both the fight against against other killers like polio, HIV and malaria. “The impact, potentially, of this decision will be quite significant on areas such as polio eradication,” said Moeti, just when Africa was close to being declared polio-free. Trump accused the Geneva-based WHO on Tuesday of promoting Chinese “disinformation” about the new coronavirus, saying this had probably worsened the outbreak and that he would stop its funding even as he defended his own handling of the crisis. More than 2 million people have been infected globally, with the largest number in the United States. Washington is the biggest donor to the WHO, which tackles specific diseases and also strengthens national health systems. The United States contributed more than $400 million to the WHO in 2019, roughly 15% of its budget. “We are very much hoping (suspension of funding) will be re-thought because the U.S. government is an important partner not only in financial terms but also it is an important strategic partner,” Moeti said. She also told the media teleconference that the organisation requires $300 million to help African governments respond to the pandemic.
17892	Terry McAuliffe Says Ken Cuccinelli tried to make it more difficult for mothers to obtain divorces.	McAuliffe’s ad says Cuccinelli introduced legislation in 2008 that would have made it more difficult for mothers to obtain divorces. Cuccinelli’s unsuccessful bill would have eliminated the ability for a spouse in a couple with minor children to unilaterally file for a no-fault divorce. The legislation would have allowed the other spouse to block the process by filing a written objection. In portraying the bill as an attack on women, McAuliffe ignores that the legislation would have made it equally more difficult for dads to get divorces. So McAuliffe’s statement has accuracy, but leaves out an important detail and context.	mixture	Families, Marriage, Virginia, Terry McAuliffe,	"Editors Note: On Sept. 16, PolitiFact Virginia rated a statement by Terry McAuliffe’s campaign that Ken Cuccinelli wants to make it more difficult for mothers to get divorces. After reconsidering the evidence available, we’ve decided to change the rating to , which means the statement is partially accurate but leaves out important details or takes things out of conext. Terry McAuliffe, Democratic Party gubernatorial candidate, turned to divorce law this month in his ongoing effort to portray Republican Ken Cuccinelli as insensitive to women. Here’s the text of a TV ad McAuliffe launched on Sept. 4 that contains a picture of a woman pushing two young children on swings: ""2008. Ken Cuccinelli writes a bill to give Virginia among the most extreme divorce laws in America. If Cuccinelli had it his way, a mom trying to get out of a bad marriage, over her husband’s objections, could only get divorced if she could prove adultery or physical abuse or her spouse had abandoned her or was sentenced to jail. Why is Ken Cuccinelli interfering in our private lives? He’s focused on his own agenda. Not us."" The ad follows a series of McAuliffe claims that Cuccinelli has sought to limit access to abortion and birth control. We wondered whether Cuccinelli really did introduce legislation aimed at making it harder for moms to end bad marriages. Let’s start with a quick primer on Virginia’s divorce laws. The grounds for ending a marriage include adultery, felony conviction, cruelty or fear of bodily harm, wilful desertion and voluntary separation of 12 months when there are minor children or six months when there are no minor children and a property agreement exists. Even when other grounds exist, couples often use the separation rule so they can obtain a so-called ""no-fault"" divorce, according to Edward Barnes, president of Barnes & Diehl, a family law firm. He said the process ends up being a little less expensive and neither party is blamed for the divorce in a final decree, which is among the paperwork available as public records. And if there’s been adultery or other grounds for ending a marriage, the no-fault grounds can be used as a bargaining chip in divorce proceedings by the innocent party. ""I think a lot of lawyers will think in terms of benefit to the children,"" Barnes said. ""There will not be an adultery decree that could be waved around later to hurt the children."" All states have unilateral no-fault divorce grounds, although they vary greatly in the separation time frame required. Cuccinelli, as a state senator in 2008, introduced legislation that would have eliminated the ability for a spouse in a couple with minor children to unilaterally file for divorce under the separation ground. The bill would have allowed the other spouse to block the process by filing a written objection. The legislation died in the Senate Courts of Justice Committee. Cuccinelli explained his support for tougher divorce laws in 2007 and 2009 campaign statements. ""Studies show that the dissolution of marriage has long term negative impacts on children and those marriages that last for five years are much more likely to go the distance,"" he wrote. ""For this reason, the state has an interest in marital preservation. I support family law reform that establishes mutual consent divorce and requires counseling where children are involved, unless abuse is involved."" McAuliffe’s TV ad suggests Cuccinelli’s 2008 bill would have weakened the options of moms seeking divorce and strengthened the hand of dads. McAuliffe’s campaign backed that message sending us links of columns from a conservative father’s rights groups supporting tightening divorce rules and from the Pennsylvania chapter of the National Organization for Women defending the no-fault divorce rules in that state. Neither article addressed Virginia law, Cuccinelli’s bill, or laid out specific arguments that no-fault divorce is more advantageous to mothers than fathers. The father’s group contended that children are best-served by being raised in a household with both of their parents; NOW said it is traumatic for children to remain in homes with dysfunctional marriages. Barnes, while no fan of Cuccinelli’s bill, said it’s misleading for McAuliffe to portray it as aimed against mothers. ""It’s gender neutral. Neither side can remarry. Both sides, if they’re living apart, can’t files tax returns as a couple and that costs them."" Our ruling McAuliffe’s ad says Cuccinelli introduced legislation in 2008 that would have made it more difficult for mothers to obtain divorces. Cuccinelli’s unsuccessful bill would have eliminated the ability for a spouse in a couple with minor children to unilaterally file for a no-fault divorce. The legislation would have allowed the other spouse to block the process by filing a written objection. In portraying the bill as an attack on women, McAuliffe ignores that the legislation would have made it equally more difficult for dads to get divorces. So McAuliffe’s statement has accuracy, but leaves out an important detail and context."
9143	Strategic brain training positively affects neural connectivity for individuals with TBI	This news release from the Center for BrainHealth at the University of Texas at Dallas describes findings from a recent study on the effects of brain training for people with chronic traumatic brain injury (TBI). The release is a little fuzzy on the details. The news release should have included numbers to put the benefits in context and explained how changes in cortical thickness — the main outcome studied — translates to cognitive improvements (and what types of improvements) for a person living with long-term TBI. TBI is a serious and prevalent condition, with an estimated 2.5 million new cases in 2010. Since treatments are limited, it’s in the public interest to find treatments that might improve brain function and to find reliable ways to measure this improvement. The study concerns a unique population of TBI patients. On average, the patients recruited have suffered from TBI symptoms for eight years. The findings show that brain training can still stimulate changes in the brain (in terms of cortical thickness and neural connectivity) even after so many years. This challenges the widely held belief that recovery from TBI is limited to two years after the initial injury. The news release suggests that an MRI-based measure of brain physiology is somehow superior to a neuropsychological test-based measure (ie. asking patients to name colors or read words). But a case can also be made that neuropsychological outcomes are actually more relevant since they are closer to what the patient experiences and to the outcomes we are trying to achieve with TBI treatments.	mixture	brain training,Center for BrainHealth,traumatic brain injury	The news release does not mention how much the brain training costs. The release could have stated that the cost of cognitive training usually includes repeat visits to a therapist. The release said that brain training “can stimulate structural changes in the brain and neural connections even years after a traumatic brain injury.” But how do these structural and neural changes translate to meaningful patient outcomes? The release said the training is correlated to “an individual’s ability to switch between tasks quickly and consistently to achieve a specific goal.” Which tasks? Which goal? To make the study findings meaningful to people with TBI or their caregivers, the release should have included some specific examples of how patients benefited from the therapy. The lack of numbers to put the findings in context is another weakness of the release. There are no numbers to show the differences in neural connectivity or cortical thickness between the two treatment arms. Ideally we would be told the absolute difference in outcomes between the two groups, the clinical significance of any difference, and the statistical significance. The only quantitative figures come from the image included in the news news release. The news release might have done a better job explaining this figure. Harms are not discussed. While presumably there is little risk from participating in brain training, cognitive training can have its downsides. Harms such as the time investment, frustration over speed or lack of progress, costs, etc. could have been mentioned. The study design is explained well — the number of patients, the treatment and control groups, the longitudinal aspect of the outcome measures. What is unclear is why the result matters. The release states: “Individuals in the strategy-based reasoning training showed a greater change in cortical thickness and connectivity compared to individuals who received the knowledge-based training.” A change can be in either direction. In fact because we have here three time points, a change could be 1) increase followed by increase, 2) increase followed by decrease, 3) decrease followed by decrease. Are all of these changes desirable? Are all of them correlated with cognitive ability? The release doesn’t tell us. We found no indication of disease-mongering. The release provides good context on how TBI disrupts the structure of the brain. The funding sources are disclosed at the end of the news release. The release compares strategy-based training against knowledge-based training. But the release neglected to mention other approaches to treating TBI. Since the focus here is on cognitive impairments, the release might have mentioned some common treatments such cognitive behavior therapy and occupational therapy. From the news release alone, it is not entirely clear if the brain training program already existed and was simply now applied to those with chronic TBI for the first time. The novelty of the findings is clearly established early on in the news release. One finding is that changes in cortical thickness and neural network connectivity may serve as good surrogate markers for treatment efficacy. A further finding is that TBI patients may stand to gain from brain training well beyond the initial injury. The releases employs a balanced tone.
12472	NASA will pay you $18,000 to stay in bed and smoke weed for 70 straight days.	Persistent story about NASA paying people $18,000 to lie in bed and smoke ganja is fake	false	Fake news, PunditFact, Bloggers,	"An online story that claimed NASA pays people thousands to smoke marijuana in bed for months is actually a viral legend that has been in orbit for quite awhile now. ""NASA will pay you $18,000 to stay in bed and smoke weed for 70 straight days,"" read the headline on a Jan. 2, 2017, post on TheSolExchange.com, a blog that is largely concerned with the latest developments in athletic sneakers. Judging by the number of commenters asking to be signed up, there also is an audience for marijuana studies. Facebook users flagged this post as possibly being fabricated, as part of the site’s efforts to fight fake news in users’ social media feeds. ""NASA has put out an ad looking for people who’re willing to take part in their ‘Rest Studies’ – a study which will require participant to spend 70 straight days in bed, relaxing and smoking different types of cannabis, for which they will receive a salary of 18.000 USD,"" the post read. ""During the relaxation period participants are allowed to read books, play games, Skype and smoke weed. They can do whatever they want as long as it involves staying in bed, week after week, earning a cool 1200 USD per week."" There are more details on the post, but you get the gist. We found versions of the same story on several other blogs going back to at least March 2016, all claiming NASA is doling out the big bucks for people who want to lounge all day and spark up. Pretty good hustle, right? Except it’s not true. Well, it’s true that NASA does perform bed rest studies. The goal is to examine the potential effects of weightlessness on astronauts, and lying in bed with your head tilted down at a six-degree angle is apparently a fair substitute. The studies sound pretty much as described at TheSolExchange.com — except for the cannabis part. Several media outlets like the Houston Chronicle, Forbes, Vice and CBS News have written in the past about the studies, which involve people getting paid something on the order of $1,200 per week for 15 weeks (that’s $18,000) to hang out in bed. But it’s not all that great of a time, from the sound of it. Boredom is a constant problem, as every moment of a volunteer’s life is spent in bed for that time. Scientists continually poke and prod them, taking readings and measurements on everything from weight to bone density. Volunteers are told when and what to eat, and have to do everything in bed. That means eating, exercising, showering and even, yes, using the facilities while lying down. A NASA spokesman told us that there have not been any sleep studies that involved consuming cannabis. There also aren’t any more sleep studies currently planned, so it’s not like NASA is suddenly going to try it the next time. Blog posts that have been saying that NASA is paying subjects $18,000 to lie in bed and smoke marijuana for 70 days are pretty far out."
2670	Vatican broadens case for condoms to fight AIDS.	Pope Benedict’s landmark acknowledgement that condoms are sometimes morally justifiable to stop AIDS can apply to anyone — gays, heterosexuals and transsexuals — if that is the only option to avoid transmitting the HIV virus to others, the Vatican said Tuesday.	true	Health News	The clarification, which some moral theologians called “groundbreaking,” was the latest step in what is already seen as a significant shift in Catholic Church policy. It came at a news conference to launch the pope’s new book, “Light of the World: The Pope, the Church, and the Sign of the Times.” In the book, a long interview with German Catholic journalist Peter Seewald, the pope made clear he was not changing the Catholic ban on contraception, but, using the example of a male prostitute, said there were cases where using a condom to avoid transmitting the HIV virus could be justified. Vatican spokesman Father Federico Lombardi made the clarification because the German, English and French versions of the book used the male article when referring to a prostitute, but the Italian version used the female form. “I asked the pope personally if there was a serious distinction in the choice of male instead of female and he said ‘No’,” Lombardi said. “The point is it (condom use) should be a first step toward responsibility in being aware of the risk of the life of the other person one has relations with,” he said. “If it is a man, a woman or a transsexual who does it, we are always at the same point, which is the first step in responsibly avoiding passing on a grave risk to the other.” Theologians, AIDS activists and liberal Catholics said the latest developments marked a highly significant, perhaps even historic, change in the Church’s attitude to condoms. “The pope’s statement ... is a startling and welcome shift by the Vatican that has the potential to save tens of thousands of lives,” said Dr. Paul Zeitz, executive director of the Washington-based Global AIDS Alliance (GAA). “The pope has created the possibility of rapid change in the way the Catholic Church views HIV/AIDS and how it can preserve the sanctity of human life,” Zeitz said. Lombardi appeared to take the debate beyond the confines of prostitution in the context of fighting the transmission of AIDS, although the church prefers measures such as abstinence. “The fact that an official Vatican spokesperson seems to be extending the possibility of use clearly is groundbreaking,” said Rev. John T. Pawlikowski, a professor of social ethics at the Catholic Theological Union in Chicago. “The real question is whether this papal statement will impact pastoral activity on the ground, particularly in AIDS-affected regions of the world,” he told Reuters. The church had been saying for decades that condoms were not even part of the solution to fighting AIDS, even though no formal policy on this existed in a Vatican document. The late Cardinal John O’Connor of New York famously branded the use of condoms to stop the spread of AIDS as “The Big Lie.” “The Vatican’s acknowledgement that Pope Benedict’s acceptance of condom use to prevent the spread of sexually transmitted infections relates to everybody shows how significant the pope’s comments are,” said Jon O’Brien, president of the U.S.-based Catholics for Choice group. In the book, the pope says the use of condoms could be seen as “a first step toward moralization,” even though condoms are “not really the way to deal with the evil of HIV infection.” Through the book and Lombardi’s comments, the pope seemed to be giving a cautious, qualified endorsement of the “ABC principle” (Abstinence-Be faithful-Condom) espoused by many governments and health organizations in preventing AIDS. Archbishop Rino Fisichella, a Vatican official who presented the book, said Catholics had to “respect” the pope’s words even though they were not made in an official papal pronouncement. “For the first time, the use of condoms in special circumstances was endorsed by the Vatican, and this is good news and a good beginning for us,” said Margaret Chan, director-general of the World Health Organization.
10217	Study: Lower salt intake could be riskier than thought	The difference between this story and the story we reviewed on the same topic by the New York Times can be seen even in the headlines. This one leads readers to believe that there is a risk in eating less salt. The New York Times, though, took the more cautious approach of saying, “Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds.” We think that given the problems with this study, the more cautious approach was appropriate. Researching the impact of salt, or any dietary factor, on health can be tricky, as both of these stories explain, and this study attempted to provide a deeper look at the connection between salt and health. But, as the authors themselves acknowledge in the paper, there are significant limitations to this study that should have given reporters more pause when reporting the findings. The biggest one was acknowledged by the New York Times in saying, “was observational, considered at best suggestive and not conclusive.” USA Today missed this point.	mixture	Diet studies,USA Today	As with the harms, the benefits were not quantified. There is no quantification of harms or benefits in this story. Instead we are told, “They found that systolic blood pressure (the top number) was slightly lower in those who excreted less sodium, but this didn’t translate into a lower risk of cardiovascular death — in fact, those with lower sodium excretion had an increased risk of cardiovascular death. The findings were consistent in participants younger and older than 60 years.” The New York Times story put the harms (and benefits) in absolute terms, showing both the small sample size of the number of people who died and the differences in the categories. Unlike the New York Times story, this one did not evaluate the quality of the evidence. The story said, vaguely, “The research is already drawing fire from medical experts here. Ralph Sacco, president of the American Heart Association and chairman of neurology at the University of Miami, says this is only one study of a relatively young, mostly white population and blood pressure tends to rise with age and affect African-Americans disproportionately.” Again, this might lead most people in the United States to think that they are at risk when, in fact, there were other significant limitations to the study that were ignored. The story did not engage in overt disease-mongering, but we do feel readers will be confused about whether they should be worried about their salt intake. There is so little information presented about the specifics of the study that many people might assume that they are eating too little salt. The story does quote an independent expert but then turns around and cites a spokesman for the Salt Institute, a salt advocacy organization. Why should they be given a platform in this story? We thought that more weight should have been given to the independent analysis, as was done in the New York Times story. The Times, for example, sought out a well respected expert, Dr. Lawrence Appel. (Addendum added May 6: It’s worth noting that the independent experts in this field, such as Dr. Appel and Dr. Sacks (who are also quoted in the Times story), are closely affiliated with NHLBI which funds much of the research on sodium. And as Gary Taubes posited many years ago in Science magazine, the NHLBI may not be a dispassionate arbiter of the evidence. (The full text of his story can be accessed at the National Association of Science Writers website: http://www.nasw.org/1999-science-society-awards.) This criterion does not apply in this story. This study is presented as just another study of equal weight with everything else that has been published on heart disease and salt. It should have been presented as an one study with significant flaws. The story does not rely on a news release.
2807	EU regulator backs Bayer, GSK drugs, knocks back Novartis, Teva.	Europe’s drugs regulator gave its backing on Friday for marketing approval to be granted for Bayer’s pulmonary hypertension drug Adempas and for GlaxoSmithKline’s diabetes medicine Eperzan.	true	Health News	The European Medicine Agency (EMA) also backed a new drug from Dainippon Sumitomo Pharma called Latuda, for the treatment of schizophrenia, and Bemfola, a new biosimilar medicine for the treatment of infertility. But the regulator decided against recommending Teva’s new multiple sclerosis (MS) pill Nerventra, or laquinimod, which the Israeli firm is developing with Swedish partner Active Biotech, and recommended rejecting an application from Swiss drugmaker Novartis to market its heart failure drug serelaxin. Recommendations for marketing approval by the EMA’s Committee for Medicinal Products for Human Use (CHMP) are normally endorsed by the European Commission within a couple of months. The prospects for laquinimod were already viewed by analysts as uncertain, since the drug missed its main goal in a late-stage trial in 2011 and U.S. regulators have asked for another Phase III study before considering it. Analysts at Jefferies in London said the rejection of Teva’s MS drug was as they had expected and was driven by three major concerns - about the possible link to risk of cancers and pregnancy dangers, and its modest effect on relapse rates which suggested an unfavorable risk-benefit balance for the drug. On Bayer’s Adempas, the EMA said the key benefits of the drug were “its ability to provide significant improvement in exercise capacity and pulmonary haemodynamics in two specific conditions known as chronic thromboembolic pulmonary hypertension and pulmonary arterial hypertension.” Adempas, which belongs to a class of drugs known as soluble guanylate cyclase stimulators that help arteries relax to increase blood flow and decrease blood pressure, got backing from drugs regulators in United States in October last year, and in Japan earlier this month. The EMA also issued negative opinions for two so-called orphan medicines - Masiviera from France’s AB Science, intended for certain types of advanced pancreatic cancer, and Translarna, from PTC Therapeutics, designed to treat Duchenne muscular dystrophy. GSK’s once-weekly diabetes drug albiglutide won the EMA’s recommendation and will be sold under the brand name Eperzan. It belongs to the same class of injectable GLP-1 drugs as Victoza, from Novo Nordisk, as well as Byetta and Bydureon, from Bristol-Myers Squibb and AstraZeneca. Last year regulators in the United States pushed back an approval decision on the drug until April 15.
16991	"Obamacare is ""one big fat VA system."	"Guilfoyle said Obamacare is ""one big fat VA system."" We found no health policy expert who agreed with that comparison. The VA is owned and operated by the federal government. Its staff are government employees. In contrast, Obamacare builds upon the existing private sector health industry. The law sets standards for insurance and health care providers and it subsidizes premiums. Washington does run the Medicaid insurance program but even under that program, it is paying private providers."	false	Health Care, Veterans, PunditFact, Kimberly Guilfoyle,	"The uproar over allegations of secret waiting lists at a Veterans Administration hospital in Phoenix, and delays that potentially cost veterans their lives has opened the Obama administration to criticism that it was slow to respond to the VA’s own internal reports. Some also see a connection between troubles at the VA and the president’s signature health care law, the Affordable Care Act. On Fox News’ The Five, four of the show’s pundits built the case that if Obama digs deeply into the VA, it will raise more questions than he would like about how the Affordable Care Act is structured. When a Fox News panelist described the VA as a ""single-payer"" system (where the financing of health care is run through the government), co-host Kimberly Guilfoyle chimed in. ""If he (Obama) shines a light on that, if we actually have some illumination there, then you're going to see this is really what the rest of you all are going to get: One big fat VA system in the form of Obamacare,"" Guilfoyle said. Using the same logic, co-host Eric Bolling later claimed that 500 people per year ""are going to die waiting"" for treatment because of Obamacare. Bolling’s claim has some fundamental problems -- we’ll address them in a bit -- but here we’re fact-checking Guilfoyle’s claim that Obamacare amounts to ""one big fat VA system."" Obamacare: One big fat VA system The VA owns hospitals. Its doctors, nurses and technicians are government employees. The people who get care at VA facilities have served in the armed forces. These facilities are not open to the general public, and Congress appropriates the funds that keep the VA running. Under the Affordable Care Act, the government works with private insurance companies and health care providers to provide health care coverage. The government subsidizes insurance premiums for some people and sets minimum standards for insurance policies. But the health care system remains in the private sector. Private sector providers get paid by insurance companies and patients. There are thousands of private providers and hundreds of insurance plans operating in hundreds of markets across the country. In the case of Medicaid, the government plays the role of the insurance company and pays private providers based on a set reimbursement schedule. Some notes about the Affordable Care Act: Employers will continue to provide health insurance to the majority of Americans through private insurance companies. The government has not seized control of hospitals or nationalized doctors. The law does not include the public option, a government-run insurance plan that would have competed with private insurers. We asked health care experts to assess the similarities and differences between the VA and the Affordable Care Act. The bottom line: it’s apples and oranges. Tom Buchmueller, who spent a year on Obama's Council of Economic Advisors and teaches at the University of Michigan, said he struggles to see any similarity at all. ""Coverage through the exchanges is private insurance,"" Buchmueller said. Tom Getzen at Temple University said the VA is much like the institution that the veterans were once part of. ""It’s an army,"" Getzen said. ""In contrast, Obamacare is a complex legislative creation (with) the exchanges, expanded Medicaid and regulation."" Getzen said, to call Obamacare the same as the VA ""is kind of like saying your farm program is a post office."" They both have government ties, but they’re fundamentally different and are operated differently. Scott Harrington, an adjunct scholar with the conseravtive American Enterprise Institute and a professor at the University of Pennsylvania Wharton School, described the changes under Obamacare as a step in the direction of a government-run health care system. ""But it’s a long way from getting there,"" Harrington said. The idea that the Affordable Care Act was a ""government takeover of health care"" was named as PolitiFact’s 2010 Lie of the Year. 500 people dying a year from Obamacare Bolling took the comparison a step further, saying the sort of delays that took place at the VA in Phoenix would repeat themselves under Obamacare, with 500 people dying a year as a result. ""President Obama wanted to insure 40 million new people under Obamacare,"" Bolling said. At the VA, he continued, the typical veteran has 13 appointments each year. Bolling applied that to 40 million new patients. ""You're talking 585 million visits, half a billion visits,"" Bolling said. ""If people are dying, how many people are going to die in Obamacare? Do the math. It will be about 500 people per year that are going to die waiting -- apples to apples."" While we won’t fact-check Bolling’s prediction, we do think it’s important to point out two problems with Bolling’s math for people who saw the segment. First, the Congressional Budget Office projects that through 2024, 26 million people will gain coverage under the Affordable Care Act. So Bolling exaggerated the base number by about 50 percent. Second, the experts we reached said veterans have very different needs than the general population. Part of the massive growth in the VA workload stemmed from disorders related to traumatic brain injury and from the lingering effects of the Vietnam War defoliant Agent Orange. Bolling doubled or even tripled the number of doctor appointments of typical Americans, experts told us. ""The average in the U.S. is between four and six,"" Getzen said. The U.S. Census Bureau reports that the average number of visits fell from 4.8 a year in 2001 to 3.9 in 2010. Point being: The math Bolling used to reach his prediction is quite flawed. Our ruling Guilfoyle said Obamacare is ""one big fat VA system."" We found no health policy expert who agreed with that comparison. The VA is owned and operated by the federal government. Its staff are government employees. In contrast, Obamacare builds upon the existing private sector health industry. The law sets standards for insurance and health care providers and it subsidizes premiums. Washington does run the Medicaid insurance program but even under that program, it is paying private providers."
9218	A potential pharmaceutical intervention for co-occurring PTSD and substance use disorder	This news release describes the outcomes of a small randomized placebo controlled study on the use of N-acetylcysteine, an inexpensive over-the-counter supplement, along with cognitive behavioral therapy in male veterans with PTSD and substance use disorder (SUD). Overall, the release provides a balanced report on the results and the limitations of the study. We think that with the addition of cost and a more in-depth discussion of harms it could have been even better. Post-traumatic stress is a huge problem among veterans who have seen combat, and the effects of PTSD can be lifelong and debilitating. Since PTSD is also found in police officers, firefighters and other emergency personnel, a safe and effective treatment for it might have wide ranging applications. This trial on a small number of veterans who suffered both from PTSD and substance use disorders could very much add to available therapies in which there are few effective treatments but many sufferers. This could also be significant to the 7 to 8 percent of Americans who develop PTSD at some point in their life.	true	Medical University of South Carolina,N-acetylcysteine,PTSD	There is no discussion of the cost of N-acetylcysteine although it is on the World Health Organization’s list of essential medicines, is available over-the-counter and is not very expensive. An online search reveals prices ranging from about $6 for 100 capsules containing 600 mg to around $12 for 50 high-dose capsules containing 700 mg. The intent of the pilot study was to determine the effect of N-acetylcysteine on PTSD symptoms, cravings and substance use. All three endpoints are described in the news release albeit in relative terms. We are told that the 8-week trial randomized 35 veterans with PTSD and substance use disorder. Some received N-acetylcysteine and others a placebo, but all of the participants received cognitive behavioral therapy (CBT). The release reported that “Veterans in the NAC-treated group showed a 46% reduction in PTSD symptoms, compared with a 25% reduction in the placebo group on the Clinical-Administered PTSD Scale (CAPS), which assesses trauma history and symptom severity. The threshold CAPS score for diagnosis of PTSD is 50.” The release quotes the lead author: “As a group, the NAC-treated veterans were below diagnostic level for PTSD at the end of treatment.” This establishes that the benefit was clinically meaningful. But we prefer to see absolute rather than relative numbers as used here. For example, the actual before and after scores on the PTSD scale would have better illustrated how large the benefit was. The release explains that the drug used “does not cause side effects at the doses used in the study, but it degrades quickly when stored, is contraindicated in patients with asthma, and can cause nausea at higher doses and so should always be obtained and administered under a physician’s supervision.” However, the published study notes a higher incidence of adverse events in the N-acetylcysteine treated group that in those treated with placebo (66.7% vs. 47.1%). N-acetylcysteine can cause “nausea, vomiting, and diarrhea or constipation. Rarely, it can cause rashes, fever, headache, drowsiness, low blood pressure, and liver problems,” according to WebMD. This news release does not exaggerate the benefits found in the study, and added helpful caveats about the limitations of the study, its applicability to the general population and its small size. We’d have preferred to see some specific language cautioning about the short duration of the study (just 8 weeks) and the fact that the results might not hold up over time. There is no obvious disease-mongering here. However, when the release notes that 7-8 percent of Americans have experienced PTSD at some point in their lives it could have been noted that the PTSD experienced by military veterans — leaving them ‘difficult-to-treat’ — is in a different category than what civilians might experience. The release clearly states the funding sources and it would be very unlikely that these researchers would have a financial interest in the product under study since it is off-patent and generically available without a prescription. The news release mentions other treatments for PTSD (such as SSRI antidepressants) even though we don’t learn how effective those treatments are compared to N-acetylcysteine. The lead researcher very helpfully mentions that the drug should not be used without cognitive behavioral therapy or other forms of psychological counseling. The news release places the results of the study in a positive light noting, “Currently, there are no well-explored pharmacological treatments for patients with co-occurring PTSD/SUD. Although selective serotonin reuptake inhibitors have been approved by the FDA for treatment of PTSD, pharmacological treatments for co-occurring PTSD/SUD have yielded suboptimal results.” While SSRI’s have been the most studied to date, other drugs that have been studied in preliminary trials could have been mentioned, including prozosin, prazosin, guanfacine, atomoxetine, topiramate, memantine, acamprosate, and ketamine. A 2014 article in Addictive Behaviors journal describes some of these: “Pharmacological treatment of comorbid PTSD and substance use disorder: recent progress.” (Addictive behaviors 39.2 (2014): 428-433.) We learn it is sold over-the-counter and available everywhere. The release claims novelty with these statements: “This trial is the first to use NAC as a pharmacotherapy for PTSD and a broad range of SUDs” and “NAC treatment with CBT would be a novel approach to treat co-occurring PTSD and SUD.” This does appear to be the first such clinical trial of the supplement to address this combination of disorders. There is no use of unjustifiable language. In fact, we were pleased to see the consistent use of “substance use disorder” or SUD to describe the inappropriate use of illegal and legal drugs. Our recent post on ways to put people first when talking about addiction shows how careful terminology improves accuracy and reduces stigma.
