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Tag: Emergency care

  • What to Stream: Kid Laroi, ‘The Pitt’ and ‘Tron: Ares’

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    Returns to “The Pitt,” the Grid and music of Kid Laroi are some of the new television, films and music headed to a device near you

    Returns to “The Pitt,” the Grid and music of Kid Laroi are some of the new television, films and music headed to a device near you.

    The first week of January brings a pair of sophomore efforts: Laroi’s album “Before I Forget” and the second season of the Emmy-winning hospital drama “The Pitt.” This week’s streaming offerings, as selected by The Associated Press’ entertainment journalists, also include the return of “The Night Manager” after nearly a decade.

    — Audiences can reenter the Grid when “Tron: Ares” hits Disney+ on Wednesday. The franchise’s third film stars Jared Leto, Greta Lee and Jodie Turner-Smith and features a return of Jeff Bridges. The 1982 original starred Bridges as a hacker who’s transported into a dangerous digital world and kicked off the cult franchise with then-state-of-the-art computer graphics and special effects. AP critic Mark Kennedy praised Leto and Lee’s performances and said despite being a movie that “bites off too much,” it was worth a watch. A bonus for music fans? The film’s Nine Inch Nails soundtrack with some throwbacks to the original film’s score.

    AP film team

    — Grammy-nominated artist the Kid Laroi — a direct inheritor of Justin Bieber’s glossy R&B-informed pop — will release his sophomore album, “Before I Forget,” on Friday. Judging by the previously released singles, listeners can expect slow-burn breakup reflections (“A Perfect World”) and high-hat heavy tracks with lovelorn lyrics (“A Cold Play”). It’s frictionless listening to start the new year.

    AP Music Writer Maria Sherman

    — In what counts as a quick turnaround these days in the world of prestige TV, “The Pitt” returns for its second season, and second day in the life of a frenetic Pittsburgh emergency room run by Noah Wyle’s beleaguered and beloved Dr. Robby. The first episode of Season 2 premieres Thursday on HBO Max at 9 p.m. Eastern. Expectations will be a lot higher this time. In the 10 months since Season 1 ended, “The Pitt” won the best drama Emmy along with four others, including best actor for Wyle and supporting actress for Katherine LaNasa, who will be returning despite her character vowing to quit after taking a punch. Ten months have also passed in the world of the show, which will again follow a single ER shift, this time on a July Fourth weekend.

    — After a much, much longer absence, “The Night Manager” will return for a second season. It’s been nearly a decade since Tom Hiddleston’s hotel worker-turned-spy stalked a dirty arms dealer on the show based on a novel by John le Carré. It was meant to be a limited series for the BBC and AMC, but its creators are now bringing it back with a new and original story. This time, its airing on Prime Video in the U.S., beginning with a three-episode drop on Sunday.

    AP Entertainment Writer Andrew Dalton

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  • A list of the top winners at the 2025 Emmy Awards

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    LOS ANGELES — LOS ANGELES (AP) — “The Studio” made history at the 77th Primetime Emmy Awards by winning 13 awards, becoming the most awarded comedy series in a single season. It beat the previous record of 11 set by “The Bear” last year.

    “The Pitt” won best drama and delivered Noah Wylie the best drama actor award for his performance as a wise but weary emergency room doctor.

    “Adolescence” won six awards in the limited series categories, including best supporting actor for 15-year-old Owen Cooper.

    “Severance” entered the ceremony as the top overall nominee and ended up taking two acting trophies.

    Here’s a list of winners at Sunday’s Emmys:

    “The Pitt”

    Noah Wyle, “The Pitt”

    Britt Lower, “Severance”

    Tramell Tillman, “Severance”

    Katherine LaNasa, “The Pitt”

    Adam Randall, “Slow Horses”

    Dan Gilroy, “Andor”

    “The Studio”

    Seth Rogen, “The Studio”

    Jean Smart, “Hacks”

    Hannah Einbinder, “Hacks”

    Jeff Hiller, “Somebody Somewhere”

    Seth Rogen and Evan Goldberg, “The Studio”

    Seth Rogen, Evan Goldberg, Peter Huyck, Alex Gregory and Frida Perez, “The Studio”

    “Adolescence”

    Stephen Graham, “Adolescence”

    Cristin Milioti, “The Penguin”

    Owen Cooper, “Adolescence”

    Erin Doherty, “Adolescence”

    Philip Barantini, “Adolescence”

    Jack Thorne and Stephen Graham, “Adolescence”

    “SNL 50: The Anniversary Special”

    “Last Week Tonight with John Oliver”

    “Last Week Tonight with John Oliver”

    “The Late Show with Stephen Colbert”

    “The Traitors”

    Ted Danson and Mary Steenburgen

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    For more on this year’s Emmy Awards, visit: https://apnews.com/hub/emmy-awards

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  • NYU Langone – Suffolk earns Level II trauma center status | Long Island Business News

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    THE BLUEPRINT:

    • Hospital – Suffolk now verified as Level II Adult

    • Status affirms readiness to handle all adult trauma cases

    • Facility meets strict staffing, training and quality assessment standards

    The American College of Surgeons (ACS) has verified NYU Langone Hospital – Suffolk in Patchogue as a Level II Adult Trauma Center, hospital officials said Friday.

    The designation affirms that the hospital is equipped to care for all adult trauma patients, regardless of severity.

    The milestone comes about six months after the facility — formerly a community hospital — officially joined the NYU Langone system following a multi-year affiliation. However, the hospital’s pursuit of Level II status began last year.

    “This milestone recognizes the dedication of our staff and affirms our enhanced capabilities to deliver the full spectrum of to our patients,” Dr. Marc S. Adler, senior vice president and chief of hospital operations at NYU Langone Hospital – Suffolk, said in a news release about the verification. “

    “Community members and our local EMS partners can feel confident knowing the highest-quality is available nearby when it’s needed most,” Adler said.

    ACS-verified Centers must meet essential criteria, including 24/7 coverage by general surgeons, orthopedic surgeons, neurosurgeons, radiologists, interventional radiologists, urologists and advanced practice providers. These centers must offer trauma injury prevention and continuing education programs for staff and the community, such as Stop the Bleed and senior fall prevention initiatives. Additionally, a comprehensive quality assessment program is required.

    The hospital became affiliated with the NYU Langone health system in March of 2022 before the merger was completed earlier this year.

    But in April 2024, the hospital began its journey to Level II Adult Trauma Center status by applying to elevate its verification from Level III with the ACS and the New York State Department of Health. In October 2024, it was designated a Provisional Level II Adult Trauma Center by the state. Following a comprehensive review in July 2025, the ACS officially verified the hospital’s Level II status.


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    Adina Genn

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  • Dozens of pregnant women being turned away from ERs despite federal law

    Dozens of pregnant women being turned away from ERs despite federal law

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    WASHINGTON — Bleeding and in pain, Kyleigh Thurman didn’t know her doomed pregnancy could kill her.

    Emergency room doctors at Ascension Seton Williamson in Texas handed her a pamphlet on miscarriage and told her to “let nature take its course” before discharging her without treatment for her ectopic pregnancy.

    When the 25-year-old returned three days later, still bleeding, doctors finally agreed to give her an injection to end the pregnancy. It was too late. The fertilized egg growing on Thurman’s fallopian tube ruptured it, destroying part of her reproductive system.

    That’s according to a complaint Thurman and the Center for Reproductive Rights filed last week asking the government to investigate whether the hospital violated federal law when staff failed to treat her initially in February 2023.

    “I was left to flail,” Thurman said. “It was nothing short of being misled.”

    The Biden administration says hospitals must offer abortions when needed to save a woman’s life, despite state bans enacted after the Supreme Court overturned the constitutional right to an abortion more than two years ago. Texas is challenging that guidance and, earlier this summer, the Supreme Court declined to resolve the issue.

    More than 100 pregnant women in medical distress who sought help from emergency rooms were turned away or negligently treated since 2022, an Associated Press analysis of federal hospital investigations found.

    Two women — one in Florida and one in Texas — were left to miscarry in public restrooms. In Arkansas, a woman went into septic shock and her fetus died after an emergency room sent her home. At least four other women with ectopic pregnancies had trouble getting treatment, including one in California who needed a blood transfusion after she sat for nine hours in an emergency waiting room.

    In Texas, where doctors face up to 99 years of prison if convicted of performing an illegal abortion, medical and legal experts say the law is complicating decision-making around emergency pregnancy care.

    Although the state law says termination of ectopic pregnancies isn’t considered abortion, the draconian penalties scare Texas doctors from treating those patients, the Center for Reproductive Rights argues.

    “As fearful as hospitals and doctors are of running afoul of these state abortion bans, they also need to be concerned about running afoul of federal law,” said Marc Hearron, a center attorney. Hospitals face a federal investigation, hefty penalties and threats to their Medicare funding if they violate the federal law.

    The organization filed complaints last week with the Centers for Medicare and Medicaid Service alleging that different Texas emergency rooms failed to treat two patients, including Thurman, with ectopic pregnancies.

    One complaint says Kelsie Norris-De La Cruz, 25, lost a fallopian tube and most of an ovary after an Arlington, Texas, hospital sent her home without treating her ectopic pregnancy, even after a doctor said discharge was “not in her best interest.”

    “The doctors knew I needed an abortion, but these bans are making it nearly impossible to get basic emergency healthcare,” she said in a statement. “I’m filing this complaint because women like me deserve justice and accountability from those that hurt us.”

    Conclusively diagnosing an ectopic pregnancy can be difficult. Doctors cannot always find the pregnancy’s location on an ultrasound, three doctors consulted for this article explained. Hormone levels, bleeding, a positive pregnancy test and an ultrasound of an empty uterus all indicate an ectopic pregnancy.

    “You can’t be 100% — that’s the tricky part,” said Kate Arnold, an OB-GYN in Washington. “They’re literally time bombs. It’s a pregnancy growing in this thing that can only grow so much.”

    Texas Right to Life Director John Seago said state law protects doctors from prosecution for terminating ectopic pregnancies, even if a doctor “makes a mistake” in diagnosing it.

    “Sending a woman back home is completely unnecessary, completely dangerous,” Seago said.

    But the state law has “absolutely” made doctors afraid of treating pregnant patients, said Hannah Gordon, an emergency medicine physician who worked in a Dallas hospital until last year.

    She recalled a patient with signs of an ectopic pregnancy at her Dallas emergency room. Because OB-GYNs said they couldn’t definitively diagnose the problem, they waited to end the pregnancy until she came back the next day.

    “It left a bad taste in my mouth,” said Gordon, who left Texas hoping to become pregnant and worried about the care she’d receive there.

    When Thurman returned to Ascension Seton Williamson a third time, her OB-GYN told her she’d need surgery to remove the fallopian tube, which had ruptured. Thurman, still heavily bleeding, balked. Losing the tube would jeopardize her fertility.

    Her doctor told her she risked death if she waited any longer.

    “She came in and she’s like, you’re either going to have to have a blood transfusion, or you’re going to have to have surgery or you’re going to bleed out,” Thurman said, through tears. “That’s when I just kind of was like, ‘Oh my God, I’m, I’m dying.’”

    The hospital declined to comment on Thurman’s case, but said in a statement it “is committed to providing high-quality care to all who seek our services.”

    In Florida, a 15-week pregnant woman leaked amniotic fluid for an hour in Broward Health Coral Springs’ emergency wait room, according to federal documents. An ultrasound revealed the patient had no amniotic fluid surrounding the fetus, a dangerous situation that can cause serious infection.

    The woman miscarried in a public bathroom that day, after the emergency room doctor listed her condition as “improved” and discharged her, without consulting the hospital’s OB-GYN.

