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Ear Tubes No Better Than Antibiotics for Otitis Media

The debate over tympanostomy tubes vs antibiotics for recurrent acute otitis media (AOM) in young children is long-standing. Now, results of a randomized controlled trial show that tubes do not significantly lower the rate of episodes compared with antibiotics, and medical management doesn’t increase antibiotic resistance.

“We found no evidence of microbial resistance by treating with antibiotics. If there’s not an impact on resistance, why take unnecessary chances on complications of surgery?” lead author Alejandro Hoberman, MD, from Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, told Medscape Medical News.

The study by Hoberman and colleagues was published today in The New England Journal of Medicine.

AOM is the most frequent condition diagnosed in children in the United States after the common cold, affecting 5 of 6 children younger than 3 years. It is the leading indication for antimicrobial treatment, and tympanostomy tube insertion is the most frequently performed pediatric operation after the newborn period.

Randomized controlled clinic trials were conducted in the 1980s, but by the 1990s, questions of overuse arose. The American Academy of Otolaryngology–Head and Neck Surgery Foundation published the first clinical practice guidelines in 2013.

Parents must weigh the pros and cons. The use of tubes may avoid or delay the next round of drugs, but tubes cost more and introduce small risks (anesthesia, refractory otorrhea, tube blockage, premature dislocation or extrusion, and mild conductive hearing loss).

“We addressed issues that plagued older studies: a longer-term follow-up of 2 years, validated diagnoses of infection to determine eligibility, and used rating scales to measure quality of life,” Hoberman said.

The researchers randomly assigned children to receive antibiotics or tubes. To be eligible, children had to be 6 to 35 months of age and have had at least three episodes of AOM within 6 months or at least four episodes within 12 months, including at least one within the preceding 6 months.

The primary outcome was the mean number of episodes of AOM per child-year. Children were assessed at 8-week intervals and within 48 hours of developing symptoms of ear infection. The medically treated children received oral amoxicillin or, if that was ineffective, intramuscular ceftriaxone.

Criteria for determining treatment failure included persistent otorrhea, tympanic-membrane perforation, antibiotic-associated diarrhea, reaction to anesthesia, and recurrence of AOM at a frequency equal to the frequency before antibiotic treatment.

In comparing tympanostomy tubes with antibiotics, Hoberman said, “We were unable to show benefit in the rate of ear infections per child per year over a 2-year period.” As expected, the infection rate fell by about half from the first year to the second in all children.

Overall, the investigators found “no substantial differences between treatment groups” with regard to AOM frequency, percentage of severe episodes, extent of antimicrobial resistance, quality of life for the children, and parental stress.

In an intention-to-treat analysis, the rate of AOM episodes per child-year during the study was 1.48 ± 0.08 for tubes and 1.56 ± 0.08 for antibiotics (P = .66).

However, randomization was not maintained in the intention-to-treat arm. Ten percent (13 of 129) of the children slated to receive tubes didn’t get them because of parental request. Conversely, 16% (54 of 121) of children in the antibiotic group received tubes, 35 (29%) of them in accordance with the trial protocol because of frequent recurrences, and 19 (16%) at parental request.

In a per-protocol analysis, rates of AOM episodes per child-year were 1.47 ± 0.08 for tubes and 1.72 ± 0.11 for antibiotics.

Tubes were associated with longer time until the first ear infection post placement, at a median of 4.34 months compared with 2.33 months for children who received antibiotics. A smaller percentage of children in the tube group experienced treatment failure than in the antibiotic group (45% vs 62%). Children who received tubes also had fewer days per year with symptoms in comparison with the children in the antibiotic group (mean, 2.00 ± 0.29 days vs 8.33 ± 0.59 days).

The frequency distribution of AOM episodes, the percentage of severe episodes, and antimicrobial resistance detected in respiratory specimens were the same for both groups.

“Hoberman and colleagues add to our knowledge of managing children with recurrent ear infections with a large and rigorous clinical trial showing comparable efficacy of tympanostomy tube insertion, with antibiotic eardrops for new infections versus watchful waiting, with intermittent oral antibiotics, if further ear infections occur,” said Richard M. Rosenfeld, MD, MPH, MBA, distinguished professor and chairman, Department of Otolaryngology, SUNY Downstate Medical Center, New York City.

However, in an accompanying editorial, Ellen R. Wald, MD, from the University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, pointed out that the sample size was smaller than desired, owing to participants switching groups.

