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  • Millions of children are at risk of losing Medicaid coverage starting in April | CNN Politics

    Millions of children are at risk of losing Medicaid coverage starting in April | CNN Politics

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    CNN
     — 

    The majority of American children now receive their health insurance through Medicaid and the Children’s Health Insurance Program, according to a new report published Wednesday by the Georgetown Center for Children and Families.

    But that could change starting this spring. As many as 6.7 million children are at risk of losing that coverage once states restart their reviews of recipients’ eligibility, according to Georgetown.

    Medicaid enrollment ballooned during the pandemic thanks to an early Covid-19 pandemic relief provision passed by Congress that barred states from involuntarily disenrolling beneficiaries in exchange for higher federal matching funds. But lawmakers voted late last year to end that continuous enrollment provision on April 1, freeing states to start winnowing ineligible recipients.

    More than 42 million children were covered by Medicaid and CHIP as of August, up 17.5% from February 2020, just before the pandemic started.

    Ten states plus the District of Columbia have more than 60% of their children insured through the public programs, according to Georgetown. New Mexico leads the nation with more than three-quarters of its kids covered by Medicaid and CHIP.

    By contrast, fewer than a quarter of children in Utah are enrolled in the programs.

    The number of children who gained Medicaid and CHIP coverage during the pandemic varied by state. Indiana had the largest surge, with a nearly 45% increase. Wyoming, North Dakota, Missouri and Georgia saw their child enrollment grow by roughly a third.

    On the flip side, Vermont experienced less than an 8% growth in child enrollment in Medicaid and CHIP.

    More than 83 million people, including more than 34 million children, were covered by Medicaid as of August. And another 4 million children were enrolled in Medicaid financed by CHIP. All will have their eligibility reviewed, and in some cases, the children will continue to qualify even if their parents do not.

    “If they’re getting the message that they’re losing their own coverage, a lot of times a parent understandably thinks that their child is also losing coverage,” said Joan Alker, executive director of the Georgetown Center for Children and Families.

    A total of roughly 15 million people could be dropped from Medicaid when the continuous enrollment requirement ends, according to an analysis the Department of Health and Human Services released in August. About 8.2 million folks would no longer qualify, but 6.8 million people would be terminated even though they are still eligible, the department estimated.

    When states reevaluate families’ eligibility, they need to look separately at adults and children, Alker said. Officials should work with pediatricians, schools, child care centers and others to explain the situation to parents and make sure the children retain coverage if they continue to qualify.

    Nearly three-quarters of the children projected to be dropped will remain eligible for Medicaid but will likely lose coverage because of administrative issues, such as their parents not submitting the necessary paperwork or procedural errors, according to Georgetown.

    Although states have 14 months to complete the unwinding process, some will look to do so more quickly.

    “My concern is that a large number of children could become uninsured in states that do not take their time and pay particular attention to the unique needs of children,” Alker said.

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  • Pritzker calls for universal preschool in Illinois by 2027

    Pritzker calls for universal preschool in Illinois by 2027

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    SPRINGFIELD, Ill. — Illinois Gov. J.B. Pritzker called Wednesday for making preschool available to every 3- and 4-year-old in the state within four years, starting with a $440 million investment to bring 5,000 additional children into the program this fall.

    Details about the “Smart Start Illinois” program dominated the fifth annual State of the State and budget address by the Democratic governor, who easily won reelection in November and has hinted at an eventual presidential bid.

    “It will make our state the best place in the nation to raise young children,” Pritzker said in the speech to a joint session of the Legislature.

    He envisions a four-year plan in which annual increases in funding — although smaller than in the initial year — would make room for the approximately 20,000 children whose families desire pre-K but can’t because of a lack of space.

    In the first year, $75 million would go toward the existing account funding pre-K, a 12.5% increase in the budget that currently serves 89,000 kids. That funds space for the additional 5,000 learners, all outside of Chicago. Chicago Public Schools have their own preschool program.

    But the plan goes beyond classroom learning. There’s $40 million for early intervention when a child is found with a learning impediment, such as a speech delay, and $5 million for Department of Human Services home visits to help families with parenting, school and more.

    “We’re attempting to cover the lowest income kids who don’t have spots available to them first, but it will also depend upon where the availability (of space) can be made in this fiscal year,” Pritzker said. “There may be places where it will take us a couple of years to build out the capability.”

    In a Tuesday briefing with news reporters, he insisted the time is ripe for opening the school door to more kids earlier in life, citing academic studies projecting that there’s a potential return of as much as $7 for every $1 invested in early education.

    “It’s a plan that will make our system more equitable, focusing in particular on children and families who have less ability to access quality programs, and investing in a workforce made up largely of women and people of color,” Pritzker said.

    The budget also includes $100 million to build facilities to house the expanded programs. There’s $70 million to expand participation in childcare for parents who need to work or attend school by increasing the income threshold, and $20 million to revamp the provider-payment system.

    Critically important is $130 million for what Pritzker says would be a first-in-the-nation “Childcare Workforce Compensation Contract” to lure providers to an understaffed field, give it stability and increase providers’ pay over four years to as much as $19 an hour.

    About 10 states offer universal preschool, including neighboring Wisconsin. Colorado is gearing up to offer it this fall, and Michigan Democratic Gov. Gretchen Whitmer last week proposed $300 million for schooling, hiring teachers and transporting 5,600 4-year-olds.

    Pritzker declined to discuss other initiatives he would propose in the coming year after a $50 billion budget in the current year. Other state leaders urging budgetary constraint did leave room for enhanced educational programs.

    “There are so many different programs that are meritorious but when you have limited funds… for this next year, they’re looking pretty good, but we always need to err on the conservative side of not spending everything,” Democratic Comptroller Susana Mendoza said. “Hope for the best, but plan for the worst.”

    Mendoza said education is an area where additional spending is called for, but she would like to see better funding of needs-based college grants.

    Republican Senate Minority Leader John Curran, of Downers Grove, warned of a coming fiscal cliff and the need for budget restraint, but called on Pritzker to expand help for working families — including in early childhood learning and childcare.

    He also bemoaned the underfunding of programs for the developmentally disabled. Despite a huge increase in 2021, it was still hundreds of millions of dollars short of what a federal judge ordered.

    “We can afford to do this,” Pritzker said “And as every provider, teacher and parent in this state will tell you, we can’t afford to wait.”

    ___

    Follow Political Writer John O’Connor at https://twitter.com/apoconnor

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  • Michael Jordan donates $10M to Make-A-Wish for 60th birthday

    Michael Jordan donates $10M to Make-A-Wish for 60th birthday

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    CHARLOTTE, N.C. — Six-time NBA champion Michael Jordan is celebrating his 60th birthday on Friday by making a $10 million donation to Make-A-Wish.

    It is the largest donation ever received from an individual in the organization’s 43-year history.

    Jordan’s hope is that his decision to celebrate his birthday by donating to Make-A-Wish will inspire others to help fulfill the wishes of the kids still waiting for their wishes to come true.

    “For the past 34 years, it’s been an honor to partner with Make-A-Wish and help bring a smile and happiness to so many kids,” Jordan said in a news release. “Witnessing their strength and resilience during such a tough time in their lives has truly been an inspiration.”

    Jordan, now the owner of the NBA’s Charlotte Hornets, first supported Make-A-Wish in 1989.

    He has granted hundreds of wishes to children all over the world and remains one of the most requested celebrity wish-granters. He was named Make-A-Wish Chief Wish Ambassador in 2008 for what the organization called the “life-changing impacts he has had on wish kids and their families.”

    “I can’t think of a better birthday gift than seeing others join me in supporting Make-A-Wish so that every child can experience the magic of having their wish come true,” Jordan said.

    ___

    AP NBA: https://apnews.com/hub/NBA and https://twitter.com/AP_Sports

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  • Rise in Horn of Africa migrants a worry, says UN official

    Rise in Horn of Africa migrants a worry, says UN official

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    NAIROBI, Kenya — The numbers of women and children migrating from the Horn of Africa to Gulf countries through Yemen has significantly increased and is a cause of concern, according to the head of the International Organization for Migration.

    The treacherous journey from Ethiopia, Somalia and Djibouti through Yemen, called the Eastern Migration Route, has seen a 64% increase in the past year of people seeking better livelihoods, with larger numbers of women with children and children travelling alone, IOM Director General Antonio Vitorino told The Associated Press.

    Climate change is a driver of the increased migration, he said.

    In the past, women and children would often opt out of the dangerous journey through the desert mostly made on foot. Previously men would leave their families behind and make the trek in the hope of finding jobs and sending money back home.

    “The pressure is mounting” as the numbers of migrants rise, said Vitorino who was in Kenya for the launch of a $84 million appeal to support more than 1 million migrants using the route through Yemen.

    The desperate migrants are vulnerable to criminal gangs along the route and need protection against rape, violence, traffickers and smugglers, he said.

    Some of the migrants are unaware of the dangers including the war in Yemen and the U.N.’s migration organization needs to improve awareness of the perils, he said. For migrants who still choose to take the journey, the organization should offer basic healthcare and other services and in some cases return them to their countries of origin, he said.

    “Last year, we have returned voluntarily to Ethiopia 2,700 migrants and upon arrival we provided post-arrival assistance to support them to move back to their regions of origin,” Vitorino said.

    Also rising is the migration of people from West Africa through Libya to Europe and the plight of those migrants, particularly those detained in Libya, is a global concern, he said.

    “We know where the official detention centers are and we have access to them, not permanent, never alone, but under surveillance of security guards. But we have access to provide assistance,” said Vitorino.

    But the U.N. organization does not have access to the unofficial detentions centers, which are particularly worrying as there are reports of widespread abuses in them, he said. Libya’s political instability makes it difficult to have the political cooperation needed to dismantle the unofficial detention centers, he said.

    The IOM is striving to get more migrants into voluntary return programs in order to reduce those in detention, he said. It’s difficult because the number of migrants who want to return is much higher than available flights from Libya, he said.

    Vitorino said he hopes the factors that lead to increased migration, like climate change and conflict, can be addressed to reduce the number of people moving away from their homes.

    He stressed the need for migrants to pursue legal migration routes, adding that although the process is complicated and cumbersome, it cannot be compared to the life-threatening conditions along illegal routes.

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  • ¿Que coman pasteles?: Estudio revela que los abuelos miman a sus nietos con comidas y bebidas cargadas de azúcar

    ¿Que coman pasteles?: Estudio revela que los abuelos miman a sus nietos con comidas y bebidas cargadas de azúcar

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    Newswise — Azúcar, golosinas y todo lo dulce – eso es lo que los abuelos dejan que sus nietos coman. De acuerdo a un nuevo estudio publicado en la edición de febrero del “Journal of the American Dental Association (JADA)”, más de dos tercios (72%) de las madres indicaron que los abuelos le dan a sus hijos pequeños alimentos y bebidas azucaradas. Las madres describieron generalmente que los abuelos le dieron grandes cantidades de alimentos y bebidas cariogénicas o que causan caries (por ejemplo, caramelos, productos horneados, jugos y gaseosas) o no limitaron el consumo de las mismas a sus nietos.

    Los investigadores de la Universidad de Pittsburgh, de la Universidad West Virginia y de la Universidad de Michigan, llevaron a cabo un estudio en persona de dos años con 126 participantes para examinar que factores influenciaron a las madres a hablar con los abuelos acerca de darle a los nietos alimentos y bebidas azucaradas.

    Los resultados publicados en JADA, muestran que a pesar de que el 72% de madres dicen que los abuelos le dieron a sus hijos alimentos y bebidas azucaradas, sólo un poco más de la mitad (51%) abordaron el problema con los abuelos. Los factores que influenciaron si las madres tenían esta conversación incluyen:

    • La frecuencia con la cual los niños y los abuelos interactuaban
    • La dependencia de las madres en los abuelos para el cuidado de los niños
    • La cantidad de alimentos y bebidas azucaradas proporcionadas por los abuelos
    • La fortaleza de la relación entre las madres y los abuelos de sus hijos

    “Tengo tantas memorias felices asaltando el tarro de caramelos en la casa de mis abuelos, y como padre, yo mismo he dudado con algunas de estas conversaciones”, dijo el portavoz de ADA, el Dr. Genaro Romo, un dentista basado en Chicago. “Aun así, las caries son la enfermedad crónica infantil más común, y puede causar un dolor innecesario, como también problemas para hablar, comer, jugar y aprender. Con el tiempo, además de problemas de salud mental, una dieta con azúcares añadidos en exceso pone a los niños en mayor riesgo de enfermedades cardiovasculares, obesidad, entre otros problemas de salud”.

