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Photo courtesy Los Angeles Unified School District

Felix Quinez, an elementary school P.E. teacher in Los Angeles Unified, leads his students in physical exercises online.

Felix Quinez, an elementary school P.E. teacher in Los Angeles Unified, leads his students in physical exercises online.

Imagine trying to work out in a crowded living room, with no exercise equipment besides rolled-up socks and soup cans.

For many students in California, thats what physical education class looks like these days. Since campuses closed in March, P.E. teachers are scrambling for creative ways to keep students physically active with no gymnasiums, sports fields or playgrounds at a time when experts say students physical and mental health is paramount.

P.E. has been one of the most challenging subjects to teach online. Teachers are working incredibly hard, said Patricia Suppe, president of the California Association for Health, Physical Education, Recreation and Dance. But the irony is, students need P.E. now more than ever, not just for physical health but mental health.

Even before the pandemic, children in California suffered from higher-than-average rates of obesity. According to 2019 data compiled by the Robert Wood Johnson Foundation, 17.1% of children ages 10-17 in California are obese, compared to 15.5% nationwide. Now, with children spending more time in front of screens and less time engaged in physical activity, the obesity rate is expected to jump in 2020.

Schools are required to provide physical education while campuses are closed, but in March, Gov. Gavin Newsom waived the minimum number of P.E. minutes schools had to offer. Previously, the law required that students receive 200 minutes of physical education every 10 days in elementary school, and 400 minutes every 10 days in middle and high school.

Most schools in California are offering some sort of virtual P.E., at least a few hours a week, Suppe said.

The challenges are many. Some students live in neighborhoods where its not safe to run or walk outside. Others live in apartments with no yards. In many cities, parks are closed due to the pandemic. And in much of California, extreme heat or smoke has limited students access to the outdoors, regardless of other issues.

A survey of 489 P.E. teachers in California, conducted this fall by Suppes organization, found other obstacles, as well. Students often turn off their cameras, so teachers cant see if students are exercising; many districts have eliminated P.E. as a stand-alone class or made it an elective; and teachers are worried about liability if students injure themselves while exercising at home.

Despite these hurdles, P.E. teachers are trying to keep students active and physically healthy during the pandemic. For starters, theyve designed workouts that can be done safely indoors, using common household objects that can be fashioned into exercise equipment. A few examples include:

Where possible, teachers are urging students to go for bike rides, hikes, jogs or walks, logging their distance and time. Other teachers are distributing basic equipment for students to use at home, such as jump-ropes, hula hoops, balls and stretch bands.

Felix Quionez, who teaches P.E. in elementary schools in Los Angeles Unified and was a district Teacher of the Year for 2019-20, has taken his lessons far beyond push-ups and jumping jacks. He talks to his students about all aspects of health, including the harmful effects of sugar, the importance of warm-up and cool-down routines and how physical activity can reduce anxiety and boost mental health overall.

Throughout every class, he asks his students to use emojis to show how theyre feeling emotionally, and adjusts his lesson plan accordingly.

Its not just movement for movements sake, he said. Its about brain health. Its about how exercise can give you a mindset to help you deal with challenges.

Its not just that exercising is good for childrens health; its also that not exercising can be particularly harmful, said Adriana Valenzuela, who oversees P.E. for Los Angeles Unified. She described the phenomenon as a double whammy.

Sitting for long periods can make one feel sluggish, mentally foggy and irritable or depressed, which in turn can make one not want to exercise, she said.

Thats why its so important that we teach students not just how to exercise, but why to exercise, she said. And its not just about kids. We try to reach families, too.

Dr. Susan Babey, senior research scientist at UCLAs Center for Health Policy Research, said the stakes for childrens health are high, and go far beyond P.E. Risk factors for obesity all appear to be on the rise.

Students who rely on healthy meals from school lunch programs might not be getting them, and are eating more junk food and snacks at home. Students are more sedentary, spending hours every day in front of computer screens. And even outside P.E., students are getting far less physical activity than they once did because theyre missing soccer, baseball and other extracurricular sports, after-school programs and even recess.

These were already problems for many students, but the pandemic has exacerbated them, Babey said.

The lack of physical activity can have a ripple effect, affecting students mental and emotional well-being, as well as their ability to focus on academics, she said.

Thats a chief concern for Michele Pacheco, manager of P.E. for Fresno Unified. She worries that without regular exercise, students wont be able to cope with the stress and uncertainty many are facing.

Lack of, or limited, physical education also has a social cost, she added. Playing sports is a way to make friends and connect with peers in an informal context, and can help students learn important social-emotional skills like how to win, how to lose and how to support your teammates. Students are also typically better behaved after exercising, she said.

P.E. is so critically important for kids, Pacheco said. It helps with emotional regulation, helps you do better in class, gives you a better outlook. It releases feel-good hormones and helps you better retain information. Your whole brain lights up.

But more than anything else, physical activity is fun something in short supply these days. Dancing, running around with friends, riding a bike those are the joys of childhood (and adulthood), said Terri Drain, president-elect of the Society of Health and Physical Educators and a retired P.E. teacher in Pleasanton.

Those moments of happiness can help students endure the more challenging times, she said.

Movement is an opportunity to experience intrinsic satisfaction, to know what it is to be alive, she said. Kids who learn these skills do better in school, and in life. My heart breaks for kids who arent able to be physically active right now.

