A few drops of Visine brand eye drops taken internally will induce uncontrollable diarrhea.

Explanation: Contrary to common belief, a few drops of Visine brand eye drops taken internally will not cause diarrhea. But swallowing it can produce much more serious medical problems.

The desire for revenge runs deep in all of us. Everyone who has ever been wronged has at one time or another felt the urge to strike a counterblow. Most of us don’t indulge in this pursuit because we’ve deemed the cost of getting even too high to justify the benefits gained, yet we revel in thoughts of comeuppances doled out by others. Such imaginings give us the chance to vicariously experience the joys of retribution, joys we’re not likely to sample in real life, such as the following:  I’ve heard that barmaids and cocktail waitresses have a secret for getting rid of obnoxious customers. Seems they use the eye medication Visine for a little Montezuma’s revenge. A few eyedrops in someone’s drink can apparently leave him sitting on the toilet for the rest of the evening with a nasty case of “the runs.”  The “Visine slipped into the drink” pay back carries additional appeal because it seems to offer an effective yet harmless form of retaliation that could be easily and furtively administered even by the wimpiest of revenge seekers. Also, the mental image of an enemy sent hotfooting for the toilet is a hugely satisfying one, especially in a society that views fecal output as something to be ashamed of. An act of spite that forces the victim into making repeated visits to the john is regarded as not only extremely inconveniencing to him, but degrading as well. Yet all is not well in revenge land. While it is true that Visine is readily obtainable (it’s an non-prescription eye drop manufactured by pharmaceutical giant Pfizer), a drink spiked with it is not a sure-fire means of producing diarrhea in the one unfortunate enough to swallow it, and ingestion of such a concoction is downright dangerous, making this “harmless” form of retaliation fraught with hazard. The active ingredient in Visine eye drops is Tetrahydrozoline HCl 0.05%. Swallowing this substance can result in a number of nasty effects, including:  Pfizer’s cautions  to users of Visine include: “If swallowed, get medical help or contact a Poison Control Center right away.” In view of the above list, that advice should not be taken lightly. One thing tetrahydrozoline has not been known to do is to cause sudden onset bouts of severe diarrhea. Although this belief has been around for decades, and everyone knows someone who knows someone who really did administer a Visine mickey to a deserving miscreant and thereby caused him an immediate serious case of the trots, there’s no documented evidence the producthas that effect. Of all the Visine poisoning cases studied by medical observers, we found none that mentioned diarrheal output brought about by the drug. Yet if Visine doesn’t cause diarrhea, it has done things far more terrible. Drinking it can (and has) caused severe depression of the central nervous system. In 1996, a two-year-old child who ingested at most 2 to 3 mL of Visine eye drops became dangerously lethargic and unresponsive to every stimulus except deep pain. Thanks to prompt medical attention the child recovered, but not before enduring intubation and two days’ worth of mechanically-assisted breathing. In June 2014, a 22-year-old woman named Samantha Elizabeth Unger was arrested in Thurmont, Maryland, and charged with aggravated assault and endangering the welfare of children. According to police, Unger confessed to poisoning her 3-year-old son by putting Visine in his water bottle and juice bottle (the boy was hospitalized several times but survived) and also causing her 1-year-old son to fall ill when he accidentally consumed the poisoned drinks she had made for his brother. In January 2015 Unger pleaded guilty to six counts of aggravated assault of a victim less than six years old and one count of endangering the welfare of a child. Medical literature reports other cases of small children brought to the brink of crisis by ingestion of tiny amounts of over-the-counter eye drops. The danger is real, and parents are well advised to keep eye drops away from children. Yet it is not only toddlers who risk central nervous system shutdown or other dire results if they swallow Visine, as demonstrated by the following examples:            Revenge seekers still not quite convinced that a Visine mickey finn won’t produce the diarrheal results they crave, or that the drinking of such a potion could potentially result in a life-threatening medical crisis in the object of their prank, should consider one final fact: the act of secreting noxious substances in ingestibles for the purpose of bringing harm to others is called poisoning. It matters not if actual harm results from the attempt — the act itself is enough to land one in the hoosegow. Sightings:   In an episode of television’s CSI (“Revenge Is Best Served Cold,” original air date 26 September 2002), a drink spiked in this fashion caused a death when the eye drops initiated a fatal reaction with chocolate the victim had eaten.


FDA Approves Bayer's Kyleena™ (Levonorgestrel-Releasing Intrauterine System) 19.5 mg for Prevention of Pregnancy for up to Five Years

Explanation: The news release focuses on a forthcoming birth control product called Kyleena. The product is implanted in the uterus and releases the hormone levonorgestrel, which the release says can prevent pregnancy for up to five years. The release does a fair job of describing the clinical trial that led to FDA’s approval of Kyleena, and also addresses potential side effects associated with the product. However, the release does not address cost at all. The release also fails to discuss similar alternatives that are already on the market, or even offer any information comparing the effectiveness of Kyleena relative to other forms of birth control. [Editor’s note: Bayer makes a number of IUD contraceptive devices including Mirena and a permanent contraceptive called Essure. This release stacks up favorably to a Bayer news release on Essure which we also reviewed (and discussed in a blog post) in terms of discussing harms, quantified benefits and quality of evidence. However, neither release addressed costs.] According to the CDC, more than 7 percent of U.S. women use long-term, reversible contraceptives — i.e., intrauterine systems or implants — to avoid unwanted pregnancy. The widespread use of these technologies means that they are both economically important and — more importantly — that such birth control systems have a significant impact on the health and well-being of millions of women. As such, it is newsworthy when new products receive FDA approval and come to market. But in order for potential users — and their healthcare providers — to make sense of a new product, they need some basic information. For example, they need to know how the new product compares to existing products on the market — and how much they will cost. This release falls short on both of those fronts.

Costs are not discussed at all. Given that this release was issued by the manufacturer of Kyleena, the oversight is especially odd. If anyone would be able to speak to potential cost, it would be them. The product appears to be similar to another birth control product also marketed by Bayer, called Mirena. It is not easy to find a clear price for Mirena, but a 2014 story on the site ClearHealthCosts says that Mirena costs in the neighborhood of $700 or $800 — not including any medical fees related to having the device put into place. It is also not clear whether Kyleena may be covered by insurance plans. This gets a satisfactory rating, but it’s really a toss-up. First, the release does offer information on the rate of (presumably unexpected) pregnancies among patients who were using Kyleena. That’s good, and is why we award a satisfactory rating here. However, the information is provided based on the Pearl Index, which most readers are unlikely to be familiar with. The Pearl Index is commonly regarded as a standard metric for evaluating contraceptive effectiveness. The effectiveness of Kyleena is cited as 1.45 pregnancies per 100 women over 5 years of use. That can be compared with other available levonorgestrel products approved for 5 years, which contain higher amounts of active hormone (52 mg levonorgestrel vs 19.5 in Kyleena) and have slightly better effectiveness (0.5 to 1.1 pregnancies per 100 women). An additional benefit of the higher-dose levonorgestrel IUDs for some women is reduction in menstrual bleeding (30-50% of women stop having periods after 2 years of use), as well as reduction in volume of menstrual flow and menstrual cramps. There is no data cited on Kyleena’s effects on these outcomes. The release would have been stronger if it had placed the information in better context. How does it compare to other, similar birth control methods — such as Mirena, which we mentioned above? We’ll address this at greater length below, under the Compare Alternatives criterion. The release goes into this at length, which is good. What would have been even better would have been for the release to compare the likelihood of potential side effects for Kyleena with the likelihood of side effects for other products on the market. The release describes the relevant clinical trial in detail, earning this a satisfactory rating. That said, there is one question that the release does not address at all — whether the trial had a control group. That’s an important point, and it’s not clear why this issue isn’t addressed. There is a strong implication that there was no control group. The lack of control group is not necessarily a problem since the main outcome of interest is prevention of pregnancy. A control group would be helpful in putting the rates of adverse effects into context. No disease mongering here. The release is clearly marked as being from the manufacturer of Kyleena. This is not satisfactory on two levels. First, Kyleena is described as an intrauterine system that releases levonorgestrel in order to prevent pregnancy, and it is described preventing pregnancy for up to five years. Another product from Bayer, Mirena, is an intrauterine device that releases levonorgestrel in order to prevent pregnancy. It also is described as preventing pregnancy for up to five years. When a company is releasing a new product that, to the non-expert audience, looks an awful lot like an existing product, the company needs to clearly describe how the products are different — in terms of mechanism, benefit, cost and risk. Other levonorgestrel-releasing devices/implants include Liletta and Skyla. How does Kyleena differ from them? Second, and more broadly, the efficacy of Kyleena at preventing unwanted pregnancy is not compared to the broader suite of birth control options available. All in all, this is a significant oversight. Potential users of Kyleena should be able to clearly compare the costs, risks and benefits of the new product to existing products. And if the product is as advantageous as the manufacturer wants the market to believe, an up-front comparison would actually help convince consumers. There are two classes of levonorgestrel IUDs currently on the market that vary in the amount of active hormone they contain: 1) 52 mg IUDs (Mirena and Liletta) and 2) a 13.5 mg IUD (Skyla). There are two important differences between them. First, the higher dose IUDs are effective for five years, whereas the lower dose Skyla is effective for three years. Second, there are differences in side effects, which for some women may make one preferable to the other. Mirena and Liletta can reduce the frequency and amount of bleeding, as well as menstrual cramping; Skyla has little effect on these factors. With a lower dose of levonorgestrel  IUD (19.5 mg) compared to the other 5-year IUDs, Kyleena would seem to be Bayer’s effort to create a lower dose IUD that is effective for 5 years. In this context, it would be especially helpful to know how its “side effects” (whether beneficial or not) compare to those of the other IUDs. The release states that Kyleena will be available by prescription in October 2016. As noted above, it’s not clear from this release (at least to a non-expert audience) how Kyleena differs from other, intrauterine levonorgestrel-releasing products that are already on the market. The release doesn’t engage in sensationalistic language. The release may be slightly out-of-bounds, however, when it states, at the top, that “Kyleena offers women an important new long-term, reversible contraception option.”  Who decides what makes something “important”? It’s a tricky question. Based on the limited information in the release, it’s not clear that the term applies here or that the product offers significant differences from other products already on the market.


