Judith Graham | (TNS) KFF Health News Carolyn Dickens, 76, was sitting at her dining room table, struggling to catch her breath as her physician looked on with concern. “What’s going on with your breathing?” asked Peter Gliatto, director of Mount Sinai’s Visiting Doctors Program. “I don’t know,” she answered, so softly it was hard to hear. “Going from here to the bathroom or the door, I get really winded. I don’t know when it’s going to be my last breath.” Dickens, a lung cancer survivor, lives in central Harlem, barely getting by. She has serious lung disease and high blood pressure and suffers regular fainting spells. In the past year, she’s fallen several times and dropped to 85 pounds, a dangerously low weight. And she lives alone, without any help — a highly perilous situation. This is almost surely an undercount, since the data is from more than a dozen years ago. It’s a population whose numbers far exceed those living in nursing homes — about 1.2 million — and yet it receives much less attention from policymakers, legislators, and academics who study aging. Consider some eye-opening statistics about completely homebound seniors from a study published in 2020 in JAMA Internal Medicine : Nearly 40% have five or more chronic medical conditions, such as heart or lung disease. Almost 30% are believed to have “probable dementia.” Seventy-seven percent have difficulty with at least one daily task such as bathing or dressing. Almost 40% live by themselves. That “on my own” status magnifies these individuals’ already considerable vulnerability, something that became acutely obvious during the covid-19 outbreak, when the number of sick and disabled seniors confined to their homes doubled. “People who are homebound, like other individuals who are seriously ill, rely on other people for so much,” said Katherine Ornstein, director of the Center for Equity in Aging at the Johns Hopkins School of Nursing. “If they don’t have someone there with them, they’re at risk of not having food, not having access to health care, not living in a safe environment.” Related Articles Health | Weight loss drugs like Ozempic, Wegovy are all the rage. Are they safe for kids? Health | Rural governments often fail to communicate with residents who aren’t proficient in English Health | Some breast cancer patients can avoid certain surgeries, studies suggest Health | Who gets obesity drugs covered by insurance? In North Carolina, it helps if you’re on Medicaid Health | How the FDA allows companies to add secret ingredients to our food Research has shown that older homebound adults are less likely to receive regular primary care than other seniors. They’re also more likely to end up in the hospital with medical crises that might have been prevented if someone had been checking on them. To better understand the experiences of these seniors, I accompanied Gliatto on some home visits in New York City. Mount Sinai’s Visiting Doctors Program, established in 1995, is one of the oldest in the nation. Only 12% of older U.S. adults who rarely or never leave home have access to this kind of home-based primary care. Gliatto and his staff — seven part-time doctors, three nurse practitioners, two nurses, two social workers, and three administrative staffers — serve about 1,000 patients in Manhattan each year. These patients have complicated needs and require high levels of assistance. In recent years, Gliatto has had to cut staff as Mount Sinai has reduced its financial contribution to the program. It doesn’t turn a profit, because reimbursement for services is low and expenses are high. First, Gliatto stopped in to see Sandra Pettway, 79, who never married or had children and has lived by herself in a two-bedroom Harlem apartment for 30 years. Pettway has severe spinal problems and back pain, as well as Type 2 diabetes and depression. She has difficulty moving around and rarely leaves her apartment. “Since the pandemic, it’s been awfully lonely,” she told me. When I asked who checks in on her, Pettway mentioned her next-door neighbor. There’s no one else she sees regularly. Pettway told the doctor she was increasingly apprehensive about an upcoming spinal surgery. He reassured her that Medicare would cover in-home nursing care, aides, and physical therapy services. “Someone will be with you, at least for six weeks,” he said. Left unsaid: Afterward, she would be on her own. (The surgery in April went well, Gliatto reported later.) The doctor listened carefully as Pettway talked about her memory lapses. “I can remember when I was a year old, but I can’t remember 10 minutes ago,” she said. He told her that he thought she was managing well but that he would arrange testing if there was further evidence of cognitive decline. For now, he said, he’s not particularly worried about her ability to manage on her own. Several blocks away, Gliatto visited Dickens, who has lived in her one-bedroom Harlem apartment for 31 years. Dickens told me she hasn’t seen other people regularly since her sister, who