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€œNot only are the majority of rich countries failing to provide healthy environments for children within https://www.georgemarioattard.com/buy-renova-cream-uk/ their borders, they are also contributing to the destruction of children’s environments renova discount coupon in other parts of the world,” said Gunilla Olsson, Director of the UNICEF Office of Research – Innocenti.Unhealthy. Dangerous. Toxic.This is the world the majority of wealthy countries are creating for children.Our latest report. #PlacesAndSpaces— UNICEF (@UNICEF) May 24, 2022 Urgent policy shiftThe latest Innocenti Report Card 17. Places and Spaces compares how 39 countries in the Organization for Economic Co-operation and Development (OECD) and European Union (EU) impact children’s environments.Indicators include exposure to harmful pollutants, such as toxic air, pesticides, damp and lead.

Access to light, green spaces and safe roads. And countries’ contributions to the climate crisis, resource consumption, and e-waste dumping.The report states that if the entire world consumed resources at the rate of OECD and EU countries, the equivalent of 3.3 earths would be needed to keep up with consumption levels.If it were at the rate at which people in Canada, Luxembourg and the United States do, at least five earths would be needed, according to the report.Not in your own backyardWhile Spain, Ireland and Portugal feature at the overall top of the list, all OECD and EU countries are failing to provide healthy environments for all children across all indicators.Based on CO2 emissions, e-waste and overall resource consumption per capita, Australia, Belgium, Canada and the United States are among other wealthy countries that rank low on creating a healthy environment for children within and beyond their borders. Meanwhile, Finland, Iceland and Norway are among those that provide healthier environments for their country’s children but disproportionately contribute to destroying the global environment.“In some cases we are seeing countries providing relatively healthy environments for children at home while being among the top contributors to pollutants that are destroying children’s environments abroad,” attested Gunilla Olsson, Director of UNICEF Office of ResearchIn contrast, the least wealthy OECD and EU countries in Latin America and Europe, have a much lower impact on the wider world.Harmful exposuresOver 20 million children in this group, have elevated levels of lead – one of the most dangerous environmental toxic substances – in their blood.In Iceland, Latvia, Portugal and the United Kingdom, one in five children is exposed to damp and mould at home. While in Cyprus, Hungary and Turkey, that number rises to more than one in four.Many children are breathing toxic air both in and outside of their homes.More than one in 12 children in Belgium, Czech Republic, Israel and Poland and are exposed to high pesticide pollution, which has been linked with cancer – including childhood leukaemia – and can harm vital body systems. Source.

WHORoutes of children’s exposure to toxic substances..

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In the 1970s, a team renova technology inc of Danish researchers published a study claiming that the Innuit population living on the coast of Greenland had lower levels of heart disease and renova online without prescription diabetes than residents of Denmark. The duo attributed these better health outcomes to an Indigenous diet heavy on fish.Decades later, hundreds of studies sparked by this initial paper have largely concluded something similar. Fish is good renova technology inc for you. The findings explain, in part, why the current U.S.

Dietary guidelines suggest adults consume two servings of seafood a week. But as the average American falls short renova technology inc of the suggested 8 ounces of fish every week, fish oil pills have taken over their own corner of the supplement market — a replacement that science doesn’t necessarily support. The upside of eating fish, evidence suggests, has more to do with the entire meal than it does with some miracle ingredient appearing on your plate. The Underlying EvidenceWhen dietary agencies provide nutritional recommendations, they draw evidence for their suggestions from long-term studies that track groups of people, their food habits, and what kind of health outcomes individuals have, says Maya Vadiveloo, a registered dietitian and nutritional epidemiologist at the University of Rhode Island.

This kind of research is renova technology inc called an observational study. Scientists keep track of people’s choices and what they deal with later in life, like whether or not participants develop heart disease, get cancer, or die prematurely from similar kinds of serious health events. Large-scale “track-the-diet-and-see-what-happens” studies have associated fish consumption with lower risks of heart attacks, heart failure, strokes, renova technology inc and liver cancer. For example, one study that assessed the findings of several of these long-term projects found that individuals who ate fish once a week were 15 percent less likely to die of cardiovascular disease.

The agreement among the range of dietary studies about the benefits of fish helped usher in recommendations that Americans eat two servings of seafood a week. But exactly why people who eat fish renova technology inc fare better isn’t completely clear yet. €œThe mechanism for which fish convey protection against cardiovascular disease is still under investigation,” Vadiveloo says. Nutrition companies often bill a particular nutrient that’s plentiful in some seafood varieties as a kind of superpower dietary factor.

Omega-3 fatty acids renova technology inc. These fats are crucial to a range of cell functions, and because our bodies can’t make them, we have to find nutritional sources. Of the three main kinds of omega-3s, one is commonly found in walnuts, flaxseed, and soybean oil. The two other versions show up in oily fish like salmon, sardines, and renova technology inc tuna.

Some research has suggested that fish rich in omega-3s, in particular, can convey heart health benefits, and the American Heart Association recommends that people should opt for versions high in those fats. The belief that omega-3s alone convey heart renova technology inc health benefits explains the popularity of fish oil supplements, too. But so far, scientific evidence has yet to peg omega-3s as the key nutrient shielding people from heart disease. Studies examining the effects of fish oil capsules on heart health show mixed results.

Some found the supplements didn’t reduce the risk of stroke, heart attacks, or other lethal cardiac diseases renova technology inc. Other research has determined that individuals already dealing with cardiovascular health issues are most likely to see any benefits from fish oil. €œCould you pop an omega-3 pill and suddenly reduce your risk of heart disease?. That’s the answer that people often want, but that's not what the data suggests,” Vadiveloo renova technology inc says.

The Broader Benefits of FishScientific evidence might support the heart health benefits of fish — not omega-3s alone — because making room for the aquatic protein on your plate forces other dietary changes, too. For example, eating fish for dinner means someone likely isn’t eating red or processed meats at that meal, Vadiveloo says. €œThe replacement and substitution piece is key.” Steak, bacon, and similar proteins are high in saturated fats that raise cholesterol levels renova technology inc and contribute to heart disease. Many Americans consume too much of those harmful fats, and eating fish twice a week might mean someone is effectively cutting some saturated fats out of their diet and replacing them with more heart-healthy options.

There’s also a chance that in research assessing lifelong health outcomes for different diets, those who eat fish are making more healthy choices generally, like having more fruits and vegetables renova technology inc and fewer processed grains. Again, long-term studies that help shape dietary guidelines don’t determine what participants eat — researchers just keep track and assess outcomes. While studies try to control for other influencing factors in data analysis, a tendency to eat healthier overall might still explain some of why fish consumption is a positive choice, Vadiveloo says. While fish can replace other harmful fats in someone’s diet and might encourage healthier eating habits, it can have downsides too — namely, renova technology inc environmental toxins that sea creatures absorb.

Mercury and chemicals like polychlorinated biphenyls, pollutants that leach from soils into water systems, build up in fish tissue and can’t be cooked out or removed. Dietary guidelines account for how much of different toxins might be in a given serving of fish, Vadiveloo says, and intend to limit how much of those harmful substances people consume. Generally, the FDA recommends that certain individuals are choosier about the fish they eat — particularly renova technology inc pregnant women, those who may become pregnant, and small children. The agency advises that those groups select low-mercury options, as dietary sources of the neurotoxin can cause development problems.

Consuming just one nutrient found in a food in a capsule — in this case, the oil from sardines, anchovies, and the like — isn’t always the same thing as eating the food itself. €œWe see this fairly consistently when you look at the evidence for renova technology inc vitamin and mineral substances,” says Vadiveloo. €œWhen we extract, we don’t always see the exact same benefits.” And when it comes to fish, the same is true. Rethinking what's on your plate likely pays off renova technology inc in a way that adding to your medicine cabinet does not.Packing on pounds seems way too easy these days.

Working from home has replaced those water-cooler chats — and we eat more when we’re lonely or bored. Plus, those round trips from the computer to the pantry and back probably don’t help much either. “A lot of us pick and snack way more than we realize we do,” says Debbie Petitpain, a registered dietician and spokesperson renova technology inc for the Academy of Nutrition and Dietetics.Those few bites here and there can quickly settle on our midlines. And as those of us who’ve tried to lose weight already know, gaining weight is easier than keeping unwanted pounds away for good.Fortunately, diets are easy to find.

We can try keto, dump carbs, go Paleo, or try fasting or grazing to boost weight loss. But picking the program is the easy renova technology inc part. Sticking to a diet is hard because our body reacts to fewer calories by slowing down our metabolisms. Once we’ve been on a diet for a while, our renova technology inc so-called “hunger hormones” start to change.

Essentially, levels of hormones that help make us feel full will drop, while hormones that make us feel hungry get a boost. We can also undercut our own efforts by focusing on a target weight that’s hard to reach and unrealistic for us to maintain. Constant dieting, “isn’t really ideal for living a pleasant life, which will make it harder to keep dieting,” says Traci Mann, a food psychologist at the University of Minnesota and author of Secrets from the Eating Lab.The Problem With DietingWe always seem to be looking for the renova technology inc next diet, the one that will melt off weight without making us obsess over food in the process. But we don’t need fad diets at all.

The answer to weight loss is simple and unchanging. We need to add more fruits and vegetables to our diets, while cutting out (or at least cutting down on) renova technology inc processed convenience foods and sweets. If we only focus on numbers on the scale, we’ll lose sight of what matters most to our overall health. Making healthy food choices and making exercise a life-long habit.

But don’t be surprised if the weight does fall off when you adopt this mindset.Even if we manage to lose weight, studies have found that most of renova technology inc us end up regaining the weight within a year. If you need convincing, Petitpain recommends that you stop by Barnes &. Noble and take note renova technology inc of the shelf of diet books that extends the length of the building. Then turn around and look at your fellow Americans, most of whom will be overweight.

€œSomehow, there is a disconnect between the quick fixes offered by diet books, and our abilities to either try them or stick to them,” she says.We’re hard on ourselves, too, and that doesn’t do us any favors. Once we’ve noticed those extra pounds, we often decide we must lose that weight really renova technology inc fast so we can be healthy again, says Petitpain. But because we have gained that weight over several years, it likely isn’t waving goodbye any time soon. Petitpain says a better approach is taking gradual steps toward healthy choices, such as cutting out processed food, being mindful of portion sizes, and adding physical activity to your routine.

And at the end of the day, whether someone is healthy or not goes beyond renova technology inc being fat or thin.“You can be overweight and physically fit, and disease risk goes down,” Petitpain says. €œWe know there are people in the normal weight range, but who don’t eat enough fruits and vegetables, and their disease risk goes up.”Balancing calories in with calories out still matters for dropping pounds, but obsessing about weight can be self-sabotaging. A better approach, says Mann, would be to accept our bodies — but don’t binge eat. Fight weight renova technology inc stigma.

Exercise because it’s good for us and eat more veggies.Clear Your CountertopsIf you tried to diet and succeeded for a while before going off course, know that it doesn't mean you're weak. €œThere’s this idea out there that dieters, or obese people, have worse self-control than everyone else, and that’s just not how it works,” Mann says renova technology inc. Depriving our bodies of calories wields a powerful force on our biology — and our bodies fight back with a variety of physiological processes designed to hold on to the weight. €œMost people wouldn’t even have … the kind of willpower you would need to overcome all of it,” says Mann.