Nebraska Sen. Bolz to run for 1st Congressional District.

Explanation: Nebraska state Sen. Kate Bolz has announced plans to run against Republican U.S. Rep. Jeff Fortenberry in the 2020 election.

Lincoln, Health, General News, Access to health care, Elections, Jeff Fortenberry, Nebraska, Donald Trump

Bolz, a Democrat, kicked off her campaign Thursday for Nebraska’s 1st Congressional District. She faces an uphill battle against Fortenberry, who is serving his eighth term in Congress. Bolz, of Lincoln, is pledging to improve access to health care and serve the interest of Nebraska farmers hurt by President Donald Trump’s trade war if elected. She also vows to fight pharmaceutical companies to lower the cost of prescription drugs. The 1st Congressional District includes most of the eastern quarter of the state outside of Omaha and some its suburbs. The district leans Republican and includes Lincoln, Bellevue, Fremont and Norfolk.


Charlie Crist Says Rick Scott signed "laws requiring mandatory ultrasounds and restricting access to abortion even in cases of rape or incest.

Abortion, Health Care, Women, Florida, Charlie Crist,

In his quest for the women’s vote. Democrat Charlie Crist continues to attack Republican Gov. Rick Scott’s record on abortion. "After it happened, Rick Scott threw a party back at the mansion. What was he celebrating?" says the Sept. 30 TV ad. "This: with a stroke of a pen Scott passed some of the most extreme anti-choice laws in the country. Laws requiring mandatory ultrasounds and restricting access to abortion, even in cases of rape or incest." "Rick Scott celebrated taking away your voice and your choice," the ad concludes. We have written a lot about Crist’s record of conflicting statements about abortion -- though in this campaign he has been endorsed by Planned Parenthood. Scott, meanwhile, has consistently favored abortion restrictions. We wanted to know if the ad accurately presented what Scott signed into law. We found it was largely correct; Scott did sign legislation that restricted access to abortion. But there a few details here that are important. Scott signed ultrasound bill in 2011 In 2011, Scott signed four abortion-related bills, including one that required all women to receive an ultrasound before undergoing an abortion. Crist had vetoed a similar ultrasound law in 2010, calling it "almost mean-spirited." That was shortly after he left the GOP for his failed bid as an independent candidate for U.S. Senate. The law Scott signed requires women to get the ultrasound as well as an opportunity to review the ultrasound and have it explained to them. (Women can decline to review the ultrasound if they sign a form.) Previously, Florida law required ultrasounds prior to second trimester or later abortions, not first trimester abortions. Though the former law didn’t require first trimester ultrasounds, 29 of 31 abortion clinics did them anyway. The Miami Herald’s Naked Politics blog reported that a month after signing the bills in 2011, Scott held a ceremonial signing with dozens of abortion opponents -- that’s the "party" that the ad references. "You should have the opportunity to see see an ultrasound of your child," Scott said in 2011. "It's your choice. You don't have to. This creates choice. I think it's very positive." Abortion law about viability in 2014 Crist’s ad also says Scott signed a law "restricting access to abortion even in cases of rape or incest." That refers to HB 1047, which Scott signed in 2014 to change the timeline for cutting off abortions. The bill banned abortions once a fetus is considered viable, which is typically around 23 or 24 weeks of gestation. Previously, Florida banned abortions in the third trimester, or starting about two weeks later than the new restriction. The main purpose of the 2014 bill was to make all abortions occur earlier -- no matter if the pregnancies were a result of rape or incest. The new law only allows abortion after the point of viability to save the woman’s life or prevent major permanent damage "other than a psychological condition." It doesn’t mention rape or incest. The previous law didn’t mention rape or incest, but it did include a broad exception to "preserve the health of the pregnant woman." That broad language was what some people interpreted to potentially include rape or incest survivors. In reality, however, no woman has received a third-trimester abortion under any exception between 2011 and so far in 2014, according to state data. In 2013, 91 percent of abortions were in the first trimester and 9 percent in the second trimester, according to state data. So that means that women who want to terminate pregnancies that occurred as a result of rape or incest can still do so in the first semester and most of the second trimester -- depending on when a doctor determines viability. Rape and incest are rarely cited in abortions, according to state data. In 2013 there were about 73,000 abortions -- two were in cases of incest and about 272 due to rape -- so combined that equals less than one percent. At the time, Scott spokesman John Tupps wrote in a statement about the law that "Gov. Scott is pro-life and was glad to sign this bill that protects the lives of children." We asked Scott campaign spokesman Greg Blair if Scott supports the rape/incest exception throughout pregnancy or only until the point of viability and Blair told us that he supports those exceptions in "all cases." We asked why Scott then signed the law this session that doesn’t include those exceptions. We didn’t get a response. Finally, the ad said Scott signed "some of the most extreme anti-choice laws in the country." That’s a subjective call, but we should note that Florida hasn’t had widespread clinic closures. A Texas law caused 13 abortion clinics to close there. In Florida, there were 68 abortion clinics when Scott took office and there are 65 now. (Seven closed under Scott, but four new ones opened.) And, Florida had restrictive laws about abortion before Scott took office. Americans United for Life, a group that opposes abortion rights, ranked Florida 26th among states for restricting abortion in 2010 and 25th among states in 2014. NARAL, an organization that supports abortion rights, has given an "F" to about half the states, including Florida. Our ruling Crist said in an ad that Scott signed "laws requiring mandatory ultrasounds and restricting access to abortion even in cases of rape or incest." Scott signed a law in 2011 that requires ultrasounds for all women before they get an abortion, and in 2014 he signed a law that stated women could not have an abortion after the point of viability. That means women could not have an abortion about two weeks earlier than before. The only stated exception was to save the woman's life. However, the previous law didn’t expressly include those exceptions either, though it had broad language that could potentially have been used to seek abortion for a rape or incest survivor in the third trimester. No woman, though, has had an abortion in Florida during the third trimester for any reason in recent years, even before the new law. The statement is accurate, but needs additional information.


UN: Nearly a half-billion in Asia-Pacific still going hungry.

Explanation: Nearly a half-billion people in the Asia-Pacific are still malnourished and eliminating hunger by 2030 requires that millions escape food insecurity each month, according to a report released Wednesday by UN agencies.

Nutrition, Health, General News, Asia, Bangkok, Poverty, United Nations, Asia Pacific

Data compiled by the United Nations show slow progress and even backsliding in the areas of child wasting and stunting and other problems related to malnutrition. Worsening inequality means that despite relatively fast economic growth, incomes in the region are not increasing fast enough to help ensure adequate, nutritional diets for hundreds of millions still living in poverty, it says. The report urges that governments combine efforts to end poverty and with nutrition, health and education-oriented policies. The UN’s sustainable development goals for 2030 call for ending hunger and ensuring all people have adequate access to food all around the year. “We are not on track,” said Kundhavi Kadiresan, the FAO’s regional representative. “Progress in reducing undernourishment has slowed a lot in the past few years.” More than a fifth of all people in the Asia-Pacific region are facing moderate to severe food insecurity, meaning they must scrimp on food or go hungry part of the year, and in the worst cases go days without eating. More than half of the 479 million in the region who are undernourished live in South Asia, where more than a third of all children suffer from chronic malnutrition, said the report written by the Food and Agriculture Organization, UNICEF, the World Food Program and the World Health Organization. In India, nearly 21% of children suffer from wasting, a more acute form of malnutrition. Failing to ensure children are well nourished jeopardizes their future development, especially their cognitive abilities — a crucial handicap in the 21st century age of advanced technologies, said Michael Samson, research director of the Economic Policy Research Institute, who spoke at the report’s release in Bangkok. Cognitive abilities cannot be traded or manufactured, so “Investing in the first 1,000 days (of a child’s life) is the most important investment you can make in future productivity,” he said. Governments have begun to implement some policies aimed at addressing the severe shortfalls in child and maternal nutrition . Thailand has provided subsidies that have helped improve the health and diets of families with young children. In neighboring Myanmar, trial programs in the Chin state are being expanded to cover more of the country. The focus is not just on providing cash, but improving awareness about nutrition, family planning and water and sanitation,” said Shein Myint, an assistant director in the Social Protection section of Myanmar’s Ministry of Social Welfare. “From monitoring we see that beneficiaries mainly use the cash to have nutritious food and use it for healthcare costs,” Shein Myint said. Cambodia is expanding a program called NOURISH that originally was funded by the U.S. Agency for International Development. It provides help for impoverished pregnant women and families during the first 1,000 days of a baby’s life. In areas where the program was implemented there was a nearly 20% decrease in stunting and marked improvement in toddlers’ diets, said Laura Cardinal, who directed the program. While many in Asia still do not get enough calories to thrive, in the Pacific the problem is too many empty calories: obesity rates in the Pacific islands are among the world’s highest and rising fast, partly because healthy foods are costly and less available and partly because local cultures focus much on feasting, said Lu’isa Manuofetoa, the acting chief executive for Tonga’s Ministry of Internal Affairs. “People like to have feasts all the time, that’s something we need to change,” she said.