5849	Maine sees increase in reported syphilis cases.	Public health officials in Maine say there has been an increase in syphilis cases, mirroring a national trend.	true	Health, Syphilis, Public health, Maine	According to the Maine Center for Disease Control, the number of syphilis cases reported in the state increased from 48 in 2016 to 84 last year. The number of national syphilis cases increased by 18 percent in between 2015 and 2016. Maine Department of Health and Human Services spokeswoman tells the Bangor Daily News the department isn’t sure why syphilis has increased in recent years. Portland Public Health Center medical director Dr. Christina DeMatteo believes opioid use and waning concerns about HIV have contributed to attitudes about having unprotected sex. Public health advocates say budget cuts resulting in changes in prevention and treatment have also affected rates in the state. ___ Information from: Bangor Daily News, http://www.bangordailynews.com
8986	Blood Test Predicts Treatment Response and Survival for Patients with Metastatic Prostate Cancer	This news release touted a study that showed a blood test for a biomarker called AR-V7 can identify patients with aggressive prostate cancer who would benefit if they switched from hormone therapy to chemotherapy. The study, which observed 142 patients who received the test and subsequent treatment, was published in JAMA Oncology. This news release from the test’s developer gave survival data and mentioned that several of its employees were study authors. It didn’t address costs or mention important caveats — such as the lack of statistical significance of that survival data or the fact that patients were not randomized. In fact, it’s unclear whether this test actually extends patients’ lives. A blood test to inform treatment decisions for aggressive prostate cancer could save money, spare patients from ineffective and toxic treatments, and extend lives. The cost of treating prostate cancer in the U.S. has been projected to exceed $15 billion by the year 2020, up from $11.9 billion in 2010, making it one of the most expensive cancers to treat.	false	blood test,Epic Sciences,liquid biopsy,prostate cancer	The $3,980 price tag for this test wasn’t mentioned. The release notes that the Centers for Medicare and Medicaid Services (CMS) are currently evaluating whether the test will be covered in the future. In other words, it is not currently covered by Medicare. We aren’t told whether other insurers cover the test. There was also no information about the costs of the treatments involved. Hormone therapies for prostate cancer are especially pricey, running more than $10,000 a month, according to published reports. The news release stated that “The results were that patients positive for AR-V7 who were treated with taxane-based chemotherapy had superior overall survival (OS) relative to those treated with ARSI therapy (median OS, 14.3 vs. 7.3 months). Importantly, patients negative for AR-V7 who were treated with ARSi therapy had superior OS relative to those treated with taxanes (media OS, 19.8 vs. 12.8 months).” But in the published paper, the results state: “The median survival of patients negative for AR-V7 was 19.8 months for those treated with an ARS inhibitor and 12.8 months for those treated with a taxane (hazard ratio, 1.67; 95% CI, 1.00-2.81; P = .05) (Figure 2A). In contrast, for patients with AR-V7–positive CTCs, those receiving taxanes had longer observed median survival times relative to those treated with ARS inhibitors (14.3 vs 7.3 months; hazard ratio, 0.62; 95% CI, 0.28-1.39; P = .25)” So, for those with a negative test, the androgent (hormone) therapy had improved survival. However, for those with a positive test, there was a trend but the sample size was very small and the p-value was >0.05 (indicating weak evidence), so the results could have been due to chance. As such, we rate this since the piece provides misleading information for part of the results. No harms are mentioned. The potential risks of blood tests are minor, although the potential of a false result could have serious consequences if it leads to a patient getting an ineffective or potentially harmful treatment. The release does a nice job describing the study parameters. But limitations of this research weren’t mentioned. For example, the difference in survival wasn’t statistically significant and could have been due to chance. Also, patients were not randomly assigned to a treatment based on the test, so it’s not clear whether differences in their outcomes resulted from the treatments or some other factor. Moreover, they applied a risk score after the fact to better define the test results. This after the event analysis is not clearly described. There is no disease-mongering here. The release states that about 50,000 men a year in the U.S. will face treatment decisions for which a test like this might prove useful. The release states that Epic Sciences “designed” the test and that different research institutions led research studies on the blood test. The release could have been much more transparent about who funded the research. The study didn’t mention all of the researchers’ industry ties, but it did mention that some of the researchers are employed by Epic Sciences, the developer of the test. The news release does not mention other ways to determine that hormone therapy isn’t working. There may not be any comparable alternatives. There are ways to assess prognosis and these could be considered alternatives. The paper states: “To investigate confounding factors that might influence the decision to administer an ARS inhibitor or taxane, a risk score was developed based on a prognostic model developed from our training cohort22 and applied to the current cohort.” This suggests the authors developed a comparator to their test. As such, it would have been reasonable to comment that there may be other ways to assess risk. The advantage of this one is that it targets what treatment should be given beyond the overall risk itself. The release said the test, Oncotype DX AR-V7 Nucleus Detect, is commercially available in the U.S. However, it didn’t clarify whether it’s FDA-approved for testing patients with prostate cancer. Because the test is not currently covered by Medicare, for those patients the test may only be available as an out-of-pocket expense. The release called this “one of the first studies to validate that a liquid biopsy test can predict therapeutic response and demonstrate a survival benefit.” Given the lack of statistically significant results, it was premature for this news release to state that the blood test “predicts treatment response and survival” for patients with metastatic prostate cancer. The statement that the test could be “as valuable to a patient’s outcome as a blockbuster cancer drug” also seemed exaggerated. It would have been appropriate to note that only by studying the test as part of the treatment program itself can we be certain that it led to improved outcomes.
10668	Cholesterol Drug Cuts Heart Risk in Healthy Patients	This story described the results of the JUPITER study which found that use of the statin medication Crestor reduced the risk of heart-related death, heart attacks and other serious cardiac problems in people who would be calculated to be at low risk of these but who had elevated levels of C-reactive protein. The story met most of our criteria, but could have emphasized that the findings are those of a single study and that results need to be replicated before they can be assumed to have widespread application. It also could have mentioned that there have been other studies with less expensive drugs with similar results. It is good that the story included skeptical comments from editorial writer Hlatky, something that a surprising number of stories ignored or failed to include. We are troubled by the high placement of the impressive-sounding 44% relative risk reduction figure, with the absolute risk reduction given later in the piece, but not juxtaposed to the more impressive-sounding statistic. We think readers need more clear help processing such stats. There was also only a brief mention of the troubling diabetes rate in the Crestor group.	true		While the story included a calculation that suggested that the intervention was as cost effective as strategies screening for elevated LDL, the story failed to indicate the actual cost to the consumer. Although the story mentioned the number of people in the two study groups who had heart-related death, heart attacks and other serious cardiac problems during the course of the study, it could have a done a better job at clarifying that this represented a small percentage of affected individuals. A more direct statement an juxtaposition of absolute versus relative risk reduction would have been helpful. The story indicated that there was an increased number of people taking Crestor who developed diabetes during the study. The story mentioned that the results of the study were presented at a recent meeting and that the results of the study had been published. It described that the study population was a group of 17,802 individuals, all of whom had elevated levels of C-reactive protein (CRP) and that it was a randomized study of individuals given 20 mg of rosuvastin (Crestor) compared with a placebo group. The story did temper the enthusiasm for more testing and more treatment by including skeptical comments from editorial writer Hlatky. The story included comments from several individuals who were not involved in the study and provided some cautionary perspective about the implications of the study. And while this piece relied heavily on comments from Dr. Ridker, the story did mention that he was an inventor of the test for CRP was also the recipient of funding from the manufacturer of the study drug. The two main issues in the study reported on was the use of CRP to identify candidates who could benefit from lipid lowering and then the use of Crestor to lower lipids in these individuals to lower cardiovascular disease risk. In terms of treatment options,the story indicated the uncertainty about whether the outcomes observed were the result of the specific drug study or could be obtained with the use of any in the statin class of drugs. It also mentioned that the reduction in CRP was not associated with the decrease in LDL levels seen in the study participants. There was no discussion, however, about what, if any, other means for lowering CRP were available. The story did mention that there was little known about what the long term impact of maintaining very low levels of LDL cholesterol. From the story, it was clear that Crestor, the medication reported on, was currently available. In addition, the story indicated that it did not have FDA approval for use in the way it was employed in the study. The story reported that the study indicated a new target population for a medication that was currently approved for use. However, the story failed to note that other studies (e.g. AFCAPS) have found benefit from lipid lowering in patients with no history of heart disease and non-elevated LDL levels, using the statin lovastatin, a drug with is now available as generic. The reductions reported were somewhat smaller, but not radically different. Does not rely exclusively on a press release.
1733	DASH named best overall diet for fifth year: report.	The DASH diet, rich in vegetables, whole grains and low-fat dairy, has been named the best overall diet for the fifth consecutive year, outpacing Weight Watchers and the Mediterranean diet, U.S. News & World Report said on Tuesday.	true	Health News	DASH, which was developed to lower blood pressure without medication, was also chosen by a panel of health experts as the top diabetes diet and the best plan for healthy eating. Weight Watchers retained the No. 1 spot as the best diet for weight loss, followed by the HMR (Healthy Management Resources) low-calorie, meal-replacement plan; and Jenny Craig, which offers prepared meals to drop excess pounds. “The DASH diet has been our top diet overall for five years now and this is the fifth year we are evaluating and ranking diets,” said Angela Haupt, senior health and wellness editor at U.S. News & World Report. “Our experts, who rate these diets for us, say it will end up being very good for your waistline, in addition to your high blood pressure, because it is such a common-sense, balanced diet,” she added in an interview. The TLC (Therapeutic Lifestyle Changes) diet, which is designed to lower levels of cholesterol, came in second in the best overall category, followed by the Mediterranean diet, Weight Watchers and the Mayo Clinic Diet, which each tied for third place. At the opposite end of the scale is the Paleo Diet, which focuses on meat, fish and vegetables, and the four-phase Dukan Diet, tied for last place. Weight Watchers, based on a point system assigned to foods, Jenny Craig and the Mediterranean Diet, with its emphasis on vegetables and olive oil, were deemed the easiest diets to follow. In addition to DASH, the TLC and the Mediterranean diets were selected the best for healthy eating. A panel of two dozen experts in diet, nutrition, obesity, heart disease, diabetes and food psychology ranked 35 eating plans to compile the annual list. They looked at sample menus and published medical studies to rate of top diets overall as well as the best for weight loss, diabetes, heart disease and the easiest to follow. “We provide people with all the facts, comprehensively, in the hope that they can make the best decision for themselves,” said Haupt. The panel selected the Ornish Diet, which is focused on fruits, vegetables and grains, as the top heart-healthy diet, along with TLC and DASH. The full ranking can be found at health.usnews.com/best-diet
33819	"The numerous current sayings listed in a ""Life in the 1500s"" article sprang from ordinary living conditions in that era. "	A later version of this piece was prefaced with a putative explanation of origins of the term “piss poor,” which we have covered in a separate article.	false	Language, Phrase Craze	An article about “Life in the 1500s” was nothing more than an extended joke, someone’s idea of an amusing leg-pull which began its Internet life in April 1999. All of the historical and linguistic facts it purported to offer were simply made up and contrary to documented facts: Anne Hathaway was the wife of William Shakespeare. She married at the age of 26. This is really unusual for the time. Most people married young, like at the age of 11 or 12. Life was not as romantic as we may picture it. Here are some examples: Anne Hathaway’s home was a 3 bedroom house with a small parlor, which was seldom used (only for company), kitchen, and no bathroom. Mother and Father shared a bedroom. Anne had a queen sized bed, but did not sleep alone. She also had 2 other sisters and they shared the bed also with 6 servant girls. (this is before she married) They didn’t sleep like we do length-wise but all laid on the bed cross-wise. At least they had a bed. The other bedroom was shared by her 6 brothers and 30 field workers. They didn’t have a bed. Everyone just wrapped up in their blanket and slept on the floor. They had no indoor heating so all the extra bodies kept them warm. They were also small people, the men only grew to be about 5’6″ and the women were 4’8″. So in their house they had 27 people living. Most people got married in June. Why? They took their yearly bath in May, so they were till smelling pretty good by June, although they were starting to smell, so the brides would carry a bouquet of flowers to hide their b.o. Like I said, they took their yearly bath in May, but it was just a big tub that they would fill with hot water. The man of the house would get the privilege of the nice clean water. Then all the other sons and men, then the women and finally the children. Last of all the babies. By then the water was pretty thick. Thus, the saying, “don’t throw the baby out with the bath water,” it was so dirty you could actually lose someone in it. I’ll describe their houses a little. You’ve heard of thatch roofs, well that’s all they were. Thick straw, piled high, with no wood underneath. They were the only place for the little animals to get warm. So all the pets; dogs, cats and other small animals, mice, rats, bugs, all lived in the roof. When it rained it became slippery so sometimes the animals would slip and fall off the roof. Thus the saying, “it’s raining cats and dogs,” Since there was nothing to stop things from falling into the house they would just try to clean up a lot. But this posed a real problem in the bedroom where bugs and other droppings from animals could really mess up your nice clean bed, so they found if they would make beds with big posts and hang a sheet over the top it would prevent that problem. That’s where those beautiful big 4 poster beds with canopies came from. When you came into the house you would notice most times that the floor was dirt. Only the wealthy had something other than dirt, that’s where the saying “dirt poor” came from. The wealthy would have slate floors. That was fine but in the winter they would get slippery when they got wet. So they started to spread thresh on the floor to help keep their footing. As the winter wore on they would just keep adding it and adding it until when you opened the door it would all start slipping outside. So they put a piece of wood at the entry way, a “thresh hold”. In the kitchen they would cook over the fire, they had a fireplace in the kitchen/parlor, that was seldom used and sometimes in the master bedroom. They had a big kettle that always hung over the fire and every day they would light the fire and start adding things to the pot. Mostly they ate vegetables, they didn’t get much meat. They would eat the stew for dinner then leave the leftovers in the pot to get cold overnight and then start over the next day. Sometimes the stew would have food in it that had been in there for a month! Thus the rhyme: peas porridge hot, peas porridge cold, peas porridge in the pot nine days old.” Sometimes they could get a hold on some pork. They really felt special when that happened and when company came over they even had a rack in the parlor where they would bring out some bacon and hang it to show it off. That was a sign of wealth and that a man “could really bring home the bacon.” They would cut off a little to share with guests and they would all sit around and “chew the fat.” If you had money your plates were made out of pewter. Sometimes some of their food had a high acid content and some of the lead would leach out into the food. They really noticed it happened with tomatoes. So they stopped eating tomatoes, for 400 years. Most people didn’t have pewter plates though, they all had trenchers, that was a piece of wood with the middle scooped out like a bowl. They never washed their boards and a lot of times worms would get into the wood. After eating off the trencher with worms they would get “trench mouth.” If you were going traveling and wanted to stay at an Inn they usually provided the bed but not the board. The bread was divided according to status. The workers would get the burnt bottom of the loaf, the family would get the middle and guests would get the top, or the “upper crust”. They also had lead cups and when they would drink their ale or whiskey. The combination would sometimes knock them out for a couple of days. They would be walking along the road and here would be someone knocked out and they thought they were dead. So they would pick them up and take them home and get them ready to bury. They realized if they were too slow about it, the person would wake up. Also, maybe not all of the people they were burying were dead. So they would lay them out on the kitchen table for a couple of days, the family would gather around and eat and drink and wait and see if they would wake up. That’s where the custom of holding a “wake” came from. Since England is so old and small they started running out of places to bury people. So they started digging up some coffins and would take their bones to a house and re-use the grave. They started opening these coffins and found some had scratch marks on the inside. One out of 25 coffins were that way and they realized they had still been burying people alive. So they thought they would tie a string on their wrist and lead it through the coffin and up through the ground and tie it to a bell. Someone would have to sit out in the graveyard all night to listen for the bell. That is how the saying “graveyard shift” was made. If the bell would ring they would know that someone was “saved by the bell” or he was a “dead ringer”. “Most people married young, like at the age of 11 or 12.” This is just plain wrong. Even in the 1500s, nearly the only people who wed that early were the progeny of royalty, and those unions were formed for political reasons and thus were much more paper marriages than real ones. A “bride” of tender years might be called upon to travel to her new homeland, where she would take up residence with her husband’s family and live like their daughter until such time as both kids were deemed old enough to advance the state of their union into full-blown matrimony. To put it more directly, though the teens might call each other “husband” and “wife,” they didn’t begin cohabiting and having sex until their mid-teens at the earliest, and only when both families agreed the kids were ready to take this step. A perfect example of such a union was the 1499 marriage between Catherine of Aragon (Spain) and Arthur, eldest son of Henry VII of England. They were married by proxy in their native lands when Arthur was 14 and Catherine was 15. Catherine did not arrive in England until 1501, when the young royals were wed again, this time in person. Although controversy exists as to whether they might have had sexual congress before Arthur’s death in 1502, if they had done so, they accomplished it by sneaking behind everybody’s back. Both sets of parents were of the opinion the youngsters should not begin this aspect of marital life too early, and they worked to prevent such a change in affairs by housing the youngsters separately, as well as by charging Catherine’s Spanish duenna to maintain a watchful eye on the pair. It was said Henry VII’s mother, Margaret Beaufort, was ruined by early childbirth (she bore Henry at age 13 and did not afterwards have other children though she was married four times), and Henry was not about to risk the succession of his line on another one-child mom. Equally as important was the thought common to that time that early sexual excesses could fatally weaken the health of young men. A teen prince who bedded too often, it was feared, was digging himself into an early grave. Some other “delayed consummation” marriages of that general era were: As stated earlier, though early marriages were common among the royals of that era, they were far from the norm among ordinary citizens. Granted, there might have been a few such early unions, but the practice was not as portrayed in this e-mail, which states that “Most people married young, like at the age of 11 or 12.” According to Stephanie Coontz, who wrote in the 2005 bestseller Marriage: A History, “In England between 1500 and 1700 the median age of first marriage for women was twenty-six.” “Everyone just wrapped up in their blanket and slept on the floor. They had no indoor heating so all the extra bodies kept them warm.” This statement would hold true in 11th and 12th century England, when it was common practice for every member of the great households to bed down on the reed-strewn floor of the main hall. (Some of the more fortunate had flock mattresses to cushion them.) Northern Europe was at that time experiencing warmer-than-usual temperatures, which made such sleeping arrangements livable. The pendulum soon swung the other way, with the coming of a “little ice age” at the beginning of the 13th century. This startling turn of climatic events (which was to last for the next 200 years) spelled the end to that style of communal living and brought about major shifts in building styles to better protect people from the horrendous cold. The advent of the chimney made it possible to warm smaller spaces, which led to the concept of sleeping singly or in pairs in bedrooms. All this is to say that by the 1500s one would have been hard pressed to find any homes that were not heated, or where the inhabitants shivered piled up together in a communal dogpile. “Most people got married in June. Why? They took their yearly bath in May, so they were till smelling pretty good by June, although they were starting to smell, so the brides would carry a bouquet of flowers to hide their b.o.” Although the modern practice of full-immersion bathing was a long way off in the 1500s (among other reasons because filling a vessel large enough to hold a person with heated water was rather impractical given the effort required to collect fresh water and fuel for heating it), people did still “bathe” in the sense of attempting to clean themselves as best they could with the resources at hand. Although today’s brides carry flowers simply because it is now the custom to do so, at one time bridal bouquets were symbols of sexuality and fertility. Covering up anyone’s bad smell played no part in why this custom came into being. “Like I said, they took their yearly bath in May, but it was just a big tub that they would fill with hot water. The man of the house would get the privilege of the nice clean water. Then all the other sons and men, then the women and finally the children. Last of all the babies. By then the water was pretty thick. Thus, the saying, “don’t throw the baby out with the bath water,” it was so dirty you could actually lose someone in it.” Although the admonition against throwing the baby out with the bathwater dates back to the 16th century, its roots are Germanic, not English. Its first written occurrence was in Thomas Murner’s 1512 versified satirical book Narrenbeschwörung, and its meaning is purely metaphorical. (In simpler terms, no literal babies or bathwater, just a memorable mental image meant to drive home a bit of advice against overreaction.) “I’ll describe their houses a little. You’ve heard of thatch roofs, well that’s all they were. Thick straw, piled high, with no wood underneath. They were the only place for the little animals to get warm. So all the pets; dogs, cats and other small animals, mice, rats, bugs, all lived in the roof. When it rained it became slippery so sometimes the animals would slip and fall off the roof. Thus the saying, ‘it’s raining cats and dogs. '” Mice, rats, and bugs definitely take up residence in thatch roofs — to them it’s a highrise hay mow. Cats and dogs, however, don’t go up there. The saying it’s raining cats and dogs was first noted in the 17th century, not the 16th. A number of theories as to its origin exist: “Since there was nothing to stop things from falling into the house they would just try to clean up a lot. But this posed a real problem in the bedroom where bugs and other droppings from animals could really mess up your nice clean bed, so they found if they would make beds with big posts and hang a sheet over the top it would prevent that problem. That’s where those beautiful big 4 poster beds with canopies came from.” Canopied four-poster beds were the province of the well-to-do, not the ordinary folk. Possibly their origin had to do with a desire to display wealth conspicuously by showing off rich tapestries and fabrics. Beautifully thick wall hangings were likewise a way of dressing up a room while at the same time putting on the dog a bit. (The hangings also served to keep the warmth of a room in.) Such fripperies were not the norm in lesser households where available funds would more likely be directed to keeping people fed and clothed than to decorative flourishes. “When you came into the house you would notice most times that the floor was dirt. Only the wealthy had something other than dirt, that’s where the saying ‘dirt poor’ came from.” “Dirt poor” is an American expression, not a British one. Claims that the saying grew out of British class distinctions as measured by style of flooring are therefore specious. As mentioned briefly above in the “everybody slept on the floor” discussion, floors of that era were rarely bare dirt anyway: fresh reeds were laid on them every day and thrown out every night, with another fresh set brought in for sleeping on. In the summer months, aromatic herbs might be added to this vegetative underfooting. “The wealthy would have slate floors. That was fine but in the winter they would get slippery when they got wet. So they started to spread thresh on the floor to help keep their footing. As the winter wore on they would just keep adding it and adding it until when you opened the door it would all start slipping outside. So they put a piece of wood at the entry way, a ‘thresh hold.’” As stated above, the reeds used on floors were typically changed daily. Besides, who ever heard of calling reeds, rushes, or sheaves of grass “threshes”? One threshes plants to separate stalk from seed, but no part of the plant is called the “thresh.” The “thresh” part of threshold apparently comes from a prehistoric source that denoted “making noise” and is related to the Old Church Slavonik tresku, meaning “crash.” By the time it reached Germanic (thresk-), it was probably being used for “stamp the feet noisily” (something that’s a good idea to do in a doorway if you’re wearing muddy boots). “In the kitchen they would cook over the fire, they had a fireplace in the kitchen/parlor, that was seldom used and sometimes in the master bedroom. They had a big kettle that always hung over the fire and every day they would light the fire and start adding things to the pot. Mostly they ate vegetables, they didn’t get much meat. They would eat the stew for dinner then leave the leftovers in the pot to get cold overnight and then start over the next day. Sometimes the stew would have food in it that had been in there for a month! Thus the rhyme: ‘peas porridge hot, peas porridge cold, peas porridge in the pot nine days old.’” This entry might claim a bit of legitimacy, as even some cooking practices of today call for tossing whatever’s on hand into the stewpot, with new ingredients added each day to whatever is left over. French bouillabaisse, for instance, is sometimes made this way, as are any number of “peasants’ stews.” “Sometimes they could get a hold on some pork. They really felt special when that happened and when company came over they even had a rack in the parlor where they would bring out some bacon and hang it to show it off. That was a sign of wealth and that a man ‘could really bring home the bacon.’” Some linguists believe the saying “bring home the bacon” long predates the 16th century, stemming from the 12th century and referring to a time when a slab of bacon was awarded to the happiest married couple (a practice referred to by Chaucer in The Wife of Bath’s Tale and Prologue). A man who “brought home the bacon” therefore wasn’t showing how good a provider he was but rather demonstrating the success of his marriage. Other linguists believe the “bacon” might refer to the pig used in the greased pig chase common to many local fairs: the winner’s prize was the pig itself, thus the skilled pig catcher got to “bring home the bacon.” “They would cut off a little to share with guests and they would all sit around and “chew the fat.”” Usage of the term “chewing the fat” hasn’t been documented prior to the latter part of the 19th century, so it certainly wasn’t a phrase that originated during the 1500s. Theories have linked it to sailors attempting to chomp on the tough rind found in salt pork sea rations, Native Americans chewing animal hides during their spare time, and farmers in Britain chewing on smoked pork, but there is no solid linguistic evidence proving any of these theories. As Richard Lederer put it, “What seems clear is that chewing the fat, like shooting the breeze, provides little sustenance for the amount of mastication involved.” “If you had money your plates were made out of pewter. Sometimes some of their food had a high acid content and some of the lead would leach out into the food. They really noticed it happened with tomatoes. So they stopped eating tomatoes, for 400 years.” Tomatoes are not native to Europe and thus were not spread to that continent until after the Spanish colonization of the Americas. Although tomatoes were first cultivated in Britain in the late 16th century, it wasn’t until about the mid-18th century that they became common fare in that region. The slowness of their adoption as a staple food was not due to discovery that tomatoes were acidic and that lead from pewter plates therefore leached into them, however. Many people believed tomatoes to be dangerous to eat because they resembled other plants known to be poisonous, such as henbane, mandrake, and deadly nightshade, so for a long time the tomato was considered primarily an ornamental plant; eating its fruit was considered to be distasteful and potentially harmful. “Most people didn’t have pewter plates though, they all had trenchers, that was a piece of wood with the middle scooped out like a bowl.” “Trencher” is a medieval word that comes from the French trancher, “to slice,” which shouldn’t seem all the remarkable when viewed in the light of the earliest ones being made from sliced bread and used at banquets to receive morsels taken from a central dish and for soaking up any dripping sauces. Food that needed to be pierced or cut was not placed on a bread trencher. Trenchers started to receive pewter or wooden underplaques (also called trenchers) in the 14th century. Though these underplaques were sometimes used as plates to eat from, by custom the more common use called upon them to support a bread platform for food until sometime in the 16th century. “They never washed their boards and a lot of times worms would get into the wood.” By the mid-16th century, what had been the wooden underplaque was coming to be viewed as dinner plate in its own right. Wooden trenchers that could hold both solid and liquid foods came into vogue, with some having separate hollows to house diners’ salt. Wooden trenchers were typically washed after every use, though. “After eating off the trencher with worms they would get ‘trench mouth.‘” “Trench mouth” wasn’t a term until 1918, according to the Oxford English Dictionary, and the “trench” part of the term referred to the trenches of World War I. Trench mouth is a bacterial infection of the mouth called “acute necrotizing ulcerative gingivitis.” Soldiers sharing water bottles (as they did while cooped up for months at a time under enemy fire in the trenches of World War I) passed the disease to each other in record numbers, hence the simpler name this disease came to be known by. Worms never played any part in this. “If you were going traveling and wanted to stay at an Inn they usually provided the bed but not the board.” No matter how you parse “board” in the previous sentence, inns were in the business of providing it. Travelers paid extra for their meals, but food was to be had at any place that deemed itself worthy of the name “inn.” (Those that wanted only a room could get just that too.) The “board” in “bed and board” (or “room and board”) refers to the board table or sideboard where food was laid out, not an eating utensil. Common usage came to shift this meaning away from the furniture itself and to encompass the food served from it. “The bread was divided according to status. The workers would get the burnt bottom of the loaf, the family would get the middle and guests would get the top, or the ‘upper crust.’” Although an admonition to “Kutt the upper crust [of a loaf of bread] for your soverayne” can be found in a 1460 work, the term ‘upper crust’ didn’t come to be used figuratively to refer to persons of the higher classes until the 19th century. Many have speculated that the phrase “upper crust” originated with a custom of slicing the choice top portion off a loaf and presenting it to the highest-ranking guests at the table, but there is no documentary evidence supporting this as the phrase’s actual origin. “They also had lead cups and when they would drink their ale or whiskey. The combination would sometimes knock them out for a couple of days. They would be walking along the road and here would be someone knocked out and they thought they were dead. So they would pick them up and take them home and get them ready to bury. They realized if they were too slow about it, the person would wake up. Also, maybe not all of the people they were burying were dead. So they would lay them out on the kitchen table for a couple of days, the family would gather around and eat and drink and wait and see if they would wake up. That’s where the custom of holding a ‘wake’ came from.” Waking the dead is an ancient custom that extends around the world and has existed in Europe for at least the past thousand years. The term refers to the practice of watching over the corpse during the period between death and burial. Partly, this had to do with making sure someone was always around in case the corpse woke up (see our Buried Alive page for numerous stories about premature interments), but the watchers were also there to make sure household animals and assorted vermin were kept off the deceased. Some so feared the possibility of live burial that they left instructions for special tests to be performed on their bodies to make sure they were actually dead. Surgical incisions, the application of boiling hot liquids, touching red-hot irons to their flesh, stabbing them through the heart, or even decapitation were all specified at different times as a way of making sure these people didn’t wake up six feet under. “Since England is so old and small they started running out of places to bury people. So they started digging up some coffins and would take their bones to a house and re-use the grave.” Burying the dead in previously-used graves happened with some frequency throughout Europe, both before, during, and after the 1500s. It didn’t have to do with any particular country being too small to hold all the dead bodies, though: it had to do with the shortage of space in established cemeteries. The family of the deceased would habitually look to inter the loved one in the graveyard attached to their parish and, like any other piece of land, graveyards were finite; they could be used to house only so many before they filled up and older tenants had to be moved out. Sometimes remains were dug up, and sometimes what was left was pushed aside, with the newcomer loaded in on top of whoever was already there. Most folks accepted this practice, provided the old bones remained near the church. When bones were disinterred, they were taken to a charnel house, in a process termed second burial. English common law states a grave is held only temporarily (not owned) and its use terminated “with the dissolution of the body.” Grave inhabitants are granted “the right of appropriation of the soil to the body interred therein until its remains shall have so mingled with the earth as to have destroyed its identity.” In other words, once you’re bones, you’ve lost your rights. Modern cemeteries in many countries routinely rent graves for two to thirty years. At the end of that period, the bones are disinterred and reburied in accordance with that country’s cemetery laws. Vancouver, British Columbia, successfully uses a 30-year-renewable lease for its graves. In London, England, the wealthy have for many years obtained 99-year leases on their graves in prestigious cemeteries. (Graves for purchase, though, are scarce.) “They started opening these coffins and found some had scratch marks on the inside. One out of 25 coffins were that way …” Scratch marks have been found on the inside of some coffins and tombs, as detailed in Our Buried Alive article. Such marks, however, were a relatively rare find, certainly nothing on a level even remotely approaching the “one out of 25” figure presented here. “… and they realized they had still been burying people alive. So they thought they would tie a string on their wrist and lead it through the coffin and up through the ground and tie it to a bell. Someone would have to sit out in the graveyard all night to listen for the bell.” Premature burial signaling devices only came into fashion in the 19th century; they weren’t around in the 16th. Some of these 19th century coffins blew whistles and raised flags if their inhabitants awoke from their dirt naps. (Once again, our Buried Alive page provides information about a number of these devices, including ones available in modern times.) “That is how the saying ‘graveyard shift’ was made.” The earliest documented uses of the phrase “graveyard shift” dates from the late 1800s, not the 1500s, and simply references work shifts that took place in the middle of the night and early morning hours, a time of day when work environments could be dark, quiet, and a bit spooky. The similar phrase graveyard watch originated at about the same time and refers to a shipboard watch covering the hours between midnight to 4 AM. It’s unlikely that sailors aboard ship were in any position to be overseeing the graves of the newly-interred. “If the bell would ring they would know that someone was ‘saved by the bell’ or he was a ‘dead ringer. '” “Saved by the bell” is a late 19th century term from the world of boxing, where a beleaguered fighter being counted out would have his fate delayed by the ringing of the bell to signify the end of the round. Need we mention that although fisticuffs were around in the 1500s, the practice of ringing a bell to end a round wasn’t? Likewise, “dead ringer” has nothing to do with the prematurely buried signaling their predicament to those still above ground: the term means an exact double, not someone buried alive. “Dead ringer” was first used in the late 19th century, with “ringer” referring to someone’s physical double and “dead” meaning “absolute” (as in “dead heat” and “dead right”). A “ringer” was a better horse swapped into a race in place of a nag. These horses would have to resemble each other well enough to fool the naked eye, hence the term came to mean an exact double. To sum up, though it’s entertaining to toy with mental images of cats and dogs falling through thatch roofs and shudder deliciously over the thought of our forebearers dining off wooden platters that had worms waving out of them, that’s about as far as one should take this craziness. No matter how many inboxes this popular e-mail has landed in, it never once enlightened anyone. Indeed, it probably left more than a few looking like utter fools when they tried to pass this “knowledge” along to friends better versed in phrase origins. As always, the bottom line is to take such missives with a grain of salt.