In addition, Rosenfeld, who was the lead author of the 2013 guidelines, said the study likely underestimates the impact of tubes “because about two-thirds of the children who received them did not have persistent middle-ear fluid at baseline and would not have been candidates for tubes based on the current national guideline on tube indications.”

“Both tubes and intermittent antibiotic therapy are effective for managing recurrent AOM, and parents of children with persistent middle-ear effusion should engage in shared decision-making with their physician to decide on the best management option,” said Rosenfeld. “When in doubt, watchful waiting is appropriate, because many children with recurrent AOM do better over time.”

Hoberman owns stock in Kaizen Bioscience and holds patents on devices to diagnose and treat AOM. One coauthor consults for Merck. Wald and Rosenfeld report not relevant financial relationships.

N Engl J Med. Published online May 13, 2021. Abstract, Editorial

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This post originally appeared on Medscape Medical News Headlines

Amazon upgrades its Echo with new features, better sound and a hidden security camera

Amazon is back with a refresh to its popular Echo Show range of smart speakers. Now, before you get too excited, this isn’t a big redesign and, from the outside, things look much the same as before. That means you get the same neat design with a screen that displays a swathe of information and even your family photo albums. However, under the hood of the new Echo Show 5 and Echo Show 8 are some pretty significant updates including a new in-built camera that can now act as a security cam when you head out for the day.
If you’re worried about what’s happening at home you can now securely access the built-in snapper through the Alexa app to check in and make sure things are as they should be. It’s a very similar feature that was launched on the new premium Echo Show 10 and brings this update to Amazon’s cheaper range of all-screen speakers. And don’t worry if family members think they are being spied on as a message appears on the display revealing that the camera has been activated.

Along with that security update, the Show 8’s new 13-megapixel camera also gets a wide-angle view which allows you to be kept in the shot of your video calls as you move around the room. The upgraded also camera automatically pans and zooms while you’re on video calls, so everyone stays centred in the frame.

The 8-inch screen has also been tweaked with it getting adaptive colour which changes depending on the conditions in the room.

A new and more powerful octa-core processor should help the visuals stay silky-smooth and there are dual stereo speakers for clear, balanced sound.

So that’s the new Echo Show 8 but Amazon is also improving the cheaper and smaller Show 5 as well with an upgraded HD camera that gets double the pixels and there are more colourful designs to choose from when you pop it in your online shopping basket.

Of course, both of these devices still come with Alexa built-in so you can ask a swathe of questions and get a sensible response. The screen can also be used to view content and you can see timers, watch the day’s news and even used the display as a karaoke machine.

Like all Echos, the new Show devices can switch on lights, ramp up the heating and remind you of events simply by asking Alexa.

“Customers love using Echo Show to stay in touch and in the past year have made nearly three times the number of video calls globally than the year prior,” said Eric Saarnio, Vice President, Amazon Devices EU. “With these new Echo Show devices, we focused on creating experiences that would add even more value to our customers — bringing a powerful camera and digital pan and zoom capabilities to the new Echo Show 8, upgrading the Echo Show 5 camera, and adding the ability to securely access the built-in camera to check in on home when you’re away.”

The Echo Show 8 costs £119.99 with the Echo Show 5 now starting from a cheaper price of £74.99.

Amazon says pre-orders start today from Amazon.co.uk as well as Argos, Currys PC World, John Lewis and Very.co.uk. Echo Show 5 is also available at Tesco. Devices will begin shipping next month.

Author:
This post originally appeared on Daily Express :: Tech Feed

Better Survival After Lumpectomy Plus RT vs Mastectomy

Overall survival and breast cancer–specific survival were consistently better for women with early breast cancer who were treated with breast conservation surgery (BCS) followed by radiotherapy (RT) compared to women who were treated with mastectomy (Mx) with or without RT, a large Swedish cohort study indicates.

“Women should be strongly advised to not get more extensive surgery than necessary to excise the tumor ― we need to excise the tumor with clear margins, but [patients] do not benefit from further removal of noncancerous tissues,” commented lead author Jana de Boniface, PhD, Capio St. Göran’s Hospital, Stockholm, Sweden.

“Women may experience a feeling of safety from having the whole breast removed, but they should be counseled that a mastectomy does not result in a better prognosis — probably rather the opposite,” she told Medscape Medical News in an email.

There are also “benefits for quality of life, body image, and social functioning that are reported by many women if they keep as much of their own body intact as possible,” she added.