    Emergency crews rushed her to another hospital, where she was placed on a ventilator and discharged after six days.

    Abortions after 15 weeks were banned in Florida at the time. Broward Health Coral Springs’ obstetrics medical director told an investigator that inducing labor for anyone who presents with pre-viable premature rupture of membranes is “the standard of care, has been a while, regardless of heartbeat, due to the risk to the mother.”

    The hospital declined comment.

    In another Florida case, a doctor admitted state law had complicated emergency pregnancy care.

    “Because of the new laws … staff cannot intervene unless there is a danger to the patient’s health,” a doctor at Memorial Regional Hospital in Hollywood, Florida, told an investigator who was probing the hospital’s failure to offer an abortion to a woman whose water broke at 15 weeks, well before the fetus could survive.

    Serious violations that jeopardized a mother or her fetus’ health occurred in states with and without abortion bans, the AP’s review found.

    Two short-staffed hospitals — in Idaho and Washington — admitted to investigators they routinely directed pregnant patients to other hospitals.

    A pregnant patient at a Bakersfield, California, emergency room was quickly triaged, but staff failed to realize the urgency of her condition, a uterine rupture. The delay, an investigator concluded, may have contributed to the baby’s death.

    Doctors at emergency rooms in California, Nebraska, Arkansas and South Carolina failed to check for fetal heartbeats or discharged patients who were in active labor, leaving them to deliver at home or in ambulances, according to the documents.

    Nursing and doctor shortages, trouble staffing ultrasounds around-the-clock and new abortion laws are making the emergency room a dangerous place for pregnant women, warned Dara Kass, an emergency medicine doctor and former U.S. Health and Human Services official.

    “It is increasingly less safe to be pregnant and seeking emergency care in an emergency department,” she said.

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  • How does heat kill? It confuses your brain. It shuts down your organs. It overworks your heart.

    How does heat kill? It confuses your brain. It shuts down your organs. It overworks your heart.

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    As temperatures and humidity soar outside, what’s happening inside the human body can become a life-or-death battle decided by just a few degrees.

    The critical danger point outdoors for illness and death from relentless heat is several degrees lower than experts once thought, say researchers who put people in hot boxes to see what happens to them.

    With much of the United States, Mexico, India and the Middle East suffering through blistering heat waves, worsened by human-caused climate change, several doctors, physiologists and other experts explained to The Associated Press what happens to the human body in such heat.

    The body’s resting core temperature is typically about 98.6 degrees Fahrenheit (37 degrees Celsius).

    That’s only 7 degrees (4 Celsius) away from catastrophe in the form of heatstroke, said Ollie Jay, a professor of heat and health at the University of Sydney in Australia, where he runs the thermoergonomics laboratory.

    Dr. Neil Gandhi, emergency medicine director at Houston Methodist Hospital, said during heat waves anyone who comes in with a fever of 102 or higher and no clear source of infection will be looked at for heat exhaustion or the more severe heatstroke.

    “We routinely will see core temperatures greater than 104, 105 degrees during some of the heat episodes,” Gandhi said. Another degree or three and such a patient is at high risk of death, he said.

    Heat kills in three main ways, Jay said. The usual first suspect is heatstroke — critical increases in body temperature that cause organs to fail.

    When inner body temperature gets too hot, the body redirects blood flow toward the skin to cool down, Jay said. But that diverts blood and oxygen away from the stomach and intestines, and can allow toxins normally confined to the gut area to leak into circulation.

    “That sets off a cascade of effects,” Jay said. “Clotting around the body and multiple organ failure and, ultimately, death.”

    But the bigger killer in heat is the strain on the heart, especially for people who have cardiovascular disease, Jay said.

    It again starts with blood rushing to the skin to help shed core heat. That causes blood pressure to drop. The heart responds by trying to pump more blood to keep you from passing out.

    “You’re asking the heart to do a lot more work than it usually has to do,” Jay said. For someone with a heart condition “it’s like running for a bus with dodgy (hamstring). Something’s going to give.”

    The third main way is dangerous dehydration. As people sweat, they lose liquids to a point that can severely stress kidneys, Jay said.

    Many people may not realize their danger, Houston’s Gandhi said.

    Dehydration can progress into shock, causing organs to shut down from lack of blood, oxygen and nutrients, leading to seizures and death, said Dr. Renee Salas, a Harvard University professor of public health and an emergency room physician at Massachusetts General Hospital.

    “Dehydration can be very dangerous and even deadly for everyone if it gets bad enough — but it is especially dangerous for those with medical conditions and on certain medications,” Salas said.

    Dehydration also reduces blood flow and magnifies cardiac problems, Jay said.

    Heat also affects the brain. It can cause a person to have confusion, or trouble thinking, several doctors said.

    “One of the first symptoms you’re getting into trouble with the heat is if you get confused,” said University of Washington public health and climate professor Kris Ebi. That’s little help as a symptom because the person suffering from the heat is unlikely to recognize it, she said. And it becomes a bigger problem as people age.

    One of the classic definitions of heat stroke is a core body temperature of 104 degrees “coupled with cognitive dysfunction,” said Pennsylvania State University physiology professor W. Larry Kenney.

    Some scientists use a complicated outside temperature measurement called wet bulb globe temperature, which takes into account humidity, solar radiation and wind. In the past, it was thought that a wet-bulb reading of 95 Fahrenheit (35 Celsius) was the point when the body started having trouble, said Kenney, who also runs a hot box lab and has done nearly 600 tests with volunteers.

    His tests show the wet-bulb danger point is closer to 87 (30.5 Celsius). That’s a figure that has started to appear in the Middle East, he said.

    And that’s just for young healthy people. For older people, the danger point is a wet bulb temperature of 82 (28 degrees Celsius), he said.

    “Humid heat waves kill a lot more people than dry heat waves,” Kenney said.

    When Kenney tested young and old people in dry heat, young volunteers could function until 125.6 degrees (52 degrees Celsius), while the elderly had to stop at 109.4 (43 degrees Celsius). With high or moderate humidity, the people could not function at nearly as high a temperature, he said.

    “Humidity impacts the ability of sweat to evaporate,” Jay said.

    Heatstroke is an emergency, and medical workers try to cool a victim down within 30 minutes, Salas said.

    The best way: Cold water immersion. Basically, “you drop them in a water bucket,” Salas said.

    But those aren’t always around. So emergency rooms pump patients with cool fluids intravenously, spray them with misters, put ice packs in armpits and groins and place them on a chilling mat with cold water running inside it.

    Sometimes it doesn’t work.

    “We call it the silent killer because it’s not this kind of visually dramatic event,” Jay said. “It’s insidious. It’s hidden.”

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    This story has corrected to “humidity,” rather than “temperature” in a mention of how people’s function is affected by humidity.

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    Read more of AP’s climate coverage at http://www.apnews.com/climate-and-environment

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    Follow Seth Borenstein on X at @borenbears

    ______

    The Associated Press’ climate and environmental coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

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  • Fill up your gas tank and prepare to wait. Some tips to prepare for April’s total solar eclipse

    Fill up your gas tank and prepare to wait. Some tips to prepare for April’s total solar eclipse

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    MISSION, Kan. — Stock up on groceries. Print off driving directions. And be very, very patient.

    Small towns and rural enclaves along the path of April’s total solar eclipse are steeling for huge crowds of sun chasers who plan to catch a glimpse of day turning into dusk in North America.

    Tourism and community leaders in the path of totality from Texas to Maine have trucked in extra fuel and port-a-potties, and urged residents and visitors to be prepared. Some counties have issued disaster declarations to get extra help with policing and other aid, similar to the aftermath of severe storms. And in Oklahoma, the National Guard will help.

    Because of expected heavy traffic and other disruptions, hundreds of schools are closing or switching to remote learning in states including Texas, Indiana, Ohio, New York, Pennsylvania and Vermont.

    Look no further back than the last U.S. total solar eclipse in 2017 to understand the concern, said Tom Traub, who is part of NASA’s eclipse ambassador program.

    That year, he traveled to Beatrice, Nebraska, where the normal population of around 12,000 swelled to around 40,000 as eclipse watchers arrived.

    “You had gas stations running out of gas,” said Traub, who also serves on the board that runs the Martz-Kohl Observatory near Frewsburg, New York. “You had restaurants running out of food. You had restrooms that were full and closed.”

    This time around, top viewing locations want to avoid a repeat.

    “They are preparing for mostly a worst-case scenario,” he said. “And hopefully that won’t be the case.”

    In central Texas, emergency officials in Hays County recommend a “solar eclipse survival bag” stocked with items including a mobile phone and charger.

    The bag, the instructions advise, also should contain a hard copy of maps and a compass — “goin’ old school!”

    The reminder to bring a fully charged phone — but to expect possible jammed signals — is widespread in prime viewing spots. In 2017, drivers using their cellphones to share photos and navigate through traffic overwhelmed towers.

    “Write down key phone numbers just in case,” advised the Lyndon B. Johnson National Historical Park, about 50 miles (80 kilometers) east of Austin.

    Don’t wait until the last minute to buy groceries is common advice from several Texas counties that have issued disaster declarations so they can get get extra help with the crowds.

    Among them is Kerr County, located about 65 miles (105 kilometers) northwest of San Antonio in the heart of the Texas Hill Country, where the normal population of 53,000 is expected to double or triple.

    “Make sure your vehicles are tanked up, that you have sufficient grocery supplies, that your prescriptions are filled and that you are stocked up on provisions for any animals in your care,” Rob Kelly, the county’s top official who signed the disaster declaration, said in an online post.

    In Ohio, where Gov. Mike DeWine signed an executive order this month to assure the state was well prepared, emergency management officials are urging residents to top off their gas tanks or fully charge their electric vehicles before heading out.

    Traub suggests people treat the eclipse like a snowstorm: “Stock up, get ready, prepare to hunker down.”

    At Serafin’s Food Market in Erie, Pennsylvania, owner Dan Serafin is ordering extra milk, eggs, water and batteries in preparation. “This is nuts,” he said.

    Even smaller regional airports are getting ready. In Cape Girardeau, Missouri, extra fuel is being hauled in, said airport manager Katrina Amos.

    The airport was caught off guard in 2017, when the city of around 40,000 along the Mississippi River also was in the path of totality.

    Between 40 to 50 extra planes landed that day. ‘We didn’t expect this,’” said Amos.

    This year, volunteers have signed up to help park all the extra planes that are expected. There also will be hamburgers and hot dogs, Amos said.

    Offshore, the Coast Guard will have boats patrolling in Lake Erie; it’s along the path and some boaters plan to watch from the water.

    It will be all hands on deck at fire departments in the path of the eclipse, said Dr. Brad Raetzke, an emergency room doctor in Columbus, Ohio, who also is a medical director for several fire departments in the area.

    He’s concerned about eye injuries if people stare at the sun without protective glasses. And with all the extra traffic, there also will likely be more crash injuries, said Raetzke.

    In 2017, he went with his family to Nashville, Tennessee, to watch the eclipse. The return trip took 15 hours, instead of the typical six. “So I can understand the importance of planning,” he said.

    In Erie, where hotels are nearing capacity, residents are urged to leave the interstates to visitors, with signs posted more than 150 miles (241 kilometers) outside the city limits warning of delays.

    Traffic will be “just almost nightmarish once totality ends,” said Chris Temple, the VisitErie spokesperson, who has been in meetings for more than a year planning for an onslaught of visitors that could double the size of the city of 94,000.

    Despite the hassles, the city’s tourism slogan to get eclipse-ready — SHINE — ends with a reminder.

    “Enjoy the moment,” said Temple.

