We the People

Thanks to Pam P.

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Homespun philosophers

Thanks to Rosemary W.

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JWST’s best images: spectacular stars and spiraling galaxies

Click the following for: Nature’s pick of the sharpest science shots this month is dedicated to the James Webb Space Telescope, which began peering into the Universe earlier this year. Thanks to Mike C.

Neptune system shows off the planet’s rings, which have not been seen with this clarity in more than three decades.
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Stressed During the Holidays? There’s an Exercise for That.

By Danielle Friedman in the NYT

The holidays may be known for their go-go-go stressful energy, but we also tend to spend a lot of time in December being sedentary. Historically, people are least physically active during the winter, thanks to falling temperatures, limited hours of sunlight, calendars jam-packed with travel and social commitments and, of course, the tug of the couch after too much eggnog.

Americans are five times more likely to say their stress level increases rather than decreases during the holidays. And while these higher stress levels aren’t only caused by a lack of physical activity, the lethargy certainly doesn’t help, said Dr. Rebecca Brendel, president of the American Psychiatric Association and an associate professor of psychiatry at Harvard University Medical School.

Exercise can be a key way to combat the stress of the season. And it can take whatever shape and form you prefer.

If you already have an established fitness routine, keep it up. Research shows that, over time, regular exercise can help to prevent stress in the first place by improving our body’s ability to neutralize stress-causing hormones and by increasing dopamine receptors in the brain, allowing us to feel more joy.

And if you haven’t been consistently working out? You can turn to exercise “as needed,” in the same way you might take an Advil for a headache, said Sepideh Saremi, a licensed clinical social worker and the founder of Run Walk Talk, a Los Angeles-based therapy program in which she treats her clients while engaging in physical activity. Research suggests that a single session of intense exercise (whatever that means for you) can boost your mood for up to 24 hours.

While just about any movement can offset holiday overwhelm, we asked mental health experts who focus on the mind-body connection for their best advice for this particular time of year.

The holidays can feel constricting, both physically and psychologically. Travel requires squeezing yourself into small spaces in airplanes or trains and crowded parties intrude on your personal space. A relative’s backhanded compliments about your life choices can make you feel emotionally small, too.

When you’re feeling squeezed, do a workout (or single exercise) that encourages the body to take up space, said Erica Hornthal, a dance therapist in Chicago.

Ms. Hornthal suggested carving out time for full body, reach-for-the-sky style stretching sessions. Even two to three minutes of this can help to offset feeling cramped. She also recommended shaking off the feeling of constriction. “Shake your hands, shake your head — kind of like an animal after it gets wet,” she said. “You can make a game out of it if you have kids.”

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I’m talking to you

Dog and Cat Cartoon Prints image 1
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Assisted living too often fails older, sicker residents, report says

Thanks to Diana C – Published in the Washington Post

Assisted-living communities too often fail to meet the needs of older people and should focus more on residents’ medical and mental health concerns, according to a recent report by a diverse panel of experts.

It’s a clarion call for change inspired by the altered profile of the population that assisted living now serves.

Residents are older, sicker and more compromised by impairments than in the past: 55 percent are 85 and older, 77 percent require help with bathing, 69 percent with walking and 49 percent with toileting, according to data from the National Center for Health Statistics.

Also, more than half of residents have high blood pressure, and a third or more have heart disease or arthritis. Thirty-one percent have been diagnosed with depression, at least 11 percent have a serious mental illness, and 42 percent have dementia or moderate-to-severe cognitive impairment.Advertisement

“The nature of the clientele in assisted living has changed dramatically,” yet there are no widely accepted standards for addressing their physical and mental health needs, said Sheryl Zimmerman, who led the panel. She’s co-director of the Program on Aging, Disability and Long-Term Care at the University of North Carolina at Chapel Hill.

The report addresses this gap with 43 recommendations from experts including patient advocates, assisted-living providers and specialists in medical, psychiatric and dementia care that Zimmerman said she hopes will become “a new standard of care.”

Posted in Advocacy, Caregiving, Dementia, Disabilities, end of life, Grief, Health | 1 Comment

A French Village’s Radical Vision of a Good Life with Alzheimer’s

by Marion Renault in The New Yorker

Four years ago, I spent a morning cooking couscous with my grandmother Denise near Grenoble, France, where she has lived most of her life. We peeled carrots and turnips, seared lamb and chicken, tied bouquets of herbs, and mixed hot water into the grains with our bare hands. I wrote down her recipe as we went along. My mamie has Alzheimer’s, and I had to learn to make her couscous on my own, before she forgot how to do it herself. That day, I recorded a video of her on my phone. She was sitting in a familiar kind of wooden ikea chair that you have probably sat on before and that I will always associate with her. As she gazed out the window, a thought occurred to her, and she turned to me and asked, “C’est samedi que tu pars?” You’re leaving on Saturday?