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Ever since he contracted the coronavirus in mid-March, Jake Elsas, 53, has spent every waking moment feeling like hes had the worst sleep of his life. The kind of sleep where a person fitfully rolls around for hours and, once in temporary slumber, has nothing but anxiety dreams and nightmares. Tired and groggy and lethargic, the cobwebs in my head become an impermeable blanket. And thats on agoodday, said Elsas, who lives in Atlanta.

On anot-so-good day, he experiences a complete meltdown. Elsas says the exhausting crash (also known as a flare or post-exertional malaise) is brutal and terrifying. Hes theexecutive director of a nonprofit art and history center.

This was the sickest I have ever been in my life. My skin was really trashed. I looked gray, pallid and wrinkly, and felt like I had aged about 10 years in less than two weeks,

On top of brain fog, Elsas suffers from what he describes as a perfect storm of coughing, sweating and debilitating fatigue, now accompanied by ringing in his ears, or tinnitus.

And he is one of the lucky ones. As sick as he was with COVID-19, Elsas was never hospitalized, never on a ventilator, had no fever and had no trouble breathing, even at his worst.

Yet six months after falling ill, he still feels terrible.

Elsas is one of the so-called long haulers, also known as having long COVID or post-COVID syndrome. They experience persistent symptoms long after recovering from the acute phase, which often was relatively mild. Their recovery is erratic, with continuing and even new symptoms that fluctuate in intensity.

The Centers for Disease Control and Prevention (CDC) found that about a third of people with milder bouts of COVID-19 who hadnt been hospitalized hadprolonged illness and persistent symptomsfor weeks after contracting the coronavirus. On his nightly cable show, CNNs Chris Cuomo often talks of his own experience as a long hauler.

Related: A lung doctor on what shes learning about coronavirus long haulers

The COVID-19 Long-Hauler SymptomsSurvey Report,conducted by Natalie Lampert at Indiana University School of Medicine, surveyed more than 1,500 people from the online support groupSurvivor Corps.The most common symptoms were severe fatigue, muscle or body aches and respiratory issues, including shortness of breath or chronic cough. Many also reported fever, chills, hair loss, racing heart, palpitations and other symptoms.

A May 2020 patient-ledsurveyof 640 long haulers, done by theBody Politic COVID-19 Support Group,found that at the time of the survey, more than 90% had not yet fully recovered. Most of the respondents had not required hospitalization. The support group was started by journalist Fiona Lowenstein, a long hauler who contracted the virus in March at age 26.

A follow-up three months later found that the majority of individuals had symptoms 20 to 25 weeks after the initial illness. There was a surprising preponderance of neurological issues, with many experiencing brain fog, memory problems, headaches, insomnia and depression/anxiety.

Dr. Joan Bosco, a primary care physician at the Center for Post-COVID Care at Mount Sinai in New York City, found that in the patients she treated during a two-month period, fatigue was the number one presenting symptom, followed by shortness of breath, cognitive impairment, neuropathy (numbness/tingling), anxiety, nightmares and alterations in taste/smell.

Bosco notes that in the patients she has seen, Age hasnt seemed to factor into who will develop residual symptoms. I have seen previously healthy 20-year-olds who still cant get out of bed, and 70-year-olds who are back to their regular workout routines.

David Putrino, a neuroscientist at Mount Sinai Hospital,studied1,400 long haulers and found the majority are women, with an average age of 44.

More: Encouraging news for these long haulers

Early in the pandemic, Mark Smith, 67, a cinematographer in Jersey City, N.J., had COVID-19. This was the sickest I have ever been in my life. My skin was really trashed. I looked gray, pallid and wrinkly, and felt like I had aged about 10 years in less than two weeks, he says. Smith continued to test positive in June, indicating that his viral load was still high.

A racer and cyclist whohad prided himself on his strength and stamina,Smith found his major problems recovering were general weakness and fatigue, along with some COVID-19-related eye, neurological and possible clotting problems. COVID is not a cold, not the flu, not like anything Ive ever experienced, he says.

An August 2020articlepublished in the British Medical Journalstated that COVID-19 tends to affect older people more severely in the acute phase, as well as certain ethnic groups, including people who are Black, South Asian and Jewish.

The article says it is too soon to know if these disparities will persist in long haulers. Many patients, particularly older ones, have co-morbidities (other medical conditions such as diabetes or high blood pressure), which may influence the duration of their post-COVID-19 symptoms.

Cardiac problems such as myocarditis (inflammation of the heart), heart rhythm abnormalities and blood clots are seen more commonly in patients, often older, with pre-existing cardiovascular disease.

Bosco has been struck by how profound some of these COVID-19 residual symptoms are, especially the cognitive impairment and debilitating post-exertional (after activity) malaise.

While I do observe general trends and similarities among the symptomatic post-COVID patients, everyone seems to present with their own unique take or flavor, says Bosco.

She says this post-viral syndrome appears to have many complex factors with inflammation certainly playing a role, as well as physical deconditioning after a severe illness, worsened nutritional status, poor sleep and psychiatric stressors, among others. Given this, there is not a one-size-fits-all explanation or treatment plan.

Because many people did not get tested for the coronavirus, and because of the number of false negatives in those who were, a person can be a long hauler without ever having a positive coronavirus or antibody test.

