By Genevra Pittman NEW YORK (Reuters Health) - Black children who are brought to the emergency room for stomach pain and cramps are less likely than white children to be given painkillers, a new study suggests. Using records from more than 2,000 ER visits, researchers found that white children and teenagers more often received painkillers available over the counter, such as ibuprofen and acetaminophen (Tylenol), or more powerful opioids, including oxycodone. The difference remained after the severity of children's conditions and various hospital-related factors were taken into account. Dr. Robert Fortuna, a health services researcher from the University of Rochester Medical Center in New York, said it was "especially concerning" to see that pattern show up among kids. Fortuna's own work and other studies have found similar racial disparities in painkiller prescribing with adult patients (see Reuters Health story of July 5, 2013 here: http://reut.rs/12r77jH). "Moving forward, we need to better understand why these disparities exist and work to correct them," he told Reuters Health, noting that blaming the differences on doctors' racial biases would be an "oversimplified response." "I don't believe the vast majority of physicians knowingly or consciously treat patients differently," he said. But, "The bottom line is that minority children in this study were less likely to receive pain medications, and that's concerning." Oxycodone and other powerful painkillers have been in the spotlight recently as deaths from overdoses rise and more drugs end up in the hands of people taking them for non-medical purposes. Dr. Tiffani Johnson from Children's Hospital of Philadelphia and her colleagues said the stressful environment of an ER and lack of an established doctor-patient relationship, combined with the subjective nature of stomach pain, may lead doctors to use mental shortcuts including racial stereotypes when making treatment decisions. The researchers used data from a national study that surveys hospitals about their ambulatory care and scales up the results to reflect the general U.S. population. Their report included information on 2,298 patients age 21 and under who visited an ER in 2006 to 2009 with stomach pain, cramps or spasms, representing 8.1 million such visits across the country. Among children in severe pain - defined as a rating of seven or higher on a 10-point scale - 27 percent of white kids were given some type of painkiller, compared to 16 percent of black children and 19 percent of Hispanic children. Across the board, black children were 39 percent less likely than white children to receive any painkillers and 62 percent less likely to be given a narcotic in particular. Differences between white and Hispanic youth were small enough that they could have been due to chance, according to findings published Monday in Pediatrics. There were no racial or ethnic disparities in the number of diagnostic tests doctors ordered or in how many children were admitted to the hospital, the researchers found. However, both black and Hispanic youth were 60 to 70 percent more likely to spend over six hours in the ER, compared to their white counterparts. For the most part, the researchers could not distinguish between different underlying diagnoses that contributed to stomach pain and may have influenced the results. Emergency departments are stressful settings, Johnson and her colleagues point out, and research on adults has found that when doctors are under pressure and have little information about a patient, they are "more likely to be influenced by stereotypes and bias." Parents' preferences regarding medication could be playing a role as well, though the study did not examine that question. Future research should also look into "system-level factors," including the availability of primary care doctors, specialists, interpreters and pediatric formulations of painkillers in hospitals serving different populations, the authors write. Johnson's team said their findings can be used to develop and test interventions to target treatment differences. Until then, doctors should be aware of these disparities and "make efforts to address pain control that may be suboptimal among minority children." Parents know their children best, Fortuna said, and need to be their advocates. He encouraged all parents to have a conversation with the doctor about their child's treatment in the ER. "Until we can better understand where the system is breaking down, the best way to fight against this bias is to have open and honest communication," he said. SOURCE: http://bit.ly/cxXOG Pediatrics, online September 23, 2013.
I tried making weed brownies for the very first time, and was shocked how delicious and strong they were
As a beginner who has never made edibles, I made easy and strong pot brownies and got expert tips for baking weed-infused food along the way.
When President Joe Biden entrusted Vice President Kamala Harris in March with leading U.S. diplomatic efforts to cut immigration from Mexico and Central America's "Northern Triangle," experts described the job as both "perilous" and a "political grenade." The subsequent weeks have shown just how challenging the role will be as the administration seeks to defuse a crisis at the border that Republicans have used to hammer Biden. Harris has pushed Central American countries to increase troops at their borders and said she plans to visit Guatemala and Mexico, which could happen in as soon as a month.