used to help her out, had a stroke. Most of the neighbors she knew well have died. Her only other close relative is a niece in the Bronx whom she sees about once a month. Dickens worked with special-education students for decades in New York City’s public schools. Now she lives on a small pension and Social Security — too much to qualify for Medicaid. (Medicaid, the program for low-income people, will pay for aides in the home. Medicare, which covers people over age 65, does not.) Like Pettway, she has only a small fixed income, so she can’t afford in-home help. Every Friday, God’s Love We Deliver, an organization that prepares medically tailored meals for sick people, delivers a week’s worth of frozen breakfasts and dinners that Dickens reheats in the microwave. She almost never goes out. When she has energy, she tries to do a bit of cleaning. Without the ongoing attention from Gliatto, Dickens doesn’t know what she’d do. “Having to get up and go out, you know, putting on your clothes, it’s a task,” she said. “And I have the fear of falling.” The next day, Gliatto visited Marianne Gluck Morrison, 73, a former survey researcher for New York City’s personnel department, in her cluttered Greenwich Village apartment. Morrison, who doesn’t have any siblings or children, was widowed in 2010 and has lived alone since. Morrison said she’d been feeling dizzy over the past few weeks, and Gliatto gave her a basic neurological exam, asking her to follow his fingers with her eyes and touch her fingers to her nose. “I think your problem is with your ear, not your brain,” he told her, describing symptoms of vertigo. Because she had severe wounds on her feet related to Type 2 diabetes, Morrison had been getting home health care for several weeks through Medicare. But those services — help from aides, nurses, and physical therapists — were due to expire in two weeks. “I don’t know what I’ll do then, probably just spend a lot of time in bed,” Morrison told me. Among her other medical conditions: congestive heart failure, osteoarthritis, an irregular heartbeat, chronic kidney disease, and depression. Morrison hasn’t left her apartment since November 2023, when she returned home after a hospitalization and several months at a rehabilitation center. Climbing the three steps that lead up into her apartment building is simply too hard. “It’s hard to be by myself so much of the time. It’s lonely,” she told me. “I would love to have people see me in the house. But at this point, because of the clutter, I can’t do it.” When I asked Morrison who she feels she can count on, she listed Gliatto and a mental health therapist from Henry Street Settlement, a social services organization. She has one close friend she speaks with on the phone most nights. “The problem is I’ve lost eight to nine friends in the last 15 years,” she said, sighing heavily. “They’ve died or moved away.” Bruce Leff, director of the Center for Transformative Geriatric Research at the Johns Hopkins School of Medicine, is a leading advocate of home-based medical care. “It’s kind of amazing how people find ways to get by,” he said when I asked him about homebound older adults who live alone. “There’s a significant degree of frailty and vulnerability, but there is also substantial resilience.” With the rapid expansion of the aging population in the years ahead, Leff is convinced that more kinds of care will move into the home, everything from rehab services to palliative care to hospital-level services. “It will simply be impossible to build enough hospitals and health facilities to meet the demand from an aging population,” he said. But that will be challenging for homebound older adults who are on their own. Without on-site family caregivers, there may be no one around to help manage this home-based care. ©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.Inflation is predicted to average 2.5% this year and 2.6% next year, according to forecasts from the Office for Budget Responsibility. The British Medical Association said the Government showed a “poor grasp” of unresolved issues from two years of industrial action, and the Royal College of Nursing called the pay recommendation “deeply offensive”. The National Education Union’s chief said teachers were “putting the Government on notice” that the proposed increase “won’t do”. The pay recommendations came after Chancellor Rachel Reeves called for every Government department to cut costs by 5%, as she started work on a sweeping multi-year spending review to be published in 2025. Independent pay review bodies will consider the proposals for pay rises for teachers, NHS workers and senior civil servants. The Department of Health said it viewed 2.8% as a “reasonable amount” to set aside, in its recommendations to the NHS Pay Review Body and the Doctors’ and Dentists’ Remuneration Board remit groups. A 2.8% pay rise for teachers in 2025/26 would “maintain the competitiveness of teachers’ pay despite the challenging financial backdrop the Government is