The study was published online on May 5 in JAMA Surgery

“The most important message from this study is that BCS is safe for our cancer patients, and this confirms data from many prospective randomized trials that it yields outcomes that are at least as good as mastectomy,” commented Lisa Newman, MD, MPH, Weill Cornell Medicine, New York City, who authored an accompanying commentary.

Breast Cancer Register

For this study, de Boniface and colleagues collected data prospectively from the Swedish National Breast Cancer Register on a total of 48,986 patients.

“We included all patients diagnosed as having primary invasive breast cancer from January 1, 2008, until December 31, 2017, who underwent breast surgery,” the investigators explain.

The team took into account comorbidities and the patients’ education, income, and country of birth, as identified from several databases across the study interval.

Women underwent surgery as follows:

  • 59.9% underwent locoregional treatment with BCS with RT (BCS+RT);
  • 25.3% underwent a mastectomy followed by RT (Mx+RT);
  • 4.7% underwent mastectomy without RT (Mx-RT).

The median follow-up was 6.28 years.

Slightly more than one third (35.2%) of deaths that occurred during follow-up were due to breast cancer, the authors note. At 5 years, 91.1% of patients were still alive; the breast cancer–specific survival rate was 96.3%.

However, the breast cancer–specific survival rate was 66% worse among the women who had MX+RT compared to those who had BCS+RT (hazard ratio [HR], 1.66).

The overall survival was 79% worse following MX-RT compared to BCS+RT (HR, 1.79), after adjustment for tumor characteristics, treatment, demographics, comorbidity, and socioeconomic background. (It is well established that mastectomy is more commonly performed in women of lower socioeconomic status as well as in women with comorbidities, de Boniface commented.)

“Honestly, we would have expected that comorbidity and socioeconomic status, being factors that affect treatment choice, would have abrogated any survival differences between the surgical groups, but seeing that this is actually not the case is puzzling and highly interesting, although we have not found any clear causal relationship yet,” de Boniface noted.

Seeing that this is actually not the case is puzzling and highly interesting. Dr Jana de Boniface

She also noted that most women have the option of undergoing BCS, even women with large tumors; it has been shown that they, too, can be safely treated with BCS.

“It is striking that extensive breast surgery is more prevalent in node-positive disease despite suitability for breast conservation, indicating a misconception of safety, probably both from a patient and a physician perspective,” the authors observe.

“This report casts additional doubt on the practice to offer mastectomy to patients who are suitable candidates for breast conservation,” they conclude.

Role of RT

In her commentary, Newman writes that these “fascinating results…challenge the wisdom of prematurely abandoning radiation after BCS for clinically early-stage disease.”

Commenting further to Medscape Medical News, she pointed out that postmastectomy RT was given routinely to the highest-risk mastectomy patients (namely, patients with node-positive disease), so outcomes among these high-risk patients cannot be compared on the basis of whether or not RT was given.

“Similarly, radiation was typically not given to the mastectomy patients with favorable biology — only 3.5% of T1N0 mastectomy patients received RT — so we cannot compare outcomes in these early-stage mastectomy patients based upon whether or not radiation was delivered,” she added.

Moreover, patients who underwent BCS were excluded from the analysis if they did not receive RT, suggesting that physicians may speculate that RT contributed to the survival advantage seen in the BCS group.

However, this does not mean that RT definitively explained the survival advantage in this cohort, she said.

“Ongoing studies evaluating omission of RT as another strategy to deescalate breast cancer treatment will need to be evaluated in the context of these data [that] suggest a possible survival benefit from radiation,” Newman acknowledged.

De Boniface and coauthors and Newman have disclosed no relevant financial relationships.

JAMA Surg. Published online May 5, 2021. Full text, Commentary

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This post originally appeared on Medscape Medical News Headlines

Joe Biden to rely on ‘world class’ Royal Navy as UK capacity hailed ‘better than France’

Last week, two Royal Navy ships – HMS Severn and HMS Tamar – were deployed to Jersey following a protest by roughly 60 French fishermen over post-Brexit rights in the waters surrounding the Crown dependency. It came after France threatened to cut off electricity to Jersey and saw Paris send two of its own vessels to the area “in a spirit of responsibility”. It sparked some concerns that the situation could escalate and led to comparisons between the British and French Navy.
But former Army officer Mr Drummond told Express.co.uk there was no comparison between the two, stating “our capabilities are better than the French”.