€œIt’s just renova technology inc too much to fight against.”Resisting food cravings day in and day out is difficult. A better approach is to make tempting food more difficult to grab. If your partner insists on having candy in the house, for example, store those goodies in an opaque container, making them harder to see. When sweets are out of sight, renova technology inc they tend to be out of mind as well.

Or forget about resisting your food cravings altogether and try a strategy Mann calls “veggies first.” This ploy is an easy one to incorporate — think a salad before dinner. Before you eat anything — whether it’s a slice of pizza or a steak — put some vegetables on your plate. Doing this adds nutrition to your diet and it fills you up, making you less likely to overindulge on fattening foods.Mann and her team tested this idea in a field study held in renova technology inc an elementary school. The researchers aimed to test whether kids would eat more of a vegetable if that was their only choice, or if the same vegetable was served along with other foods.

First, the researchers determined what the baseline consumption of carrots was during a typical school lunch, when they were served alongside other foods renova technology inc. Then three months later, the same meal was served, but this time the kids were given carrots before the rest of their meal. The team found that the kids gobbled up more carrots when the vegetable was served alone, before the rest of their food.The researchers also tested their veggies-first approach on college students and keeping track of their carrot and M&M consumption depending on which food was served first. The students ate more carrots when they were served first, and renova technology inc ate less candy as a result.

Slip-ups Aren’t SetbacksWhat matters in the long run for health are your overall eating habits, says Petitpain. An occasional splurge meal doesn’t negate the healthier choices you’ve made on a day-to-day basis. But know that if wellness is your goal, you renova technology inc do need to make a regular a habit of consuming health-promoting foods, especially those that are minimally processed. They’re easy to find because they’re generally anything you can pick up on the perimeter of the supermarket.In addition to Mann’s veggies-first plan, another healthful approach involves adding vegetables to every meal and finding creative swaps.

Try adding salsa to eggs, spinach to smoothies, sliced mushrooms to burgers, or having veggies and hummus instead of chips.If you’re making tacos, tortillas can be replaced by a lettuce leaf renova technology inc. Beans make a tasty and high-fiber stand-in for reducing or replacing taco meat. You might not miss cheese and sour cream toppings if you add extra corn, onions and tomatoes. For dessert, a similar strategy incorporates renova technology inc fruit.

Try pears poached in wine sauce or pineapple with frozen vanilla yogurt. Or, if you're looking for a portable snack for kids, bring cups of applesauce and dump in the gummy fruit-flavored snacks. These small changes make renova technology inc a big difference over time, says Petitpain.With this approach, there’s no need to do anything radical, like develop a taste for a vegetable you dislike, or force down more veggies at dinner. If you love carrots or broccoli, simply eat them more often and find creative ways to sneak them in meals.Self-Care Now, Diet Later?.

No matter your weight or fitness goals, remember that wellness is more than a diet and exercise regime. Now more than ever, stress plays a renova technology inc vital role on our overall wellbeing. If stress and anxiety is causing poor sleep, you’ll be too tired to exercise or make the right food decisions.It can be helpful to take a step back and recognize that living through a traumatic year has likely taken a mental and physical toll. Just view weight loss as one part of an overall plan to get yourself back on track and take small steps renova technology inc to boost your overall health.“Maybe it’s better to think about the overall journey, rather than being so hyper-focused on achieving an endpoint,” says Petitpain.Think about how long it took you to gain that weight and be realistic about how quickly those pounds can come off.

The American Obesity Society recommends a rate of one-to-two pounds a week, which is sustainable over time, and provides some health benefits. Or find a dietician and get some personalized help.But whatever you do, don’t start a diet if you’re not emotionally ready to commit. €œIf you don’t have the bandwidth right now to tackle an renova technology inc aggressive diet, then don’t start one, because it might be worse to try and fail. Focus instead on self-care.

Try sleeping better, moving a little bit, eating a little healthier at every meal,” says Petitpain. €œThese are hard times renova technology inc. You really have to prioritize.”In the midst of an ongoing apocalyptic reality that never seems to end, what’s in your pots and pans might be the last thing on your mind. But now, more than ever, it might be time to take stock of what’s in the kitchen and make sure it’s safe to cook on.

In recent months, there’s been an unprecedented renova technology inc return to the home kitchen. In a survey of 1,000 people by the International Food Information Council, half said they were more likely to cook a meal from scratch than they had been at the beginning of the renova. Thirty percent said they tried new renova technology inc recipes. At the same time, a growing number of consumers are seeking cookware that will get the job done and limit their exposure to humanmade industrial chemicals.

But how do the different options on store shelves stack up in terms of health, environmental impact, durability, and ease of use?. Discover asked the experts for their advice on picking pots and pans that can cook renova technology inc up delicious food and not add unintended, toxic ingredients to your dish. Suzanne Fenton, a reproductive endocrinologist at the National Institutes of Environmental Health Sciences (NIEHS). J.

Kenji López-Alt, a chef, author of the cooking science book The Food Lab, and chief culinary consultant for renova technology inc Serious Eats. And Olga Naidenko, vice president of science investigations at the Environmental Working Group (EWG), a nonprofit and nonpartisan advocacy organization.Traditional Nonstick (Credit. Iurii Stepanov/Shutterstock)Nonstick is the cooking surface that is probably the most likely to sound alarm bells in consumers’ minds. This kind of coating, known commercially as Teflon, lines metal pans with a tough, synthetic resin to renova technology inc create a slippery surface.

Its chemical name is polytetrafluoroethylene, or PTFE. Historically, it was renova technology inc made using PFOAs, or perfluorooctanoic acids. PFOAs are part of a group of stubborn chemicals that have been linked with health risks like thyroid problems, possible hormone disruption, kidney disease and immune system issues. The FDA worked with companies to phase out the use of PFOAs and other similar chemicals in food-contact applications by 2016.

However, similar to in the renova technology inc cosmetics industry, manufacturers don’t have to disclose every ingredient they use in their coatings. PTFE coating, or Teflon, isn’t necessarily dangerous if ingested by accident from scratching or chipping, according to Fenton and Naidenko, though its nonstick properties will weaken if scratched. What’s more worrisome is when a PTFE nonstick pan is used at a high heat — say, searing a steak or leaving a burner on by accident. Molecular bonds in the coating begin to break down at around 500 degrees, according to a presentation on home chemical coatings by Michael Michalczyk, a renova technology inc chemical consultant.

Nonstick coatings can then release dangerous fumes that irritate the respiratory system. According to Naidenko, PTFE coating today is essentially the same as the old versions — just made with much smaller amounts of PFOAs. But she adds that “the risk renova technology inc of it overheating, and harming our lungs — that risk stays. Those pans should not be overheated [during] their lifetime — that would be a concern.” Both Naidenko and Fenton noted that the health dangers posed by Teflon cookware is a small risk compared to the environmental contamination associated with manufacturing and disposing of these products.

According to the EWG, renova technology inc per- and polyfluoroalkyl substances (or PFAS), a group of chemicals that PFOAs belong to, can be found in the drinking water of many U.S. Cities. PFAS enter the environment from Teflon products breaking down in landfills, and from the production of plastic wrappings, water-repellant items, and things like military firefighting foam. Although the Environmental Protection Agency says this group of chemicals can be incinerated as a way to keep them from other waste streams, Naikendo said that this can cause an air pollution problem for communities where incineration occurs.López-Alt says he rarely uses nonstick cookware, but when he does it’s for low-heat tasks like cooking an renova technology inc omelet, where nonstick has a big advantage.Ceramic (Credit.

Melica/Shutterstock)Some of the most popular new cookware crowding Instagram feeds and online stores are ceramic. These pots and pans boast labels like “PTFE and PFOA-free” or “non-toxic,” and “healthy.” But because they’re a relatively new nonstick alternative, our experts say not as much is known about them in terms of the long-term effects on health and the environment. Pans marketed as “nonstick ceramic” are not made of pottery or clay, renova technology inc however. Pure ceramic cookware that’s closer to pottery does exist, but it’s less common.

Instead, many products labeled as ceramic include a metal renova technology inc core with a chemically-combined coating that is sprayed on. There’s a good chance a ceramic pan has a coating containing silica — the same mineral that sand and silicone are made out of — and various other substances. The viral Always Pan, along with other popular options in the cookware aisle, are made using sol-gel — a wet-chemical process that forms nanoparticles into solid materials and dehydrates them into ceramic or glasslike surfaces. But a downside to ceramic nonstick is that renova technology inc the coating doesn’t last as long as PTFE-based pans.

According to Naidenko, because it’s hard to know what the exact contents of these coatings are, “even if one has a pan that has not a lot of PTFE in it, they still should not overheat something” in a ceramic pan. Cast Iron(Credit. Natashamam/Shutterstock)It might be time to pay more attention to that friend who won’t stop talking about seasoning renova technology inc their cast-iron skillet. That’s because cast iron cookware is one of the most reliable and time-honored materials that can grace your kitchen.

Cast iron cookware is quite heavy — which for some might be enough reason to pass on it. But because of its weight renova technology inc and density, cast iron can retain heat much longer than other metals like aluminum. However, it doesn’t distribute its heat very evenly, according to López-Alt. From a safety perspective, what you see is what renova technology inc you get.

Iron alloyed with varying amounts of carbon and silicon, forged into a shape. €œSeasoning” a cast iron pan is the process of adding oil or fat and heating the pan. This creates a reaction with the oil and the iron that forms a somewhat nonstick black layer renova technology inc — a polymer, López-Alt says, which gets built up as it's used. The surface stands up well to most kinds of cooking, and prevents sticking, although acids like tomato and vinegar can break down the coating that forms.

Contrary to popular belief, cast iron can be washed with soap without damaging the surface — but leaving cast iron wet with water can cause it to rust. According to López-Alt, “The whole idea that you can't clean cast iron renova technology inc with soap is just a complete myth that no longer applies,” he says, noting that older soaps containing lye did affect cast iron, but not modern soaps. €œI think people just sort of baby their cast iron much more than they have to.” Small amounts of iron do, in fact, end up in food, but for people prone to iron deficiency, this can actually be a benefit. Carbon Steel and Stainless Steel(Credit.

Yevlashkina Anastasiia/Shutterstock)Steel cookware is some of the most common and popular cookware around because of its durability and how well it stores heat energy compared to other metals — a little less than cast renova technology inc iron or copper, but better than others, says López-Alt. Stainless steel usually has more added materials, like chromium or nickel, and a conductive core like aluminum or copper, while carbon steel is just steel. Carbon steel, renova technology inc which is common for woks and crêpe pans, is more similar to cast iron. It has some nonstick properties and is very durable and heat-resistant, but can also rust.

Stainless steel can be put in a dishwasher, unlike carbon steel, and it won’t react with acids as much. But overall, both are scratch-resistant and safe renova technology inc surfaces to cook on. Fenton favors stainless steel pans, while Lopez-Alt says he prefers his carbon steel cookware, which should be seasoned like cast iron. €œMy real advice would be to learn how to use carbon steel because it's the best,” he says.

Aluminum and Anodized renova technology inc Aluminum(Credit. A. Zhuravleva/Shutterstock)Aluminum might comprise a whole pan, be mixed with other metals, or make up a layer within the pan. It’s less renova technology inc dense than metals like steel or iron, so it doesn’t retain heat very well.