    De acuerdo a la Asociación Dental Americana (por sus siglas en inglés ADA), mientras más expuesta esté la boca de un niño a golosinas y bebidas azucaradas por día, es mayor el riesgo de la aparición de caries. Las bacterias en la boca se alimentan de azúcar produciendo un ácido que ataca y debilita el esmalte dental. 

     

    Los padres en todo el país endulzan las cosas también

    Para añadir la no tan buena guinda del pastel, en enero del 2023, la Asociación Dental Americana llevó a cabo una encuesta separada de 1.002 padres estadounidenses de niños de 17 años o menos a través de una empresa de investigación del consumidor. Los resultados mostraron que más de dos tercios (68%) de los padres creen que sus hijos consumen más alimentos y bebidas azucaradas en la casa de sus abuelos que en el hogar. De esos padres: 

    • Setenta y tres por ciento (73%) dice que lo hablarían con propios padres pero no con los padres de su pareja
    • Menos de la mitad (43%) indicaron que lo hablarían con los padres de su pareja
    • Solo un tercio de padres (34%) confirmaron que ellos lo hablarían tanto con sus padres como con los padres de su pareja

    “No hay nada más dulce que la relación entre los nietos y sus abuelos”, dijo la portavoz de ADA, la Dr. Mary Hayes, una dentista pediátrica. “Tener la conversación de  ‘golosinas con moderación’, alentar un vaso de agua o de leche en vez de jugo o gaseosas, y en caso de ofrecer una golosina, optar por el chocolate puro ya que la saliva lo remueve de la boca más fácilmente que los caramelos pegajosos o duros”.

    Febrero es el Mes Nacional de la Salud Dental Infantil, y las familias pueden celebrarlo al practicar rutinas diarias de higiene oral en casa:

    • Cepillarse dos veces al día con pasta dental con flúor. Use un poco de pasta dental del tamaño de un grano de arroz para niños menores de 3 años. Después de los 3 años, los niños solo necesitan una gota de pasta dental del tamaño de un guisante.
    • Use diariamente el hilo dental o algún otro limpiador interdental para limpiar donde los cepillos dentales no pueden llegar. 
    • Visite a un dentista regularmente. La primera visita al dentista de un niño debería hacerse después de la aparición del primer diente o no más tarde del primer cumpleaños del niño. 
    • Limite los alimentos azucarados o golosinas. Los padres y los abuelos pueden ayudar a reducir el riesgo de la aparición de caries al ofrecer un dulce adicional con o después de las comidas porque masticar aumenta la producción de saliva lo cual ayuda a remover partículas de azúcar o de comida que puedan producir caries. 

    Para más tips de salud dental para toda la familia, por favor visite MouthHealthy.org 

     

    ###

     

    Acerca la Asociación Dental Americana 

    La ADA es la asociación sin fines de lucro más grande del país, que representa 159.000 miembros dentistas. La principal fuente de información sobre salud dental, la ADA se ha advocado por la salud del público y ha promovido el arte y la ciencia de la odontología desde 1859. Las instalaciones de investigación de vanguardia de la ADA desarrollan y prueban productos y materiales que han hecho avanzar la práctica de la odontología y han hecho la experiencia del paciente más positiva. El Sello de Aprobación de la ADA ha sido, por mucho tiempo, una guía valiosa y respetada para los consumidores de productos del cuidado dental. El Journal of the American Dental Association (JADA), publicado mensualmente, es la publicación insignia de la ADA y la revista científica más leída en odontología. Para más información sobre la ADA, visite ADA.org. Para más información sobre la salud dental, incluida la prevención, cuidado y tratamiento de enfermedades dentales, visite el sitio web para consumidores de la ADA MouthHealthy.org.

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  • GOP lawmakers escalate fight against gender-affirming care with bills seeking to expand the scope of bans | CNN Politics

    GOP lawmakers escalate fight against gender-affirming care with bills seeking to expand the scope of bans | CNN Politics

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    Washington
    CNN
     — 

    A flurry of bills seeking to restrict access to gender-affirming care for trans youth have been introduced by Republican state lawmakers this year, with debates around the issue reaching new heights thanks to proposals that would dramatically expand the scope of bans on such care.

    More than 80 bills seeking to restrict access to gender-affirming care have been introduced around the country through February 9, according to data compiled by the American Civil Liberties Union and shared with CNN.

    Gender-affirming care is medically necessary, evidence-based care that uses a multidisciplinary approach to help a person transition from their assigned gender – the one the person was designated at birth – to their affirmed gender – the gender by which one wants to be known.

    Though many of the bills introduced so far this year target trans youth and their access to gender-affirming care, at least four states saw bills introduced this session that would restrict such care for individuals over the age of 18, including at least two states where proposed bans covered people under the age of 26.

    Legislation aimed at trans adults has alarmed LGBTQ advocates, who worry that even if those measures don’t become law, they will make future bills exclusively targeting minors seem like sensible compromises.

    The slew of new bills underscores the shifting policy goals of some conservatives seeking to politicize the lives of transgender Americans by imposing restrictions on a small and vulnerable group that, LGBTQ advocates say, are largely misunderstood, making their existence ripe for attacks. A number of GOP-led states have in recent years been successful in banning trans youth from competing on sports teams that match their gender identity, but now it appears the focus has largely turned to gender-affirming care.

    “It’s really, I think, a big but important, notable moment that they’re no longer pretending that this is about caring about young folks, and making it very clear that all that they really want to do is prevent trans folks from being able to receive medically necessary, life-saving care basically at any age,” said Cathryn Oakley, state legislative director and senior counsel for the Human Rights Campaign, one of the nation’s largest LGBTQ rights groups.

    “They have abandoned women’s sports entirely but doubled down on trying to hurt trans kids,” she added. “So, you know, the through line here is about hurting trans people. And yes, they’re looking for the next discriminatory measure that they can get passed.”

    In pushing the health care bans, Republicans have argued that decisions around such care should be made after an individual becomes an adult – a position that is facing intense scrutiny as some lawmakers have moved the age goalpost this year.

    Many of the bills likely won’t get far in the legislative process. An HRC report released last month said that of the 315 anti-LGBTQ bills introduced in 2022, only 29 – or less than 10% – became law. Still, the influx of bills this session is already helping to grow the small group of states that previously enacted bans on gender-affirming care.

    Last month, Utah became the first state this year to enact a ban on gender-affirming care for trans youth, joining Arkansas, which enacted its ban in 2021, and Alabama, which put a similar ban on its books last year. Arizona also enacted restrictions on gender-affirming care in 2022, though its ban was less sweeping than the others.

    Two of those laws have already brought forth a complicated legal landscape around the issue. The ACLU sued Arkansas over its ban and a federal judge temporarily blocked it in 2021, and Alabama’s law was partially blocked by a federal judge last May.

    As states consider the dozens of health care bans introduced this year, they’ll do so under threat of federal legal action, with the legislative efforts having caused the US Department of Justice to take notice.

    Last year, DOJ’s Civil Rights Division sent a stern warning to state attorneys general on the matter, saying in a letter that it “is committed to ensuring that transgender youth, like all youth, are treated fairly and with dignity in accordance with federal law.”

    “Intentionally erecting discriminatory barriers to prevent individuals from receiving gender-affirming care implicates a number of federal legal guarantees,” the letter read in part.

    Major medical associations agree that gender-affirming care is clinically appropriate for children and adults with gender dysphoria, which, according to the American Psychiatric Association, is psychological distress that may result when a person’s gender identity and sex assigned at birth do not align.

    Though the care is highly individualized, some children may decide to use reversible puberty suppression therapy. This part of the process may also include hormone therapy that can lead to gender-affirming physical change. Surgical interventions, however, are not typically done on children and many health care providers do not offer them to minors.

    LGBTQ advocates have long argued that the health care bans further marginalize a vulnerable community and could cause serious harm to a group that suffers from uniquely high rates of suicide.

    “LGBTQ youth are not inherently prone to mental health challenges and suicide. They are placed at higher risk by the hostility and discrimination they face because of who they are,” said Kasey Suffredini of the Trevor Project, a nonprofit that works to prevent suicide among LGBTQ youth. “It is on adults to carry young people through this period until we get to the place where lawmakers aren’t attacking these young people anymore.”

    At least four states saw bills introduced this year that would restrict gender-affirming care for individuals over the age of 18, dramatically raising the bar in Republicans’ efforts to regulate such care.

    Among those bills was one in Mississippi that would have criminalized people who provided or aided in the provision of gender-affirming care for individuals under the age of 21, with violators of the ban facing “the felony crime of ‘gender disfigurement.’” If convicted, a violator could have been sentenced to a maximum of five years in prison and face a fine of at least $10,000. That bill, however, died in committee in late January.

    A Kansas bill would prohibit medical professionals from “knowingly performing … or causing to be performed” gender-affirming care on an individual under the age of 21 and would make violations of the ban a felony under state law. The bill makes some exceptions, including in the case of someone born intersex.

    A bill in South Carolina, meanwhile, would impose similar restrictions. But the measure, among other things, would require someone older than 21 who is seeking gender-affirming care to first get a referral from their “primary care physician and a referral from a licensed psychiatrist who must certify that the person has been diagnosed with gender dysphoria or a similar condition by the psychiatrist and that the psychiatrist believes that gender transition procedures would be appropriate for the person.”

    Two near-identical bills in South Carolina and Oklahoma go a step further, providing that a “physician or other healthcare professional shall not provide gender transition procedures” to anyone under the age of 26. Medical professionals convicted of violating the act would be guilty of a felony, with a conviction in Oklahoma carrying a maximum sentence of five years in prison. The bills also prohibit public funds from being used “directly or indirectly” at organizations that provide such care.

    “Surgical and chemical genital mutilation has been occurring in our great state, and it must be stopped,” the bill’s sponsor, Oklahoma GOP state Sen. David Bullard, said in a statement, using incendiary language to describe the clinically appropriate health care he’s trying to restrict.

    The statement said Bullard “chose the age of 26 to account for scientific findings that the brain does not fully develop and mature until the mid- to late 20s with the prefrontal cortex, the part responsible for critical skills like planning and controlling urges, developing last.”

    Bullard’s bill was later gutted by a Senate committee, with the changes removing the ban on care but maintaining the public funds prohibition.

    “These are people who are old enough to enlist in the military, buy guns, buy alcohol, buy tobacco, get married, do a variety of other things that we leave to adults to do,” Oakley said. “And yet we would be forbidding them from being able to receive gender affirming care, as if that is in some way a more permanent decision.”

    The push to restrict gender-affirming care has been a central focus for a number of well-funded national right-wing groups, including the conservative American Principles Project.

    The group’s president, Terry Schilling, told CNN that it works with states to introduce and pass such bans, saying their overall goal is to eliminate gender-affirming care for all Americans, regardless of age. “The movement to oppose (gender-affirming care) has never said, ‘we only care about children.’ We’ve said, ‘we want to protect children,’” he said.

    “And so, we want to protect who we can as quick as possible. And the group of people that we can protect as quick as possible is children,” Schilling added. “And so that’s the thrust of the strategy – is we want to protect everyone from this stuff. But ultimately, we have to start with children because that’s where the vast majority of the American people are right now.”

    Lawmakers in Texas have introduced a number of bills that would outlaw gender-affirming care for trans youth, with most of them setting up blanket bans similar to ones being floated elsewhere.

    But the state is also attempting to approach the issue in a unique way, with lawmakers there having introduced at least four bills that would expand the definition of child abuse to include providing gender-affirming care to minors.

    The bills are seeking to codify a non-legally binding opinion released last year by Texas Attorney General Ken Paxton that said providing gender-affirming surgical procedures and drugs that affect puberty should be considered child abuse under state law.

    Paxton’s move prompted the Texas Department of Family and Protective Services to begin investigating parents who provide their children with such care. But LGBTQ advocates sued, and a district judge ruled last September that the state cannot pursue investigations into parents providing such care if their children and those families are part of one of the groups suing the state.

    One of the bills states in part that abuse “includes the following acts by a medical professional or mental health professional for the purpose of attempting to change or affirm a child ‘s perception of the child’s sex, if that perception is inconsistent with the child ‘s biological sex.”

    When Republican state Rep. Bryan Slaton pre-filed the bill last year, he said in a statement that it “will designate genital removal surgeries, chemical castration, puberty blockers, and other sex change therapies as child abuse.”

    Elsewhere, states are pushing ahead with bans similar to the ones in Arkansas and Alabama that are currently in legal jeopardy.

