James' World 2

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Last year, a 28-year-old E.R. nurse named Tristin Smith took her own life. Her father found a note among her effects, titled Letter to My Abuser. “Ever since I was young, I expressed interest in healthcare,” she wrote. “I gave my heart, my body, and my mind to you.” But as “unnecessary” support staff was cut, the quality of care plummeted. Requests for more resources were met with online training sessions telling nurses “to just smile more and be friendlier to patients.” Instead of receiving the “support we deserve, we get a pizza party and free pens for the ‘healthcare heroes.’” Her disillusionment deepened: “You use and exploit us to line your pockets, using the common citizen’s money for overpriced healthcare.” For me, as an emergency physician, Tristin’s words ring with startling clarity. I know firsthand the challenges of constantly doing more with less. I recognize the surreal disorientation of having real needs met with empty gestures, like free pens or a hospital potato. I have felt that the systems in which I work no longer value me, or the patients whom I treat. But the most astute aspect of Tristin’s letter is the culprit she points to for these problems: an obscenely expensive health care system that values profit above all else, to the detriment of patients and providers alike.

We in the medical profession are all, to varying degrees, like Tristin. A survey of over 12,000 physicians released last month by the American Medical Association found that 48 percent of them had at least one symptom of burnout. Another survey last month found that nearly two-thirds of physicians would not recommend a career in medicine to their children. It’s not just physicians, of course: Health care providers of all kinds are burned out and considering leaving their jobs. “That’s a disaster for a system that is already struggling to fill critical roles,” said L. Casey Chosewood, an official at the National Institute for Occupational Safety and Health, NIOSH.

This is a massive problem not only for our health care system but for every single person in America who depends on it. Burnout is associated with medical errors and malpractice litigation; hospital-acquired infections; and anxiety, depression, and suicidality among providers. Physicians with burnout are twice as likely to leave their jobs and five times more likely to quit medicine entirely, at an annual cost as high as $6 billion. For nurses, the annual cost of turnover related to burnout is estimated at $9 billion.

The pandemic clearly made burnout worse, for obvious reasons. But things aren’t improving, even though the acute crisis of Covid has passed. Why not?

There was a time when remedies for burnout in health care emphasized resilience and individual action. In 2021, at the height of the delta variant of Covid, I assessed my own level of burnout using a standard metric, the Maslach Burnout Inventory. No surprise: I was suffering from significant burnout. The MBI offered unhelpful suggestions like “step up self-care practices” and “attend presentations, meetings, and workshops on burnout.”

Fortunately, this attitude seems to be evolving. Last year, the U.S. surgeon general published a report that called for “systems-oriented, organizational-level solutions” over “individual-level support.” In November, NIOSH launched a new campaign to address burnout called Impact Wellbeing. Chosewood, whose office will coordinate the effort, acknowledged that resilience training was like a “Band-Aid on a gaping wound.” Instead, the campaign promises to help hospital leaders “address the systemic factors at the root of staff burnout.”

Directing attention toward the health care system itself is progress. But what are the systemic factors at the root of burnout? According to the National Academy of Medicine, they include excessive workload, longer working hours, inadequate staffing, insufficient time with patients, and high administrative task burden. I can attest that all of these contribute to burnout. However, these factors are only symptoms of a larger, more central problem.

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As I watched my parents’ generation reach their 80s, I was struck by the dramatic dif­fer­ences among them. A handful suffered from dementia, but many others remained cognitively sharp—even if their knees and hips didn’t quite keep up with the speed of their thoughts.

That observation runs counter to prejudices about aging, which were high­lighted early in the 2024 presidential race between elderly candidates, but these biases permeate society in general. “The belief about old people is that they’re all kind of the same, they’re doddering, and that aging is this steady downward slope,” says psychologist Laura Car­sten­sen, founding director of the Stanford Center on Longevity. That view, she says, is a great misunderstanding.

Instead, research highlights the very differences I noticed. In our 40s, most people are cognitively similar. Divergences in cognition appear around age 60. By 80 “it’s quite dramatically splayed out,” says physician John Rowe, a professor of health policy and aging at Columbia University’s Mailman School of Public Health. Yes, there will be a group diminished by dementia and cognitive decline, but in general the 80-somethings “include the wisest people on the planet,” Carstensen says.

Focusing on only those with poor brain health misses more than half the population. Rowe led research showing that in the six years after turning 75, about half of people showed little to no change in their physical, biological, hormonal and cognitive functioning, whereas the other half changed quite a lot. A longer-term study followed more than 2,000 individuals with an average age of 77 for up to 16 years. It showed that the three quarters who did not develop dementia showed little to no cognitive decline.