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  • We Got Lucky With the Mystery Dog Illness

    We Got Lucky With the Mystery Dog Illness

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    In late July 1980, a five-month-old Doberman pinscher puppy in Washington, D.C., started throwing up blood. It died the next day at an animal hospital, one of many pets that suffered that year from a new illness, parvovirus. “This is the worst disease I’ve ever seen in dogs,” a local veterinarian told The Washington Post, in an article describing the regional outbreak. It killed so fast that it left pet owners in disbelief, he said.

    The world was in the middle of a canine pandemic. The parvovirus, which was first recognized in 1978, can live for months outside the body, spreading not just from animal to animal but through feces, sneaking into the yards of dog owners via a bit of excrement stuck to the bottom of a person’s shoe. It quickly traveled across countries and continents, infecting thousands and possibly millions of dogs in the late ’70s and early ’80s. Essentially every dog alive at the time caught it, Colin Parrish, a virology professor at Cornell University’s College of Veterinary Medicine, told me. And untold numbers  died: A single Associated Press report from August 1980 mentions the city of Chicago losing 300 dogs by July of that year, and South Carolina losing more than 700 in just two months.

    A vaccine was quickly developed, but with doses in short supply, the outbreaks dragged on for years. Today, puppies are routinely vaccinated for parvovirus, and the 1978 canine pandemic has faded from public consciousness. Since then, no outbreak has unfolded on that scale, even as dogs have become more integrated into American households. Few people stay up at night worrying about what might happen if a new and devastating disease did appear. Yet, for a moment at the end of last year, it seemed like one might have.

    In late 2023, veterinarians started noticing something odd. They’d seen an uptick in cases of dogs sick with respiratory symptoms responding poorly to antibiotics. Some would develop severe pneumonia quickly and die. Soon, cases of this suspected illness started popping up in states across the country. Around Thanksgiving, media reports began warning dog owners about a “mystery dog illness” spreading nationwide.

    Many experts now suggest that there probably was no “mystery dog illness.” More likely, some mix of previously known illnesses were surging around the same time. Still, the case is not entirely closed, and the prospect of a deadly new disease has left dog owners fearful and jumpy: How much should they worry? Could that seemingly normal cough in the family pet actually be something much more dangerous?

    And if a new disease had started a modern dog pandemic, the world’s first in almost 50 years, what would have happened next is not entirely clear. Unlike humans and livestock, companion animals do not have sophisticated, coordinated infrastructure dedicated to monitoring and managing their diseases. The technology and science might exist to fight a dog pandemic, but any response would depend on what kind of illness we found ourselves dealing with—and whether it could infect humans as well.

    Because dogs don’t interact with one another as much as humans do, dog transmission networks are different from ours. They see one another on walks, in day cares, or in dog parks. Some might travel between states or even between countries, but many just stay in their backyard. Their cloistered networks make it hard for some viruses to move among them. In 2015 and 2016, outbreaks of a nasty canine flu called H3N2, which was traced to a single introduction in the United States from South Korea, never reached full pandemic status. “I just remember seeing so many of these pretty sick dogs, like every day,” Steve Valeika, a veterinarian and infectious-disease specialist in North Carolina, told me. “And then it just stopped.” Most of his cases were from one boarding facility.

    A disease such as parvo, which can spread without direct contact, has a better chance of circulating widely. But even then, authorities could respond quickly, maybe even quicker than in 1978. The same mRNA tools that led to the speedy development of a COVID vaccine for humans could be used in a dog pandemic; the ability to test for dog diseases has improved since parvovirus. Information travels that much faster over the internet.

    Still, as companion animals, dogs and cats fall into an awkward space between systems. “There is no CDC for dogs,” Valeika said. “It’s all very patchwork.” Typically, animal disease is managed by agricultural agencies—in this country, the USDA. But these groups are more focused on outbreaks in livestock, such as swine flu, which threaten the food supply, the economy, or human safety. If an outbreak were to emerge in companion animals, veterinary associations, local health departments, and other dog-health groups may all pitch in to help manage it.

    The dairy and pig industries, for example, are far more coordinated. “If they said, ‘We need to get all the players together to talk about a new emerging disease issue on pigs,’ that’d be easy. They’d know who to call, and they’d be on the phone that afternoon,” Scott Weese, professor in veterinary infectious diseases at the University of Guelph, in Canada, explains. Organizing a conference call like that on the topic of a dog disease would be trickier, especially in a big country like the United States. And the USDA isn’t designed around pets, although “it’s not that they don’t care or don’t try,” he said. (The USDA did not respond to a request for comment.) No one is formally surveilling for dog disease in the way government agencies and other groups monitor for human outbreaks. At base, monitoring requires testing, which is expensive and might not change a vet’s treatment plan. “How many people want to spend $250 to get their swab tested?” Parrish asked.

    Dogs aren’t human. But they are close to humans, and it is easy to imagine that, in a dog pandemic, owners would go to great lengths to keep their pets safe. Their closeness to us, in this way, could help protect them. It also poses its own risk: If a quickly spreading dog disease jumped to humans, a different machinery would grind into gear.

    If humans could be vulnerable and certainly if they were getting sick, then the CDC would get involved. “Public health usually takes the lead on anything where we’ve got that human and animal side,” Weese told me. These groups are better funded, are better staffed, and have more expertise—but their priority is us, not our pets. The uncomfortable truth about zoonotic disease is that culling, or killing, animals helps limit spread. In 2014, after a health-care worker in Spain contracted Ebola, authorities killed her dog Excalibur as a precaution, despite a petition and protests. When the woman recovered, she was devastated. (“I’ve forgotten about everything except the death of Excalibur,” she later told CNN.) Countries routinely cull thousands of livestock animals when dealing with the spread of deadly diseases. If a new dog-borne pathogen threatened the lives of people, the U.S. would be faced with the choice of killing infected animals or dedicating resources to quarantining them.

    A scenario in which pet owners stand by while their dogs are killed en masse is hard to imagine. People love their pets fiercely, and consider them family; many would push to save their dogs. But even in a scenario where humans were safe, the systems we’ve set up might not be able to keep pets from dying on a disturbing scale. Already, there’s a nationwide shortage of vets; in a dog-health emergency, people would want access to emergency care, and equipment such as ventilators. “I am concerned that we don’t have enough of that to deal with a big pandemic as it relates to pets,” Jane Sykes, a medicine and epidemiology professor at the UC Davis School of Veterinary Medicine and the founder of the International Society for Companion Animal Infectious Diseases, told me.

    Congress has mandated that the CDC, USDA, and Department of the Interior, which oversees wildlife, work on strengthening “federal coordination and collaboration on threats related to diseases that can spread between animals and people,” Colin Basler, the deputy director of CDC’s One Health Office, wrote in an email statement. A new, deadly canine disease would almost certainly leave experts scrambling to respond, in some way. And in that scramble, pet owners could be left in a temporary information vacuum, worrying about the health of their little cold-nosed, four-legged creatures. The specifics of any pandemic story depend on the disease—how fast it moves, how it sickens and kills, and how quickly—but in almost any scenario it’s easy to imagine the moment when someone fears for their pet and doesn’t know what help will come, and how soon.

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    Caroline Mimbs Nyce

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  • Consumer product agency issues warning on small magnetic balls linked to deaths

    Consumer product agency issues warning on small magnetic balls linked to deaths

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    The U.S. Consumer Product Safety Commission has issued a warning about the danger of high-powered, pea-sized magnets found in toys

    ByThe Associated Press

    December 9, 2023, 3:39 PM

    The U.S. Consumer Product Safety Commission is warning about the danger of high-powered, pea-sized magnets found in toys, announcing one company’s recall of a set containing them and saying it was aware of seven deaths linked to their ingestion.

    The federal agency estimated that ingestion of the magnets led to 2,400 hospital emergency room visits from 2017-2021 in addition to the deaths, two of which it said occurred outside the United States.

    “Consumers should stop using the recalled magnetic balls immediately, (and) take them away from children,” the commission said in an online notice. Made from rare-earth metals, each ball measures five millimeters.

    The safety commission said the magnets were stronger than permitted by federal toy regulations and could kill children if two or more are swallowed as they can attract each other in the stomach, perforating intestinal walls, twisting and/or blocking intestines — which could lead to infection and blood poisoning.

    The Neodymium Magnetic Balls recalled on Thursday were sold by XpressGoods, a North Carolina company, from July 2021 through May 2022 and made in China, the agency said. It said the company offered full refunds and directly contacted purchasers of the roughly 700 units it had sold.

    A commission spokeswoman told The New York Times that five other companies that also sold the magnetic balls had refused to do recalls, so it was alerting consumers.

    The commission did not say who manufactures the balls.

    XpressGoods did not immediately respond to an email seeking comment Saturday.

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  • Consumer product agency issues warning on small magnetic balls linked to deaths

    Consumer product agency issues warning on small magnetic balls linked to deaths

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    The U.S. Consumer Product Safety Commission has issued a warning about the danger of high-powered, pea-sized magnets found in toys

    ByThe Associated Press

    December 9, 2023, 3:39 PM

    The U.S. Consumer Product Safety Commission is warning about the danger of high-powered, pea-sized magnets found in toys, announcing one company’s recall of a set containing them and saying it was aware of seven deaths linked to their ingestion.

    The federal agency estimated that ingestion of the magnets led to 2,400 hospital emergency room visits from 2017-2021 in addition to the deaths, two of which it said occurred outside the United States.

    “Consumers should stop using the recalled magnetic balls immediately, (and) take them away from children,” the commission said in an online notice. Made from rare-earth metals, each ball measures five millimeters.

    The safety commission said the magnets were stronger than permitted by federal toy regulations and could kill children if two or more are swallowed as they can attract each other in the stomach, perforating intestinal walls, twisting and/or blocking intestines — which could lead to infection and blood poisoning.

    The Neodymium Magnetic Balls recalled on Thursday were sold by XpressGoods, a North Carolina company, from July 2021 through May 2022 and made in China, the agency said. It said the company offered full refunds and directly contacted purchasers of the roughly 700 units it had sold.

    A commission spokeswoman told The New York Times that five other companies that also sold the magnetic balls had refused to do recalls, so it was alerting consumers.

    The commission did not say who manufactures the balls.

    XpressGoods did not immediately respond to an email seeking comment Saturday.

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  • Handcuffed and sent to the ER – for misbehavior: Schools are sending more kids to the hospital

    Handcuffed and sent to the ER – for misbehavior: Schools are sending more kids to the hospital

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    SALISBURY, Md. — Three times a week, on average, a police car pulls up to a school in Wicomico County on Maryland’s Eastern Shore. A student is brought out, handcuffed and placed inside for transport to a hospital emergency room for a psychiatric evaluation.

    Over the past eight years, the process has been used at least 750 times on students. Some are as young as 5 years old.

    The state law that allows for these removals, known as petitions for emergency evaluation, is meant to be limited to people with severe mental illness, who are endangering their own lives or safety or someone else’s. It’s the first step toward getting someone involuntarily committed to a psychiatric hospital.

    But advocates say schools across the country are sending children to the emergency room for psychiatric evaluations in response to behaviors prompted by bullying or frustration over assignments. The ER trips, they say, often follow months, and sometimes years, of their needs not being met.

    Black students are more frequently subjected to these removals than their peers, according to available data. Advocates point to students with disabilities also being removed at higher rates.

    “Schools focus on keeping kids out rather than on keeping kids in,” said Dan Stewart, managing attorney at the National Disability Rights Network. “I think that’s the fundamental crux of things.”

    Schools in Wicomico County agreed not to misuse emergency petitions as part of a 2017 settlement with the U.S. Department of Justice. But while the number of suspensions and expulsions declined, mandated trips to the emergency room ticked up.