He explained: “Our submarine force is modern and extremely capable, even more so when we get the new Dreadnought nuclear submarines.

“We’ve got two aircraft carriers, not one like they are going for – they don’t have the footprint that we have.

“Our frigates set the bar very high – the Type 45 destroyer is a wold class ship.

“We have got mass in our fleet, that they don’t have and of course the Royal Marines who are incredibly capable.

“The Royal Navy is ahead of the French Navy, it’s not bad, we just have a better navy being an island nation.”

Mr Drummond believed his view is reciprocated across the Atlantic, stating that the US President “would almost certainly” believe “our navy is superior to the French”.

He noted how US Marine Corps F-35B Lightning II Joint Strike Fighters flew over 5,000 miles last week for an upcoming deployment aboard the British aircraft carrier HMS Queen Elizabeth.

The fighter jets flew from Marine Corps Air Station Yuma in Arizona to RAF Lakenheath for final training before next month’s deployment.

READ MORE: Biden pushed for UK deal amid Xi and Putin threats: ‘Created Concorde and cracked Enigma’

It has eight RAF and 10 US Marine Corps F-35Bs on board and will be accompanied to Asia by six Royal Navy ships, a submarine, 14 naval helicopters and a company of Royal Marines.

Earlier, other members of the strike group, destroyers HMS Defender and HMS Diamond, also left the naval base in Hampshire.

They will be joined by US destroyer USS The Sullivans and the Dutch frigate HNLMS Evertsen while carrying out visits to India, Japan, South Korea and Singapore.

And Mr Drummond believes it will mark the start of blossoming ties with Washington.

He added: “By us having a carrier strike group we relieve some of the pressure off the Americans in the Middle East and North Atlantic.

“They want theirs to be focused on Asia, so it’s a huge capability we’ve added to support them.”

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This post originally appeared on Daily Express :: World Feed

Did Channing Tatum Say He Has to ‘Get Better at Acting’ So He Doesn’t Have to be ‘Naked’ in Movies?

Channing Tatum has played many comedic, romantic, and action-heavy roles in his acting career, but he is perhaps most well-known for playing a stripper in the “Magic Mike” movies.

During a May 4, 2021, interview on “The Kelly Clarkson Show,” Tatum talked about working out for his on-screen roles. He said, “As someone who works out for a job, I promise you I would not look like this unless I had to be naked in most of my movies mostly. At some point, I got to get better at acting so I don’t have to be naked in all of them.”

Watch the full interview here:

Tatum also applauded those who managed to fit in full-time jobs, child care, and family duties alongside working out and self-care.

Given that he said this in an interview that is available to watch online, we rate this claim as “True.”

Author: Nur Ibrahim
This post originally appeared on Snopes.com

Help! How Can I Be a Better Mentor?

My company started a mentorship program mid-pandemic, and I was assigned to mentor a young and extremely talented colleague. I’m thrilled about this! But I can’t quite shake the feeling that I’m not doing enough for her. We check in regularly and talk about a mix of big-picture issues and specific projects she’s working on, but I don’t control her work assignments, and we can’t meet in person, and I don’t know if I’m having the impact she was looking for when she signed up. How can I be a better mentor?

–New York

The good news, New York, is that simply by having a mentor, your young colleague is already ahead of the game. While 75 percent of professional workers crave mentorship, according to Harvard Business Review, just 37 percent of them say they have a mentor. So take heart that you’re making some sort of difference just by being present.

I will confess, though, to some mixed feelings about company-sponsored mentorship programs. It’s better than nothing, of course: At many (most?) workplaces, you’re left to sink or swim on your own, with some help from a supportive boss if you’re exceptionally lucky. But in my experience, official mentoring programs often feel like they’re more about HR ticking a box than reflecting actual corporate values. Companies often start these efforts in response to employee complaints that they don’t see a path to advancement—and doubly so for women and people of color.

But this approach is a bit of a square peg in a round hole. The biggest problem is that true mentorship is not about helping someone get promoted (or at least not solely so). CEOs need mentorship just as much as their assistants do. And companies are mostly terrible at creating clear paths for advancement, especially for those people they’ve neglected for years or decades. But fixing that requires putting in the hard, slow work of changing the company, not just spending a few hours pairing people up.