This means that it can cool down quickly, but it does conduct — or transfer — heat very well, making it a popular addition to pans made with other metals. According to López-Alt, chefs in restaurants often use aluminum pans renova technology inc because their industrial burners can maintain stronger heat than a typical home kitchen stove. Anodization gives aluminum a very hard, non-corrosive surface. Anodized aluminum is made with an electrolytic process that makes it much harder and smooth — the one downside is that you can’t put these kinds of pans in the dishwasher or you risk ruining the surface, according to the book Things Cooks Love, by Marie Simmons.

While there has been inconclusive renova technology inc research on links between aluminum and Alzheimer's, aluminum cookware is currently not considered to be a health risk. The CDC says that while aluminum cookware can transfer aluminum into foods, especially acidic ones, “aluminum levels found in processed foods and foods cooked in aluminum pots are generally considered to be safe.”Copper (Credit. FabrikaSimf/Shutterstock)Copper is favored by professional chefs for its superior conductivity, which means it heats up quickly and evenly. But copper should not come into contact with food on its own, because it can react with acidic ingredients like wine, fruit juice, renova technology inc or vinegar and leach into food, according to the FDA’s 2017 Food Code.

€œWhile copper is very good because of its heating properties, too much copper is not good for the body, especially for children,” says Naidenko. €œIt can even cause things like diarrhea and nausea.” Many copper pots or pans are lined with a metal like tin or stainless steel for this reason. Tin can wear more easily than steel, so if you have an old tin-lined copper pot, or if you spot one at a yard sale for a good price, renova technology inc Naidenko said it’s a good idea to look for scratches. Copper also can be quite expensive and can oxidize in damp air, leaving a green discoloration.

Takeaways From the renova technology inc Experts(Credit. Ekkapop Sittiwantana/Shutterstock)Each type of cookware comes with some advantages and drawbacks. A general rule of thumb is to choose cookware that works well for your needs, and steer clear of products if the materials aren’t clearly defined. You can’t go wrong with renova technology inc basic heavy cookware that is durable and long-lasting.

But note that even nonstick cookware has its place in modern kitchens and can be reserved for preparing delicate dishes that are prone to sticking. If you have the means and must replace a pot or pan, consider cookware that will stand the test of time. And know that even if the materials are considered renova technology inc safe for humans at home, they could become environmental hazards when they break down in landfills at the end of their life. As Fenton said, “If you're going to invest in cookware, you might as well go for something that's going to be a little bit safer and last you a little bit longer.” And no matter which type of pan you choose, the safest pan for your health may come down to how you wield it in the kitchen.

€œI think pretty much all the cookware out there right now is pretty safe, renova technology inc as long as you take care of it,” she says.Citizen Science Salon is a partnership between Discover and SciStarter.org. The future of individualized medicine may depend on an army of one million volunteers. And scientists want you to get involved. Researchers with the National Institutes of Health are recruiting renova technology inc citizen scientists to enlist in a study of unprecedented scope and depth.

The program, called All of Us, promises to take personal data from a diverse cross-section of volunteers and turn it into groundbreaking insights about the complex roles our genes, lifestyles and environments play in our health. €œBy studying people longitudinally over time, we’re able to see diseases arise,” says Sheri Schully, the All of Us program’s acting chief medical and scientific officer.In return for completing surveys and offering up biological samples, the program will send participants personalized results about everything from their ancestry to their genetic predisposition for certain diseases. It’s also free to join renova technology inc. And last month, All of Us sent participants back the first set of genetic results.

Take Part. Join the National Institutes of Health’s All of Us Program‘The Right Treatment renova technology inc at the Right Time’In January of 2015, President Barack Obama stood in front of the country during the State of the Union and offered a bold vision for accelerating research. A research program then called the Precision Medicine Initiative would recruit at least one million people from across the United States and study them, leading to rapid advances in drug discovery and customized treatments for patients based on personal data.“I want the country that eliminated polio and mapped the human genome to lead a new era of medicine — one that delivers the right treatment at the right time,” Obama told the nation. He added that the project renova technology inc could bring us closer to curing diseases like cancer and diabetes, while offering people access to personal information that could help them stay healthy.

Five years later, NIH has already enrolled hundreds of thousands of participants, and last month, those volunteers started receiving the first results from their genetic samples. But the project still has a long way to go to reach one million people. And with the approach of renova technology inc Citizen Science Month in April, they’re calling on volunteers from around the country to get involved in not only All of Us, but also a group of featured citizen science projects and events produced with global and national partners like SciStarter, Arizona State University, Science Friday and National Geographic. €œThe power of citizen science is the massive impact that is made by everyday people, individually and collectively,” says Darlene Cavalier, founder of SciStarter and a professor of practice at the School for the Future of Innovation in Society at Arizona State University.

€œOnline and virtual events during Citizen Science Month will help introduce thousands of people to citizen science and help them find ways to act upon issues they are curious or concerned about, individually or as a community.”The NIH has now enrolled hundreds of thousands of volunteers, and participants have now started to receive the first results from their genetic samples. (Credit. All of Us/NIH)Kickstarting Precision MedicineParticipants with All of Us start by taking a survey about their lifestyle, family history and more. Then, they can agree to share their health records with researchers and offer up blood and urine samples, as well as physical measurements like height, weight and heart rate.

Participants can even share daily personal health data from smart devices like a Fitbit. The data is stripped of all personal identifiers, but this granular level of detail, when monitored over time, can give researchers a real-time look at the ways diseases arise. It’s all part of what researchers call precision medicine. Precision medicine stands in contrast to the current one-size-fits-all approach to disease treatment used by doctors around the world.

But if medical professionals could better understand their patients at an individual level, doctors could predict the best possible treatment for a particular disease. €œ[Precision medicine] is understanding what a person is experiencing and what’s going on inside and outside their body in relation to disease,” Schully says. €œIt’s really evaluating a person holistically. What are they eating?.

What’s their lifestyle like?. And what kind of job do they have?. Precision medicine to us doesn't just mean targeted treatment, it means targeted prevention.”A Holistic Look at skin care products’s ImpactResearchers are already studying the database. And it’s even giving them new insights into skin care products.

Back before the renova started, All of Us was enrolling about 3,000 people every week. Eventually, the skin care forced them to temporarily pause that enrollment. But when researchers went back and studied the 24,000 blood samples they’d collected between late 2019 and early 2020, they found some surprises. At the time, researchers didn’t know skin care products was spreading in communities around the country.

Yet a significant number of the blood samples All of Us collected showed signs of skin care products antibodies, meaning that the disease was spreading in many states well before health officials realized. Researchers with the project recently published those results in the New England Journal of Medicine. Meanwhile, All of Us has also been asking participants about skin care products symptoms via a survey sent out last May. The survey included broad skin care products-related questions, including inquiries about people’s mental well-being and whether they’d lost their job.

The initial results of that work were released to researchers in December, and they offer a detailed look at how skin care products is affecting families and communities. Among other things, All of Us heard back that people are suffering long-term heart defects and breathing effects, problems that medical professionals have seen elsewhere. Armed with this data, the program hopes they can monitor these lingering health problems over time. It’s a sort of holistic look that has been part of the program’s mission since the start.

An All of Us staff member measures a participant’s height. (Credit. All of Us/NH)A Truly Diverse DatasetOther large projects have collected genetic databases aimed at advancing disease diagnosis and treatment, but All of Us stands out for its staggering size and its mission. Researchers aren’t just studying people’s DNA, All of Us is putting its participants at the epicenter of their program.

The community helps make decisions, with volunteers even sitting on governing boards, deciding how data can be used. If that aim wasn’t lofty enough, All of Us is also after a diverse cross-section of the American public, including people from diverse ethnic and economic backgrounds, as well as a mix of rural and urban residents. That’s something other studies have long struggled with. The project’s leaders say that most of modern medicine has been biased toward studying people with European ancestry, leaving other segments of the population underrepresented in research.

And as an incentive to get one million people involved, the project will also share genetic information with its participants, including things like ancestry and whether they’re at an increased risk for disease. €œNever before have we really put the participant at the center of the study and really valued the back and forth, giving them what matters to them,” Schully says. €œWe really want to be a catalyst for change in how things are done in science.”Insights into Disease PredispositionIn December, they started returning those first individual ancestry and genetic trait results to volunteers. €œParticipants are our most important partners in this effort, and we know many of them are eager to get their genetic results and learn about the science they’re making possible,” All of Us chief executive officer Josh Denny said in an announcement.

€œWe’re working to provide that valuable information in a responsible way.”Later this year, All of Us plans to start telling interested participants about how their DNA could affect their body’s response to certain drugs, or even about genes that could increase their risk of a variety of diseases like cancer. Those results will be paired with counseling to help people understand the implications of their DNA profile. And, like everything with the program, the personal data will be tightly protected. €œIt's a huge milestone for our project,” Schully says.

€œReturning results on this level has never been done before.”And people who get involved throughout the year — including during Citizen Science Month — can look forward to learning more about their family’s ancestry and genetic predispositions. Citizen Science Month is all about turning curiosity into impact, and what better way than with a project that could help you better understand yourself while helping researchers better understand human health at large?. You can join the All of Us program by visiting joinallofus.org/nlm.Your digestive system plays host to a mind-boggling 100 trillion microbes — microscopic pinch-hitters that allow you to absorb energy from your food and churn out compounds like serotonin, which affect your mental well-being. While some of these microbes take up residence in your gut from birth, others emerge or wane depending on the lifestyle choices you make.New research suggests that if you exercise, take antidepressants or use cannabis, your gut-bacterial balance may shift profoundly.

But scientists still face a so-called black box conundrum. They’re not always sure what biological processes cause these microbial shifts or how the shifts affect other body functions. Planned larger-scale studies promise to deepen experts’ understanding of the bacterial changes your daily habits usher in, as well as the long-term health implications.Exercise to ColonizeNot only does regular exercise boost your overall well-being, it also swells the ranks of gut bacteria that promote a healthy metabolism, says Satu Pekkala, a bacteriologist at Finland’s University of Jyväskylä. In a 2018 study, Pekkala and his colleagues recruited 17 overweight women who participated in three endurance exercise sessions each week for six weeks.

The women rode an exercise bike that adjusted workout intensity so that riders stayed at about 85% of their maximum heart rate.The team had participants collect stool samples before and after the six-week training period, then sequenced DNA from these samples to detect changes in the women’s gut bacteria. After the training regimen, the women had higher levels of gut bacteria from the genus Akkermansia — a bacterial group tied to improved metabolic function — than they had before. They also had lower levels of Proteobacteria, a genus linked to inflammation in the body.Pekkala has secured approval to conduct another study that examines bacteria-produced molecules to explore what biological role Akkermansia and Proteobacteria might play in the gut — and how Akkermansia abundance might affect the body’s ability to burn fat stores. €œNot everybody loses fat mass even if they exercise,” Pekkala says.

€œIt’s important to know how the metabolic functions [of gut bacteria] affect fat loss.” The Cannabis ConnectionPlenty of research shows that marijuana compounds reduce disease-related inflammation, and, according to a 2019 study, these compounds’ effects on gut bacteria might explain some of their anti-inflammatory properties.In exploring possible treatments for Multiple Sclerosis (MS), University of South Carolina researchers treated mice that had a similar condition with molecules like delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).The mice showed fewer signs of inflammation after the cannabis treatment — and an analysis showed that gut-bacterial shifts were likely responsible, at least in part. Before treatment, the mice had high levels of the bacterial species Akkermansia muciniphila, which produces compounds called lipopolysaccharides that are linked to brain inflammation. After treatment, mice had lower levels of this species in their guts and lower levels of lipopolysaccharides in their brains. Future studies may show whether cannabis can spur similar gut-bacterial and brain changes in humans with MS.Gut CheckAn antidepressant that millions of Americans take may alter their gut-bacterial mix as well as their mental outlook, University of California-Los Angeles researchers say.