    Last year, children were handcuffed and sent to the emergency room at least 117 times from Wicomico schools, about once per every 100 students, according to data obtained from public records requests to the Wicomico County Sheriff’s Office.

    At least 40% were 12 or younger. More than half were Black children, even though a little more than a third of Wicomico public school children are Black.

    In interviews, dozens of students, parents, educators, lawyers and advocates for students with disabilities in Wicomico County said a lack of resources and trained staff, combined with a punitive culture in some schools, are behind the misuse of emergency petitions.

    One Wicomico mom, who asked for anonymity because she feared retaliation from the school, recalled the terror she felt when her son’s school called and said they were going to have him assessed for a forced psychiatric hospitalization. When she arrived at the school, she said, her son was already in handcuffs. He was put in the back of a police car and taken to the hospital.

    “He said his wrists hurt from the handcuffs,” the mother said. “He was just really quiet, just sitting there, and he didn’t understand why he was in the hospital.”

    The practice isn’t just happening in Wicomico.

    Recent data shows New York City schools still call police to take children in emotional distress to the emergency room despite a 2014 legal settlement in which they agreed to stop the practice.

    A Kentucky school district was found to have used a psychiatric assessment on kids more than 1,000 times in a year. In Florida, thousands of school-aged children have been subjected to the Baker Act, the state’s involuntary commitment statute.

    In a settlement with the Education Department’s Office of Civil Rights, the Stockton Unified School District in California agreed to protocols that require other interventions before referring students with disabilities for psychiatric evaluation.

    In Maryland, Wicomico uses emergency petitions more often per capita than almost every other Maryland district where data is available.

    Baltimore City, for example, last year had 271 emergency petitions from schools, compared with Wicomico’s at least 117, according to data obtained from law enforcement agencies through public records requests. But Baltimore’s student population is five times as large.

    Wicomico parents describe struggling to get support for their children when they fell behind on basics like reading and math in early grades. These gaps in learning can lead to frustration and behaviors challenging for teachers to manage.

    The Wicomico mother whose son was handcuffed said she fought for years with administrators to obtain accommodations for her child, who is autistic, an experience echoed by other parents. Her son, who also has ADHD, was several years behind in reading by the time he got to middle school. The mother said he was sent to the hospital after an outburst rooted in frustration, not mental illness.

    She recalled school officials telling her, “‘He doesn’t have special needs, he just has anger issues.’ They were trying to get him out of the school.”

    Her son had grown increasingly discouraged and agitated over an assignment he was unable to complete, she said. The situation escalated, she said, when the teacher argued with him. He knocked a laptop on his desk to the floor, and the school called for an emergency petition. After being taken to the hospital in handcuffs, he was examined and released.

    “After that, he went from angry to terrified,” she said. “Every time he saw the police, he would start panicking.”

    A spokeswoman from the Wicomico County Public Schools said emergency petitions “are used in the most extreme, emergency situations where the life and safety of the student or others are at risk.”

    “(Emergency petitions) are not used for disciplinary purposes and frequently do not result from a student’s behaviors,” Tracy Sahler said in an email. “In fact, a majority of EPs are related to when a student exhibits suicidal ideation or plans self-harm.”

    School officials did not respond to questions about why the rate of emergency petitions was so much higher in Wicomico than in other counties in Maryland. The Sheriff’s Department declined to share records that would show the reasons for the removals.

    By law, certain classroom removals must be recorded. Suspensions, expulsions and arrests are the most commonly documented indicators of racial disparities in discipline. Schools are required by law to publicly report the data, which often triggers oversight and investigations.

    But with the exceptions of Florida and New York City, most places do not routinely collect information on removals from school for psychiatric assessments.

    Without that data, there is no way to hold schools accountable, said Daniel Losen, senior director for the education team at the National Center for Youth Law.

    “The civil rights of children is at stake, because it’s more likely it’s going to be Black kids and kids with disabilities who are subjected to all kinds of biases that deny them an educational opportunity,” he said.

    Families who have experienced emergency petitions say educators who can communicate with their child are stretched thin, and measures that could de-escalate a situation are not always taken. The day her son was sent to the hospital, the mother recalled, the administrator who had consistently advocated for him was out of the building.

    In another instance, a middle schooler said the required accommodations for his learning and behavioral disabilities included taking a walk with a trusted educator when he became agitated. The day he was involuntarily sent to the hospital, that staff member was unavailable. He began yelling and spitting when an administrator blocked him from leaving on his own. He said that by the time police arrived, he was calm and sitting in the principal’s office. Still, he was handcuffed and taken to the hospital, where he was examined and released a few hours later.

    Because emergency petitions happen outside the standard discipline process, missed school days are not recorded as suspensions. For students with disabilities, that has special consequences – they are not supposed to be removed from class for more than 10 days without an evaluation of whether they are receiving the support they need.

    “If you use the discipline process, and you’re a student with a disability, your rights kick in,” said Selene Almazan, legal director for the Council of Parent Attorneys and Advocates.

    In many places around the country, the resources needed to support students with disabilities are scarce.

    On Maryland’s Eastern Shore, lawyers and advocates for families said the spectrum of alternatives for students is limited by both money and geography. Those can include private, out-of-district placements and specialized classrooms for specific needs like dyslexia, for example.

    In cases where children need targeted services unavailable in the local district, the district must allow them to be educated outside the school system — and pay for it.

    “You’re stuck between a rock and a hard place because you’re like, ‘This kid needs more services,’ but you can’t get the school to agree,” said Angela Ford, clinical director at Maple Shade Youth and Family Services, which serves children with emotional and behavioral disabilities in Wicomico.

    The 2017 settlement with the Justice Department required the Wicomico district to reduce the significant racial and disability-related disparities in suspensions, placements in alternative schools and other discipline measures.

    The district agreed not to use emergency petitions “where less intrusive interventions … can be implemented to address the behavioral concern” and not to use them “to discipline or punish or to address lack of compliance with directions.”

    But since the settlement, many parents, teachers and community leaders said the district has seemed more concerned with keeping suspension numbers down than providing support for teachers to help prevent disruptive behavior.

    “If we know how to handle and deal with behaviors, then we will have less EPs,” said Anthony Mann, who was an instructional aide at Wicomico County High School last year and is a Wicomico public school parent.

    Tatiyana Jackson, who has a son with a disability at Wicomico Middle School, agrees teachers need more training. “I don’t think they have a lot of patience or tolerance for children with differences. It’s like they give up on them.”

    Wicomico school officials said ongoing professional development for staff includes the appropriate use of emergency petitions.

    “Each school has a well-trained team that includes a social worker and school counselor, with the support of school psychologists,” said Sahler. “All supports that may be beneficial to assist the student are utilized. However, the safety of the student is paramount and the determining factor is ensuring that there is no unnecessary delay in obtaining aid for the student.”

    But Denise Gregorius, who taught in Wicomico schools for over a decade and left in 2019, questioned the feasibility of the discipline and behavior strategies taught during professional development.

    What the teachers really want, she said, is more support.

    After the settlement, which had a two-and-a-half year monitoring period, the number of suspensions and expulsions in Wicomico declined markedly – for Black and white students. But the number of emergency petitions, which don’t appear in state statistics, has ticked up.

    Other measures of exclusionary discipline remained high, including school arrests. In 2021-22, Wicomico had 210 school-based arrests – the second highest number in the state, while they were 15th in student enrollment. More than three-quarters of the children arrested were Black and 80% were students with disabilities.

    “Monitoring the numbers doesn’t bring you the solution,” said Losen, from the National Center for Youth Law. In many districts, “the problem is more than what they’re doing with discipline.”

    The Department of Justice declined to comment.

    Some Wicomico parents and educators point to an insular culture in the school district where problems are hidden rather than resolved.

    They are frustrated that there is no relationship with the county’s mobile crisis unit, which is often relied on in other counties to help de-escalate issues instead of calling the police.

    Jermichael Mitchell, a community organizer who is an alum and parent in Wicomico County Schools, said educators often do not know how to empathize and respond to the trauma and unmet needs that may lead to children’s behavior.

    “A Black kid that’s truly going through something, that truly needs support, is always looked at as a threat,” he said. “You don’t know how those kids have been taught to cry out for help. You don’t know the trauma that they’ve been through.”

    Studies have found Black and Latino children who have a teacher of the same race have fewer suspensions and higher test scores, but that diversity is lacking in Wicomico County. Wicomico schools have the largest gap between the number of students of color and teachers of color in the state.

    Wicomico school officials said they do not discriminate against any of their students.

    A Wicomico teenager described a years-long process of becoming alienated from school, with an emergency petition as the ultimate break. He said he was bullied in middle school over a series of months until one day he snapped and hit the student who had been taunting him.

    The school called the police. He told the officers not to touch him, and that he needed to calm down. Instead, the officers grabbed him and shoved him into the ground, he said. He was handcuffed and transported to the emergency room. But when he returned, he said the only thing that was different was how he felt about the adults in the building.

    “I got used to not trusting people, not talking to people at school,” he said. “Nothing else really changed.”

    _____

    This story about emergency petitions was produced by The Associated Press and The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education.

    _____

    The Associated Press education team receives support from the Carnegie Corporation of New York. The AP is solely responsible for all content.

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  • Rural hospitals are closing maternity wards. People are seeking options to give birth closer to home

    Rural hospitals are closing maternity wards. People are seeking options to give birth closer to home

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    Alisha Alderson placed everything she needed for the last month of her pregnancy in various suitcases as she prepared to leave the comfort of her home in rural eastern Oregon. The only maternity ward within 40 miles abruptly closed in August, so she would be staying at her brother’s house in Idaho to be closer to a hospital.

    “I was sitting in a hair salon a few days ago and some people started joking about me giving birth on the side of the road,” the 45-year-old said. “And in that moment, I just pictured all the things that could go wrong with my baby and broke down in tears in front of strangers.”

    Fewer than half of rural hospitals in the U.S. have maternity units, which forces pregnant women to travel longer distances for care or face giving birth in an emergency room. It’s also prompted government officials and families to scramble for answers. One solution gaining ground is freestanding midwife-led birth centers, but those also often rely on hospitals when serious complications arise.

    The closures have worsened so-called “maternity care deserts” — counties, mostly rural, with no hospitals or birth centers and no OB providers. More than two million women of childbearing age live in these areas. And fewer hospital maternity units makes having babies less safe, doctors and researchers say.

    “Moms have complications everywhere. Babies have complications everywhere,” said Dr. Eric Scott Palmer, a neonatologist who practiced at Henry County Medical Center in rural Tennessee before it ended obstetric services this month. “There will be people hurt. It’s not a question of if — simply when.”

    The American Hospital Association says at least 89 obstetric units closed in rural hospitals between 2015 and 2019, and more have shuttered since. The main reasons are decreasing numbers of births; staffing issues; low reimbursement from Medicaid; and financial distress, according to Peiyin Hung, deputy director of the University of South Carolina’s Rural and Minority Health Research Center.

    Officials at Saint Alphonsus, the hospital in Baker City where Alderson wanted to give birth, cited a shortage of OB nurses and declining deliveries. While they said financial concerns didn’t factor into the decision, they also underlined the unit had operated in the red over the last 10 years.

    A lack of money was the major reason why Henry County Medical Center in Paris, Tennessee, closed its OB unit. CEO John Tucker told The Associated Press that it was a necessary step to save the hospital overall. He also said the number of deliveries had dropped in recent years.

    Six days before the unit closed, just one woman was there to deliver. All of the other rooms contained empty beds and bassinets. Art had been removed from the walls.