In fact, some research has found that women suffer from too much mentorship, when what they actually need is sponsorship—not someone to give them advice, but rather someone advocating for them to get a promotion or a raise. Personally, I’ve encountered many more men eager to offer life lessons, solicited or not, than ones interested in making sure I get credit for my work or a seat at the table for consequential meetings. The latter group, though, is the one who has made the much bigger impact on my career. Meanwhile, my best mentors have always been peers, not superiors—the kind of people I can go to with a “Hey, how are you dealing with this?” or who will suggest my name for opportunities.

None of this is to say that mentorship doesn’t matter, though, or that there’s no point in aspiring to be a better mentor to your young colleague. But in order to do it, you’re going to need to be very clear about her goals. Your question specifies that this is a voluntary program, so understanding what was on her mind when she signed up will be core to a productive relationship. If you didn’t do this earlier, it’s not too late—the first part of your relationship may have been about getting to know each other; chapter two can be more mission-focused.

A disproportionate amount of the burden of making a relationship feel fruitful is necessarily going to fall on the mentee, not the mentor. Only she knows how you can be most helpful to her, and you should ask her directly. (People are often afraid of awkwardness when asking “What do you want from me?” but OOO comes down firmly on the side of being direct.) Does she aspire to a career like yours? Does she need a senior person to whom she can put questions too delicate to take to her boss? Or is she mostly looking for someone to bounce ideas off?

Author: Megan Greenwell
This post originally appeared on Business Latest

Weyerhaeuser vs. Rayonier: Which Lumber Stock is a Better Buy?

Author: StockNews
This post originally appeared on Stock Market News

Weyerhaeuser vs. Rayonier: Which Lumber Stock is a Better Buy?© Reuters. Weyerhaeuser vs. Rayonier: Which Lumber Stock is a Better Buy?

Lumber has recently hit an all-time high due to soaring demand driven by industrial and residential activities. We believe Weyerhaeuser (WY) and Rayonier (NYSE:) are well-positioned to capitalize on rising lumber prices. But let’s find out which of these stocks is a better buy now.Weyerhaeuser Company (NYSE:) manufactures and sells forest products. The company operates through three main business segments—timberlands, wood products, and real estate, energy & natural resources. Its wood products segment delivers lumber, structural panels, engineered wood products and complementary building products for residential, industrial and light commercial applications.

Rayonier Inc . (RYN) is a leading timberland real estate investment trust with assets located in some of the most productive softwood timber growing regions in the United States and New Zealand. The company operates through seven segments—Southern Timber, Pacific Northwest Timber, New Zealand Timber, Timber Funds, Real Estate, Trading, Corporate and Other.

The U.S. lumber market has been witnessing a soaring demand since the economy began recovering. Given low inventories, rising demand from industrial and residential activities has caused lumber prices to spike on April 19 to an all-time high of $ 1,328.50 per thousand board feet. The booming housing market, the country’s anticipated infrastructure developments and home improvement trends should keep driving lumber prices. Indeed, the global reclaimed lumber market size is expected to grow at a 4.6% CAGR to reach $ 70.37 billion by 2028.

Continue reading on StockNews

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Mosaic vs. Scotts Miracle-Gro: Which Fertilizer Stock is a Better Buy?

Author: StockNews
This post originally appeared on Stock Market News

Mosaic vs. Scotts Miracle-Gro: Which Fertilizer Stock is a Better Buy?© Reuters. Mosaic vs. Scotts Miracle-Gro: Which Fertilizer Stock is a Better Buy?

The fertilizer industry is well positioned to capitalize on rising food prices. That is why domestic fertilizer companies Scotts Miracle-Gro (SMG) and Mosaic (MOS) are increasing their production. But let’s find out which of these two stocks is a better buy now.The Scotts Miracle-Gro Company (NYSE:) manufactures, markets and sells branded consumer lawn and garden care products worldwide. The company operates through three segments—U.S. Consumer, Hawthorne and Other. In addition, it offers hydroponic products and lighting components that help in growing plants and vegetables indoors, using little or no soil. It serves home and garden centers, nurseries, large hardware chains, e-commerce platforms, and food and drug stores.

The Mosaic Company (NYSE:) produces and markets concentrated phosphate and potash crop nutrients in North America and internationally. The company operates through three segments—Phosphates, Potash, and Mosaic Fertilizantes. In addition, it provides nitrogen-based crop nutrients and animal feed ingredients, and other ancillary services. MOS sells its products to wholesale distributors, retail chains, farmers, cooperatives, independent retailers, and national accounts.