Some of this is related to genetics. Studies of successful aging have shown that genes account for 30 to 50 percent of physical and cognitive changes. But factors like a healthy way of life and good self-­esteem are also consequential. So to an extent, Rowe says, “this is really good news because it means that you are, in fact, in control of your old age.”

Research has also busted the myth that there is no upside to aging past 70 or so. “We have found very clearly that there are things that improve with age,” Rowe says. The ability to resolve conflicts strengthens, for instance. Aging is also associated with more positive overall emotional well-being, which means older adults are more emotionally stable than younger adults, as well as better at regulating desires.

The normal aging process does bring changes to the brain, says Denise Park, a neuroscientist at the University of Texas at Dallas. There is some shrinkage in the frontal lobes and some damage to neurons and their connections. Cognitive processing slows down. Yet that slowdown is usually on the order of milliseconds and doesn’t always make a meaningful difference in daily life. And to compensate, older people activate more of the brain for tasks such as reading. “Older adults will often forge additional pathways” for particular activities, Park says. “Those pathways may not be as efficient as the pathways that younger adults use, but they nonetheless work.”

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Jay Bendt

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Since mindfulness is something you can practice at home for free, it often sounds like the perfect tonic for stress and mental health issues.

Mindfulness is a type of Buddhist-based meditation in which you focus on being aware of what you’re sensing, thinking, and feeling in the present moment.

The first recorded evidence for this, found in India, is over 1,500 years old. The Dharmatrāta Meditation Scripture, written by a community of Buddhists, describes various practices and includes reports of symptoms of depression and anxiety that can occur after meditation.

It also details cognitive anomalies associated with episodes of psychosis, dissociation, and depersonalization (when people feel the world is “unreal”).

In the past eight years, there has been a surge of scientific research in this area. These studies show that adverse effects are not rare.

A 2022 study, using a sample of 953 people in the US who meditated regularly, showed that over 10 percent of participants experienced adverse effects which had a significant negative impact on their everyday life and lasted for at least one month.

According to a review of over 40 years of research that was published in 2020, the most common adverse effects are anxiety and depression. These are followed by psychotic or delusional symptoms, dissociation or depersonalization, and fear or terror.

Research also found that adverse effects can happen to people without previous mental health problems, to those who have only had a moderate exposure to meditation and they can lead to long-lasting symptoms.

The western world has also had evidence about these adverse effects for a long time.

In 1976, Arnold Lazarus, a key figure in the cognitive-behavioural science movement, said that meditation, when used indiscriminately, could induce “serious psychiatric problems such as depression, agitation, and even schizophrenic decompensation”.

There is evidence that mindfulness can benefit people’s wellbeing. The problem is that mindfulness coaches, videos, apps, and books rarely warn people about the potential adverse effects.

Professor of management and ordained Buddhist teacher Ronald Purser wrote in his 2023 book McMindfulness that mindfulness has become a kind of “capitalist spirituality”.

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CLIMATEWIRE | Wind and solar generated more power than coal through the first seven months of the year, federal data shows, in a first for renewable resources.

The milestone had been long expected due to a steady stream of coal plant retirements and the rapid growth of wind and solar. Last year, wind and solar outpaced coal through May, before the fossil fuel eventually overtook the pair when power demand surged in the summer.

But the most recent statistics showed why wind and solar are on track in 2024 to exceed coal generation for an entire calendar year — with the renewable resources maintaining their lead through the heat of July. Coal generation usually declines in the spring months, due to falling power demand and seasonal plant maintenance, and picks up when electricity demand rises in the summer.

Renewables’ growth has been driven by a surge in solar production over the last year. The 118 terawatt-hours generated by utility-scale solar facilities through the end of July represented a 36 percent increase from the same time period last year, according to preliminary U.S. Energy Information Administration figures. Wind production was 275 TWh, up 8 percent over 2023 levels. Renewables’ combined production of 393 TWh outpaced coal generation of 388 TWh.

“I think it is an important milestone,” said Ric O’Connell, who leads GridLab, a clean electricity consulting firm. “I think you’re seeing a solar surge and a coal decline, and hence the lines are crossing.”

EIA previously reported that renewable generation eclipsed coal in 2020 and 2022 and then repeated the feat in 2023. But those figures notably included other resources, such as hydropower. Now, wind and solar are posed to overtake coal on their own. The pair accounted for 16 percent of U.S. power generation through July, slightly more than coal’s share of the power generation market.