12348	"The New York State Senate ""passed legislation allowing minors to race snowmobiles, get their own hunting licenses, and not be employed gathering or picking rags, cigar stumps, or collecting bones."	"Comedian Samantha Bee said the New York State Senate ""passed legislation allowing minors to race snowmobiles, get their own hunting licenses, and not be employed gathering or picking rags, cigar stumps, or collecting bones."" Each of the bills is real and passed the Senate this year. Her claim is True. "	true	Children, New York, Samantha Bee,	"State lawmakers have left Albany for the year without taking up a bill that would extend the statute of limitations for child sex abuse victims. Current law allows those victims to bring criminal charges against their alleged abuser until the age of 23. The Child Victims Act would extend the age to 28 and create a one-year revival period for past cases regardless of when they happened. Victims could also bring civil cases until age 50. The bill passed in the State Assembly with the support of Gov. Andrew M. Cuomo, but was blocked by Republicans in the State Senate. Comedian Samantha Bee took aim at the Senate on her weekly late-night talk show last week. ""I don't want you to think the New York Senate is anti-child,"" Bee said. ""This session they passed legislation allowing minors to race snowmobiles, get their own hunting licenses, and not be employed gathering or picking rags, cigar stumps, or collecting bones."" Anyone who does not follow New York state politics closely may be surprised by the claim. Those inside what’s known as the ‘Albany bubble’ were most likely not. But Bee is known for comedy. Some may have seen her claim as satirical. Were those bills a joke, or was Bee talking about legislation that actually passed the Senate? Snowmobile racing The Senate passed a bill in March that would allow people under the age of 18 to compete in organized snowmobile racing events without a safety certificate from the state. Current law requires anyone under the age of 18 to take a state-approved safety course before they ride a snowmobile. Anyone under 14 has to also be supervised by an adult when riding. The regulations do not apply if the minor rides on land owned by their parent or guardian. The bill would throw out those rules as long as the minor is participating in a snowmobile racing event. The bill, sponsored by Republican Sen. Betty Little of the North Country, passed the 63-member Senate with 49 votes. The Assembly did not take up the bill. Looser hunting restrictions Another bill, passed by the Senate in June, would allow 12-year-olds to get a universal hunting license by lowering the age for some hunting activities. You can start hunting when you are 12 in New York, but certain restrictions remain until the hunter is 14. The bill would drop the age from 14 to 12 for someone to participate in muzzle-loading season, obtain muzzle-loading privileges, hunt with a crossbow, and hunt big game. The child would have to be supervised by a parent or youth mentor. The sponsor, Republican Joseph Griffo, says in the bill’s memo it’s intended to give parents the opportunity to teach children about hunting at a younger age. The bill passed the Senate with 53 votes. The Assembly did not take it up. Begging for money The third bill targets people who use children to panhandle on the street. It’s already illegal for someone to use a child to beg for money but the crime is under the state’s arts and cultural affairs law instead of the penal law. This bill, sponsored by Democratic Sen. Jeffrey Klein of the Bronx, would transfer the crime to the penal law and strengthen the penalty for repeat offenders. The bill says someone cannot ask or allow a child under 16 to beg for money or receive payment for ""picking rags, or collecting cigar stumps, or collecting bones."" That provision has actually been in state law since 1971. It’s part of a broader law that bans children from doing several things for money. Among the more interesting: children cannot be employed as tightrope walkers and cannot receive money for displaying a physical deformity. The Klein bill to move the crime to the penal law passed the Senate in June with 55 votes. The bill was not taken up in the Assembly. Our ruling Comedian Samantha Bee said the New York State Senate ""passed legislation allowing minors to race snowmobiles, get their own hunting licenses, and not be employed gathering or picking rags, cigar stumps, or collecting bones."" Each of the bills is real and passed the Senate this year. Her claim is ."
2089	Mental health experts ask: Will anyone be normal?.	An updated edition of a mental health bible for doctors may include diagnoses for “disorders” such as toddler tantrums and binge eating, experts say, and could mean that soon no-one will be classed as normal.	true	Health News	A patient watches TV at the activity room at a mental hospital of Changzhi, north China's Shanxi province May 18, 2007. REUTERS/Stringer Leading mental health experts gave a briefing on Tuesday to warn that a new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is being revised now for publication in 2013, could devalue the seriousness of mental illness and label almost everyone as having some kind of disorder. Citing examples of new additions like “mild anxiety depression,” “psychosis risk syndrome,” and “temper dysregulation disorder,” they said many people previously seen as perfectly healthy could in future be told they are ill. “It’s leaking into normality. It is shrinking the pool of what is normal to a puddle,” said Til Wykes of the Institute of Psychiatry at Kings College London. The DSM is published by the American Psychiatric Association (APA) and contains descriptions, symptoms, and other criteria for diagnosing mental disorders. It is seen as the global diagnostic bible for the field of mental health medicine. The criteria are designed to provide clear definitions for professionals who treat patients with mental disorders, and for researchers and pharmaceutical drug companies seeking to develop new ways of treating them. Wykes and colleagues Felicity Callard, also of Kings’ Institute of Psychiatry, and Nick Craddock of Cardiff University’s department of psychological medicine and neurology, said many in the psychiatric community are worried that the further the guidelines are expanded, the more likely it will become that nobody will be classed as normal any more. “Technically, with the classification of so many new disorders, we will all have disorders,” they said in a joint statement. “This may lead to the belief that many more of us ‘need’ drugs to treat our ‘conditions’ — (and) many of these drugs will have unpleasant or dangerous side effects.” The scientists said “psychosis risk syndrome” diagnosis was particularly worrying, since it could falsely label young people who may only have a small risk of developing an illness. “It’s a bit like telling 10 people with a common cold that they are “at risk for pneumonia syndrome” when only one is likely to get the disorder,” Wykes told the briefing. The American Psychiatric Association did not immediately respond to a request for comment. The scientists gave examples from the previous revision to the DSM, which was called DSM 4 and included broader diagnoses and categories for attention deficit hyperactivity disorder (ADHD), autism and childhood bipolar disorders. This, they said, had “contributed to three false epidemics” of these conditions, particularly in the United States. “During the last decade, how many doctors were harangued by worried parents into giving drugs like Ritalin to children who didn’t really need it?,” their statement asked. Millions of people across the world, many of them children, take ADHD drugs including Novartis’ Ritalin, which is known generically as methylphenidate, and similar drugs such as Shire Plc’s Adderall and Vyvanse. In the United States alone, sales of these drugs was about $4.8 billion in 2008. Wykes and Callard published a comment in The Journal of Mental Health expressing their concern about the upcoming DSM revision and highlighting another 10 or more papers in the same journal from other scientists who were also worried. DSM 5 is due to be published in May 2013.
9582	Injected Drug May Help Fight Osteoporosis in Women	The story reports on research published in the Journal of the American Medical Association studying an experimental drug known as abaloparatide and its ability to prevent a new vertebral fracture in postmenopausal women with osteoporosis. A standout positive for this story is its choice to report the absolute risk, rather than relative risk, of fracture due to low bone density (see Disease Mongering criterion below). Read more on why this matters. But, there are a few problems concerning the subtleties of the study design. Specifically, the research study was not powered to detect significant differences between abaloparatide and its currently-available competitor, Forteo (teriparatide). Thus, any juxtaposition of quantitative figures comparing the efficacy of the two drugs must be presented with important caveats, which we didn’t see emphasized enough in the news story. Instead, the story leads with a claim that abaloparatide reduces fracture risk “better” than the competing drug–something the study wasn’t designed to address and which is misleading. We’d note that a JAMA news release about the study, which we also reviewed, largely sidesteps this issue by avoiding any statements that directly compare the two drugs. But could the release have helped reporters out here by making a clear, unambiguous statement regarding the purpose of the study and its limitations? The researchers include such a statement in the text of the research article itself (see below under the “Evidence” criterion), and in hindsight it seems that the news release would have done well to emphasize this key nuance. Another way journalists can avoid this problem? Emphasize the findings related to the study’s primary endpoints, and always read the study’s discussion and limitations sections to find important caveats. Accompanying editorials also often have illuminating points to make, too. Given the prevalence of osteoporosis, paired with the few treatment options, a new safe, effective medication would be welcomed. Accurate distillation of the research is essential in news coverage.	true	osteoporosis	Although it is not known how much abaloparatide will cost at this stage, the article does discuss the cost of its would-be competitor, Forteo, which costs about $2,500 a month for those without insurance. The story does a good job discussing the quantitative evidence from the study. (The few missteps, which are actually quite critical in their nature, were related to a not-entirely-adequate grasp of the study design. This we discuss in detail in a separate criterion, Quality of Evidence, below.) The story discusses several measures by which the effectiveness of abaloparatide was compared to the placebo (and Forteo), including the number of spine fractures, the number of other types of fractures, and the number of cases of hypercalcemia. And it does so using actual numbers. For example: “Fewer women on the injectable drug abaloparatide had spine fractures (0.58 percent) than women receiving a placebo (4.22 percent)…” The story lists nausea and heart palpitations among the serious side effects of both abaloparatide and Forteo. The story contains a subtle misunderstanding of the study design that leads it to misinterpret the quantitative evidence for abaloparatide and Forteo. The study’s presentation of the quantitative results suggest that the figures can be directly juxtaposed for the two drugs, when this is not actually the case. Toward the end of the research article on which the story is based, we have the following statement: “Comparison of abaloparatide vs teriparatide [Forteo] for the primary efficacy end point [cases of spine fractures] was not part of the study objectives because the study would have required a sample size of approximately 22,000 per treatment group to provide 90% power to detect the treatment difference between abaloparatide (observed rate, 0.58%) and teriparatide (observed rate, 0.84%) based on our study results.” This effectively means that comparing the 0.58% observed rate of spine fractures under abaloparatide and the 0.84% rate under Forteo, is, quite simply put, rather meaningless. The clinical trial study was never powered to discover a significant difference between the two, i.e. the study was not designed to be able to detect any meaningful difference. Indeed, the statements by Dr. Caroline Messer, interviewed in the story, and the research article’s accompanying editorial, partly reprinted at the end of the story, both emphasize that this research study does not in fact compare abaloparatide directly to Forteo. Another minor point is that Forteo had to be injected via its trademarked injection pen in the study, rather than subcutaneously as was done with abaloparatide and the placebo. This obviously has implications for the blinded nature of the study. While an ideal clinical trial is double-blinded, in this case both patients and doctors knew when Forteo was being administered. The story shares the fact that “A study based on 2010 U.S. Census data estimated that more than 3 million women between the ages of 50 and 69 have osteoporosis. A 60-year-old woman has a 44 percent lifetime risk of fracture due to low bone density.” An explanation of the term “lifetime risk” would be helpful to the reader. (In this setting, it means the probability of experiencing a fracture during the remaining years of life. In fact, the figure reported is really a “residual lifetime risk.”) Now for a slight tangent: It is great that the story chose to report an absolute risk here rather than a relative risk. This is a point we at HealthNewsReview.org try to hammer home. In a 2007 article in the Journal of Bone and Mineral Research, Nguyen et. al. in their article titled “Residual lifetime risk of fractures in women and men” had the following comment on relative versus absolute risk: Communication of risk in the osteoporosis field has traditionally relied on the concept of relative risk. However, relative risk can be misleading to patients and clinicians,(42) because the interpretation of a relative risk or its change is highly dependent on the baseline risk. For instance, doubling a minor risk is still minor, but doubling a common risk is alarming. It is therefore desirable that individuals who have BMD measurements be informed about their fracture probability risk category instead of their relative scores. (4) The lifetime risk estimates from this study provide such a means for communication of risk to an individual patient. Dr. Caroline Messer of the Center for Pituitary and Neuroendocrine Disorders at Lenox Hill Hospital was interviewed as an independent source. She correctly pointed out that a head-to-head trial directly comparing Forteo and abaloparatide is needed in the next step of research. The story also discloses that the research study was funded by the maker of abaloparatide, Radius Health. However, the story doesn’t point out that the study author (whom they quote extensively) also serves on a Radius Health Advisory Board. The story describes Forteo, the current dominant drug on the market for treating low bone mineral density. But see Quality of Evidence section above for how this could have been done better. The story states that abaloparatide is currently in a Phase 3 trial stage. The story does not make clear the novelty of abaloparatide, and seems to focus rather on the similarities between it and Forteo. The story does not appear to rely on a news release.
36006	Since 1958, a four-megaton atomic bomb has been missing off the coast of Georgia, and we don't know if it's active.	A Four-Megaton Atomic Bomb Was Lost off Georgia’s Coast in 1958 (And No One Knows If It’s Active)	true	Fact Checks, Viral Content	In November 2019, the Facebook page “Weird History” shared the following meme, which claimed that a four-megaton atomic bomb remained missing near Georgia — and that it might be live:Under an image of a Cold War-style bomb or missile (which was incidentally published to Wikipedia in 2008), text read:There’s been a four-megaton atomic bomb lost off the coast of Georgia since 1958 and no one really knows whether or not it’s active.The meme was shared a day ahead of the release of the fourth and final season of Man in the High Castle. A streaming and expanded adaptation of the 1962 Philip K. Dick novel of the same name, Man in the High Castle portrays an alternate history of Cold War-era America in which the Allies lost World War II.In the meme, the bomb is described as a “four-megaton atomic bomb.” Megatons are a unit of measurement used to express the force of hydrogen bombs; atomic bombs are typically quantified in kilotons:Thermonuclear bombs can be hundreds or even thousands of times more powerful than atomic bombs. The explosive yield of atomic bombs is measured in kilotons, each unit of which equals the explosive force of 1,000 tons of TNT. The explosive power of hydrogen bombs, by contrast, is frequently expressed in megatons, each unit of which equals the explosive force of 1,000,000 tons of TNT. Hydrogen bombs of more than 50 megatons have been detonated, but the explosive power of the weapons mounted on strategic missiles usually ranges from 100 kilotons to 1.5 megatons.To their credit, “Weird History” did include a status update along with a Facebook-formatted link:A Routine Training Mission Went Incredibly Wrong And Resulted In The Loss Of A Nuclear Weapon — rnkr.co/TybeeIslandThat link pointed to an entry on the listicle-heavy site Ranker, with a title similar to the text of the meme: “The US Air Force Lost A Nuclear Bomb Off The Coast Of Georgia In 1958 — And They Still Haven’t Found It.” It claimed:At around 1 am on February 5, 1958, Major Howard Richardson was piloting a B-47 Stratojet back to Homestead Air Force Base in Florida. The Major was cruising along at 38,000 feet following what he thought was a successful top-secret training mission – a simulated bombing in Virginia. Then, the situation went underwater – in every sense of the word.Unbeknownst to Richardson, the simulation was to feature one more pretend attack — from an F-86 Sabre jet fighter piloted by Lieutenant Clarence Stewart. That’s when disaster struck. […]The device is believed to have landed somewhere near Tybee Island – and the incident has since come to be known as the Tybee Island mid-air collision.One source cited by Ranker was a 2009 BBC article about the collision and its aftermath:More than 50 years after a 7,600lb (3,500kg) nuclear bomb was dropped in US waters following a mid-air military collision, the question of whether the missing weapon still poses a threat remains. […]Shortly after midnight on 5 February 1958, Howard Richardson was on a top-secret training flight for the US Strategic Air Command. It was the height of the Cold War and the young Major Richardson’s mission was to practise long-distance flights in his B-47 bomber in case he was ordered to fly from Homestead Air Force Base in Florida to any one of the targets the US had identified in Russia.Colonel Howard Richardson We thought maybe it was something from outer space, but it could only be another plane Colonel Howard Richardson The training was to be as realistic as possible, so on board was a single massive H-bomb – the nuclear weapon he might one day be instructed to drop to start World War III.As he cruised at 38,000 feet over North Carolina and Georgia, his plane was hit by another military aircraft, gouging a huge hole in the wing and knocking an engine almost off its mountings, leaving it hanging at a perilous angle … Colonel Richardson told me that the decision was instantaneous – and he still has no doubt it was the right thing to do.They would ditch their nuclear payload as soon as possible in order to lighten the aircraft for an emergency landing and also to eliminate the danger of an enormous explosion when they made their unsteady arrival at the nearest available runway.A May 2004 CBS article described the lost munition as an “H-bomb,” reporting on the area in which nuclear weapons enthusiast Derek Duke believed it sat in the waters off Savannah. Duke’s decades-dormant interest in the story was reinvigorated by internet chatter in the late 1990s, and he went looking with Geiger counters and a boat:There seems to be nothing special out here. But beneath the ocean floor off Savannah, an aluminum cylinder lies entombed in silt. It’s like an 11-foot-long bullet with a snub nose and four stubby fins. Written on it, its name: “No. 47782.” Enclosed in its metal skin: 400 pounds of conventional explosives and a quantity of bomb-grade uranium.No. 47782 is an H-bomb.A Mark 15, Mod 0 to be exact, one of the earliest thermonuclear devices developed by the United States. This is the kind whose mushroom clouds boiled in South Pacific tests. It was designed to be 100 times more powerful than the Hiroshima bomb.No. 47782 has rested off Savannah since Feb. 5, 1958.In some pieces the missing weapon was described as an atomic bomb or A-bomb, and in others, a hydrogen bomb or H-bomb. The explosive in question was the “first relatively light (3450 kg) thermonuclear bomb,” a Mark 15, in service from 1955 to 1965.CBS went on to describe conflicting information on whether the device posed a threat in its purported “watery grave”:Four months after Richardson’s [1958] accident, the Atomic Energy Commission changed [a] policy, banning the use of nuclear bombs during training exercises.As Duke was learning all of this, he turned up a copy of the Atomic Energy Commission receipt Richardson had signed. Written in ink near the top of the document was the word “simulated.” That, according to the Air Force, meant the bomb, containing 400 pounds of conventional explosives and an undisclosed amount of uranium, did not have a detonation capsule. Without it, there was no risk of a nuclear explosion.That was reassuring. And it might have been the end of the story if not for another document Duke soon acquired.This one was a letter, written in 1966 to the chairman of the Joint Committee on Atomic Energy, recounting the testimony of Assistant Defense Secretary Jack Howard before a 1966 congressional committee investigating the country’s missing and lost nuclear weapons.Howard, the letter says, testified there were four complete nuclear weapons, including detonation capsules, that were missing or lost. Among them: the bomb Richardson had dropped off the coast of Georgia.Reporters also contacted Richardson, the pilot, who maintained the sunken bomb was not active, and that if it was he would have known. In October 2004, the New York Times reported that the United States military began its first search for the missing bomb, but maintained it was “incapable” of detonation:It is the first time the military has sought signs of the 7,600-pound hydrogen bomb in the murky waters of Wassaw Sound since a crippled B-47 bomber dumped the Mark-15 bomb into the sea near Savannah in 1958.A team of 20 experts in nuclear weapons, gamma spectroscopy and underwater salvage confined their search to an area roughly the size of a football field, marked by buoys floating on the surface … The Air Force says the bomb is incapable of a nuclear explosion because it lacks the plutonium capsule needed to trigger one. Still, it contains about 400 pounds of conventional explosives and an undisclosed amount of uranium.The bomb was dropped into Wassaw Sound in February 1958 during a training flight when the bomber carrying it collided with a fighter jet.Four years later, a February 2009 NPR piece about the mystery of the missing nuke off Tybee Island began with the following clarification:Clarification: In the broadcast version of this report, NPR said that there was general agreement that the lost Savannah nuclear bomb contains significant quantities of uranium and plutonium. A 1966 Congressional document indicates that the bomb was a complete weapon containing both uranium and plutonium. But the Air Force and the former pilot of the plane, retired Col. Howard Richardson, deny the bomb contains plutonium.NPR reported that the Navy initially spent two months looking for the weapon, finally deciding that leaving it in its place was a better course of action than a recovery attempt:The Navy searched for the bomb for more than two months, but never found it, and today recommends it should remain in its resting place. In a 2001 report on the search and recovery of the bomb, the Air Force said that if the bomb is still intact, the risk associated with the spread of heavy metals is low. If [it is] left undisturbed, the explosive in the bomb poses no hazard, the report said. It went on to say that an “intact explosive would pose a serious explosion hazard to personnel and the environment if disturbed by a recovery attempt.”The original meme claimed that a “four-megaton atomic bomb” was “lost off the coast of Georgia” in 1958, and that “no one really knows whether or not it’s active.” On February 5 1958, an F-86 collided with the B-47 carrying a Mark 15 thermonuclear weapon, causing an emergency landing — during which the bomb was jettisoned, landing in the waters near Tybee Island, Georgia.Initial Naval searches for it were unsuccessful, and the missing nuke remained a subject of interest for more than half a decade; as the meme indicated, some dispute still surrounds its level of risk. Documents from the Cold War regarding whether the sunken munition contained both uranium and plutonium and whether it could be detonated contain conflicting information.
2957	The painful path to Obamacare deadline.	Tuesday is a moment of truth for Obamacare.	true	Health News	It marks the final deadline for most Americans to sign up for health insurance under President Barack Obama’s 2010 Affordable Care Act, popularly known as Obamacare, if they want coverage starting on January 1. If enough people - and the right mix of young and old - do not enroll, the ambitious program designed to provide health benefits to millions of uninsured and under-insured Americans risks eventually unraveling. The deadline caps a turbulent roll-out this year for Obamacare and the HealthCare.gov website that is key to enrolling millions of people in the initiative. The website crashed upon its launch on October 1, frustrating users trying to shop for insurance plans. It now is functioning much better, but is still not at 100 percent. Despite the continuing problems, the administration is expressing confidence that Obamacare is getting back on track after enrollment accelerated in December, with more than 1 million people signing up for private insurance. Here is a look at some notable moments in the months leading up to Obamacare’s troubled launch. In June 2012, Margaret Tavenner was worried. As acting director of the Centers for Medicare and Medicaid Services (CMS), she was responsible for orchestrating the launch of the most sweeping U.S. domestic legislation in more than four decades. With uncertainty surrounding how the new law would work, most states were undecided whether to establish their own insurance marketplaces or rely instead on a federally run exchange. “What keeps me up at night is knowing around December, there are going to be like 30 states who want to come in and be state-based exchanges,” Tavenner told a Washington healthcare conference, according to the Modern Healthcare newsletter. Tavenner’s anxiety - more than a year ahead of the planned launch of the exchanges - spurred concerns among industry and advocacy groups, which publicly questioned whether the multiple government agencies involved in the effort would be able to pull it off. The White House was closely briefed on the issues. Tavenner was cleared to visit White House officials involved in the project 425 times from December 2009 to June 2013, including several meetings with Obama, visitor logs show. The White House said later that Obama knew only the broad picture, not details of the effort. The administration also sought industry feedback, but some groups complained their warnings fell on deaf ears. On a video of a February 2013 conference of health insurance brokers and agents in Washington, attendees could be heard grumbling when CMS official Chiquita Brooks-Lasure asked for feedback by the next day on a “streamlined” insurance application form. The 21-page packet was jammed with questions on income and insurance status. For insurance brokers who had learned to keep it simple for customers, it was a harbinger of trouble. “It was ridiculous,” said Tom Harte, president of the National Association of Health Underwriters, which sponsored the conference. He said the group had been making suggestions to the administration on Obamacare enrollment for months. “The image I always had (of the administration’s efforts) was of a horse with blinders on, just plowing ahead and ignoring everything else,” he said. Added to technical and administrative issues, CMS had run into political problems on Capitol Hill with Tavenner’s permanent appointment as director. A former head of Virginia’s state health system, Tavenner had been acting director of CMS since December 2011 while her confirmation was delayed by partisan clashes in the Senate over Obamacare. Finally, a Senate hearing was set for April 9, 2013, and she and others on the CMS staff had to prepare her for tough questions about the healthcare program’s roll out. Tavenner assured the panel that software development and testing for HealthCare.gov would be done by September 2013. A week later, on April 18, Tavenner’s boss, Katherine Sebelius, secretary of Health and Human Services, delivered a similar message to a House budget panel. She said work on the insurance exchanges was “up and running, and we are on track.” These confident public displays masked a different reality. Earlier that month, Tavenner and Sebelius had been briefed by an outside consultant about a broad array of risks threatening the October 1 launch of HealthCare.gov. The report by the consulting firm McKinsey & Co depicted a tangled, leaderless bureaucracy managing the effort and warned of possible system failures that materialized barely six months later. It blamed tight deadlines, insufficient testing and the absence of a “single, empowered decision-making authority.” The report sounded the alarm. Attendees at high-level briefings that followed included Todd Park, the White House chief technology officer, and Brian Sivak, the HHS technology whiz brought in to jumpstart health technology systems. The consultants met with Tavenner and Jeanne Lambrew, Obama’s healthcare adviser who, two decades earlier, had worked on a failed healthcare overhaul spearheaded by then-first lady Hillary Clinton. Obama also was briefed on McKinsey’s findings, White House press secretary Jay Carney later acknowledged. White House logs show two McKinsey consultants arriving for a meeting on April 8, but the company would not comment on the visit. The first public hints of official concern about possible problem’s with Obamacare’s technology actually came on March 22 - before Tavenner and Sebelius had expressed their confidence to Congress and just as McKinsey’s findings began to make their way through the administration. At a forum sponsored by America’s Health Insurance Plans, the national trade association representing the health insurance industry, CMS chief technology officer Henry Chao noted that the launch of HealthCare.gov was about 200 days away. “I’m pretty nervous — I don’t know about you,” Chao told the group, according to Congressional Quarterly. “The time for debating about the size of the text on the screen, or the color, or is it a world-class user experience, that’s what we used to talk about two years ago,” Chao said. “Let’s just make sure it’s not a third-world experience.” By July, Chao’s concerns had escalated. A former Navy avionics technician once billed as a rising federal tech star, his reputation was tied up in the success of a website that was partially built and not yet fully tested. His agency already had paid the website’s prime contractor, CGI Federal Inc, nearly $88 million by March 2013. And costs were climbing. Chao wrote to colleagues on July 16 to say that he feared CGI could “crash the plane at takeoff,” according to e-mails released by Republican congressional investigators. CGI has declined to comment. Alarming assessments streamed in from CMS technical advisers. “We believe that our entire build is in jeopardy,” wrote one, referring to the elaborate website construction. E-mails flew back and forth between Chao and the contractors until a CGI vice president assured Chao, “I am on top of this.” For Chao, meeting the October 1 deadline to have the website functioning well had become a matter of personal honor. Along with Tavenner, he had given sworn testimony to a congressional committee and assured skeptical members that the agency was on track. On July 20, Chao urged his staff to redouble its effort and sent a link to his testimony. “I wanted to share this with you so you can see and hear that both Marilyn and I, under oath, stated we are going to make October 1,” Chao wrote. He urged them to “put yourself in my shoes” and help him make those words the truth. As October 1 approached, bleak assessments about the website surfaced everywhere - except from the Obama administration. Brett Graham, a partner at the healthcare consultant Leavitt Partners, predicted a rocky enrollment period. “The lack of testing and short timelines increases the probability of exchanges experiencing unexpected problems,” he told a House subcommittee on September 10. At CMS, system tests during the third week of September were “not good and not consistent at all,” one employee told Chao in an e-mail. At a time when the website should have been able to accommodate 10,000 simultaneous users, it was crashing with 500 simulated users on it - about a week before the site’s scheduled launch. Contractor CGI called the glitches “part of the tuning exercise.” Chao shot off an all-caps message to his staff, ordering that tests continue, just five days before the deadline. At the White House, technology officer Park questioned Chao about the website’s progress. If Park sensed disaster, he gave no hint. “Massive kudos again for the incredible progress the team is making!” Park wrote in an e-mail. HealthCare.gov went live on October 1 amid a sea of error messages, blank pages and crashed applications. “We are making improvements as we speak,” Tavenner told reporters on a conference call that afternoon. The site’s meltdown continued, however. A frustrating month of up-and-down performance prevented many Americans from purchasing insurance. The administration brought in technical advisers to help with an upgrade. After a few weeks of stumbling explanations from top officials, Sebelius took responsibility during an October 30 congressional hearing. “No one indicated it could possibly go this wrong,” she said. “Hold me accountable for the debacle.” Obama apologized on November 14. Compounding the technical problems, Obama’s repeated promise that Americans could keep their existing insurance if they wished proved to be inaccurate. Millions of people with bare-bones policies that did not meet the minimum standards set in the Affordable Care Act lost them. Republican critics of Obamacare accused the administration of a lack of transparency. “The administration was on track - on track for disaster,” Rep. Fred Upton, the Republican chairman of the House Energy and Commerce Committee said on November 19. “But stubbornly, they stayed the course.” The political damage flowing from the website’s troubles is likely to continue through the 2014 elections. Control of Congress will be at stake, and Republicans have vowed to make Obamacare’s troubled roll out, as symbolized by the botched debut of Healthcare.gov, part of an assault on the healthcare program that they say is too costly and robs Americans of coverage choices. The website eventually found its footing. As of late Sunday, more than 1 million people had signed up for private coverage through HealthCare.gov, and hundreds of thousands more were expected to do so Monday and Tuesday, just before a deadline to get coverage that starts January 1. Even so, the administration’s initial goal of signing up 3.3 million people by the end of December seems out of reach.