The huge rise in food consumption during the COVID-19 pandemic has benefited the fertilizers industry, resulting in record net sales last year. However, the high demand for fertilizers to get good crop yields had caused a shortage in the supply of potash and phosphate, two major components used in producing fertilizers, leading to a rise in their prices.

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Texas lawmaker pushes for bill to better track data on moms dying, barely surviving childbirth

AUSTIN (KXAN) – Jamie Brown-Rosas had a healthy pregnancy and didn’t think she would have any complications delivering her baby girl. 

Jamie Brown-Rosas is a HELLP syndrome survivor. The complication impacted the delivery of her daughter and years later son. (Courtesy: Jamie Brown-Rosas)

But she quickly realized something was wrong right before her delivery in June of 2018. She remembers being told that she couldn’t get an epidural because her blood platelets were severely low and she was at risk of bleeding out. 

“When they’re telling you all of this, you’re just, you don’t even know what to say. You have a baby you’re trying to deliver, and they’re giving you all this information and it’s the first time you’re hearing it. So, it’s very scary,” explained Brown-Rosas.

The former Austin resident now lives outside of Houston and was diagnosed with HELLP syndrome during the birth of her daughter. It would be a complication that would reappear again during the delivery of her second child, a baby boy. 

According to the March of Dimes[1], HELLP syndrome is a serious pregnancy complication that affects the blood and liver. HELLP stands for hemolysis, elevated liver enzymes, and a low platelet count. 

“You think this is a completely natural occurrence to, to be pregnant and to have your baby in the hospital. And when it’s not, it’s very scary and it’s even scarier when you could possibly lose your life, lose your baby,” said the mom.

Better tracking 

The complication is one State Rep. Shawn Thierry, D-Houston, said should be tracked by the state. 

She refiled a bill this session that would create the development of a work group to establish the first statewide, online maternal mortality and morbidity data registry. 

The work group would include members with appropriate expertise including physicians, an epidemiologist and a number of others with experience in maternal health.

The web portal would collect and store data from hospitals and other health care providers across the state on deaths during or within one year of delivery and near deaths.

KXAN’s “Mothers Erased”[3] investigation in 2019 highlighted problems with how the state tracks maternal deaths and near-deaths data. 

“We had inconsistent data in Texas. The collection process was not the same,” explained Thierry. “For example, if a woman died 43 days after giving birth that was not considered a maternal mortality whereas the woman who died 42 days before would be.”

House Bill 136[4] would require that data to be collected on a daily basis and would also include the most high-risk conditions and complications. Demographic data and patients health benefit coverage status would also be detailed. 

The Department of State Health Services would oversee the data registry.

“If we do not begin to use a uniform process and start to collect this data in real time, we’re going to be talking about this for years to come – decades we’ll still be talking about the maternal and morbidity rates in Texas,” said Thierry. 

Future at a standstill 

The bill was referred to the Public Health Committee in late February, but there hasn’t been much other movement. 

Thierry hopes a hearing will be scheduled in the next few weeks. Last session, the bill cleared the same committee but never made it to the full chamber. 

“We’ve still got a little time but the clock is ticking for session. So my hope, my wish and my prayer is that I will get a hearing for this bill,” said Thierry. 

She said funding for the bill would come out of the state budget which already has set aside money for improving maternal health. 

Thierry explained that the data can lead to programs and services to improve outcomes. 

“I’ve lived this and at the time – when in 2012 – when I had my daughter and almost lost my life, I had no idea what the statistics were,” said Thierry. I didn’t know that Black women were three times more likely to die in childbirth. I didn’t know that all women in Texas were dying at higher rates than women around the country.”

She explained that the pandemic has really shown the importance of prioritizing women’s health. 

This session she’s also filed bills that push for doula services[5] to be included in Medicaid coverage and she said that the state needs to extend Medicaid eligibility[6] after a pregnancy. 

Survivors push for awareness

After her HELLP syndrome diagnosis during the birth of her daughter, Brown-Rosas said she was closely monitored during her second pregnancy. 

Jamie Brown-Rosas had her baby boy during the pandemic. She said this pregnancy was closely monitored. (Courtesy: Jamie Brown-Rosas)

Though she said she was more prepared she ended up having an emergency C-section during her baby boy’s delivery six months ago.

Once again her blood platelets dipped low and this time the umbilical cord was also wrapped around the baby. 

“I do remember laying on the operating table, wondering if him and I were gonna make it,” said Brown Rosas. “So, it’s intense.”