New York hospital sends some 'borderline' COVID-19 patients home with oxygen monitors.

Explanation: Some coronavirus patients who would have been admitted into the emergency department at a New York hospital are being sent home with an oxygen-monitoring device as the city’s medical system struggles to reserve resources for only the sickest people.

The new program at NewYork-Presbyterian Hospital is an example of how doctors are adapting and loosening normal protocols to ease the strain on emergency rooms and intensive care units in New York state, the epicenter of the coronavirus pandemic in the United States. Since last week, more than 200 people with confirmed or suspected COVID-19, the respiratory illness caused by the virus, have been sent home with a pulse oximeter to track their oxygen levels. A doctor or nurse practitioner follows up with them via video conference. “Some of these patients might have been on the borderline of admission,” Dr. Rahul Sharma, who is overseeing the program as the chief of emergency medicine at Presbyterian’s Weill Cornell Medical Center, said in an interview. An oximeter is a small electronic device that clips onto a fingertip to indirectly measure the oxygen saturation of a patient’s blood. In severe COVID-19 cases, the virus can block up the lungs, hindering their ability to pass oxygen from the air into the bloodstream. While most who contract the virus recover, it has killed at least 4,900 people in the city, according to a Reuters tally. Click tmsnrt.rs/2w7hX9T for a GRAPHIC tracking the coronavirus in the United States. Some of the NewYork-Presbyterian patients are also being sent home with a 30lb (14 kg) portable oxygen concentrating machine which sends oxygen-rich air through a nasal cannula, a two-pronged tube inserted into the nostrils. The patient is asked to log their oximeter readings to share with a doctor or nurse practitioner at 12-hour and 24-hour consultations. The patient may be re-admitted to the hospital  if they take a turn for the worse. No patient in the program is known to have died at home as of Wednesday, but about 15 percent were asked to return to hospital to be admitted for inpatient care, a hospital spokeswoman said. At least two other hospital systems outside of New York unveiled similar new programs using oximeters in late March. Doctors at other hospitals said Presbyterian’s approach could have benefits for patients with a disease about which they still have much to learn. “There’s no guarantees in either direction, there are risks to hospitalization and there are risks with sending people home,” Dr. Laura Burke, an assistant professor of emergency medicine at Harvard Medical School, said in an interview. Doctors have noticed there can be a worrisome lag in symptoms among some COVID-19 patients, with oxygen saturation dropping for some time before a patient is aware of breathing problems. For patients that turn up at an emergency department with other COVID-19 symptoms, giving a pulse oximeter to use at home could be one way to “err on the side of safety,” Burke said.


Fitness experts separate folklore from fact.

Explanation: Can crunches create six-pack abdominal muscles? Do weight-lifting women risk bulging biceps? Is stretching always a good idea?

Experts say disentangling folklore from fact is not easy in fitness, where misconceptions are as pervasive as push-ups and as stubborn as love handles. Jennifer Burke, a fitness manager at a Crunch gym in West Hollywood, California, said many women still worry that weight training will create big and bulky muscles. “Women say ‘I don’t want to get bulky,’ but unless you take in extra calories or testosterone supplements, that’s just not going to happen,” said Burke, who eases reluctant clients into resistance training gently, with body-weight exercises. “When they see their bodies getting long lean muscles, getting toned, they trust you a little more and you can start adding in dumbbells and machines,” Burke said. The Centers for Disease Control and Prevention (CDC) recommends that adults engage in muscle-strengthening activities that work all major muscle groups - legs, hips, back, abdomen, chest, shoulders and arms - two or more days a week. “A lot of people think if they want to lose a lot of weight they should do cardio, but the best thing is to add in resistance training as well,” Burke said. “You’ll get bigger, faster results because you’re working on lean muscle tissue which burns more calories in the long run.”  While it’s true that muscle weighs more than fat, it’s also more compact. “Five pounds (2.3 kilograms) of muscle is the size of your fist. Five pounds of fat is the size of your forearm” she said. Burke added that another misconception is that lower-intensity exercise such as the fat-burning setting on most cardio machines is better for burning calories. “That’s absolutely not true,” said Burke. “If you increase the intensity you’ll burn more calories.”  The CDC’s rule of thumb is that one minute of vigorous-intensity activity is about the same as two minutes of moderate-intensity activity. Stephanie Huckabee, a South Carolina-based fitness instructor, said people who believe it is necessary to exercise every day are setting themselves up for failure. “I tell my clients to expect days when they don’t exercise,” said Huckabee. “That’s just being realistic.”  Another fiction, Huckabee said, is that you can move fat away from a problem area. “When I wanted to reduce my stomach, I had to do an all-over conditioning program to get that fat tissue to shrink,” she said. “Cardio will burn the fat over all. After that, you can work on sculpting an area with resistance training.”  Burke said one of the biggest fitness myths is that crunches can banish belly fat. “You build your six-pack in the kitchen,” she said, while noting that no one will see even the most developed abdominals if they’re hiding under a layer of fat. Moira Merrithew, co-founder of Merrithew Health & Fitness, said one of the most common misconceptions is that it’s always good to stretch before a game of football or a run. “For some athletes probably the worst thing they can do is stretch before they run,” said Merrithew, who is based in Toronto, Canada. “There’s simply no hard and fast rule,” said Merrithew, a former dancer. “Pilates is good for dancers before they go out, because it mobilizes the joints. There are so many effects that stretching can and cannot have. There are limits to really pushing that stretch.”  And even the most dedicated couch potato cannot turn muscle to fat, according to Carol Torgan, a consultant exercise physiologist with the American College of Sports Medicine. “Muscles and fat are two different types of cells. It would be like turning apples into oranges,” she said. More troubling is the fallacy that one can never drink too much water. “It can result in a condition known as hyponatremia, in which there is an imbalance of water to salt,” Torgan said. “This is also known as water intoxication or over-hydration, and can be extremely serious.”


Donald Trump Says the USMCA is the “biggest trade deal ever made.”

Explanation: The USMCA, which replaces NAFTA, is the largest trade multilateral agreement signed by the United States. But there have been bigger trade deals around the world, notably a deal between the European Union and Japan, which covers 600 million people.

President Donald Trump touted the United States-Mexico-Canada Agreement, as the "biggest trade deal ever made" shortly after signing it into law. BIGGEST TRADE DEAL EVER MADE, the USMCA, was signed yesterday and the Fake News Media barely mentioned it. They never thought it could be done. They have zero credibility! His tweet built on past claims that the USMCA is the "largest," "most significant," "modern" and "balanced" trade agreement. The revised agreement mostly updates NAFTA, which has been in place since 1994 and was previously the largest U.S. trade deal ever signed. The USMCA adds significant changes for the auto industry and implements new policies on intellectual property protection, the Canadian dairy market, and labor and environmental standards. Trump overreaches by calling it the "biggest trade deal ever made." For one, it’s not a trade agreement from scratch; it’s building off of NAFTA. And two, this neglects larger trade pacts across the world. In 2018, the European Union signed a trade agreement with Japan, covering a quarter of the global economy and 600 million people. Although the Trans-Pacific Partnership never came into force, it included the same three USMCA partners –– the United States, Canada and Mexico –– as well as nine other Pacific Rim countries and would have represented nations with 40% of global gross domestic product. Trump withdrew the United States from the pact his first week in office. Then there is the mammoth 1994 Uruguay Round trade talks, which included the United States and 122 other countries, kicking off the World Trade Organization. The initial membership of the WTO "accounted for more than 90% of international trade in goods and services," found the Federal Reserve Bank of Boston. The WTO now has more than 160 members, including China. Trump’s campaign pointed us to evidence that shows how substantial the USMCA is for the United States alone. The latest International Trade Administration data shows that total U.S. trade with Canada and Mexico (under NAFTA) is the largest of any U.S. free trade partners. As a percentage of total trade, Canada and Mexico account for about 30% of U.S. goods exports and imports, according to a 2019 Census Bureau report on top trading partners. Trump tweeted that the United States-Mexico-Canada Agreement, or USMCA, is the "biggest trade deal ever made." The deal is more incremental than Trump describes. It updates NAFTA and introduces changes for the auto industry and the United States’ access to Canada’s dairy market. It also implements new policies on intellectual property protection, labor and environmental standards and digital trade. In terms of U.S. trade deals, the USMCA replaces NAFTA as the biggest American deal. Overall, multiple other trade deals around the world eclipse the USMCA in terms of the number of countries involved and economic output.


Women in the United States are 50 percent more likely to die from pregnancy or childbirth-related causes compared to their mothers.