This has led many patients to complain of medical gaslighting, or minimizing their symptoms. They point out that some health care professionals, and even friends and family, do not comprehend the severity of the post-COVID experience and blame it on anxiety or stress.

Some long haulers are beginning to show signs of a post-viral syndrome known as myalgic encephalomyelitis, also known as chronic fatigue syndrome. Its main feature is complete exhaustion after physical activity or cognitive overload, often worsening 24 hours after the triggering event.

Also read: Pandemic sets record case numbers across the U.S. as White House suggests the crisis is over

Because symptoms must be present for six months, doctors are just beginning to acknowledge that a cohort of patients may end up with this long-term, debilitating disorder.

Yet the news is not all bad. Bosco says one method that is persistently helpful to post-COVID patients is supervised exercise programs that include breathing and chest exercises as well as those that improve physical strength and stamina.

Smith recently ran past the Statue of Liberty from his home. While I still dont feel as good running as I did seven months ago, Iwasable to get out for that run, he says. I have done some hard races over the years and I have the mental framework to persevere. I am continuing to improve and to get my endurance and strength back. For that, I am thankful.

Barbra Williams Cosentino RN, LCSW, is a psychotherapist in Queens, N.Y., and a freelance writer whose essays and articles on health, parenting and mental health have appeared in the New York Times, Medscape, BabyCenter and many other national and online publications.

This article is reprinted by permission fromNextAvenue.org, 2020 Twin Cities Public Television, Inc. All rights reserved.

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Dr. Alejandro Badia

MIAMI (PRWEB) November 04, 2020

Recent studies suggest injuries to the ulnar collateral ligament (UCL) in the elbow are rising, particularly among teenage baseball athletes 15-19 years old, and orthopedic surgeons, like noted hand-and-upper-limb-specialist Alejandro Badia MD, are sounding an alarm. They blame the increase on continued participation in year-round sports programs, heightened competitiveness, insufficient injury-prevention programs, and failure to teach proper body mechanics.

Even more concerning, the documented success of Tommy John surgery as the gold standard for reconstructing a ruptured elbow UCL in adults is often not appropriate for treating less severe UCL injuries in children, including those whose bones are still growing and developing. Yet, we have no long-term research showing what conservative, nonoperative approaches to UCL injuries can help young athletes maintain healthy, functional elbows now and in the future, especially if they intend moving on to professional sports careers, says Dr. Badia, founder and chief medical officer of the Florida-based Badia Hand to Shoulder Center and OrthoNOW and author of the new book Healthcare from the Trenches.

Experts agree. In a study published in the Journal of the American Academy of Orthopaedic Surgeons, authors write that the intensity of training and competition among young athletes can place them at increased risk of acute and chronic [musculoskeletal] injuries, which occur in patterns unique to the skeletally immature athlete. Prompt recognition and treatment of these injuries are critical to prevent long-term functional disability and deformity.

Dr. Badia also cites results of an American Orthopaedic Society for Sports Medicine survey of high-school baseball coaches, players, and their parents. In that survey, a significant percentage of respondents indicate being under the misguided belief that the number of balls thrown at high velocity by a pitcher is not associated with greater risk of UCL elbow damage. Some even suggest Tommy John surgery might be a welcome procedure because they think it improves a pitchers velocity and command.

The UCL is a system of three fibrous tissue bands on the inside of the elbow. One end of the band is connected to the upper-arm bone (humerus) and the other to the ulna on the pinky side of the forearm. The UCL complex plays a critical role in stabilizing the elbow joint, which is formed by the intersection of the humerus, the ulna, and a second forearm bone, the radius (on the thumb side).

Although a traumatic blow to the elbow or a fall on an outstretched arm can rupture the UCL, repeated stress on the elbow from overhead activities, such as throwing a baseball, spiking a volleyball or serving in tennis, is what usually causes the UCL to deteriorate over time, gradually fraying and tearing. In fact, a biomechanical analysis done of professional baseball pitchers and reported in 2016 finds the torque and force of a thrown ball on the elbow and shoulder are equivalent to five 12-pound bowling balls pulling down on [a persons] arm.

Symptoms of a partial or fully torn UCL include pain sometimes intense pain -- on the inside of the elbow when throwing, pain when accelerating the arm forward, and numbness or a tingling sensation in the pinky and ring fingers. The injury, however, does not normally interfere with other activities, including lifting, explains Dr. Badia.

Tommy John surgery named after the professional pitcher on whom the technique was pioneered in 1974 is performed as the reconstructive method of choice for a completely torn elbow UCL, according to Dr. Badia. The procedure involves taking a ligament from elsewhere in a patients body and then grafting it onto the elbow joint as a UCL replacement. The surgery is normally conducted in an outpatient setting and takes about an hour to 90 minutes to complete. The patient can go home the same day.

While experienced orthopedic surgeons are generally agreed on the optimal surgical approach to a ruptured UCL, Dr. Badia says a member survey taken several years ago by the American Shoulder and Elbow Surgeons (ASES) shows lack of consensus regarding non-surgical management of partial UCL tears and ligament strains, particularly in children, adolescents, and athletes who are not professionals. One approach gaining some traction has been injection of a patients own platelet-rich plasma (PRP). In the ASES survey, more than a third of respondents said they use PRP for some UCL injuries.