- The Week
The coronavirus pandemic is continuing to pose an "unprecedented risk" to travelers, the State Department said Monday, and travel advisories are being updated to "outline current issues affecting travelers' health." The changes "better reflect" the Centers for Disease Control and Prevention's travel health notices, the State Department said, and will "result in a significant increase in the number of countries at Level 4: Do Not Travel, to approximately 80 percent of countries worldwide." The advisories also take into account "logistical factors," the State Department said, like "in-country testing availability and current travel restrictions for U.S. citizens." Level 4 is the highest travel advisory level, and there are now about three dozen countries with this designation, CNN reports. The CDC is recommending that people delay international travel until they are fully vaccinated against the coronavirus, adding that even those who have been inoculated "are at increased risk for getting and possibly spreading new COVID-19 variants." More stories from theweek.comThe new HBO show you won't be able to stop watchingDonald Trump's most dangerous political legacyFauci flubs the freedom question
- Business Insider
The rare clots people get after taking COVID-19 vaccines are different from other clots and require special treatment
The CDC has issues special guidance for the specific post-vaccine clots, known as vaccine-induced immune thrombotic thrombocytopenia, or VITT.
- The Daily Beast
REUTERS/Jane RosenbergAs Derek Chauvin’s murder trial comes to a close, both sides made their closing arguments on Monday, with prosecutors insisting the former Minneapolis cop’s fatal arrest of George Floyd wasn’t “policing” but “murder”—as his defense claimed he used “reasonable” force.Prosecutors on Monday detailed to jurors in Hennepin County court how Chauvin’s decision to press his knee into the 46-year-old Black man’s neck while he repeated that he could not breathe was unjustifiable and inhumane.“The truth of the matter is that the reason that George Floyd is dead is that Mr. Chauvin’s heart was too small,” special prosecutor Jerry Blackwell said Monday just before the case was sent to the 12-member jury.Prosecutor Steve Schleicher also insisted the officer “knew better; he just didn’t do better” during Floyd’s May 25 arrest over a fake $20 bill. “What [Chauvin] did is not policing. What [Chauvin] did is assault.”“That day, his badge wasn’t in the right place. He’s not on trial for who he was. He’s on trial for what he did,” Schleicher argued, adding that Chauvin “chose pride over policing.” During his closing argument—which lasted 2 hours and 47 minutes—defense attorney Eric Nelson argued that Chauvin was distracted while dealing with the growing anger from bystanders—and failed to notice that Floyd had stopped breathing. “A reasonable police officer will hear the frustration growing...the increase of the volume of the voices...will hear the name-calling...they’ll take that into their consideration,” Nelson said. “Officers are human beings capable of making mistakes in highly stressful situations.”“There is absolutely no evidence that Officer Chauvin intentionally, purposefully applied unlawful force,” Nelson claimed.Defense Expert Claims Exhaust From Cop Car Contributed to George Floyd’s DeathThe closing arguments come after four weeks of testimony in the watershed trial. During the trial, prosecutors have insisted to jurors that Chauvin, 45, “betrayed” his badge when he ignored Floyd’s dozens of pleas for help as he knelt on his neck for a total of “9 minutes and 29 seconds” over a suspected counterfeit $20 bill. During the arrest, Floyd cried out he could not breathe a staggering 27 times before losing consciousness.Chauvin “heard him and all he did was mock him, [saying] ‘It takes a lot of oxygen to complain,’” Schleicher said. “George Floyd struggled, desperate to breathe, to make enough room in his chest to breathe. But the force was too much. He was trapped, with the unyielding pavement beneath him, as unyielding as the men who held him down,” Schleicher said. “A grown man, crying out for his mother. A human being.”Prosecutors called 38 witnesses over 11 days. Among those were five current and former cops—as well as the Minneapolis police chief, who said Chauvin used excessive force in violation of his training and department protocol. Three medical experts concluded Floyd died of low oxygen, or asphyxia, from Chauvin’s actions during the arrest, while several bystanders, family members, and friends of Floyd gave days of emotional testimony.Schleicher insisted Monday that Floyd’s death “wasn’t a sudden cardiac arrhythmia, a heart attack, a drug overdose, a death from underlying conditions or an accident. It was an intentional act by Chauvin.”