The development comes at a time when the reliability of the electric grid is in the spotlight amid increasing power demand due to the growth of artificial intelligence, data centers, and more frequent and severe heat waves — which drive up air conditioning use. EIA statistics show electricity demand through the first seven months of the year was up 4 percent to 2,436 TWh through the end of July.

The growth in demand has been a boon for power generators. Nuclear generation was 459 TWh through July, a 3 percent increase helped by two new reactors in Georgia coming online within the last year. Hydro was up a slight 1 percent to 159 TWh. Gas has been particularly important for supplying additional demand, increasing 5 percent over 2023 levels to 987 TWh.

Mark Repsher, an analyst who tracks the power industry at PA Consulting Group, said the figures point to larger challenges facing the power grid. Additional power plants that can be turned on at the flip of a switch will be needed to meet demand, he said. The question is whether it will come from natural gas or zero-carbon resources, such as nuclear or geothermal.

“Renewables will continue to be a huge part of the industry, but I think there will be an inflection point where the incremental value of an additional megawatt-hour from renewables will be less than some other alternatives,” he said.

Others were less sure. The rapid growth of wind, solar, and batteries in Texas shows that renewables can be built quickly and stabilize the electric grid, said O’Connell. The state is “sailing through a crazy summer” thanks to record wind, solar, and battery output, he said.

Coal may yet hold off wind and solar with a strong five months to close 2024. But renewables are likely to overtake the former king of the power sector sooner rather than later.

The last coal plant built in the continental United States came online in 2013. American coal capacity then declined 38 percent over the following decade.

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It is considered the body’s most complex organ after the brain and contains over 2 million working parts. About 80% of all learning happens through vision.

So how can we keep our eyes in tip-top condition? And what should we never do if we want them to stay as healthy as possible?

That’s what we — Raj Punjabi and Noah Michelson, the hosts of HuffPost’s “Am I Doing It Wrong?” podcast — asked Dr. Amanda Redfern, an ophthalmologist and assistant professor at Oregon Health & Science University’s Casey Eye Institute, when she recently dropped by our studio.

″[Sleeping with contact lenses in your eyes] is bad. It’s real bad. Don’t do it,” Redfern told us, adding that this even applies to naps. “It’s like a game of Russian roulette.”

That’s because you can get a corneal ulcer, which is an infection on part of the eye that a contact covers.

“It’s not going to happen every time, but when it happens, it’s terrible,” Redfern said. “It can be so bad you could, in really terrible cases, lose your eyeball.”

In less severe situations, Redfern said you could end up with a scar on your cornea.

“If that scar is in the center of your vision, that could affect your vision permanently, unless you get a corneal transplant,” she said.

Redfern also warned us not to engage in any activity that could cause lenses to become compromised or contaminated, including swimming in a pool or lake while wearing contacts or even showering with them.

“The problem with contact lenses is that it will sandwich bacteria between the lens and your cornea, and you can get infected and then have all the complications we talked about,” she said. “In general, we frown upon anything where your eye is going to expose to something nonsterile.”

That includes using tap water to rinse or store lenses.

When asked what she would suggest if someone were on vacation and forgot to bring contact lens solution, pushing them to choose between sleeping while wearing contacts or using tap water to store them, Redfern refused to pick either choice.

“Both of those are awful options,” she said. “I’d rather you [throw the contacts out] and just walk around a little bit blurry for the weekend.”

One thing Redfern does want us to do to keep our eyes healthy? Use eye protection more regularly.

“I always wear eye protection if I’m doing a house project where I’m hammering, sawing — anything where something can fly at my eye,” she said. “Always wear eye protection, because I actually spend half my time seeing hospital consults, and the trauma that you see is just crazy.”

If you end up getting something lodged in your eye, don’t try to remove it yourself. Instead, tape a paper cup over your eye and immediately see a medical professional.

“Pulling it out in an uncontrolled fashion [could cause] the inner contents of the eye to come out with it,” Redfern said.

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August’s full moon is known as the Sturgeon Moon, but this year, it also will be a supermoon and a rare blue moon. Here’s how to see it on Monday night. Stargazers will be treated to a rare celestial event on Monday night as a blue moon rises, although it won’t be a typical blue moon. It will also be the first of four consecutive supermoons.