facing”, the Department for Education said. The Cabinet Office also suggested pay increases for senior civil servants should be kept to no more than 2.8%. Paul Johnson, director of the influential economics think tank the Institute for Fiscal Studies (IFS), said it was “not a bad ballpark figure” and feels “just about affordable” given the Government’s public spending plans. The downside, he said, is that public sector workers have lost out since 2010 and unions will be upset that this is not making up the gap, he told Sky News’ Politics Hub with Sophy Ridge. “But given the constraints facing the Chancellor I think it’s pretty hard to argue for more for public sector pay when public sector services ... are under real strain,” he said. Unions expressed their disappointment in the recommendations, with some hinting they could be willing to launch industrial action. The Royal College of Nursing general secretary and chief executive called for “open direct talks now” to avoid “further escalation to disputes and ballots”. Professor Nicola Ranger said: “The Government has today told nursing staff they are worth as little as £2 extra a day, less than the price of a coffee. “Nursing is in crisis – there are fewer joining and too many experienced professionals leaving. This is deeply offensive to nursing staff, detrimental to their patients and contradictory to hopes of rebuilding the NHS. “The public understands the value of nursing and they know that meaningful reform of the NHS requires addressing the crisis in nursing. “We pulled out of the Pay Review Body process, alongside other unions, because it is not the route to address the current crisis. “That has been demonstrated today. “Fair pay must be matched by structural reform. Let’s open direct talks now and avoid further escalation to disputes and ballots – I have said that directly to government today.” Professor Philip Banfield, chairman of the British Medical Association’s council, urged the sector’s pay review body to “show it is now truly independent”. “For this Government to give evidence to the doctors’ and dentists’ pay review body (DDRB) believing a 2.8% pay rise is enough, indicates a poor grasp of the unresolved issues from two years of industrial action,” he said. He said the proposal is far below the current rate of inflation and that the Government was “under no illusion” when doctors accepted pay offers in the summer that there was a “very real risk of further industrial action” if “pay erosion” was not addressed in future pay rounds. “This sub-inflationary suggestion from the current Government serves as a test to the DDRB. “The BMA expects it to take this opportunity to show it is now truly independent, to take an objective view of the evidence it receives from all parties, not just the Government, and to make an offer that reflects the value of doctors’ skills and expertise in a global market, and that moves them visibly further along the path to full pay restoration.” The NEU’s general secretary, Daniel Kebede, said teachers’ pay had been cut by more than one-fifth in real terms since 2010. “Along with sky-high workload, the pay cuts have resulted in a devastating recruitment and retention crisis. Teacher shortages across the school system hit pupils and parents too. “A 2.8% increase is likely to be below inflation and behind wage increases in the wider economy. This will only deepen the crisis in education.” In a hint that there could be a return to industrial action he added: “NEU members fought to win the pay increases of 2023 and 2024. “We are putting the Government on notice. Our members care deeply about education and feel the depth of the crisis. This won’t do.” The offer for teachers is the “exact opposite of fixing the foundations” and will result in bigger class sizes and more cuts to the curriculum, Pepe Di’Iasio, general secretary of the Association of School and College Leaders, said: “The inadequacy of the proposed pay award is compounded by the Government’s intention that schools should foot the bill out of their existing allocations. “Given that per-pupil funding will increase on average by less than 1% next year, and the Government’s proposal is for an unfunded 2.8% pay award, it is obvious that this is in fact an announcement of further school cuts.” Paul Whiteman, general secretary at school leaders’ union NAHT, said: This recommendation falls far short of what is needed to restore the competitiveness of the teaching profession, to enable it to retain experienced professionals and attract new talent. Unison head of health Helga Pile said: “The Government has inherited a financial mess from its predecessors, but this is not what NHS workers wanted to hear. “Staff are crucial in turning around the fortunes of the NHS. Improving performance is a key Government pledge, but the pay rise proposed is barely above the cost of living.”