In a 2019 study, the UCLA team added fluoxetine (Prozac) to a tube with a common gut bacterial species called Turicibacter sanguinis, which normally tells intestinal cells to produce more serotonin — a neurotransmitter that affects mood. After the team put in fluoxetine, the bacteria transported less serotonin than it had before. Further experiments showed that mice dosed with fluoxetine had lower gut levels of Turicibacter than other mice.These results suggest that Turicibacter populations fluctuate in the presence of drugs like fluoxetine that modify serotonin levels. Next, the UCLA team plans to tease out the molecular mechanisms that reveal just how fluoxetine affects certain gut bacteria — and how that might influence the way the drug works in the brain and the rest of the body.

€œThere’s variation in how effective fluoxetine is for different people,” says UCLA microbiologist Jonathan Lynch. €œSomething like the interaction with the microbiome might be mediating that.”Future studies of these gut-brain interactions could allow a personalized-medicine approach that identifies people who are good candidates to respond to drugs like fluoxetine, Lynch says. Someday, based on your gut microbe profile, doctors might be able to tell you which antidepressants will work for you and which ones you shouldn’t even try..

In the renova discount coupon 1970s, a team of Danish researchers published a study claiming that the Innuit population living on the coast of Greenland had lower levels of heart disease and diabetes than residents of Denmark. The duo attributed these better health outcomes to an Indigenous diet heavy on fish.Decades later, hundreds of studies sparked by this initial paper have largely concluded something similar. Fish is renova discount coupon good for you. The findings explain, in part, why the current U.S.

Dietary guidelines suggest adults consume two servings of seafood a week. But as the average American falls short of the suggested 8 ounces of fish every week, fish oil pills have taken over their renova discount coupon own corner of the supplement market — a replacement that science doesn’t necessarily support. The upside of eating fish, evidence suggests, has more to do with the entire meal than it does with some miracle ingredient appearing on your plate. The Underlying EvidenceWhen dietary agencies provide nutritional recommendations, they draw evidence for their suggestions from long-term studies that track groups of people, their food habits, and what kind of health outcomes individuals have, says Maya Vadiveloo, a registered dietitian and nutritional epidemiologist at the University of Rhode Island.

This kind of research renova discount coupon is called an observational study. Scientists keep track of people’s choices and what they deal with later in life, like whether or not participants develop heart disease, get cancer, or die prematurely from similar kinds of serious health events. Large-scale “track-the-diet-and-see-what-happens” studies have associated fish consumption with lower risks renova discount coupon of heart attacks, heart failure, strokes, and liver cancer. For example, one study that assessed the findings of several of these long-term projects found that individuals who ate fish once a week were 15 percent less likely to die of cardiovascular disease.

The agreement among the range of dietary studies about the benefits of fish helped usher in recommendations that Americans eat two servings of seafood a week. But exactly renova discount coupon why people who eat fish fare better isn’t completely clear yet. €œThe mechanism for which fish convey protection against cardiovascular disease is still under investigation,” Vadiveloo says. Nutrition companies often bill a particular nutrient that’s plentiful in some seafood varieties as a kind of superpower dietary factor.

Omega-3 fatty renova discount coupon acids. These fats are crucial to a range of cell functions, and because our bodies can’t make them, we have to find nutritional sources. Of the three main kinds of omega-3s, one is commonly found in walnuts, flaxseed, and soybean oil. The two other versions show up in oily fish like renova discount coupon salmon, sardines, and tuna.

Some research has suggested that fish rich in omega-3s, in particular, can convey heart health benefits, and the American Heart Association recommends that people should opt for versions high in those fats. The belief that omega-3s alone convey heart renova discount coupon health benefits explains the popularity of fish oil supplements, too. But so far, scientific evidence has yet to peg omega-3s as the key nutrient shielding people from heart disease. Studies examining the effects of fish oil capsules on heart health show mixed results.

Some found the supplements didn’t renova discount coupon reduce the risk of stroke, heart attacks, or other lethal cardiac diseases. Other research has determined that individuals already dealing with cardiovascular health issues are most likely to see any benefits from fish oil. €œCould you pop an omega-3 pill and suddenly reduce your risk of heart disease?. That’s renova discount coupon the answer that people often want, but that's not what the data suggests,” Vadiveloo says.

The Broader Benefits of FishScientific evidence might support the heart health benefits of fish — not omega-3s alone — because making room for the aquatic protein on your plate forces other dietary changes, too. For example, eating fish for dinner means someone likely isn’t eating red or processed meats at that meal, Vadiveloo says. €œThe replacement and substitution piece is key.” Steak, bacon, and similar proteins are high in saturated fats that renova discount coupon raise cholesterol levels and contribute to heart disease. Many Americans consume too much of those harmful fats, and eating fish twice a week might mean someone is effectively cutting some saturated fats out of their diet and replacing them with more heart-healthy options.

There’s also a chance that in research assessing lifelong health outcomes for different diets, those who eat fish are making more healthy choices generally, like having more fruits and vegetables and renova discount coupon fewer processed grains. Again, long-term studies that help shape dietary guidelines don’t determine what participants eat — researchers just keep track and assess outcomes. While studies try to control for other influencing factors in data analysis, a tendency to eat healthier overall might still explain some of why fish consumption is a positive choice, Vadiveloo says. While fish can replace other harmful fats in someone’s diet and might encourage healthier eating habits, it can have downsides too — namely, environmental toxins that sea renova discount coupon creatures absorb.

Mercury and chemicals like polychlorinated biphenyls, pollutants that leach from soils into water systems, build up in fish tissue and can’t be cooked out or removed. Dietary guidelines account for how much of different toxins might be in a given serving of fish, Vadiveloo says, and intend to limit how much of those harmful substances people consume. Generally, the FDA recommends that certain individuals renova discount coupon are choosier about the fish they eat — particularly pregnant women, those who may become pregnant, and small children. The agency advises that those groups select low-mercury options, as dietary sources of the neurotoxin can cause development problems.

Consuming just one nutrient found in a food in a capsule — in this case, the oil from sardines, anchovies, and the like — isn’t always the same thing as eating the food itself. €œWe see this fairly renova discount coupon consistently when you look at the evidence for vitamin and mineral substances,” says Vadiveloo. €œWhen we extract, we don’t always see the exact same benefits.” And when it comes to fish, the same is true. Rethinking what's on your plate likely pays off in a way that adding to your medicine cabinet does not.Packing on renova discount coupon pounds seems way too easy these days.

Working from home has replaced those water-cooler chats — and we eat more when we’re lonely or bored. Plus, those round trips from the computer to the pantry and back probably don’t help much either. “A lot of us pick and renova discount coupon snack way more than we realize we do,” says Debbie Petitpain, a registered dietician and spokesperson for the Academy of Nutrition and Dietetics.Those few bites here and there can quickly settle on our midlines. And as those of us who’ve tried to lose weight already know, gaining weight is easier than keeping unwanted pounds away for good.Fortunately, diets are easy to find.

We can try keto, dump carbs, go Paleo, or try fasting or grazing to boost weight loss. But picking renova discount coupon the program is the easy part. Sticking to a diet is hard because our body reacts to fewer calories by slowing down our metabolisms. Once we’ve been on a diet for renova discount coupon a while, our so-called “hunger hormones” start to change.

Essentially, levels of hormones that help make us feel full will drop, while hormones that make us feel hungry get a boost. We can also undercut our own efforts by focusing on a target weight that’s hard to reach and unrealistic for us to maintain. Constant dieting, “isn’t really ideal for living a pleasant life, which will make renova discount coupon it harder to keep dieting,” says Traci Mann, a food psychologist at the University of Minnesota and author of Secrets from the Eating Lab.The Problem With DietingWe always seem to be looking for the next diet, the one that will melt off weight without making us obsess over food in the process. But we don’t need fad diets at all.

The answer to weight loss is simple and unchanging. We need to add renova discount coupon more fruits and vegetables to our diets, while cutting out (or at least cutting down on) processed convenience foods and sweets. If we only focus on numbers on the scale, we’ll lose sight of what matters most to our overall health. Making healthy food choices and making exercise a life-long habit.

But don’t renova discount coupon be surprised if the weight does fall off when you adopt this mindset.Even if we manage to lose weight, studies have found that most of us end up regaining the weight within a year. If you need convincing, Petitpain recommends that you stop by Barnes &. Noble and take note renova discount coupon of the shelf of diet books that extends the length of the building. Then turn around and look at your fellow Americans, most of whom will be overweight.

€œSomehow, there is a disconnect between the quick fixes offered by diet books, and our abilities to either try them or stick to them,” she says.We’re hard on ourselves, too, and that doesn’t do us any favors. Once we’ve noticed those extra pounds, we often decide we must lose that weight really fast so renova discount coupon we can be healthy again, says Petitpain. But because we have gained that weight over several years, it likely isn’t waving goodbye any time soon. Petitpain says a better approach is taking gradual steps toward healthy choices, such as cutting out processed food, being mindful of portion sizes, and adding physical activity to your routine.

And at the end of the day, whether someone is healthy or not goes beyond being fat or thin.“You can renova discount coupon be overweight and physically fit, and disease risk goes down,” Petitpain says. €œWe know there are people in the normal weight range, but who don’t eat enough fruits and vegetables, and their disease risk goes up.”Balancing calories in with calories out still matters for dropping pounds, but obsessing about weight can be self-sabotaging. A better approach, says Mann, would be to accept our bodies — but don’t binge eat. Fight weight renova discount coupon stigma.

Exercise because it’s good for us and eat more veggies.Clear Your CountertopsIf you tried to diet and succeeded for a while before going off course, know that it doesn't mean you're weak. €œThere’s this idea out renova discount coupon there that dieters, or obese people, have worse self-control than everyone else, and that’s just not how it works,” Mann says. Depriving our bodies of calories wields a powerful force on our biology — and our bodies fight back with a variety of physiological processes designed to hold on to the weight. €œMost people wouldn’t even have … the kind of willpower you would need to overcome all of it,” says Mann.

€œIt’s just too much to fight against.”Resisting food renova discount coupon cravings day in and day out is difficult. A better approach is to make tempting food more difficult to grab. If your partner insists on having candy in the house, for example, store those goodies in an opaque container, making them harder to see. When sweets are renova discount coupon out of sight, they tend to be out of mind as well.

Or forget about resisting your food cravings altogether and try a strategy Mann calls “veggies first.” This ploy is an easy one to incorporate — think a salad before dinner. Before you eat anything — whether it’s a slice of pizza or a steak — put some vegetables on your plate. Doing this adds nutrition to your diet and it renova discount coupon fills you up, making you less likely to overindulge on fattening foods.Mann and her team tested this idea in a field study held in an elementary school. The researchers aimed to test whether kids would eat more of a vegetable if that was their only choice, or if the same vegetable was served along with other foods.

First, the researchers determined what the baseline renova discount coupon consumption of carrots was during a typical school lunch, when they were served alongside other foods. Then three months later, the same meal was served, but this time the kids were given carrots before the rest of their meal. The team found that the kids gobbled up more carrots when the vegetable was served alone, before the rest of their food.The researchers also tested their veggies-first approach on college students and keeping track of their carrot and M&M consumption depending on which food was served first. The students ate more carrots when they were served first, and ate less candy as a renova discount coupon result.