Explanation: Are American Women ’50 Percent More Likely’ to Die From Pregnancy or Childbirth Than Their Mothers?

Hidden in the middle of a story about the effects of social media disinformation on a pregnant woman is a statistic that might give readers pause, but it is chilling — and accurate.The information was part of a February 20 2020 NBC News story on “freebirth” advocacy groups:A woman in America today is 50 percent more likely to die from pregnancy or childbirth than her mother was. While many of these deaths are preventable and have more to do with access than improper medical care, the statistic itself can lead women to doubt medical institutions. Meanwhile, one-third of U.S. women give birth by C-section, a rate experts have called alarming for a procedure that can save lives but also comes with increased health risks to mothers and babies.The passage links to a separate NBC story from October 2018 covering a widely-publicized post by Neel Shah, a Harvard University professor of gynecology and reproductive biology. Shah wrote in the Harvard Health Blog:In 1990, about 17 maternal deaths were recorded for every 100,000 pregnant women in the United States. While relatively rare, this number has risen steadily over the last 25 years, indicating a worsening safety problem. In 2015, more than 26 deaths were recorded per 100,000 pregnant women. This means that compared with their own mothers, American women today are 50 percent more likely to die in childbirth. And the risk is consistently three to four times higher for black women than white women, irrespective of income or education.Additionally, for every death, pregnancy-related conditions, such as high blood pressure or blood clotting disorders, result in up to 100 severe injuries. For every severe injury, tens of thousands of women suffer from inadequately treated physical or mental illnesses, as well as the broader disempowerment mothers face in the absence of paid parental leave policies and other social support.However, Shah added that very few of these deaths occurred during the birthing process; in four out of each five cases of maternal death, the victim passed away “in the weeks and months before or after birth,” representing a failure of not just medical care, but also of social and medical support for mothers:A few days after having a baby, American women are sent home from the hospital, infant in hand. More often than not, mother and family are left on their own until a cursory 15-minute visit with a healthcare provider several weeks later. During long gaps between checkups, mothers experience deep worry for their infants. They struggle with rapidly accelerated responsibilities, extreme sleep deprivation, and relentless pressure to return to work. And all while recovering from pregnancy and adjusting to parenthood — a transition that marks one of life’s greatest physiological endurance tests. Too often, this experience is isolating, disempowering, and mortally dangerous. And over time, these risks are getting increasingly severe.In its February 2020 story about 28-year-old “Judith,” NBC News linked Shah’s findings to a bigger dissatisfaction concerning maternal care; a study published in the journal Reproductive Health also cited by the network found that one in six women reported mistreatment including “violations of physical privacy,” as well as physical and verbal abuse, by their providers during the pregnancy and birth process.According to the network Judith’s own mistrust and bad medical experiences drew her to the “freebirth” community online, which advocates for women to give birth without any involvement from caregivers. Her immersion was abetted by Facebook:There were doubts — sprouted from seeds planted by real-life friends who knew about her plan and doctors whom Judith had to see to sign up for state insurance benefits. But Judith had fortified herself against the creeping unease with the stories she read online from freebirthing mothers and the real-time support she received on Facebook. With a little help from algorithms that nudged increasingly questionable information and sources her way, Judith had become a part of the internet’s most extreme pregnancy communities.However, Judith’s refusal to accept medical help extended into her 42nd week of pregnancy, when medical professionals recommend that prospective mothers have an induction to “jump-start” the birthing process. When she noticed complications 10 hours into her own process, though, Judith sought medical help. But it was too late to prevent her from suffering a stillbirth.NBC reported that at least one private Facebook group advocating for freebirth, with 2,000 members, still used a photograph of Judith’s pregnant belly taken at the 42-week mark as its banner image. But she shared her experience with the network, she said, to help other women who might be taken in by those groups.“Sad stories aren’t out there nearly as much,” Judith said. “Maybe my extreme story could help somebody.”


Expert Panel Reaffirms Need for Colon Cancer Screen Beginning at Age 50

Explanation: This story about updated colon cancer screening recommendations offers readers a reasonably faithful summary of the key conclusions of the U.S. Preventive Services Task Force (USPSTF). The key point of the new guidelines is that several methods of screening all work pretty well for people ages 50-to-75, yet many Americans don’t get screened. Unfortunately, the article doesn’t do much to inform the reader beyond the task force’s news release (available for download here), only stating that “there are varying amounts of proof supporting the effectiveness of each, and each method has its advantages and limitations.” While it may be cumbersome to explain those benefits and risks in detail, it still would have been useful to go over some of the specifics, such as risks and costs, so that people get a basic idea of some of the complex trade-offs at hand. While cancer screening doesn’t always produce clear benefits, the USPSTF concludes colon cancer screening does offer substantial benefits for most people between the ages of 50 and 75. Given the high rates of colon cancer in the U.S., this is important news to convey to the public.

colon cancer,US Preventive Services Task Force

The costs of screening vary dramatically, not only by test but also by the terms of a person’s health care insurance coverage. Insurance may completely cover the cost of screening, but depending on their insurance, people who get follow-up tests to check a suspicious screening test result may get hit with thousands of dollars in medical bills. Especially since the task force highlighted the importance of individuals deciding on the right type of colon cancer screening for themselves, which certainly includes their insurance coverage, the story should have mentioned costs. Also, though not directly addressed in these guidelines, it is worth noting that colon cancer screening is covered under the Affordable Care Act, but that workup of an abnormal screening test may not be. The story does not quantify the benefits of the different colon cancer screening methods. While we’re sympathetic to the challenges of doing so on deadline–especially when the task force went out of its way to not cover this ground–this nonetheless should have been included. The effectiveness of different screening tests differ, as well as the quality of that evidence, and readers would welcome knowing these differences in quantified terms. The story should have mentioned some of the potential harms of screening, ranging from anxiety over a worrisome result to bleeding, colon perforation, sedation-related events and other problems. Also, since the story specifically included comments lauding colonoscopy, it should have also mentioned that colonoscopy accounts for most of the serious harms caused by colon cancer screening. The USPSTF recommendation is the result of not only a structured review of available studies on colon cancer screening, but also new analyses of the data, in order to seek a deeper understanding of the pros and cons of various screening strategies. Though the story could have done a lot more to explain that, enough of the basics are included to warrant a Satisfactory here. The story ideally would have explained what sets this recommendation apart from other reports that come from various groups of experts giving their opinions. Also, it should have noted that the USPSTF gave the recommendation for screening between ages 50 and 75 an “A” grade (the highest level of confidence), while screening of those over 75 (based on individual considerations) received only a “C” grade (moderate certainty). If anything, this story more restrained than the USPSTF recommendation, which strongly urges colon cancer screening, saying that the biggest problem is that nearly one-third of eligible adults have never been screened. The story includes comments from a physician who is not on the USPSTF and who expresses a different viewpoint. We won’t mark down the story for not discussing conflicts of interest because the USPSTF is a voluntary, publicly-funded body and none of the members reported any conflicts in their disclosure forms. The story lists all the screening techniques the USPSTF looked at. It notes that the report intentionally did not rank the techniques and includes a dissenting opinion from a physician who was not part of the task force. It was also worth mentioning that an average risk person who is informed about the screening may chose not to be screened as a reasonable choice, but only as part of a shared decision making process with her/his doctor. It is clear that all of the screening tests mentioned in the story are generally available. The story points out that this report and recommendation is an update of one the USPSTF issued in 2008. It is clear that all of the screening tests mentioned in the story have been available for years, except for a DNA-based stool test that the story notes was approved recently. The story includes comments from an independent physician, which is enough to squeak by as Satisfactory on this rating. However, it should be noted that all of the comments from the USPSTF came from a news release. Although the story clearly attributes the source of the USPSTF comments, which is good, ideally there would also have been at least some original commentary directly from task force members, providing unique insights not found in the news release.


Okposo says he’s healthy after concussion put him in ICU.

Explanation: Sabres winger Kyle Okposo said he is fully healthy after a concussion led to sleeping trouble, significant weight loss and a trip to intensive care last March.

NHL hockey, Health, Kyle Okposo, North America, Buffalo

Okposo missed the final few weeks of Buffalo’s season with a previously undisclosed illness. In a letter posted on the team’s website Monday, Okposo said a routine hit in practice caused his mood to change and other problems that required hospitalization. The 29-year-old said he lost his appetite, had a negative reaction to sleep medications and that at one point he weighed less than 200 pounds. He spent time in the Neuro Surgical ICU at Buffalo General Hospital to be stabilized. Okposo’s playing weight is listed at 218 pounds. Okposo played in a 4-on-4 summer league game in Minnesota with other NHL players last week and reported feeling great. New general manager Jason Botterill said Okposo was on track to be ready for training camp. “I’ve worked with a lot of different people — concussion experts and people who have dealt with concussions themselves — and I feel confident in the fact that I can play hockey again,” Okposo said in the letter. “In fact, I know I can play again. I know I can play and not worry about hitting my head, which is a major hurdle for someone who’s dealt with this. If I didn’t feel 100 percent right now, that probably wouldn’t be the case.” Okposo’s last NHL game was March 27 against Florida. He had 19 goals and 26 assists for 45 points in 65 games during his first season with Buffalo. He signed a $42 million, seven-year contract with the Sabres last summer. ___ For more AP NHL coverage: https://apnews.com/tag/NHLhockey


Explanation: This story reports on a large meta-analysis of observational studies looking at the association between sedentary behavior (sitting and TV-watching), exercise, and risk of dying prematurely. Its main take-home message is “it takes about 60 to 75 minutes of ‘moderate intensity’ exercise to undo the damage of sitting for at least eight hours a day.” Although that’s a faithful account of how the study researchers frame their results, we think it’s likely to leave readers with a misleading impression. Despite what the researchers may claim, this type of study can’t prove that exercise can “undo the damage of sitting” — all it can do is show associations between these behaviors and risk of death. There are many factors, other than exercise and sedentary behavior, that affect one’s risk of death (e.g. diet, illnesses, socioeconomic factors), and the story didn’t explain that researchers can’t account for all of those factors in a study like this. Suggesting that exercise “reverses” the damage of sitting implies a certainty to the study’s conclusions that simply doesn’t exist. Every day, readers are bombarded with health news messages from observational studies such as this one relating to diet, exercise, and other lifestyle issues. Because this type of research is not definitive, it is liable to be contradicted by the next study that comes along, which in turn generates a new set of headlines that is in conflict with what readers just heard from the last study. This generates confusion among the public and mistrust of both scientists and journalists who can’t seem to get their stories straight. We offer tips for reporting on observational studies in our toolkit.