Yes, I told her. I was returning to the United States, where my parents moved our family when I was eighteen months old. I found it painful to leave; each time we visited France, the progression of her disease seemed to become more unignorable. Her pencil trembled when she practiced her handwriting. She moved her daily baguette from the kitchen counter into the plate drawer. Late at night, she muttered and puttered around her apartment. When her wandering inconvenienced us, we guided her back to her chair. My family talked about the chair as if it were her refuge; it was probably more accurately described as our refuge from her confusion.

In the summer of 2020, my grandmother stopped eating and getting out of bed. She had fallen, fractured a vertebra, and forgotten about it. I flew to France with a dozen of Mamie’s favorite sesame-seed bagels, and I lived with her as she recovered, fetching prescriptions for the pain she was constantly rediscovering, and rubbing her back when she coughed until she retched. I lay in bed with her until she fell asleep. I fed her. I learned, for the first time in my life, what it meant to care for someone. After five weeks, my mom took my place as Mamie’s at-home caretaker.

Like so many families that are affected by Alzheimer’s, we searched desperately for a new place where my grandmother could live. We viewed her isolation in her seventh-floor apartment as a risk to her health and safety, and felt that it was not only right but necessary to exchange what was left of her autonomy for the round-the-clock, structured care that she could receive at a nursing home. About half of the six hundred thousand people who live in France’s ehpads, or “housing establishments for dependent elderly people,” have dementia. These are imperfect institutions: in 2018, French nursing-home workers went on strike to protest staff shortages and cost-cutting, and, earlier this year, disturbing reports of abuse and neglect, untrained staff, and the rationing of food and diapers by a for-profit nursing-home company put the country’s elder-care system under intense public scrutiny.

A nursing home in a nearby suburb finally offered her a place after weeks of uncertainty.

My grandmother’s life now seems safer, but smaller. Her memory-care unit is locked with keypads to prevent her from wandering out and is rarely unsupervised; the woman who taught me to cook couscous no longer has a kitchen. My family is satisfied with her care: the staff is affectionate, Mamie is often cheerful during visiting hours, and she regularly participates in Montessori activities such as vegetable peeling and sing-alongs. I never saw her with pets when I was younger, but she now lets the nursing home’s service dog, an enormous Labrador named Nova, cuddle with her in bed. Still, it seems inevitable that, as my grandmother’s condition declines, she will lose the few freedoms she has left. Last year, I stopped bringing her bagels after I noticed that they were furring themselves green inside their plastic bags. This year, she complained of being weaker, of fighting with her brain but not understanding why. She sometimes referred to her nursing home as her aunt’s house, or the children’s daycare where she worked for decades. Someday soon, she will no longer be able to play dominoes with me—she won’t understand how to win, or even how to count the dots on each tile. Later, she might be moved to the unit next door, where people with more serious cognitive limitations live under even closer surveillance.

Anyone who has cared for someone with Alzheimer’s is likely to be familiar with this transaction. We cede their freedom to gain a sense of security—theirs, but also ours. We attempt to resize their world, removing the choices that might pose a danger to them. But I often wonder whether the standard approach of a nursing home—the constant surveillance, the rigid schedules for waking, bathing, eating, socializing, and sleeping—is the best that we can offer to loved ones with dementia.

Posted in Aging Sites, Dementia, Uncategorized | 3 Comments

big fire next door to south (Friday 9pm)

About 9:00PM Friday, looking from 26th floor observation deck. Foreground roof is The Terraces. Visible flames are from rear of building, which caught fire several years ago.
https://sfdlive.com/?area=First+Hill
About 9:05pm
Image
via Twit
Aftermath. Saturday 4pm.

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Covid becomes plague of elderly, reviving debate over ‘acceptable loss’

Nearly 9 in 10 covid deaths are in people 65 or older [from Washington Post]

Some epidemiologists and demographers predict the trend of older, sicker and poorer people dying at disproportionate rates will continue, raising hard questions about the trade-offs Americans are making in pursuit of normalcy — and at whose expense.

By Ariana Eunjung Cha and Dan Keating

The red curve is us.

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Why Is It So Hard for Men to Make Close Friends?