2 types of blue moons

The blue moon that most people have heard about occurs when there are two full moons in a calendar month, a phenomenon that happens once every two or three years. When this happens, the second one of the month is considered a blue moon.

Monday night’s event falls into a different category, known as a seasonal blue moon.

Each season usually has three full moons, but every few years, a season will have four, with the third of the series being dubbed a blue moon. This summer is one of those rare occasions, and it won’t happen again until May 20, 2027.

After Monday, the fourth and final full moon of the season will rise on Sept. 17, just five nights before the end of astronomical summer.

Does a blue moon actually look blue?

Despite what the nickname suggests, Monday’s blue moon will not take on any strange color and will look like many other full moons throughout the year.

The moon will rise in the east shortly after sunset and will slowly slide across the southern sky throughout the night before setting in the west right around daybreak.

August’s full moon will have many other nicknames, including the Sturgeon Moon, the Black Cherries Moon, the Corn Moon, and the Mountain Shadows Moon.

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August’s full moon will not only be known as the Sturgeon Moon, but it will also rise as a rare seasonal blue moon. Catch the rise of the Blue Sturgeon Moon on Aug. 19.

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Any primary care doctors have had a complicated relationship with tests designed to screen their patients for Alzheimer’s disease. Beyond recommending a few lifestyle changes—tweaks to diet, exercise, and sleep most would recommend anyway—there was little they could do to help patients with a confirmed diagnosis. 

As new drugs expand the options for treating and preventing Alzheimer’s, demand from older people worried about their mental fitness and seeking routine screening for Alzheimer’s and other dementia is expected to rise quickly. In anticipation, several commercial firms are racing to bring to market new digital screening tools that can detect warning signs that the disease could be developing. (Diagnostic tools, by contrast, are used to establish the presence of the disease, usually by detecting amyloid.) Many of these new screening tools use artificial-intelligence algorithms and can be administered by medical assistants without extensive training. They hold out the promise of inexpensive and noninvasive methods of screening people for Alzheimer’s. 

“Dementia is the number-one fear of people over 55,” says David Bates, CEO of Boston-based Linus Health, a digital assessment company. “You have drug companies that are about to be advertising their drugs. And you’re going to have commercials and marketing stoking that fear to drive people to ask for the drug. So you’re going to have this onslaught of demand in the health system. Primary care doctors will not be able to meet that demand. They’re going to get overwhelmed.”

PET imaging and tests of cerebrospinal fluid, which document the presence of amyloid beta plaques in the brain, are currently the gold standard for providing a diagnosis of Alzheimer’s. But these tests are too expensive and cumbersome to administer to meet the anticipated need for Alzheimer’s screening in large populations. Although blood tests that can flag the buildup of amyloid are beginning to emerge from the lab, they are not yet widely available.

For years, primary care physicians have instead relied on pen-and-paper cognitive tests to screen patients with mild cognitive impairment, but these tests can take 20 to 30 minutes to complete and require a trained administrator.  The “reality is primary care doctors don’t have that time,” says Brad O’Connor, CEO of CogState in Australia.

A test sold by Linus Health combines an established pen-and-paper test based on a simple drawing test with added artificial intelligence to make it easier to administer and more powerfully analytic. In the test, a patient is asked to draw a clock with the clock hands indicating a specific time. The task engages disparate areas of the brain involved in motor, visual, analytical and other functions that are often impaired by dementia. 

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Together, they make up a “smorgasbord” that allows people to reap benefits and gravitate to what speaks to them the most, said Sat Bir Singh Khalsa, associate professor of medicine at Harvard Medical School and editor in chief of the International Journal of Yoga Therapy. “It’s about optimizing your functioning and performance as a human being on all levels,” Khalsa said.

Research suggests that yoga may sharpen our minds by honing our ability to regulate stress and use our cognitive resources efficiently. Studies have found that yoga is associated with changes in the brain.

“That’s what yoga is all about. It’s about enhancing psychological and physiological performance,” said Khalsa, who has practiced yoga since he took an undergraduate course on it in 1971.

Yoga may protect against cognitive decline

Yoga has been found to improve attention, processing speed, executive function, and memory in healthy children and adults, according to a 2015 meta-analysis. A 2021 review of randomized controlled trials found that yoga was associated with improved cognition, memory, and executive functions in healthy older adults.

A new study suggests that yoga may also be beneficial for older adults at increased risk for cognitive decline.

Researchers conducted a randomized controlled trial with 79 women, at least 50 years of age, who self-reported cognitive decline and were at increased risk for developing Alzheimer’s disease because of menopause or cardiovascular risk factors.