Associated Press,limits of observational studies

There’s no direct cost to walking an hour a day, so we won’t ding the story for omitting discussion of cost. However, there is clearly a time cost involved, and many people may struggle to find the time for exercise if it means less time for paying work or caregiving. Others, especially older adults, may have medical problems that preclude the exercise. We wish the story had mentioned these factors. The story provides no numbers. It doesn’t tell us how much risk of death is increased by sitting 8 hours a day, or how much it is reduced by exercise. It tells us that “Not exercising and sitting all day is as dangerous as being obese or smoking,” but how dangerous is that? We can’t think of any harms from engaging in a brisk hour-long walk. Injury is always a possibility, but that’s apparent enough that we don’t think the story was obligated to discuss this. The story inappropriately uses cause-and-effect language in the headline and elsewhere that overstates what this study can tell us (e.g. “To reverse damage of sitting, take a brisk, hour-long walk”). It should have said that walking, sitting, etc. are “associated with” or “linked to” health effects, but not that walking can “undo” or “reverse” damage. In the study itself, the researchers provide a long list of limitations that suggest a lack of certainty regarding the strength of these conclusions. But the story did not report on any of them. For example, the researchers state,”we attempted to minimise bias from reverse causation (ie, illness causing individuals to become sedentary) by including apparently healthy participants; however, we cannot fully rule this bias out.”  What this means is that the results could be skewed by individuals who had undiagnosed, subclinical disease that caused them to become less likely to exercise. While the assumption is that lack of exercise makes people sick, perhaps the reverse is true in some cases, which would obviously affect results from a study such as this one. No disease-mongering. The story gets credit here for quoting the author of an accompanying editorial. But we’d point out that it probably wouldn’t have been hard to find someone who would have looked at the study more critically and offered some comment on its limitations. The story is basically a comparison of the competing effects of exercise vs. sedentary behavior. The story addresses this as an issue with this line: Andersen said that some cultures make it easier than others to squeeze in an hour of exercise every day, noting that in Denmark and much of Scandinavia, about half of all people either cycle or walk to work. Although the story nods to previous research, noting that “Previous studies have found that prolonged sitting can raise the chances of heart disease, various cancers and an earlier death,” it doesn’t explain that this study is meant to address a specific issue that has generated conflicting results in previous research. Here’s how the researchers put it: Two other meta-analyses had examined the associations of sitting time with non-communicable disease incidence and mortality. One of these concluded that prolonged sitting time was associated with increased risks of deleterious health outcomes regardless of physical activity level, whereas the other concluded that physical activity (no details on the amount of activity were provided) seemed to attenuate the increased risk of all-cause mortality due to high sitting. In other words, this newer study was attempting to answer this question: Given the conflicting results from older research, what role does physical activity play, if any, in counteracting prolonged daily sitting? Although the story quotes from a news release, it acknowledges the source of the quotation and also includes an interview with the author of the accompanying commentary. It’s apparent that there was some independent reporting done here.


Idaho officials say cat has rabies, first case in decades.

Explanation: Idaho health officials say a cat has tested positive for rabies for the first time in 27 years.

Rabies, Health, General News, Cats, Bats, Pets, Idaho

The Department of Health and Welfare says the cat in Owyhee County was behaving aggressively and bit its owner. It tested positive for a strain of rabies normally associated with bats. The department’s state public health veterinarian Dr. Leslie Tengelsen says in a prepared statement that rabies is fatal virtually 100% of the time. She says the cat was likely exposed to a rabid bat, and that’s how it became infected. Tengelsen says pet owners should vaccinate their dogs, cats, ferrets and horses against the disease. Ten bats have tested positive for rabies in Idaho this year.


A teenage schoolgirl in Texas became pregnant through a flu vaccination.

Explanation: WNDR assumes however all responsibility for the satirical nature of its articles and for the fictional nature of their content. All characters appearing in the articles in this website — even those based on real people — are entirely fictional and any resemblance between them and any persons, living, dead, or undead is purely a miracle.

Junk News, flu shot, world news daily report

A 14-year old schoolgirl has suffered serious complications after a flu shot allegedly left the young girl terribly ill and with severe cramps, until the family doctor finally realized weeks later she had been impregnated by the vaccine, reports the Forth Worth Telegram this week. “She had all the typical symptoms of a pregnant woman. It’s not the first time a young woman falls pregnant without the consent of her parents, but the girl seemed sincere when she said she had never had sexual relations with a boy, and she urged me to check her hymen, which I eventually did, and to my utter surprise, the hymen was fully intact. It is impossible she has been impregnated by male sperm” she assures. “In my 26 years of practice, I have never heard once of such a thing as someone being impregnated by a vaccine, but I did some research and found out it is more common than most people think”. The claim cleverly layered the suggestion of a falsehood within its own fabrication to facilitate the spread of the story. Due to that sleight of hand, readers surmised the girl had lied about her sexual experience and had blamed the flu vaccine to deflect suspicion about the true nature of her pregnancy. None of this (neither the girl’s claims nor the article reporting them) was true, however. World News Daily Report is just one of many fake news sites that print fictitious articles, as noted in their disclaimer:


Last month, 20,000 migrant children were illegally brought into the United States. ... These children are used as human pawns by vicious coyotes and ruthless gangs.

Explanation: In a national address, President Donald Trump called on Congress to provide $5.7 billion for a border wall to address what he called a “crisis” on the border. The president made some false and misleading claims, and provided some facts without context.