    Dr. Pamela Evans, who helped with deliveries for years and will stay on as a gynecologist, said she fears things like preterm deliveries, infant mortality and low-birthweight babies are bound to get worse. Prenatal care suffers when people must travel long distances or take lots of time off work for appointments, she said. Not all insurance covers out-of-state deliveries, and it’s an hour or more to some alternative in-state hospitals that families are looking at.

    A solution to the rural care crisis might be about two hours away, where a handful of women sat in a circle for a prenatal group meeting at The Farm Midwifery Center, a storied place in Summertown, Tennessee, that’s more than a half-century old. Midwife Corina Fitch led discussions and gave them individual checkups.

    “This is the perfect place for me,” said pregnant mom Betsy Baarspul of Nashville, whose first child was born in an emergency C-section in a hospital. “It feels like you’re held in a way.”

    Some states and communities are taking steps to create more free-standing birth centers. Connecticut Gov. Ned Lamont recently signed legislation that will license such centers to operate as an alternative for women with low-risk pregnancies.

    Alecia McGregor, who studies health policy and politics at the Harvard T.H. Chan School of Public Health, said midwife-led birth centers “can be a very important solution to lowering costs within the U.S. health care system and improving outcomes.”

    A report on deliveries at The Farm in its first 40 years showed 5% of clients were transported to the hospital.

    Doctors told the AP that rural hospitals will need to be part of the equation, and they believe governments must do more.

    Oregon politicians mobilized this summer and considered requesting the help of OB nurses from the U.S. Public Health Service Commissioned Corps, which largely responds to natural disasters and disease outbreaks. While the idea didn’t pan out, the federal service sent experts to Baker City, who recommended several things, including looking into establishing a free-standing birth center.

    County commissioner Shane Alderson — the husband of Alisha — said rural communities shouldn’t be stripped of health care options because of their size or the number of low-income people with public insurance.

    “That’s not equitable,” he said. “People can’t survive like that.”

    ___

    Rush reported from Baker City, Oregon, and Kuna, Idaho. Ungar reported from Paris, Tennessee, and Summertown, Tennessee.

    ___

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

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  • Red States Are Rolling Back the Rights Revolution

    Red States Are Rolling Back the Rights Revolution

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    The struggle over the sweeping red-state drive to roll back civil rights and liberties has primarily moved to the courts.

    Since 2021, Republican-controlled states have passed a swarm of laws to restrict voting rights, increase penalties for public protest, impose new restrictions on transgender youth, ban books, and limit what teachers, college professors, and employers can say about race, gender, and sexual orientation. Some states are even exploring options to potentially prosecute people who help women travel out of state to obtain an abortion.

    In the early legal skirmishing over this agenda, opponents including the federal Justice Department have won a surprising number of decisions, mostly in federal courts, blocking states from implementing the new laws.

    But eventually most of these issues are likely to be resolved by the U.S. Supreme Court, and the court’s six-member Republican-appointed majority has generally ruled in ways that favor the conservative social-policy priorities reflected in the red-state actions. That inclination was most dramatically demonstrated in last year’s Dobbs decision, when the Court overturned the constitutional right to abortion.

    In the coming years, the Court will face a series of decisions on the new red-state agenda that may determine whether the U.S. maintains a strong baseline of civil rights available in all states or reverts back toward a pre-1960s world where people’s rights varied much more depending on where they lived.

    “The idea of the Bill of Rights was that we would have a floor of civil rights and civil liberties that the states could not go below,” David Cole, the national legal director of the American Civil Liberties Union, told me. “But for that floor to be meaningful, it has to be enforced by the Supreme Court ultimately.

    “In our history, the courts have sometimes done that courageously and bravely, and other times they have fallen down on the job,” Cole continued. “And when they have fallen down on the job, you get a two-tier system in this country.”

    Since President Joe Biden’s election, the 22 states where Republicans hold unified control of the governorship and the state legislature have moved with remarkable speed to create a two-tier system on issues including abortion, classroom censorship, and the treatment of LGBTQ people. “The fact that all of this is happening on so many different fronts simultaneously is unprecedented,” Donald Kettl, a former dean and professor emeritus of the University of Maryland’s School of Public Policy, told me.

    This broad red-state push to retrench rights, as I’ve written, is reversing the general trend since the 1960s of nationalizing more rights, a process often called “the rights revolution.”

    Civil-rights advocates have limited options for reversing this tide of red-state legislation. So long as the Senate filibuster exists, Democrats have virtually no chance of passing national legislation to override the red-state actions on issues such as abortion and voting rights, even if the party regains unified control of the federal government after the 2024 elections.

    In some states, opponents can try to rescind these measures directly through ballot initiatives, like the Ohio referendum that, if passed in November, would overturn the state’s six-week abortion ban. But not all states permit such referendums, and even in those that do, ballot measures to reverse many of the key red-state restrictions would face an uncertain fate given the underlying conservative lean of their electorates.

    Opponents are challenging some of the new statutes in state courts. The Center for Reproductive Rights, a group that supports legal abortion, has cases pending in six states, including Ohio, Wyoming, Iowa, and Florida, arguing that abortion restrictions adopted since the Dobbs decision violate provisions in those states’ constitutions. But recent rulings by state supreme courts—in South Carolina, upholding the state’s six-week abortion ban, and in Texas, dismissing an injunction against the state’s ban on gender-affirming care for transgender minors—show the limitations of relying on red-state courts to undo the work of red-state political leaders.

    “Sometimes the state courts provide a sympathetic venue,” Cole said. “But oftentimes in the red states, precisely because the courts have been appointed by red-state governors and legislatures, they are not especially open to challenges to their legislature’s laws.”

    That leaves federal courts as the principal arena for those hoping to overturn the restrictive red-state laws.

    These federal cases raise a range of legal arguments. Mostly they revolve around the claim that the state laws violate the U.S. Constitution’s protection of free speech in the First Amendment and the due process and equal protection provisions of the Fourteenth Amendment. As courts consider these claims, the key early federal rulings have covered cases involving a variety of issues.

    Freedom of speech: In a striking victory for critics, a federal district judge in Florida issued two decisions blocking enforcement of Florida Governor Ron DeSantis’s signature Stop WOKE Act, which restricts how private employers and college and university professors talk about racial inequity. In one ruling, Judge Mark Walker called the law “positively dystopian.” He wrote: “The powers in charge of Florida’s public university system have declared the state has unfettered authority to muzzle its professors in the name of ‘freedom.’”  The Eleventh Circuit Court of Appeals has denied DeSantis’s request to lift Walker’s injunction against the law while the case proceeds.

    Federal courts have also blocked enforcement of the Florida law DeSantis signed increasing the penalties for public protest. But another federal judge has twice dismissed a case attempting to block DeSantis’s “Don’t Say Gay” law restricting discussion of sexual orientation and gender identity in K–12 classrooms. (Opponents of the law are appealing that decision.)

    Litigation against the multiple red-state measures making it easier for critics to ban books in school libraries has not advanced as far. But in May, PEN America, a free-speech group, together with Penguin Random House and several authors filed a suit against Florida’s Escambia County school district over the removal of titles about people of color and LGBTQ people that could become the bellwether case.

    Abortion: Though the Supreme Court’s Dobbs decision preempted any frontal federal legal challenge to the state laws restricting or banning the procedure, abortion-rights supporters continue to fight elements of the new statutes.

    In late July, a federal district judge blocked guidance from Raúl Labrador, the Republican attorney general of Idaho, a state that has banned abortion, warning doctors that they could be prosecuted for helping patients travel out of state to obtain the procedure. A separate federal lawsuit filed in July is challenging Idaho’s law imposing criminal penalties on adults who transport a minor out of state to obtain an abortion. The Justice Department won an injunction last year preventing Idaho from enforcing another portion of its abortion ban on the grounds that it violates federal law requiring treatment of people needing emergency care in hospitals.

    Dobbs overturned 50 years of precedent and got rid of the fundamental liberty right to abortion, but it definitely didn’t answer every question,” Amy Myrick, a senior staff attorney at the Center for Reproductive Rights, told me. “And federal courts are now being faced with a public-health crisis of enormous magnitude, so at some point they will have to decide whether a ban becomes irrational if it forces patients to get sick or even die based on what a state says.”

    Immigration: Another front in the red-state offensive is an increasing effort to seize control of immigration policy from the federal government. The Biden administration last week won a federal-district-court decision requiring Texas to remove a flotilla of buoys it has placed in the Rio Grande River to repel undocumented migrants (though the conservative Fifth Circuit Court of Appeals put that ruling on hold just one day later). A coalition of civil-rights groups is suing Florida in federal court over a DeSantis law making it a crime to transport an undocumented migrant in the state.

    Voting: As with abortion, critics have found a legal basis to challenge only provisions at the periphery of the voting restrictions approved in most red states since 2021. Last month, the Justice Department won a federal court ruling blocking a measure that Texas had passed making it easier for officials to reject absentee ballots. In July, a federal-district-court judge upheld key components of Georgia’s 2021 law making voting more difficult, but did partially overturn that law’s most controversial element: a ban on providing food and water to people waiting in line to vote.

    LGBTQ rights: Federal litigation has probably progressed most against the intertwined red-state moves to impose new restrictions on transgender people. The Biden Justice Department has joined cases seeking to overturn the red-state actions on each of the major issues.

    Two federal appellate courts have blocked policies requiring transgender students to use the bathroom (or locker room) of their gender assigned at birth, while the Eleventh Circuit late last year upheld such a law in Florida. Two federal circuit courts have also blocked the enforcement of laws in Idaho and West Virginia barring transgender girls from participating on female sports teams in high school, though a lower federal court has subsequently upheld the West Virginia law.

    Of all the issues affecting transgender people, litigation against the statutes passed in 22 Republican-controlled states barring gender-affirming care for minor children, even with their parents’ approval, may reach the Supreme Court first. In a flurry of decisions made mostly this summer, multiple federal district courts have issued injunctions blocking the implementation of such laws in several states. One federal appellate court has upheld such an injunction, but two others recently overturned lower-court rulings and allowed Tennessee and Alabama to put their laws into effect. (After those decisions, a federal district court last week also allowed Georgia to enforce its ban.) Such a split among circuit courts could encourage the Supreme Court to step in, as do the momentous and timely stakes for families facing choices about medical care. “For families who have adolescents who need this care, some of whom have been receiving this care, it’s a matter of family urgency,” Jennifer Pizer, the chief legal officer at Lambda Legal, a group that advocates for LGBTQ rights, told me.

    Although liberal groups and the Biden administration have been heartened by many of these early rulings, they recognize that the most significant legal fights are all rolling toward the same foreboding terminus: the Supreme Court.

    Over recent years, the Court has restricted the ability of blue states to impinge on rights that conservatives prize while mostly allowing red states to constrain rights that liberals prioritize. The Court has displayed the former instinct in its rulings striking down gun-control laws in blue jurisdictions, allowing religious-freedom exemptions to state civil-rights statutes, and barring public universities from using affirmative action. Conversely, the Court has loosened restrictions on red states with the Dobbs decision and the 2013 Shelby County ruling effectively revoking the Justice Department’s authority to preemptively block changes in state voting laws.

    Those who see this past as prologue believe that the current Supreme Court majority may provide the red states great leeway to establish a legal regime that defines rights much more narrowly than in the rest of the country. At various points in American history, the Supreme Court has certainly done that before, most notoriously in the 1896 Plessy v. Ferguson case, when the justices approved the system of “separate but equal” Jim Crow segregation across the South that persisted for nearly the next 70 years.