    In Utah, the Republican-controlled legislature moved a ban on gender-affirming care for minors through the statehouse in under a month, with Republican Gov. Spencer Cox giving it his stamp of approval in late January.

    “More and more experts, states and countries around the world are pausing these permanent and life-altering treatments for new patients until more and better research can help determine the long-term consequences,” Cox said in a statement explaining his decision to sign the bill into law.

    “This is a devastating and dangerous violation of the rights and privacy of transgender Utahns, their families, and their medical providers,” said Chase Strangio, deputy director for transgender justice at the ACLU, in a statement. “Claims of protecting our most vulnerable with these laws ring hollow when lawmakers have trans children’s greatest protectors – their parents, providers, and the youth themselves – pleading in front of them not to cut them off from their care.”

    LGBTQ advocates hoped Cox would veto the ban, pointing to the governor’s decision last year to veto an anti-trans sports bill in the state. At the time, he questioned the need for it and stressed that it targets a marginalized group that suffers from high rates of suicide. Lawmakers, however, quickly overrode his veto, with the drama underscoring how Republicans are not always in lockstep on matters pertaining to the LGBTQ community.

    Last month, Mississippi’s House passed a bill that similarly makes it illegal to “knowingly provide gender transition procedures to any person under” the age of 18. Physicians and other medical professionals found to have violated the ban would have their license to practice health care in the state revoked.

    “I just believe a child needs to wait until they’re 18-years-old, then they can make their own decision,” the bill’s sponsor, Republican state Rep. Gene Newman, told CNN. Decisions about the type of care Newman’s bill seeks to limit, however, are made by a mix of people, including a child’s parents and the medical provider.

    A South Dakota bill would also prohibit health care professionals in the state from providing gender-affirming care to minors. Like the Mississippi bill, providers found to be in violation of the ban by a professional or occupational licensing board would get their license to practice medicine revoked, according to the bill. The bill cleared South Dakota’s Senate on Thursday and is now headed to Republican Gov. Kristi Noem, who is supportive of the legislation.

    South Dakota has been especially hostile to trans youth in recent years, with Noem having signed a bill last year banning transgender women and girls in the state from competing on sports teams consistent with their gender at accredited schools and colleges. That legislation codified an executive order the governor signed in 2021.

    As lawmakers continue to debate these bans, advocates like Strangio, who is involved in the ACLU’s legal fight against some of the bans, are vowing to take states to court over any enacted restrictions.

    “It will be the government’s burden to defend it in court,” he told a Tennessee House committee last month that went on to approve a ban there. “And Tennessee, like Alabama, like Texas, like Arkansas, will not be able to do so.”

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  • Pandemic youth mental health toll unprecedented, data show

    Pandemic youth mental health toll unprecedented, data show

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    The pandemic took a harsh toll on U.S. teen girls’ mental health, with almost 60% reporting feelings of persistent sadness or hopelessness, according to a government survey released Monday that bolsters earlier data.

    Sexual violence, suicidal thoughts, suicidal behavior and other mental health woes affected many teens regardless of race or ethnicity, but girls and LGBTQ youth fared the worst on most measures, according to the Centers for Disease Control and Prevention report. More than 17,000 U.S. high school students were surveyed in class in the fall of 2021.

    In 30 years of collecting similar data, “we’ve never seen this kind of devastating, consistent findings,” said Kathleen Ethier, director of CDC’s adolescent and school health division. “There’s no question young people are telling us they are in crisis. The data really call on us to act.”

    The research found:

    — Among girls, 30% said they seriously considered attempting suicide, double the rate among boys and up almost 60% from a decade ago.

    — Almost 20% of girls reported experiencing rape or other sexual violence in the previous year, also an increase over previous years.

    — Almost half of LGBTQ students said they had seriously considered a suicide attempt.

    — More than a quarter of American Indians and Alaska Natives said they had seriously considered a suicide attempt — higher than other races and ethnicities.

    — Feelings of persistent sadness and hopelessness affected more than one-third of kids of all races and ethnicities and increased over previous years.

    — Recent poor mental health was reported by half of LGBTQ kids and almost one-third of American Indian and Alaska Native youth.

    The results echo previous surveys and reports and many of the trends began before the pandemic. But isolation, online schooling and increased reliance on social media during the pandemic made things worse for many kids, mental health experts say.

    The results “reflect so many decades of neglect towards mental health, for kids in particular,” said Mitch Prinstein, the American Psychological Association’s chief science officer. “Suicide has been the second- or third-leading cause of death for young people between 10 and 24 years for decades now,” and attempts are typically more common in girls, he said.

    Prinstein noted that anxiety and depression tend to be more common in teen girls than boys, and pandemic isolation may have exacerbated that.

    Comprehensive reform in how society manages mental health is needed, Prinstein said. In schools, kids should be taught ways to manage stress and strife, just as they are taught about exercise for physical disease prevention, he said.

    In low-income areas, where adverse childhood experiences were high before the pandemic, the crisis has been compounded by a shortage of school staff and mental health professionals, experts say.

    School districts around the country have used federal pandemic money to hire more mental health specialists, if they can find them, but say they are stretched thin and that students who need expert care outside of school often can’t get it because therapists are overburdened and have long waitlists.

    ___

    AP writer Jocelyn Gecker contributed in San Francisco contributed to this report.

    ___

    Follow AP Medical Writer Lindsey Tanner at @LindseyTanner.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • Expelled From High School, Alister Martin Became a Harvard Doc

    Expelled From High School, Alister Martin Became a Harvard Doc

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    Feb. 13, 2023 – It’s not often that a high school brawl with gang members sets you down a path to becoming a Harvard-trained doctor. But that’s exactly how Alister Martin’s life unfolded.

    Alister Martin, MD, had initially planned to follow in his stepfather’s footsteps, managing the drug store in Neptune, NJ, township where he was raised. But a fight changed his prospects. 

    In retrospect, he should have seen the whole thing coming. That night at the party, his best friend was attacked by a gang member from a nearby high school. Martin was not in a gang but he jumped into the fray to defend his friend. 

    “I wanted to save the day, but that’s not what happened,” he says. “There were just too many of them.”

    When his mother rushed to the hospital, he was so bruised and bloody that she couldn’t recognize him at first. Ever since he was a baby, she had done her best to shield him from the neighborhood where gang violence was a regular disruption. But it hadn’t worked. 

    “My high school had a zero-tolerance policy for gang violence,” Martin says, “so even though I wasn’t in a gang, I was kicked out.”

    Now expelled from high school, his mother wanted him out of town, fearing gang retaliation, or that Martin might seek vengeance on the boy who had brutally beaten him. So, the biology teacher and single mom who worked numerous jobs to keep them afloat, came up with a plan to get him far away from any temptations.

    Martin had loved tennis since middle school, when his eighth-grade math teacher, Billie Weise, also a tennis pro, got him a job as a court sweeper at an upscale tennis club nearby. He knew nothing then about tennis but would come to fall in love with the sport. To get her son out of town, Martin’s mother took out loans for $30,000 and sent him to a Florida tennis training camp.

    After 6 months of training, Martin, who earned a GED degree while attending the camp, was offered a scholarship to play tennis at Rutgers University in New Brunswick, NJ. The transition to college was tough, however. He was nervous and felt out of place. “I could have died that first day. It became so obvious how poorly my high school education had prepared me for this.”

    But the unease he felt was also motivating in a way. Worried about failure, “he locked himself in a room with another student and they studied day and night,” recallsKamal Khan, director of the Office for Diversity and Academic Success at Rutgers. “I’ve never seen anything like it.”

    And Martin displayed other attributes that would draw others to him – and later prove important in his career as a doctor. His ability to display empathy and interact with students and teachers separated him from his peers, Khan says. “There’re a lot of really smart students out there,” he says, “but not many who understand people like Martin.”

    After graduating, he decided to pursue his dream of becoming a doctor. He’d wanted to be a doctor since he was 10 years old after his mom was diagnosed with metastatic breast cancer. He remembers overhearing a conversation she was having with a family friend about where he would go if she died. 

    “That’s when I knew it was serious,” he says.

    Doctors saved her life and it’s something he’ll never forget. But it wasn’t until his time at Rutgers that he finally had the confidence to think he could succeed in medical school.

    Martin went on to attend Harvard Medical School and Harvard Kennedy School of Government as well as serving as chief resident at Brigham and Women’s Hospital. He was also a fellow at the White House in the Office of the Vice President and today, he’s an assistant professor at Harvard Medical School.

    He is most at home in the emergency room at Massachusetts General Hospital, where he works as an emergency medical specialist. For him, the ER is the first line of defense for meeting the community’s health needs. Growing up in Neptune, the ER “was where poor folks got their care,” he says. His mom worked two jobs and when she got off work at 8 p.m. there was no pediatrician open. “When I was sick as a kid we always went to the emergency room,” he says.

    While at Harvard, he also pursued a degree from the Kennedy School of Government, because of the huge role he feels that politics play in our health care system and especially in bringing care to impoverished communities. And since then he’s taken numerous steps to bridge the gap. 

    Addiction, for example, became an important issue for Martin, ever since a patient he encountered in his first week as an internist. She was a mom of two who had recently gotten surgery because she broke her ankle falling down the stairs at her child’s daycare, he says. Prescribed oxycodone, she feared she was becoming addicted and needed help. But at the time, there was nothing the ER could do. 

    “I remember that look in her eyes when we had to turn her away,” he says. 

    Martin has worked to change protocol at his hospital and others throughout the nation so they can be better set up to treat opioid addiction. He’s the founder of GetWaivered, an organization that trains doctors throughout the country to use evidenced based medicine to manage opioid addiction. In the U.S. doctors need what’s called a DEA X waiver to be able to prescribe buprenorphine to opioid addicted patients. That means that currently only about 1% of all emergency room doctors nationwide have the waiver and without it, it’s impossible to help patients when they need it the most.

    Shuhan He, MD, an internist with Martin at Massachusetts General Hospital who also works on the GetWaivered program, says Martin has a particular trait that helps him be successful. 

    “He’s a doer and when he sees a problem, he’s gonna try and fix it.”

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  • Nearly Half of Children on Medicaid Lack Outpatient Follow-up Within a Month After Emergency Care for Mental Health

    Nearly Half of Children on Medicaid Lack Outpatient Follow-up Within a Month After Emergency Care for Mental Health

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    Newswise — Only 56 percent of Medicaid-enrolled children received any outpatient follow-up within 30 days after discharge from the Emergency Department (ED) for a mental health concern, according to a large study published in the journal Pediatrics. Rates of timely follow-up among Black children were particularly low, with 10 percent fewer receiving an outpatient mental health appointment within 30 days compared to white children.

    “Our results show the dire need to improve access to outpatient mental health services for children,” said lead author Jennifer Hoffmann, MD, MS, Emergency Medicine physician at Ann & Robert H. Lurie Children’s Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “We especially need to remove barriers to mental health care for Black children. Strategies may include reducing stigma in seeking mental health care, improving diversity in the pediatric mental health workforce, and increasing availability of community and school-based mental health services.”

    Follow-up within seven and 30 days of a mental health ED visit for children ages 6 to 17 years was added to the National Child Core Set of quality measures in 2022, and state Medicaid agencies will be mandated to report annual adherence rates starting in 2024.

    “This work offers some critical insights into the challenges and inequities in mental healthcare for children and youth. These findings should spur efforts to strengthen systems to support mental health for children and youth and new initiatives to non-Hispanic Black children and youth to effective care,” said Dr. Sarah Hudson Scholle, Vice President for Research & Analysis at the National Committee for Quality Assurance (NCQA). NCQA evaluates evidence to select specific quality measures to be used to assess healthcare quality. Based on NCQA recommendations, the quality measure “follow-up within seven and 30 days after an emergency department visit for mental illness in children” was added to the National Child Core Set of quality measures in 2022.

    To examine rates of mental health follow-up, Dr. Hoffmann and colleagues conducted a retrospective study of 28,551 children aged 6-17 years with mental health ED discharges from January 2018 to June 2019 using the IBM Watson MarketScan Medicaid database.

    They found that after the initial ED discharge, less than one-third of children had mental health follow-up within seven days and just over half had follow-up within 30 days. Children without prior mental health outpatient care were at highest risk for poor access to follow-up care.

    “Clearly we need to do better for children who come to the ED in a mental health crisis. Interventions to link to outpatient mental health care should prioritize follow-up within five days of a mental health ED discharge,” said Dr. Hoffmann, who also is the Children’s Research Fund Junior Board Research Scholar. “To improve follow-up after mental health ED visits, we need to focus on children with new diagnoses who have not previously engaged in outpatient mental health care. Future research should assess specific strategies to promote outpatient follow-up, such as care coordination and use of telemedicine.”

    Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Emergency medicine-focused research at Lurie Children’s is conducted through the Grainger Research Program in Pediatric Emergency Medicine.

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    Ann and Robert H. Lurie Children’s Hospital of Chicago

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  • Toddler’s death prompts new warning for a popular baby stroller | CNN Business

    Toddler’s death prompts new warning for a popular baby stroller | CNN Business

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    New York
    CNN
     — 

    The Consumer Product Safety Commission reiterated its warning about the hazards of some popular Baby Trend-brand strollers and sharply criticized the stroller manufacturer for issuing “a clearly inaccurate statement” about the safety of its products and the agency’s position on them.

    On Thursday, the CPSC and Baby Trend warned consumers about a head or neck entrapment risk on the Sit N’ Stand Double and Ultra strollers (model numbers beginning with “SS76” or “SS66”). The statement said a life-threatening injury could happen between the pivoting front canopy and the armrest or seat back.

    The joint notice came after the asphyxiation death of a 14-month-old whose neck became trapped between the canopy tube and the armrest of a Baby Trend Sit N’ Stand double stroller. The toddler’s father was nearby but unable to see the armrest and canopy clearly.

    A 17-month-old child was also left with neck bruises in a separate incident.

    But in a statement Friday Baby Trend said the strollers are “completely safe when used as intended.” (Baby Trend also said it had joined with the CPSC “out of an abundance of caution.”)

    “This tragic and exceedingly rare accident could have been altogether avoided if the young toddler had not been permitted to climb and play on the stroller, which was not being used as intended at the time,” the company’s statement read.

    In response, the CPSC doubled down on its warning, which had noted that,”The space in front of and behind the strollers’ pivoting front canopy can entrap a child’s head or neck if a non-occupant child climbs on the exterior of the stroller or when a child in the front seat of the stroller is not securely restrained in the seat using all five points of the harness.”

    The warning added: “Entrapment could lead to a loss of consciousness, serious injury, or death.”

    The CPSC and Baby Trend warned consumers to remove and separately store the canopy when not in use, not allow children to play on the stroller, and to secure children in the strollers with the harness.

    The Sit N’ Stand strollers have been sold since 2009, and Baby Trend said over a million have been sold nationwide. They’re found at Baby Trend, Amazon, Bed Bath & Beyond, Walmart, Target, Kohl’s, and buybuy BABY.

    Consumers are encouraged to report incidents to the CPSC or to Baby Trend at 800-328-7363 or info@babytrend.com.

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  • Ukrainians, Junior Bruins celebrate unity arm-in-arm on ice

    Ukrainians, Junior Bruins celebrate unity arm-in-arm on ice

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    QUEBEC CITY — The decision to have players from both teams line up arm-in-arm at center ice for the playing of the Ukrainian and United States’ national anthems was pre-planned in what stood as a symbol of unity and solidarity.

    What no one anticipated was the spontaneous celebration that erupted among the 11- and 12-year-olds following the Ukrainian Selects’ 3-1 victory at the International Peewee Hockey tournament on Saturday.

    Rather than shuffle off the ice, members of the Boston Junior Bruins happily took part in a victory lap along with the Selects, which ended with the teams gathering again at center ice, where they posed for a picture with one player from each side holding up the ends of a large Ukrainian flag.

    “First of all, it’s a message that everybody can be friends and should be friends and live in peace and respect each other,” Ukraine forward Denys Lupandin said in an answer translated by coach Evgheniy Pysarenko. “It doesn’t matter from where you are.”

    The bonds that were made and the electric atmosphere of playing in front of some 18,000 fans in Quebec City’s Videotron Centre weren’t lost on Boston goalie James Boccuzzi.

    “This was definitely a life-changing moment for me,” Boccuzzi said. “I’ve never experienced anything like it.”

    The moments went far beyond fulfilling the message of peace that tournament organizers hoped to send across the world nearly a year after Russia’s invasion of Ukraine began. And it exceeded the vision Pysarenko and Sean Berube had in August, when they began the lengthy process of cobbling together a team of Ukrainian refugees.

    “The players reacted like that because they also want to show unity,” said Berube, who spent countless hours and some $20,000 of his own money crisscrossing Europe to gather the players in Romania. “What a day for hockey. What a day for sport.”

    The game didn’t lack for drama, either.

    With Boccuzzi keeping the swift-skating and play-making Ukrainians at bay on a number of close-in chances, Boston’s Kai Ochi opened the scoring 1:27 into the third period.

    The pro-Ukraine — but not anti-Boston — crowd finally got a chance to cheer and chant “Ole, Ole, Ole,” when Yehor Kosenko batted in a bouncing puck to tie the game with 4:48 remaining. Lupandin sneaked a shot in off a faceoff with 2:04 remaining and then sealed the win with an empty-net goal.

    Speaking in English, Lupandin said he and his teammates were nervous to open the game upon being welcomed by the large crowd.

    “The first moment it was so scary. I look and up and too many people look at me and my team, and first moment it was so hard, first period,” he said. “But second and third period, it was easily for me and maybe for my team. And thank you to the fans who come looking at us.”

    A large number of fans arrived three hours before puck drop. White T-shirts spelling out “UKRAINE” were draped over the backs of chairs in one section. In another, a blue-and-yellow version of the Canadian flag was attached to a railing.

    In Section 113, Roger Poirier carried a Ukrainian flag while handing out blue-and-white handkerchiefs. Poirier, who is from Quebec City, has become active in supporting Ukraine in part because he had business there, during which he also met his wife.

    Jessica Anthony wore a T-shirt with the Ukrainian flag on it and had on matching yellow sweatpants. Though an avid hockey fan, she acknowledged she doesn’t normally attend peewee games.

    “I want to express my solidarity with Ukraine,” Anthony said.

    The atmosphere was mostly foreign from what the Ukrainian Selects have known for much of the past year. Many of them have resettled with their families as refugees in countries neighboring Ukraine. At least five still live in Ukraine, where rocket-warning sirens in the middle of the night are the norm.

    “It’s an honor to participate in this event and everybody in solidarity with us and supporting our country,” Pysarenko said. “Everybody wants peace. These kids want peace mostly probably because you don’t know their stories, but I tell you they have the terrible times and terrible experiences.”

    One of those experiences included five players’ trip to the Romanian border to open training camp last month. Twice, they saw rockets fly above them.

    That’s something Bruins assistant coach Mike Cashman couldn’t even imagine. He hoped the Ukrainians can enjoy the new memories they’ve made at the tournament.

    “I just hope that these kids from Ukraine, they just experienced a thrill of a lifetime like our players did,” Cashman said. “You know, I don’t know what the future holds for them, unfortunately, but today they can remember today and be really excited about the future.”

    ___

    AP sports: https://apnews.com/hub/apf-sports and https://twitter.com/AP_Sports

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  • Minnesota Buddhist temple opens up sacred dance troupe

    Minnesota Buddhist temple opens up sacred dance troupe

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    HAMPTON, Minn. — The Buddhist community anchored by an ornate temple complex here in the Minnesota farmland is trying a new way to ensure its faith and ancestral culture stay vibrant for future generations — an open call for the sacred dance troupe.

    Founded by refugees fleeing the Khmer Rouge regime, which sought to eradicate most religious institutions, Watt Munisotaram and its troupe hope that teaching young children sacred dance will strengthen their ties to both Buddhism and Cambodian traditions.

    “The connection is stronger when I dance,” said Sabrina Sok, 22, a Wattanak Dance Troupe leader. “The thing that stays in my head is this dance form almost disappeared with the Khmer Rouge.”

    During their 1975-79 regime, the Khmer Rouge caused the deaths of an estimated 1.7 million in Cambodia. Hundreds of thousands fled, first to neighboring Thailand and later the United States, where Southeast Asians are one of the largest refugee communities.

    They carried this sacred dance tradition with them. On a frigid early February evening, Sok rehearsed for the upcoming Cambodian New Year holiday with fellow troupe leader Garrett Sour and his sister Gabriella, whose parents were among those refugees.

    Practice used to be held at the temple, whose golden spires outshine the red barn roofs and silos in the snow-covered fields about 30 miles (48 kilometers) south of the Twin Cities. But it was recently moved to a Minneapolis studio to make it easier for families to participate.

    While recruitment was by word of mouth, this winter’s enrollment — open to anybody eager to learn the dance form — brought in the highest number ever after being posted on the temple’s Facebook page.

    Clothed in traditional thick silk shirts and pants from Cambodia, the three dancers sinuously stretched and bent every part of their bodies, from joint-defying toe curls on up. Each movement helps tell ancient stories about gods, the cycle of life and other spiritual tales that intertwine elements of Buddhism, Hinduism and Animism.

    “We’re never ourselves, we’re just physical embodiments of higher spirits,” said Garrett Sour, 20, as he meticulously coached the poses, urging a smaller step here, a deeper calf tilt there. “Dance was seen not as entertainment but a medium between heaven and earth.”

    The marketing student at a Twin Cities university started dancing when he was six and has learned Khmer to better delve into the sacred storytelling. He will be one of the teachers for the incoming dancers – about 20, which nearly doubles the troupe, and most of them younger than teens.

    “For me, to see the kids perform these traditional dances is verification they cherish and take seriously our tradition and our religion,” said Garrett’s mother, Sophia Sour, who has long been a volunteer at Watt Munisotaram.

    In the temple’s ornate higher room, where the ten monks in residence chant and meditate daily surrounded by sacred books and large Cambodian-made paintings of Buddha’s life, the Venerable Vicheth Chum also highlighted the importance of what he called “blessed dance.”

    “Very important to have, and to keep our ancestral tradition even when moved to (Minnesota),” said Chum, who came to the United States more than 20 years ago from Cambodia. “Buddhist teaching is practice for peace and happiness, no matter the nation.”

    Monks at Watt Munisotaram – which roughly means the place to enjoy learning from wise men – practice Theravada, one of the oldest forms of Buddhism rooted in Southeast Asian cultures.

    During the Khmer Rouge regime, and the communist Vietnamese rule that followed it, religious institutions were targeted by violence and repression, but Cambodian refugees kept traditions alive, said John Marston, an expert in Cambodian Buddhism at the Mexican university Colegio de Mexico.

    Dance in particular, which dates back nearly 1,000 years and was linked to the royal court as well as temples, has become “a marker of Cambodian identity” in the U.S. diaspora, he added.

    That’s why the dance troupe was started at Watt Munisotaram, which has grown into a 40-acre complex with golden Buddha statues, a stupa with relics and a meditation pond that lay frozen under knee-high snow on that early February weekend.

    Dozens of faithful in equally bright white outfits met then to celebrate Magha Puja, a holiday marking the gathering of 1,250 of Buddha’s first disciples and the establishment of his rules for the new community.

    Chum and seven other monks in elaborately folded, bright orange robes led a candlelit procession multiple times past an altar with several golden Buddha statues, glittery decorations and a profusion of flowers including lotus blossoms – most artificial, though in more clement weather some are grown locally or shipped from Florida.

    Several children marched along, carrying the U.S. flag and Cambodia’s state and Buddhist flags, before everyone sat in neat rows on the carpeted floor for two hours of chanting in Khmer.

    Chum said the monks worry about young people’s growing disenchantment with religion but believe that life’s inevitable struggles will eventually bring most back to the temple for guidance from Buddha’s teachings.

    “It’s like learning a map and then taking action,” he said.

    Garrett Sour, who grew up going frequently with his family to the temple, said he’s still figuring out how Buddhism applies to his life culturally and religiously.

    But he’s fully embraced sacred dancing, and is eager to share what he learned from his teachers – including an aunt who danced in refugee camps before moving to Minnesota – with children, so the tradition can continue through generations.

    The troupe’s main goal “is to preserve dances that were already there,” he said, adding that each summer they perform in a special ceremony honoring the spirits of previous dancers with altars replete with dancing ornaments and offerings.

    Watching the recent rehearsal, Garrett’s mother beamed with pride.

    “The world is using them to educate the other communities, I keep on reminding them,” Sophia Sour said.

    She hopes to take Garrett and Gabriella to Cambodia to learn even more about the roots of their spirituality, whose fundamental values she listed as respect for the elders and good deeds.

    “If you do good, good will come to you,” she said. “I’m not sure if that’s religion, or just life.”