37345	A preteen shot and killed two undocumented intruders in her family's Montana home.	11-Year-Old Girl With Shotgun Stops Invaders?	false	Disinformation, Fact Checks, Politics, Viral Content	Since 2007, a rumor about a young girl with a gun (Patricia Harrington) and two undocumented people breaking in (Ralphel Resindez and Enrico Garcia) plays on xenophobia and fear to make its point during its cyclical appearances on Facebook and in email boxes:Shotgun Preteen vs. Illegal alien Home Invaders: Butte, Montana November 5, 2007Two illegal aliens, Ralphel Resindez, 23, and Enrico Garza, 26, probably believed they would easily overpower home-alone 11 year old Patricia Harrington after her father had left their two-story home.It seems the two crooks never learned two things: they were in Montana and Patricia had been a clay shooting champion since she was nine.Patricia was in her upstairs room when the two men broke through the front door of the house. She quickly ran to her father’s room and grabbed his 12 gauge Mossberg 500 shotgun.Resindez was the first to get up to the second floor only to be the first to catch a near point blank blast of buckshot from the 11-year-old’s knee crouch aim. He suffered fatal wounds to his abdomen.The email asks if you ever wonder why “good stuff” never makes the news. The truth is that the Butte shooting story did not make the news because it’s entirely fabricated. According to the Montana Standard and the Butte-Silver Bow Sheriff’s department in Montana, the entire story was completely invented:“This never happened,” Walsh said.The story claims the girl shot and killed the two intruders while she was home alone. The story doesn’t provide a street address or attribute the information to any official sources.Walsh brushed off the story of an urban myth.“It’s amazing how these things get around,” he said.Despite the fact that it has been unequivocally and repeatedly debunked by the media and law enforcement, the tall tale still circulates in perpetuity. The Billings-Gazette took a look at the persistent yarn in 2007:Numerous people from all over the United States have contacted The Montana Standard in the past year via e-mail or phone to verify if the story is true. The story is often given the headline “Home Invasion Gone Wrong.”A recent search for this story on the Internet search engine Google.com returned with more than 400 hits.The story has been printed as fact on some anti-gun control and anti-immigration Web sites. The phony story identifies the 11-year-old girl as Patricia Harrington, who shoots and kills the two “illegal aliens” identified as Ralphel Resindez and Enrico Garza.Columnist Phillip Morris with The Plain Dealer wrote a retrospective about the myth in 2013, noting that he still received emails about the same story — which is, again, entirely false:So why does this story still circulate?Probably, because it seems perfectly believable. For a nation that remains bitterly divided on the issues of immigration and gun control, this violent parable highlights the worst fears of what illegal immigration and stricter gun control could portend for the nation.No one is safe without easy access to a gun. Not even little American girls. That is the point of this hoax from Montana that is passed around online as if it were gospel.The irony of this story is that there are plenty of true examples of armed, law-abiding citizens using guns to defend themselves, their homes and their loved ones.But many of those stories don’t read as well or carry the emotional capital embedded in the tale of a well-trained girl using her daddy’s gun to defend the house. That’s why some prefer a lie to the truth.Update, September 20 2019, 3:39 PM: Although the email forwards quoted above began circulating in 2007 (at the latest), the tale remained alive and well across Facebook — particularly in mid-to-late 2019. Two separate-but-similar versions of the story were shared in July 2019, with interest cresting in mid-September 2019.One iteration was shared on July 9 2019 by user Ronel Scott, and was being shared by the dozens every few minutes more than two months later:Text-based posts copied-and-pasted from that iteration were identifiable by their “thanks FOX NEWS for reporting it” line at the start. One day later, user Kenneth Lindsey shared a near-identical post — telling the same story over a decade after it purportedly happened:11 YR. OLD WHO SHOT ILLEGALS ?? A Shotgun-armed Preteen vs. Illegal Alien Home Invaders. Two illegal aliens, Ralphel Resindez, 23, and Enrico Garza, 26, probably believed they would easily overpower home-alone 11-year-old Patricia Harrington after her father had left their two-story home. It seems these crooks never learned two things: 1. They were in Montana. 2. Patricia had been a clay shooting champion since she was nine. Patricia was in her upstairs room when the two men broke through the front door of the house. She quickly ran to her father’s room and grabbed his 12-gauge Mossberg 500 shotgun. Resindez was the first to get up to the second floor, only to be the first to catch a near point blank blast of buckshot from the 11-year-old’s knee-crouch aim. He suffered fatal wounds to his abdomen and genitals. When Garza ran to the foot of the stairs, he took a blast to the left shoulder and staggered out into the street where he bled to death before medical help could arrive. It was found out later that Resindez was armed with a stolen 45-caliber handgun he took during another home invasion robbery. That victim, 50-year-old David 0’Burien, was not so lucky. He died from stab wounds to the chest. Ever wonder why good stuff never makes NBC, CBS, PBS, MSNBC, CNN, or ABC news? An 11-year-old girl, properly trained, defended her home, and herself against two murderous, illegal immigrants and she wins. She is still alive. Now THAT is Gun Control! Thought for the day: Calling an illegal alien an undocumented immigrant’ is like calling a drug dealer an ‘unlicensed pharmacist.’ I BELIEVE YOU’LL PROBABLY PASS THIS ON!!!! !So old was the story, in fact, that the purported 11-year-old girl at its center would be in her mid-twenties as it continued making its way across the internet.Its graduation from email forward (primarily) to Facebook breathed new life into the phony news item, seemingly bolstered by random images appended to posts spreading the rumor. One of the two images depicted a grown woman aiming a weapon, and the other showed a teenage girl holding a gun — of course, neither image had anything to do with the false claim.
2776	J&J chooses Yale to review requests for clinical drug data.	Johnson & Johnson has selected the Yale School of Medicine to review requests from investigators and physicians looking for access to clinical trial data involving the diversified healthcare company’s pharmaceuticals.	true	Health News	Under the agreement, the “Yale Open Data Access Project,” will independently review and make final decisions regarding all requests for information on the company’s drug clinical trials, including anonymous patient data. The action comes amid growing pressure from outside scientists for access to raw data from clinical trials, reflecting general concerns that too many studies cannot be independently confirmed and may well be wrong. J&J, which sells drugs including blood thinner Xarelto and prostate cancer treatment Zytiga, said it is in the process of determining how best to share trial data from its other two areas of operation: medical devices and consumer products. “This is a multi-year effort on our part to try to contribute to advancing medical knowledge and science,” Joanne Waldstreicher, J&J’s chief medical officer, said in a telephone interview. Others drugmakers have made similar moves. Britain’s GlaxoSmithkline Plc has set up an online system to provide researchers with access to anonymous patient-level data about its medicines. Pfizer Inc said in December it would broaden access to information from its clinical trials to independent researchers and to patients who take part in the studies. Pfizer also set up an independent review panel of academic scientists to decide which researcher requests it would answer.
35260	Michigan Gov. Gretchen Whitmer banned the sale or purchase of American flags during the COVID-19 pandemic.	Increasing tremors on a volcanic island in New Zealand on Wednesday heightened the risk of another massive eruption, preventing the recovery of bodies two days after an eruption engulfed dozens of tourists in steam and hot ash.	false	Politics, COVID-19	Six people were killed in Monday’s explosion at White Island, which lies some 50 km (30 miles) off the mainland, with another nine officially listed as missing, and 30 injured. Australian Gavin Dallow, 53, and his stepdaughter Zoe Hosking, 15, were the latest victims to be identified on Wednesday. “Our hearts break at the loss of Zoe at such a young age,” the Dallow family said in an emailed statement. “We mourn the loss of Gavin and Zoe.” And the death toll could rise with 29 people in intensive care in several hospitals around the country. Twenty seven people have horrific burns to 30% or more of their body and 22 are also on airway support due to the severity of their burns, said medical authorities. “We anticipate we will require an additional 1.2 million square centimeters of skin for the ongoing needs of the patients,” Counties Manukau Chief Medical Officer, Dr Peter Watson, said at Middlemore Hospital in Auckland. “The nature of the burns suffered is complicated by the gases and chemicals in the eruption. This has necessitated more rapid treatment of these burns than is the case for thermal-only burns,” said Watson. Surgical teams were engaged in around-the-clock treatment. “This is just the start of a very long process that for some patients will last several months,” he said. The Australian government said it expected to transfer up to 10 injured citizens from New Zealand starting in the next 24 hours, if medical staff approve them for travel. GRAPHIC: Volcanic Eruption in New Zealand - here Authorities monitoring the uninhabited island said conditions were worsening and there was now a 40-60% chance of a massive eruption similar to Monday in the next 24 hours. “In summary, yesterday there was a high risk of an eruption. Today there is an even higher risk of an eruption. And the parameters are worsening at the moment,” Graham Leonard, a senior volcanologist at GNS Science, told a news conference in Wellington. A plume of smoke could still be seen coming from the island. “I’ve spoken to many of those involved in the operation and they are very, very eager to get back there, they want to bring people’s loved ones home,” New Zealand Prime Minister Jacinda Ardern said in an interview with Reuters in Wellington. Aerial surveillance has detected no signs of life on the island, where at least one tour group was captured on automated webcams in the crater just a minute before the eruption. GRAPHIC: Volcano map of New Zealand - here Police said the safety of recovery teams was the priority and are awaiting advice from experts on when they could access the island. That has prompted some criticism authorities are being too cautious. “We cannot put other people in jeopardy to go out there until we’re absolutely certain that the island is actually safe,” Acting Assistant Commissioner Bruce Bird told a media conference in Whakatane, the town that is an access point for tourist trips to the island. There were 47 people on White Island at the time of the eruption. Twenty-four of those were from Australia, nine from the United States, five from New Zealand, four from Germany, two each from China and Britain and one from Malaysia. A mother and daughter were the first Australians to be named as victims, media said on Wednesday. Brisbane woman Julie Richards, 47, and her daughter Jessica, 20, had been confirmed dead, family friend John Mickel told Sky News. The death toll from Monday’s eruption rose to six after one victim died in hospital on Tuesday. Daily tours bring more than 10,000 visitors to the privately owned island every year, marketed as “the world’s most accessible active marine volcano”. GeoNet raised the alert level for the volcano in November because of an increase in volcanic activity. The alert level was increased further after the eruption, and remains elevated. GRAPHIC: Volcanic alerts for White Island since 1995 - here
9266	Study shows acetaminophen can be tolerated by children with mild, persistent asthma	This study published in the New England Journal of Medicine (NEJM) is the first randomized, double-blind, controlled trial comparing acetaminophen to ibuprofen to treat pain and fever in children with asthma. No statistically significant differences were found between the two treatment arms. Previous observational studies had suggested that acetaminophen could exacerbate asthma symptoms in young children. This University Hospitals Case Medical Center news release does a good job summing up much of the relevant information, but more elaboration with data backing up the claims would have been helpful for busy reporters covering this important topic. Compared to a news release by Boston Children’s Hospital, which we also reviewed, this release omitted quantitative data needed to back up its statements, especially those addressing benefits and harms such as no “significant differences in safety [found] between the two drugs.” As we had noted in previous news releases, the word “significant” here is supposed to mean “statistically significant” – a fact that’s often not clear. The University Hospitals news release also could have been more explicit in explaining the importance of the study, given its context. Finally, although the news release correctly points out that caregivers used either acetaminophen or ibuprofen, it suggests the brand names Tylenol and Advil/Motrin were given to participants, when researchers actually administered Little Fevers by Little Remedies and Children’s Advil. A short discussion of costs would have been beneficial in the news release, since acetaminophen (Little Remedies) generally tends to be more expensive than ibuprofen (Children’s Advil). It’s important context — but it was not discussed in this news release — that there has been concern among some pediatricians that acetaminophen should not be used in kids with asthma. This study set out to study the equivalence of acetaminophen and ibuprofen. Acetaminophen is the most commonly used pediatric medication in the United States. Previous observational studies found a correlation between acetaminophen and increased asthma symptoms, as well as decreased lung function. Other analyses found that acetaminophen use resulted in more unscheduled medical visits for asthma than ibuprofen use. These findings have even led to alarm, as some physicians called for recommendations that acetaminophen should be avoided until more safety data become available. But observational data carry limitations – namely, confounding by indication. That’s to say, people who use a drug more frequently differ in health and other features from those who use the drug less frequently or who do not take the drug at all. This was the first appropriately designed and randomized clinical trial in a well-characterized cohort to settle the debate of causation. The study’s message to parents and caregivers of young children is that acetaminophen use will not worsen asthma symptoms.	mixture	acetaminophen,asthma,University Hospitals Case Medical Center	Like the Boston Children’s Hospital news release, the University Hospitals Case Medical Center news release does not address costs. The acetaminophen medication used in the study, Little Remedies, costs about 50 percent more than Children’s Advil — $8.86 for 4 fluid ounces versus $4.96, respectively — at Walmart. It would have been helpful to include the costs of the generic versions of these drugs which could be significantly lower than brand name drugs. Since costs are not mentioned in the news release, we give it a Not Satisfactory rating here. One of the questions the study attempted to answer was whether ibuprofen is a safer drug than acetaminophen in children with mild persistent asthma. Although the Boston Children’s Hospital news release details the numbers, this news release does not include any quantitative data. It only states that researchers “did not find any significant differences in safety between the two drugs.” The quantitative data are helpful because they show just how closely the two groups were matched and because they back up the claim to equivalent safety. As seen in many other news releases, the use of the word “significant” here is ambiguous, since it is meant as being “statistically significant,” instead of the colloquial use of the term. As a result, we give the news release a Not Satisfactory rating here. Another major study question was whether frequent acetaminophen use in children with mild persistent asthma worsens symptoms. This was measured by asthma exacerbation rate, number of days of asthma control, need for “rescue” medication and unscheduled medical visits for asthma, as the news release points out. As mentioned above in the “Quantify Benefits” section, this release does not lay out any supporting quantitative data for these benchmarks. It only states, “The study did not detect any worsening of asthma in the children treated with acetaminophen compared with those receiving ibuprofen.” For these reasons, we give the news release a Not Satisfactory rating here. Unlike the news release from Boston Children’s Hospital, which does a thorough job outlining the study design, University Hospitals Case Medical Center only gives the bare bones of the study, including information only on the number of enrollment and criteria. Other pieces of information are not given, including medication dosage and follow-up time. There is also no mention of the study’s limitations, such as a lack of a placebo group and the narrow inclusion criteria. Due to these factors, we give the news release a Not Satisfactory rating here. The news release does not engage in disease mongering. University Hospitals Case Medical Center discloses in its first paragraph the fact that the National Institutes of Health and the National Heart, Lung and Blood Institute’s Asthma Network (AsthmaNet) funded the study. However, according to the published study, several of the researchers have ties to Pfizer, the maker of Children’s Advil, and to McNeil Consumer Healthcare and Johnson & Johnson, makers of Tylenol. These are important ties to mention in a news release. The study was designed to compare the safety of two drugs – acetaminophen and ibuprofen – in children with mild, persistent asthma, since previous observational studies had correlated acetaminophen with increased asthma symptoms. Since the drugs themselves are already alternatives in treating pain and fever. The availability of acetaminophen and ibuprofen is not in question, since these are well-known, over-the-counter drugs. This release was not explicit in describing what this study brings to the existing body of knowledge. Instead, it hints the new study’s findings go against previous observational studies in the long comment from the study’s co-author, but the reader doesn’t have a clear idea what makes this study so important and newsworthy, especially when this topic has been looked at before. It would have been helpful to mention that this study really was the first trial that was blinded, randomized and controlled in comparing acetaminophen and ibuprofen in young children with mild asthma. Despite the ambiguity, we think the news release gave just enough information for a Satisfactory rating here. The news release from University Hospitals Case Medical Center does not use unjustifiable, sensational language.
27808	"Hyland's Teething Tablets have been discontinued for causing ""adverse events"" in children."	Over a 10-year period, from 2006 to 2016, the FDA collected reports of “adverse events” in more than 370 children who had used Hyland’s homeopathic teething tablets or gel, a similar product that is applied directly to a baby’s gums. Agency records show eight cases in which babies were reported to have died after taking Hyland’s products, though the FDA says the question of whether those products caused the deaths is still under review.	true	Medical, homeopathic, hyland's	Note: As of 2016, Hyland’s has stopped distributing their teething products in the United States. In October 2010, the Food and Drug Administration (FDA) notified consumers that Hyland’s Teething Tablets, a homeopathic product, intended to provide temporary relief of teething symptoms in children, was being recalled after that agency received “reports of serious adverse events in children.” The FDA stated the tablets contained “inconsistent amounts of belladonna” that could pose a serious risk of harm to children (potentially including seizures) and warned consumers to stop using and discard the product: The tablets are manufactured to contain a small amount of belladonna, a substance that can cause serious harm at larger doses. For such a product, it is important that the amount of belladonna be carefully controlled. FDA laboratory analysis has found that Hyland’s Teething Tablets contain inconsistent amounts of belladonna. FDA has received reports of serious adverse events in children taking this product that are consistent with belladonna toxicity. The FDA has also received reports of children who consumed more tablets than recommended, because the containers do not have child resistant caps. The FDA has not evaluated Hyland’s Teething Tablets for safety or efficacy, and is not aware of any proven clinical benefit offered by the product. FDA recommends that consumers not use this product and dispose of any in their possession. FDA advises consumers to consult their health care professional if their child experiences symptoms such as seizures, difficulty breathing, lethargy, excessive sleepiness, muscle weakness, skin flushing, constipation, difficulty urinating, or agitation after using Hyland’s Teething Tablets. Nine months later, in July 2011, Hyland’s announced the imminent return to market of their teething tablets product, stating they had modified the manufacturing process to ensure uniformity in dosage and had added child-resistant caps to the packaging: Hyland’s voluntarily took Teething Tablets off the market in October 2010. We chose to exercise an abundance of caution by making this decision. Hyland’s and the FDA conducted a thorough review of all of our manufacturing processes and reports. Together, we identified manufacturing processes of Teething Tablets that could be improved to ensure uniformity in dosage. We also used this opportunity to refine the production, packaging and testing protocols on this product. We’ve added a child-resistant cap and updated the packaging and are introducing new strengths of the same ingredients that have calmed teething babies and their moms for more than 85 years. We have made significant changes in our manufacturing process and introduced rigorous testing protocols. We have kept all of the same ingredients that have made Hyland’s Baby Teething Tablets effective and safe and improved effectiveness by increasing the homeopathic potency of each active ingredient. As homeopathic potency increases, raw drug concentration decreases, providing an even wider margin of safety than before. Following an FDA warning issued in September 2016 stating that “homeopathic teething tablets and gels may pose a risk to infants and children,” Hyland’s announced they would discontinue manufacture of the product (although some may remain on store shelves or available for purchase online): For generations, we at Hyland’s have been proud to offer safe, effective and natural health solutions to families like yours. In fact, for over 90 years, parents have trusted Hyland’s teething medicines to ease the pain of teething in infants. We thank you for that longstanding trust. It is therefore with much sadness that we share with you that we have chosen to discontinue the distribution of our Hyland’s teething medicines in the United States. This decision was made in light of the recent warning issued by the Food & Drug Administration (FDA) against the use of homeopathic teething tablets and gels. This warning has created confusion among parents and limited access to the medicines. A February 2017 report suggested that hundreds of cases in which children had been taken ill (or even died) after the use of Hyland’s homeopathic teething products had been relayed to the FDA over the years: Babies who were given Hyland’s teething products turned blue and died. Babies had repeated seizures. Babies became delirious. Babies were airlifted to the hospital, where emergency room staff tried to figure out what had caused their legs and arms to start twitching.
12088	Even with a permanent income tax increase... the budget is more than $1 billion out of balance…	"Gov. Bruce Rauner said Illinois’ current operating budget is ""is more than $1 billion out of balance…"" The head of the Illinois Teachers Retirement System confirms Rauner’s claim that the new pension plan expected to generate $500 million in anticipated savings won’t be enacted during the current fiscal year (or even the next one). The Civic Federation reports that the small surplus in the budget will finance only $3 billion of the $6 billion Rauner plans to borrow. But putting $3 billion toward past-due Medicaid bills would generate $3 billion in federal matching funds -- something Rauner has not discussed. Failure to sell or get the expected price for the Thompson Center are possible scenarios that could further imperil the budget. Some of the assumptions identified as sources of the trouble originated in Rauner’s own budget, a fact that Rauner does not acknowledge and that needs to be considered here. Whether or not the imbalance reaches more than $1 billion is debatable, but Rauner is correct that there remains much work to do."	true	State Budget, Taxes, Illinois, Bruce Rauner,	"Illinois’ record budget standoff ended July 6 with legislative Democrats, joined by a handful of Republicans, approving a $36 billion spending plan for the fiscal year that began July 1, which is underpinned by a 32 percent hike in the state income tax rate. Enactment came July 6 over the objections of Republican Gov. Bruce Rauner, who two days earlier had vetoed the budget. ""Even with the (House Speaker Michael) Madigan permanent 32% income tax increase, this budget remains $2 billion out of balance for fiscal year 2018,"" Rauner wrote in his July 4 veto statement. More than two months later -- after a summer in which tension over school funding made the budget debate seem a faint and distant memory -- Rauner has revived his claim that the Legislature has placed the state on a path to fiscal doom. ""Even with a permanent income tax increase costing the average Illinois household more than $1,000 a year, the budget is more than $1 billion out of balance…,"" Rauner said in a Sept. 7 press release. However, his office cautions not to read too much into the downward revision of the unbalanced budget claim from $2 billion in July to $1 billion now. The difference, the administration says, is due to technical reasons and doesn’t mean the budget is in better shape than the governor originally asserted. The not-so-subtle subtext of Rauner’s claims in both his July veto message and his renewed criticism is that Democrats significantly jacked up taxes to impose a woefully deficient budget. Unpacking the governor’s argument requires a trip into the weeds of budget minutia, not to mention a detour into political hypocrisy. When it comes to budgeting, Rauner has been clearly guilty of some of the same sins he is now complaining about. But being inconsistent and being wrong aren’t necessarily the same thing. Is Rauner correct that the General Assembly has produced a budget deeply in the red? We took a look at the numbers. The Illinois Constitution defines a budget as balanced when spending doesn’t exceed ""funds estimated to be available for the fiscal year."" But ""estimated"" has given politicians license to stretch or shrink their definition of ""balanced"" to suit their needs. The Civic Federation, a Chicago-based government fiscal watchdog, noted in a Sept. 7 analysis that the budget as passed on July 6 -- which contained a $360 million operating surplus -- met the textbook definition of ""balanced."" ""On paper, the budget enacted by the General Assembly on July 7 — in an override of another gubernatorial veto — has a modest surplus,"" noted the federation’s Institute for Illinois’ Fiscal Sustainability. But the budget is ""built on assumptions"" and making it work will depend on whether Rauner and the General Assembly can ""make those assumptions hold up,"" said Civic Federation President Laurence Msall. Governor and ILGA should work together to create credibility of State’s FY2018 surplus for borrowing plan to proceed https://t.co/thNHqFGLBK Two of those assumptions form the bulk of Rauner’s claim that the budget is in the red by more than $1 billion. The first involves a Rauner-driven change in state pension options that Democrats came to embrace. Referred to as ""Tier 3,"" it gives state workers a choice to divert some of their traditional benefits into a 401(k) style savings plan. The budget enacted over Rauner’s veto projects Tier 3 will save $500 million this fiscal year. But Rauner spokesman Jason Schaumburg said savings from this plan won’t happen during this budget year. And Illinois Teachers Retirement System Executive Director Dick Ingram told the Better Government Association that TRS anticipates an effective date of July 1, 2019, for the new plan. That means savings won’t show up until FY 2020. This validates a significant part of Rauner’s ""out of balance"" claim, but the irony here can’t go unmentioned. The $500 million savings figure in the current budget came from an estimate originally presented in Rauner’s ill-fated budget proposal from last February. That budget also contained $4.6 billion in phantom money identified only as ""Working together on ‘grand bargain.’"" And it was hardly the only time Rauner has pushed a budget full of the same sort of holes he now condemns. The first budget Rauner proposed in 2015 anticipated $2.2 billion in savings from a sweeping overhaul of pensions that at the time was of questionable constitutionality and was soon rendered invalid by the Illinois Supreme Court. The Sept. 7 press release in which Rauner made his claim about the budget imbalance also announced that the state would issue $6 billion in bonds to pay down part of the $16 billion bill backlog that accrued during the budget impasse of 2015-2017. The Illinois Comptroller’s Office said at the end of FY 2017 that the state was paying late payment penalties of 9 and 12 percent on $5.5 billion contained in the backlog. This costs the state about $2 million a day, according to the comptroller. By borrowing, the state can lower that rate by up to half while also getting payment quickly to creditors. Thus, the budget enacted in July contained a provision empowering the governor’s office to borrow up to $6 billion for this purpose. But as the Civic Federation noted, ""the small projected budget surplus was estimated to support only $3 billion in borrowing capacity."" Rauner was more pointed in his press release: ""(A) $6 billion issuance would require 12 annual principal payments of $500 million, plus interest payments depending on the interest rate. The legislature-passed budget did not account for the increase in debt service costs to cover the bill backlog bond issuance."" Schaumburg put the total figure at $600 million annually, which roughly squares with the Civic Federation’s statement. ""The governor's office is identifying several hundred million dollars in possible spending reductions to address this budgetary shortfall,"" Rauner’s press release said. ""The governor also would like the General Assembly to return to Springfield this fall to work with him to balance the budget and enact structural reforms that could save much more."" But one of the budget’s chief architects, Rep. Greg Harris, D-Chicago, said Rauner is trying to make a crisis from what should be a source of fiscal relief. Though the budget gives the governor’s budget office the authority to borrow up to $6 billion, Rauner need not do it all at once. If the administration borrows $3 billion and uses it to pay down outstanding Medicaid bills, it will get $3 billion in matching funds from the federal government that can go toward paying down the backlog, Harris said. ""A huge portion of the bills are Medicaid,"" Harris said. ""That’s money that’s just sitting there."" Medicaid bills make up $4.1 billion of the $16 billion backlog, according to the Illinois Comptroller’s Office. But an even bigger chunk of the backlog comes from bills owed to providers in the State Employee Group Insurance Program. In its May monthly report, the General Assembly’s Commission on Government Forecasting and Accountability said the state owed $4.65 billion in group health insurance payments plus $462 million in late fees. The comptroller’s office now estimates group health insurance costs make up $5.1 billion of the total backlog. The Civic Federation report also emphasizes that the $360 million surplus claimed in the budget (and disputed by Rauner) is fragile at best. It is built in large part on proceeds of $240 million from the sale of the James R. Thompson Center in Chicago. The sale of the 17-story behemoth in the heart of Chicago’s Loop has been stymied by political fighting ever since Rauner first proposed it in October 2015. ""The (budget) surplus could be reduced if it takes longer than expected to find a buyer or if the structure is sold for less than the projected price,"" the report says. Rauner’s office also complains that new revenue projections provided in August by the Illinois Department of Revenue to the Governor’s Office of Management and Budget show more trouble ahead. ""The General Assembly’s budget was based on an earlier revenue projection from April, but FY17 revenues continued to underperform for the remainder of FY17,"" Schaumburg said. ""As a result, the GOMB estimate is $500 million lower than the General Assembly’s FY18 revenue estimate."" This argument, however, ignores the budget-making calendar in the Illinois Constitution, which puts a May 31 deadline on passing a budget with a simple majority in the Legislature. The tone of Rauner’s news release makes clear that there will be tension in Springfield in the months to come as lawmakers work to, as Msall puts it, make the budget’s assumptions hold up. This is not an unfamiliar position for Rauner and the Legislature, even though for the entirety of Rauner’s term they have yet to agree on a full budget. In March 2015, state government faced the prospect of running out of money unless the governor and lawmakers closed a gap of $1.6 billion. Working together, Rauner and the Legislature hammered out a solution that appeared, briefly, to signal good things for future bipartisan cooperation. Then as now, the effort involved salvaging an existing budget. That’s a departure from the two fiscal years in between, when government operating without any budget controls ran up the $16 billion bill backlog. Gov. Bruce Rauner said Illinois’ current operating budget is ""is more than $1 billion out of balance…"" The head of the Illinois Teachers Retirement System confirms Rauner’s claim that the new pension plan expected to generate $500 million in anticipated savings won’t be enacted during the current fiscal year (or even the next one). The Civic Federation reports that the small surplus in the budget will finance only $3 billion of the $6 billion Rauner plans to borrow. But putting $3 billion toward past-due Medicaid bills would generate $3 billion in federal matching funds -- something Rauner has not discussed. Failure to sell or get the expected price for the Thompson Center are possible scenarios that could further imperil the budget. Some of the assumptions identified as sources of the trouble originated in Rauner’s own budget, a fact that Rauner does not acknowledge and that needs to be considered here. Whether or not the imbalance reaches more than $1 billion is debatable, but Rauner is correct that there remains much work to do."