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Join Sam McKewon and Amie Just as they dive deep into the Husker sports scene — rationalizing, analyzing, and summarizing as only they can! In the latest episode of The Showdown, Sam McKewon and Amie Just break down a jam-packed week for Nebraska Athletics. The open with the football game between Nebraska and Wisconsin, how the Huskers' can come out victorious in the matchup and the weird comments from Luke Fickell about who will be the Badgers' play caller. They move onto the doubleheader between both Nebraska and Creighton basketball teams, including the loss of Natalie Potts and how Creighton's difficult schedule can help the Husker women. The duo also talk the Husker men's chances against the Bluejays and Ryan Kalkbrenner. They close out with Nebraska volleyball's upcoming match against Wisconsin on Senior Day and the looming match against Penn State. Subscribe to HuskerExtra.com Join co-hosts Sam and Amie as they dive deep into the Husker sports scene – rationalizing, analyzing, and summarizing as only they can! Get local news delivered to your inbox!Ray'Sean Taylor, Ring Malith lead SIU Edwardsville over Ball State 82-69City GOP leaders and Charles “Chuck” Marshall, the candidate it backed in the race to replace former DPW Commissioner Jason Golub, filed a lawsuit against the Saratoga County Board of Elections and its commissioners in state Supreme Court Monday to force election officials to create the ballot for a special election in the new year. In a decision Friday afternoon, state Supreme Court Justice James Walsh ruled in favor of moving forward with the special election on Jan. 28. "This court ruling is a victory for all the voters of Saratoga Springs,” Marshall said in a press release. “It reaffirms that if everyone plays by the rules, there are legitimate outcomes.” It comes amid debate between local Democrats and Republicans as to whether the election would actually be held in the wake of Golub's resignation this summer to take a job with the state Department of Corrections and Community Supervision and the subsequent decision by the City Council to name former deputy mayor Henry “Hank” Kuczynski as the interim DPW commissioner. Oral arguments were heard Thursday in state Supreme Court in front of Walsh, who spent much of his pre-judgeship legal career arguing election cases. Republican Election Commissioner Joseph Suhrada said Friday that he had also been told Walsh, who is also the husband of Republican state Assemblywoman Mary Beth Walsh, ruled in favor of the city GOP and Marshall. Walsh said in his ruling he would not create a new calendar for the Jan. 28 special election either, essentially establishing Marshall as the only candidate on the ballot, because “this court is without authority to grant the remedy of an opportunity to ballot” since it is a special election and not a primary election. City Democratic Party Chairman Otis Maxwell said the ruling doesn’t seem legal. “When we first proposed this special election back in August, the Republicans objected saying there wasn’t enough time, it would disenfranchise voters because there wasn’t enough time to allow for petitioning by third parties and to get ballots from overseas voters and that was with the two month lead time,” Maxwell said. “Now we have a lead time of just a little over a month, so I don’t understand how this could be legal. Of course we’ll have to investigate and hopefully there is an error that’s been made. If worse comes to worse certainly we would run a write in campaign.” Brandi argued in the lawsuit that the city proclaimed on Oct.15 that the special election would be held Jan. 28, setting in motion various deadlines, including Oct. 25 as a filing date for candidates to be on the ballot and a date to create said ballots — 53 days before the election, or Dec. 6. “This ruling protects the integrity of the electoral process," Brandi said. “The people of Saratoga Springs deserve fair elections in accordance with the law free from partisan obstruction.” The Democratic Party, which did not file a certificate for a candidate by Oct. 25, argued the election wasn’t actually set because Suhrada did not agree to the date in the proclamation. Democrat Election Commissioner Cassandra Bagramian previously said they did not formally agree to the special election and so political parties could not “operate under a political calendar for an election that doesn’t exist.” Sign Up: The Daily Gazette's Saratoga Springs weekly newsletter in your inbox In an email Monday, Bagramian said she was unaware of the lawsuit, “but if a judge rules that we are required to do so then we will.” READ THE FULL TEXT OF THE DECISION:
Pinion has 22 points as Arkansas State beats No. 16 Memphis 85-72