Slip-ups Aren’t SetbacksWhat matters in the long run for health are your overall eating habits, says Petitpain. An occasional splurge meal doesn’t negate the healthier choices you’ve made on a day-to-day basis. But know that renova discount coupon if wellness is your goal, you do need to make a regular a habit of consuming health-promoting foods, especially those that are minimally processed. They’re easy to find because they’re generally anything you can pick up on the perimeter of the supermarket.In addition to Mann’s veggies-first plan, another healthful approach involves adding vegetables to every meal and finding creative swaps.

Try adding salsa to eggs, spinach to renova discount coupon smoothies, sliced mushrooms to burgers, or having veggies and hummus instead of chips.If you’re making tacos, tortillas can be replaced by a lettuce leaf. Beans make a tasty and high-fiber stand-in for reducing or replacing taco meat. You might not miss cheese and sour cream toppings if you add extra corn, onions and tomatoes. For dessert, renova discount coupon a similar strategy incorporates fruit.

Try pears poached in wine sauce or pineapple with frozen vanilla yogurt. Or, if you're looking for a portable snack for kids, bring cups of applesauce and dump in the gummy fruit-flavored snacks. These small changes make a big difference over time, says Petitpain.With this renova discount coupon approach, there’s no need to do anything radical, like develop a taste for a vegetable you dislike, or force down more veggies at dinner. If you love carrots or broccoli, simply eat them more often and find creative ways to sneak them in meals.Self-Care Now, Diet Later?.

No matter your weight or fitness goals, remember that wellness is more than a diet and exercise regime. Now more than renova discount coupon ever, stress plays a vital role on our overall wellbeing. If stress and anxiety is causing poor sleep, you’ll be too tired to exercise or make the right food decisions.It can be helpful to take a step back and recognize that living through a traumatic year has likely taken a mental and physical toll. Just view weight loss as one part of an renova discount coupon overall plan to get yourself back on track and take small steps to boost your overall health.“Maybe it’s better to think about the overall journey, rather than being so hyper-focused on achieving an endpoint,” says Petitpain.Think about how long it took you to gain that weight and be realistic about how quickly those pounds can come off.

The American Obesity Society recommends a rate of one-to-two pounds a week, which is sustainable over time, and provides some health benefits. Or find a dietician and get some personalized help.But whatever you do, don’t start a diet if you’re not emotionally ready to commit. €œIf you don’t have renova discount coupon the bandwidth right now to tackle an aggressive diet, then don’t start one, because it might be worse to try and fail. Focus instead on self-care.

Try sleeping better, moving a little bit, eating a little healthier at every meal,” says Petitpain. €œThese are renova discount coupon hard times. You really have to prioritize.”In the midst of an ongoing apocalyptic reality that never seems to end, what’s in your pots and pans might be the last thing on your mind. But now, more than ever, it might be time to take stock of what’s in the kitchen and make sure it’s safe to cook on.

In recent months, renova discount coupon there’s been an unprecedented return to the home kitchen. In a survey of 1,000 people by the International Food Information Council, half said they were more likely to cook a meal from scratch than they had been at the beginning of the renova. Thirty percent said they tried new recipes renova discount coupon. At the same time, a growing number of consumers are seeking cookware that will get the job done and limit their exposure to humanmade industrial chemicals.

But how do the different options on store shelves stack up in terms of health, environmental impact, durability, and ease of use?. Discover asked the experts for their advice on picking pots and pans that can cook up delicious food and not add unintended, toxic ingredients renova discount coupon to your dish. Suzanne Fenton, a reproductive endocrinologist at the National Institutes of Environmental Health Sciences (NIEHS). J.

Kenji López-Alt, a chef, author of renova discount coupon the cooking science book The Food Lab, and chief culinary consultant for Serious Eats. And Olga Naidenko, vice president of science investigations at the Environmental Working Group (EWG), a nonprofit and nonpartisan advocacy organization.Traditional Nonstick (Credit. Iurii Stepanov/Shutterstock)Nonstick is the cooking surface that is probably the most likely to sound alarm bells in consumers’ minds. This kind of coating, known commercially as Teflon, lines metal pans with a tough, synthetic resin renova discount coupon to create a slippery surface.

Its chemical name is polytetrafluoroethylene, or PTFE. Historically, it was made renova discount coupon using PFOAs, or perfluorooctanoic acids. PFOAs are part of a group of stubborn chemicals that have been linked with health risks like thyroid problems, possible hormone disruption, kidney disease and immune system issues. The FDA worked with companies to phase out the use of PFOAs and other similar chemicals in food-contact applications by 2016.

However, similar to in the cosmetics industry, manufacturers don’t have to disclose every renova discount coupon ingredient they use in their coatings. PTFE coating, or Teflon, isn’t necessarily dangerous if ingested by accident from scratching or chipping, according to Fenton and Naidenko, though its nonstick properties will weaken if scratched. What’s more worrisome is when a PTFE nonstick pan is used at a high heat — say, searing a steak or leaving a burner on by accident. Molecular bonds in the coating begin to break down at around 500 degrees, according to a presentation on home chemical coatings by Michael Michalczyk, a chemical consultant renova discount coupon.

Nonstick coatings can then release dangerous fumes that irritate the respiratory system. According to Naidenko, PTFE coating today is essentially the same as the old versions — just made with much smaller amounts of PFOAs. But she adds that “the renova discount coupon risk of it overheating, and harming our lungs — that risk stays. Those pans should not be overheated [during] their lifetime — that would be a concern.” Both Naidenko and Fenton noted that the health dangers posed by Teflon cookware is a small risk compared to the environmental contamination associated with manufacturing and disposing of these products.

According to the EWG, per- and renova discount coupon polyfluoroalkyl substances (or PFAS), a group of chemicals that PFOAs belong to, can be found in the drinking water of many U.S. Cities. PFAS enter the environment from Teflon products breaking down in landfills, and from the production of plastic wrappings, water-repellant items, and things like military firefighting foam. Although the Environmental Protection Agency says this group of chemicals can be incinerated as a way to keep them from other waste streams, Naikendo said that this can cause an air pollution problem for communities where incineration occurs.López-Alt says he rarely uses nonstick cookware, but renova discount coupon when he does it’s for low-heat tasks like cooking an omelet, where nonstick has a big advantage.Ceramic (Credit.

Melica/Shutterstock)Some of the most popular new cookware crowding Instagram feeds and online stores are ceramic. These pots and pans boast labels like “PTFE and PFOA-free” or “non-toxic,” and “healthy.” But because they’re a relatively new nonstick alternative, our experts say not as much is known about them in terms of the long-term effects on health and the environment. Pans marketed as “nonstick ceramic” renova discount coupon are not made of pottery or clay, however. Pure ceramic cookware that’s closer to pottery does exist, but it’s less common.

Instead, many products labeled as renova discount coupon ceramic include a metal core with a chemically-combined coating that is sprayed on. There’s a good chance a ceramic pan has a coating containing silica — the same mineral that sand and silicone are made out of — and various other substances. The viral Always Pan, along with other popular options in the cookware aisle, are made using sol-gel — a wet-chemical process that forms nanoparticles into solid materials and dehydrates them into ceramic or glasslike surfaces. But a downside to ceramic nonstick is that the coating renova discount coupon doesn’t last as long as PTFE-based pans.

According to Naidenko, because it’s hard to know what the exact contents of these coatings are, “even if one has a pan that has not a lot of PTFE in it, they still should not overheat something” in a ceramic pan. Cast Iron(Credit. Natashamam/Shutterstock)It might be time to pay more attention to that friend who renova discount coupon won’t stop talking about seasoning their cast-iron skillet. That’s because cast iron cookware is one of the most reliable and time-honored materials that can grace your kitchen.

Cast iron cookware is quite heavy — which for some might be enough reason to pass on it. But because of its weight and density, renova discount coupon cast iron can retain heat much longer than other metals like aluminum. However, it doesn’t distribute its heat very evenly, according to López-Alt. From a safety perspective, what you see is what you get renova discount coupon.

Iron alloyed with varying amounts of carbon and silicon, forged into a shape. €œSeasoning” a cast iron pan is the process of adding oil or fat and heating the pan. This creates a reaction with renova discount coupon the oil and the iron that forms a somewhat nonstick black layer — a polymer, López-Alt says, which gets built up as it's used. The surface stands up well to most kinds of cooking, and prevents sticking, although acids like tomato and vinegar can break down the coating that forms.

Contrary to popular belief, cast iron can be washed with soap without damaging the surface — but leaving cast iron wet with water can cause it to rust. According to López-Alt, “The whole idea that you can't clean cast iron with soap is just a complete myth that no longer applies,” he says, noting that renova discount coupon older soaps containing lye did affect cast iron, but not modern soaps. €œI think people just sort of baby their cast iron much more than they have to.” Small amounts of iron do, in fact, end up in food, but for people prone to iron deficiency, this can actually be a benefit. Carbon Steel and Stainless Steel(Credit.

Yevlashkina Anastasiia/Shutterstock)Steel cookware is some of the renova discount coupon most common and popular cookware around because of its durability and how well it stores heat energy compared to other metals — a little less than cast iron or copper, but better than others, says López-Alt. Stainless steel usually has more added materials, like chromium or nickel, and a conductive core like aluminum or copper, while carbon steel is just steel. Carbon steel, which renova discount coupon is common for woks and crêpe pans, is more similar to cast iron. It has some nonstick properties and is very durable and heat-resistant, but can also rust.

Stainless steel can be put in a dishwasher, unlike carbon steel, and it won’t react with acids as much. But overall, both are scratch-resistant and safe surfaces renova discount coupon to cook on. Fenton favors stainless steel pans, while Lopez-Alt says he prefers his carbon steel cookware, which should be seasoned like cast iron. €œMy real advice would be to learn how to use carbon steel because it's the best,” he says.

Aluminum and renova discount coupon Anodized Aluminum(Credit. A. Zhuravleva/Shutterstock)Aluminum might comprise a whole pan, be mixed with other metals, or make up a layer within the pan. It’s less dense than metals renova discount coupon like steel or iron, so it doesn’t retain heat very well.

This means that it can cool down quickly, but it does conduct — or transfer — heat very well, making it a popular addition to pans made with other metals. According to López-Alt, chefs in restaurants often use renova discount coupon aluminum pans because their industrial burners can maintain stronger heat than a typical home kitchen stove. Anodization gives aluminum a very hard, non-corrosive surface. Anodized aluminum is made with an electrolytic process that makes it much harder and smooth — the one downside is that you can’t put these kinds of pans in the dishwasher or you risk ruining the surface, according to the book Things Cooks Love, by Marie Simmons.

While there has been inconclusive research on links between aluminum and Alzheimer's, aluminum cookware is currently not considered to be renova discount coupon a health risk. The CDC says that while aluminum cookware can transfer aluminum into foods, especially acidic ones, “aluminum levels found in processed foods and foods cooked in aluminum pots are generally considered to be safe.”Copper (Credit. FabrikaSimf/Shutterstock)Copper is favored by professional chefs for its superior conductivity, which means it heats up quickly and evenly. But copper should not come into contact with food on its own, because it can react with acidic ingredients like wine, renova discount coupon fruit juice, or vinegar and leach into food, according to the FDA’s 2017 Food Code.