2876	Drugmaker AstraZeneca forecasts faster return to growth.	AstraZeneca expects new drugs and a recent diabetes deal to offset a wave of patent expiries and return it to growth faster than analysts predict, with 2017 revenue likely to be broadly in line with the 2013 level.	true	Health News	The company’s forecast implies a potential $3 billion upgrade to the consensus estimate from analysts and marks an attempt to call a bottom to a sales decline driven by the loss of exclusivity on several top-selling medicines. Britain’s second-biggest drugmaker is already suffering from generic competition to its antipsychotic Seroquel, while its Nexium treatment for excess stomach acid loses U.S. patent cover this year. Top-selling Crestor, for high cholesterol, faces competition from cheap copycat drugs in 2016. The patent expiries leave AstraZeneca’s sales on a near-term downward spiral at a time when most of its rivals have put their biggest patent losses behind them. Shares in the group rose 1.6 percent by 1215 GMT on the more upbeat outlook, against a 0.3 percent decline for the European healthcare sector. Chief Executive Pascal Soriot, who has been leading the company for a little more than a year, will set out the new revenue guidance in a presentation at the J.P. Morgan Healthcare conference in San Francisco later on Tuesday. The company will then give a more detailed update on its progress in full-year results on February 6. The consensus of analyst forecasts compiled by Thomson Reuters is for 2017 revenue of $22.5 billion, down from the $25.8 billion estimated for 2013. However, a number of the 2017 forecasts pre-date the diabetes drug deal struck last month that is already expected to add some $1 billion to $2 billion to annual revenue. Citigroup analyst Andrew Baum said the positive medium-term outlook reinforced his “more constructive thesis” for the stock, adding that he expects Soriot to strike more earnings-boosting deals this year. Panmure Gordon’s Savvas Neophytou remains more wary, pointing out that Soriot’s predecessor, David Brennan, had made a similar attempt to talk up AstraZeneca’s longer-term prospects. “In our view, management is stepping onto thin ice with this same sort of guidance,” Neophytou said, pointing out the previous management’s failure to hit its forecasts. AstraZeneca has become more confident about its revenue outlook after the $4 billion deal last month to buy Bristol-Myers Squibb’s share of a diabetes joint venture. The acquisition is expected to complete in the first quarter of 2014 and will boost sales immediately. Mark Clark of Deutsche Bank said this was set to lift analysts’ revenue forecasts significantly, suggesting that a more realistic “adjusted consensus” for 2017 was around $24.3 billion rather than $22.5 billion. Soriot has been striking a number of bolt-on deals to refill the company’s thin pipeline of new medicines and accelerating in-house research programs. The group now has 11 new-drug programs in late-stage Phase III testing, almost double the number a year ago, and 27 in Phase II. Hopes are particularly high for its cancer research, where it has started trials for immunotherapy combination treatments for which the first results are anticipated in 2014/15. AstraZeneca is behind the likes of Bristol-Myers, Roche and Merck & Co in the race to develop immunotherapies - a hot new area of cancer research - but it is betting on combination treatments to help it to catch up. Immunotherapy, which harnesses the body’s immune system to fight cancer, has shown great promise in clinical trials and analysts believe that the treatments may extend patients’ lives significantly and generate tens of billions of dollars in annual sales.
9060	Minimally invasive treatment provides relief from back pain	To read this release, one would come away with the impression that nearly everybody suffers from low back pain and that nearly everybody could benefit from “image-guided pulsed radiofrequency treatment.” This impression is built on a faulty structure. There is not enough data provided in a clear enough way. The true context around low back pain prevalence is not presented in a realistic way. Nor are the costs and caveats around the quality of evidence included. It would have been helpful if the release had noted that the study, presented at a medical conference, has not been peer reviewed or published. A story by NBCNews.com, which we also reviewed, provides readers with a lot of the information that’s missing from the release, mainly through interviews with outside experts. There have been numerous reports on new low back pain treatments that sound amazing, but often turn out to be too good to be true. This release does a good job of hyping a new treatment for one type of low back pain. The headline and start of the release refer to low back pain in general and how common it is. The study reported here focuses on one type of back pain that is due to a herniated disc that pinches nerves coming out of the back that go to the legs. These patients have leg pain in addition to back pain. A herniated disc is probably the cause of low back pain for fewer than 10 percent of patients. Moreover, most patients with pain due to a herniated disc will improve with conservative treatment. So the patients in this study actually only represent a few percent of patients with low back pain.	false	back pain,radiofrequency treatment,Radiological Society of North America	There is no mention of costs in the release. The release addresses benefits with this statement: “Of the 80 patients treated, 81 percent were pain free one year after a single 10-minute treatment session. Six patients required a second pulsed radio-frequency session. Ninety percent of the patients were able to avoid surgical treatment.” This would imply that 65 of 80 patients had pain relief at one year. The release does mention side effects, saying, “Dr. Napoli said no patients experienced side effects after receiving the minimally invasive outpatient treatment.” But just because there were no side effects in this small study, does that mean there is no risk of such side effects for anyone? That seems like downplaying the risks. The release would have been more thorough had it mentioned that any invasive treatment such as this one carries a risk of infection. The release does not adequately describe the quality of the evidence. It does not explain that these results are not peer reviewed nor published. And it does not provide any sort of caveats around potential shortcomings of the approach. It’s a weakness of the study that there was no comparative group. As an expert interviewed by NBC News for a story on this study explained: “We don’t know what would have happened if compared to nothing or sham,” said Dr. Seth Waldman, director of pain management at the Hospital for Special Surgery. “More research needs to be done in a randomized control trial.” Finally, the release might also leave readers with the impression that the pain relief seen is entirely due to the intervention when we know that a substantial portion of patients with back pain will get better on their own. It’s misleading not to point this out. The release overstates the severity of the problem of low back pain, and it doesn’t need to. Pain is a very real problem in the United States and around the world. But stating that “Low back pain is an extremely common problem that affects at least 80 percent of the population at some point in their lifetime” is emphasizing something that may be intermittent or even acute for a few years and making it seem like it is constant. The actual prevalence of low back pain globally is about 8,500 cases for every 100,000 people, according to the University of Washington’s Institute for Health Metrics and Evaluation. So, while it may technically be true that 80 percent of us will “at some point” experience low back pain, we feel like providing the actual prevalence of low back pain would be a more realistic context. Further, this study focuses on those with back and leg pain due to a disc herniation. Disc herniations only represent a small fraction of patients with low back pain. Moreover, these patients had symptoms for more than 3 months. Most patients (around 75 percent) with a disc herniation improve over time without invasive treatment. So the actual population studied here is a fraction of the low back pain population that is mentioned in the title and the start of this piece. It’s not obvious from the release who funded this work. The release mentions that the study included 80 patients “experiencing at least three months of low back pain due to a herniated disk that had not responded to conservative treatments including exercise and medication.” But that’s an inadequate description of accepted alternatives. Patients with persistent pain due to a disc herniation have a number of well accepted alternative treatments including epidural steroid injections, surgical discectomy as well as other minimally invasive procedures. The release does a nice job of explaining the procedure and, we feel, gives readers enough detail to understand how it would work. But it does not make it clear how widely this procedure is available and the type of technical skill necessary to administer it. Novelty is not established in this release. If the authors had mentioned that there are other minimally invasive procedures and that their limitations led to this new technique, that would have established the novelty of this procedure. It’s not clear how the technique differs from other similar techniques or exactly how the low level energy reduces pain. At one point, the lead investigator Alessandro Napoli, says, “The results have been extraordinary. Patients have been relieved of pain and resumed their normal activities within a day.” Can we really call these results extraordinary? As noted above, we are talking about results in just 65 patients over just one year. There are a long list of treatments for low back disorders that initially reported results that sounded too good to be true, but weren’t.
2748	Pfizer breast cancer drug succeeds in mid-stage trial.	Pfizer Inc’s experimental breast cancer drug significantly delayed progression of symptoms in a mid-stage trial, meeting the study’s primary goal and keeping Pfizer in the forefront of a race for a new standard of care for the disease.	true	Health News	Pfizer shares were up nearly 4 percent on positive findings for the oral treatment, called palbociclib, one of the company’s most important experimental drugs that some analysts believe could eventually claim annual sales of more than $5 billion, if approved. The trial tested the pill in post-menopausal patients with locally advanced or newly diagnosed breast cancer that had spread to other parts of the body. “We are delighted with the final data,” Pfizer said in a release, adding the company will discuss the successful data on progression-free survival with the U.S. Food and Drug Administration “to determine next steps” for palbociclib. A secondary goal of the study is to determine whether palbociclib can prolong overall survival. But Pfizer spokeswoman Sally Beatty said the company does not yet have such data, because it takes longer periods to follow patients and gauge survival trends. Although Pfizer is conducting two larger late-stage trials of palbociclib, ISI Group analyst Mark Schoenebaum noted the company has previously said it might discuss with the FDA the potential to seek approval of the medicine based upon mid-stage trial data, if the data warranted. Palbociclib, which blocks enzymes known as cyclin-dependent kinases (CDKs) 4 and 6, was taken in combination with a standard treatment called letrozole among women who were estrogen receptor positive - meaning tumors grow in response to estrogen - and HER2-negative, meaning that the HER2 protein is not causing the cancer. Such patients make up about 60 percent of advanced breast cancer cases. Letrozole is the chemical name of Femara, a Novartis AG drug that belongs to a class of treatments called aromatase inhibitors that block production of estrogen. Pfizer on Monday did not present detailed data from the trial results, saying they would be presented at a scientific meeting in San Diego in April. The success of the trial, called Paloma-1, follows highly favorable interim data that Pfizer unveiled in December 2012. At that point in the study, those taking both palbociclib and letrozole went an average of 26.1 months before tumors worsened. That compared with 7.5 months for those taking letrozole, but not palbociclib. The 18.6-month difference was considered statistically significant. Side effects from palbociclib were similar to those previously reported, Pfizer said on Monday. The earlier interim results had shown that patients taking the drug combination experienced anemia, fatigue and neutropenia - a decline in white blood cells called neutrophils that can put patients at higher risk of infection. Palbociclib was designated a “breakthrough” drug by the FDA last April based on initial data from the trial. The FDA grants “breakthrough” status to drugs that may offer substantial improvement over existing treatments for serious or life-threatening diseases. The status helps to speed up the approval process. Pfizer has started two late-stage trials of the drug - Paloma-2 and Paloma-3 - in patients with advanced breast cancer. Paloma-2 will test the same drug combination, palbociclib and letrozole, as an initial treatment for breast cancer. Paloma-3 will evaluate palbociclib in combination with another hormone therapy, fulvestrant, in women whose cancer has progressed after hormonal therapy. The drug, sold under the brand name Faslodex by AstraZeneca Plc, is called an estrogen receptor antagonist. Companies trying to develop treatments similar to palbociclib include Novartis and Eli Lilly & Co. Breast cancer killed more than 508,000 women worldwide in 2011, according to the World Health Organization. Pfizer shares were up 3.7 percent at $31.53 on Monday morning on the New York Stock Exchange.
11246	Mammogram Rate Declining, Study Suggests	"The story focuses on the documented decrease in use of mammography, which is portrayed here as a negative. The anchor and her guest, a breast cancer surgeon, speculate why fewer women have been getting mammograms; they attribute this trend, in part, to legal issues closing mammography centers. They also speculate that if women aren’t getting their HRT prescriptions, they aren’t getting their mammogram, for which there is little evidence. The decrease is described as ""shocking"" and ""frightening"" (and by implication, those who are not screened are at risk of dying), and there is no acknowledgement that not being screened may be a reasoned response by informed consumers. By using such terms, the broadcast is fear-mongering. It is not ""shocking"" that some women, especially lower-risk women age 40-49, would forego an annual mammography in light of recent evidence that the value of mammography is questionable in this group, and for women who have other medical conditions that might shorten their lives. The story begins with the statement, ""Women over the age of 40 are supposed to have one every year."" But a major medical group, the American College of Physicians (ACP), published new clinical guidelines on mammography in the 40s just a month before this story, and those guidelines do not agree with the story’s opening statement. The ACP guidelines were never mentioned in the story. Although most agree mammography saves lives among women aged 50 to 69, mammography also has the potential to cause these women harm. Mammograms increase the diagnosis of lesions. Left untreated, some of these will become cancers, but many will not. The discovery of lesions leads not only to fear and anxiety, but also to invasive diagnostic tests and invasive treatments (including mastectomy or lumpectomy). Finally, mammography exposes women to radiation that could itself cause breast cancer 10 or 20 years down the road. (Br J Cancer 2005;93:590-6. Lancet 2000;355:1757-70). Because medicine does not yet have perfect estimates of the harms of mammography, journalists should explain the potential benefits and harms, and thus help women to evaluate their own individual preferences so that they can choose the course of action that best suits them. A secondary focus of the story is the ""feel good"" elements of planning a mammogram around a day of shopping or a spa date. “Pampering yourself” might help some women overcome the fear of scheduling a mammogram, but this does not factor into their decision about whether or not to be screened for breast cancer, and broadcast news organizations do a disservice to their female viewers by placing health screenings in this context."	false		"The broadcast does not provide the cost of mammography, but does address health insurance coverage and notes that a lack of insurance may be a deterrent in women’s choice to have an annual mammography. The reporter does cite data, but just relative not absolute (see our primer), and probably paints a rosier picture than reality, especially for women in their 40s. Individuals studies vary widely but there are lots of problems with the studies. Average is about 20-30% reduction in mortality. The story focuses on the ""feel good"" elements of planning a mammogram around a day of shopping instead of providing useful data-driven health information to the viewer. The story doesn’t mention any potential harms of mammography. This is a major flaw, as it was in an January 26th ABC broadcast on this topic. We repeat what we wrote then: ""Although mammograms can identify disease early and reduce deaths, they are also associated with several harms. Mammograms increase the diagnosis of lesions. Left untreated, some of these will become cancers, but many will not. The discovery of lesions leads not only to fear and anxiety, but also to invasive diagnostic tests and invasive treatments (including mastectomy or lumpectomy). Finally, mammography exposes women to radiation that could itself cause breast cancer 10 or 20 years down the road. (Br J Cancer 2005;93:590-6. Lancet 2000;355:1757-70). Because medicine does not yet have perfect estimates of these harms, the decision to have mammography is not always simple."" The broadcast demonstrates no grasp of the evidence around this controversial area of preventive medicine. There is no mention of the quality of evidence to support the fear that fewer mammograms will categorically result in more cancer deaths, nor any attempt to weigh this evidence against the evidence that mammography may produce harms as well as benefits. (See “Harms of Treatment” below). The story begins with the statement, ""Women over the age of 40 are supposed to have one every year."" But at least one major medical group, the American College of Physicians (ACP), published new clinical guidelines on mammography in the 40s just a month before this story, and those guidelines do not agree with the story’s opening statement. The ACP guidelines were never mentioned in the story. The broadcast does provide accurate American Cancer Society estimates for annual deaths from breast cancer, but ""2 million women who survived breast cancer"" cannot be attributed solely to screening. Early detection and treatment have together have been shown to improve survival. By using terms like ""shocking!’ and ""troubling"", the broadcast is fear mongering. It is not ""shocking"" that some women, especially lower-risk women age 40-49, would forego annual mammography in light of recent evidence the value of mammography is questionable in this group and in women who have other medical conditions that might shorten their lives. Finally, the news story overlooks the flip side of screening. Although most agree it saves lives among women aged 50 to 69, mammography also has the potential to cause these women harm. (See “Harms of treatment” below.) Viewers would be better-served by an even-handed explanation of the potential benefits and risks of having a mammogram, so that women could make an informed decision. The story begins with the statement, ""Women over the age of 40 are supposed to have one every year."" But at least one major medical group, the American College of Physicians (ACP), published new clinical guidelines on mammography in the 40s just a month before this story, and those guidelines do not agree with the story’s opening statement. The ACP guidelines were never mentioned in the story. We are only given one point of view, that of a breast cancer specialist who encourages all women over 40 to be screened. She does not discuss the downside of this screening. Balance and additional sources are needed. The broadcast provides no information about other alternatives to mammography, which for some might include doing nothing. Also, the broadcast does not mention the rate of false positives with mammography, which may increase the number of breast biopsies and unnecessary breast cancer treatments. The broadcast explains that the number of U.S. women receiving annual mammograms has decreased in recent years. The segment only offers speculation on why this is, but provides no sources. A GAO report found that, despite facility closings, “current capacity is adequate.” Mammography is not new. The broadcast reports a new study reporting a decline in mammography screening and speculates on the causes. Information in this broadcast does not appear to be taken directly from a press release."
3189	WHO: Death toll from measles outbreak in Congo hits 6,000.	The death toll from a measles epidemic in Congo has surpassed 6,000, the World Health Organization said Tuesday as it warned that more funds are needed to save lives during the world’s worst outbreak of the infectious disease.	true	Health, Measles, General News, Africa, Epidemics, Senegal, Infectious diseases, United Nations, Ebola virus, International News	Measles has killed nearly three times as many people in Congo than an Ebola outbreak in the country that has garnered far more international attention, particularly after health teams came under attack from armed militias operating in the area. “Lack of funding remains a huge impediment to successfully curbing the outbreak,” WHO said in announcing its appeal. While $27.6 million already has been mobilized to curb the measles epidemic, WHO said that $40 million is needed for a special six-month plan to vaccinate older children between the ages of 6 and 14. A vaccine against measles has existed for decades but some 310,000 cases have been reported in Congo since the beginning of 2019. Health workers in Congo struggle to access remote parts of the vast country, and vaccination rates remain low in areas where armed groups operate. Many health resources in Congo this year also have been devoted to the simultaneous outbreak of Ebola, which has become the second worst in history after the 2014-2016 West Africa epidemic. At least 2,231 people have died of Ebola since that outbreak was first identified in August 2018.
41720	Joe Biden wrote in a 1981 op-ed “that he believed that women working outside the home would, quote, ‘create the deterioration of [the] family.’”	Several of the factual distortions concerned what the candidates had to say about one another.	mixture	child care, climate change, DREAMers, health care, insurance, pay inequality, Police, Taxes,	Another debate, and another crop of false and misleading claims.CNN hosted the second of two Democratic debates on July 31 in Detroit, with another field of 10 candidates. For our story on the first night, see “FactChecking the Second Democratic Debate.”Biden initially said that his health care plan would cover the “vast, vast, vast majority” of Americans, but when pushed by Harris, he later said it would “cover everyone.” His own campaign website says otherwise.Harris: I’m going to go back to Vice President Biden, because your plan does not cover everyone in America.By your staff’s and your own definition, 10 million people — as many as 10 million people will not have access to health care. And in 2019 in America, for a Democrat to be running for president with a plan that does not cover everyone, I think is without excuse. Our plan covers everyone. …Biden: My plan does — will cover everyone, number one.Biden’s website does not claim that his health care plan would cover everyone in the U.S.Biden’s plan calls for, among other things, offering a Medicare-style public health insurance option as a choice and increasing tax credits for individuals purchasing insurance on the Affordable Care Act’s exchanges.His website says his plan to “build on the Affordable Care Act” will “insure more than an estimated 97% of Americans.”Harris’ campaign told us she gets to Biden leaving “as many as 10 million people” uninsured by calculating 3 percent of the currently estimated U.S. population of 329.3 million, which works out to 9.88 million people. However, that figure includes more than just “Americans,” as Biden’s campaign website said, because not everyone living in the U.S. is a citizen.It’s worth noting that Biden’s campaign has reportedly said that under his plan, immigrants living in the U.S. illegally would be able to purchase insurance through the ACA exchanges, which is currently not allowed. Those immigrants still wouldn’t be eligible for federal subsidies, his campaign explained.We asked Biden’s campaign about his debate claim of coverage for everyone, but we did not receive a response.Biden launched his own health care attack on Harris, saying her plan “will require middle-class taxes to go up, not down.”Harris has proposed her own version of a Medicare for All plan that features an expanded Medicare system, including private insurers, and phased in over a 10-year period.But, in a July 29 Medium post, Harris said her plan to pay for her proposal will “exempt households making below $100,000, along with a higher income threshold for middle-class families living in high-cost areas.”She said she would take that approach because, to pay for his Medicare for All plan, Sen. Bernie Sanders has proposed potentially charging a 4 percent income-based premium for families of four making over $29,000. “I believe this hits the middle class too hard,” Harris’ post said.The Biden campaign did not respond to our request for an explanation of his claim of a middle-class tax hike.In a lengthy back-and-forth about how much a Medicare for All proposal would cost in taxes, the candidates glossed over the fact that such a universal health care plan would raise federal taxes substantially but would decrease or eliminate all other sources of payment for health care. One side in this argument — Bennet and Biden — focused only on the taxes, while the other side — Harris and de Blasio — focused on costs in the current health care system.Bennet said that “the plan that Senator Warren and Senator Sanders and Senator Harris have proposed” would “massively raise taxes on the middle class to the tune of $30 trillion.” (See our item above on the “middle class” claim.) De Blasio later responded: “Certainly, with all due respect to Senator Bennet, what he’s saying is absolutely inaccurate about taxes. Americans right now are paying so much money for their health care, ask people about the reality of premiums, deductibles, copays, out-of-pocket expenses.”Bennet countered: “Bernie Sanders … is the guy who says it will cost $32 trillion and that we’re going to have to raise those taxes to pay for it. … Don’t try to distract from the truth.” Biden sided with Bennet, saying: “Thirty trillion dollars has to ultimately be paid. And I don’t know what math you do in New York, I don’t know what math you do in California, but I tell ya, that’s a lot of money, and there will be a deductible. The deductible will be out of your paycheck, because that’s what will be required.”Earlier, Biden had said: “The plan, no matter how you cut it, costs $3 trillion when it is, in fact, employed, number one,” to which Harris responded, “First of all, the cost of doing nothing is far too expensive. Second, we are now paying $3 trillion a year for health care in America.”Harris is right about what we spend now. Total national health care expenditures were $3.5 trillion in 2017, according to the National Health Expenditure Accounts.As we’ve explained before, we don’t know how much Medicare for All — or Harris’ new health care plan, which preserves a role for private insurers — would ultimately cost, since many details are yet to be determined. But two estimates, one by the Urban Institute and another by the Mercatus Center at George Mason University, said the federal government cost would be $32 trillion or $32.6 trillion over 10 years. The government would have to raise taxes or fees, or cut other spending, to cover the costs. But, as Bennet and Biden leave out, current health care spending by private insurers, employers, individuals and states would shift to the federal government.Gillibrand asked Biden to explain statements that he made in a 1981 newspaper op-ed about legislation to expand a federal child care tax credit.“He voted against it, the only vote, but what he wrote in an op-ed was that he believed that women working outside the home would, quote, ‘create the deterioration of family,’” Gillibrand said. “He also said that women who were working outside the home were, quote, ‘avoiding responsibility.’” That’s not exactly what Biden wrote.The op-ed, which her campaign communications director posted on Twitter, was critical of expanding the federal tax credit for those Biden called “upper-income families.”Biden wrote that it is “legitimate and necessary” for the government to help “single parents on limited incomes to get off of welfare” or “families of modest means to adequately provide the material necessities of child-rearing.” But he called it ridiculous for the government to subsidize child care expenses for an “upper-income family” that wants a second income to buy a swimming pool or a larger home.He offered an unsuccessful amendment that would have imposed an income cutoff, writing that 6,000 families earning more than $100,000 claimed the tax credit in 1978. (According to the Bureau of Labor Statistics, $100,000 would be equivalent to about $400,000 in today’s dollars. )Gillibrand mentioned none of that, but she instead focused on another argument that Biden made in his op-ed: two-income families are resulting in “the deterioration of family.”“I think it’s a sad commentary on our society when the Senate of the United States says, as a matter of social policy, that we should make it easier for people who have neither the financial necessity nor personal need to forsake their responsibility to care for their own children,” Biden wrote, calling himself “old-fashioned.”Gillibrand said that Biden wrote “that he believed that women working outside the home would, quote, ‘create the deterioration of family,’” but the op-ed never explicitly said that women should stay home to care for children. And, in a recent story on Biden’s position on the 1981 legislation, HuffPost said a news story quoted Biden at the time as saying either the man or woman could stay home.“I do not care whether in a modern marriage you want the man or the woman to take that responsibility. That has to be resolved by each couple individually,” Biden was quoted as saying in the July 29, 1981, edition of the Indianapolis News.But, as the HuffPost noted, Biden’s position at the time “would have disproportionately affected women” — which led Gillibrand to ask Biden twice if he “no longer believes” that women should stay at home and not work.“I never believed it,” Biden said.Businessman Andrew Yang went way beyond the facts when he said, “Amazon is closing 30 percent of America’s stores and malls and paying zero in taxes while doing it.” (He was arguing for higher taxes on corporations to finance his plan to give $1,000 per month to every American. )We find no support for the claim that 30% of U.S. stores are closing, much less that Amazon.com Inc. is the sole cause. Furthermore, the online giant has paid federal income taxes over the years. The Wall Street Journal has estimated that Amazon paid 8% of its income in taxes for the years 2012 through 2018 — which the Journal noted was “low, but not zero or negative.”Store closures — When we asked Yang’s campaign for evidence to support his claim, his staff cited a 2017 Business Insider report estimating that 30% of retail malls (not stores) were being pushed “to the brink of death” by a wave of store closures announced by JCPenney, Macy’s, Sears, American Apparel, The Limited and Abercrombie & Fitch. Yang’s staff also pointed to a 2016 CNBC interview with retail analyst Jan Kniffen, who predicted that about one-third of retail malls (not stores) were “not long for this world.”But neither article said Amazon was the sole cause. Kniffen laid the blame on too many stores. “On an apples-to-apples basis, we have twice as much per-capita retail space as any other place in the world,” Kniffen said. In the video interview, Kniffen cited Amazon as a contributing factor. The Business Insider report didn’t mention Amazon at all. It cited “declining customer traffic, falling occupancy rates, and low sales productivity” in “lower quality malls.” We also note that Yang spoke of “stores and malls” and not just “malls.” Malls and stores are two different things, and the number of stores may be going up.The National Retail Federation reports that “54 percent of surveyed retailers plan to open new stores in 2019, and 36 percent of those surveyed will have a higher store count than in 2018.” One example of a flourishing brick-and-mortar store chain is retailer Dollar General — which says it puts its stores in “convenient neighborhood locations,” as opposed to malls. Since 2007, Dollar General has nearly doubled the number of its stores, from 8,194 to 15,597 as of May 3 this year.So we find the claim that 30 percent of “stores” are closing is without factual support.Taxes — It was widely reported that in 2018 Amazon paid $0 in federal income taxes — and actually got a $129 million rebate — mainly as a result of the 2017 corporate tax cut signed by President Trump. But the Wall Street Journal later reported it is not actually certain that Amazon paid zero tax in 2018 (tax returns are private under federal law). And based on Amazon’s financial disclosures to investors, the Journal said: “From 2012 through 2018, Amazon reported $25.4 billion in pretax U.S. income and current federal tax provisions totaling $1.9 billion. That is an 8% tax rate—low, but not zero or negative.”At one point in the debate, de Blasio pressed Biden to explain his position on “all those deportations” that occurred during the Obama administration.“You were vice president of the United States. I didn’t hear whether you tried to stop them or not, using your power, your influence in the White House,” de Blasio said. “Do you think it was a good idea, or you think it was something that needed to be stopped?”Biden responded by praising Obama’s record on immigration, but the former vice president went too far.Biden: The president came along, and he’s the guy that came up with the idea, first time ever, dealing with the Dreamers. He put that in the law. He had talked about a comprehensive plan which he put on the – laid before the Congress, saying that we should find a pathway to citizenship for people. He said we should up the number of people that we’re able to bring in to this country.As president, Obama did support a comprehensive immigration plan, but he wasn’t successful in getting it into law. As a result, Obama resorted to using his executive powers to temporarily defer deportation for so-called Dreamers.The executive action, which Obama announced on June 15, 2012, allowed young immigrants who were brought to the U.S. illegally as children to apply for work permits without fear of deportation for two years, subject to renewal, if they meet certain eligibility requirements. The policy — the Deferred Action for Childhood Arrivals, or DACA — applies to those who are 30 or younger and who came to the U.S. before the age of 16.But Obama did not “put that in the law,” as Biden said.The Biden campaign told us that the policy has the force of law. But, because it is not a law, another president can rescind it. That is exactly what Trump has done — resulting in a state of limbo for many young people still living in the U.S. without legal status.In a fact sheet on the history of the DREAM Act, the American Immigration Council recounts how Trump has attempted to rescind the policy but has been partially blocked by the courts. Currently, the program is not accepting new applicants, but those in the program or those who have been in the program in the past can apply for renewal of the DACA protections on a two-year basis, according to the Department of Homeland Security.A law would have provided the so-called Dreamers with permanent legal status. But such legislation has failed to garner enough Republican support — even though the first Senate bill was introduced in 2001 by a Republican, then-Sen. Orrin Hatch of Utah. “The first version of the Development, Relief, and Education for Alien Minors (DREAM) Act was introduced in 2001. As a result, young undocumented immigrants have since been called Dreamers,” the American Immigration Council fact sheet says. “Over the last 18 years, at least ten versions of the Dream Act have been introduced in Congress. While the various versions of the Dream Act have contained some key differences, they all would have provided a pathway to legal status for undocumented youth who came to this country as children.”New York City Mayor Bill de Blasio falsely claimed that a federal investigation barred the city from taking action against the police officer involved in the 2014 death of Eric Garner, a black man killed while being arrested for illegally selling loose cigarettes on Staten Island.The U.S. attorney for the Eastern District of New York announced on July 16 that there would be no federal civil rights charges in the case. The high-profile case became a focus during the debate, as protesters interrupted candidates with calls for the firing for Officer Daniel Pantaleo, who placed Garner in a chokehold.At one point, moderator Jake Tapper asked de Blasio: “Why is that police officer still on the force, the one who killed Eric Garner? Please respond.”De Blasio replied: “Well, let me tell you. I know the Garner family. They’ve gone through extraordinary pain. They are waiting for justice and they are going to get justice. There’s finally going to be justice. I have confidence in that — in the next 30 days — in New York. You know why? Because for the first time, we are not waiting on the federal Justice Department, which told the city of New York that we could not proceed because the Justice Department was pursuing their prosecution. And years went by, and a lot of pain accrued.”But de Blasio’s own previous statements affirm that the city deferred to the Justice Department — not that the city was technically prevented from taking disciplinary action.