LANDOVER, Md. (AP) — Austin Seibert missed his second extra point of the game with 21 seconds left after Washington’s Jayden Daniels and Terry McLaurin connected on an 86-yard touchdown, Dallas’ Juanyeh Thomas returned the ensuing onside kick attempt for a touchdown, and the Cowboys pulled out a 34-26 victory Sunday that extended the Commanders’ skid to three games. Seibert, who missed the previous two games with a right hip injury, was wide left on the point-after attempt following a low snap. Thomas then took the kick back 43 yards as the Cowboys (4-7) ended their losing streak at five in improbable fashion. Part of that was the play of backup Cooper Rush, who threw for 247 yards and two TDs in his third start in place of starter Dak Prescott. Part was also the defense forcing two turnovers, as Chauncey Golston ripped the ball out of Brian Robinson Jr.’s hands for what was called an interception of Daniels in the second quarter, and Donovan Wilson stripped John Bates midway through the fourth. KaVonte Turpin provided the fireworks with a spinning, 99-yard kickoff return TD seconds after Daniels found Zach Ertz in the end zone and scored on a 2-point conversion to cut the deficit to three with 3:02 left. In the final three minutes alone, the Commanders (7-5) scored 10 points and allowed Thomas' TD. All that after the score was 10-9 through three quarters before madness ensued. Washington's playoff hopes that looked solid not long ago are now in serious jeopardy after losing to Pittsburgh, Philadelphia and Dallas. Before the scoring outburst late, much of this defeat had to do with Daniels and the offense not being able to find any kind of a rhythm. The Cowboys did, despite playing without their two best offensive linemen, top cornerback and starting tight end. Rush's 6-yard pass to Jalen Tolbert was Dallas' first third-quarter TD of the season, and his 22-yarder to Luke Schoonmaker came after Wilson's forced fumble. Daniels finished 25 of 38 for 274 yards, including his second interception of the game on a failed Hail Mary as the clock expired. Rico Dowdle ran 19 times for 86 yards to spring the upset for the Cowboys, who were 10 1/2-point underdogs on BetMGM Sportsbook. Injuries Cowboys: LG Tyler Smith was inactive with ankle and knee injuries. ... RG Zack Martin (ankle), CB Trevon Diggs (groin/knee) and TE Jake Ferguson (concussion) were ruled out prior to game day and did not travel for the game. Commanders: RB Austin Ekeler was injured on a kickoff return in the final seconds. ... Robinson left with an ankle injury in the first half, returned and then left again. ... RT Andrew Wylie was concussed in the third quarter and did not return. ... C Tyler Biadasz was evaluated for a concussion in the fourth. ... (hamstring) missed a third consecutive game at the trade deadline from New Orleans. Up next Cowboys: Host the New York Giants on Thursday in the traditional Thanksgiving Day game in Dallas. Commanders: Host the Tennessee Titans next Sunday in Washington’s final game before its late bye week. ___ AP NFL: Stephen Whyno, The Associated PressTop executives from the U.S. telecom industry and national security officials gathered at the White House to address concerns over a Chinese cyber-espionage campaign targeting high-ranking U.S. political figures. What Happened : Chinese hackers managed to breach major U.S. telecom providers to spy on phone calls and text messages. The meeting was an opportunity for telecom executives to propose ways the government could bolster its defenses against such advanced cyber-attacks, the White House stated. According to the report by CNN , the cyber-attack is seen as one of the most significant challenges to cyber and national security for the upcoming Donald Trump administration. A classified briefing for all senators has been scheduled for December 4, after Congress reconvenes from its recess next month. “This is by far the worst telecom hack in our nation’s history,” Sen. Mark Warner (D-Va.), who chairs the Senate Intelligence Committee, told the outlet. The full scope of the hack, its implications, and the individuals affected are still being investigated. According to Warner, the FBI has notified fewer than 150 victims, most in the Washington area. But all of those victims have likely called or sent texts to numerous people, meaning the number of records accessed by the hackers is likely far greater. The hackers could listen to the calls of specific targets for certain periods of time, said Warner. Also Read: Possible Espionage Threat? US Officials Warn Of Chinese Interference With Undersea Internet Cables In Pacific US broadband and internet providers AT&T T , Verizon VZ , and Lumen LUMN have all been victims of this hacking campaign. The hackers also targeted phone communications of senior figures from both the Republican and Democratic parties. China has refuted the hacking allegations. However, U.S. officials continue to express concern about China’s hacking program, which, according to FBI Director Christopher Wray , is larger than those of all other major countries combined. Why It Matters : This incident underscores the growing threat of cyber-espionage and the need for robust cybersecurity measures. The implications of such attacks are far-reaching, affecting not just the telecom industry but also the political landscape. As the investigation continues, it remains crucial for the US to strengthen its defenses against such sophisticated cyber-attacks. Read Next US Warns Tech Startups Of Espionage Threats From China And Others Adversaries Via Foreign Investments: ‘Can Directly Lead To The Failure Of These Companies’ This content was partially produced with the help of AI tools and was reviewed and published by Benzinga editors. © 2024 Benzinga.com. Benzinga does not provide investment advice. All rights reserved.