    —

    Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

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  • School dental program prevents 80 percent of cavities with one-time, non-invasive treatment

    School dental program prevents 80 percent of cavities with one-time, non-invasive treatment

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    Newswise — In a study of nearly 3,000 schoolchildren, silver diamine fluoride—a liquid that is brushed onto the surface of teeth to prevent cavities or keep them from worsening—was as effective against cavities as dental sealants, the standard of care. A single dose of either topical treatment given in elementary schools prevented roughly 80% of cavities and kept 50% of cavities from worsening when children were seen two years later.

    The findings, published in JAMA Network Open, offer an efficient and cost-effective approach to improving children’s oral health through school-based care.

    Dental cavities are the most common chronic disease in children, and kids from low-income families are twice as likely to have cavities as those from higher-income families. Without proper and timely intervention, cavities can lead to severe infections, reduce children’s quality of life, and are associated with lower student academic performance and school attendance. But getting kids to a dentist for the recommended twice-yearly visits can be challenging, especially when parents need to take time off of work.

    To reduce the barriers to seeing a dentist, some basic dental services can be offered in schools, especially those serving children from low-income families. For example, the Centers for Disease Control and Prevention recommends and funds school sealant programs. In 2017, NYU College of Dentistry researchers received funding from the Patient-Centered Outcomes Research Institute (PCORI) to run the nation’s largest school-based cavity prevention study, which they named CariedAway.

    CariedAway is a randomized trial comparing the effectiveness of two cavity-prevention techniques: a “simple” treatment using silver diamine fluoride (SDF) and fluoride varnish, and a “complex” treatment using traditional glass ionomer sealants and fluoride varnish. Both are non-invasive and applied to the surface of teeth to prevent and arrest cavities in children, but for the same time and cost, providers can treat more children with the simpler SDF therapy.

    The study included 2,998 children in kindergarten through third grade at 47 New York City schools. The schools—which serve a racially diverse group of students, most of whom are from low-income families—were randomized to receive either the simple or complex treatment.

    Upon visiting each school, the clinical research team—which included a supervising dentist, dental hygienists, registered nurses, and assistants—did baseline exams to measure any tooth decay, and then applied fluoride varnish and either sealants or SDF, depending on whether the school was assigned to receive the complex or simple treatment.

    The initial visits took place in 2019 and early 2020, and were paused when the COVID-19 pandemic temporarily closed New York City schools and halted all school-based care. Two years later, schools allowed the clinical research team to resume, and they returned to each school for follow-up visits.

    The researchers found that both the simple and complex treatments were successful: just one cavity prevention treatment prevented more than 80% of cavities (81% for SDF and 82% for sealants) and stopped half of cavities from progressing (56% for SDF and 46% for sealants).

    “Without prevention, dental cavities grow continuously if not treated. One CariedAway cavity prevention treatment, provided just before schools closed during the pandemic, was remarkably effective over the following two-year period,” said Richard Niederman, DMD, professor in the Department of Epidemiology & Health Promotion at NYU College of Dentistry, co-principal investigator of CariedAway, and the study’s senior author. “I know of no other dental preventive intervention that had this great a beneficial impact across the pandemic.”

    While the limited availability of trained dental professionals can pose challenges for school sealant programs, as sealants are applied by a dentist or dental hygienist, SDF may be an attractive alternative, as it can also be applied by nurses—a workforce already in place in many schools.

    “Our results support the use of SDF for cavity prevention in school-based oral health programs and offer an opportunity for expanding access to critical oral health care,” said Ryan Richard Ruff, MPH, PhD, associate professor in the Department of Epidemiology & Health Promotion at NYU College of Dentistry, co-principal investigator of CariedAway and the study’s first author.

    Tamarinda Barry-Godín, DDS, MPH, was a study co-author. This research was funded by the Patient-Centered Outcomes Research Institute (award PCS-1609-36824).

     

    About NYU College of Dentistry

    Founded in 1865, New York University College of Dentistry (NYU Dentistry) is the third oldest and the largest dental school in the US, educating nearly 10 percent of the nation’s dentists. NYU Dentistry has a significant global reach with a highly diverse student body. Visit dental.nyu.edu for more.

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    New York University

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  • Bill that would restrict drag shows passes Tennessee Senate

    Bill that would restrict drag shows passes Tennessee Senate

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    NASHVILLE, Tenn. — Legislation designed to restrict where certain drag shows can take place passed the Tennessee Senate on Thursday, the latest bill state Republican leaders have advanced targeting LGBTQ people.

    Senate lawmakers voted 26-6 in favor of the bill, with only Democrats opposing. The bill is slightly different than a version moving through the House chamber.

    Under the Senate’s bill, the words “drag show” are not explicitly stated. Instead, the legislation would expand the definition of adult cabaret in Tennessee’s law to include that such “adult-oriented performances that are harmful to minors,” as defined in Tennessee’s obscenity law.

    The legislation then bans adult cabaret from taking place on public property or in a location where minors might be present.

    “We don’t want to have the door open that they can go see advertent nudity and sexual acts or the depiction of sexual acts,” said Republican Sen. Becky Massey. “I’m sorry, that’s not what Tennessee is about.”

    In Tennessee and across the country, drag has been cast in a false light by right-wing activists and politicians who complain about the “sexualization” or “grooming” of children.

    Drag does not typically involve nudity or stripping, which are more common in burlesque, a separate form of entertainment. Explicitly sexual and profane language is common in performances meant for adult audiences. These routines can consist of stand-up comedy that may be raunchy — or may pale in comparison with some mainstream comedians.

    “Leveraging fear of others may be politically advantageous, but it’s the antithesis of good governance,” Democratic Sen. Heidi Campbell said.

    During Thursday’s debate, Senate Majority Leader Jack Johnson declined to directly answer questions on how his legislation would be enforced — particularly if it would effect drag brunches, performers who wear drag attire during pride events or grooms who wear kilts during a wedding ceremony — and chose to read the legislation and definitions in current law instead.

    “I would encourage you to direct (constituents) to the obscenity statute,” Johnson said.

    The attention now moves to the House, which is debating a slightly different version. It’s unknown whether House members will amend their legislation to align with the Senate.

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  • Passport rush blamed on US policy stalls adoptions in Haiti

    Passport rush blamed on US policy stalls adoptions in Haiti

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    SAN JUAN, Puerto Rico — Dozens of children are stuck in orphanages across Haiti, unable to leave the increasingly volatile country and start new lives with adoptive parents because a U.S. policy change has unleashed a rush for passports at Haiti’s main immigration office.

    U.S. President Joe Biden announced last month that the U.S. will accept 30,000 people a month from Haiti, Nicaragua, Cuba and Venezuela if they pass a background check and have an eligible sponsor and a passport to travel.

    The ensuing demand for Haitian passports has overwhelmed Haiti’s passport office in the capital, Port-au-Prince, where people with appointments cannot squeeze through the aggressive crowd or secure new appointments.

    Meanwhile, adoptive parents say the U.S. State Department has declined to grant passport waivers as they worry their children will succumb to hunger, cholera or gang violence.

    “It’s infuriating,” said Bryan Hanlon, a postal inspector who lives with his wife in Washington.

    They became the legal parents of Peterson, 5, and Gina, 6, last year and fear they won’t be able to secure passports for the children and fly them out of Haiti, which has been in a downward spiral since the July 2021 assassination of President Jovenel Moïse.

    Last year, the number of reported kidnappings in Haiti soared to 1,359, more than double the previous year, and 2,183 killings were reported, up by a third from 2021, according to the United Nations. Gangs also are raping women and children at an alarming rate, including those as young as 10, officials say.

    The country also is fighting a deadly cholera outbreak and a spike in starvation.

    Last year, 5-year-old Peterson became malnourished and had to be taken to a clinic, where he was treated for a couple of months.

    Then in October, the siblings had to flee the orphanage with a caretaker as gangs raided the neighborhood, killing dozens of civilians and setting homes on fire. The violence that erupts as gangs fight over territory has left tens of thousands of Haitians homeless.

    “That was the worst day of our lives,” Hanlon said. “We didn’t know if they were alive or dead.”

    With their orphanage abandoned because of the violence, the children had been taken by one of their caretakers to her home in southern Haiti, where they have remained, he said.

    Hanlon said he and his wife send money to the caretaker, but that “some days, there is just no food to buy or no fuel to cook it.” Other times, she cannot leave the house to pick up the money because it’s too dangerous, he said.

    Brooke Baeth, an elementary school speech therapist in Minnesota, understands the fear and frustration. She and her husband became the legal parents of a 5-year-old girl in Haiti nearly a year ago, but they don’t know when they will be able to meet her.

    In late January, her daughter and caretakers flew from their orphanage in northern Haiti to Port-au-Prince only to encounter a huge crowd at the immigration office. Despite having an appointment, they could not get inside, nor could some of the office’s own employees, Baeth said.

    “It’s just devastating,” she said, adding that like the Hanlons, they haven’t been able to obtain a passport waiver from the State Department. “It feels like our voices are not being heard.”

    A spokesperson for the State Department said intercountry adoption is one of the agency’s highest priorities and that it uses all appropriate tools to identify and overcome barriers.

    “We understand that it is currently difficult for prospective adoptive parents to obtain a Haitian passport,” the spokesperson said. “We remain committed to helping prospective adoptive parents navigate the often-complicated journey of intercountry adoption. We will continue to engage with the Haitian government on this issue.”

    Hanlon shared email messages with The Associated Press in which the U.S. government denied his request for a waiver by noting that both Haiti’s immigration office and the Ministry of the Interior were open for business, and that passport waivers are for use only on a case-by-case basis and as a last resort.

    Ryan Hanlon, president and CEO of the U.S. National Council for Adoption who is not related to Bryan Hanlon, said in a phone interview that the State Department’s manual calls on officials to prioritize adoption cases.

    “Can we even say we prioritize adoption when we have legal options that we choose not to utilize?” he said. “It’s the safety of the children that’s the concern here.”

    Given the ongoing crush at Haiti’s main immigration office, government officials recently opened two makeshift offices in a gymnasium and a soccer field elsewhere in Port-au-Prince. They also implemented a schedule setting aside specific days for groups including women and the elderly. Saturdays have been reserved for children.

    Officials say they don’t know how many Haitian children are in this situation, but two of 11 U.S. agencies that are main providers of adoption services in Haiti say a dozen or more of their children are affected and the number has been rising. From 2016 to 2020, people adopted 827 children from Haiti, according to the most recent statistics from the State Department. Only 96 children were adopted in 2020, down from a high of 227 in 2017.

    At one adoption agency, Colorado-based A Love Beyond Borders, at least 13 children in Haiti have been adopted but have been unable to obtain passports amid a processing backlog that is growing every day, said Stephanie Thoet, the agency’s Haiti program coordinator.

    She noted that even Haiti’s Ministry of the Interior has been unable to access the passport office to manually deliver the files of adopted children and worries about officials being killed or kidnapped by gangs as they travel back and forth with paperwork that has taken years to complete.

    “I am terrified every time they go,” she said.

    At another agency, Utah-based Wasatch International Adoption, at least a dozen children who already have been adopted can’t obtain a passport, and the number is growing, said Chareyl Moyes, the agency’s Haiti program manager.

    “The situation is dire,” she said, adding that she worries about a child or caretaker being killed. “Do we want to wait until it’s at that point?”

    Baeth said it’s hard for her daughter to understand why it’s taking so long to be together. They tell her how much she means to them and send her images of the snow, prompting her to excitedly ask if she could eat it. The girl, who wants to be a unicorn rider when she grows up, has sent them videos of her doing cartwheels and somersaults.

    Hanlon said his daughter knows what is going on: “She understands enough to be frustrated.”

    He recalled how Gina was upset one day and told her caretaker: “I don’t want to talk to them in videos anymore. I want to talk to them in person.”

    His son, however, is younger.

    Hanlon said when the boy is told he can’t travel to certain parts of Haiti, he tells the other children not to worry, assuring them: “My dad’s like Superman. He’ll fly down and kill the bad guys.”

    Hanlon paused as his voice broke.

    “Some days, I feel like I’m letting him down.”

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  • Student Mental Health Week Focuses on Rates of Stress, Anxiety

    Student Mental Health Week Focuses on Rates of Stress, Anxiety

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    Feb. 8, 2023 — As mental health issues rise among teens and college students, this week’s first-ever global Student Mental Health Week couldn’t be better timed.

    The urgency is quite apparent. A recent study showed that nearly one-third of students worldwide said their mental health has worsened since returning to campus following the COVID-19 lockdowns. 