By Catherine Pearson in the NYT

Ed note: I’m wondering just how vulnerable a man needs to be. Here’s one published comment on the article below: “I have different male friends that I DO different activities with. We do not need to “talk about our feelings” in order for this to be ‘close friends.’ Once again, an ‘expert’ is saying men need fixing and the fix is to feminize them.” What’s your take on male friendship?

The Tuesday before every Thanksgiving, Aaron Karo and Matt Ritter, both 43, go out to dinner with a group of seven men whom they befriended as second graders in Plainview, N.Y.

At the dinner, one of the friends wins the Man of the Year prize — a silly accolade the group concocted as an excuse to reconnect. They eat and they laugh, and the winner leaves with his name engraved on a cartoonishly large silver cup.

“It’s not really about the trophy,” said Mr. Karo, who co-hosts a podcast with Mr. Ritter called “Man of the Year,” which explores adult friendship. “It’s about the traditions that keep us together.” The friends jockey for the prize in a running group text, where they share memes and talk a bit of trash but also keep up with one another.

“I think men have been convinced that success in life does not necessarily include friendship — that if they’re successful at work or they’ve started a family, they’ve won,” Mr. Ritter said. “Our definition has always included having these thriving friendships.”

Mr. Ritter’s close crew notwithstanding, American men appear to be stuck in a “friendship recession” — a trend that predates the Covid-19 pandemic but that seems to have accelerated over the past several years as loneliness levels have crept up worldwide. In a 2021 survey of more than 2,000 adults in the United States, less than half of the men said they were truly satisfied with how many friends they had, while 15 percent said they had no close friends at all — a fivefold increase since 1990. That same survey found that men were less likely than women to rely on their friends for emotional support or to share their personal feelings with them.

“I think men have a deep craving for intimacy with their friends,” said Nick Fager, a licensed mental health counselor and the co-founder of Expansive Therapy, an L.G.B.T.Q.-focused psychotherapy group. “And yet getting there can feel so incredibly challenging.”

The four strategies below won’t eliminate all of the obstacles that can stand in the way of deep male friendship, but they are a start.

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Better believe it – research into the placebo effect

Thanks to Marilyn W.

Ed Note: Placebo is a Latin word which translates as “I shall please.” If you’re interested, click here to read a blog post I wrote about one of my patients responding to the “drug” obecalp.

By Sam Scott in the Stanford Magazine

Alia Crum’s long history of experiments exploring the mind’s influence over the body began with a record-scratch moment midway through her undergraduate career at Harvard, in the early 2000s. At the time, Crum was a member of Harvard’s ice hockey team, a juggernaut that would go to three consecutive NCAA championship games during her four years in Cambridge. Crum was a role player, but her dedication was total. If the team trained three hours, she would top it off with an hour alone on the StairMaster. All the sweat equity, however, didn’t much impress psychology professor Ellen Langer, Crum’s academic adviser. “You know that exercise is just a placebo, right?” Crum recalls Langer saying. 

The comment left Crum momentarily stunned. “Like, um, what did you just say?” But almost as quickly, it crystallized thoughts Crum had long had. Her studies—and life experiences—had made her keenly aware of the power of the mind to sway the body. Later that year, she would write a life mission statement, one that describes her work at Stanford today: “To help improve people’s health and happiness through increased understanding of the mind-body connection.” So, was she getting fitter and stronger because of all those hours in the gym? Or was it because she believed she would get fitter and stronger? What had sounded like a preposterous claim became an invitation for Crum to dig deeper.

Working under Langer, Crum recruited 88 female housekeepers from seven hotels to test the influence of their beliefs on their physical health. Few of the women said they got regular exercise—a third said they got none. Then the researchers gave half the women presentations revealing a hidden truth. Just by doing their jobs—where they might, for example, burn 60 calories in 15 minutes cleaning bathrooms—they were easily satisfying the surgeon general’s recommendation for a healthy lifestyle.

This change in perception seemed to change reality. Four weeks later, the women who heard the presentation perceived themselves as getting more exercise, despite reporting no change in their job duties or outside activities. Their bodies seemed likewise convinced. They showed a decrease in weight, waist-to-hip ratio, and systolic blood pressure, which dropped an average of 10 points. 

“These results support the hypothesis that exercise affects health in part or in whole via the placebo effect,” the pair wrote in the ensuing paper, published in Psychological Science in 2007. Crum may have been the first author, but the paper’s restrained academic tone didn’t come close to capturing the wonder she felt. “It really opened the floodgates,” she says. “If placebo-like effects matter in shaping the benefits of exercise, where else are they playing a role that we’re not paying attention to?”