However, the jury remains out on the effectiveness of PRP, mesenchymal stem cells, and other orthobiologics, Dr. Badia says. For example, a study in the American Journal of Orthopedics concludes that PRP injections may be particularly beneficial in young athletes who have sustained acute damage to an isolated part of the [UCLM] ligament and in athletes unwilling or unable to undergo the extended rehabilitation required after surgical reconstruction of the ligament.

The ideal solution, of course, is to prevent UCL injuries in the first place, Dr. Badia says. He offers the following tips to athletes, coaches, trainers, and parents of young athletes:

Finally, should you, or your athletic son or daughter, develop elbow pain, especially when performing an overhead activity in your sport, do not ignore it. Contact an orthopedic specialist immediately to avoid further damage to the joint, Dr. Badia advises.

Bio: Alejandro Badia, MD, FACS, is an internationally renowned hand and upper-limb surgeon and founder of Badia Hand to Shoulder Center and OrthoNOW, a network of walk-in orthopedic centers. Dr. Badia is the author of Healthcare from the Trenches. http://www.drbadia.com http://www.orthonowcare.com

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Support staff and Black and Latinx hospital employees with and without patient care responsibilities are at highest risk for SARS-CoV-2 infection in health care settings, a Rutgers study found.

After screening 3,904 employees and clinicians at a New Jersey hospital between late April and late June for the SARS-CoV-2 virus and for lgG-antibodies to the virus, whose presence suggests past recent infection, the study, published in the journal Open Forum Infectious Diseases, found that these employees are at higher risk than previously thought.

"The risk to workers in health care settings with little or no patient contact has attracted relatively little attention to date, but our results suggest potentially high infection rates in this group," said lead author Emily S. Barrett, an associate professor at Rutgers School of Public Health and a member of the Environmental and Occupational Health Sciences Institute. "By contrast and to our surprise, physicians, nurses and emergency medical technicians showed much lower infection rates."

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Health care workers who live in highly impacted communities may have been susceptible to becoming infected outside of the hospital during the early surge of COVID-19, according to co-lead author Daniel B. Horton, an assistant professor at Rutgers Robert Wood Johnson Medical School and a member of the Institute for Health, Health Care Policy and Aging Research.

"In the early phase of the pandemic, support staff in the hospital may also have had less access to personal protective equipment or less enforcement of safety protocols," he said. "Going forward, as cases of COVID-19 in the hospital rise again, protecting these and all hospital workers from infection both in and out of the hospital is critical."

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In the hospital-based study, researchers found that 13 participants tested positive for the virus and 374 tested positive for the antibody, which suggests recent past infection nearly 10 percent of those studied and that Black and Latinx workers had two times the odds of receiving a positive test for the virus or antibody compared to white workers.

Phlebotomists had the highest proportionate rate of positive testsnearly 1 in 4 testedfollowed by those employed in maintenance/housekeeping, dining/food services and interpersonal/support roles. By comparison, positivity rates were lower among doctors (7 percent) and nurses (9 percent).

Regardless of whether the infections originated in the hospital or in the community, Barrett said, the results suggest a need to enact safety protocols for hospital employees to protect the health care workforce from future waves of infection.

"The 40 percent of infected health care workers who reported having had no symptoms of infection could be a potential source of SARS-CoV-2 spread in hospitals even if their infections were initially acquired in the community," she said.

The study was funded by the National Center for Advancing Translational Sciences and the National Institute of Allergy and Infectious Diseases at the National Institutes of Health.

Other Rutgers authors include Jason Roy, Weiyi Xia, Patricia Greenberg, Tracy Andrews, Maria Laura Gennaro, Veenat Parmar, William D. Russell, Nancy Reilly, Priyanka Uprety, John J. Gantner, Lydia Stockman, Stanley Z. Trooskin, Martin J. Blaser, Jeffrey L. Carson and Reynold A. Panettieri Jr.

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This will be part of the free-of-charge online Federalist Society convention:

MONDAY, NOVEMBER 9Religious LibertiesReligious Liberty and the New Court11:00 a.m. 12:15 p.m.

Prof. Stephanie Barclay, Associate Professor of Law, University of Notre Dame LawSchoolProf. Gerard V. Bradley, Professor of Law, University of Notre Dame Law SchoolProf. Eugene Volokh, Gary T. Schwartz Distinguished Professor of Law, University ofCalifornia, Los Angeles School of LawMs. Lori Windham, Senior Counsel, The Becket Fund for Religious LibertyModerator: Hon. Neomi Rao, United States Court of Appeals, District of ColumbiaCircuit

My understanding is that Prof. Barclay and Ms. Windham will be on the side of reading the Free Exercise Clause as securing a strong presumption of religious exemptions from generally applicable laws (i.e., applying the Sherbert v. Verner and Wisconsin v. Yoder approach to a wide range of laws), while Prof. Bradley and I will be on the other side (i.e., generally supporting Employment Division v. Smith). Ought to be fun as well as, we hope, enlightening.

Register for the webinars or watch the live streams at https://fedsoc.org/2020nlc.

CLE Instructions are at https://fedsoc.org/nlc-cle (payment is required to get CLE credit, but notif you just want to watch the programs).