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Victims of child sexual abuse in the US have sued Apple for $US1.2 billion in damages, over claims the tech giant failed to stop the distribution of illegal material. The lawsuit against the trillion-dollar company is being brought by a 27-year-old woman who was molested by a male family member as an infant, The New York Times reported. The relative, who was eventually arrested and sent to prison, took photographs of the abuse and shared them online with other offenders. The woman, who spoke to The Times on the condition of anonymity, said she and her mother were reminded of the abuse nearly every day due to multiple notifications from law enforcement that someone had been charged with possessing the images. “It was hard to believe there were so many out there,” she said. “They were not stopping.” In late 2021, the woman received a notification that the images were found on a Vermont man’s MacBook, with authorities later confirming they’d also been stored in Apple’s iCloud. She ultimately decided to sue the company, she told The Times , because it had broken its promise to protect victims like her. As many as 2689 victims could be eligible for compensation as part of the lawsuit, which was filed in Northern California over the weekend. Under US law, child sexual abuse victims are entitled to a minimum of $US150,000 ($234,683) in damages, meaning Apple’s payout could exceed $US1.2 billion ($1.87 billion) if it’s found liable by a jury. The filing refers to NeuralHash, a tool unveiled by Apple in 2021 that allowed it to scan for illegal images of sexual abuse via its iPhones, which would store a database of distinct digital signatures (known as hashes), associated with known child sexual abuse material. Those digital signatures would be compared against photos in a user’s iCloud storage service, and flag and report any matches of suspected sexual abuse material to authorities. NeuralHash never came to fruition – after cybersecurity experts said the technology could open the door to other government surveillance requests, Apple dropped the plan, saying it was impossible to scan iCloud photos without “imperilling the security and privacy of our users”. With NeuralHash, Apple has been selling defective products that harmed a class of customers, the lawsuit said, because it briefly introduced “a widely touted improved design aimed at protecting children” but “then failed to implement those designs or take any measures to detect and limit” child sexual abuse material. The complainants are not only seeking compensation, but for Apple to change its practices. In response to the lawsuit, Apple spokesperson Fred Sainz described the material as “abhorrent”, and said the company is “committed to fighting the ways predators put children at risk”. “We are urgently and actively innovating to combat these crimes without compromising the security and privacy of all our users,” he told The Times in a statement. The lawsuit comes amid increased scrutiny of Apple’s failure to effectively monitor its platforms or scan for images and videos of child sexual abuse. Following a 2019 investigation by The Times that revealed tech companies had failed to rein in abusive material, Apple executive Eric Friedman, who was responsible for fraud protection, messaged a senior colleague to say he thought the company was underreporting child sexual abuse material. “We are the greatest platform for distributing child porn,” he wrote in the 2020 text exchange, pointing out that was because Apple gave priority to privacy over user trust and safety. In August, the UK’s National Society for the Prevention of Cruelty to Children (NSPCC) accused the company of vastly undercounting how often the material appears on its products, and had been implicated in 337 recorded offences of child abuse images between April 2022 and March 2023 in England and Wales, The Guardian reported at the time. While Facebook and Google filed more than one million reports each of suspected child sexual abuse material to America’s National Centre for Missing & Exploited Children (NCMEC), Apple submitted just 267. “There is a concerning discrepancy between the number of UK child abuse image crimes taking place on Apple’s services and the almost neglible number of global reports of abuse content they make to authorities,” NSPCC head of child safety online policy, Richard Collard, told The Guardian . “Apple is clearly behind many of their peers in tackling child sexual abuse when all tech firms should be investing in safety.”