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Why (not) be in the news business

Thanks to Rosemary W.

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How to talk to a widow

By Betty Rollin in the NYT

Ms. Rollin is a former NBC News correspondent and the author of several books, including the memoirs “First, You Cry” and “Last Wish.”

People are kind; some are wonderful. For a time. Then they move on to the next widow.

That’s how it should be. But I realized I wasn’t prepared for this after the following email exchange. A friend wrote, “How are you?” I wrote back, “I’m better.” The friend replied, “Oh! I didn’t know you were sick.” Given that I became a widow more than a year earlier, she had assumed that I had moved on and that I was feeling better after, perhaps, a cold or the latest Covid. But I meant that I was feeling better about my widowhood. I guess I was supposed to have recovered from that. Apparently the correct amount of time is a year or so. Apparently I wasn’t doing the recovery thing right.

Given all the widows in society today (11.4 million compared with about 3.4 million widowers), it’s surprising to me that people often struggle with how to talk to us, how to be with us. America has never been a more sensitive — or hypersensitive — place: There has never been as much discussion about mental health needs, especially of younger Americans. Although many of us are OK compared with other groups, we need people to be aware of us and to be mindful that we’re not all alike and not all experiencing loss and grief in the same way. And I have a word to my fellow widows, too: Interacting with people takes effort and creativity on our part, as well.

First, a little more about us. Most of the women who are widowed each year are over 65, and they frequently outlive their husbands by many years. Widows are far more likely than married women to be poor. Widowed men are far more likely to remarry than widowed women (and often remarry younger women). Black Americans, male and female, become widowed at younger ages than white Americans. By ages 65 to 74, about 24 percent of Black Americans are widowed, compared with about 15 percent of white ones.

Not all widows suffer their loss. For some, their husband’s dying was so horrific that death was merciful and, at least at first, the widow experienced mostly relief. Most older widows also have grown children, who may help their mother feel there’s someone left who loves them. One of the main ways I’m different is that I never had children (or siblings). When I was in my 30s and had breast cancer, a doctor advised me against having children. I might not have had them anyway; it was the 1970s, and I was what was then called a career girl. When, many years later, we learned that a colonoscopist for my husband, Ed, had seemingly failed to notice evidence of advanced colon cancer and that Ed was a goner, we joked about adopting a 60-year-old.

Ed and I married late. He was 42; I was 43. We had just short of 42 years together. Improbably, they were wonderful years. “Improbably” because we were so different — him, a mathematician WASP from the Midwest, me a New York Jew whose worst subject in school was, of course, math. But it worked out. More than worked out. We both felt dizzy with our good fortune at having found each other. When we walked home from the doctor’s office after getting the news that Ed had two years to live (they tell you straight out these days), Ed wanted to talk about how lucky we had been and still were. And when we got home and sat down in the living room, our coats still on, the sky growing dark, and I talked about wanting to write to the colonoscopist who seemed not to have noticed Ed’s progressing cancer, wanting, desperately wanting, to give him a piece of my mind, Ed said no. “I have two years, and we’re not going to spend any of that time being angry. I’m not writing to that doctor, and neither are you. We’re going to forget about him and be as happy as we can.”

And that’s what we did. Well, that’s what he did. A good part of the time, I was pretending.

Childless couples like us often have big social lives, and during the pandemic, thanks to Zoom, we continued ours with a vengeance. But as Ed got sicker and when he got on the heavy meds — thank you, hospice — we had to cut down on our time with friends. Ed continued to work on his math book. Did I mention he was writing a math book as he was dying? He managed to finish it four days before he died, and the book, incredibly, has recently been published. I’m thinking of having a party of close friends. First, though, I must get into more of a party mood than I am now. I’m trying. A psychiatrist helps. This guy is the one I saw before I married Ed; I hadn’t been any good at choosing men and was worried I might be making another mistake. The psychiatrist didn’t seem to think so. He was right, obviously. Anyway, I got his email and wrote to him. He wrote back that he was 1) still alive and 2) still working. So for the past year or so, he’s been trying to get me to cheer up. Well, that’s not quite correct. Mainly, he wants to help me get out of the black hole I still seem to be in.