€œWhile copper is very good because of its heating properties, too much copper is not good for the body, especially for children,” says Naidenko. €œIt can even cause things like diarrhea and nausea.” Many copper pots or pans are lined with a metal like tin or stainless steel for this reason. Tin can wear more easily than steel, so if you have an old tin-lined copper pot, or if renova discount coupon you spot one at a yard sale for a good price, Naidenko said it’s a good idea to look for scratches. Copper also can be quite expensive and can oxidize in damp air, leaving a green discoloration.

Takeaways From the renova discount coupon Experts(Credit. Ekkapop Sittiwantana/Shutterstock)Each type of cookware comes with some advantages and drawbacks. A general rule of thumb is to choose cookware that works well for your needs, and steer clear of products if the materials aren’t clearly defined. You can’t go wrong with basic heavy cookware that is durable renova discount coupon and long-lasting.

But note that even nonstick cookware has its place in modern kitchens and can be reserved for preparing delicate dishes that are prone to sticking. If you have the means and must replace a pot or pan, consider cookware that will stand the test of time. And know that even if the materials are considered safe for humans renova discount coupon at home, they could become environmental hazards when they break down in landfills at the end of their life. As Fenton said, “If you're going to invest in cookware, you might as well go for something that's going to be a little bit safer and last you a little bit longer.” And no matter which type of pan you choose, the safest pan for your health may come down to how you wield it in the kitchen.

€œI think pretty much all the cookware out there right now is pretty safe, as long as you take care of it,” she renova discount coupon says.Citizen Science Salon is a partnership between Discover and SciStarter.org. The future of individualized medicine may depend on an army of one million volunteers. And scientists want you to get involved. Researchers with the National Institutes of renova discount coupon Health are recruiting citizen scientists to enlist in a study of unprecedented scope and depth.

The program, called All of Us, promises to take personal data from a diverse cross-section of volunteers and turn it into groundbreaking insights about the complex roles our genes, lifestyles and environments play in our health. €œBy studying people longitudinally over time, we’re able to see diseases arise,” says Sheri Schully, the All of Us program’s acting chief medical and scientific officer.In return for completing surveys and offering up biological samples, the program will send participants personalized results about everything from their ancestry to their genetic predisposition for certain diseases. It’s also renova discount coupon free to join. And last month, All of Us sent participants back the first set of genetic results.

Take Part. Join the National Institutes of Health’s All of Us Program‘The Right Treatment at the Right Time’In January of 2015, President Barack Obama stood in front of the country during the State of the Union and offered a bold vision for accelerating research renova discount coupon. A research program then called the Precision Medicine Initiative would recruit at least one million people from across the United States and study them, leading to rapid advances in drug discovery and customized treatments for patients based on personal data.“I want the country that eliminated polio and mapped the human genome to lead a new era of medicine — one that delivers the right treatment at the right time,” Obama told the nation. He added that the project could bring us closer to curing diseases like cancer and diabetes, while offering people access to personal information that could help them stay healthy renova discount coupon.

Five years later, NIH has already enrolled hundreds of thousands of participants, and last month, those volunteers started receiving the first results from their genetic samples. But the project still has a long way to go to reach one million people. And with the approach of Citizen Science Month in April, they’re calling on volunteers from around the country to get involved in not only All of Us, but also a group of featured citizen science projects renova discount coupon and events produced with global and national partners like SciStarter, Arizona State University, Science Friday and National Geographic. €œThe power of citizen science is the massive impact that is made by everyday people, individually and collectively,” says Darlene Cavalier, founder of SciStarter and a professor of practice at the School for the Future of Innovation in Society at Arizona State University.

€œOnline and virtual events during Citizen Science Month will help introduce thousands of people to citizen science and help them find ways to act upon issues they are curious or concerned about, individually or as a community.”The NIH has now enrolled hundreds of thousands of volunteers, and participants have now started to receive the first results from their genetic samples. (Credit. All of Us/NIH)Kickstarting Precision MedicineParticipants with All of Us start by taking a survey about their lifestyle, family history and more. Then, they can agree to share their health records with researchers and offer up blood and urine samples, as well as physical measurements like height, weight and heart rate.

Participants can even share daily personal health data from smart devices like a Fitbit. The data is stripped of all personal identifiers, but this granular level of detail, when monitored over time, can give researchers a real-time look at the ways diseases arise. It’s all part of what researchers call precision medicine. Precision medicine stands in contrast to the current one-size-fits-all approach to disease treatment used by doctors around the world.

But if medical professionals could better understand their patients at an individual level, doctors could predict the best possible treatment for a particular disease. €œ[Precision medicine] is understanding what a person is experiencing and what’s going on inside and outside their body in relation to disease,” Schully says. €œIt’s really evaluating a person holistically. What are they eating?.

What’s their lifestyle like?. And what kind of job do they have?. Precision medicine to us doesn't just mean targeted treatment, it means targeted prevention.”A Holistic Look at skin care products’s ImpactResearchers are already studying the database. And it’s even giving them new insights into skin care products.

Back before the renova started, All of Us was enrolling about 3,000 people every week. Eventually, the skin care forced them to temporarily pause that enrollment. But when researchers went back and studied the 24,000 blood samples they’d collected between late 2019 and early 2020, they found some surprises. At the time, researchers didn’t know skin care products was spreading in communities around the country.

Yet a significant number of the blood samples All of Us collected showed signs of skin care products antibodies, meaning that the disease was spreading in many states well before health officials realized. Researchers with the project recently published those results in the New England Journal of Medicine. Meanwhile, All of Us has also been asking participants about skin care products symptoms via a survey sent out last May. The survey included broad skin care products-related questions, including inquiries about people’s mental well-being and whether they’d lost their job.

The initial results of that work were released to researchers in December, and they offer a detailed look at how skin care products is affecting families and communities. Among other things, All of Us heard back that people are suffering long-term heart defects and breathing effects, problems that medical professionals have seen elsewhere. Armed with this data, the program hopes they can monitor these lingering health problems over time. It’s a sort of holistic look that has been part of the program’s mission since the start.

An All of Us staff member measures a participant’s height. (Credit. All of Us/NH)A Truly Diverse DatasetOther large projects have collected genetic databases aimed at advancing disease diagnosis and treatment, but All of Us stands out for its staggering size and its mission. Researchers aren’t just studying people’s DNA, All of Us is putting its participants at the epicenter of their program.

The community helps make decisions, with volunteers even sitting on governing boards, deciding how data can be used. If that aim wasn’t lofty enough, All of Us is also after a diverse cross-section of the American public, including people from diverse ethnic and economic backgrounds, as well as a mix of rural and urban residents. That’s something other studies have long struggled with. The project’s leaders say that most of modern medicine has been biased toward studying people with European ancestry, leaving other segments of the population underrepresented in research.

And as an incentive to get one million people involved, the project will also share genetic information with its participants, including things like ancestry and whether they’re at an increased risk for disease. €œNever before have we really put the participant at the center of the study and really valued the back and forth, giving them what matters to them,” Schully says. €œWe really want to be a catalyst for change in how things are done in science.”Insights into Disease PredispositionIn December, they started returning those first individual ancestry and genetic trait results to volunteers. €œParticipants are our most important partners in this effort, and we know many of them are eager to get their genetic results and learn about the science they’re making possible,” All of Us chief executive officer Josh Denny said in an announcement.

€œWe’re working to provide that valuable information in a responsible way.”Later this year, All of Us plans to start telling interested participants about how their DNA could affect their body’s response to certain drugs, or even about genes that could increase their risk of a variety of diseases like cancer. Those results will be paired with counseling to help people understand the implications of their DNA profile. And, like everything with the program, the personal data will be tightly protected. €œIt's a huge milestone for our project,” Schully says.

€œReturning results on this level has never been done before.”And people who get involved throughout the year — including during Citizen Science Month — can look forward to learning more about their family’s ancestry and genetic predispositions. Citizen Science Month is all about turning curiosity into impact, and what better way than with a project that could help you better understand yourself while helping researchers better understand human health at large?. You can join the All of Us program by visiting joinallofus.org/nlm.Your digestive system plays host to a mind-boggling 100 trillion microbes — microscopic pinch-hitters that allow you to absorb energy from your food and churn out compounds like serotonin, which affect your mental well-being. While some of these microbes take up residence in your gut from birth, others emerge or wane depending on the lifestyle choices you make.New research suggests that if you exercise, take antidepressants or use cannabis, your gut-bacterial balance may shift profoundly.

But scientists still face a so-called black box conundrum. They’re not always sure what biological processes cause these microbial shifts or how the shifts affect other body functions. Planned larger-scale studies promise to deepen experts’ understanding of the bacterial changes your daily habits usher in, as well as the long-term health implications.Exercise to ColonizeNot only does regular exercise boost your overall well-being, it also swells the ranks of gut bacteria that promote a healthy metabolism, says Satu Pekkala, a bacteriologist at Finland’s University of Jyväskylä. In a 2018 study, Pekkala and his colleagues recruited 17 overweight women who participated in three endurance exercise sessions each week for six weeks.

The women rode an exercise bike that adjusted workout intensity so that riders stayed at about 85% of their maximum heart rate.The team had participants collect stool samples before and after the six-week training period, then sequenced DNA from these samples to detect changes in the women’s gut bacteria. After the training regimen, the women had higher levels of gut bacteria from the genus Akkermansia — a bacterial group tied to improved metabolic function — than they had before. They also had lower levels of Proteobacteria, a genus linked to inflammation in the body.Pekkala has secured approval to conduct another study that examines bacteria-produced molecules to explore what biological role Akkermansia and Proteobacteria might play in the gut — and how Akkermansia abundance might affect the body’s ability to burn fat stores. €œNot everybody loses fat mass even if they exercise,” Pekkala says.

€œIt’s important to know how the metabolic functions [of gut bacteria] affect fat loss.” The Cannabis ConnectionPlenty of research shows that marijuana compounds reduce disease-related inflammation, and, according to a 2019 study, these compounds’ effects on gut bacteria might explain some of their anti-inflammatory properties.In exploring possible treatments for Multiple Sclerosis (MS), University of South Carolina researchers treated mice that had a similar condition with molecules like delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).The mice showed fewer signs of inflammation after the cannabis treatment — and an analysis showed that gut-bacterial shifts were likely responsible, at least in part. Before treatment, the mice had high levels of the bacterial species Akkermansia muciniphila, which produces compounds called lipopolysaccharides that are linked to brain inflammation. After treatment, mice had lower levels of this species in their guts and lower levels of lipopolysaccharides in their brains. Future studies may show whether cannabis can spur similar gut-bacterial and brain changes in humans with MS.Gut CheckAn antidepressant that millions of Americans take may alter their gut-bacterial mix as well as their mental outlook, University of California-Los Angeles researchers say.

In a 2019 study, the UCLA team added fluoxetine (Prozac) to a tube with a common gut bacterial species called Turicibacter sanguinis, which normally tells intestinal cells to produce more serotonin — a neurotransmitter that affects mood. After the team put in fluoxetine, the bacteria transported less serotonin than it had before. Further experiments showed that mice dosed with fluoxetine had lower gut levels of Turicibacter than other mice.These results suggest that Turicibacter populations fluctuate in the presence of drugs like fluoxetine that modify serotonin levels. Next, the UCLA team plans to tease out the molecular mechanisms that reveal just how fluoxetine affects certain gut bacteria — and how that might influence the way the drug works in the brain and the rest of the body.