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Federalist Society Panel on the Free Exercise Clause Next Monday (the 9th), 11 am to 12:15 pm Eastern - Reason

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When COVID-19 struck, the oncology community, along with health care systems across the globe, faced new challenges. Rutgers Cancer Institute of New Jersey in partnership with RWJBarnabas Health moved quickly to adapt to these new demands and made adjustments to operations in patient care to protect patients, their families and staff.

Andrew M. Evens, the associate director for clinical services and director of the lymphoma program at Rutgers Cancer Institute and the medical director of oncology services at RWJBarnabas Health, discusses the impact of the COVID-19 pandemic on cancer care.

What were the biggest adjustments that occurred to keep patients and staff safe?As New Jersey's only National Cancer Institutedesignated Comprehensive Cancer Center and the state's leading authority on cancer, experts at Rutgers Cancer Institute of New Jersey and RWJBarnabas Health know that cancer doesn't stop, and cancer care simply can't wait. Our primary concern is our patients, and even before COVID-19, we have been concerned about the risk of any patient with cancer contracting infection. We were tasked with meeting the ongoing needs of cancer patients and implementing safety guidelines so essential cancer treatments could continue.

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Several processes and guidelines for reducing the spread of the virus have been implemented at our facilities across the state to ensure that patients can continue to receive their cancer care. These include screening for COVID-19 symptoms upon entry, following strict social distancing measures, prohibiting most visitors, enhancing already rigorous cleaning and disinfecting practices, and mandating a mask or face covering for all patients, visitors and staff. Through these heavy precautions and screening measures, we have maintained a stable environment to continue providing exceptional care to patients throughout the pandemic.

To further promote social distancing, we have leveraged the use of our telemedicine program that we had established last year pre-COVID as a way to better provide opinions from our oncology experts to patients who might be hours away. Some patients might still feel uncomfortable coming into our facilities, so telemedicine has been a highly useful option for managing care and giving patients the assurances that they need during the pandemic, including for new patient consultations.

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How did COVID-19 impact treatment and surgery for cancer patients?Rearranging or delaying cancer treatment because of the coronavirus has remained a highly individualized decision. Cancer experts have an understanding of which cancers need immediate treatment depending on a patient's health, and have the knowledge to determine if treatment would outweigh the risk of the virus. In deciding whether to delay treatment, patients were encouraged to discuss a plan with their expert cancer care team. In New Jersey, surgical care for cancer patients continued during the pandemic. In adherence to all public health guidance and regulatory policies, we enhanced our safety measures to continue preforming essential cancer surgeries.

Currently, all patients are tested for coronavirus prior to undergoing any scheduled surgical procedures or prior to starting chemotherapy. Staff involved in surgical care are screened for exposure and tested for coronavirus as necessary prior to working in the operating room or being involved in a surgical procedure. Additionally, rigorous cleaning and disinfecting practices have been concentrated on surgical and recovery room spaces, frequently touched surfaces, exam rooms and computer terminals. Whatever we face in the coming months, our teams at Rutgers Cancer Institute and RWJBarnabas Health will continue to evaluate these safety practices in accordance with federal, state and local guidance.

How does COVID-19 impact access to cancer screening?At the start of the pandemic, other aspects of cancer care including screenings were put on hold to slow the spread of COVID-19 in healthcare settings, especially in areas of high transmission. Research has shown that new cancer diagnoses have declined, possibly due to delayed cancer screenings or delayed routine appointments. This has led to some cancers being diagnosed at later stages, which can present treatment challenges.

Healthcare facilities continue to schedule routine screenings. Cancer screenings remain important as they help to detect cancer at its earliest stages. We are continuing to communicate with the community that rescheduling your routine screening is safe at this time, and it is imperative to focus on overall health and wellness while continuing to stay committed to preventing the spread of the virus.

Has COVID-19 impacted research or enrollment in clinical trials?Cancer research globally has been impacted due to the pandemic. Across the world, research at cancer centers, academic institutions and within the industry was affected due to mandated procedural shifts, such as how many people were safely permitted inside a laboratory to conduct basic science research. In addition, restrictions also posed some limitations for clinical cancer research. However, Rutgers Cancer Institute did an outstanding job in maintaining enrollment on therapeutic clinical trials throughout the pandemic. Furthermore, Rutgers has designed and opened several clinical trials studying COVID-19, including in cancer patients.

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Its all about stigma. Philadelphia wants to enforce its laws against sexual orientation discrimination, while an agency that contracts with the city wants an exemption, rooted in free exercise of religion, so it does not have to give foster children to same-sex couples. The stigma of racial discrimination was raised at the argument before the Supreme Court in Fulton v. City of Philadelphia, which took place on November 4, 2020. The question is whether the Justices will see sexual orientation discrimination as similarly stigmatic to racial discrimination, or if they will think it is a good thing protected by religious freedom.

Justice Sonia Sotomayor mentioned the role of stigma in antidiscrimination laws. As she put it, the government has a compelling state interest in protecting against racial discrimination. The reason for a compelling state interest was not merely that race was important but that the burden on the people who are rejected because of race is an interest that the state could seek to protect. That a rejection on the basis of race or any protected category creates a stigma on that person, and its a compelling state interest for the state to have an antidiscrimination law on the basis of protecting classes. (emphasis added).