    But several legal experts I spoke with said it was premature to assume that these recent rulings ensure that the Supreme Court will reflexively uphold the contemporary wave of red-state measures. Erwin Chemerinsky, the dean of UC Berkeley’s law school, told me that the Court’s decisions in recent years have advanced “what’s been the conservative Republican agenda for decades: Overrule Roe v. Wade; eliminate affirmative action; protect gun rights.” It’s less clear, Chemerinsky believes, what the Court will do with this “new conservative agenda” rising from the red states. Although the six Republican-appointed justices are clearly sympathetic to conservative goals, he said, “some of what the [states] are doing is so radical, I don’t know that the Supreme Court will go along.”

    The ACLU’s Cole notes that the Court appeared to move more cautiously in the term that ended in June than it did in the 2021–22 session, which concluded with the cannon shot overruling Roe. With a few prominent exceptions headlined by the decision banning affirmative action in higher education, “civil rights and civil liberties did pretty well in the Supreme Court this term,” Cole maintained. “Much is still to be determined, but I think this term showed us that you can’t just assume that this Court is going to impose right-wing results regardless of precedent.”

    Conservatives remain confident that this Supreme Court majority will not reject many of these new red-state laws. They see an early signal of how some of these fights may play out in the August decision by the Eleventh Circuit Court of Appeals allowing Alabama to enforce its law banning gender-affirming care for minors.

    Written by Barbara Lagoa, who was appointed by Donald Trump, that ruling specifically cited the Supreme Court’s logic in the Dobbs case to argue that Alabama’s ban on gender-affirming care for minors would likely survive legal scrutiny. In Dobbs, the majority opinion written by Justice Samuel Alito said the Fourteenth Amendment did not encompass the right to abortion because there was no evidence that such a right was “deeply rooted” in American history. Likewise, Lagoa wrote of gender-affirming care that “the use of these medications in general—let alone for children—almost certainly is not ‘deeply rooted’ in our nation’s history and tradition.”

    Sarah Parshall Perry, a senior legal fellow at the conservative Heritage Foundation’s Edwin Meese Center for Legal and Judicial Studies, predicted that such logic would ultimately persuade the conservative Supreme Court majority. “What we are seeing now is the use of the Dobbs framework in actual action,” she told me. “I think the Supreme Court quite frankly is going to be very wary of expanding Fourteenth Amendment jurisprudence to rubber-stamp an experimental new treatment, especially when minor children are involved.”

    The one point both sides can agree on is that the Supreme Court’s rulings on the red-state measures will represent a crossroads for the country. One path preserves the broadly consistent floor of civil rights across state lines that Americans have known since the 1960s; the other leads to a widening divergence reminiscent of earlier periods of intense separation among the states.

    Kettl believes that if the Supreme Court doesn’t constrain the red states, they almost certainly will push much further in undoing the rights revolution.We haven’t seen what the boundary of that effort will be yet,” he told me, pointing to the ordinances some Texas localities have passed attempting to bar women from driving through them to obtain an abortion out of state.

    If the Supreme Court allows the red states a largely free hand to continue devising their own system of civil rights and liberties, Chemerinsky said, it will present Americans with a “profound” question:

    “Will the county accept being two different countries with regard to so many of these important things, as it did with regard to other important things such as slavery and civil rights?” he said. “Or will there be a point that people will say, ‘What divides us as a country is much greater than what unites us.’ And will we start hearing the first serious calls to rethink the United States?”

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    Ronald Brownstein

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  • Vigil planned for Massachusetts teen who died after taking part in One Chip Challenge

    Vigil planned for Massachusetts teen who died after taking part in One Chip Challenge

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    WORCESTER, Mass. — The family of a teenager who died after eating an extremely spicy tortilla chip as part of a social media challenge will gather to remember the promising basketball player at a vigil Friday while they await word from Massachusetts authorities about what caused his death.

    Harris Wolobah died on Sept. 1 and an autopsy is pending. But the 14-year-old’s family blamed the One Chip Challenge, which requires participants to eat the spicy chip and see how long they can go without consuming other food and water.

    Since his death, Texas-based manufacturer Paqui has asked retailers to stop selling the individually wrapped chips, a step 7-Eleven has already taken.

    The One Chip Challenge chip sells for about $10 and comes wrapped in a sealed foil pouch that is enclosed in a coffin-shaped cardboard box. The package warns the chip is made for the “vengeful pleasure of intense heat and pain,” is intended for adults and should be kept out of reach of children.

    Paqui, a subsidiary of The Hershey Company, said in a statement posted on its website Thursday that it was “deeply saddened by the death” of Wolobah.

    “We have seen an increase in teens and other individuals not heeding these warnings,” the company said. “As a result, while the product continues to adhere to food safety standards, out of abundance of caution, we are actively working with retailers to remove the product from shelves.”

    Authorities in Massachusetts also responded to the teen’s family’s accusations by warning parents about the challenge, which is popular on social media sites such as TikTok.

    Scores of people, including children, post videos of themselves unwrapping the packaging, eating the spicy chips and then reacting to the heat. Some videos show people gagging, coughing and begging for water.

    “We urge parents to discuss this with their children and advise them not to partake in this activity,” Worcester County District Attorney Joseph Early said in a series of posts about the challenge on the social network X, formerly known as Twitter. “The company warnings state the chips are intended for adult consumption. Other states across the country have seen hospitalizations due to the chip challenge, including teens.”

    A 10-year-old Florida girl was suspended this week for bringing the Paqui chip to school, her father, D’Anton Patrick, told West Palm Beach television station WPTV. Six children at Forest Park Elementary School needed medical attention after coming into contact with the chip Wednesday, according to the suspension letter sent the girl’s parents.

    The girl’s 12-year-old brother bought the chip, but his mother made him throw it out, Patrick said. The girl fished it out of the garbage and brought it to school.

    There have been reports from around the country of teens getting sick after taking part in the challenge, including three students from a California high school who were sent to a hospital. Paramedics were called to a Minnesota school last year when seven students fell ill after taking part in the challenge.

    “You can have very mild symptoms like burning or tingling of the lips in the mouth, but you can also have more severe symptoms,” said Dr. Lauren Rice, the chief of pediatric emergency medicine at Tufts Medical Center in Boston, noting this is an opportunity for parents, coaches, teachers to learn about the various social media challenges out there that could pose dangers.

    “This goes back to the ingredients that are used with the tortilla chip,” she continued. “There are some spices like capsaicin, which is a chemical ingredient that we use in things like pepper spray and so they are very strong chemicals and they can be very irritating. Some of the more severe symptoms that we see can be things like significant abdominal pain or nausea and vomiting.”

    Dr. Peter Chai, an associate professor of emergency medicine and medical toxicology at Brigham and Women’s Hospital in Boston, said the chips can be dangerous under certain circumstances.

    “It’s possible eating these chips with high concentration of capsaicin could cause death,” Chai said. “It would really depend on the amount of capsaicin that an individual was exposed to. At high doses, it can lead to fatal dysrhythmia or irreversible injury to the heart.”

    Police in Worcester, the state’s second-largest city, said in a statement that they were called to Wolobah’s house Friday afternoon and found him “unresponsive and not breathing.” He was transported to a hospital, where he was pronounced dead.

    Family and friends of Wolobah believe the chips caused his death and his family called for the chips to be banned from store shelves. A vigil for the teen is planned for Friday evening at a park in Worcester in central Massachusetts.

    “The chip is responsible in our eyes for whatever took place because he was a healthy kid,” said Douglas Hill, who runs the basketball league Wolobah played in and described him as a quiet teen whose family came to the U.S. from Liberia.

    “The conversation now is about the chip, but there will be other challenges coming and we want to make sure children know they shouldn’t be participating in anything that could put them in harm’s way,” said Douglas, who organized a basketball event Saturday to honor the teen.

    There is little doubt why someone would eat the chips.

    In addition to its name, One Chip Challenge, the package lays out the challenge rules, which encourage the buyer to eat the entire chip, “wait as long as possible before drinking or eating anything” and post their reaction on social media. The packaging also asks how long can the individual last on a scale from one minute to one hour.

    The back of the package warns buyers not to eat the chip if they are “sensitive to spicy foods, allergic to peppers, night shades or capsaicin or are pregnant or have any medical conditions.”

    The warning adds that individuals should wash their hands after touching the chip and “seek medical assistance should you experience difficulty breathing, fainting or extended nausea.”

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  • Company pulls spicy One Chip Challenge from store shelves as Massachusetts investigates teen’s death

    Company pulls spicy One Chip Challenge from store shelves as Massachusetts investigates teen’s death

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    WORCESTER, Mass. — The maker of an extremely spicy tortilla chip sold as the One Chip Challenge and popularized as a dare on social media is pulling the product after the family of a Massachusetts teenager blamed the stunt for his death.

    The cause of Harris Wolobah’s death last Friday hasn’t been determined and an autopsy was still pending as of Thursday, but the 14-year-old’s family blames the challenge. Since his death, the Texas-based manufacturer, Paqui, has asked retailers to stop selling the individually wrapped chips — a step 7-Eleven has already taken.

    The One Chip Challenge chip sells for about $10 and comes wrapped in a sealed foil pouch that is enclosed in a coffin-shaped cardboard box. The package warns that the chip is made for the “vengeful pleasure of intense heat and pain,” is intended for adults and should be kept out of reach of children.

    Paqui, a subsidiary of The Hershey Company, said in a statement posted on its website Thursday that it was “deeply saddened by the death” of Wolobah.

    “We have seen an increase in teens and other individuals not heeding these warnings,” the company said. “As a result, while the product continues to adhere to food safety standards, out of abundance of caution, we are actively working with retailers to remove the product from shelves.”

    Authorities in Massachusetts have also responded to the death by warning parents about the challenge, which is is popular on social media sites such as TikTok. Scores of people, including children, post videos of themselves unwrapping the packaging, eating the spicy chips and then reacting to the heat. Some videos show people gagging, coughing and begging for water.

    “We urge parents to discuss this with their children and advise them not to partake in this activity,” Worcester County District Attorney Joseph Early said in a series of posts about the challenge on the social network X, formerly known as Twitter. “The company warnings state the chips are intended for adult consumption. Other states across the country have seen hospitalizations due to the chip challenge, including teens.”

    There have been reports from around the country of people who have gotten sick after taking part in the challenge, including three students from a California high school who were sent to a hospital. And paramedics were called to a Minnesota school last year when seven students fell ill after taking part in the challenge.

    “You can have very mild symptoms like burning or tingling of the lips in the mouth, but you can also have more severe symptoms,” said Dr. Lauren Rice, the chief of pediatric emergency medicine at Tufts Medical Center in Boston, noting that this is an opportunity for parents, coaches, teachers to learn about the various social media challenges that are out there and could pose dangers.

    “This goes back to the ingredients that are used with the tortilla chip,” she continued. “There are some spices like capsaicin, which is a chemical ingredient that we use in things like pepper spray and so they are very strong chemicals and they can be very irritating. Some of the more severe symptoms that we see can be things like significant abdominal pain or nausea and vomiting.”

    Dr. Peter Chai, an associate professor of emergency medicine and medical toxicology at Brigham and Women’s Hospital, said these chips can be dangerous under certain circumstances.

    “It’s possible eating these chips with high concentration of capsaicin could cause death,” he said. “It would really depend on the amount of capsaicin that an individual was exposed to. At high doses, it can lead to fatal dysrhythmia or irreversible injury to the heart.”

    Police in Worcester, which is in central Massachusetts and is the state’s second-largest city, said in a statement that they were called to Wolobah’s house Friday afternoon and found him “unresponsive and not breathing.” He was transported to the hospital, where he was pronounced dead.

    Family and friends of Wolobah believe the chips caused his death, and his family called for the chips to be banned from store shelves.

    “The chip is responsible in our eyes for whatever took place because he was a healthy kid,” said Douglas Hill, who runs the basketball league Wolobah played in and described him as a quiet teen whose family came to the U.S. from Liberia.