“Years ago, we put our faith in the federal government to act. We won’t make that mistake again,” de Blasio said in a July 16 statement. “New York City is not the same city it was five years ago. We are a different city, and we must act like a different city. Moving forward, we will not wait for the federal government to commence our own disciplinary proceedings.”Likewise, a New York City Police Department deputy commissioner said in a 2018 letter to the Justice Department that the force had delayed disciplinary proceedings out of “deference to ongoing requests from the U.S. Department of Justice … so as not to have an adverse impact on any ongoing federal criminal civil rights investigation or possible federal criminal prosecution.”A Justice Department media statement responding to that letter said the DOJ had “informed” the deputy commissioner “this spring” that “the New York Police Department may move forward with their disciplinary proceedings as they deem appropriate.”The police department’s disciplinary trial for Pantaleo concluded in June. A decision is still forthcoming.Two candidates, Booker and Inslee, used language of survival and existence to describe the threat of climate change, which could be misleading.Booker said during the climate section of the debate, “Everything must be sublimated, to the challenge and the crisis that is existential, which is dealing with the climate threat.”Inslee, in his closing remarks, echoed that sentiment.Inslee: For decades, we have kicked the can down the road on climate change. And now under Donald Trump, we face a looming catastrophe. But it is not too late. We have one last chance. And when you have one chance in life, you take it. Think about this: Literally the survival of humanity on this planet and civilization as we know it is in the hands of the next president. Many other candidates have also used the word “existential” in the past to describe the threat of climate change, including Sen. Elizabeth Warren in last night’s debate. The language is vague, so it’s hard to tell exactly what is meant in each case, but it’s worth noting that climate scientists do not expect climate change to eliminate the human race from the planet.“There is too much over-heated rhetoric these days arguing that all life, including human beings, will go extinct,” said Penn State climate scientist Michael Mann about climate change in an email. “That simply cannot be defended scientifically.”Nevertheless, he said it was valid to argue that if the world fails to reduce its greenhouse gas emissions, it could lead to levels of warming and other climate effects — including sea level rise and extreme weather events — that represent threats to civilization.“A ‘Mad Max’-like future, while not constituting extinction per se,” he said, “is not a future any of us would want to live in.”Sonali McDermid, a climate scientist at New York University, agreed. “While I don’t think [climate change] will annihilate our species, I think it will make this planet a much more difficult place to live, negatively impact a lot of people who had very little to do with causing the problem, and generally compromise our well-being,” she said.Benjamin Cook, a climate scientist at NASA, also concurred with that assessment. “Do I think climate change is going to wipe humanity off the face of the Earth?” he asked. “No.”But the effects could be serious, he said, and are likely to depend on where one lives. “It could be existential in a given locality if the impacts are so severe that the current way of life is no longer tenable,” he said.Inslee’s comments also imply that the next four or so years represent a “last chance” to take action on climate change. That’s unlikely to be true. As we’ve explained before, scientists don’t view climate change as having a hard cutoff. Being aggressive on emissions now will certainly reduce negative consequences and make it easier in the long run to address the challenge, but that does not mean efforts at a later date would have no impact.Biden related a story from Harris’ past that charged her with failing to prevent abuse in the criminal justice system.Biden: Secondly, she also was in a situation where she had a police department when she was there that in fact was abusing people’s rights. And the fact was that she in fact was told by her own people that her own staff that she should do something about and disclose to defense attorneys like me that you in fact have been — the police officer did something that did not give you information [that would exculpate] your — your client. She didn’t do that. She never did it. And so what happened.Along came a federal judge and said enough, enough. And he freed 1,000 of these people. If you doubt me, Google 1,000 prisoners freed, Kamala Harris.When allowed to respond, Harris said, “That is — is simply not true.”Biden is likely referring to events when Harris was district attorney of San Francisco. In June, the Wall Street Journal reported that in 2005, against the advice of her staff, Harris did not institute a so-called “Brady policy” that would have required prosecutors to inform defendants of any past misconduct by law enforcement. In 2010, a crime lab tech was found to be stealing drug evidence from the lab, which led to a scandal in which 1,000 drug cases were dismissed.A Superior Court judge, Anne-Christine Massullo, reprimanded Harris, saying in a court order that the “District Attorney failed to disclose information that clearly should have been disclosed.”After the scandal, Harris did institute a Brady policy.Based on the reporting, Biden’s version of events mostly hews to what happened. But he erred in saying Harris never implemented a Brady policy and when referencing 1,000 “prisoners” being freed, when that was the number of cases that were dropped. He also misidentified the judge by gender and court level.Harris suggested that figures representing the pay gap between men and women who work full-time, year round, were for men and women doing “equal work.”Harris: Since 1963, when we passed the Equal Pay Act, we have been talking about the fact women are not paid equally for equal work. Fast forward to the year of our lord 2019, and women are paid 80 cents on the dollar, black women 61 cents, Native American woman 58 cents, Latinas 53 cents.Harris appears to be citing figures the National Partnership for Women & Families published in May. But the statistics are not representative of men and women doing the same work.“Nationally, the median annual pay for a woman who holds a full-time, year-round job is $41,977 while the median annual pay for a man who holds a full-time, year-round job is $52,146,” the NPWF fact sheet says. “This means that, overall, women in the United States are paid 80 cents for every dollar paid to men, amounting to an annual gender wage gap of $10,169.”And for women of color, the comparison wasn’t to all men, but to non-Hispanic white males working full-time, year-round.“Among women who hold full-time, year-round jobs in the United States, Black women are typically paid 61 cents, Native American women 58 cents and Latinas just 53 cents for every dollar paid to white, non-Hispanic men,” the fact sheet explains.Now, as we’ve written before, an April 2019 report from the Institute for Women’s Policy Research analyzed the gap in median weekly earnings for male and female full-time workers doing the same job. It did conclude that “[w]omen’s median earnings are lower than men’s in nearly all occupations,” but the gaps varied widely depending on the occupation.The group’s report on 2018 earnings says that the female-to-male earnings ratio for all full–time weekly workers was 81.1 percent, and women’s percentage of their male counterparts’ median weekly earnings was higher than that in 14 of the top 20 most common occupations for women.Those who made nearly as much as their male counterparts included cashiers and customer service representatives (almost 99 percent); bookkeeping, accounting and auditing clerks (95 percent); social workers (nearly 94 percent); and registered nurses (91 percent). And in two cases, female workers earned more than their male counterparts: receptionists and information clerks (102 percent) and general office clerks (nearly 105 percent).On the other hand, the analysis shows that women do not earn more than men in any of the top 20 male-dominated occupations.The study didn’t find enough data for female workers to make a valid comparison in five of those fields, but in the other 15 professions for which comparable data are available, women earned more than 81.1 percent of their male counterparts’ earnings in just six professions, including software developers (nearly 87 percent) and laborers and freight, stock and material movers (87.3 percent).De Blasio used his opening remarks to tout his mayoral record, including on crime. “We got rid of stop and frisk and we lowered crime,” he said.De Blasio’s claim would benefit from additional context. The controversial policy of stopping people for suspicious activity — Stop, Question and Frisk — has been largely curtailed under de Blasio, but the most recent data available show such stops are not gone altogether.As we’ve explained before, such stops were already on the decline when de Blasio took office in early 2014, but they have been greatly reduced under his administration. The number of such stops was at nearly 700,000 in 2011, according to New York City Police Department data. That was reduced to about 192,000 in 2013 — the year before de Blasio took office — and then to nearly 46,000 in 2014. Since then, the number of stops has dropped to about 11,000 in 2018.The de Blasio campaign could not provide data for 2019. “We ended the era of mass stop & frisk — which was really at its peak in 2011,” a de Blasio spokeswoman told us.As for de Blasio’s claim about lowered crime in the city, many crimes in New York have indeed declined under his administration. The total number of major felony offenses, for example, has dropped every year under de Blasio, NYPD data show. For more on that, see “The Trumps vs. de Blasio on NYC Crime.”Farley, Robert. “The Trumps vs. de Blasio on NYC Crime.” FactCheck.org. 17 May 2019.“Seven Major Felony Offenses.” New York City Police Department. Accessed 31 Jul 2019.“Stop, Question and Frisk Data.” New York City Police Department. Accessed 31 Jul 2019.Cook, Benjamin. Climate scientist, NASA. Interview with FactCheck.org. 26 Jul 2019.Mann, Michael. Distinguished Professor of Atmospheric Science, Pennsylvania State University. Email sent to FactCheck.org. 23 Jul 2019.McDermid, Sonali. Assistant Professor of Environmental Studies, New York University. Email sent to FactCheck.org. 28 Jul 2019.Arkin, Daniel. “NYPD officers in Eric Garner case face disciplinary action.” NBC News. 19 Jul 2018.“Statement by United States Attorney Richard P. Donoghue.” Press release, U.S. Attorney’s Office for the Eastern District of New York. 16 Jul 2019.“Statement from Mayor de Blasio on Department of Justice Decision Regarding the Death of Eric Garner.” Press release, City of New York. 16 Jul 2019.McLaughlin, Eliott C. and Mark Morales. “With his career on the line, NYPD police officer accused of fatally choking.” CNN. 6 Jun 2019.Rubin, Richard. “Does Amazon Really Pay No Taxes? Here’s the Complicated Answer” Wall Street Journal. 14 Jun 2019.Peterson, Haley and Skye Gould. “Store closures will push 30% of US malls to the brink of death.” Business Insider. 7 Mar 2017.DiChristopher, Tom. “1 in 3 American malls are doomed: Retail consultant Jan Kniffen.” CNBC.com. 12 May 2016.Aronholt, Bethany. “Setting the record straight on the state of retail and store closures.” National Retail Federation. 15 Apr 2019.Dollar General Corporation. “Fast Facts.” Undated web page. accessed 1 Aug 2019.Conway, Jan. “Number of stores of Dollar General in the United States from 2007 to 2018.” Statistica. 28 May 2019.Davis, Andrew. “Why Amazon paid no 2018 US federal income tax.” CNBC.com. 4 Apr 2019.Holahan, John, et. al. “The Sanders Single-Payer Health Care Plan.” Urban Institute. May 2016Blahous, Charles. “The Costs of a National Single-Payer Healthcare System.” Mercatus Center, George Mason University. Jul 2018.Terkel, Amanda and Arthur Delaney. “In 1981, Joe Biden Took A Lonely Stand Against Expanding A Child Care Tax Credit.” HuffPost. 26 Jul 2019.White House. “Remarks by the President on Immigration.” Transcript. 15 Jun 2012.Napolitano, Janet. Secretary, Department of Homeland Security. Letter to David V. Aguilar, acting commissioner, U.S. Customs and Border Protection et al. 15 Jun 2012.“The Dream Act, DACA, and Other Policies Designed to Protect Dreamers.” American Immigration Council. 3 Jun 2019.Department of Homeland Security. “Deferred Action for Childhood Arrivals (DACA).” 23 Jun 2018.U.S. Senate. “S.1291 – DREAM Act.” (as introduced 1 Aug 2001).Elinson, Zusha and Alejandro Lazo. “Kamala Harris Didn’t Act for 5 Years on Policy to Help Ensure Fair Trials.” The Wall Street Journal. 10 Jun 2019.“1,000 San Francisco drug cases to be dismissed in lab scandal.” AP. 1 Apr 2010.People of the State of California v. Bilbao. Superior Court of the State of California, County of San Franscisco. 17 May 2010.
37541	United States President Donald Trump made several statements downplaying the nature of the COVID-19 pandemic.	‘Timeline of Trump’s COVID-19 Statements’ Meme	true	Fact Checks, Politics	As criticism spread against United States President Donald Trump’s administration for its response to the COVID-19 pandemic in mid-March 2020, one graphic disseminated on social media listed his multiple attempts to downplay the disease:In this case, the graphic is completely accurate. The various statements are correctly attributed to Trump, and each has been verified in independent timelines compiled by news outlets.“We’re ordering a lot of supplies. We’re ordering a lot of, uh, elements that frankly we wouldn’t be ordering unless it was something like this. But we’re ordering a lot of different elements of medical.” — Trump on the coronavirus pic.twitter.com/id6YLzbmRE— Aaron Rupar (@atrupar) February 28, 2020A video with similar content, posted by writer Lindsay Holst and featuring audio of several of Trump’s remarks alongside a graph showing the spread of the disease, has been shared thousands of times on Twitter:57 days later. pic.twitter.com/umsfZHyBuo— Lindsay Holst (@LindsayLHolst) March 17, 2020On March 17 2020, journalists asked Trump why his tone had shifted so quickly and dramatically regarding the epidemic. He told reporters, “I’ve always known this is a real — this is a pandemic. I felt it was a pandemic long before it was called a pandemic. I’ve always viewed it as very serious.”
9147	Children and adolescents who eat pasta have better overall diet quality new research shows	This news release from the National Pasta Association claims a new study shows that American children and adolescents who eat pasta consume a higher quality diet than children who don’t eat pasta. But this association is based on survey data measured against recommended dietary guidelines — which makes for a less-than-conclusive result. We can’t know from this type of study whether eating pasta led to healthier children. While nutrient intake was reported on questionnaires, health status wasn’t measured or reported, according to the brief study abstract. The release itself states that “No significant associations were seen with body weight, waist circumference and body mass index.” Further, the release doesn’t offer readers any numbers with which to assess the claims. Good nutrition advice is needed in the United States. “The percentage of children with obesity in the United States has more than tripled since the 1970s,” according to the CDC. “Today, about one in five school-aged children (ages 6–19) has obesity,” the agency says. But this release does not help the reader understand whether there is a meaningful message in an association study between pasta eating patterns and health outcomes. A better diet may have less to do with pasta eating than with household income or cultural attitudes about home-cooked meals. These variables might have influenced dietary patterns more substantially than the noodles.	mixture	diet,National Pasta Association,pasta	The release does not address the cost of including pasta in meal preparation but it’s generally known to anyone who buys food that a box of dry noodles can be purchased for less than $1. The release does not give us any numbers that allow us to see the proof of the association described. Here is one statement from the release. The study “demonstrated that young pasta-eaters have greater intakes of important vitamins and minerals and lower intakes of saturated fat and total fat in the diet compared to their peers who do not consume pasta.” Readers need to see definitions of greater, lower and important in that paragraph. Without numbers and definitions, there is no context for the reader. For more discussion on pasta association research, see this blog post, “Eat Pasta, Lose Weight,” published here in 2016. The release does not mention any harms from increased pasta consumption. The problem is not with pasta’s nutrients but with potentially filling up on high-calorie pasta and excluding other healthy foods (not named in the release) from your diet. We give the news release some credit for using appropriate language such as when it used the words “associated with” when describing the research. However, we wish there had been a specific discussion of the fact that this kind of study can’t demonstrate cause and effect. The study looked at USDA dietary recommendations, then compared them with data obtained from annual national surveys of what American adults and children ate between 2001-2012. The release doesn’t mention any limitations from association studies nor that data obtained from food frequency questionnaires (FFQ) used in the national annual survey are based on recall which can introduce error. We wish it had cautioned about the preliminary nature of the findings and the fact that the findings presented at conference haven’t been published and likely undergone limited peer review. There was no disease mongering. While the release named some nutrients that the USDA deems are in “shortfall” in American diets, we would have liked the release to provide more context about what nutrient mix is considered ideal for children, which is a complicated picture. The release clearly states that an industry financed association paid for the research. Readers should be able to take the hint (without being told explicitly) that the association has a financial interest in selling more pasta. The release does not discuss alternative diets that might provide the shortfall nutrients identified by the USDA. We’ll rate this Not Applicable since it is generally known that pasta is inexpensive and widely available. The release states that “new research shows that pasta consumption in children and adolescents is associated with a better diet quality than that of children who do not eat pasta.” Due to the limitations of the research and the lack of outcomes data we don’t believe the release demonstrates any new or novel conclusions that could impact children’s health. In fact, readers should probably question whether the study was commissioned to increase knowledge in this area or to help increase pasta sales. The release does not rely on sensational language. However, we think the headline language goes overboard based on the scant evidence provided in the release. “Children and adolescents who eat pasta have better overall diet quality new research shows” seems an exaggeration based on what is offered in the release. The release merely says that a few vitamins and nutrients were at higher levels in the pasta-eating children. It does not guarantee their diets are of overall better quality.
4491	Child advocacy group: Kids in 173 countries better off now.	A children’s advocacy group says youngsters in all but three of the 176 countries it evaluated have a better chance of growing up healthy, educated and protected from harmful practices like child labor and child marriage than at any time in the past two decades.	true	U.S. News, Health, Africa, Marriage, Save the Children, United Nations, Niger, U.S. News, Central Africa, Child labor	Save the Children said in a report released Tuesday saying that U.N. statistics show at least 280 million children are better off today. But it said a quarter of the world’s children are still denied the right to a safe and healthy childhood, with youngsters fleeing or caught in conflict the most disadvantaged. Singapore tops the rankings as the country that best protects and provides for its children, followed by Sweden, Finland, Norway, Slovenia, Germany, Ireland, Italy, South Korea and Belgium. At the bottom were Central African Republic, Niger despite recent progress, Chad, Mali and South Sudan. The Global Childhood Report 2019 said the most dramatic progress since 2000 was among some of the world’s poorest countries. Sierra Leone made the biggest improvements, followed by Rwanda, Ethiopia and Niger. The United States ranks 36th in the 2019 report, tied with China. It ranks just above Bahrain, Belarus and Kuwait and ahead of Bosnia and Russia, tied at 38. Carolyn Miles, president and CEO of Save the Children, said the report looked at eight indicators of a good childhood including child survival, education, child labor and early marriage and compared the year 2000 with 2018. “There has been remarkable progress if you look across the world,” she said at a recent briefing on the report’s finding. “It’s an amazing statistic” that the indicators overall got better in 173 of 176 countries. Compared with 2000, Miles said there was a 49% drop in deaths of children under age 5, a 40% drop in child labor, a 33% drop in chronic malnutrition and stunting, and a 25% drop in child marriage. She said only one of the indicators rose — the number of children living in conflict or affected by violence — and it increased “very significantly.” There was an 80% rise in children living in or fleeing conflict zones in the 2000-2018 period, Miles said, “and today’s conflicts last much, much longer.” According to the report, an estimated 420 million children are living in conflict zones, more than double the number in 1995, and nearly 31 million children today have been forcibly displaced from their homes. Launched ahead of International Children’s Day on June 1, the report said that in 2000, an estimated 970 million children were robbed of their childhood by events such as exclusion from education, malnutrition, sickness, violent death, child marriage and early pregnancy. That number today has been reduced to 690 million, it said, meaning at least 280 million children are better off today than they would have been in 2000. The report said this means that today there are 4.4 million fewer child deaths every year, 49 million fewer stunted children, 130 million more children in school, 94 million fewer children working, 11 million fewer child marriages and 3 million fewer teen births.
120	Sanofi pulls Zantac from U.S. and Canada after carcinogen found.	Sanofi SA said on Friday it would recall popular heartburn medicine Zantac in the United States and Canada, after the medicines were linked with a probable cancer-causing impurity.	true	Health News	The French drugmaker said it was working with health authorities to determine the level and extent of the recall, which it called a precautionary measure being taken due to possible contamination with a substance called N-nitrosodimethylamine (NDMA). Sanofi has sold over-the-counter Zantac in the U.S. and Canada since 2017. It is pulling the drug off shelves after previous recalls by some manufacturers of generic versions of the drug. Sanofi reported Zantac sales of 127 million euros in 2018 69 million euros over the first half of 2019. U.S. and European health regulators said last month they were reviewing the safety of ranitidine, which is commonly sold as Zantac and its generic alternatives, after an online pharmacy called Valisure notified them that it had found impurities in the drugs. The U.S. Food and Drug Administration said earlier this month it found unacceptable levels of NDMA in drugs containing ranitidine. The regulator asked ranitidine makers to conduct their own testing to assess levels of the impurity and to send samples of their products for testing by the agency. Canada has requested drugmakers halt distribution of the drug while it gathers more information. Sanofi CEO Paul Hudson, speaking at a press conference in Framingham, Mass., earlier this week, downplayed concerns about the drug. “We don’t believe there’s a risk,” Hudson said on Tuesday. “But we have to - and are appropriately duty bound to - satisfy the regulators, which we will do, and we’ll move on from there.” Other drugmakers including GlaxoSmithKline and Novartis have recalled or halted distribution of their versions of the drug. Retailers and pharmacy chains including Walmart Inc CVS Health Corp, Walgreens Boots Alliance Inc and Rite Aid Corp have suspended the sale of drugs containing ranitidine. The FDA has said it does not have enough scientific evidence yet to determine how long NDMA has been present in ranitidine. But Valisure - the online pharmacy that flagged the issue to regulators - believes the problem is inherent to the drug itself and NDMA may have been present as long as its been on the market. Ranitidine is the latest drug in which cancer-causing impurities have been found. Regulators have been recalling some blood pressure and heart failure medicines since last year.
10930	Study: Proton treatment for prostate cancer results in few complications	This story provides a very unbalanced look at one highly-promoted treatment option for men with prostate cancer. It reported on a talk given at a meeting (meaning that the information has not undergone rigorous peer review). Journalists need to understand that talks at scientific meetings may not be ready for prime time – especially not without any independent expert analysis. The story fell short on evaluating the evidence, on quantifying harms, and on giving context and comparisons with other approaches. it was troubling to see large chunks of the story that seemed to come directly from a university news release. It’s equally disturbing that the Los Angeles Times picked up this Florida story and re-posted on their website as is. So did many TV station websites. Men with a diagnosis of prostate cancer need to understand how various treatment options compare in men like themselves in order to make a decision that is right for them. There have been many new technologies in recent years (robots, cyberknife, proton beam) that are being aggressively marketed to patients with early-stage cancer despite limited evidence for their benefits and harms.	false	Cancer	Adequate job. The story explained: “proton therapy is expensive for hospitals and for patients. It typically costs $100 million to build a proton treatment center and treatment may be $20,000 more expensive than conventional radiation treatments. That’s why the medical community is still debating whether the expense is worth it.” The story did not include information about the percentage of men who appeared to be free of prostate cancer after treatment. Instead, the focus of the story was more on the percentage of men who did not experience the complications of complete incontinence or the majority of men who self-reported being sexually active after treatment. As noted in the “evidence” and “harms” criteria above, we just didn’t learn enough about the data. While mentioning the possible side effects of the chances of incontinence and impotence, the story didn’t give readers any sense of how often this happened. It also failed to provide readers with a critical piece of information – what percentage of men receiving this treatment went on to have metastatic prostate cancer. Since this is the outcome the treatment is aimed at preventing, it is the potential harm that is key to evaluating its benefit. The story briefly alludes to men in the trial taking androgen deprivation therapy (ADT). Presumarly some of the ADT was provided along with radiation for high-risk patients (standard recommendation), but patients who needed ADT after treatment would represent treatment failures. Because no information is provided on the number of patients receiving ADT or the indications, it is difficult to interpret results. Sexually active does not necessarily mean having erections sufficient for intercourse–a standard metric–so this result is also difficult to interpret. Another issue is that the low-risk patients (definition not provided, number of patients not provided) might not have needed any treatment–active surveillance might have been appropriate for this group so that their “harm” could be overtreatment. Finally, 18 months may not be sufficient time to determine treatment complications–particularly sexual dysfunction–which may not appear for at least several years after radiation. These are not merely academic concerns. They are issues a story should take into account before publishing a headline as a statement of fact: “Proton treatment results in few complications.” The story reported on results of a study presented at a meeting without mentioning the nature of the study. A major problem with the study is the lack of a comparison group making it difficult to interpret the validity of the findings. Another problem is that the article (or perhaps investigators) did not report the proportion of men who were actually followed for 18 months. If the proportion was substantially less than 100% the results could be biased. Having poor outcomes is often a reason that subjects do not return for follow up. Dropping back to the big picture, any story based on a talk at a scientific meeting, as this was one was, should include some discussion of the limitations of drawing conclusions from the talk. The work hasn’t undergone the same rigorous peer review as a paper submitted to a medical journal. In their paper, “Media Coverage of Scientific Meetings: Too Much, Too Soon?” — Woloshin & Schwartz recommend the following language for journalists who choose to write about preliminary unpublished research presented at meetings: There were no such caveats in this story. As you can see, it would only take about 25 more words to address this concern. The story avoided disease mongering. No independent source was quoted in the story. The story failed to provide information about how men similar to those in this proton beam case series fared when following a course of active surveillance or surgery or conventional radiation therapy to treat prostate cancer. While addressing the cost to hospitals for setting up the machinery to deliver ‘proton therapy’, the story did not discuss the current, rather limited number of facilities (about a dozen in place or in development in the US) that are equipped to provide this form of radiation. So, while we acknowledge this is an Orlando paper reporting on a Gainesville center’s study, we still think it’s important for readers to know how limited is the availability of this approach – no matter where you live. The story accurately portrayed the novelty of this treatment. Entire phrases and sections of the story are almost identical to those in a University of Florida news release. Examples: Story said: Although erectile dysfunction after treatment can occur, complete impotence was rare and few were dissatisfied with their treatment choice. The results were reported by Dr. Bradford Hoppe, a radiation oncologist at the UF Proton Therapy Institute, during the 52nd Annual Meeting of the American Society for Radiation Oncology. News release said: Although erectile dysfunction after treatment can occur, complete impotence was rare and few were dissatisfied with their treatment choice. The results were reported by UF Proton Therapy Institute radiation oncologist Bradford S. Hoppe, M.D., during the 52nd Annual Meeting of the American Society for Radiation Oncology. Story said: News release said:
27712	A young woman named Elisa Lam disappeared under mysterious circumstances in Los Angeles, her body later found in a hotel's water tank.	A young woman named Elisa Lam disappeared under mysterious circumstances in Los Angeles in 2013, her body later found in a hotel's rooftop water tank.	true	Horrors, elisa lam, freakish fatalities	On 31 January 2013, Canadian student Elisa Lam was last seen alive by an employee of the Hotel Cecil in Los Angeles. Lam disappeared on that day, and she remained missing for several weeks after she failed to check out of the property as scheduled in February 2013. On 6 February 2013, the Los Angeles Police Department (LAPD) released information about the disappearance of Elisa Lam in the hopes of finding her alive, and on the following day held a press conference on the case that was covered in local and national news. On 14 February 2013, surveillance video from the Hotel Cecil in Los Angeles was released by police; in those lengthy clips, Lam was seen lingering in an elevator and behaving in an unusual fashion. Many viewers of the unsettling clips inferred Lam was interacting with an unknown person or persons off camera, while others suspected the young woman was experiencing an episode of acute mental illness or was under the influence of drugs Five days after the release of the videos, the hotel began to investigate guest complaints of low water pressure and an odd taste in the water supply, and maintenance workers located a body, later identified as that of Elisa Lam, in one of four large water tanks on the roof of the Hotel Cecil. The next day, public health officials issued a “do not drink” advisory to hotel guests pending testing of the water to determine whether it was safe to use. In June 2013, Lt. Fred Corral of the Los Angeles County coroner’s office investigations division confirmed Elisa Lam’s cause of death was accidental, with bipolar disorder as a significant condition. The location of Lam’s body (inside a hard-to-access water tank) and her odd behavior were among mysteries not resolved when the forensic investigation was completed: Those test results were initially expected to take six to eight weeks to complete, but coroner’s spokesman Ed Winter said in response to queries that the office was still awaiting complete testing results. Corral said no other information on the cause of death or condition of the woman’s body was being released. Authorities including police and the coroner have not stated how they believe Lam got into the tank. Law enforcement officials had been careful to say that the death could be accidental, despite widespread public suspicions of foul play. In the time since Elisa Lam’s mysterious death, the enduring questions she left behind have been the source of speculation. Adding to the uneasiness many have about Lam’s demise is the checkered history of the Hotel Cecil, where a woman leapt to her death from the roof in the 1960s and serial killer Richard Ramirez (the “Night Stalker”) lived for a time in the mid-1980s. One of the aspects of the Elisa Lam’s disappearance and death that has fed continuing interest in the case is its trajectory and unresolved aspects. Given that Lam was initially one of a number of missing students at the time, her disappearance didn’t draw much attention until the release of surveillance video by the LAPD in February 2013. Even then, it wasn’t until the unusual circumstances of her death by drowning were revealed that media interest in Lam’s case surged. Contrary to later retellings, Lam’s death made headlines both locally and internationally. Another matter of interest to the public was that even police were stumped as to how Lam’s body came to end up in a water tank that is difficult to access. Foul play was initially investigated as a possibility, but the coroner’s office ruled Lam’s death to be an accidental one: The mysterious death of the young woman whose body was found in a water tank on the roof of a cheap downtown hotel has been ruled accidental. The Los Angeles County coroner’s office issued the ruling in the case of Elisa Lam, Lt. Fred Corral of the coroner’s investigations division said. The cause of death was listed as accidental due to drowning, with bipolar disorder listed as a significant condition, he said.