The compelling state interest question arose because Fulton examines the governments approach to sexual orientation discrimination, which is illegal. Justice Anthony Kennedy wrote about the dignity of same-sex marriage in Obergefell v. Hodges: There is dignity in the bond between two men or two women who seek to marry and in their autonomy to make such profound choices. Discrimination on the basis of sexual orientation in the context of employment law is prohibited by Title VII. Philadelphia ended its contract with Catholic Social Services (CSS) because CSS refused to give foster children to same-sex couples. Philadelphia law protects against such discrimination, and should protect against the stigma of discrimination against LGBTQs, which they have long suffered.

Questions about racial discrimination arose several times during the argument. Justice Elena Kagan asked if the compelling state interest test applied to racial discrimination, but not to other forms of discrimination, including gender and sexual orientation discrimination. The Solicitor General, arguing in support of Fulton, did not take a position on the other forms of discrimination, but did say the argument against racism was super compelling.

Justice Amy Coney Barrett asked Fultons lawyer what would happen if an agency opposed to interracial marriage wanted to do business with the city, and refused to give foster children to interracial marriages. Lawyer Lori Halstead Windham replied that the Court would use the strict scrutiny it has always used for racial discrimination, and not allow the exemption.

Justice Stephen Breyer asked the Solicitor Generals attorney Hashim Mooppan, who was arguing in support of Fulton, if he was saying We should write an opinion which says discrimination on the basis of race constitutionally speaking is different from discrimination on the basis of gender, on the basis of religion, on the basis of nationality, on the basis of homosexuality. . . . Is that the opinion you want us to write? The SGs answer was that race is unique.

Justice Sotomayor and others raised the question of what would happen if a contractor could discriminate, not only on the basis of sexual orientation, but if a different contractor wanted to exclude families from other religions or someone with a disability from consideration.

I wrote an amicus brief in this case supporting Philadelphia on behalf of Miguel H. Diaz, Ambassador to the Holy See, Retired; CHILD USA; Dignity USA; New Ways Ministry; the Womens Alliance for Theology, Ethics and Ritual; and the Womens Ordination Conference. Our brief explained that some religions long supported in the past and continue to support racial discrimination. Slaveholders invoked the Bible to support their activity, and much of society accepted the discrimination as a plan of God.

Fortunately the courts have repeatedly explained that racial discrimination is illegal, even when religions want to practice it. Religious organizations do not enjoy religious freedom to stigmatize people of color. We believe the same rule should apply to sexual orientation discrimination, which has long stigmatized LGBTQs wherever such discrimination occurs. The claimed religious need to discriminate against and stigmatize based on sexual orientation is no easier to defend than religiously motivated discrimination based on race. The believers can believe whatever they like and organize their affairs through discriminatory purposes, to be sure, but not when the government is paying and not when the public is impacted.

And that is the beauty of Employment Division v. Smith, the free exercise case that is at stake in Fulton. Smith says everyone has to obey neutral laws of general applicability, without religious exception, as the lower courts said Fulton should do here. Smith protects us from a world in which, once Fulton gets its exception, other contractors get theirs. Fulton can discriminate on the basis of sexual orientation? And then someone else will want to favor one religion over others. Or one gender over another. And so forth. Some of the Justices pointed out all the kinds of discrimination that could occur once one type is allowed. Unfortunately, Fulton and others would like Smith overruled so that they get more religious freedom to discriminate with city funds as a contractor for the government.

The litigants and Justices raised the worry that fewer children will be assigned to foster parents, and great harm is being done by keeping CSS out of the program. Neal Kumar Katyal, Philadelphias lawyer, explained that studies from around the country show that nondiscrimination programs increase, not decrease the number of people available to care for foster children because it opens them to people who had previously been excluded. And new studies suggest that more, not fewer, parents became available when religious agencies closed in Boston and elsewhere.

At the end, Jeffrey L. Fisher, Child Advocates lawyer with Philadelphia, addressed a question from Justice Barrett, who said the law would not really allow an exemption for racial discrimination. Mr. Fisher responded that in the context of this case there was no difference between gender and sexual orientation discrimination and racial discrimination in terms of exemption.

I wait to see what the Court will decide, and hope it will rule against stigma!

Link:
Stigma and the Oral Argument in Fulton v. City of Philadelphia - Justia Verdict

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COVID-19 can do some pretty scary things to the human heart. It can trigger blood clots in severe cases and cause inflammation and scarring.

New research now shows that even young people with COVID-19 who are asymptomatic are at risk for developing potentially dangerous inflammation around the heart.

I am an imaging cardiologist who is developing diagnostic techniques to assess changes in heart muscle function in patients with COVID-19. In a study released Nov. 4, my colleagues and I found evidence of heart abnormalities in over one-third of student athletes who tested positive for COVID-19 and underwent cardiac screening at West Virginia University this fall.

While we didnt detect ongoing damage to the heart muscle itself, we frequently found evidence of inflammation and excess fluid in the pericardium, the sac around the heart. Almost all of the 54 students tested had either mild COVID-19 or were asymptomatic.

Based on our results and other studies, a group of experts convened by the Journal of the American College of Cardiology: Cardiovascular Imaging has also published a list of recommendations for heart testing and recovery times before student athletes return to play.

An important takeaway: Student athletes who test positive for COVID-19 should consult their primary care physicians to determine if heart screening tests are needed even if they never showed symptoms.

There is still a lot we dont know about COVID-19 and its lingering effects on the human body.