    “The conversation now is about the chip, but there will be other challenges coming and we want to make sure children know they shouldn’t be participating in anything that could put them in harm’s way,” said Douglas, who organized a basketball event Saturday to honor the teen. A Friday vigil is also planned.

    There can be no doubt about why someone would eat these chips.

    In addition to its name, One Chip Challenge, the package lays out the “rules for the challenge,” which encourages the buyer to eat the entire chip, “wait as long as possible before drinking or eating anything,” and post their reaction on social media. The packaging also asks how long can the individual last on a scale from one minute to one hour.

    The back of the package warns buyers not to eat the chip if they are “sensitive to spicy foods, allergic to peppers, night shades or capsaicin or are pregnant or have any medical conditions.” It also said individuals should wash their hands after touching the chip and “seek medical assistance should you experience difficulty breathing, fainting or extended nausea.”

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  • Company pulls spicy One Chip Challenge from store shelves as Massachusetts investigates teen’s death

    Company pulls spicy One Chip Challenge from store shelves as Massachusetts investigates teen’s death

    [ad_1]

    WORCESTER, Mass. — The maker of an extremely spicy tortilla chip sold as the One Chip Challenge and popularized as a dare on social media is pulling the product after the family of a Massachusetts teenager blamed the stunt for his death.

    The cause of Harris Wolobah’s death last Friday hasn’t been determined and an autopsy was still pending as of Thursday, but the 14-year-old’s family blames the challenge. Since his death, the Texas-based manufacturer, Paqui, has asked retailers to stop selling the individually wrapped chips — a step 7-Eleven has already taken.

    The One Chip Challenge chip sells for about $10 and comes wrapped in a sealed foil pouch that is enclosed in a coffin-shaped cardboard box. The package warns that the chip is made for the “vengeful pleasure of intense heat and pain,” is intended for adults and should be kept out of reach of children.

    Paqui, a subsidiary of The Hershey Company, said in a statement posted on its website Thursday that it was “deeply saddened by the death” of Wolobah.

    “We have seen an increase in teens and other individuals not heeding these warnings,” the company said. “As a result, while the product continues to adhere to food safety standards, out of abundance of caution, we are actively working with retailers to remove the product from shelves.”

    Authorities in Massachusetts have also responded to the death by warning parents about the challenge, which is is popular on social media sites such as TikTok. Scores of people, including children, post videos of themselves unwrapping the packaging, eating the spicy chips and then reacting to the heat. Some videos show people gagging, coughing and begging for water.

    “We urge parents to discuss this with their children and advise them not to partake in this activity,” Worcester County District Attorney Joseph Early said in a series of posts about the challenge on the social network X, formerly known as Twitter. “The company warnings state the chips are intended for adult consumption. Other states across the country have seen hospitalizations due to the chip challenge, including teens.”

    There have been reports from around the country of people who have gotten sick after taking part in the challenge, including three students from a California high school who were sent to a hospital. And paramedics were called to a Minnesota school last year when seven students fell ill after taking part in the challenge.

    “You can have very mild symptoms like burning or tingling of the lips in the mouth, but you can also have more severe symptoms,” said Lauren Rice, the chief of pediatric emergency medicine at Tufts Medical Center in Boston, noting that this is an opportunity for parents, coaches, teachers to learn about the various social media challenges that are out there and could pose dangers.

    “This goes back to the ingredients that are used with the tortilla chip,” she continued. “There are some spices like capsaicin, which is a chemical ingredient that we use in things like pepper spray and so they are very strong chemicals and they can be very irritating. Some of the more severe symptoms that we see can be things like significant abdominal pain or nausea and vomiting.”

    Dr. Peter Chai, an associate professor of emergency medicine and medical toxicology at Brigham and Women’s Hospital, said these chips can be dangerous under certain circumstances.

    “It’s possible eating these chips with high concentration of capsaicin could cause death,” he said. “It would really depend on the amount of capsaicin that an individual was exposed to. At high doses, it can lead to fatal dysrhythmia or irreversible injury to the heart.”

    Police in Worcester, which is in central Massachusetts and is the state’s second-largest city, said in a statement that they were called to Wolobah’s house Friday afternoon and found him “unresponsive and not breathing.” He was transported to the hospital, where he was pronounced dead.

    Family and friends of Wolobah believe the chips caused his death, and his family called for the chips to be banned from store shelves.

    “The chip is responsible in our eyes for whatever took place because he was a healthy kid,” said Douglas Hill, who runs the basketball league Wolobah played in and described him as a quiet teen whose family came to the U.S. from Liberia.

    “The conversation now is about the chip, but there will be other challenges coming and we want to make sure children know they shouldn’t be participating in anything that could put them in harm’s way,” said Douglas, who organized a basketball event Saturday to honor the teen. A Friday vigil is also planned.

    There can be no doubt about why someone would eat these chips.

    In addition to its name, One Chip Challenge, the package lays out the “rules for the challenge,” which encourages the buyer to eat the entire chip, “wait as long as possible before drinking or eating anything,” and post their reaction on social media. The packaging also asks how long can the individual last on a scale from one minute to one hour.

    The back of the package warns buyers not to eat the chip if they are “sensitive to spicy foods, allergic to peppers, night shades or capsaicin or are pregnant or have any medical conditions.” It also said individuals should wash their hands after touching the chip and “seek medical assistance should you experience difficulty breathing, fainting or extended nausea.”

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  • Harvard-trained pediatrician shares 5 things she never does when her ‘own kids’ are sick

    Harvard-trained pediatrician shares 5 things she never does when her ‘own kids’ are sick

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    Like every parent, I know how hard it is to care for a sick kid. It involves a heady mix of emotions: fear, love, confusion, concern and sadness.

    And when your child is ill, the last thing you need is to be overwhelmed by conflicting information or unsolicited advice. You just want them to get better.

    As a Harvard-trained complex-care pediatrician and mom of two kids, here are five things I never do when my own kids are sick:

    1. If they have a fever but are sleeping, I never wake them up for medication.

    Sleep is important for healing, recovery and growth, and it can be hard to come by when your child has a cough or congestion that keeps them awake.

    While it can be scary when your child has a fever, if they are comfortable and resting, it isn’t an emergency that requires medication right this minute.

    By allowing them to rest, it’s possible that their immune system will be better equipped to do its job and help fight off viruses.

    2. I never hesitate to give fever controlling medication if they look uncomfortable.

    If your kid has a fever and they’re breathing faster or harder, drinking less fluids, or are having trouble resting, I would not hesitate to give widely-used, safe and effective medicine like acetaminophen and ibuprofen to promote comfort.

    But if you find you are giving these medicines three or four times a day, for more than three days, it’s probably time to see the doctor.

    3. I never focus on temperature over their appearance.

    Thermometers are not the most precise instruments. I’ve taken many panicked phone calls from parents who see a high number like a 105.

    But look at your child before you panic. 

    If they are feeling like themselves, are breathing normally and are well-hydrated, it’s probably not an emergency. However, if they look very sick and your thermometer says there is no fever, they may still need medical attention.

    4. I never use anything but honey to help a cough. 

    Cough medications like codeine or dextromethorphan can do more harm than good, and the American Academy of Pediatrics recommends against them

    Cough syrups with many medications in one product can increase the risk of a medication error. For example, if you gave a kid Tylenol, and then their cough medicine also had acetaminophen as a key ingredient, it could lead to an overdose.

    Adding extra ingredients such as melatonin or elderberry does not always make sense, and is not shown to be more effective than simpler cough syrups.

    For kids older than one year, I exclusively use honey or cough syrup with honey as the main ingredient. These have been shown to work just as well as other medications, but with fewer risks.

    5. I never measure medicine in teaspoons.

    Nearly 700,000 kids deal with medication errors every year. Young kids are at the highest risk since they often have multiple caregivers who may not check in about who gave them what and when, despite their best efforts.

    There is also the complexity of using liquid medicines. Children’s doses vary by age and weight. Teaspoons are different sizes, and teaspoons and tablespoons get mixed up, too.

    For safety, I always give dosing information in milliliters to enhance precision and prevent errors.

    Kelly Fradin, MD is a pediatrician, mother of two and author of “Advanced Parenting: Advice for Helping Kids Through Diagnoses, Differences, and Mental Health Challenges.” She shares advice for parents on Instagram and her Substack newsletter.

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  • Video of police fatally shooting a pregnant Black woman set to be released, Ohio department says

    Video of police fatally shooting a pregnant Black woman set to be released, Ohio department says

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    COLUMBUS, Ohio — Body camera footage showing the final moments of a pregnant Black woman who was shot and killed by police in an Ohio parking lot last week is expected to be released to the public on Friday.

    Ta’Kiya Young, a 21-year-old from Columbus, was pronounced dead shortly after the Aug. 24 shooting outside a grocery store in the suburb of Blendon Township. Her unborn daughter did not survive.

    Suspected of shoplifting, police say Young was killed after she accelerated her car toward an officer.

    The family’s lawyer, Sean Walton, claims the police department has waited to release the bodycam video to minimize media attention on potentially damaging footage. Walton did not immediately respond to phone messages from The Associated Press seeking additional comment.

    Blendon Township Police Chief John Belford said the delay resulted from a small staff trying to process the video and properly redact certain footage in accordance with Ohio law. The family will be able to review the video before it’s made public, he said.

    The police chief gave a brief account of the shooting in an Aug. 25 video statement in which he said two officers were helping someone get into a locked car when a supermarket employee told them several people were leaving with stolen items.

    Young was among them, according to the employee who pointed her out sitting in her car in the parking lot. She allegedly took bottles of alcohol without paying. One officer went to the driver’s side of Young’s car and told her to stop and get out multiple times, Belford said, while the other officer moved to the front of the vehicle.

    Young then put the car in gear and accelerated, Belford said.

    “The officer who was directly in the path of the oncoming car fired one shot through the front windshield,” the chief said. “The body camera footage I’ve reviewed also confirms the officer was directly in the path of the car.”

    Police have not provided further details on the moments when Young was shot.

    Her car continued about 50 feet (15 meters) before stopping on the sidewalk outside the grocery store. Officers broke the car window, pulled her out and began medical assistance with the help of an emergency room doctor who happened to be there, Belford said.

    The two officers’ names, ages and races were not immediately released. They are on paid administrative leave while the Ohio Bureau of Criminal Investigation examines the shooting, which is standard in cases of police use of deadly force.

    Young was expected to give birth to a daughter in November. She also was the mother of two young sons, ages 6 and 3. An online effort to pay her funeral expenses has raised nearly $7,000.

    Family and friends held a private vigil a day after Young was killed, releasing balloons and lighting candles spelling out “RIP Kiya.”

    Her grandmother, Nadine Young, described her granddaughter as a family-oriented prankster who was a loving older sister and mother.

    “She was so excited to have this little girl,” Nadine Young said at a press conference Wednesday. “She has her two little boys, but she was so fired up to have this girl. She is going to be so missed.”

    “I’m a mess because it’s just tragic,” she said, “but it should have never ever ever happened.”

    ___

    Samantha Hendrickson is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

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  • Canadian wildfires led to spike in asthma ER visits, especially in the Northeast

    Canadian wildfires led to spike in asthma ER visits, especially in the Northeast

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    NEW YORK — The smoke from Canadian wildfires that drifted into the U.S. led to a spike in people with asthma visiting emergency rooms — particularly in the New York area.

    The U.S. Centers for Disease Control and Prevention published two studies Thursday about the health impacts of the smoke, which shrouded city skylines with an orange haze in late spring. A medical journal also released a study this week.