Of course, I realize I have no right to be in a black hole. All I need to do is open any newspaper or turn on NBC News, where I used to be a correspondent, to know that I have no right to sadness and certainly no right to misery in the world we live in today. But one reason I’m confessing is that I know there are a lot of us who are in my situation and feel the way I do. Even the ones who have children don’t often live near the children. Or the children aren’t kind, or they have their own problems. And some of us oldsters are a lot sicker than I am. One of the nastiest surprises about being 86 is that you probably have something wrong with you, something that makes you feel your body wasn’t meant to last this long. And of course, there’s Covid. Even if you don’t have it, you’re probably still nervous about getting it. Especially now that you’re alone.

Although you are alone, there are some ways to be less alone. You can help others with a skill you may have. You can keep in touch with friends, even if they’re not perfect. Plus, I Zoom with friends, which still beats a phone conversation.

Here’s another tip: If you want to keep those friends, don’t forget to ask them how they are doing. That’s something that even happy people often forget to do. And here’s a choice that may work only for yours truly: I read books that have nothing to do with today. Like Trollope. Watching movies doesn’t do much for me, but I know it does a lot for some of us. Physical activity can be cheering. It makes the heart beat in a reassuring way. And if none of that does the trick, many widows can reflect on the fact that the main part of our lives was Covid-free, and free of Vladimir Putin and Donald Trump, in a world far nicer than it is now.

Finally, Friends of Widows, here are a few pointers: The main one is don’t do one sympathetic email with your widowed friend, then disappear. Don’t tell sad stories about your other widowed friends. Don’t (see first paragraph) assume that, after a year or so, the widow is all cheery again. Don’t assume anything about the widow’s finances. And now, just speaking personally: My Christian friends sent flowers; my Jewish friends sent food. Food is better.

Posted in Advocacy, Aging Sites, end of life, Grief | 2 Comments

Concert tonight in the Performance Hall – POSTPONED DUE TO WEATHER

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Shocking!

Thanks to Mike C.

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Researchers begin trial for mRNA flu vaccine

mRNA-vaccine-story_2col.jpg

The investigational vaccine is in the third phase of trials and targets flu strains expected to circulate this winter

Researchers at Kaiser Permanente Washington Health Research Institute (KPWHRI) are now recruiting participants age 65 and older who have not yet received this season’s flu vaccine for a trial of an investigational mRNA flu vaccine developed by Pfizer. The trial, taking place at many research sites across the U.S., will evaluate the vaccine’s efficacy and the immune response that it generates. If the vaccine performs well, it could contribute to improved protection against flu, which still has a large health impact in the U.S. and globally.

Current flu vaccines do not use mRNA technology, and both Pfizer and Moderna are testing mRNA flu vaccine candidates, which could become the first vaccines against influenza that use this approach. Vaccines using mRNA use the genetic sequence of a virus, rather than the whole virus, and are able to be manufactured rapidly at a large scale. They are also more easily adaptable, which could make it easier to match the vaccine to circulating flu variants.

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An OCD robot in the ODR

Robot With Flower New Yorker  giclee print image 1
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19,000 Polyclinic, Everett Clinic patients face in-network insurance loss

Ed note: Once again, we’re faced with consumer unfriendly restrictions and costs in the health care industry. Now we’re seeing bargaining over care vs. profits! United Health Group Inc (UNH) is for profit and it’s stock continues to soar gaining 132.82% over the past five years as it buys up health care systems. It is now controlling about 25% of the “health care market.” Regence is part of the non-profit Cambia Health System. In the negotiations reported below (which have almost nothing to do with your health care, but a lot to do with your premiums) if these two giants can’t agree on how much Regence should pay United Health for their patients to be cared for at the Polyclinic and the Everett Clinic, Regence patients will have restricted access (or none at all). It points out one of the potential disadvantages of Medicare Advantage over Original Medicare and the mess we call “health care.”

By Elise Takahama Seattle Times staff reporter

Thousands of patients of The Polyclinic and The Everett Clinic could soon have to find new medical providers or face higher rates, if the clinics’ owner and a major health insurer can’t agree on a new contract within the month.

While negotiations remain ongoing, the contracts between the two physicians’ groups and Regence BlueShield, a Seattle-based health insurer founded in Tacoma, are set to expire Dec. 19.

If the contracts expire without a resolution, patients with a Regence plan will no longer be able to pay in-network rates with The Polyclinic or The Everett Clinic, so anyone who continues to receive care from either will likely have to pay higher, out-of-network rates.

Patients who will likely be most affected are those in King, Pierce, Snohomish and Whatcom counties. The Polyclinic also has locations in Chelan County.