SARS-CoV-2, the coronavirus that causes COVID-19, can cause a mind-boggling array of damage, including triggering inflammatory responses in the heart muscle and surrounding tissue as the body tries to fight it off. As many as 1 in 8 hospitalized COVID-19 patients have some form of heart damage.

What we worry most about with competitive athletes is whether the virus can get into the heart muscle and trigger myocarditis, rare inflammation of the heart muscle that can be caused by viral infections. Myocarditis can disrupt your hearts ability to pump blood and cause arrhythmias. It can also cause sudden heart failure in athletes who seemed healthy. If you have myocarditis, you should not be on the field or in training until well after you recover.

A small number of college athletes with COVID-19 are known to have been diagnosed with myocarditis. In one study, Ohio State University doctors tested 26 college athletes in September and found signs of heart inflammation consistent with myocarditis in four.

Myocarditis isnt the only heart problem to worry about, however. Sports doctors for years have warned that athletes who develop pericarditis should not return to play until it resolves.

At West Virginia University, my colleagues and I examined 54 student athletes who had tested positive for COVID-19 three to five weeks earlier.

We didnt find convincing signs of ongoing myocarditis, but we did see a lot of evidence of pericarditis. Among the student athletes screened, 40% had pericardial enhancement, suggesting resolving inflammation in the sac that protects the heart, and 58% had pericardial effusion, meaning excess fluid had built up.

Usually, this kind of inflammation heals within a few weeks with no residual effects. However, in some cases, there can be long-term effects, like pericardial inflammation recurring. It can lead to scarring of the pericardial sac, which in rare cases can be severe, and the pericardium can constrict around the heart. This can lead to symptoms similar to heart failure and cause congestion in the lungs and liver.

Its difficult to predict if a patient will develop any of these rare long-term complications, and its too soon to tell if its happening.

Currently, athletic programs around the country have a patchwork of rules for quarantining and screening COVID-19-positive athletes for heart damage as they try to balance players health and the desire to return to play.

To help them develop standards, I and other cardiologists from the U.S., Canada, U.K. and Australia reviewed the current evidence and wrote an expert consensus statement. A similar statement focused on myocarditis was published by some of the same doctors in JAMA Cardiology.

We suggest the following:

Any student athlete testing positive for COVID-19 should follow quarantine rules and avoid exposing their teammates, coaches or anyone else to the virus.

Before returning to play, athletes who test positive for COVID-19 should consult with their physicians to determine if heart screening tests are needed. Although routine testing is not recommended for all asymptomatic individuals, a physician should determine on an individual basis when the risks are high enough.

If an athlete has active myocarditis, we recommend no competition or strenuous training for three to six months, with follow-up exams with a cardiologist. Exercise can worsen the diseases progression and create arrhythmias, or irregular heartbeat. After that period, the athlete can gradually resume exercise and play if he or she has no lingering inflammation or arrhythmia.

If an athlete has active features of pericarditis, we also recommend restricting exercise, since it can exacerbate inflammation or cause inflammation to return. Athletes should avoid competitive sports during the acute phase. Once tests show no inflammation or excess fluid, the athlete should be able to return to play.

[Deep knowledge, daily. Sign up for The Conversations newsletter.]

COVID-19 is no joke. The best way for athletes to stay healthy so they can keep playing sports is to avoid getting the coronavirus in the first place. Teams should test student athletes for the virus and make sure those who test positive see a doctor to determine if screening tests for heart damage are needed.

Read more:
Even if you're asymptomatic, COVID-19 can harm your heart, study shows here's what student athletes need to know - The Conversation US

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NEW BRUNSWICK, NJ Election Day 2020 is here! You cannot machine vote at the polls on Nov. 3 unless you have a documented disability.

Even if you go to to your regular polling place to vote, you will only be able to vote via a provisional ballot (paper ballot) and they count provisional ballots last, after all the mail-in and machine votes have been counted. County clerks across New Jersey have said the best way to vote is drop your sealed ballot in a ballot drop box Don't forget to sign it.

Middlesex County put ballot drop boxes in New Brunswick in two locations:

Ballot drop boxes are collected and returned directly to the Middlesex County Board of Elections office. These ballots are only handled by designated Board of Elections representatives.

If you are mailing it, you must put the ballot in the mail today so it is postmarked Nov. 3.

Residents can either cast a write-in vote or choose, among the major parties, between Republican President Donald Trump and Vice President Mike Pence, or Democratic former Vice President Joe Biden and US Sen. Kamala Harris. Also running are: Don Blankenship/William Mohr (Constitution Party); Howie Hawkins/Angela Nicole Walker (Green); Jo Jorgensen/Spike Cohen (Libertarian); Gloria La Riva/Sunil Freeman (Party for Socialism and Liberation); Roque De La Fuente/Darcy Richardson (The Alliance Party) and Bill Hammons/Eric Bodenstab (Unity Party).

Congress: One U.S. Senate seat is up for vote: Incumbent Democrat Cory Booker will face Republican Rik Mehta.

Original post:
Voting In New Brunswick: Everything You Need To Know - New Brunswick, NJ Patch

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Army veteran, proud New Yorker, eager to make a lasting social impact.