In a national address, President Donald Trump called on Congress to provide $5.7 billion for a border wall to address what he called a “crisis” on the border. The president made some false and misleading claims, and provided some facts without context:Trump, who campaigned on a promise to build a wall along the Southwest border, delivered a nationally televised address to urge Congress to end the budget stalemate and provide his administration with $5.7 billion in border security funds.The president, who spoke as the partial government shutdown entered its 18th day, repeatedly used the word “crisis” to describe the border situation. What are the facts?It’s true that in recent months the number of people caught trying to cross the U.S.-Mexico border illegally has risen, and was actually higher in November (the most recent month for which the U.S. Customs and Border Protection has published figures) than it was when Trump was sworn in.But the total remains far below what it was several years ago, before President George W. Bush doubled the number of Border Patrol agents.During the first 11 months of last year, the average monthly number of apprehensions was not much above what it was in Barack Obama’s last year in office, and it was less than one-third of what it had been in 2000, before the big surge in the number of agents at the border. (Our apprehension numbers come from U.S. Border Patrol historical figures, updated with the most recent figures from the website of its parent, U.S. Customs and Border Protection. )Trump made the misleading claim that: “Every day, Customs and Border Patrol agents encounter thousands of illegal immigrants trying to enter our country.”In October and November, Border Patrol made 102,857 apprehensions at the Southwest border, according to data from Customs and Border Protection. That works out to roughly 1,700 apprehensions each day.Trump may get to “thousands” per day by including 20,371 additional people who presented themselves at ports of entry on the Southwest border but were deemed “inadmissible” to the U.S. Those individuals, however, sought to enter the country legally, not illegally.Furthermore, in fiscal year 2018, Border Patrol made 396,579 apprehensions at the Southwest border, or just under 1,100 each day. Including inadmissible individuals who lawfully tried to enter through a port of entry only increases the figure to over 1,400 per day.Trump suggested that 20,000 children were illegally brought into the country last month by “vicious coyotes and ruthless gangs,” but there’s no evidence of that in the available statistics.Trump, Jan. 8: Last month, 20,000 migrant children were illegally brought into the United States, a dramatic increase. These children are used as human pawns by vicious coyotes and ruthless gangs.The data from Customs and Border Protection show that 25,172 family units were apprehended by the Border Patrol in November. “Family units” are individuals, including children and parents or legal guardians, that were caught with a family member.We wrote about the issue of adults trafficking children to the border in June, when Department of Homeland Security Secretary Kirstjen Nielsen claimed there had been a “314 percent increase” in such fraudulent cases over the previous five months. That sounded like a large increase, but not so much when the raw numbers were revealed.DHS confirmed to us that there were 191 suspected fraudulent cases in the first five months of fiscal 2018. That was 0.61 percent of the total family unit apprehensions in that time period.Similarly, the Washington Post reported in November that CBP had separated 170 such fraudulent “families” between April 19 and Sept. 30 last year. In September alone, there were 16,658 family units apprehended, so the 170 figure is a small fraction of the families stopped trying to illegally cross the border.As for parents traveling with children overall, those numbers have increased in recent years. We only have data going back to fiscal 2013, when 14,855 people apprehended on the Southwest border were part of a “family unit.” The number jumped significantly in fiscal 2014 to 68,445. For fiscal 2018, 107,212 family units were apprehended.Update, Jan. 10: DHS spokeswoman Katie Waldman told the Washington Post Fact Checker that 19,313 children were apprehended on the Southwest border in December, a number that includes both those traveling in a family unit and unaccompanied children. So, if that’s the number the president is using, it refers to all children, not only those the administration suspects aren’t traveling with a legitimate parent or guardian. But, as we explained, the suspected cases of fraudulent child-parent relationships have been a tiny fraction of all family unit apprehensions.Trump said “the border wall would very quickly pay for itself” by stopping the flow of illegal drugs. “The cost of illegal drugs exceeds $500 billion a year — vastly more than the $5.7 billion we have requested from Congress,” Trump said.The president overstated the economic cost of illegal drugs.In a 2017 report, the White House Council of Economic Advisers estimated “the economic cost of the opioid crisis was $504.0 billion” in 2015 — but it is not all “illegal drugs,” as the president said. That figure “includes individuals who abuse prescription painkillers such as OxyContin and Vicodin and individuals who abuse heroin or other illicit opioids,” the report said. The Centers for Disease Control and Prevention has said that prescription drugs were involved in more than 35 percent of all opioid overdose deaths in 2017.More to the point, Trump falsely claims that the wall would pay for itself by stopping the flow of illegal drugs. As we have written more than once, the majority of illicit drugs is smuggled through legal ports of entry. In its most recent National Drug Threat Assessment, the Drug Enforcement Administration said the Southwest border “remains the primary entry point for heroin into the United States,” and “the majority of the flow” enters through private vehicles and tractor-trailers at legal ports of entry.Stephen D. Morris, a Middle Tennessee State University political science professor whose research has largely focused on Mexico, told us for a story last year that “the wall will not do very much to stop drugs.”Trump continued to claim that he is staying true to his campaign pledge that Mexico would pay for the border wall, insisting that Mexico will pay “indirectly” through a new international trade agreement. But that’s spin.Trump, Jan. 8: The wall will also be paid for, indirectly, by the great new trade deal we have made with Mexico.The United States-Mexico-Canada Agreement was signed on Nov. 30 by the leaders of all three countries, but it still must be ratified by Congress. Even if it is, though, there is nothing in it specifying that Mexico will pay for any border wall.The president’s argument is that Mexico will pay “indirectly” because of benefits that accrue to the U.S. through the new trade agreement. But economists told us that while the trade agreement is arguably a slightly more advantageous deal for the U.S. than its predecessor, the North American Free Trade Agreement, it won’t generate enough additional federal revenues to pay for the border wall, and shouldn’t be construed as Mexican payments, anyway.“Even if we accept conceptually the argument that government revenue attributable to the revised trade agreement constitutes ‘Mexico paying for the wall,’ there are no plausible assumptions of USMCA’s impact that would see government revenue increase by $25 billion,” said Geoffrey Gertz, a fellow in the Global Economy and Development program at the Brookings Institution and a research associate at the Global Economic Governance Programme at the University of Oxford.Kent Smetters, a professor of business economics and public policy at the University of Pennsylvania’s Wharton School, agreed.“Relative to NAFTA, the Mexican government would not nearly lose enough tariff revenue that could be constituted as paying for the wall, at least the wall as previously envisioned by the Administration; nor would the U.S. government revenue increase enough based on a dynamic score,” said Smetters, who was an economist at the Congressional Budget Office in the 1990s. “In fact, the additional revenue to U.S. relative to NAFTA would, optimistically, not cover annual maintenance and improvements of the wall much less the original build.”


Weight loss can be boosted fivefold thanks to novel mental imagery technique

Explanation: The news release focuses on a study reporting that overweight individuals who engaged in functional imagery training (FIT) were more successful at losing weight than individuals who engaged in a type of talk therapy called motivational interviewing (MI). However, the release does not answer many questions that are relevant to determining how useful FIT is for weight loss. For example, because the study does not appear to have collected information on diet or exercise, it’s not clear whether the difference in outcomes stems from differences in lifestyle choices made by study participants. It would have been helpful if the release (and study) had analyzed specifically how increased motivation and lifestyle choices can result in weight loss. The published study notes that data relating to “participants’ experiences and process variables, including frequency of motivational cognitions, self-efficacy for diet and physical activity, self-reported diet and physical activity” were collected but that the results would be reported separately. When comparing the efficacy of MI and FIT, it’s important to know what sort of lifestyle changes study participants made. If a significant percentage of participants who engaged in FIT also joined a for-profit diet program, that support system might explain the differing results. By the same token, it’s not clear if the MI group and the FIT group were matched for initial weight, sex or age — any of which could influence how much weight was lost. Without knowledge of those details, it is difficult or impossible to say how much more effective FIT was than MI (if at all). According to the published research, there were some differences in full-time employment and the range in baseline weight that weren’t addressed in the limitations section of the study and which could affect the reliability of the data.

functional imagery training (FIT),University of Plymouth,weight loss

Both MI and FIT rely on patients engaging in multiple sessions with a trained therapist. Whether done in a for-profit country like the United States or a country that partially or fully subsidizes health care, there are cost considerations. The cost of those sessions, and follow-up consultations, was not mentioned. The release describes benefits in terms of kilograms lost at six months and twelve months after the FIT/MI intervention. Benefits are also described in terms of centimeters lost from their waist circumference. This information would have been more meaningful if it had provided information about the starting weight and waist circumference for the groups, since that would have shed light on whether one group would find it more difficult to shed kilograms or centimeters. Some forms of weight loss can pose risks for patients, such as various fad diets or when people with a sedentary lifestyle suddenly begin engaging in rigorous exercise. But this study does not appear to have evaluated how people tried to lose weight, instead focusing on the extent to which they were motived to make changes based on the intervention. Because of the nature of the study, we’ll rate this as not applicable. However, it would have been valuable to include language encouraging people to talk to a health care provider before making abrupt changes to their lifestyle. The release does a fairly good job of describing the study design. However, as noted above, some crucial information is missing. Did the FIT and MI groups have comparable numbers of men and women? Were the groups comparable in age? Were the groups comparable in terms of overall health? Essentially, the release should make clear whether the researchers were comparing apples and oranges. What’s more, it would be important to know what steps the people in each group took to lose weight. If both groups consisted of comparable demographics AND both consisted solely of people who started watching what they ate and engaging in more light exercise, then the hypothesis holds that FIT was responsible for the difference in outcomes. But even if both groups were comparable demographically, but one group happened to adopt a different weight loss approach, that could account for the difference. In other words, it’s possible that some unknown variable was responsible for the FIT group’s success — because it’s not clear whether the study controlled for that. The release specifically notes that the study did not dictate how study participants chose to lose weight. But the study should still have tracked what those efforts looked like, in order to determine FIT’s role in the weight loss. Weight loss is not inherently good. The release refers, once, to study participants as being “overweight,” but it’s not clear what they mean. Are these people who could stand to lose a pound or two? Or are they morbidly obese? It is possible to be both healthy and “overweight,” depending on how you define those terms. In the paper, they define “overweight” as having a body mass index (BMI) of greater than or equal to 25. Having a BMI of 25 puts you exactly on the borderline between “normal” and “overweight” — and the BMI itself is a very incomplete means of measuring an individual’s body fat and assessing health. The funding source is clearly identified. There are no apparent conflicts of interest, though the release would have been stronger if it had addressed this directly. The release addresses this, sort of, when it states: “Most people agree that in order to lose weight, you need to eat less and exercise more, but in many cases, people simply aren’t motivated enough to heed this advice – however much they might agree with it. So FIT comes in with the key aim of encouraging someone to come up with their own imagery of what change might look and feel like to them, how it might be achieved and kept up, even when challenges arise.” That’s enough to earn it a satisfactory ranking, particularly since it is consistent with the underlying study. However, it would be more valuable to see how effective FIT is when used in conjunction with proven weight loss techniques. The release describes FIT as a “new motivational intervention.” Is it in widespread use? How difficult would it be for someone to find a practice that can provide FIT for weight loss? The release doesn’t address this. The release refers to FIT as “novel” and “new” — but (as noted above), researchers have been publishing on FIT since at least May 2016. We’ll give the release the benefit of the doubt here since reasonable people can disagree on what constitutes novelty or “new-ness.” This 2016 paper looked at the use of FIT to inform dietary choices for people who wanted to lose weight. The new paper appears to be the first to look specifically at weight loss, but that context is missing since the release does not place the work in context with other research in the field. The release avoids unjustifiable language.


The most likely triggering cause of (microcephaly)" is the "DTaP shot, a vaccine that had been recently mandated by the Brazilian government to be injected into pregnant women.