    When air quality worsens, “an asthmatic feels it before anyone else,” said Dr. Adrian Pristas, a pulmonologist based in Hazlet, New Jersey, who remembered a flood of calls from patients in June during the days of the heaviest smoke.

    People with asthma often wheeze, are breathless, have chest tightness and have either nighttime or early-morning coughing.

    “I have no doubt that every asthmatic had an uptick in symptoms,” Pristas said. “Some were able to manage it on their own, but some had to call for help.”

    Each of the studies looked at different geographic areas — one was national, one was specific to New York state and the last focused on New York City.

    Nationally, asthma-associated ER visits were 17% higher than normal during 19 days of wildfire smoke that occurred between late April and early August, according to one CDC study that drew data from about 4,000 U.S. hospitals.

    Hospital traffic rose more dramatically in some parts of the country during wildfire smoke: 46% higher in New York and New Jersey.

    A second study released by the CDC focused on New York state only, not New York City, because the state and city have separate hospital data bases, one of the authors said.

    It found asthma-associated ER visits jumped 82% statewide on the worst air quality day, June 7. The study also said that the central part of New York state saw the highest increases in ER visits — more than twice as high.

    The third study, published by the American Journal of Respiratory and Critical Medicine, focused solely on New York City. It found more than a 50% increase in asthma-associated ER visits on June 7, said the study’s lead author, George Thurston of New York University.

    None of the studies looked at other measures of health, such as increases in heart attacks or deaths.

    Wildfire smoke has tiny particles, called PM2.5, that can embed deep in the lungs and cause severe problems for asthmatics. But problematic as the wildfire smoke was, an analysis showed it had lower amounts of some toxic elements found in urban air pollution, Thurston said.

    The third study also attempted to compare the surge in ER visits during the wildfire smoke with what happens at the height of a bad pollen season — and the wildfires led to about 10% more ER visits.

    “That’s reassuring. It may not have been as bad as it looked,” Thurston said

    Jeffrey Acquaviva, a 52-year-old asthmatic in Holmdel, New Jersey, found that conclusion hard to swallow.

    “Yeah, right,” said Acquaviva, who works at family-owned construction business.

    As the smoke got worse in June and the air in his backyard grew thick and “golden,” Acquaviva changed the filters on his air conditioners and stayed indoors for 2 1/2 days.

    His symptoms still got worse — his breathing dangerously difficult — and finally he was taken by ambulance to a hospital and stayed there three days.

    Pristas, Acquaviva’s doctor, recalled how invasive the smoke was: “There was nowhere to hide.”

    ___

    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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  • Maui town ravaged by fire will ‘rise again,’ Hawaii governor says of long recovery ahead

    Maui town ravaged by fire will ‘rise again,’ Hawaii governor says of long recovery ahead

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    LAHAINA, Hawaii — Hawaii Gov. Josh Green said Friday that what’s rebuilt from the ashes of the devastating wildfires on Maui will be determined by the people.

    “Lahaina will rise again,” Green said during a livestreamed evening address from Honolulu. The seaside town will be rebuilt as a living memorial to those lost — a number that increased by three on Friday to 114 — while preserving and protecting Native Hawaiian culture, he said.

    His wife, Jaime Kanani Green, stood next to him and cried as she described Lahaina as a vibrant community rich in history and culture.

    “Tragically it took less than a single day for us to lose Lahaina in the deadliest fire our country has seen in more than a century,” she said.

    Native Hawaiians and others from Lahaina said earlier Friday they worry Hawaii’s governor is moving too quickly to rebuild what was lost while the grief is still raw.

    “The fire occurred only 10 days ago, and many people are still in shock and mourning,” Tiare Lawrence, who grew up in Lahaina, said at an emotional news conference organized by community activists.

    They called on Green to give residents time to grieve, provide community leaders with recovery decision-making roles and comply with open-records laws amid distrust in the government response to the disaster.

    In Green’s address, he attempted to allay their concerns, while noting that rebuilding will take years of work and billions of dollars.

    “Let me be clear,” he said. “Lahaina belongs to its people and we are committed to rebuilding and restoring it the way they want.”

    Earlier this week, Green said he would announce details of a moratorium on land transactions in Lahaina to prevent people from falling victim to land grabs. But his Friday address didn’t provide details, other than saying he directed the state attorney general to “impose enhanced criminal penalties on anyone who tries to take advantage of victims by acquiring property in the affected areas.”

    Since the flames consumed much of Lahaina, locals have feared a rebuilt town could become even more oriented toward wealthy visitors.

    “The governor should not rush to rebuild the community without first giving people time to heal, especially without including the community itself in the planning,” Lawrence said. “Fast-track development cannot come at the cost of community control.”

    The coalition of activists, under the umbrella of a group calling itself “Na Ohana o Lele: Lahaina,” were especially concerned about the impact of development on the environment and noted how mismanagement of resources — particularly land and water — contributed to the quick spread of the fire.

    There was no word Friday on who would replace the Maui Emergency Management Agency administrator who abruptly resigned after defending a decision not to sound outdoor sirens during the fire.

    Herman Andaya had said this week that he had no regrets about not deploying the system because he feared it could have caused people to go “mauka,” a Hawaiian term that can mean toward the mountains or inland.

    “If that was the case, then they would have gone into the fire,” Andaya explained. He stepped down Thursday, a day later.

    Andaya’s resignation letter was brief and had no mention of the health reasons that county officials cited for his resignation.

    “I appreciated the opportunity to head this agency for the last 6 years,” he wrote. “I have enjoyed working for the agency and am grateful for the support provided me during my tenure as administrator.”

    The county released Andaya’s resignation letter Friday after The Associated Press requested a copy.

    The decision to not use the sirens, coupled with water shortages that hampered firefighters and an escape route clogged with vehicles that were overrun by flames, has brought intense criticism.

    While crews sifted through ashes and rubble in Lahaina, scenes of normalcy continued in other parts of Maui, even if the tragedy hung heavy over the island.

    Off the coast of Kihei on Friday morning, a holiday marking Hawaii’s statehood, paddlers in outrigger canoes glided through Maalaea Bay about 20 miles (32 kilometers) south of Lahaina. Fishermen cast their lines from knee-deep water. And beachgoers strolled along the sand.

    Green reiterated a plea for visitors not to go to West Maui. “However, all other areas of Maui and the rest of Hawaii are safe and open to visitors and continue to welcome and encourage travel to our beautiful state, which will support the local economy and speed the recovery of those who have already suffered so much,” he said.

    More than 60% of the disaster area had been searched, Green said Friday, adding that he expects the number of dead to increase each day of the search.

    Six forensic anthropologists with the Department of Defense POW/MIA Accounting Agency are assisting in gathering and identifying human remains, the Pentagon said in a statement Friday. The group is experienced in verifying DNA from long-lost service members, many of whom died as long ago as World War II.

    The lack of sirens has emerged as a potential misstep, part of a series of communication issues that added to the chaos, according to reporting by The Associated Press.

    Hawaii has what it touts as the largest system of outdoor alert sirens in the world, created after a 1946 tsunami that killed more than 150 on the Big Island. Its website says they may be used to alert for fires.

    Hawaii Attorney General Anne Lopez said earlier Thursday that an outside organization will conduct “an impartial, independent” review of the government’s response.

    The cause of the wildfires is under investigation. But Hawaii is increasingly at risk from disasters, with wildfire rising fastest, according to an AP analysis of FEMA records.

    “We will get to the bottom of exactly how the fire started, how our emergency procedures and protocols need to be strengthened, how we can improve our defenses to protect us in the future,” Green said.

    Corrine Hussey Nobriga said it was hard to lay blame for a tragedy that took everyone by surprise, even if some of her neighbors raised questions about the absence of sirens and inadequate evacuation routes.

    The fire moved quickly through her neighborhood, though her home was spared.

    “One minute we saw the fire over there,” she said, pointing toward faraway hills, “and the next minute it’s consuming all these houses.”

    Authorities hope to empty crowded, uncomfortable group shelters by early next week, said Brad Kieserman, vice president for disaster operations with the American Red Cross. Hotels also are available for eligible evacuees who have been sleeping in cars or camping in parking lots, he said.

    Contracts with the hotels will last for at least seven months but could easily be extended, he said. Service providers at the properties will offer meals, counseling, financial assistance and other disaster aid.

    The governor has said at least 1,000 hotel rooms will be set aside. In addition, Airbnb said its nonprofit wing will provide properties for 1,000 people.

    Ernesto and Adoracion Garcia, who moved from the Philippines a decade ago, joined a dozen other relatives in two time-share apartments at the Hyatt Regency in Kaanapali after being left homeless by the fire.

    They were thankful that they would no longer be staying at shelters, after fleeing the flames.

    Green, who was an emergency room doctor before becoming governor, described meeting survivors. He said one woman was seven months pregnant and told him she’s not sure how she’ll make it to her next medical appointment.

    “Tears in her eyes,” Green recalled, “she told me she intends to name her baby Faith.”

    ___

    Kelleher reported from Honolulu and Weber from Los Angeles. Contributing to this report were Associated Press journalists Michael Casey in Concord, New Hampshire; Jennifer McDermott in Providence, Rhode Island; Seth Borenstein in Washington, D.C.; and Heather Hollingsworth in Kansas City, Missouri.

    ___

    Associated Press climate and environmental coverage receives support from several private foundations. See more about AP’s climate initiative here. The AP is solely responsible for all content.

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  • A cyberattack has disrupted hospitals and health care in several states

    A cyberattack has disrupted hospitals and health care in several states

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    MANCHESTER, Conn. — A cyberattack has disrupted hospital computer systems in several states, forcing some emergency rooms to close and ambulances to be diverted, and many primary care services remained closed on Friday as security experts worked to determine the extent of the problem and resolve it.

    The “data security incident” began Thursday at facilities operated by Prospect Medical Holdings, which is based in California and has hospitals and clinics there and in Texas, Connecticut, Rhode Island and Pennsylvania.

    “Upon learning of this, we took our systems offline to protect them and launched an investigation with the help of third-party cybersecurity specialists,” the company said in a statement Friday. “While our investigation continues, we are focused on addressing the pressing needs of our patients as we work diligently to return to normal operations as quickly as possible.”

    In Connecticut, the emergency departments at Manchester Memorial and Rockville General hospital were closed for much of Thursday and patients were diverted to other nearby medical centers.

    “We have a national Prospect team working and evaluating the impact of the attack on all of the organizations,” Jillian Menzel, chief operating officer for the Eastern Connecticut Health Network, said in a statement.

    The FBI in Connecticut issued a statement saying it is working with “law enforcement partners and the victim entities” but could not comment further on an ongoing investigation.

    Elective surgeries, outpatient appointments, blood drives and other services were suspended, and while the emergency departments reopened late Thursday, many primary care services were closed on Friday, according to the Eastern Connecticut Health Network, which runs the facilities. Patients were being contacted individually, according to the network’s website.

    Similar disruptions also were reported at other facilities system-wide.

    “Waterbury Hospital is following downtime procedures, including the use of paper records, until the situation is resolved,” spokeswoman Lauresha Xhihani, said in a statement. “We are working closely with IT security experts to resolve it as quickly as possible.”

    In Pennsylvania, the attack affected services at facilities including the Crozer-Chester Medical Center in Upland, Taylor Hospital in Ridley Park, Delaware County Memorial Hospital in Drexel Hill and Springfield Hospital in Springfield, according the Philadelphia Inquirer.

    In California, the company has seven hospitals in Los Angeles and Orange counties including two behavioral health facilities and a 130-bed acute care hospital in Los Angeles, according to Prospect’s website. Messages sent to representatives for these hospitals were not immediately returned.

    ____

    Associated Press writer Amy Taxin in Santa Ana, California contributed to this report

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