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Geophysicists have discovered a gigantic hidden ocean beneath Mars’ surface, and they say it could harbor life.

The massive underground reservoir, discovered using seismic data taken by NASA’s InSight Lander, contains enough liquid to cover the entire planet with a mile of water. However, it is far too deep to access by any known means.

Trapped inside a layer of fractured rock 7 to 13 miles (11.5 to 20 kilometers) beneath the Red Planet’s outer crust, reaching the water would require a drilling operation that has yet-to-be achieved on Earth.

But if humans do access it one day, its discoverers say it’s a promising place to search for life. The researchers published their findings Aug 12. In the journal Proceedings of the National Academy of Sciences (PNAS).

“Water is necessary for life as we know it,” study co-author Michael Manga, a professor of earth and planetary science at UC Berkeley, said in a statement. “I don’t see why [the underground reservoir] is not a habitable environment. It’s certainly true on Earth — deep, deep mines host life, the bottom of the ocean hosts life.”

“We haven’t found any evidence for life on Mars, but at least we have identified a place that should, in principle, be able to sustain life,” Manga added.

Dried-up river channels, deltas, and lake beds crisscross Mars’ surface, giving scientists ample evidence that water once existed in abundance on the surface of the barren planet. Yet roughly 3.5 billion years ago, an abrupt change in Mars’ climate stripped the water from its surface.

What caused the rapid desiccation is unclear, although scientists have suggested it could be due to a sudden loss of the planet’s magnetic field, an asteroid impact, or ancient microbial life that broke the planet with climate change. Pinning down the right explanation, and finding out where the water went, has become an important question.

To investigate the planet’s interior for clues, the researchers behind the new study used data collected by NASA’s InSight lander — a robotic seismology lab that studied the interior workings of the Red Planet from 2018 to 2022. InSight’s sensors enabled it to record quakes of up to magnitude 5, which reverberated through the planet in the wake of meteor impacts and shifts from volcanic activity.

By feeding this data into a mathematical model similar to those used to find aquifers and oil deposits on Earth, the scientists mapped out Mars’ interior to find “the thickness of the crust, the depth of the core, the composition of the core, even a little bit about the temperature within the mantle,” Manga said.

Investigation of the deeper crust revealed that it most likely consists of a patchwork of fragmented igneous rock containing more than enough liquid water to fill Martian oceans. This is a sign that the water did not escape into space all those billions of years ago, but instead dripped down into the planet’s crust.

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I hate doing the laundry, which is why I usually send mine out with a service to avoid it altogether. Sometimes, that’s just not possible, though, and I find myself with the boring task of washing and folding a ton of clothes. I don’t believe in needless suffering, so I’ve invested some time and money into making this neverending task less tedious and miserable. Here are some products that help make your laundry day more efficient.

Rethink your hamper

I’ve talked about this before, but you need a hamper upgrade. You need one with wheels (or at least a shoulder strap of some kind) so you can take the laundry to the machine with ease, whether it’s in another room or down the street at a laundromat. Ideally, you should also get one with sections, so you can sort by color, family member, or type of clothing. Overall, look for something like this:

Get tools to help with the job

Keeping your clothes in order and getting them to the machine easily is just the first step toward doing the laundry more efficiently. What you use while actually washing the clothes is also important. My first recommendation is the SockDock, which I’ve had for about two years and has completely cut out the stress of matching my socks up after a wash.

It’s really basic: It’s a stretchy cord on a foot-shaped hook that has dividers along it. I keep mine by the hamper and put each pair of socks I take off right into one of the spaces along the cord. The entire device gets popped in the wash and the socks stay stuck together while they’re in there, so when you pull it out, they’re already in pairs. The time this saves after each wash is significant.

There are other ways to keep your socks in order while you wash, like individual sock clips ($17.90 for 20) or mesh bags ($19.79 for four bags with seven compartments each). I prefer the SockDock because it’s not fussy; I just clip the socks to it, and I’m done without having to zip a bunch of compartments. Still, the mesh bags are handy for a variety of things including and beyond socks, like intimates, headbands, sleep masks, bonnets, scrunchies, or any other small fabric items you need to wash.

Speaking of mesh bags, consider this one that’s specially designed for shoes. Washing shoes can be stressful because they bang around in the machine, which is noisy and can be damaging to both your footwear and your appliances. Use this bag instead, since it attaches to the inside of the washer’s door, stopping the shoes from getting tossed around in there.

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