Global News Service, Public Health, Centre for Research on Globalization,

There are many unanswered questions about the connection between the Zika virus and microcephaly, a birth defect in which the baby’s head is much smaller than expected. Not every baby of an infected woman develops this syndrome, and the mechanism by which the virus might affect the fetus is uncertain. But moving around on the Internet is an entirely different take on the tie between Zika and microcephaly. It doesn’t exist, according to certain blogs, tweets and articles on conspiracy-leaning websites. The Canadian-based Centre for Research on Globalization, a group that advances ideas it feels the "mainstream press" ignores, had an article Feb. 4, 2016, from Dr. Gary Kohls that challenged the linkage theory and said the primary suspect is DTaP,  a common vaccination to prevent whooping cough (along with tetanus and diphtheria). "In the whole week of reports that I heard or read about, not a single interviewer asked about – and not a single ‘expert’ or mainstream journalists ever mentioned the most likely triggering cause of the epidemic, and that is the neurotoxic, cytotoxic, genotoxic, aluminum that was in every DTaP shot, a vaccine that had been recently mandated (early in 2015) by the Brazilian government to be injected into pregnant women – and therefore into their fetuses," Kohls wrote. So is DTaP is the "most likely triggering cause" of microcephaly? Most of Kohls’ article describes why the Centers for Disease Control and Prevention, pharmaceutical companies and researchers would care to blame the Zika virus rather than the vaccine, but its main point is the overlap of the microcephaly incidence and Brazil’s immunization campaign. Brazil did begin vaccinating pregnant women starting in late 2014. (Hat tip to Brazilian fact-checker Cristina Tardáguila at Lupa News.) However, according to the Brazilian Health Department press release, the vaccine they distributed was a version called Tdap. This was part of an international push to reduce whooping cough in infants. Inoculating mothers late in pregnancy allowed them to pass antibodies to their unborn children. For the rest of this fact-check, we look at Tdap. The Web article named the incorrect vaccine, but if there’s any merit to Kohls’ case -- and there isn’t -- it lies with the vaccine Brazil used. Kohl also wrote that "there are 35 other countries across the globe that have confirmed cases of Zika virus illness, but none are having any microcephaly reports." The European Centre for Disease Prevention and Control does show about that number of countries and territories where Zika has been found, but in 13 of those places, there are few cases. Either no instances of Zika have been found in the past two months, or the number of cases was less than 10. So it’s a bit misleading to suggest that the absence of microcephaly disproves the link between the birth defect and the Zika virus. If we find more detailed statistics on the number of cases of Zika and microcephaly, we’ll update this item, but there’s a much bigger problem with Kohls’ statement. Evidence on the safety of Tdap The weakest part of the argument that Tdap plays a role in microcephaly is that  pregnant women in the United States, and elsewhere, have been getting the vaccine and there is no hint of a connection to microcephaly. Elyse Kharbanda is a top national researcher on vaccine safety at HealthPartners Institute for Education and Research in Minneapolis. "Our research has not shown any link between Tdap vaccination in pregnant women and microcephaly in their children," Kharbanda told us. Melissa Brower in the CDC press office reiterated that point. "Our safety monitoring is continuous," Brower said. "We have not observed any unusual or unexpected patterns of reporting that would indicate a potential safety problem with maternal Tdap vaccination and microcephaly as a birth outcome." A 2015 study published in the peer-reviewed Journal of the American Medical Association included over 29,000 pregnant women in six states. It found no problems of any birth defects for any woman who was vaccinated with Tdap during pregnancy. Another JAMA study looked at over 26,000 pregnant women in California and reached the same conclusion. Researchers at the Vanderbilt Vaccine Research Program further affirm the safety of Tdap. Director and specialist in pediatric infectious diseases Buddy Creech said nothing shows any link between the vaccine and microcephaly or any other birth defect. Creech also noted that the vaccine is given later in pregnancy, between weeks 27 and 36. That timing is important. "Most organ development and structural changes are occurring in the first trimester," Creech said. "It’s after the period of most intense organ development, so it removes the question of whether a vaccine caused congenital heart disease, etc." However, the CDC says in some cases, microcephaly can occur after the first trimester, so in theory, a vaccination could overlap with the onset of microcephaly. But that doesn’t change the rest of the research pattern. The United Kingdom launched a vaccination program in 2012, making Tdap available to about 700,000 pregnant women. Researchers looked at the impact on about 20,000 of them and found no increase in pregnancy risks. On a related note, the New England Journal of Medicine reports that the Zika virus was found in the brain tissue of an aborted fetus suffering from microcephaly. While this says nothing about the role of Tdap, it does directly link the Zika virus to a particular birth defect. We contacted the editors at the Centre for Research on Globalization and they said they forwarded our questions to Kohls. If we hear back, we’ll update this item. Our ruling An online article on the website of the Centre for Research of Globalization said the DTaP vaccine is the mostly likely cause of microcephaly in Brazil. First of all, Brazil used Tdap, a slightly different version of the vaccine. More important, not a bit of evidence supports the assertion that either variety lies behind microcephaly. Many thousands of pregnant women in the United States and around the world have been getting this vaccine for at least five years and multiple studies have found no ill effects on their babies. Not a single study has raised a red flag for any birth defect and certainly not microcephaly. In addition, administering the vaccine later in pregnancy reduces the likelihood that it will interfere with fetal development. The statement is inaccurate in every respect including naming the wrong version of the vaccine used in Brazil.


2 Aussie wildfires merge into inferno; man seriously burned.

Explanation: Two wildfires merged to form a massive inferno in southeastern Australia and a man suffered serious burns protecting a home, in a night of treacherous conditions during the nation’s unprecedented wildfire crisis, officials said Saturday.

Wildfires, Australia, International News, General News, New South Wales, Fires, AP Top News, Science, Asia Pacific, Burns

Authorities were assessing the damage after firefighters battled flames fanned by strong winds through the night and lightning strikes sparked new blazes in New South Wales and Victoria, Australia’s most populous states. Conditions were milder Saturday and forecast to remain relatively benign for the next week. “In the scheme of things, we did OK last night,” said Andrew Crisp, Victoria’s emergency management commissioner. New South Wales Rural Fire Service Commissioner Shane Fitzsimmons told reporters that officials were “extremely relieved” the fires were not more destructive overnight. A man suffered burns protecting a home near Tumbarumba in southern New South Wales and was airlifted to a Sydney hospital in serious condition to undergo surgery, Fitzsimmons said. Several firefighters received minor burns and one suffered shortness of breath, but they were not admitted to a hospital, he said. With no heavy rain expected, the 640,000-hectare (1.58 million-acre) blaze that formed overnight when two fires joined in the Snowy Mountains region near Tumbarumba, close to the Victorian border, is expected to burn for weeks, officials said. The fire crisis in Australia has killed at least 26 people, destroyed more than 2,000 homes and scorched an area larger than the U.S. state of Indiana since September. It also has brought accusations that Prime Minister Scott Morrison’s conservative government needs to take more action to counter climate change, which experts say has worsened the blazes. Thousands of protesters rallied late Friday in Sydney and Melbourne, calling for Morrison to be fired and for Australia to take tougher action on global warming. The protesters carried placards saying, “We deserve more than your negligence,” “This is ecosystem collapse” and “We can’t breathe,” referring to wildfire smoke that has choked both cities. Australia is the world’s biggest exporter of coal and liquid natural gas. Australians are also among the worst greenhouse gas emitters per capita. On Friday, thousands of people in the path of fires fled to evacuation centers, while some chose to ignore evacuation orders and stayed to defend their homes. Evan Harris, who lives in the New South Wales rural village of Burragate, said police and fire crews told him he should leave his cottage because of the threat. He told them he wasn’t going anywhere. Burragate was choked with smoke for several hours Friday and was directly in a fire’s path. A fire strike team and several members of the Australian Army arrived to try to save properties, and they were prepared to hunker down in a fire station if the flames overran them. In the end, the winds died down and so did the fire. But crews worry the flames will flare up again during a fire season that could continue for months. Harris said he likes to live off the grid in his remote home, which is made from mud bricks. He has no electricity, instead using batteries to power the lights and a small wood burner to heat water. The cottage itself has a warm and cozy feel. And Harris feels like he has a point to make. “If this house survives, I think it will be a bit of a wake-up call for people,” he said. “That maybe people should start building like this, instead of over-exorbitant houses.” Harris prepared for the blazes by tacking sheets of iron over his windows and clearing the area around the house of grass and shrubbery that might have caught fire. He dug a hole away from the cottage to house his gas canisters. Harris said he was disappointed in the environmental destruction and that people should be paying attention to the more sustainable way that indigenous Australians previously lived. “This is a result of the human species demanding too much of the environment,” he said of the wildfires. ____ Associated Press writer Rod McGuirk in Canberra, Australia, contributed to this report.


Lamont fills top public health, insurance agency jobs.

Explanation: Connecticut Gov. Ned Lamont has announced his choices to lead the departments of public health and insurance.

Ned Lamont, Financial services, Health, Connecticut, Stamford, Public health

The Democrat is nominating Renee D. Coleman-Mitchell, a health care executive, to oversee the health department. Coleman-Mitchell is executive director of Cougar Health Services at Washington State University. She previously worked at the Connecticut Department of Public Health, beginning in 1986 with the HIV/AIDS division. Lamont is also nominating Andrew N. Mais of Wilton to oversee the insurance department. Mais specializes in insurance regulation at the Deloitte Center for Financial Services in Stamford, where he has worked since 2011. He previously worked at the New York State Insurance Department. Both appointees await legislative confirmation.