“The government put on a very strong case. I thought that the testimony of the chief and other officers that the force was not authorized or part of [the] training was very effective. It is rare to have testimony from police officers in these cases other than retained experts. The cross of the use-of-force witnesses was largely ineffective,” Jonathan Smith, the executive director of the Washington Lawyers’ Committee for Civil Rights and Urban Affairs, told The Daily Beast.Chauvin’s defense lawyer, however, argued that his client was simply doing what “he was trained to do throughout his 19-year career,” calling on seven witnesses in two days and focusing heavily on Floyd’s previous health issues and alternative explanations for his death. Chauvin declined to testify on his own defense, invoking his Fifth Amendment right. On Monday, Nelson compared criminal cases to baking chocolate cookies and emphasized the high standard of reasonable doubt. “Space aliens flew in and inhabited the body of Derek Chauvin and caused this death. That’s fanciful,” Nelson said.The defense attorney then focused on two key points: The state has to prove beyond a reasonable doubt that Floyd died as a direct result of Chauvin’s actions and the ex-officer must have intentionally harmed him.“The use of force is an incredibly difficult analysis,” Nelson insisted, urging the jury to look at the totality of the incident and not just the nine minutes that Chauvin held his knee on Floyd’s neck. “You can’t limit it to 9 minutes and 29 seconds, but it started nearly 17 minutes earlier.”The defense attorney argued that several factors could have contributed to Floyd’s death, including carbon monoxide poisoning from the police squad car or drug overdose.Smith, a former official in the Department of Justice’s civil-rights division who also led the independent investigation into Elijah McClain’s death at the hands of police in Colorado, said he believed Nelson’s defense was “more effective at trying to create confusion on the cause of death” than anything else.Defense Expert in Chauvin Trial: Knee on George Floyd Was ‘Justified,’ Caused No Pain“The controversy on whether Mr. Floyd had an enlarged heart and about carbon monoxide blood levels should have been avoidable for the prosecution, but it is unclear whether it will matter much in the end,” he said, before noting that conviction in police cases are rare. “Even in light of the very strong case by the state, it remains to be seen what the jury will do.”The idea of creating confusion in the courtroom also caused late drama in the case when prosecutors slammed the defense’s witnesses who seemed to suggest Floyd could have died from carbon monoxide poisoning.On Thursday, Martin Tobin, a renowned pulmonologist who testified that Floyd’s airflow was so restricted it was “as if a surgeon had gone in and removed” his lung, was called back to the stand at the last minute to rebut the bizarre idea the squad car’s exhaust contributing to Floyd’s death.The idea was brought forward by David Fowler, a forensic pathologist, without any data or test results. Tobin’s testimony also came after prosecutors said they got last-minute test results of “blood gas readings” that show Floyd’s carbon monoxide levels were normal.Andrew Baker, the Hennepin County medical examiner who performed the autopsy on Floyd, also testified for the defense that the 46-year-old died of “cardiopulmonary arrest complicating law-enforcement subdual, restraint, and neck compression” and that heart disease, fentanyl use, and methamphetamine were “other significant conditions.”“The defense seems to have put most of its marbles in that basket,” said Mike Lawlor, an associate professor at the University of New Haven and a former prosecutor, added about Floyd’s cause of death. He added to The Daily Beast that the defense’s “expert witnesses did not really undermine the state’s case–and “have bolstered it to some extent.”While the defense seemed focused on sowing doubt, prosecutors leaned heavily on emotional testimony and showing jurors the deep trauma that watching Floyd’s death caused so many people.“The most moving, and searing part of the trial were the eyewitnesses. Their testimony was compelling and impactful. The trauma that they experienced watching Mr. Floyd be killed and the helplessness they felt in being unable to stop Chauvin came through clearly,” Smith said.Among the group were an off-duty Minneapolis firefighter and EMT—who said she was ignored after repeatedly offering her assistance—as well as an MMA fighter who tried to explain that Chauvin’s chokehold was cutting off Floyd’s circulation. Several teenagers, and one 9-year-old girl, also testified how they begged the officers to stop as Floyd was “gasping for air.”“You could see his eyes slowly, you know, rolling back up and in his head, and him having his mouth open, wide open,” MMA fighter Donald Williams, who is heard in the viral video yelling at Chauvin to release Floyd, testified during the trial. Eventually, Williams said, Floyd began to “fade away, like a fish in a bag” before he lost consciousness.As prosecutors played the viral video to jurors on Monday, Chauvin kept his eyes down at the defense table.“George Floyd was not a threat to anyone,” Schleicher said Monday while lightly pounding his hand onto the lectern before insisting to jurors that “no courage was shown that day” while Floyd begged for his life in front of strangers. “George Floyd begged until he could speak no more and the defendant continued this assault.”