Regence notified its nearly 19,000 affected Polyclinic and Everett Clinic members of the change earlier this month, saying in a letter that Optum, the parent company of the groups, left its provider network after “insisting on an unprecedented increase in what we pay them for your care.”

Optum asked for an increase of about 14.75% in negotiated rates, The (Everett) Herald reported, though the company hasn’t confirmed the figure. A spokesperson for the company did not respond to several other questions about how the change might affect patients.

Optum is a subsidiary of Minneapolis-based health care giant UnitedHealth Group. It bought The Polyclinic, which started as a local physicians’ group more than 100 years ago, and The Everett Clinic in 2019. Both still serve much of the Puget Sound region.

“Supporting our patients with compassionate, quality care is our highest priority,” The Polyclinic and The Everett Clinic said in a statement. “We remain hopeful that we will reach an agreement with Regence so patients will have continued access to their trusted Polyclinic and Everett Clinic doctors and care teams.”

Regence, meanwhile, has said it’s “disappointed” that Optum plans to remove its local clinics from its provider network.

“Our premiums are based on what we expect care to cost,” the insurance company said in a statement Monday. “When providers demand unsustainable rate increases to provide care, our members and customers pay more out of pocket.”

Patients with some conditions might be able to continue network treatment for a short time, including those seeing a provider for a “serious” or “complex” condition, those benefiting from inpatient care, those who are pregnant and are seeing a provider for pregnancy-related care and those who are terminally ill, according to the state’s Health Care Authority.

“Our top priority is ensuring our members have access to high-quality, affordable health care,” the Regence statement said. “We are a tax-paying nonprofit founded in Tacoma more than 100 years ago and our commitment has always been to make care better for Washingtonians.”

For those looking for a new provider, UW Medicine, Virginia Mason Franciscan Health, Providence Swedish and Overlake Medical Center in King County are in the Regence network. MultiCare, Providence Medical Group and Western WA Medical Group in Snohomish and Pierce counties are also in-network.

The Polyclinic was founded in 1917 by six Seattle physicians, and has grown to become one of the largest multispecialty physician groups in the Greater Seattle area. Its now 200-plus physicians represent most medical specialties, and work out of more than 12 locations around the Puget Sound area. 

Delivered weekday mornings, this email provides a quick overview of top stories and need-to-know news, including the latest on the novel coronavirus.Sign up

The Everett Clinic began in Everett in 1924, and was acquired by DaVita Medical Group in 2016. In late 2017, DaVita Medical Group agreed to sell the group and other practices to UnitedHealth.

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The Climate Meta: Nine Aspects of the Big Picture

Skyline readers: I am preparing a series of Sci-Tech talks, my annual update on climate prospects. Advance comments would be most welcome. The most valuable comments are those that tell me where you stumbled, tuned out, or where you initially misinterpreted. Don’t feel that you need to rewrite something in order to comment. Just flag the stumbles.

A quarter-century ago, the editor of The Atlantic spent a week trying to persuade me to write what became their January 1998 cover story, “The Great Climate Flip-Flop.” It was the first long magazine article (8,300 words) on abrupt climate change and “Gulf Stream” shutdowns. It could use updating but that is not my present concern and there are better people to do that job.

It is time to cover the 21st-century surprises that signal the need for rapid removal of the excess CO2 overhead. I have broken it down into nine aspects.

1. Climate action now needs the medical mindset                                      5

2. ‘Think again’ about the climate diagnosis and treatment plan             9

3. The carbon dioxide hanging over our heads                                           15

4. Heatwaves will need A/C powered by small modular reactors           19

5. Will climate change be gradual? (That’s so 20th-century!)                 23

6. 21st-century surges in extreme weather                                                27

7. Climate surprises and slippery slopes                                                     33

8. Heading off climate-triggered collapse                                                  37

9. Design and prototype CO2 scrubbers                                                     41

                      Download the latest draft, hidden at faculty.washington.edu/wcalvin/2022/ABC.pdf

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All-terrain wheelchairs arrive at U.S. parks: ‘This is life-changing’

Thanks to Pam P.

Click here for the article in the Washington Post

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Here Are All the Winners of the 2022 National Gingerbread Contest

This year, 219 entries competed for $40,000 in cash and prizes.

By Mike Pomranz  Published on November 23, 2022

Thanks to Bob P.

National Gingerbread House Contest, Grand Prize Winner/Adult First Place Winner
The Grand Prize Winner by Ann Bailey. PHOTO: COURTESY OF THE OMNI GROVE PARK INN

Thanksgiving week marks the official start of the holiday season. But it also marks the official end of the National Gingerbread House Competition. Now in its 30th year, the annual event — billed as the largest gingerbread house competition in America — announces its winners just before Thanksgiving, leaving event hose The Omni Grove Park Inn in Asheville, North Carolina time to put everything on display for the Christmas rush.