€œThere’s variation in how effective fluoxetine is for different people,” says UCLA microbiologist Jonathan Lynch. €œSomething like the interaction with the microbiome might be mediating that.”Future studies of these gut-brain interactions could allow a personalized-medicine approach that identifies people who are good candidates to respond to drugs like fluoxetine, Lynch says. Someday, based on your gut microbe profile, doctors might be able to tell you which antidepressants will work for you and which ones you shouldn’t even try..

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IntroductionLa Peste (Camus 1947) has served as a basis for several critical works, including some in the field of medical humanities (Bozzaro 2018 can i buy renova online. Deudon 1988. Tuffuor and Payne 2017) can i buy renova online. Frequently interpreted as an allegory of Nazism (with the plague as a symbol of the German occupation of France) (Finel-Honigman 1978. Haroutunian 1964), it has also received philosophical readings beyond the sociopolitical context in which it was written (Lengers 1994).

Other scholars, on the other hand, have centred their analyses on its literary aspects (Steel can i buy renova online 2016).The skin care products renova has increased general interest about historical and fictional epidemics. La Peste, as one of the most famous literary works about this topic, has been revisited by many readers during recent months, leading to an unexpected growth in sales in certain countries (Wilsher 2020. Zaretsky 2020). Apart from that, commentaries about the novel, especially among health sciences scholars, have can i buy renova online emerged with a renewed interest (Banerjee et al. 2020.

Bate 2020. Vandekerckhove 2020 can i buy renova online. Wigand, Becker, and Steger 2020). This sudden curiosity is easy to understand if we consider both La Peste’s literary value, and people’s desire to discover real or fictional situations similar to theirs. Indeed, Oran inhabitants’ experiences are not quite far from our own, even if geographical, chronological and, specially, scientific factors (two different diseases occurring at two different stages in the history of medical development) prevent us from establishing too close resemblances between both situations.Furthermore, it will not be strange if skin care products serves as a frame for fictional works in can i buy renova online the near future.

Other narrative plays were based on historical epidemics, such as Daniel Defoe’s A Journal of the Plague Year or Giovanni Boccaccio’s Decameron (Wigand, Becker, and Steger 2020. Withington 2020). The biggest renova in the last century, the so-called ‘Spanish Influenza’, has been described as not very fruitful in this sense, even if it produced famous novels such as Katherine A Porter’s Pale Horse, Pale Rider or can i buy renova online John O’Hara’s The Doctor Son (Honigsbaum 2018. Hovanec 2011). The overlapping with another disaster like World War I has been argued as one of the reasons explaining this scarce production of fictional works (Honigsbaum 2018).

By contrast, we may think that skin care products is having a global impact hardly overshadowed by other events, and can i buy renova online that it will leave a significant mark on the collective memory.Drawing on the reading of La Peste, we point out in this essay different aspects of living under an epidemic that can be identified both in Camus’s work and in our current situation. We propose a trip throughout the novel, from its early beginning in Part I, when the Oranians are not aware of the threat to come, to its end in Part V, when they are relieved of the epidemic after several months of ravaging disasters.We think this journey along La Peste may be interesting both to health professionals and to the lay person, since all of them will be able to see themselves reflected in the characters from the novel. We do not skip critique of some aspects related to the authorities’ management of skin care products, as Camus does concerning Oran’s rulers. However, what we want to foreground is La Peste’s intrinsic value, its suitability to be read now and after skin care products has passed, when Camus’s novel endures as a solid art work and skin care products remains only as can i buy renova online a defeated plight.MethodsWe confronted our own experiences about skin care products with a conventional reading of La Peste. A first reading of the novel was used to establish associations between those aspects which more saliently reminded us of skin care products.

In a second reading, we searched for some examples to illustrate those aspects and tried to detect new associations. Subsequent readings of certain parts were done to integrate the information can i buy renova online collected. Neither specific methods of literary analysis, nor systematic searches in the novel were applied. Selected paragraphs and ideas from Part I to Part V were prepared in a draft copy, and this manuscript was written afterwards.Part ISome phrases in the novel could be transposed word by word to our situation. This one pertaining to its start, for instance, may make us can i buy renova online remember the first months of 2020:By now, it will be easy to accept that nothing could lead the people of our town to expect the events that took place in the spring of that year and which, as we later understood, were like the forerunners of the series of grave happenings that this history intends to describe.

(Camus 2002, Part I)By referring from the beginning to ‘the people of our town’, Camus is already suggesting an idea which is repeated all along the novel, and which may be well understood by us as skin care products’s witnesses. Epidemics affect the community as a whole, they are present in everybody’s mind and their joys and sorrows are not individual, but collective. For example (and we are anticipating Part II), the narrator says:But, once the gates were closed, they all noticed that they were in the same boat, including the narrator himself, and that they had to adjust to can i buy renova online the fact. (Camus 2002, Part II)Later, he will insist in this opposition between the concepts of ‘individual’, which used to prevail before the epidemic, and ‘collective’:One might say that the first effect of this sudden and brutal attack of the disease was to force the citizens of our town to act as though they had no individual feelings. (Camus 2002, Part II)There were no longer any individual destinies, but a collective history that was the plague, and feelings shared by all.

(Camus 2002, Part III)This distinction is not trivial, since the story will display a strong confrontation between those who get involved and help their neighbours and those who can i buy renova online remain behaving selfishly. Related to this, Claudia Bozzaro has pointed out that the main topic in La Peste is solidarity and auistic love (Bozzaro 2018). We may add that the disease is so attached to people’s lives that the epidemic becomes the new everyday life:In the morning, they would return to the pestilence, that is to say, to routine. (Camus 2002, Part III)Being collective issues can i buy renova online does not mean that epidemics always enhance auism and solidarity. As said by Wigand et al, they frequently produce ambivalent reactions, and one of them is the opposition between auism and maximised profit (Wigand, Becker, and Steger 2020).

Therefore, the dichotomy between individualism and collectivism, a central point in the characterisation of national cultures (Hofstede 2015), could play a role in epidemics. In fact, concerning can i buy renova online skin care products, some authors have described a greater impact of the renova in those countries with higher levels of individualism (Maaravi et al. 2021. Ozkan et al. 2021).

However, this finding should be complemented with other national cultures’ aspects before concluding that collectivism itself exerts a protective role against epidemics. Concerning this, it has been shown how ‘power distance’ frequently intersects with collectivism, being only a few countries in which the last one coexists with a small distance to power, namely with a capacity to disobey the power authority (Gupta, Shoja, and Mikalef 2021). Moreover, those countries classically classified as ‘collectivist’ (China, Japan, South Korea, India, Vietnam, etc.) are also characterised by high levels of power distance, and their citizens have been quite often forced to adhere to skin care products restrictions and punished if not (Gupta, Shoja, and Mikalef 2021). Thus, it is important to consider that individualism is not always opposed to ‘look after each other’ (Ozkan et al. 2021, 9).

For instance, the European region, seen as a whole as highly ‘individualistic’, holds some of the most advanced welfare protection systems worldwide. It is worth considering too that collectivism may hide sometimes a hard institutional authority or a lack in civil freedoms.Coming back to La Peste, we may think that Camus’s Oranians are not particularly ‘collectivist’. Their initial description highlights that they are mainly interested in their own businesses and affairs:Our fellow-citizens work a good deal, but always in order to make money. They are especially interested in trade and first of all, as they say, they are engaged in doing business. (Camus 2002, Part I)And later, we see some of them trying selfishly to leave the city by illegal methods.

By contrast, we observe in the novel some examples of more ‘collectivistic’ attitudes, such as the discipline of those quarantined at the football pitch, and, over all, the main characters’ behaviour, which is generally driven by auism and common goals.Turning to another topic, the plague in Oran and skin care products are similar regarding their animal origin. This is not rare since many infectious diseases pass to humans through contact with animal vectors, being rodents, especially rats (through rat fleas), the most common carriers of plague bacteria (CDC. N.d.a, ECDC. N.d, Pollitzer 1954). Concerning skin care, even if further research about its origin is needed, the most recent investigations conducted in China by the WHO establish a zoonotic transmission as the most probable pathway (Joint WHO-China Study Team 2021).

In Camus’s novel, the animal’s link to the epidemic seemed very clear since the beginning:Things got to the point where Infodoc (the agency for information and documentation, ‘ all you need to know on any subject’) announced in its free radio news programme that 6,231 rats had been collected and burned in a single day, the 25th. This figure, which gave a clear meaning to the daily spectacle that everyone in town had in front of their eyes, disconcerted them even more. (Camus 2002, Part I)This accuracy in figures is familiar to us. People nowadays have become very used to the statistical aspects of the renova, due to the continuous updates in epidemiological parameters launched by the media and the authorities. Camus was aware about the relevance of figures in epidemics, which always entail:…required registration and statistical tasks.

(Camus 2002, Part II)Because of this, the novel is scattered with numbers, most of them concerning the daily death toll, but others mentioning the number of rats picked up, as we have seen, or combining the number of deaths with the time passed since the start of the epidemic:“ Will there be an autumn of plague?. Professor B answers. €˜ No’ ”, “ One hundred and twenty-four dead. The total for the ninety-fourth day of the plague.” (Camus 2002, Part II)We permit ourselves to introduce here a list of recurring topics in La Peste, since the salience of statistical information is one of them. These topics, some of which will be treated later, appear several times in the novel, in various contexts and stages in the evolution of the epidemic.

We synthesise them in Table 1, coupled with a skin care products parallel example extracted from online press. This ease to find a current example for each topic suggests that they are not exclusive of plague or of Camus’s mindset, but shared by most epidemics.View this table:Table 1 Recurring topics in La Peste. Each topic is accompanied by two examples from the novel and one concerning skin care products, extracted from online press.Talking about journalism and the media (one of the topics above), we might say that skin care products’s coverage is frequently too optimistic when managing good news and too alarming when approaching the bad. Media’s ‘exaggerated’ approach to health issues is not new. It was already a concern for medical journals’ editors a century ago (Reiling 2013) and it continues to be it for these professionals in recent times (Barbour et al.

2008). It is well known that media tries to attract spectators’ attention by making the news more appealing. However, they deal with the risk of expanding unreliable information, which may be pernicious for the public opinion. Related to the intention of ‘garnishing’ the news, Aslam et al. (2020) have described that 82% of more than 100 000 pieces of information about skin care products appearing in media from different countries carried an emotional, either negative (52%) or positive (30%) component, with only 18% of them considered as ‘neutral’ (Aslam et al.

2020). Some evidence about this tendency to make news more emotional was described in former epidemics. For instance, a study conducted in Singapore in 2009 during the H1N1 crisis showed how press releases by the Ministry of Health were substantially transformed when passed to the media, by increasing their emotional appeal and by changing their dominant frame or their tone (Lee and Basnyat 2013). In La Peste, this superficial way of managing information by the media is also observed:The newspapers followed the order that they had been given, to be optimistic at any cost. (Camus 2002, Part IV)At the first stages of the epidemic in Oran, journalists proclaim the end of the dead rats’ invasion as something to be celebrated.