“No courage was required, all that was required was a little compassion and none was shown on that day,” the prosecutor added. Throughout the trial, jurors also got a peek into how cracked the thin blue line really is in Minneapolis. In addition to Police Chief Medaria Arradondo’s sharp rebuke of Chauvin’s actions, several current and former police officials all disagreed with the use of force.‘Totally Unnecessary’: Cops Desert Derek Chauvin on the Witness Stand“Totally unnecessary. First of all, pulling him down to the ground face-down and putting your knee on a neck for that amount of time is just uncalled for,” Lt. Richard Zimmerman, the longest-serving officer in Chauvin’s old department, testified. “I saw no reason why the officers felt they were in danger. And that’s what they would have to feel to be able to use that kind of force.”The defense, however, tried to smooth over the clear signal that Chauvin has been abandoned by his former peers, bringing forward former cop Barry Vance Brodd, who insisted the former law enforcer’s knee restraint on Floyd was not a “use of force”—but a “control technique” because it caused him no pain.Lawlor added that while he believes that the prosecution did an “excellent job,” the defense did poke holes in the theory Chauvin inequitably caused Floyd’s death—but that the matter is now up to the jury. The sequestered jury will now decide whether Chauvin is guilty of second-degree murder, third-degree murder, and second-degree manslaughter.To do so, the 12-person jury will have to unanimously agree that Chauvin caused Floyd’s death, intentionally intended to commit harm, and acted unreasonably as a police officer by not adhering to the training of the Minneapolis Police Department.“It’s clear to me that Chauvin expects to be heading to prison at some point. How long he spends there is in the hands of this jury,” Lawlor said, adding that for the defense, “their only hope at this point [is] reasonable doubt.”Read more at The Daily Beast.Got a tip? Send it to The Daily Beast hereGet our top stories in your inbox every day. Sign up now!Daily Beast Membership: Beast Inside goes deeper on the stories that matter to you. Learn more.
- Business Insider
Sony admits it made the 'wrong decision' and will now keep storefronts open for classic PlayStation games after fans complained
PlayStation fans were furious that Sony had plans to close the PlayStation 3 and PlayStation Vita digital storefronts. Now, Sony's reversing course.
Philippine President Rodrigo Duterte said on Monday he was prepared to send his military ships in the South China Sea to "stake a claim" over oil and mineral resources in the disputed part of the strategic waterway. With some critics complaining Duterte had gone soft by refusing to push Beijing to comply with an arbitration ruling, he said the public can be assured he would assert the country's claims to resources like oil and minerals in the South China Sea. Duterte has sought to build an alliance with China and has been reluctant to confront its leadership, having been promised billions of dollars of loans and investments, much of which have yet to materialise, frustrating nationalists.
Britain will add India to its travel "red-list" on Friday after detecting 103 cases of a coronavirus variant first identified in the country, health minister Matt Hancock said on Monday. "UK and Irish residents and British citizens who've been in India in the past 10 days before their arrival will need to complete hotel quarantine for 10 days from the time of arrival."
- Associated Press
Now that the Royal Family has said farewell to Prince Philip, attention will turn to Queen Elizabeth II’s 95th birthday on Wednesday and, in coming months, the celebrations marking her 70 years on the throne. Then in 2017, he represented the queen at the annual Remembrance Day ceremony marking the end of World War I, laying the monarch’s wreath at the foot of the Cenotaph in London.
- Business Insider
The continuous live stream, which Lindell says will be two days long, is being hosted exclusively on his website.
- Associated Press
New Delhi imposed a weeklong lockdown Monday night to prevent the collapse of the Indian capital's health system, which authorities said had been pushed to its limit amid an explosive surge in coronavirus cases. In an effort to combat crisis, India announced that it would soon expand its vaccination campaign to all adults. “People keep arriving, in an almost collapsing situation,” said Dr. Suresh Kumar, who heads Lok Nayak Jai Prakash Narayan Hospital, one of New Delhi's largest hospitals for treating COVID-19 patients.
- The Independent
President says of the polarisation among Americans: ‘It shocked me’
- Business Insider
Iran says it only enriched its uranium to 60% as a show of strength, and can revert to nuclear-deal levels if the US lifts sanctions
Iran said it wanted to show its strength after an attack on its Natanz nuclear plant earlier this month, which it blames Israel for.
- Idaho Statesman
Police say they found the child’s body in a car in Emmett.