The city of Atlanta has $56 million in its reserves.

Explanation: Numbers show support for Reed's claim about Atlanta finances

Federal, state and local leaders are constantly searching for every spare dollar or threatening to raise taxes to keep things running in this sluggish economy. So it surprised us when Atlanta Mayor Kasim Reed made this claim when discussing his first-year accomplishments:  "When I came in, the reserves of the city of Atlanta were $7.4 million," Reed said in a speech to the YMCA Hungry Club lunch forum on Nov. 30. "As I stand here ... the reserves of the city of Atlanta are in excess of $56 million." How did the city get this done? Are the city's numbers correct? Atlanta, like most governments, has several accounts to manage its finances. The main account the city uses to pay for most services (police, fire, parks and recreation) is called the "general fund." Some city services, such as water and sewer service, are paid through different funds. The general fund, which currently has a budget of about $560 million, is paid for through a combination of property taxes, sales taxes, business licenses, a hotel/motel tax it shares with state government, permits, court fines and other sources. Atlanta's budget year, which the city calls "fiscal year," begins July 1 and ends June 30. For the fiscal year that ended June 30, 2009, the city says it had a reserve fund of about $7.4 million. For the fiscal year that ended June 30, 2010, the mayor says the city's general fund reserve is at least $56 million. Some city data show the total is $58 million, which drew Reed some praise from New York Times columnist Thomas Friedman in a Christmas Day column. So how does the city say it got there? It began in June 2009, when the City Council voted 8-7 to put $27 million in its general fund reserve and raised property taxes by about $240 for the average city homeowner. Then-Mayor Shirley Franklin and her staff felt the city eventually needed a rainy day fund of about $100 million to protect the city if the economy falters, in hopes of avoiding what happened in 2008, when Atlanta, after feeling the first ripples of the recession, laid off several hundred employees and cut back a host of services. Skyrocketing employee pension costs, falling revenue from the recession and some bad long-standing budgeting practices were found to be the primary culprits of the financial troubles at City Hall. A key moment in building its reserves took place in the early months of 2009. The Franklin administration was conservative in its estimates of how much it would receive in revenue during fiscal year 2010. It expected scores of property owners to appeal their assessments, said Duriya Farooqui, a top city official under Franklin who is now one of Reed's deputy chief operating officers. Lower assessments typically mean lower property values. Lower property values mean less paid in property taxes, which account for approximately 35 percent of Atlanta's general fund revenue. As a result of the conservative estimates, city officials say revenue was $13 million above expectations. A city spreadsheet for May 2010 offers a further glimpse into the mayor's claim. In addition to showing higher-than-expected revenue, several city agencies spent much less than budgeted. By the end of June, the following departments were under budget: In many cases, city officials say some vacant positions were not filled. Atlanta said two departments, Corrections and Public Works, were over budget by a combined $2.6 million. Farooqui said Reed and his staff told department heads on track to spend less than budgeted to end the fiscal year at those lower levels. The city also got help from the federal government. The Obama administration gave Atlanta nearly $5 million in stimulus funds it used for job training, Farooqui said. Atlanta also re-examined its lease agreements and engaged in new spending practices, Farooqui said. By this past June, the end of the city's fiscal year, Atlanta officials reported a general fund balance of $68 million. City officials said they were able to add nearly $12.3 million to the reserve through principal and other interest payments. That includes the $27 million reserve, the higher-than-expected revenue and controlled spending. Under city guidelines, one-quarter of that money must be used for large-scale projects. Subtract that and Atlanta is left with about $51 million. Once you carry the $7 million in the reserve fund from fiscal year 2009, the reserve is about $58 million. City Councilman Howard Shook, chairman of the council's budget committee in 2008 and 2009, said he does not dispute the mayor's math. Shook said the city has tighter fiscal management, largely aided by Atlanta's new (albeit over-budget) Oracle computer system that better tracks spending. The councilman said the painful budget cuts in 2008 and the council's decision to raise property taxes in 2009 helped. "A lot of the most painful medicine was taken before the new administration came in," Shook said. Roger Lusby III, a certified public accountant, looked at some of the city's monthly budget spreadsheets at AJC PolitiFact's request. Lusby said Atlanta's numbers seem accurate, but he wanted to see more information about its reserves, how the city is handling its massive pension liability and how it manages its severance pay. Those and other factors, Lusby said, may give him a better idea of how solid the city's surplus estimate is. Lusby said he would reserve ruling that the city's claim is true until its books are audited by an independent firm, which city officials said is scheduled to be done early this year. "I think [Reed] is doing a good job, but I hope he's working with accurate information," said Lusby, managing partner of the Alpharetta office of Frazier & Deeter, a certified public accounting firm. The spreadsheets show Reed's claim seems on the money. But, as Lusby noted, the city's fiscal year 2010 books haven't been audited. Farooqui said "there is no reason to believe the numbers will change dramatically" after the audit. Since there's additional information that may come from the audit, we reserve the right to change the ruling if there is significant information that shows the city's numbers were on target or incorrect. For now, we'll be a little conservative here and rate Reed's statement as .


CVI: The impairment affecting children whose eyes are fine.

Explanation: Tripp McCardle has had a tough go of it during his two years of life. When he was 8 months old, he contracted meningitis, starting a health journey on which he is still traveling.

One of the consequences he suffered from the disease was cortical vision impairment, or CVI. This occurs when the eyes are healthy and able to see, but the brain is not interpreting what is being visualized. “He can see little slits of light, but it doesn’t have any meaning, any form,” said Martha McCardle, Tripp’s grandmother. Fortunately for Tripp, he’s getting therapy from the only person in Mississippi to have undergone extensive training and experience working with children with CVI. University of Southern Mississippi graduate Jillian Colon is the first official CVI Range Endorsee in the state. She sees children with the impairment at The Children’s Center for Communication and Development at Southern Miss. “I knew she was really good,” McCardle said. “She worked with him so well on his eyes. “I didn’t even know what CVI stood for, and she was very patient to explain it to me.” When someone can’t see, the first inclination is to think there is a problem with the eyes. That impulse is not correct with CVI. “CVI is when — due to some brain injury or damage, — the brain has difficulty processing visual information,” Colon said. “Kids (with CVI) will go to see if they need glasses and an exam will show their eyes are fine.” In normal vision, the eye takes a picture of an object and sends the message to the brain via optic nerves. The brain recognizes the image and integrates it with other sensory messages such as hearing, touch, smell and taste. In people with CVI, the eye takes a picture of the object and sends the message to the brain, but the message is not properly processed because of abnormal brain function. The condition is usually diagnosed by a neurologist or ophthalmologist. Colon said certain habits of children with CVI may indicate they are experiencing the disorder. “If the child likes to look out the window or look at the ceiling fan or is not making eye contact with you,” she said. “If you bring your hand to the child’s face, they may not blink.” Children may also have distinct color preferences, preference for looking at lights, viewing objects up close and at odd angles, viewing moving objects and difficulty visualizing new surroundings or objects. In Tripp’s case, he likes to look at lights and the colors red, yellow and hot pink. Colon uses this information to work with him. His grandmother has also used a red lollipop and a flashlight to stimulate him. CVI is caused by anything that damages the visual parts of the brain. That can be a stroke, decreased oxygenation, decreased blood supply, increased pressure, seizure, metabolic disease, infection, head trauma or other neurologic disorders. With so many causes of CVI, and an increasing number of premature babies surviving with brain injuries, Colon expects to be busy. “There are a lot of kids who have these characteristics that haven’t been assessed or diagnosed,” she said. “I want to help as many kids as possible. “I hope to meet these kids whose parents want help with their vision and meet with these therapists and provide knowledge about the subject.” According to the National Institutes of Health, an estimated 10.5 percent of children with developmental disabilities have CVI. The condition is also prevalent in developing countries, where a large number of babies are born with oxygen deprivation. Colon said some things can be done to help a child with CVI. “At school or at their desk — give them a black background with a single object on it,” she said “Outline words in their favorite color. “Reduce complexity in their environment — don’t have the child sit in front of a cluttered shelf. Turn them away from natural light.” Vision can improve with CVI, but treatment of the underlying neurologic disease is essential. Then, as the brain matures, new connections can develop and the initial injury or deficit may be overcome. For Tripp, who suffered several complications from his meningitis that could have caused CVI, little steps are meaningful. “We’re extremely proud of him,” McCardle said. “Jillian is awesome with him. “She had a silver salad bowl with dimples in it and the light would bounce off it. He responded to it. This might seem like small things to other people, but they’re major hurdles to us. We celebrate every one.” Colon has hope that children like Tripp will improve with the right therapy. “The children will always need some sort of adaptation little or big to use their vision the best they can,” she said. “We’re trying to get information about CVI out to more people so there is a better understanding of it, so children who are young and present the characteristics can get the interventions they need. “The younger we start with these children, the better.” At a glance CVI: Cortical Vision Impairment is a decreased visual response caused by a neurological problem affecting the visual part of the brain. ___ Information from: The Hattiesburg American, http://www.hattiesburgamerican.com