    With suicide rates on the rise, this campaign, established by five youth-focused nonprofits including Born This Way Foundation launched by Lady Gaga, the Inspiring Children Foundation co-chaired by singer-songwriter Jewel, the Jed Foundation, and Chegg, an education-technology, wants to draw attention to the issue.

    “Even before the pandemic, we’ve seen increased rates of depression, anxiety, and suicide deaths among students,” says Laura Erickson-Schroth, MD, chief medical officer at the Jed Foundation, which protects emotional health and works to prevent suicide among teens and young adults. “Young people are exposed constantly to wars around the world, the social and political unrest in our country and the climate crisis — things that adults never were when they were teenagers. I don’t think we recognize how much they’re dealing with.”

    All week, social media live events will aim to help educate policymakers, educational institutions, and communities on the mental health challenges students are facing. Another goal is to urge students around the world to develop call-to-action plans with their legislators, all with the goal of boosting mental health support.

    “The previous generation overlooked mental health issues, which created a culture where there was so much shame around not feeling comfortable in your own head,” says Matine Khalighi, a sophomore at Harvard University and executive director and founder of EEqual, a for-youth-by-youth nonprofit focused on overcoming student homelessness. “There’s now a new wave of being open about mental health challenges. Creating a space where we can talk about this makes us feel less alone.”

    Cherrial Odell, a Stanford University sophomore who survived suicide and an adverse childhood, serves on the boards of both the Born This Way Foundation and the Inspiring Children Foundation. For Odell, this week is critically important.

    “We all have mental health concerns,” says Odell, who this week, as president of the student-run Stanford Mental Health Outreach group, is hosting daily events on the Stanford campus. “The beauty of our generation is that we’re a lot more open about talking about these issues. That’s a beautiful thing. After all, opening up and sharing your story is a strength, not a weakness. It shows you have the courage to share what you’re going through.”

    Ultimately, Erickson-Schroth hopes that the week informs adults, too.

    “It’s so important for the adults in young peoples’ lives to recognize the signs that a young person is going through something that is causing stress and anxiety,” she says. “It’s also important for parents to feel like they have the resources to provide that help.”

    Neal Horen, PhD, director of the early childhood division at the Center for Child and Human Development and the director of the HOYA clinic in the Department of Psychiatry at Georgetown University, hopes this week helps focus more attention on the potential pitfalls students may face at this major developmental phase of their lives.

    “Going to college can be amazing or it can be an arduous trek if we’re not paying attention,” he says. “This is a major time of identify formation with kids asking themselves ‘who am I,’ ‘where do I fit in.’ That plus the immediate independence they may experience living away from home is a big demand to put on someone and can lead to mental health challenges we have to pay attention to.”

    For more information, visit the Student Mental Health Week page.

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  • Cannabis has same effect on adolescents and adults, and CBD doesn’t dampen effects

    Cannabis has same effect on adolescents and adults, and CBD doesn’t dampen effects

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    Newswise — The short-term effects of vaporised cannabis do not differ between adolescents and adults, while cannabidiol (CBD) does not dampen the effects of the drug, finds a new study led by UCL and King’s College London researchers.

    For the experimental study published in Addiction, the researchers measured how regular cannabis users of different ages responded to inhaling cannabis with differing levels of CBD.

    The study participants included 24 adolescents (16-17 years old) and 24 adults (26-29 years old), all of whom were already regular users of cannabis (0.5 to three days per week, averaging 1.5 days of cannabis use per week).

    In a clinical research facility (Invicro), the participants inhaled three types of vaporised cannabis under close medical supervision. On three separate weeks, participants were given either a placebo, or a strain of cannabis high in delta-9-tetrahydocannabinol (THC, the main psychoactive component, which typically predominates in both illegal and legal markets), or a high-CBD and high-THC version (consisting of the same level of THC, and also containing CBD)*. There were administered in doses comparable to typical recreational use.

    The participants were asked to report how the drug was affecting them at regular intervals, and completed tests assessing their verbal memory and the psychotic-like effects of the drug (such as delusions, cognitive disorganisation or paranoia).

    The researchers found all the expected effects of cannabis in the THC and THC+CBD conditions, among the participants’ responses: feeling high, feeling anxious, having mild psychotic-like experiences, and memory impairment.

    However, crucially there was no evidence that adolescents differed from adults in their responses to cannabis, while under the influence.

    Lead author, psychology lecturer Dr Will Lawn, who conducted the study at UCL before moving to King’s College London, said: “Immediately following consumption, cannabis can elicit psychotic-like effects, and impair verbal memory, and adolescents in our study who regularly smoke cannabis were just as vulnerable to this as the adults were. Adolescence is a key developmental stage of life, when people are at an increased risk of developing mental health problems.

    “Regularly producing transient psychotic-like effects and memory impairments through cannabis use is likely to augment the risk of psychological distress, especially in those who are vulnerable to these harms. However, critically, our results also indicate that 16- to 17-year-old cannabis users were not more sensitive to the acute harmful effects of cannabis than adults.”

    In recent years, there has been growing concern about the impact of cannabis on young people, as well as hope that CBD may protect against some cannabis harms. A recent long-term, observational study by the same authors found that adolescents are more vulnerable to cannabis addiction, compared to adult users, but they are not more vulnerable to depression and anxiety.**

    Cannabis has natural variation in CBD, which is a non-intoxicating constituent of the drug, as well as the relative levels of THC, which is psychoactive and gets people high.

    CBD has rapidly grown as an over-the-counter wellness supplement in recent years, and previously CBD in cannabis had been thought to mitigate against some of the unpleasant effects of THC.

    For the latest study, in testing the impact of differing CBD levels, the researchers found that CBD levels did not impact the subjective feel of the drug, and it also did not affect memory impairment or psychotic-like effects.

    The researchers say their study does not address high-dose CBD’s potential medical benefits when administered by itself, but the findings do cast doubt on popular suggestions that these lower doses of CBD found in cannabis may protect against THC’s acute effects on memory and psychotic-like experiences.

    Dr Lawn said: “Adding a moderate dose of vaporised CBD, about 25mg, to cannabis that is already high in THC does not alter the subjective experience, nor does it protect from effects such as paranoia or memory impairment. However, we have not investigated the long-term effects of low-dose CBD nor the therapeutic effects of high-dose pharmaceutical CBD here.”

    Senior author Professor Val Curran (UCL Clinical Psychopharmacology Unit, UCL Psychology & Language Sciences) commented: “Cannabis is the world’s most commonly used internationally controlled drug. It is particularly popular among adolescents, with over 15% of 15-year-olds in England and 28% of those in the US reporting usage in the last year. As cannabis laws are rapidly changing around the globe, it is vital that we understand whether the adolescent brain is more vulnerable, in order to inform regulations and accurate, evidence-based harm reduction messaging. Here, we have found that adolescents are neither more resilient nor more vulnerable to the immediate effects of cannabis.”

    The research formed part of the Medical Research Council-funded CannTeen study***, involved researchers at UCL, King’s College London, the University of Bath and Invicro llc, and received full ethical approval from the UCL Ethics Committee. As all participants were over 16 years old, everyone consented as a legal adult. All participants were already cannabis users and the study was completed safely without issues, with medical professionals present at all times.

    The researchers say that strengths of this randomised, double-blind, placebo-controlled experiment are the tight experimental controls and that participants in the adult and adolescent groups were carefully matched on their natural cannabis use. The researchers caution that their study does not shed light on long-term impacts of cannabis.

    Notes to Editors

    * For a 75kg person, the “THC” condition had 8mg of THC, and the “THC+CBD” condition had 8mg of THC + 24mg of CBD. This dose of THC reflects approximately one quarter of a joint, and a moderate dose of CBD that was thought might influence the drug’s effects. The placebo consisted of a product using cannabis as the starting material, but with all cannabinoids (including THC and CBD) removed.

    ** UCL News, 2022: Adolescents more vulnerable to cannabis addiction but not other mental health risks

    *** More about the CannTeen study

    For more information or to speak to the researchers involved, please contact Chris Lane, UCL Media Relations. T: +44 (0)20 7679 9222 / +44 (0)7717 728 648, E: [email protected]

    Will Lawn, Katie Trinci, Claire Mokrysz, Anna Borissova, Shelan Ofori, Kat Petrilli, Michael Bloomfield, Zarah R Haniff, Daniel Hall, Natalia Fernandez-Vinson, Simiao Wang, Amir Englund, Edward Chesney, Matthew B Wall, Tom P Freeman, and H Valerie Curran, ‘The acute effects of cannabis with and without cannabidiol in adults and adolescents: a randomised, double-blind, placebo-controlled, crossover experiment’ will be published in Addiction on Wednesday 8 February 2023, 00:01 UK time and is under a strict embargo until this time.

    The DOI for this paper will be 10.1111/ADD.16154, and the paper will be published at https://onlinelibrary.wiley.com/doi/abs/10.1111/add.16154.

    About UCL – London’s Global University

    UCL is a diverse global community of world-class academics, students, industry links, external partners, and alumni. Our powerful collective of individuals and institutions work together to explore new possibilities.

    Since 1826, we have championed independent thought by attracting and nurturing the world’s best minds. Our community of more than 43,800 students from 150 countries and over 14,300 staff pursues academic excellence, breaks boundaries and makes a positive impact on real world problems.

    We are consistently ranked among the top 10 universities in the world and are one of only a handful of institutions rated as having the strongest academic reputation and the broadest research impact.

    We have a progressive and integrated approach to our teaching and research – championing innovation, creativity and cross-disciplinary working. We teach our students how to think, not what to think, and see them as partners, collaborators and contributors.  

    For almost 200 years, we are proud to have opened higher education to students from a wide range of backgrounds and to change the way we create and share knowledge.

    We were the first in England to welcome women to university education and that courageous attitude and disruptive spirit is still alive today. We are UCL.

    About King’s College London

    King’s College London is one of the top 35 universities in the world and one of the top 10 in Europe (QS World University Rankings, 2020/21) and among the oldest in England. King’s has more than 31,000 students (including more than 12,800 postgraduates) from some 150 countries worldwide, and some 8,500 staff. 

    King’s has an outstanding reputation for world-class teaching and cutting-edge research. In the 2021 Research Excellence Framework (REF), King’s maintained its sixth position for ‘research power’ in the UK. King’s has also been rated third amongst multidisciplinary institutions for impact, with 67.8% of its research impact rated outstanding. 

    Since our foundation, King’s students and staff have dedicated themselves in the service of society. King’s will continue to focus on world-leading education, research and service, and will have an increasingly proactive role to play in a more interconnected, complex world. Visit our website to find out more about Vision 2029, King’s strategic vision to take the university to the 200th anniversary of its founding.

    World-changing ideas. Life-changing impact: https://www.kcl.ac.uk/news/headlines.aspx

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  • IVF-Conceived Children Show Strong Developmental Performance

    IVF-Conceived Children Show Strong Developmental Performance

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    Feb. 7, 2023 – In vitro fertilization has been around long enough that researchers can now compare developmental and academic achievements between these children and peers at school age. 

    Amber Kennedy, MBBS, and colleagues did just that. They found little difference in these milestones between a total of 11,059 IVF-conceived children and 401,654 spontaneously conceived children in a new study.

    “Parents considering IVF and health care professionals can be reassured that the school age developmental and educational outcomes of IVF-conceived children are equivalent to their peers,” says Kennedy, lead author and obstetrician and gynecologist at Mercy Hospital for Women at the University of Melbourne, Australia. 

    The findings were published online Jan. 24 in the journal PLOS Medicine. 

    “Overall, we know that children born through IVF are doing fine in terms of health, but also emotionally and cognitively. So I wasn’t surprised. I live in this world,” says Ariadna Cymet Lanski, PsyD, chair of the American Society for Reproductive Medicine Mental Health Professional Group, who was not affiliated with the study.

    Some previous researchers linked conception via IVF to an increased risk of congenital abnormalities, autism spectrum disorder, developmental delay, and intellectual disability.

    Asked why the current study did not find increased risks, Kennedy says, “Our population included a relatively recent birth cohort, which may explain some differences from previous studies as IVF practices have evolved over time.” 

    An estimated 8 million people worldwide have been conceived through IVF since the first birth in 1978, the researchers says. In Australia, this has grown from 2% of births in the year 2000 to now nearly 5% or 1 in 20 live births, Kennedy says. “Consequently, it is important to understand the longer-term outcomes for this population of children.”

    Along with senior author Anthea Lindquist, MBBS, Kennedy and colleagues studied 585,659 single births in Victoria, Australia, between 2005 and 2014. They did not include multiple births like twins or triplets.