- Associated Press
Tokyo police are investigating cyberattacks on about 200 Japanese companies and research organizations, including the country’s space agency, by a hacking group believed to be linked to the Chinese military, the government said Tuesday. Police have forwarded the case involving attacks on the Japan Aerospace Exploration Agency to prosecutors for further investigation, Chief Cabinet Secretary Katsunobu Kato told reporters. Police believe a series of hacks of JAXA were conducted in 2016-2017 by “Tick,” a Chinese cyberattack group under the direction of a unit of the People’s Liberation Army, Kato said.
Hilary Duff says her 9-year-old son walked in 'right as I was pulling the baby out' during her home birth
Hilary Duff said that it's important to her to have an honest conversation with Luca about women and childbirth so he respects the women in his life.
European soccer's governing body UEFA led a backlash against plans for a breakaway Super League on Monday, saying associated players and clubs could be banned from its competitions - including three of this season's Champions League semi-finalists. Addressing an emergency meeting the day after 12 of Europe's top clubs announced the new league, UEFA president Aleksander Ceferin described the Super League plan as a "spit in the face" of all football lovers. Three of the 12 clubs in the new league - Real Madrid, Manchester City and Chelsea - could be withdrawn from this season's Champions League semi-finals, UEFA executive committee member Jesper Moller told Danish broadcaster DR.
Hong Kong will suspend flights from India, Pakistan and the Philippines from April 20 for two weeks after the N501Y mutant COVID-19 strain was detected in the Asian financial hub for the first time, authorities said in a statement late on Sunday. The three countries would be classified as "extremely high risk" after there had been multiple imported cases carrying the strain into Hong Kong in the past 14 days, the government said. Hong Kong has recorded over 11,600 cases in total and 209 deaths.
- The Daily Beast
ABCMyPillow CEO Mike Lindell is currently engaged in a 48-hour livestream marathon to promote his new “social media” “platform,” and when he wasn’t lashing out at various writers for The Daily Beast he was expressing his disappointment with late-night host Jimmy Kimmel.“Thank you for joining us on what was, I have to admit, one of the least productive days that we’ve had here at our office in quite some time,” Kimmel said at the top of his monologue Monday night, admitting that he is fully “obsessed” with the Trump-loving pillow salesman. “You know, a lot of people said the CEO of a pillow company couldn’t successfully launch a major social media site—and those people were 100 percent correct.”“I highly recommend it,” Kimmel said of Lindell’s “yell-a-thon,” adding, “It is quite a spectacle. If you’re high, I recommend it. It’s like the Jerry Lewis telethon if Jerry was on a public access channel and crack.”From there, the host played a montage of Lindell repeatedly complaining that he was trying to “make a joke” out of his big launch event, before claiming that he’s “praying” for him. “Thanks for all the shout-outs,” Kimmel replied. “Do you think he’s really praying for me? Like, honestly, do you think when he said his prayers before bed he actually named me?”“What Mike Lindell doesn’t seem to understand is, I’m his biggest fan,” Kimmel added. “I have no idea what he’s doing, but I love it.” He even invited Lindell to come on his show, in person, for an interview in bed surrounded by pillows. “Just me and Mike snuggled up side-by-side in a California King surrounded by sacks of goose feathers.”John Oliver: We Must Take to the Streets Over Police Killings of Daunte Wright and Adam Toledo“How is he going to do this for 30 more hours?” Kimmel asked later. “I hope he has a doctor on standby. I looked up some of the long-term effects of using crack cocaine. Crack cocaine abuse may cause the following mental or emotional problems: Aggression, extreme depression, delirium, hallucinations, irritability, mood disturbances, panic attacks, paranoia, psychosis… and launching your own social media site.”Finally, the host shared the major highlight of the day: when Lindell thought he was fielding a live call from Donald Trump before quickly realizing it was a prank. “Hopefully the real Trump will call in,” Kimmel said. “Hopefully a dozen fake Trumps and then the real Trump will call in. And by the way, if you get through to Mike Lindell and he thinks he has Donald Trump on the line, go with it! Don’t just scream your website out, milk it! You set the hook, reel him in!”Kimmel concluded by wishing Lindell “the best of luck with Delusion-Palooza.”For more, listen and subscribe to The Last Laugh podcast.Read more at The Daily Beast.Get our top stories in your inbox every day. Sign up now!Daily Beast Membership: Beast Inside goes deeper on the stories that matter to you. Learn more.
- USA TODAY
'Do not travel' list: The US State Department is raising the alert level for most countries due to COVID
The State Department said more than 80% of countries around the world will soon carry its "do not travel'' level. Fewer than 20% carry that label now.