The mom is grateful that she and her babies survived complications twice. 

She is now pushing for more awareness and believes a data registry would give moms like her a better idea of what’s happening statewide with deaths and complications. 

“Knowledge is power, so we need it,” said Brown-Rosas.

References

  1. ^ March of Dimes (www.marchofdimes.org)
  2. ^ KXAN Investigates: Mothers Erased (www.kxan.com)
  3. ^ “Mothers Erased” (www.kxan.com)
  4. ^ House Bill 136 (capitol.texas.gov)
  5. ^ doula services (capitol.texas.gov)
  6. ^ extend Medicaid eligibility (capitol.texas.gov)

Arezow Doost

Man Utd boss Ole Gunnar Solskjaer has found better Henrikh Mkhitaryan after Granada win

The last Manchester United player to score six or more European goals in a single campaign was Henrikh Mkhitaryan. But Marcus Rashford has now overtaken that tally, nothing seven in both the Europa League and Champions League combined. The England international scored as Granada were beaten 2-0 in Spain, with Bruno Fernandes scoring another.
Manchester United went into their game against Granada looking to take a giant step towards the Europa League semi-finals.

And though it wasn’t pretty, the Red Devils got the job done – boosting their hopes of ending a four-year wait for silverware in the process.

Rashford opened the scoring United, with Fernandes then joining him on the scoresheet from the penalty spot.

The England international latched onto a looping ball from Victor Lindelof – whose execution was similar to Toni Kroos’ effort against Liverpool on Tuesday night,  to keep his cool and beat Rui Silva with a composed finish – helping his side to a healthy first leg lead in the process.

And his goal was his seventh in European competitions this term, beating the six achieved by Mkhitaryan in the 2017/2018 campaign.

That year, the Armenia international was on song when it came to the tournament – notching six times including against Ajax in the final.

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Though he struggled in the Premier League under Jose Mourinho, his goals helped the Portuguese win the Europa League that very same year.

Mkhitaryan was a dud signing for the club. But, in the Europa League, he produced his best showings before eventually being offloaded to Arsenal.

And, now, Rashford is coming good in the same competition – though has already outshone his former team-mate when it comes to the Premier League.

Five of the England international’s European goals this season came in the Champions League, a competition the club exited far too soon for their own liking.

And, now, he’s scored two in the Europa League – against Granada and Real Sociedad respectively.

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In the Premier League, Rashford has bagged 10 goals and registered seven assists from 30 matches. More than Timo Werner, Raheem Sterling and Pierre-Emerick Aubameyang.

So that brings him to 20 for the season, with many matches still left to play.

He was taken off with 25 minutes left to play, a Solskjaer move that was hailed by Robbie Savage, after limping several times throughout the game.

The Norwegian had warned fans he wouldn’t risk Rashford before the game, saying: “I don’t think he’ll be a 90-minute man.

“I don’t pick players when we know there’s a risk. Of course there’s always a risk when you step onto the pitch and play football.

“If the medical advice is there’s too much risk to play him, I will never ever play a player that we know about in advance, or if he’s going to make it worse and it’s a serious one.

“His back has recovered but he’s a tough one. He wants to play and give his all for Man United. It’s also the responsibility of the player to tell us as he did on Sunday and say no it’s too sore, I’ve got to come off.”

There were other positives for United on the night as well, despite the game requiring plenty of digging in.

A clean sheet for David De Gea on his return to the side, having recently been dislodged by Dean Henderson for the 2-1 victory over Brighton at Old Trafford, while a moody Fernandes smiled again after finding the net.

Paul Pogba looked sturdy being deployed in a central midfield role, as opposed to the wide role he’s been given by Solskjaer at times throughout the season, despite being given a yellow card early on.

And Scott McTominay was a good partner in crime, though will be missed in the second leg.

The Scotland international is becoming a vital asset under Solskjaer and likely explains the lack of Donny van de Beek, who continues to be overlooked.

It’s been a torrid first season at Old Trafford and the fact he was left unused until late on, in arguably their most-important match of the season with a trophy and Champions League football at stake, speaks volumes about his current status.

But one blow will be the absences of the key trio Maguire, Shaw and McTominay.

Overall, this wasn’t one for the highlights reel – even if Maguire tried to make it one with many shots from distance.

Yet United are on track to win a trophy and finish second in the Premier League table. For Solskjaer, that’ll be the biggest positive of all.