Hometown: Queens, New York

Fun Fact About Yourself:Last year, I convinced my family to do the Coney Island Polar Bear plunge with me. Afterward, Telemundo asked me for a soundbite on what draws people to continuing the annual tradition of taking a plunge in the bay on New Years Day.

Undergraduate School and Major:

United States Military Academy at West Point

B.S. in Defense and Strategic Studies

Most Recent Employer and Job Title:

U.S. Army

Military Intelligence Company Commander

Aside from your classmates, what was the key part of the schools MBA programming that led you to choose this business school and why was it so important to you? I chose to attend Stern primarily because of its location in the heart of New York City and its focus on IQ + EQ. Stern capitalizes on its location by offering its students opportunities to become immersed in and learn from NYC-based businesses. The schools Stern Solutions experiential learning opportunities and Stern Consulting Corps empower MBA students to solve complex business problems during the semester with esteemed Stern professors help.

What makes you most excited about getting your MBA at NYU Stern? What makes you most nervous? I am most excited about joining the Sternie community. Sterns vast alumni network in NYC has already opened many doors for me. I am most nervous about being a valued contributor considering most of my classmates are incredibly accomplished. Several have years of experience working for prominent firms.

What club or activity excites you most at this school? The Military Veterans Club. Both former and current veterans at Stern were welcoming even before I was officially accepted. I am excited to have a community of people I can lean on and who have a better understanding of what it is like to transition from the military to business.

What word best describes the NYU Stern classmates youve met so far? Why? Trailblazers. My classmates come from all walks of life, but they have one thing in common: they have been agents of change in their previous companies and organizations. Sternies are not afraid to chart their own path, and that mentality is apparent in the conversations we have on a daily basis.

Describe your biggest accomplishment in your career so far: In my last job as a military intelligence company commander, I led a team of 130 soldiers during a training exercise. My company outperformed other intelligence companies in the Army that had gone through the same training exercise. During the 14-day training exercise, our success set new metrics for other intelligence companies in the Army to be graded against.

In preparation for that validating exercise in Louisianas swamps, I developed new systems, implemented a culture change within the company, and redesigned the companys structure to be more decentralized. During the training exercise, we were able to validate a data collection platform in a short period in part because of the new decentralized company structure that allowed my soldiers to be more effective by working in small, symbiotic virtual teams. We also utilized a new virtual cloud system. My company was the first to successfully implement that type of system in a tactical environment during this validating training exercise. I am proud of what my company accomplished because that training exercise was the culminating event of several lines of effort that took months to develop and refine. My companys accomplishments contributed significantly to my brigades overall success during that training exercise.

What led you to pursue an MBA at this point in your career? After serving in the military for eight years, I decided it was time to take the skills I had learned leading teams of soldiers and use those skills to optimize civilian organizations. As a military officer, I enjoyed figuring out ways to help teams accomplish specific objectives. Although there are valuable lessons drawn from the military context, managing a civilian organization is a bit different. Getting an MBA is the first step in bridging the gap between my military experience and my goal of managing and optimizing organizations in the corporate world through personnel and group management.

What other MBA programs did you apply to? Columbia Business School, Georgetowns McDonough School of Business, Vanderbilts Owen School of Management, Rices Jones Graduate School of Business

What was the most challenging question you were asked during the admissions process? The standard Tell me about yourself was the most challenging question to answer. Where do you start with a question like that? What aspect of your life do you focus on? For me, there was the additional challenge of removing military jargon from my vocabulary. After almost a decade of being indoctrinated to speak a certain way and to use specific terminology, it was challenging to break myself of certain speech habits.

How did you determine your fit at various schools? It was important to me to attend a school located in an urban area, primarily because of the increased opportunities to network with a broader range of companies and with individuals from diverse backgrounds. Returning to NYC was particularly appealing because I know the area and my family is here.

What have you been doing to prepare yourself for business school? Among the first things I did when deciding to apply to business school was reflect on my weaknesses. I commissioned into the military immediately after college, so I had no experience working in a civilian organization. I decided to intern with Amazon as a manager in their operations department while I transitioned out of the military through the U.S. Chamber of Commerce Foundations Hiring Our Heroes Program. That experience gave me a glimpse into the cultural and structural difference of working for a civilian organization. It also helped me better explain during the application process how my military experience taught me skills that are transferable to a corporate organization.

What was your defining moment and how did it prepare you for business school? I was a newly-trained intelligence officer during my first deployment to Kandahar, Afghanistan. No training could genuinely prepare me for the challenges of serving as an intelligence officer in that environment, where I was expected to interface with various stakeholders to accomplish mission objectives and help keep US Soldiers safe. I learned to be resilient in almost any stressful situation during that deployment and how to effectively analyze what sometimes felt like an insurmountable amount of data.

On the aircraft back to the US, I reflected on how fulfilling and effective it was to use data to drive strategic change. My time in the military as an intelligence officer has prepared me to tackle business school because I now have a robust foundation of essential skills, including problem-solving, data analysis, and resiliency.

What is your favorite Company, and what could business students learn from them? Besides the United States Army, the company I admire the most is Amazon. Amazons ability to implement an expeditious operation tempo, continuously innovate and expand, and empower its employees through a commitment to 14 leadership principles is impressive.

DONT MISS: MEET NYU STERNS MBA CLASS OF 2022

View post:
Meet the MBA Class of 2022: Josue Gonzalez, New York University (Stern) - Poets&Quants

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