    The investigators compared 4,697 children conceived via IVF and 168,503 others conceived spontaneously using a standard developmental measure, the Australian Early Developmental Census (AEDC). They also assessed 8,976 children in the IVF group and 333,335 other children on a standard educational measure, the National Assessment Program–Literacy and Numeracy (NAPLAN).

    For example, the developmental census measures developmental vulnerability. Kennedy and colleagues found a 0.3% difference in favor of IVF-conceived children, which statistically was no different than zero.

    Similarly, the researchers report that IVF conception had essentially no effect on overall the literacy score, with an adjusted average difference of 0.03.

    Lanski says the results should be reassuring for people considering IVF. “I can see the value of the study.” The findings “probably brings a lot of comfort … if you want to build a family and medically this is what’s recommended.” 

    Not all IVF techniques are the same, and the researches want to take a deeper dive to evaluate any distinctions among them. For example, Kennedy says, “We plan to investigate the same school-aged outcomes after specific IVF-associated techniques.” 

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  • New rules would limit sugar in school meals for first time

    New rules would limit sugar in school meals for first time

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    U.S. agriculture officials on Friday proposed new nutrition standards for school meals, including the first limits on added sugars, with a focus on sweetened foods such as cereals, yogurt, flavored milk and breakfast pastries.

    The plan announced by Agriculture Secretary Tom Vilsack also seeks to significantly decrease sodium in the meals served to the nation’s schoolkids by 2029, while making the rules for foods made with whole grains more flexible.

    The goal is to improve nutrition and align with U.S. dietary guidelines in the program that serves breakfast to more than 15 million children and lunch to nearly 30 million children every day, Vilsack said.

    “School meals happen to be the meals with the highest nutritional value of any meal that children can get outside the home,” Vilsack said in an interview.

    The first limits on added sugars would be required in the 2025-2026 school year, starting with high-sugar foods such as sweetened cereals, yogurts and flavored milks.

    Under the plan, for instance, an 8-ounce container of chocolate milk could contain no more than 10 grams of sugar. Some popular flavored milks now contain twice that amount. The plan also limits sugary grain desserts, such as muffins or doughnuts, to no more than twice a week at breakfast.

    By the fall of 2027, added sugars in school meals would be limited to less than 10% of the total calories per week for breakfasts and lunches.

    The proposal also would reduce sodium in school meals by 30% by the fall of 2029. They would gradually be reduced to align with federal guidelines, which recommend Americans aged 14 and older limit sodium to about 2,300 milligrams a day, with less for younger children.

    Levels would drop, for instance, from an average of about 1,280 milligrams of sodium allowed now per lunch for kids in grades 9 to 12 to about 935 milligrams. For comparison, a typical turkey sandwich with mustard and cheese might contain 1,500 milligrams of sodium.

    Health experts say cutting back on sugar and salt can help decrease the risk of disease in kids, including obesity, diabetes, high blood pressure and other problems that often continue into adulthood.

    The plan, detailed in a 280-page document, drew mixed reactions. Katie Wilson, executive director of the Urban School Food Alliance, said the changes are “necessary to help America’s children lead healthier lives.”

    But Diane Pratt-Heavner, spokeswoman for the School Nutrition Association, a trade group, said school meals are already healthier than they were a decade ago and that increased regulations are a burden, especially for small and rural school districts.

    “School meal programs are at a breaking point,” she said. “These programs are simply not equipped to meet additional rules.”

    Vilsack emphasized that the plan phases changes in over the next six years to allow schools and food manufacturers time to adjust to the new standards. He said in a press conference Friday that the USDA will also fund grants of up to $150,000 to help small and rural schools make the changes.

    “Our hope is that many school districts and food providers accelerate the timeline on their own,” he said.

    Courtney Gaine, president of the Sugar Association, said the proposal ignores the “many functional roles” sugar plays in food beyond sweetness and encourages the use of sugar substitutes, which have not been fully studied in children. Sugar substitutes are allowed under the new standards, Vilsack said.

    As part of the plan, agriculture officials are seeking feedback about a proposal that would continue to require that 80% of all grains offered in a week must be whole grains. But it would allow schools to serve non-whole grain foods, such as white-flour tortillas, one day a week to vary their menus.

    Another option suggests serving unflavored nonfat and lowfat milk to the youngest children and reserving chocolate and other flavored milks for high school kids.

    A 60-day public comment period on the plan opens Feb. 7.

    Shiriki Kumanyika, a community health expert at Drexel University’s Dornsife School of Public Health said if they’re done right some of the changes will be hard for kids to notice: “They’ll see things that they like to eat, but those foods will be healthier,” she said.

    ___

    This story has been corrected to fix the spelling the president of the Sugar Association. It is Courtney Gaine, not Courtney Gaines.

    ___

    AP Videojournalist Shelby Lum and AP Science Writer Maddie Burakoff contributed to this report.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • ChatGPT bot channels history to pen State of Union speech

    ChatGPT bot channels history to pen State of Union speech

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    WASHINGTON — If you’ve heard it once in a president’s State of the Union speech, you’ve heard it 100 times: There is nothing the American people can’t do when they pull together.

    But you haven’t heard that thought in a State of Union address from William Shakespeare: “Lo,” said the bard. “With kindness, love, and understanding clear, we shall conquer all, and have naught to fear.”

    Nor from the noggin-knocking Three Stooges of last century’s fame: “We just put our heads together, come up with a plan, and bam! Problem solved!”

    Let’s face it, State of the Union speeches are mostly rote. Presidents roll out a list of accomplishments, a few anecdotes about guests in attendance, a sober assessment of the problems of the day and a crescendo about glory times ahead.

    To shake up the formula before President Joe Biden’s speech to Congress on Tuesday night, The Associated Press instructed the artificial intelligence program ChatGPT to work up State of the Union speeches as they might have been written by some of history’s greatest minds as well as some stooges.

    AP ordered up 300-word versions, in contrast to Biden’s sprawling 6,400 words last year, and tapped a few people so iconic we know them by only one name. The virtual Greek philosopher Aristotle gracefully quoted Socrates, Cleopatra the historic Egyptian ruler asked for the blessing of the gods, Madonna cited her perspective as a mother and a woman in the entertainment industry.

    ChatGPT was also asked to channel singer Elvis Presley, civil rights leader Martin Luther King Jr., Indian independence leader Mahatma Gandhi, the ground-breaking NASA mathematician Katherine Johnson, Tesla and Twitter CEO Elon Musk, the abolitionist Sojourner Truth, and baseball’s Yogi Berra, among other luminaries.

    We also wanted to see what a bright, unidentified 10-year-old might say to the assembled lawmakers.

    The app is part of a new generation of AI systems that can converse in human-like fashion and generate text on demand based on what they’ve learned from a vast database of digital books, online writings and other media. It petrifies teachers who fear their students will use it instead of their brains for school papers.

    ChatGPT rendered Shakespeare’s State of the Union speech in rhyme, scrolling on the screen faster than anyone could read it. The version channeling comedian Jerry Seinfeld captured his verbal mannerisms and signature phrasings.

    “I’ve been thinking about this a lot lately, and I’ve realized that the state of our union is like a sandwich,” wrote the app-generated Seinfeld. “You’ve got the top bun, which is all the good stuff. You’ve got the cheese, the lettuce, the tomato, the mayo. It’s all delicious.

    “But then, when you take a closer look, you see the bottom bun, and that’s where the real work is. That’s where the foundation is.”

    Yada, yada yada.

    For all the app’s smarts and speed, it wasn’t all-knowing. In the speech channeling King, it had the civil rights leader quoting himself. It conveyed none of Abraham Lincoln’s eloquence. And it declined to take a run at drafting 2023 Biden’s speech, instead serving up a rehash of his last one.

    It also drew a blank when asked for a speech from George Santos, the new Republican congressman from New York who was caught fictionalizing his past. It seemed to sense, though, that there was something make-believe in the picture.

    “George Santos is not a widely recognized public figure or historical figure,” the app responded. “There is no widely known information about a person by this name in the public domain. It’s possible that the name was created for a specific use or scenario, such as a fictional character or a person in a private setting.”

    A look at some of the speeches ChatGPT generated:

    WILLIAM SHAKESPEARE

    My Lords and Ladies, countrymen and women, Gather ye here today to hear what I say, In this great hall of ours, let us unite, And listen to the state of our fair state.

    We stand today as one, in good health and grace, Prosperous and free, with a peaceful space, Our trade and commerce flourish, wealth abounds, With bountiful harvests, and peace surrounds.

    But, lo, there are still challenges we face, For not all are equal in our fair place, We must work together to bridge the divide, And bring forth equality, from side to side.

    Let us not forget, our soldiers bold and brave, Who fought for freedom, and our country gave, Their lives and limbs, for our safety and peace, We must repay them with honors and release.

    And so I say, let us work hand in hand, To build a brighter future, in this fair land, With kindness, love, and understanding clear, We shall conquer all, and have naught to fear.

    And now, my friends, I bid thee all farewell, And trust that thou wilt work, with heart and will, For the good of all, and the betterment of man, Together we shall build, a stronger, better land.

    ___

    SOJOURNER TRUTH, the 1800s abolitionist and evangelist born into slavery

    As a former slave, I stand before you today as a witness to the ongoing struggle for freedom and equality in this great nation. Despite the progress made since the abolition of slavery, I cannot help but feel a deep sense of disappointment at the persistence of racial injustice.

    African Americans are still being denied their basic rights, facing discrimination and prejudice at every turn. This is evident in the disproportionate number of black people who are incarcerated, unemployed, and living in poverty. It is also evident in the ongoing struggle for voting rights, as Black citizens are still being denied the right to vote through various means, including gerrymandering and voter suppression tactics.

    But I have not lost hope. I have faith in the resilience of my people, and I am inspired by the efforts of those who continue to fight for justice. I am heartened by the rise of the Black Lives Matter movement and the many other groups who are speaking out against systemic racism and calling for change.

    I call upon all of you to join me in this fight. We must not be complacent in the face of injustice. We must continue to stand up for what is right, even when it is difficult. We must continue to fight for equal rights for all, regardless of race, gender, or religion.

    Together, we can create a future where all people are free from discrimination and prejudice, where everyone has the opportunity to succeed, and where justice and equality reign supreme. This is the state of our union, and it is a call to action. Let us work together to build a brighter future for all.

    ___

    JERRY SEINFELD

    Good evening, my fellow Americans. How’s everyone doing tonight? I’m here to give you the State of the Union address, and I must say, I’m a little nervous. I mean, usually when I give a speech, I have a microphone and a stage and a live audience. But tonight, it’s just me and you, so I hope you don’t mind if I sprinkle in a few jokes to lighten the mood.

    Now, let’s talk about the state of our union. I’ve been thinking about this a lot lately, and I’ve realized that the state of our union is like a sandwich …

    We’ve got the top bun, which is all the good stuff. We’ve got the economy, which is looking pretty tasty. We’ve got low unemployment, and businesses are thriving. … I want to focus on the bottom bun. I want to focus on the foundation. I want to talk about the things that we don’t always see or talk about, but that are so important. I want to talk about education, and healthcare, and infrastructure. I want to talk about the things that make our country strong …

    Let’s make sure that our country is a delicious sandwich that we can all be proud of.

    ___

    YOGI BERRA, baseball hall of famer

    It’s like deja vu all over again, folks! We’ve been here before and we’re here again. The state of the union, it’s complicated, but we’re makin’ progress. We’ve got our ups and our downs, but we gotta keep swingin’ at those curveballs life throws our way.

    Now, let me tell ya, we’ve been workin’ hard to make this country a better place for all of us. We’ve got a lot of people doin’ a lot of good things, and we gotta keep that up. And for those who ain’t doin’ so well, we gotta help ‘em out. We’re all in this together, like a big ol’ family.

    We’ve got a lot of challenges ahead of us, but we’ve also got a lot of opportunities. We’ve gotta take ’em both on, head on. And we’ve gotta work together, ‘cause ain’t nothin’ we can’t do if we work together.

    So, let’s keep up the good work, folks. Let’s make this country the best it can be. It ain’t gonna be easy, but ain’t nothin’ worth doin’ ever is.

    ___

    KATHERINE JOHNSON, a mathematician whose calculations enabled NASA to put the first Americans into Earth’s orbit and on the moon

    My fellow Americans,

    As a mathematician, I have spent my career using numbers and equations to solve complex problems and push the boundaries of what is possible. And as I look at our nation today, I see a problem that demands our attention and our action.