This year, the number of entries — which were first solicited back in July — nearly doubled from over 120 last year to a massive 219 houses in 2022. The cash and prizes across all of the categories also increased: a value of $40,000 compared to $25,000 in previous years.

Those weren’t the only changes. The event added new speciality awards alongside its usual first, second, and third place winners in its Adult, Teen, Youth, and Child categories. They also added a new judge: 2020 James Beard finalist Ashleigh Shanti joined a team headlined by celebrity chef Carla Hall. However, the judging criteria remained the same: All entries had to be 100% edible and composed of at least 75 percent gingerbread; they were then evaluated on “overall appearance, originality/creativity, difficulty, precision, and consistency of theme.”Ikea Made Gingerbread Patterns for Some of Its Famous Furniture

Here are this year’s winners:

National Gingerbread House Contest, Grand Prize Winner/Adult First Place Winner
The Grand Prize Winner by Ann Bailey. COURTESY OF THE OMNI GROVE PARK INN
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Dance, dance – and dance!

Thanks to Rosemary W.

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Seasonal affective disorder treatment: Choosing a light box

Ed note: It is felt that early morning light helps to regulate both mood and sleep. How so? Light striking the retina triggers the optic nerve. The optic nerves cross on the way to the cerebral cortex. Above where they cross is the suprachiasmatic nucleus (SCN). This nucleus, when triggered by light, sends a stimulus to the pineal glad which secretes melatonin thus regulating our circadian rhythm. Below are some ideas about light therapy. This is important particularly in the dark winters we endure in the Pacific Northwest.

Light therapy boxes can offer an effective treatment for seasonal affective disorder. Features such as light intensity, safety, cost and style are important considerations.

By Mayo Clinic Staff

Seasonal affective disorder (SAD) is a type of depression that typically occurs each year during fall and winter. Use of a light box can offer relief. But for some people, light therapy may be more effective when combined with another SAD treatment, such as an antidepressant or psychotherapy, also called talk therapy.

Light boxes are designed to deliver a therapeutic dose of bright light to treat symptoms of SAD. There are many different types of light boxes. All light boxes for SAD treatment are designed do the same thing, but one may work better for you than another.

Talk with your health care provider first

It’s best to talk with your health care provider about choosing and using a light box. If you’re experiencing both SAD and bipolar disorder, the advisability and timing of using a light box should be carefully reviewed with your health care provider. Increasing exposure too fast or using the light box for too long each time may induce manic symptoms if you have bipolar disorder.

If you have past or current eye problems such as glaucoma, cataracts or eye damage from diabetes, get advice from your eye specialist before starting light therapy.

Understanding a light box

A light therapy box mimics outdoor light. It’s thought that this type of light may cause a chemical change in the brain that lifts your mood and eases other symptoms of SAD, such as being tired most of the time and sleeping too much.

Generally, the light box should:

  • Provide an exposure to 10,000 lux of light
  • Produce as little UV light as possible

Typical recommendations include using the light box:

  • Within the first hour of waking up in the morning
  • For about 20 to 30 minutes
  • About 16 to 24 inches (41 to 61 centimeters) from your face, but follow the manufacturer’s instructions about distance
  • With eyes open, but not looking directly at the light

Light boxes aren’t regulated by the Food and Drug Administration (FDA) for SAD treatment, so it’s important to understand your options.

You can buy a light box without a prescription, but it’s best to use it under the guidance of a health care provider and follow the manufacturer’s guidelines. Your health care provider may recommend a specific light box. Most health insurance plans don’t cover the cost.

What to consider

Here are some questions to think about when buying a light box for seasonal affective disorder:

  • Is it made specifically to treat SAD? If not, it may not help your depression. Some light therapy lamps are designed for skin disorders — not for SAD. Lamps used for skin disorders mainly produce ultraviolet (UV) light and could damage your eyes if used incorrectly.
  • How bright is it? Light boxes produce different intensities of light. Brighter boxes will require less time to use each day, compared with dimmer boxes, to achieve the same effect. Usually, the recommended intensity of light is 10,000 lux.
  • How much UV light does it release? Light boxes for SAD should be designed to filter out most or all UV light. Contact the manufacturer for safety information if you have questions.
  • Can it cause eye damage? Some light boxes include features designed to protect the eyes. Make sure the light box filters out most or all UV light to avoid damaging your eyes. Ask your eye specialist for advice on choosing a light box if you have eye problems such as glaucoma, cataracts or eye damage from diabetes.
  • Is it the style you need? Light boxes come in different shapes and sizes, with varied features. Some look like upright lamps, while others are small and rectangular. Smaller light boxes are more portable and easier to pack if you’re traveling during fall and winter. The effectiveness of a light box depends on daily use, so buy one that’s convenient for you.
  • Can you put it in the right location? Think about where you’ll want to place your light box and what you might do during its use, such as reading, doing a craft or watching TV. Check the manufacturer’s instructions, so you receive the right amount of light at the proper distance.

Talk to your health care provider about light box options and recommendations, so you get one that’s best suited to your needs.

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Time to enjoy that Thanksgiving feast

Skyline is serving over 200 people in an overflow of the ODR into the Bistro and Mount Baker Room. Enjoy and give thanks to our wonderful staff.

This Instagram account is our generation's New Yorker cartoons
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Five Readings for Your Thanksgiving Table

by Thomas Friedman in the NYT

I always enjoy Thanksgiving, but I’m particularly going to savor this year’s in light of the midterm elections. They surfaced something beautiful and decent and vitally important in the soul of the nation. It was a readiness to defend the core of our democracy — our ability to peacefully and legitimately transfer power — when it was under imminent threat by Donald Trump and his imitators.

Had we lost our commitment to the solemn obligation that one party smoothly hands off power to another, we’d be totally lost as a country today. But instead, democracy was reaffirmed. Enough Americans — principled Republicans, Democrats and independents — sorted through their ballots and rejected almost all of the high-profile Trumpist election deniers for major state and federal offices.

In “using the tools of democracy to protect democracy,” as Vox put it, they reconnected the country with something deep in our heritage — that losers concede gracefully and move on, and winners win gracefully and govern. In celebration of that tradition, I offer these five readings for your Thanksgiving table:

Sept. 19, 1796, excerpts from President George Washington’s Farewell Address, explaining that he would not seek a third term and the most important lessons he had learned:

“The unity of government which constitutes you one people is also now dear to you. It is justly so; for it is a main pillar in the edifice of your real independence, the support of your tranquillity at home, your peace abroad, of your safety, of your prosperity, of that very liberty which you so highly prize. … You should properly estimate the immense value of your national Union to your collective and individual happiness. … With such powerful and obvious motives to union affecting all parts of our country … there will always be reason to distrust the patriotism of those who in any quarter may endeavor to weaken its bands. …

“The basis of our political systems is the right of the people to make and to alter their constitutions of government. But the constitution which at any time exists, until changed by an explicit and authentic act of the whole people, is sacredly obligatory upon all. The very idea of the power and the right of the people to establish government presupposes the duty of every individual to obey the established government.”

Al Gore’s 2000 concession speech shown in Times Square.

Dec. 13, 2000, Al Gore’s concession speech after the Supreme Court effectively handed the 2000 election to George W. Bush:

“Good evening. Just moments ago, I spoke with George W. Bush and congratulated him on becoming the 43rd president of the United States. … Almost a century and a half ago, Senator Stephen Douglas told Abraham Lincoln, who had just defeated him for the presidency: ‘Partisan feeling must yield to patriotism. I’m with you, Mr. President, and God bless you.’ Well, in that same spirit, I say to President-elect Bush that what remains of partisan rancor must now be put aside, and may God bless his stewardship of this country. Neither he nor I anticipated this long and difficult road. Certainly, neither of us wanted it to happen. Yet it came, and now it has ended, resolved, as it must be resolved, through the honored institutions of our democracy. …

“The U.S. Supreme Court has spoken. Let there be no doubt, while I strongly disagree with the court’s decision, I accept it. I accept the finality of this outcome, which will be ratified next Monday in the Electoral College. And tonight, for the sake of our unity as a people and the strength of our democracy, I offer my concession. I also accept my responsibility, which I will discharge unconditionally, to honor the new president-elect and do everything possible to help him bring Americans together in fulfillment of the great vision that our Declaration of Independence defines and that our Constitution affirms and defends. …

“This is America, and we put country before party; we will stand together behind our new president. … As for the battle that ends tonight, I do believe, as my father once said, that ‘no matter how hard the loss, defeat might serve as well as victory to shape the soul and let the glory out. …’

“And now, my friends, in a phrase I once addressed to others: It’s time for me to go.”

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