33277	A gun-toting Australian granny blew the testicles off the two men who raped her granddaughter.	It’s no accident that this work of fiction features two adult male rapists (which one immediately pictures as strong, overpowering creeps), a teenage girl victim, and a frail little old lady of 81 years (a retired library worker, at that). The contrast makes for a more thrilling tale, and the cheers over David’s toppling Goliath become louder and more enthusiastic.	false	Crime, Vigilante Justice, weekly world news	MELBOURNE, Australia Gun-toting granny Ava Estelle, 81, was so ticked-off when two thugs raped her 18-year-old granddaughter that she tracked the unsuspecting ex-cons down — and shot their testicles off! “The old lady spent a week hunting those bums down — and when she found them, she took revenge on them in her own special way,” said admiring Melbourne police investigator Evan Delp. “Then she took a taxi to the nearest police station, laid the gun on the sergeant’s desk and told him as calm as could be: ‘Those bastards will never rape anybody again, by God. '” Cops say convicted rapist and robber Davis Furth, 33, lost both his penis and his testicles when outraged Ava opened fire with a 9-mm pistol in the seedy hotel room where he and former prison cellmate Stanley Thomas, 29, were holed up. The wrinkled avenger also blew Thomas’ testicles to kingdom come, but doctors managed to save his mangled penis, police said. “The one guy, Thomas, didn’t lose his manhood, but the doctor I talked to said he won’t be using it the way he used to,” Detective Delp told reporters. “Both men are still in pretty bad shape, but I think they’re just happy to be alive after what they’ve been through.” The Rambo Granny swung into action August 21 after her granddaughter Debbie was carjacked and raped by two knife-wielding creeps in a section of town bordering on skid row. “When I saw the look on my Debbie’s face that night in the hospital, I decided I was going to go out and get those bastards myself ’cause I figured the police would go easy on them,” recalled the retired library worker. “And I wasn’t scared of them, either — because I’ve got me a gun and I’ve been shootin’ it all my life.” So, using a police artist’s sketch of the suspects and Debbie’s description of the sickos’ car, tough-as-nails Ava spent seven days prowling the wino-infested neighborhood where the crime took place till she spotted the ill-fated rapists entering their flophouse hotel. “I knew it was them the minute I saw ’em, but I shot a picture of ’em anyway and took it back to Debbie and she said sure as hell, it was them,” the ornery oldster recalled. “So I went back to that hotel and found their room and knocked on the door — and the minute the big one, Furth, opened the door, I shot ’em, got right square between the legs, right where it would really hurt ’em most, you know. Then I went down to the police station and turned myself in.” Now, baffled lawmen are tying to figure out how to deal with the vigilante granny. “What she did was wrong, but you can’t really throw an 81-year-old woman in prison.” Det. Delp said, “especially when all 3 million people in the city want to nominate her for sainthood.” The supposed news story reproduced above about a “Rambo Granny” taking the law into her own hands is a fanciful tale of imagined revenge and nothing more. It originated as a 20 October 1998 article published in the Weekly World News, an entertainment tabloid (now a web site) whose stock in trade is the fantastically fictional. Grambo exists only in our hearts and inboxes. Although some may cherish her story anyway, it’s an unlikely tale of vigilante justice in which a police spokesman is characterized as “admiring” of someone who stalked and shot two people. As righteous as the fictional Grambo’s cause might have been, the moment a crime victim or one of her sympathizers takes matters into her own hands, that person becomes a criminal engaged in illegal activity. Police would not be “baffled” about what to do with such a person: they’d arrest her and let the legal system sort out what charges to lay against her and how to punish her. Okay, so we can’t believe the story. Many of us still want to, though. Fake or real, Grambo is perceived as a hero. In a world populated by bad guys seemingly always getting away with one horrible act after another, we need to believe that at least someone somewhere stood up to the wrongs, took matters into her own hands, and dealt out some much-needed justice, even if it was of the street variety. Popular culture is filled with instances of the wronged being denied protection by the authorities and having to right the world on their own because that theme plays into both what we hold as true deep in our hearts (criminals escape justice through legal loopholes) and what we wish for (justice being meted out to these miscreants anyway).
4156	Study: Stopping global warming only way to save coral reefs.	Reducing pollution and curbing overfishing won’t prevent the severe bleaching that is killing coral at catastrophic rates, according to a study of Australia’s Great Barrier Reef. In the end, researchers say, the only way to save the world’s coral from heat-induced bleaching is with a war on global warming.	true	Climate, AP Top News, Climate change, Australia, Science, Corals, Asia Pacific, Coral reefs, Overfishing, Pollution	Scientists are quick to note that local protection of reefs can help damaged coral recover from the stress of rising ocean temperatures. But the new research shows that such efforts are ultimately futile when it comes to stopping bleaching in the first place. “We don’t have any tools to climate-proof corals,” said Terry Hughes, director of the ARC Center of Excellence for Coral Reef Studies in Australia and lead author of the study being published on Thursday in the journal Nature. “That’s a bit sobering. We can’t stop bleaching locally. We actually have to do something about climate change.” Across the world, scores of brilliantly colored coral reefs once teeming with life have in recent years become desolate, white graveyards. Their deaths due to coral bleaching have grown more frequent as ocean temperatures rise, mainly due to increasing greenhouse gases in the atmosphere. The hot water stresses corals, forcing them to expel the colorful algae living inside them, which leaves the corals vulnerable to disease and death. Given enough time, bleached coral can recover if the water cools, but if the temperature stays too high for too long, the coral will die. Preserving coral reefs is crucial, given that human depend on them for everything from food to medical research to protection from damaging coastal storms. Scientists and policymakers have thus been scrambling to find ways to prevent bleaching. Last year, for example, Hawaiian officials proposed several measures they hoped would fight bleaching on the state’s reefs, such as limiting fishing, establishing new marine protected areas and controlling polluted runoff from land. The question was whether such efforts could provide the corals any resistance to bleaching, or just help them recover. The researchers conducted aerial and underwater surveys of the Great Barrier Reef, which has experienced three major bleaching events, the worst of which occurred last year. The scientists found that the severity of bleaching was tightly linked to how warm the water was. In the north, which experienced the hottest temperatures, hundreds of individual reefs suffered severe bleaching in 2016, regardless of whether the water quality was good or bad, or whether fishing had been banned. That means even the most pristine parts of the reef are just as prone to heat stress as those that are less protected. Prior exposure to bleaching also did not appear to provide any protective benefit to the coral. The scientists found that the reefs that were highly bleached during the first two events, in 1998 and 2002, did not experience less severe bleaching last year. Ultimately, the study concluded, saving reefs from the ravages of bleaching requires urgent action to reduce global warming. “I think it’s a wake-up call,” Hughes said. “We’ve been hoping that local interventions with water quality and fishing would improve the resistance of the corals to bleaching. We found no evidence that that’s actually true, at least during a very severe event.” The study shows that older ways of thinking about reef management, such as reducing river runoff, are now moot points when it comes to preventing bleaching, said Kim Cobb, a climate scientist and coral researcher at the Georgia Institute of Technology in Atlanta. “It all seems so quaint now, really,” said Cobb, who wasn’t part of the study. “A future that we thought was decades coming is basically here.” The research also illustrated the gravity of the situation facing the 2,300-kilometer (1,400-mile) Great Barrier Reef. The team found 91 percent of the reef has been bleached at least once during the three bleaching events. Even more alarming, Hughes said, is that a fourth bleaching event is already underway. Corals need years to recover from bleaching, so back-to-back events increase the possibility that the bleached coral will die. The study shows that very intense coral bleaching events are no longer isolated and are happening more regularly, said coral reef scientist Julia Baum of Canada’s University of Victoria. That assertion has been further bolstered by the Great Barrier Reef’s latest bleaching event, which began a few weeks ago and which Baum says has stunned scientists. “None of us were expecting the water to be heating up again right now,” Baum said. “I think it’s beyond what any of us could have imagined. It’s our worst nightmare.”
7917	Healthcare group Novacyt wins U.S. approval for coronavirus test.	Novacyt, a healthcare company specializing in clinical diagnostics, announced on Monday approval from the U.S. Food & Drug Administration (FDA) regulator for its product aimed at testing for coronavirus.	true	Health News	Novacyt said the FDA’s approval meant that hospitals and laboratories in the United States would be able to use the test for clinical diagnosis of the coronavirus, and that the test was now available for immediate distribution in the U.S. market. “The U.S. FDA EUA authorization is another important endorsement of the performance and quality of our COVID-19 test and demonstrates once again Novacyt’s growing role in tackling this pandemic,” said Novacyt CEO Graham Mullis.
32381	"List of double entrendres collects ""the top nine comments made by NBC sports commentators during the Summer Olympics."	"Dubious list of old jokes and double entrendres purportedly collects ""the top nine comments made by NBC sports commentators during the Summer Olympics."""	false	Humor, ASP Article, Laughable Lists, olympics	This mirth-provoking list of “the top nine comments made by NBC sports commentators during the Summer Olympics,” a collection of facepalm statements and double entrendres, is dusted off every four years and recirculated online to much social amusement. Although we can’t guarantee that no sports commentator anywhere ever said any of these things, the age of this list and its inclusion of hoary urban legends (such as the “kiss his balls” tale) and items attributed to a variety of different sports figures over the years puts paid to the notion that all the entries issued from the mouths of NBC Olympics commentators. Similar lists with somewhat differently worded entries attributed to other people (and featuring some non-Olympic sports) have been making the rounds since at least as far back as 1999, such as the following example from in Australia circulated during the run-up to the 2000 Olympics in Sydney: “We actually got the winner three minutes from the end but then they equalised.” (Ian McNail — Football) “This is really a lovely horse; I once rode her mother.” (Ted Walsh — Horse Racing Commentator) “We now have exactly the same situation as we had at the start of the race, only exactly the opposite.” (Murray Walker — F1 Motor racing Commentator) On the difficulties of adjusting to playing football and living in Italy: “It was like being in a foreign country.” (Ian Rush — Footballer) “Bill Frindal has done a bit of mental arithmetic with a calculator.” (John Arlott — Cricket Commentator) “I’ve never had major knee surgery on any other part of my body.” (Winston Bennett — Footballer) “The lead car is absolutely unique, except for the one behind it which is identical.” (Murray Walker — F1 Motor racing Commentator) “I owe a lot to my parents, especially my mother and father.” (Greg Norman — Golfer) “Sure there have been injuries and deaths in boxing — but none of them serious.” (Alan Minter – Boxer) “The racecourse is as level as a billiard ball.” (John Francombe — Jockey) “If history repeats itself, I should think we can expect the same thing again.” (Terry Venables — Football Coach) “We’ll still be happy if we lose. It’s on at the same time as the Beer Festival.” (Noel O’Mahoney, Cork City boss before the game in Munich) “I would not say he (David Ginola) is the best left winger in the Premiership, but there are none better.” (Ron Atkinson — Footballer) “He dribbles a lot and the opposition don’t like it — you can see it all over their faces.” (Ron Atkinson — Footballer) “I never comment on referees and I’m not going to break the habit of a lifetime for that prat.” (Ron Atkinson — Football Coach) On Tony Adamson’s alcoholism: “It took a lot of bottle for Tony to own up.” (Ian Wright — Footballer) “Julian Dicks is everywhere. It’s like they’ve got 11 Dicks on the field.” (Metro Radio) ” … and later we’ll have action from the men’s cockless pairs.” (Sue Barker — Commentating on Rowing) “Her time is about 4.33, which she’s capable of.” (David Coleman — Athletics) Grand National winning jockey Mark Fitzgerald: “Sex is an anti-climax after that.” Desmond Lynam: “Well, you gave the horse a wonderful ride, everybody saw that.” “To play Holland, you have to play the Dutch.” (Ruud Gullit — Football Coach) “Well, either side could win, or it could be a draw.” (Ron Atkinson — Football Coach) “For those of you watching in black and white, Spurs are in the all-yellow strip.” (John Motson — Football Commentator) “Strangely, in slow motion replay, the ball seemed to hang in the air for even longer.” (David Acfield) “I’d like to play for an Italian club, like Barcelona.” (Mark Draper — Aston Villa) “There goes Juan Torera down the back straight, opening his legs and showing his class.” (David Coleman at the Montreal Olympics) “One of the reasons Arnie (Arnold Palmer) is playing so well is that, before each tee-shot, his wife takes out his balls and kisses them — Oh my God, what have I just said?” (US TV commentator) > “And for those of you who watched the last programme (Fanny and Johnny Craddock), I hope all your doughnuts turn out like Fanny’s.” (David Coleman at the start of Match of the Day) “Just under 10 seconds for Nigel Mansell. Call it 9.5 seconds in round numbers.” (Murray Walker) “I’ve never had major knee surgery on any other part of my body.” (Winston Bennett) “I can see the carrot at the end of the tunnel.” (Stuart Pearce) “The Port Elizabeth ground is more of a circle than an oval. It’s long and square.” (Trevor Bailey) “Watch the time — it gives you an indication of how fast they are running.” (Ron Pickering) “That’s inches away from being millimetre perfect.” (Ted Lowe) “I’ll fight Lloyd Honeyghan for nothing if the price is right.” (Marion Starling) “I can’t tell who’s leading. It’s either Oxford or Cambridge.” (John Snagge, covering The Boat Race) “Lara’s chanced his arm, and it’s come off.” (Brian Johnston) “Fred Davis, the doyen of snooker, now 67 years of age and too old to get his leg over, prefers to use his left hand.” (‘Whispering’ Ted Lowe) “A brain scan revealed Andrew Caddick is not suffering from a stress fracture of the shin.” (Jo Sheldon) “Bobby Gould thinks I’m trying to stab him in the back. In fact, I’m right behind him.” (Stuart Pearson) “There’s going to be a real ding dong when the bell goes.” (David Coleman) “We didn’t underestimate them. They were just a lot better than we thought.” (Bobby Robson, after playing Cameroon in the 1990 World Cup finals) “I was in a no-win situation, so I’m glad I won rather than lost.” (Frank Bruno)
8841	Actos arrests heart disease in diabetics: study.	The popular diabetes pill Actos prevented the build-up of fatty deposits in heart arteries in a study of patients with type 2 diabetes, U.S. researchers said on Monday.	true	Health News	They said the Takeda Pharmaceutical Co Ltddrug Actos, known generically as pioglitazone, is the first diabetes therapy shown to reduce the progression of atherosclerosis. “The results are very striking. In my view, this is really a breakthrough study,” Dr. Steven Nissen of the Cleveland Clinic, who led the study, said in an interview. “No one has ever shown any diabetes therapy could slow the progression of disease. Keep in mind the leading cause of death for diabetics is cardiovascular disease,” said Nissen, whose findings were published online in the Journal of the American Medical Association and presented at a meeting of the American College of Cardiology in Chicago. Diabetics are especially prone to atherosclerosis, which involves the build-up of fat, calcium and other deposits in the arteries. The study, known as PERISCOPE, compared two types of medications to treat type 2 diabetes — Actos and glimepiride, an older sulfonylurea drug that is among the most commonly used classes of diabetes therapies. Actos is in a class of drugs known as thiazolidinediones, a relatively new group of antidiabetic agents that are known to raise the risk of heart failure and bone fractures. In the current study, Nissen and colleagues compared the two drugs to see how well they reduced progression of atherosclerosis in 543 patients with type 2 diabetes and coronary disease. The trial took place from 2003-2006 in 97 hospitals in North and South America. The team used intravascular ultrasound to measure fatty deposits inside the arteries. Patients took glimepiride or pioglitazone for 18 months and their arteries were measured again for plaque build-up. While plaque increased 0.73 percent in the glimepiride group, it fell 0.16 percent in the pioglitazone group. The researchers also looked at maximum plaque thickness and saw it increased in the glimepiride group and decreased in the pioglitazone group. “Evidence for a slowing of disease progression has proven a very challenging end point in recent years with the prominent failure of several promising approaches,” Nissen and colleagues wrote in JAMA. Nissen said a single study is not enough to change medical practice, but it does signal the need for more research on how different diabetes drugs stack up. Dr. Salim Yusuf of McMaster University in Ontario, Canada, however, noted that patients in the study who took Actos did have a significant number of fractures. “We need proper studies in diabetes. This suggests there may be differences in drugs. We need to test that,” Yusuf told reporters.
21094	"The United States' regulations ""are among the most difficult in the world."	"Scott said ""our regulations are among the most difficult in the world."" As his evidence, he cites companies moving their oil rigs from the Gulf Coast overseas and a medical device manufacturer cutting more than 1,000 jobs ""because of new Obamacare taxes."" Even if some companies move overseas or cut jobs and attribute those actions to overregulation, that doesn't mean that regulations in the U.S. are among the most difficult in the world. The reports we found ranked the U.S. between 4th and 10th for business climate. Scott, along with other political or business leaders, certainly can point to concerns about the number, cost or impact of regulations. But Scott hasn't proven that our country's regulations are among the most difficult in the world. In fact, the evidence we found points in the opposite direction."	false	Environment, Economy, Health Care, Regulation, Florida, Rick Scott,	"Republican Gov. Rick Scott repeated a familiar politician's mantra when he bashed ""overregulation."" In a Nov. 14, 2011, press release, Scott criticized President Barack Obama for accusing America of being ""lazy"" in attracting investment: ""Obstacles to job creation in America are a result of policy, not of motivation,"" Scott said. ""Our business taxes are among the highest in the world. Our regulations are among the most difficult in the world. If you need evidence, look no further than the companies who have moved their oil rigs from the Gulf coast to foreign countries in the last year because of the regulatory environment. Just last week, yet another major medical device manufacturer announced they were cutting more than 1,000 jobs because of new Obamacare taxes. ""The president's comments indicate a belief that more taxes, more regulation and more government is the solution, yet those are the very things standing in the way of those of us who are trying – very energetically – to recruit businesses and jobs to our states."" Scott made a few strongly-worded claims in that statement, but for this Truth-O-Meter we will explore whether ""our regulations are among the most difficult in the world."" Scott has portrayed himself as a slayer of regulations. He promised to freeze all regulations in Florida during his 2010 campaign. We went in search of data about the U.S. and overregulation. We found several measures that contradicted Scott's statement: • The World Bank publishes an annual ""Doing Business"" ranking that examines the business climate in 183 countries. In its most recent report, released in October 2011, it gave the U.S. an overall ranking of fourth, behind Singapore, Hong Kong and New Zealand. The U.S. scored particularly high compared to other countries in getting credit (4), protecting investors (5) and starting a business (13). • The conservative Heritage Foundation, together with the Wall Street Journal, publishes an annual ""Index of Economic Freedom,"" which in 2011 placed the U.S. 9th out of 179 countries with a score of 77.8 out of 100. This index looks at several factors including government spending, property rights and business freedom. On business freedom -- on which the U.S. scored 91 -- Heritage wrote, ""The overall freedom to create and run a private enterprise, regulated primarily at the state level, is strongly protected. However, new regulatory uncertainty hampers business expansion and employment creation."" Heritage's index relies heavily on the World Bank's report. • The libertarian Cato Institute publishes an ""Economic Freedom of the World"" report that stated that ranked the U.S. 10th among 141 countries in 2009. ""The world's largest economy, the United States, has suffered one of the largest declines in economic freedom over the last 10 years, pushing it into tenth place. Much of this decline is a result of higher government spending and borrowing and lower scores for the legal structure and property rights components,"" the report said. The report shows that ""the U.S. is still more free by comparison to much of the world,"" said Ian Vásquez, director of the Cato Institute's Center for Global Liberty and Prosperity, in an e-mail to PolitiFact. ""But that measure only captures regulations that can be compared across countries and misses a lot. There is no good global index on this issue. Bottom line, the statement is probably true about some regulations, but not overall in the world."" What experts told us We sent Scott's claim -- and the examples he cited about oil rigs moving overseas and job cuts at a medical manufacturer -- to several experts. (Scott's press release didn't identify the medical manufacturer.) None of them fully defended Scott's statement that the United States' regulations are among the most difficult in the world. Several referred us to the World Bank report we mentioned above, while others warned that comparing regulations among countries can be difficult. The U.S.'s ranking ""is a far cry from 'most difficult,"" wrote Lawrence J. White of New York University in an e-mail, pointing to the World Bank ratings. James Gattuso of the Heritage Foundation said that the trends in the World Bank report are mixed for the U.S. and pointed to an Oct. 28 Wall Street Journal report (subscription required to view full article) that said that although the U.S. is ranked fourth, it has dropped in some categories in recent years including on paying taxes and ease of registering property. And the cost of starting a business measured as a percentage of per capita income as well as the cost to import have increased. Paul Portney, an economics professor at the University of Arizona, was chief economist for the White House Council on Environmental Quality in 1979-80 under President Jimmy Carter. He sent us an answer as it pertains to environmental regulations, which is relevant here because half of Scott's evidence cited in his press release related to oil rigs moving from the Gulf to foreign countries due to regulation. ""The U.S., like many of the world's developed countries, does have stringent environmental regulations. Ours are in general about as stringent as those in Europe and Japan, though I'd say that Europe's are now tougher than ours. In some respects, though, we go beyond what other countries do (an example is the regulation of auto emissions, though that is more the doing of the State of California than federal standards). Compared to China, India, Russia and Brazil--the rapidly developing countries of the world--our standards are much tougher, and that has no doubt played some role in the relocation of industry to those places. However, you have to remember that there are benefits that accompany the higher costs of regulation in the U.S. My guess is that few Floridians would be willing to tolerate Beijing, Mumbai, Moscow or Rio de Janeiro air quality, to take but one example. ... I'd say that there are other, more important factors that affect business location than regulatory burdens, even while acknowledging that we can and must streamline our regulatory process."" Gov. Scott responds Scott spokesman Brian Burgess e-mailed us a response. ""I hope you aren’t missing the forest for the trees…but the phrase you have chosen to zero in on is rather vague, not really quantifiable, and simply refers to the difficult long-term outlook that American job creators are facing."" Burgess directed us to the Florida chamber's small business survey which stated ""The top issues facing Florida’s small businesses continue to include government regulations, access to capital, healthcare, taxes."" Burgess also stated in an e-mail that federal regulations have been on the rise in recent years and that thousands more are in the works -- but that wasn't what Scott said. As for the World Bank study, Burgess wrote that the World Bank study notes that it is limited in scope and quoted from the preface: ""It does not attempt to measure all costs and beneﬁts of a particular law or regulation to society as a whole. Nor does it measure all aspects of the business environment that matter to ﬁrms and investors or affect the competitiveness of an economy."" Burgess concluded: ""In short, the governor’s comment is based on his own experience in international business, his conversations with other business owners, entrepreneurs and other job creators in Florida and throughout the world, and the hard data that shows that the U.S. regulatory environment has grown progressively worse in recent years and is projected to continue down that path – an outlook that makes the United States regulatory environment among the most difficult in the world. The statement was worded carefully because the subject matter is difficult to quantify. Even World Bank admits as much."" Our ruling Scott said ""our regulations are among the most difficult in the world."" As his evidence, he cites companies moving their oil rigs from the Gulf Coast overseas and a medical device manufacturer cutting more than 1,000 jobs ""because of new Obamacare taxes."" Even if some companies move overseas or cut jobs and attribute those actions to overregulation, that doesn't mean that regulations in the U.S. are among the most difficult in the world. The reports we found ranked the U.S. between 4th and 10th for business climate. Scott, along with other political or business leaders, certainly can point to concerns about the number, cost or impact of regulations. But Scott hasn't proven that our country's regulations are among the most difficult in the world. In fact, the evidence we found points in the opposite direction."
7828	"Psychiatrists unveil their long-awaited diagnostic ""bible""."	The long-awaited, controversial new edition of the bible of psychiatry can be characterized by many numbers: its 947 pages, its $199 price tag, its more than 300 maladies (from “dependent personality disorder” and “voyeuristic disorder” to “delayed ejaculation,” “kleptomania” and “intermittent explosive disorder”), each limning the potential woes of being human.	true	Health News	But to the psychiatrist who shepherded the tortuous creation of the “Diagnostic and Statistical Manual of Mental Disorders,” perhaps the single most important number is the “5” in its title: This is the DSM-5, not the DSM-V. That may seem like a cosmetic change, but the American Psychiatric Association, which will release the book on Saturday at its annual meeting, decided to use Arabic instead of Roman numerals because “we want it to be a living document,” said Dr David Kupfer of the University of Pittsburgh, the chairman of the task force that produced the DSM-5. Rather than waiting another generation to revise the manual - the DSM-IV was published in 1994 - psychiatrists will regularly update it with, for example, findings from genetics and neuroscience, labeling the revisions DSM-5.1 and DSM-5.2 and so on. “We used ‘5’ because V.0 and V.1 just don’t look good,” said Kupfer. The fact that the world’s most powerful psychiatrists (their decisions determine what counts as a mental disorder, and thus what insurers cover and which children receive special services in school) are already building in ways to change the manual is commendable, even its critics say. But it is also emblematic of the DSM-5’s failures, they argue, which include turning normal human behavior and feelings into mental illnesses, and expanding the criteria for disorders until an astonishing one in four U.S. adults has a diagnosable mental illness every year - and even more do over a lifetime. The latest revision began in 1999 with high hopes for putting mental illness on a scientific footing, using neuroscience in particular to tell the difference between, say, normal sadness and major depression. That reflected persistent criticism that “drawing a line between sickness and disease is a special problem in psychiatry,” said psychotherapist Gary Greenberg, who participated in the “field trials” that tested the DSM-5’s proposed diagnostic criteria before they made the final cut. “We don’t have blood tests or other objective criteria to distinguish mental sickness from health. So you have a set of criteria that are very common, which means the potential for many people being diagnosed as mentally ill when they’re not.” The 1,500 experts who contributed to the DSM-5 would have liked nothing better than to base diagnoses on genetics or neuroscience, rather than on subjective judgment and lists of mostly self-reported symptoms such as fear of acting “in a way that will be negatively evaluated” (social anxiety disorder) or approaching and interacting “with unfamiliar adults” (disinhibited social engagement disorder in children). “It would be great if we had been able to have a paradigmatic shift” by basing the diagnosis of mental illness on biology, as the APA hoped to when it began the DSM-5 process, said Dr Jeffrey Lieberman, chairman of psychiatry at Columbia University and president-elect of the APA. But the science did not arrive in time. “The DSM can only reflect the research we have,” said Lieberman.” With rare exceptions such as narcolepsy, which can be diagnosed by testing cerebrospinal fluid, there are no objective biological measures for mental illness. This lack of scientific rigor led the nation’s leading mental health official to attack the DSM-5 for a “lack of validity,” as Dr Thomas Insel, director of the National Institute of Mental Health, said in a blog post late last month. The manual bases diagnoses on symptoms, he noted, but “symptoms alone rarely indicate the best choice of treatment.” Allergies and flu share some symptoms, for instance, but no doctor would try to treat flu with an antihistamine. “Patients with mental disorders deserve better,” said Insel, who announced that “NIMH will be re-orienting its research away from DSM categories.” Pittsburgh’s Kupfer shrugged off this attack. “NIMH expressed that a couple of years ago,” he said. “It would be a mistake to reify the DSM for research purposes.” “Reification” has become a buzzword among the DSM’s critics. In this context, it means “taking a concept and turning it into a reality,” said Greenberg, whose new book, “The Book of Woe: The DSM and the Unmaking of Psychiatry” argues that the manual and the process behind it are hopelessly and dangerously flawed. “The categories are not reliable in a biological sense.” That can cause harm to people who are labeled “mentally ill” when all they have is a variation of normal human behavior, said Greenberg. “The sphere of normality has to have room for some distress, which is part of being human.” On a practical level, “once you have a diagnosis in your medical record you can have trouble getting insurance or a security clearance, and it changes how you think of yourself,” said Greenberg. BLACK-BOX WARNING Changes that make it easier to qualify as mentally ill - fewer symptoms, lasting for a shorter time - have drawn the most impassioned criticism of the DSM-5. Dr Allen Frances, the psychiatrist who led the development of the last DSM and who has emerged as the new one’s fiercest and most eminent critic, warns of a “hyperinflation” of diagnoses and calls for “a black-box warning” in the dozen or so most controversial changes, much like the black-box warning that regulators require on the labels of potentially dangerous drugs. The black box, he said in a 2012 essay, would indicate the risks of calling people who engage in binge eating, for instance, or who grieve a dead child mentally ill, and would serve as “an admission that the change is a hypothesis,” not a scientific fact. The new DSM does not include more disorders than its predecessor, said Lieberman, “and it shouldn’t increase the number of people who warrant a diagnosis of mental illness.” The changes it does make, however, could have far-reaching consequences. It classifies compulsive gambling as an addiction, the first behavior to be so categorized. That could make it easier for pathological gamblers to get help, said Jeff Beck of the New Jersey Council on Compulsive Gambling and a recovering gambling addict. The new manual also breaks out compulsive hoarding from obsessive-compulsive disorder and makes it a stand-alone disorder. That should tell clinicians that treatments that work in OCD are not the best way to treat hoarders, said psychologist Randy Frost of Smith College, who has developed a unique therapy for hoarding. One of the more controversial changes was to eliminate the previous DSM’s “bereavement exclusion” for depression. Now, if a father grieves for a murdered child for more than a couple of weeks, he is mentally ill. A footnote in the DSM-5 explains that “the inability to anticipate happiness or pleasure” in such a situation is a diagnostic criterion for the mental disorder of depression. To some, this smacks of pathologizing a normal, understandable human reaction. “This completely leaves the person out of the equation and turns people into patients,” said psychotherapist Eric Maisel, a critic of the DSM. “The DSM claims that an unwanted, distressing feeling is a sign of a disorder rather than being just a feeling, and it isn’t at all interested in whether your circumstances could have caused those feelings.” It is important to consider circumstances, he said, because if someone experiences deep anxiety as a result of losing her job, becoming ill or facing foreclosure, “the remedy shouldn’t be a pill,” the usual outcome of a diagnosis of “generalized anxiety disorder.” The DSM-5 will likely reduce diagnoses of autism spectrum disorders (ASD). It eliminated Asperger’s syndrome and tightened the ASD criteria. While no one wants to see children incorrectly labeled, said Katie Weisman of the patient advocacy group Safe Minds, “children who were borderline cases under the previous DSM now won’t get a diagnosis, which means they won’t be eligible” for early, intensive behavior therapy - or won’t have it paid for by insurance. A mother of triplets on the autism spectrum, Weisman says “I’m not sure my boys would be where they are today” - in regular school classrooms, not special education - “without these services.” Whether the critics’ fears come true will become clear only once psychiatrists, psychologists and even primary-care providers - who write the majority of prescriptions for drugs to treat mental illness - begin using the new DSM. “We’re trying to establish accurate and reliable guidelines, and you can’t completely control how they’re applied,” said Columbia’s Lieberman. “The problem is not with the instrument but with the way it’s used.”