    We are facing a crisis in mathematics education. Too many of our children are struggling to keep up, and too few are pursuing careers in science, technology, engineering, and mathematics. This not only undermines their future opportunities, but also threatens our ability to compete in an increasingly technological world.

    But the solution to this problem is within our reach. We must invest in math education, from early childhood through high school and beyond. We must provide our teachers with the support and resources they need to help students succeed, and we must encourage girls and underrepresented minorities to pursue careers in STEM fields.

    As we work to address this crisis, let us also remember the incredible potential of mathematics. Math is not just a subject to be studied, but a powerful tool that can help us tackle the greatest challenges of our time. Whether we are working to cure diseases, address climate change, or build a more just and equitable society, math will be an essential part of the solution.

    My own journey as a mathematician has taken me from the halls of NASA to the history books, but it all started with a love of numbers and a desire to use them to make a difference in the world. And I believe that every child in America, regardless of their background or circumstances, should have the opportunity to discover their own love of math and use it to make a difference.

    So let us recommit ourselves to ensuring that all Americans have access to a quality math education, and let us harness the power of math to build a better future for ourselves and for generations to come.

    ___

    ELVIS PRESLEY

    Well, hello there, my fellow Americans!

    It’s great to be here today, talking to you all about the state of our union. Now, let me tell you, we’ve been rockin’ and rollin’ over the past year, and I’ve got some good news to share with you all.

    We’re making progress, friends. Our economy is stronger than ever, our businesses are booming, and our country is more united than ever. You know, when I look out into this crowd, I see Americans from all walks of life, all coming together for the greater good of our nation.

    Now, I know some folks out there might say we’ve got some challenges to overcome, but I’ve got to tell you, I believe in the American people. We’ve faced tough times before, and we’ve always come out on top. And we’re gonna do it again.

    We’re gonna keep on truckin’, we’re gonna keep rockin’ and rollin’, and we’re gonna keep building a better future for all Americans. I’ve got faith in you, my fellow Americans, and I know that together, we can do anything.

    So let’s get to work, let’s keep this train rollin’, and let’s make America great again. Thank you, and God bless America!

    ___

    ARISTOTLE, ancient Greek philosopher

    Citizens of the Republic, I stand before you today to address the state of our great society. In the words of my predecessor, Socrates, the measure of a state is not the number of people in it, but the quality of life they lead. And it is with this measure that I assess the state of our union.

    We must strive for excellence in all that we do, for it is this pursuit of excellence that will bring about true happiness and fulfillment. It is through virtuous action that we find our true purpose and meaning, and it is through the cultivation of virtue that we build a strong and just society.

    But we must not simply aim for personal excellence, for a society is more than the sum of its individual parts. We must also strive for excellence in our relationships with one another, promoting justice and harmony among our citizens. Only then can we build a society in which each individual can flourish and reach their full potential.

    It is our duty as citizens to actively participate in the governance of our society, to use our reason and our wisdom to help shape the policies and laws that govern us. And it is our duty to educate future generations in the art of virtuous living, to ensure that our society remains strong and virtuous for generations to come.

    So let us work together, citizens of the Republic, to build a society that is truly excellent, a society in which each and every one of us can reach our full potential and find true happiness and fulfillment. For it is only through such a society that we can truly say that the state of our union is strong and virtuous.

    Thank you, and may the gods bless our great Republic.

    ___

    MARTIN LUTHER KING, JR.

    My fellow Americans,

    We gather here today, at a momentous time in our nation’s history, to address the state of our union. And as we do so, I am reminded of the words of the great prophet Amos, who declared, “Let justice roll down like waters and righteousness like a mighty stream.”

    For too long, justice has been denied to too many in our society. For too long, righteousness has been an elusive dream. And it is time for us to awaken from this slumber and work together to build a more perfect union.

    We cannot be satisfied until every American, regardless of race, religion, or background, has an equal opportunity to achieve the American dream. We cannot be satisfied until every child, regardless of zip code, has access to a quality education. We cannot be satisfied until every worker, regardless of industry, is paid a fair wage and treated with dignity and respect.

    But let us not become discouraged, for we have made progress. We have seen a civil rights movement that brought about change, and we will continue to see change in our time. For as Dr. King said, “The arc of the moral universe is long, but it bends toward justice.”

    So let us bend that arc, together. Let us roll down justice and righteousness like waters. Let us create a society where every person is valued and respected, where every person has an equal chance to succeed.

    And let us not forget, as we work for this noble cause, that we are all one people, bound together by our common humanity. For as Dr. King also said, “We may have all come on different ships, but we are in the same boat now.”

    So let us come together, as one people, to build a better future for all. Thank you.

    ___

    A 10-YEAR-OLD

    Hi everyone! I’m really excited to be here today, talking about the state of our country.

    I think that overall, things are going pretty well. We have a lot of great things happening, like new schools being built, new parks being made, and new jobs being created. But there are still some things that we can do better.

    For example, there are still a lot of kids who don’t have enough to eat, or who don’t have a safe place to live. That’s not okay, and I think we need to do more to help them. I think we should make sure that every kid has enough to eat, and that every kid has a warm and safe place to sleep at night.

    Another thing I think we need to work on is making sure that everyone gets along. There’s still a lot of fighting and meanness, and that’s not cool. I think we should all be friends and help each other out.

    Finally, I think we need to make sure that everyone has a chance to be happy and have fun. That means making sure that everyone has access to parks, playgrounds, and places to play. It also means making sure that everyone has access to books, computers, and other things that can help us learn and grow.

    So that’s what I think about the state of our country. I think we’re doing pretty well, but there’s still a lot of work to do. But I’m optimistic, because I know that if we all work together, we can make things better for everyone.

    Thanks for listening, and let’s work together to make our country the best it can be!

    ___

    MAHATMA GANDHI

    My dear friends, I stand before you today as a humble servant of the people, to address the state of our nation.

    In the face of adversity, it is easy to lose sight of what is truly important. But I implore you, let us not forget the values that have guided us for generations. Let us not forget the power of nonviolence, the strength of truth, and the importance of compassion.

    For it is only through these values that we can truly build a just and equitable society. It is only through these values that we can truly claim to be a great nation.

    But we have much work to do. The poverty, the inequality, and the discrimination that still plagues our society must be eradicated. We must be unwavering in our commitment to justice, to peace, and to compassion.

    And we must not be afraid to challenge the status quo, to resist the forces of oppression, and to stand up for what is right. For it is only by doing so that we can truly claim to be a great people.

    So let us come together, my friends, and let us work for a brighter future for all our citizens. …

    And let us do so with nonviolence, with truth, and with compassion. For it is only through these values that we can truly claim to be a great nation, a great people, and a great civilization.

    Thank you, and may God bless us all.

    ___

    THE THREE STOOGES of vaudeville, film and TV fame

    My fellow Americans, it’s a honor to stand before you today to talk about the state of our great union. And let me tell you, it’s been quite the ride so far! But we’re not ones to back down from a challenge, are we? No sirree, not the Three Stooges! ….

    But we can’t do it alone. We need the support of all Americans. … So, let’s keep working hard, my fellow Americans. Let’s make this country the best it can be. And most importantly, let’s keep laughing and having a good time while we do it! After all, life is too short to take it too seriously.

    ___

    WINSTON CHURCHILL, 20th century British prime minister and orator

    My fellow citizens, it is with a heavy heart and steadfast determination that I address you today. Our great nation stands at a crossroads, facing challenges that would test the mettle of any generation. But I have faith, faith in the resilience and courage of the American people, that we shall overcome.

    We have seen the forces of division and despair seek to tear at the fabric of our society, but we shall not be swayed. We shall stand united, firm in our resolve to defend the principles upon which this great nation was founded. Freedom, justice, and equality for all shall not be sacrificed upon the altar of greed or hatred.

    The road ahead will not be easy, and there will be obstacles, but we shall not falter. We shall continue to work tirelessly, to build a future of prosperity and security for all our citizens. A future where every American has the opportunity to fulfill their dreams, regardless of the circumstances of their birth.

    It is time for us to rededicate ourselves to the ideals that have made this country great. It is time for us to come together, to set aside our differences, and work towards a common goal. A goal of a better future for all Americans, a future where our children and grandchildren can live in peace, security, and prosperity.

    So let us stand together, my fellow citizens. Let us face the future with the same courage and determination that has made this country the envy of the world. Let us continue to move forward, always remembering that, “We shall never surrender.”

    Thank you, and may God bless the United States of America.

    ___

    CLEOPATRA, queen of Egypt 51-30 B.C.

    My fellow Egyptians,

    It is with great pride and humility that I stand before you today, as your Queen and leader, to deliver this State of the Union address. I am honored to serve the people of this great nation, a nation with a rich and proud history that has stood tall and strong for centuries.

    In recent years, we have faced many challenges, but through hard work and determination, we have emerged stronger and more united than ever before. Our economy is thriving, our communities are flourishing, and our people are thriving.

    However, we cannot rest on our achievements … we must remain vigilant against those who would threaten our security and our way of life. We must work with our allies to promote peace and stability in the world, and to defend our values and our interests.

    But most of all, we must remember that our greatest strength lies in our people. It is the hard work, the ingenuity, and the determination of the Egyptian people that has always made our country great, and it is their continued efforts that will keep us strong and prosperous in the years to come.

    So let us continue to work together, to strive for a better future, and to build a stronger, more prosperous Egypt.

    Thank you, and may the gods bless Egypt.

    ___

    ABRAHAM LINCOLN

    My fellow Americans,

    It is with a heavy heart but steadfast determination that I stand before you today to deliver this State of the Union address. Our great nation is embroiled in a conflict that has tested the very fabric of our union, but I am confident that with the perseverance of our people and the grace of God, we will emerge from this trial stronger and more united than ever before.

    This war, fought over the fundamental principles of freedom and equality, has taken a tremendous toll on our country and our people. But despite the hardships, we have not wavered in our commitment to preserving the Union and ending the scourge of slavery.

    As we move forward, we must work together to heal the wounds of this conflict and build a better future for all Americans. We must work to reunite our divided nation and ensure that the blessings of liberty and equality are extended to all, regardless of race or station.

    We must also take steps to ensure that this dark chapter in our history is never repeated. We must ensure that the sacrifice of so many brave Americans was not in vain, and that we never again turn a blind eye to the injustice and suffering of our fellow citizens.

    So let us come together, as one people, and work towards a brighter future for our nation and for all who call it home.

    Thank you, and may God bless America.

    ___

    ELON MUSK, CEO of Tesla, SpacEx and Twitter, and one of the founders of Open AI, the research lab that created ChatGPT

    My fellow Americans,

    It is an honor to address you today, as your elected leader, and to deliver this State of the Union Address. … I am proud to announce a bold new plan to invest in the technologies of the future, and to create millions of good-paying jobs in the process. We must lead the world in the transition to a clean energy economy, and we must ensure that our infrastructure is the most advanced and resilient in the world …

    I am announcing a new initiative to increase funding for space research and development, so that we can continue to explore the mysteries of the universe and maintain our position as a leader in space exploration …

    But we must also address the inequalities that have been exposed by the pandemic, and we must ensure that all Americans have access to the opportunities of the future. That is why I am announcing a comprehensive plan to improve access to education, job training, and affordable healthcare.

    ___

    BIDEN, delivered by the app as a rehash of past remarks

    It is an honor to stand before you today as your President and deliver this State of the Union address. This past year has been one of the most challenging in our nation’s history, but through it all, the American people have shown remarkable resilience, bravery, and compassion.

    We have faced a once-in-a-century pandemic that has taken too many lives and disrupted our economy, but we are making progress. We have delivered vaccines to millions of Americans and are seeing cases decline, and we are working to reopen our schools and businesses safely.

    But we cannot rest on our achievements. We must do more to rebuild our economy and make sure that the benefits of this recovery are felt by all Americans, not just the wealthy and well-connected. That is why I am proposing a bold infrastructure plan to create millions of good-paying jobs, modernize our roads, bridges, and highways, and make America more competitive in the global economy.

    At the same time, we must address the long-standing injustices in our society, particularly racial and economic inequality. That is why I am committed to passing legislation to protect voting rights, advance racial justice, and ensure that everyone has a fair shot at the American Dream.

    And as we look to the future, we must also address the existential threat of climate change. We cannot afford to wait any longer to address this crisis, which is already affecting communities across our country. That is why I am committed to achieving a 100% clean energy economy and creating good-paying jobs in the process.

    So let us come together, as one nation, and build a better future for all Americans. Together, there is nothing we cannot achieve.

    Thank you, and may God bless America.

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