10991	Promise Seen for Detection of Alzheimerâ€™s	"This is a story that celebrates the ""eureka moment,"" so much so that it includes three eureka moments. The problem with eureka moments and with stories like this is that they don’t reflect the true nature of scientific discovery. Yes, scientists get excited about breakthroughs, as they should, but those breakthroughs are often quite a distance away from actual application in a clinical setting. This story spends too much time drum rolling for a presentation at meeting in Hawaii that is weeks away and not enough time explaining why this particular pathway for Alzheimer’s detection is worth pursuing over the many other lines of inquiry that are alluded to in the story. People who have family members with Alzheimer’s or who are suffering from early signs of dementia want desperately to feel that there is hope for them to change course. Right now, there is no such hope. It’s important for journalists to explain, as this reporter does, the history of detection and treatment of brain diseases, but that solid explanatory and even investigative reporting should not be overshadowed by the thrill of the eureka moment. Malcolm Gladwell did a much better job in his recent piece about cancer drugs. He used the Eureka moments to show how even the most celebrated scientific victories can be swept away by the rigors of scientific scrutiny. Proving that detection regimens or therapies work is tricky business, and we have to drive this home for readers."	mixture		"There is one glancing reference to cost. ""The type of scans used in this study, PET scans, are expensive and patients have to go to a scanning center, get injected with a radioactive dye, wait for the dye to reach their brain and then have a scan."" How expensive? (The average cost of a PET scan is $3-6,000.) And, if this scan is truly the revolution that this story is making people believe it is, every person in America will want to have this scan done when they turn 50, maybe younger. What would that do to health care costs? This story is ALL about the potential benefits. It says, ""Brain scans that showed plaque could help with some fundamental questions — who has or is getting Alzheimer’s, whether the disease ever stops or slows down on its own and even whether plaque is the main culprit causing brain cell death."" But it makes no attempt to quantify. No. There is nothing in this story about what it would mean, for example, if everyone over a certain age started having their brains injected with radioactive dye on a regular basis. Everyone has a lifetime radioactive load limit, for one. What else might the dye do to people who have other chronic conditions or are taking medications? The second sentence gives savvy readers the proper context, ""The findings, which will be presented at an international meeting of the Alzheimer’s Association in Honolulu on July 11, must still be confirmed and approved by the Food and Drug Administration."" But most readers won’t realize what a small step this actually is on the way to a true clinical application. Instead, the rest of the story might as well be fireworks going off. We have to wait until the very end of the story before we see any actual numbers. What are those numbers? The results of SIX patients, and those results are poorly explained. Here’s what we were able to gather. Of the six, one person was incorrectly diagnosed with Alzheimer’s. One was misdiagnosed with Parkinson’s. One had been properly diagnosed with memory loss. The remaining three had been correctly diagnosed. So, in effect, two out of six people may have benefited from this scan. There is no further context, however, to help us understand whether this is an improvement over previous studies, over competing scanning methods in other trials or over the range of physical and mental exercises that physicians use today to decide whether a person has Alzheimer’s. Might a doctor have examined these patients without a scan and correctly diagnosed all six? It’s possible. We were told earlier that 20% of patients are misdiagnosed. This study seems to show that number may be higher, but can we really say anything based on six patients? The eureka moment that is trumpeted in the lead — the email results that are sent to the lead scientist — turns out to be a set of results based on 35 patients. We are told nothing about the study design other than that it was controversial and that it involved hospice patients, some of whom were grateful to be included. After all that buildup, these are the last two sentences, ""The Avid study was complete, and the full data will be presented at the meeting next month. Other companies, still doing their studies, did not yet have data to examine."" Some of the best parts of the story have to do with the confusion and lack of hard data about Alzheimer’s. This quote is typical: ""Even at the best medical centers, doctors often are wrong. Twenty percent of people with dementia — a loss of memory and intellectual functions — who received a diagnosis of Alzheimer’s, did not have it."" More stories should try to explain how hard it is to diagnose some of these disorders. There are outside sources, but they aren’t used to good effect. The comment from ""Dr. Michael Weiner of the University of California, San Francisco, who is not part of the company’s study and directs a federal project to study ways of diagnosing Alzheimer’s"" is couched in such a way that it makes us think he could be commenting on any breakthrough that would lead to sharper detection of Alzheimer’s, not necessarily this study. Did he actually review the study results? Has he seen the results of similar studies? Does this work perhaps advance his work in some way? None of that is clear. Dr. Mathis is really only used to create another eureka moment. A good question for both Weiner and Mathis would have been, ""What is it exactly about this scan that makes you think it rises above all the other detection methods being studied? And how many years away from a clinical application are we in the best and worst case scenarios? Ten to 20 years? 20 to 30 years? Not in our lifetime?"" Nonetheless, we’ll give the story the benefit of the doubt on at least approaching independent sources. As mentioned above, there should have been some attempt here to explain why this scan would be better than a doctor talking with her patient. Nonetheless it does mention the existing diagnostic approaches along with the difficulties in making the diagnosis, so we’ll give it the benefit of the doubt on this criterion. The whole story is about how there is nothing available right now to accurately detect Alzheimer’s and how this procedure may move the ball forward. Although, as the story rightly points out, the new scan won’t necessarily answer all the questions about Alzheimer’s. It should make it clear up high how long it would take for this scan to go through the FDA process. The story makes it clear that ""There is no treatment yet to stop or slow the progress of Alzheimer’s. But every major drug company has new experimental drugs it hopes will work, particularly if they are started early."" And it goes on to say that, ""Other tests are being studied — ones that look for amyloid in cerebrospinal fluid that bathes the brain; MRI scans that look for shrinkage of the brain in areas needed for memory and reasoning; PET scans that look for uptake of glucose, a cellular fuel, to show areas where the brain was active and where it was not. The tests, though, were not necessarily specific for Alzheimer’s and none had been studied to see if they accurately predicted plaque on autopsy."" This is not a news release story. This is a story based largely on early access to the scientist as a buildup to the meeting where the results will be discussed, which is a similar but different animal."
33574	"The lyrics of James Taylor's ""Fire and Rain"" chronicle his reaction to the death of his girlfriend in a plane crash."	Although James Taylor’s eponymous debut album was not a tremendous commercial success, he sufficiently overcame the personal issues with which he had been grappling to leave Apple Records, sign with Warner Bros., and record an album (Sweet Baby James) that, propelled by the success of its second single, “Fire and Rain,” reached a lofty #3 position on the Billboard charts in 1970.	false	Entertainment, james taylor, music, Songs	Gentle, plaintive, and compelling, “Fire and Rain” was the hit that launched the career of James Taylor, one of the 1970’s premier singer-songwriters: Example: [Collected on the Internet, 2000] The real story behind ‘Fire and Rain,’ as I understand it, is that some friends of James were going to surprise James by bringing his girlfriend, Suzanne, to one of his concerts — unbeknownst to James. According to the story, Suzanne’s plane crashed (‘sweet dreams and flying machines in pieces on the ground’) on her way to see the concert and Suzanne dies (‘Suzanne the plans they made put an end to you’). The song’s mournful lyrics of loss and redemption were enigmatic to many, and some listeners tried to make sense of the words by reading literal meaning into them: Just yesterday morning, they let me know you were gone. Suzanne, the plans they made put an end to you. I walked out this mornin’, and I wrote down this song; I just can’t remember who to send it to. I’ve seen fire, and I’ve seen rain. I’ve seen sunny days that I thought would never end. I’ve seen lonely times when I could not find a friend, But I always thought that I’d see you again. Won’t you look down upon me Jesus? You gotta help me make a stand. You just got to see me through another day. My body’s achin’, and my time is at hand. I won’t make it any other way. Been walkin’ my mind to an easy time, My back turned towards the sun. Lord knows when the cold wind blows, it’ll turn your head around. Well there’s hours of time on the telephone line to talk about things to come: Sweet dreams and flying machines in pieces on the ground. Taylor’s audience collectively developed an autobiographical story line for his “Fire and Rain” lyrics: Suzanne, the girl who was now “gone,” had been Taylor’s girlfriend. They were frequently separated as he traveled on tour, but they kept in close touch, spending “hours of time on the telephone line” and talking about the good “things to come” when Taylor finally established himself as a musician. Seeing how disconsolate Taylor was at being away from his love, his friends arranged for Suzanne to fly out to meet him at his next tour stop. Suzanne joyfully accepted, but the flight carrying her to a reunion with her beloved crashed, and she was killed. Both the “flying machine” and Taylor’s “sweet dreams” were now “in pieces on the ground,” and he had lost the woman he “always thought” he’d “see again.” Although James Taylor’s song is indeed autobiographical, it doesn’t match the heart-wrenching story line of popular legend. By the time “Fire and Rain” established Taylor as an international pop star at the tender age of twenty-two, he’d experienced plenty of psychological and physical pain upon which he could draw in crafting his lyrics. He already had a long history of depression and substance abuse for which he’d been hospitalized several times (his first hospital experience was the basis of one of his earliest songs, ‘Knocking ‘Round the Zoo’), and he’d spent quite a while recuperating from a near-fatal motorcycle accident which had broken both his hands and feet and prevented him from picking up a guitar for several months. All of this was fodder for his songwriting, as he explained in a 1972 interview with Rolling Stone: “Fire and Rain” has three verses. The first verse is about my reactions to the death of a friend. The second verse is about my arrival in this country with a monkey on my back, and there Jesus is an expression of my desperation in trying to get through the time when my body was aching and the time was at hand when I had to do it … And the third verse of that song refers to my recuperation in Austin Riggs which lasted about five months. The “Suzanne” mentioned in the lyrics to “Fire and Rain” wasn’t Taylor’s girlfriend or fiancée, but merely an acquaintance (Suzanne Schnerr) whom he had met while he was a teenager in New York in 1966-67 performing (with friends Danny Kortchmar and Joel O’ Brien) as part of a group called The Flying Machine. As quoted in Timothy White’s biography of him, Taylor said that “I knew Suzanne well in New York, and we used to hang out together and we used to get high together; I think she came from Long Island. She was a kid, like all of us.” A few years later, after Taylor had decamped to London and was finishing up his debut album for the Beatles’ Apple Records label, he found out that Suzanne had committed suicide several months earlier, and that his friends had withheld the news from him so as not to let it distract him and derail his career: [Suzanne] committed suicide sometime later while I was over in London. At the time I was living with Margaret [Corey], and Richard [Corey] was around a lot, and so was Joel O’ Brien. All three of them were really close to Susie Schnerr. But Richard and Joel and Margaret were excited for me having this record deal and making this album, and when Susie killed herself they decided not to tell me about it until later because they didn’t want to shake me up. I didn’t find out until some six months after it happened. That’s why the ‘They let me know you were gone’ line came up. And I always felt rather bad about the line, ‘The plans they made put an end to you,’ because ‘they’ only meant ‘ye gods,’ or basically ‘the Fates.’ I never knew her folks but I always wondered whether her folks would hear that and wonder whether it was about them. By the time Taylor left London for the United States at the end of 1968, he was battling a heroin addiction for which he was hospitalized in Manhattan shortly after his return; he then committed himself to Austen Riggs, a private psychiatric facility in Stockbridge, Massachusetts. It was during his Manhattan hospital stay that he formed the song’s second verse, with its pleas to Jesus to “look down upon” him and help him “make a stand” against the ravages of drug addiction. Earlier, during his senior year of high school, Taylor had entered McLean Hospital in Belmont, Massachusetts, where he spent several months being treated for depression. After leaving that facility he traveled to New York and hooked up with childhood friend Danny Kortchmar, where they formed the aforementioned group The Flying Machine, a venture that ended badly for Taylor both professionally and personally: The nadir of the nadir for The Flying Machine was a booking in the Bahamas at a failing nightspot called the Jokers Wild Club in Freeport; after three weeks of bad food and no pay, the group used their return tickets to flee. They disbanded once their flight landed in New York.Sadder still was Taylor’s horrifying descent, just before The Flying Machine had hit career turbulence and begun to lose altitude, into full-blown heroin addiction. The third and fourth verses of “Fire and Rain,” finished off during Taylor’s months at Austen Riggs, muster his feelings about his life in and around his hospital stays, as he struggled with depression, strove against heroin addiction, and experienced the disappointment of a bad ending in his fledgling musical career. Thus the allusion in the song’s final line about “sweet dreams and flying machines in pieces on the ground” is not merely an indirect reference to shattered ambitions and ruined lives, but a sly direct reference to a previous professional failure.
13305	Sen. (Richard) Burr voted no on the Violence Against Women Act.	"Ross’ ad said Burr ""voted no on the Violence Against Women Act."" Burr did vote against the 2012 version of the law’s reauthorization, which was important because it effectively meant delaying the revival of an act that had expired. However, the ad ignores that three other times over 13 years Burr voted for a reauthorization of the same law."	mixture	Criminal Justice, Women, North Carolina, Deborah Ross,	"In a recent campaign ad, North Carolina Democrat Deborah Ross blasted her opponent, Republican Sen. Richard Burr, for voting against the landmark Violence Against Women Act. ""Sen. Burr voted no on the Violence Against Women Act,"" a narrator says in the ad, while the text, ""Richard Burr: Opposed Violence Against Women Act,"" appears on the screen, along with a citation for a bill considered in the Senate in 2012. Here’s a screenshot from the ad: Is Ross’ ad correct? In part, but it it leaves out important context. What was Burr voting for? First, we should note that the ad used some loose language about what Burr was actually voting on. The 2012 vote referenced in the ad was for a reauthorization bill -- that is, an updating of the existing Violence Against Women Act, which had lapsed in 2011. Burr was not in Congress when the act itself was initially passed in 1994; he was sworn in for his first term in the U.S. House the following year, in 1995. The 2000 and 2005 votes Congress voted to reauthorize the act in both 2000 and 2005, and both legislative efforts were fairly uncontroversial. For the 2000 effort, Burr was in the House, and he voted in favor of the reauthorization, which was passed by the overwhelming margin of 415-3. While that version didn’t become law, another version did become law during that Congress; it passed the House by voice vote. Individual House members’ votes aren’t recorded in a voice vote, but they are usually only held for non-controversial measures. By the time the 2005 reauthorization effort rolled around, Burr had been elected to the Senate. The reauthorization bill passed the Senate by unanimous consent, a process by which senators are given a chance to object to a bill and, if there no objections are made, the bill is deemed passed. So Burr would not have opposed the 2005 reauthorization. The 2012 vote The 2012 reauthorization effort was far more controversial than the previous two, since it involved changes that some social conservatives found objectionable. At the time, the Democrats controlled the presidency and the Senate, while the Republicans controlled the House. The Senate bill would ""allow Indian tribal courts to try certain non-Indians in some cases of domestic violence on reservations, expand the number of temporary visas for illegal immigrants who were victims of domestic violence and extend the protections of that act to gay men and lesbians,"" the New York Times reported at the time. These provisions were anathema to many conservatives, and when faced with a vote on April 26, 2012, Burr was one of 31 Republicans to vote against it, while 15 Republicans voted for it. Overall, the measure passed the chamber by a 60-31 margin. Instead, Burr voted for a failed Republican-sponsored amendment that would have stripped out some of the elements of the bill that were controversial to Republicans. We were unable to find a contemporaneous explanation by Burr on the reason for his vote through Google or Nexis. The only comment he made on the bill to a media outlet came was procedural rather than substantive, when he said that he thought there were more urgent bills for the chamber to prioritize than the reauthorization. Ultimately, the Republican-led House passed a version that omitted the provisions of the Senate bill that conservatives opposed. The House and Senate were unable to come to an agreement, and the measure was dead for the duration of that Congress. It’s worth noting that Politico reported on March 14, 2012, that the Democratic effort to push a vote on the Violence Against Women Act in the spring of 2012 was to make it a ""political weapon."" ""Republicans have several objections to the legislation, but instead of making changes, Schumer wants to fast-track the bill to the floor, let the GOP block it, then allow Democrats to accuse Republicans of waging a ‘war against women,’ "" the Politico story said. ""It’s fodder for a campaign ad, and it’s not the only potential 30-second spot ready to spring from Senate leadership these days."" With this ad, that mission was accomplished. The 2013 vote After the failure to get the two chambers to agree on a single version in 2012, the new Congress took up the effort again in 2013. Partisan control of each part of government remained the same in 2013, and the reauthorization effort played out in a similar fashion. Republicans pursued an amendment to strip out some of the elements they found problematic, such as the provisions related to native Americans and gender identity. On Feb. 7, 2013, the amendment failed by a 34-65 margin, with Burr voting in favor of it. Then, on Feb. 12, 2013, the Senate passed the original measure, 78-22. Burr was among a handful of Republican senators who switched their position and supported the bill. In fact, Burr has subsequently trumpeted elements of this bill. Burr joined with Sen. Barbara Boxer, D-Calif., to introduce the Child Protection Compact Act, which was enacted as part of the Violence Against Women Act reauthorization. This provision ""seeks to protect and rescue children from trafficking by creating ‘Child Protection Compacts’ between the United States and countries with significant numbers of children in human trafficking,"" Burr’s Senate website says. On the other hand, the Ross camp argues, the refusal of Republicans to approve the original bill resulted in a year-long delay in the reauthorization, which kept sexual violence awareness and assistance programs on college campuses from being established, even though reports of sexual assault on college campuses were at an all-time high. So where does this leave us? The Ross camp argues that the ad is accurate since it said that Burr voted against the 2012 version of the bill. They have a point, but making this argument requires ignoring that Burr voted to reauthorize the Violence Against Women Act three times -- in 2000, 2005 and 2013 -- even as he voted against it once, in 2012. The Ross camp also argues that the 2012 vote is important because Burr opposed -- and even voted to strip -- provisions involving LGBT and native Americans. They also have a point here, but their argument would have been stronger had the ad specifically cited Burr’s actions toward LGBT and native Americans. The ad makes no such distinctions; a viewer would be left to assume that he opposed anything to combat violence against women. Finally, we think it’s relevant to note here that, according to Politico, the Democrats specifically teed up this vote to put Republicans in a bind so they could use their votes in campaign ads -- a tactic that both parties have used when they are in a position to do so. Our ruling Ross’ ad said Burr ""voted no on the Violence Against Women Act."" Burr did vote against the 2012 version of the law’s reauthorization, which was important because it effectively meant delaying the revival of an act that had expired. However, the ad ignores that three other times over 13 years Burr voted for a reauthorization of the same law."
9375	Earlier Mammograms May Mean Less Need for Aggressive Treatments	This HealthDay news story reports on findings among women diagnosed with breast cancer: those who had longer intervals between mammograms end up getting more aggressive treatments, including chemotherapy and surgery. The story would have been stronger had it described the findings using absolute rather than relative numbers. But, we were glad to see an independent source offer some reservations about the small observational study raised. A final note — the image accompanying the story was laughably unrealistic. Mammograms are the primary screening method for detecting breast cancer. However, when to start getting mammograms and how often to get screened have been subjects of controversy for the past decade. That’s because the data on how to balance risk of developing breast cancer and the risk of harms from screening (unnecessary tests and procedures) are interpreted differently by doctors and other experts. A story that adds new data to the field and that might tip current guidelines one way or the other is newsworthy.	true	breast cancer,mammography,screening	The article did not discuss costs. Screening mammograms impose a significant cost on the U.S. health care system and insurers, particularly Medicare. The story detailed the relative harms of earlier mammograms, but did not translate those percentages into absolute numbers. For instance, women who were diagnosed with breast cancer 25 months or more after their last mammogram were “50 percent more likely” to need chemotherapy, “32 percent more likely” to need mastectomy, and “66 percent more likely” to need lymph nodes removed. However, relative risk can be misleading, sometimes inflating numbers to sound scarier than when absolute numbers are used. Also, we don’t know what kind of risk these women had at baseline, so it’s hard to know if they were higher risk. The story made no mention of the harms of earlier or more frequent screening, which have been documented time and time again. More screening can mean more false positives or more finding of breast changes that lead to more testing, such as biopsies, more costs, and more worry. The story did make clear some of the weaknesses of the study: The study found an association but did not prove causality and the study population was limited to a single health care institution. The story also mentions that the findings were presented at a meeting, which means they have not undergone peer-review. The story does not directly engage in fear-mongering. However, some of the quotes advocating for earlier and more frequent screening play into a scenario that breast cancer is lurking in every woman. A discussion of what a woman’s average lifetime risk is would have been helpful. The story quotes the study author and an outside source. The story makes clear that different advisory groups have differing guidelines for what age to start getting mammograms (40 or 50 years old). It would have been nice if the story had included examples of what makes someone higher risk or not (personal cancer history, family history, history of radiation), but we think this was satisfactory. We believe that mammograms are well-known to be widely available. And the earlier and more frequent screening described here is not earlier or more frequent than what many guidelines recommend, so would not be expected to be denied by health insurers. The story makes clear the distinctive aspects of this study —using avoidance of more aggressive treatment regimens as a deciding factor, as opposed to the more extreme avoidance of cancer death. The story goes beyond what was contained in a news release on the presentation at the American Society of Breast Surgeons annual meeting.
5798	Oregon effort to declare health care a right falters.	An effort to insert an amendment in Oregon’s Constitution making health care a right died amid concerns by lawmakers that it would expose the state to lawsuits.	true	Legislature, Access to health care, Constitutions, Health, Lawsuits, Oregon, Portland, State legislature	Such an amendment would have been unprecedented among U.S. states, according to the National Conference of State Legislatures. The Democratic-controlled state House approved the measure 35-25 on Feb. 13, but it never reached the floor of the Democratic-controlled Senate for a vote. Sen. Laurie Monnes Anderson, chairwoman of the Senate Health Care Committee, said it was never brought to a vote in committee because it did not appear likely to pass by the entire Senate. “I firmly believe that health care is a right,” Monnes Anderson, a Democrat from the Portland suburb of Gresham, said in an email. “As a retired public health nurse I see how no access to health care affects your ability to keep a job and children to learn.” The amendment to the 160-year-old Constitution would have obliged the state “to ensure that every resident of Oregon has access to cost-effective, medically appropriate and affordable health care as a fundamental right.” Opponents had said there was no plan to fund making health care access a right, and warned that doing so would make the state vulnerable to lawsuits. The League of Women Voters was among the opponents. “The State of Oregon has insufficient income to support its current responsibilities and cannot provide the added cost of health care coverage for all its residents at this time,” it said in written testimony. Lawmakers have wrestled over the issue as the Trump administration has tried to dismantle former President Barack Obama’s health care law. “There were general concerns that there might be a lawsuit or something similar that might force the issue on what is now being touted as an aspirational thing,” said Rick Osborn, spokesman for the Senate Democrats. Senate Majority Leader Ginny Burdick, a Democrat from Portland, said there just wasn’t enough time during the current five-week legislative session to gain critical mass on the measure. “The bill would have needed extensive amendments for it to get the support it needs in the Senate,” Burdick said. ___ Follow Andrew Selsky on Twitter at https://twitter.com/andrewselsky
11188	Telephone-Based Cognitive Behavioral Therapy for Anxiety in Rural Older Adults	The news release reports on the outcome of a randomized clinical trial testing how well telephone-based therapy can be used for older rural patients experiencing general anxiety disorder. It’s an interesting and important topic. The release would have been improved significantly with just a few more details. The research paper points out that generalized anxiety disorder “is one of the most common anxiety disorders in older adults” and is “associated with poor quality of life, increased health care utilization, impaired memory, and potentially increased morbidity and mortality.” Those issues can be amplified by life in rural communities where psychological care can be scarce. Older adults can be more prone to these issues based on their physical isolation. So if therapy could be effectively delivered via telephone, adults facing these challenges might be more readily helped.	true	Journal news release,mental health	At no point in the release was cost mentioned. Psychotherapy and counseling can be costly, especially for the elderly on fixed incomes. Readers would be well-served with some estimate of the costs of the services provided through this trial. Also, a mention of a comparison between the costs of office visits for such therapy versus that delivered via telephone would be useful to give readers a fuller picture of the practical potential for this approach. Medicare requires in person contact for payment. That’s why the cost issue is important in this case. We think news releases can and should address these matters. The release fails to give readers any indication of the degree of differences between the two approaches tested, and falls back on simply saying that X “was superior to” Y and “resulted in a greater reduction of symptoms.” Without any numerical values being offered, readers can’t gauge for themselves the value of one approach over the other. It’s difficult to gauge the clinical effectiveness versus the statistical differences. It would have been helpful to compare the degree of reduction of symptoms with office-based therapy, and drug treatment. Journal news releases can help educate journalists and all readers by quantifying potential benefits – and by reinforcing the expectation in readers that such information should be provided The release mentioned no possible harms from this approach, although in fairness, supportive telephone conversations are unlikely to carry much risk. However, we wonder about situations where the telephone therapy sessions may not detect some problems that might surface during a face-to-face consultation. The study itself used accepted psychological assays to gauge participants’ degree of GAD, and relied on self-reports by participants to determine any improvements following therapies. All of these are subjective by nature, rather than empirical and some reference to that would have been useful. Rather than saying, “there was greater decline in worry severity,” the release more accurately could have said “participants reported” a greater decline to remind reads of the caveats to the findings. The authors of the journal article also made the point that their results could be regression to the mean. Nonetheless, we’ll rate this satisfactory because of the details that were provided. The release does not demonstrate disease mongering. An end note points out that this study was funded by the National Institute of Mental Health. There was no indication of any conflicts of interest. The release points out that the study focuses on older adults living in rural settings where psychotherapy may be unavailable. It also points out that older adults may prefer psychotherapy over medications. We wonder about other approaches to address loneliness in the elderly, especially in rural areas, that could improve a person’s quality of life. Since the telephone is ubiquitous in modern life, one assumes that such a program as explained in this clinical trial could be available in short notice, assuming financial support for the project. Telephone-based support programs are not new and the release makes no claims that the approach is necessarily novel. It specifically says that it “is one way to overcome some barriers to mental health treatment.” The release does not appear to use any unjustifiable language. But, on a side note about language, the release never defined “non directive supportive therapy,” which is what the comparison group received. Many journalists – and general public readers – might not know what that means and would benefit from a one line definition.

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