Dr Rieux, the character through which Camus symbolises caution (and comparable nowadays to trustful scientists, well-informed journalists or sensible authorities), exposes then his own angle, quite far from suggesting optimism:The vendors of the evening papers were shouting that the invasion of rats had ended. But Rieux found his patient lying half out of bed, one hand on his belly and the other around his neck, convulsively vomiting reddish bile into a rubbish bin. (Camus 2002, Part I)Camus, who worked as a journalist for many years, insists afterwards on this cursory interest that some media devote to the epidemic, more eager to grab the noise than the relevant issues beneath it:The press, which had had so much to say about the business of the rats, fell silent. This is because rats die in the street and people in their bedrooms. And newspapers are only concerned with the street.

(Camus 2002, Part I)By then, Oranians continue rejecting the epidemic as an actual threat, completely immersed in that phase that dominates the beginning of all epidemics and is characterised by ‘denial and disbelief’ (Wigand, Becker, and Steger 2020, 443):A pestilence does not have human dimensions, so people tell themselves that it is unreal, that it is a bad dream which will end. […] The people of our town were no more guilty than anyone else, they merely forgot to be modest and thought that everything was still possible for them, which implied that pestilence was impossible. They continued with business, with making arrangements for travel and holding opinions. Why should they have thought about the plague, which negates the future, negates journeys and debate?. They considered themselves free and no one will ever be free as long as there is plague, pestilence and famine.

(Camus 2002, Part I)Probably to avoid citizens' disapproval, among other reasons, the Oranian Prefecture (health authority in Camus' novel) does not want to go too far when judging the relevance of the epidemic. While not directly exposed, we can guess in this fragment the tone of the Prefect’s message, his intention to convey confidence despite his own doubts:These cases were not specific enough to be really disturbing and there was no doubt that the population would remain calm. None the less, for reasons of caution which everyone could understand, the Prefect was taking some preventive measures. If they were interpreted and applied in the proper way, these measures were such that they would put a definite stop to any threat of epidemic. As a result, the Prefect did not for a moment doubt that the citizens under his charge would co-operate in the most zealous manner with what he was doing.

(Camus 2002, Part I)The relevant role acquired by health authorities during epidemics is another topic listed in our table. Language use, on the other hand, is an issue linkable both with the media topic and with this one. As in La Peste, during skin care products we have seen some public figures using words not always truthfully, carrying out a careful selection of words that serves to the goal of conveying certain interests in each moment. Dr Rieux refers in Part I to this language manipulation by the authorities:The measures that had been taken were insufficient, that was quite clear. As for the ‘ specially equipped wards’, he knew what they were.

Two outbuildings hastily cleared of other patients, their windows sealed up and the whole surrounded by a cordon sanitaire. (Camus 2002, Part I)He illustrates the need of frankness, the preference for clarity in language, which is often the clarity in thinking:No. I phoned Richard to say we needed comprehensive measures, not fine words, and that either we must set up a real barrier to the epidemic, or nothing at all. (Camus 2002, Part I)At the end of this part, his fears about the inadequacy of not taking strict measures are confirmed. Oranian hospitals become overwhelmed, as they are now in many places worldwide due to skin care products.Part IILeft behind the phases of ‘denial and disbelief’ and of ‘fear and panic’, it appears among the Oranians the ‘acceptance paired with resignation’ (Wigand, Becker, and Steger 2020, 443):Then we knew that our separation was going to last, and that we ought to try to come to terms with time.

[…] In particular, all of the people in our town very soon gave up, even in public, whatever habit they may have acquired of estimating the length of their separation. (Camus 2002, Part II)In skin care products as well, even if border closure has not been so immovable as in Oran, many people have seen themselves separated from their loved ones and some of them have not yet had the possibility of reunion. This is why, in the actual renova, the idea of temporal horizons has emerged like it appeared in Camus’s epidemic. In Spain, the general lockdown in March and April 2020 made people establish the summer as their temporal horizon, a time in which they could resume their former habits and see their relatives again. This became partially true, and people were allowed in summer to travel inside the country and to some other countries nearby.

However, there existed some reluctance to visit ill or aged relatives, due to the fear of infecting them, and some families living in distant countries were not able to get together. Moreover, autumn brought an increase in the number of cases (‘the second wave’) and countries returned to limit their internal and external movements.Bringing all this together, many people nowadays have opted to discard temporal horizons. As Oranians, they have noted that the epidemic follows its own rhythm and it is useless to fight against it. Nonetheless, it is in human nature not to resign, so abandoning temporal horizons does not mean to give up longing for the recovery of normal life. This vision, neither maintaining vain hopes nor resigning, is in line with Camus’s philosophy, an author who wrote that ‘hope, contrary to what it is usually thought, is the same to resignation.’ (Camus 1939, 83.

Cited by Haroutunian 1964, 312 (translation is ours)), and that ‘there is not love to human life but with despair about human life.’ (Camus 1958, 112–5. Cited by Haroutunian 1964, 312–3 (translation is ours)).People nowadays deal with resignation relying on daily life pleasures (being not allowed to make further plans or trips) and in company from the nearest ones (as they cannot gather with relatives living far away). Second, they observe the beginning of vaccination campaigns as a first step of the final stage, and summer 2021, reflecting what happened with summer 2020, has been fixed as a temporal horizon. This preference for summers has an unavoidable metaphorical nuance, and their linking to joy, long trips and life in the streets may be the reason for which we choose them to be opposed to the lockdown and restrictions of the renova.We alluded previously to the manipulation of language, and figures, as relevant as they are, they are not free from manipulation either. Tarrou, a close friend to Dr Rieux, points out in this part of the novel how this occurred:Once more, Tarrou was the person who gave the most accurate picture of our life as it was then.

Naturally he was following the course of the plague in general, accurately observing that a turning point in the epidemic was marked by the radio no longer announcing some hundreds of deaths per week, but 92, 107 and 120 deaths a day. €˜The newspapers and the authorities are engaged in a battle of wits with the plague. They think that they are scoring points against it, because 130 is a lower figure than 910.’ (Camus 2002, Part II)Tarrou collaborates with the health teams formed to tackle the plague. Regarding these volunteers and workers, Camus refuses to consider them as heroes, as many essential workers during skin care products have rejected to be named as that. The writer thinks their actions are the natural behaviour of good people, not heroism but ‘a logical consequence’:The whole question was to prevent the largest possible number of people from dying and suffering a definitive separation.

There was only one way to do this, which was to fight the plague. There was nothing admirable about this truth, it simply followed as a logical consequence. (Camus 2002, Part II)We consider suitable to talk here about two issues which represent, nowadays, a great part of skin care products fears and hopes, respectively. New genetic variants and treatments. Medical achievements are another recurrent issue included in table 1, and we write about them here because it is in Part II where Camus writes for the first time about treatments, and where it insists on an idea aforementioned in Part I.

That the plague bacillus affecting Oran is different from previous variants:…the microbe differed very slightly from the bacillus of plague as traditionally defined. (Camus 2002, Part II)Related to skin care products new variants, they represent a challenge because of two main reasons. Their higher transmissibility and/or severity and their higher propensity to skip the effect of natural or treatment-induced immunity. Public health professionals are determining which is the actual threat of all the new variants discovered, such as those first characterised in the UK (Public Health England 2020), South Africa (Tegally et al. 2021) or Brazil (Fujino et al.

2021). In La Peste, Dr Rieux is always suspecting that the current bacteria they are dealing with is different from the one in previous epidemics of plague. Since several genetic variations for the bacillus Yersinia pestis have been characterised (Cui et al. 2012), it could be possible that the epidemic in Oran originated from a new one. However, we should not forget that we are analysing a literary work, and that scientific accuracy is not a necessary goal in it.

In fact, Rieux’s reluctances have to do more with clinical aspects than with microbiological ones. He doubts since the beginning, relying exclusively on the symptoms observed, and continues doing it after the laboratory analysis:I was able to have an analysis made in which the laboratory thinks it can detect the plague bacillus. However, to be precise, we must say that certain specific modifications of the microbe do not coincide with the classic description of plague. (Camus 2002, Part II)Camus is consistent with this idea and many times he mentions the bacillus to highlight its oddity. Insisting on the literary condition of the work, and among other possible explanations, he is maybe declaring that that in the novel is not a common (biological, natural) bacteria, but the Nazism bacteria.Turning to treatments, they constitute the principal resource that the global community has to defeat the skin care products renova.

Vaccination campaigns have started all over the world, and three types of skin care products treatments are being applied in the European Union, after their respective statements of efficacy and security (Baden et al. 2021. Polack et al. 2020. Voysey et al.

2021), while a fourth treatment has just recently been approved (EMA 2021a). Although some concerns regarding the safety of two of these treatments have been raised recently (EMA 2021b. EMA 2021c), vaccination plans are going ahead, being adapted according to the state of knowledge at each moment. Some of these treatments are mRNA-based (Baden et al. 2021.

Polack et al. 2020), while others use a viral vector (Bos et al. 2020. Voysey et al. 2021).

They are mainly two-shot treatments, with one exception (Bos et al. 2020), and complete immunity is thought to be acquired 2 weeks after the last shot (CDC. N.d.b, Voysey et al. 2021). Other countries such as China or Russia, on the other hand, were extremely early in starting their vaccination campaigns, and are distributing among their citizens different treatments than the aforementioned (Logunov et al.

2021. Zhang et al. 2021).Even if at least three types of plague treatments had been created by the time the novel takes place (Sun 2016), treatments do not play an important role in La Peste, in which therapeutic measures (the serum) are more important than prophylactic ones. Few times in the novel the narrator refers to prophylactic inoculations:There was still no possibility of vaccinating with preventive serum except in families already affected by the disease. (Camus 2002, Part II)Deudon has pointed out that Camus mixes up therapeutic serum and treatment (Deudon 1988), and in fact there exists a certain amount of confusion.

All along the novel, the narrator focuses on the prophylactic goals of the serum, which is applied to people already infected (Othon’s son, Tarrou, Grand…). However, both in the example above (which can be understood as vaccinating household contacts or already affected individuals) and in others, the differences between treating and vaccinating are not clear:After the morning admissions which he was in charge of himself, the patients were vaccinated and the swellings lanced. (Camus 2002, Part II)In any case, this is another situation in which Camus stands aside from scientific matters, which are to him less relevant in his novel than philosophical or literary ones. The distance existing between the relevance of treatments in skin care products and the superficial manner with which Camus treats the topic in La Peste exemplifies this.Part IIIIn part III, the plague’s ravages become tougher. The narrator turns his focus to burials and their disturbance, a frequent topic in epidemics’ narrative (table 1).

Camus knew how acutely increasing demands and hygienic requirements affect funeral habits during epidemics:Everything really happened with the greatest speed and the minimum of risk. (Camus 2002, Part III)Like many other processes during epidemics, the burial process becomes a protocol. When protocolised, everything seems to work well and rapidly. But this perfect mechanism is the Prefecture’s goal, not Rieux’s. He reveals in this moment an aspect in his character barely shown before.

Irony.The whole thing was well organized and the Prefect expressed his satisfaction. He even told Rieux that, when all was said and done, this was preferable to hearses driven by black slaves which one read about in the chronicles of earlier plagues. €˜ Yes,’ Rieux said. €˜ The burial is the same, but we keep a card index. No one can deny that we have made progress.’ (Camus 2002, Part III)Even if this characteristic may seem new in Dr Rieux, we must bear in mind that he is the story narrator, and the narration is ironic from time to time.

For instance, speaking precisely about the burials:The relatives were invited to sign a register –which just showed the difference that there may be between men and, for example, dogs. You can keep check of human beings-. (Camus 2002, Part III)In Camus’s philosophy, the absurd is a core issue. According to Lengers, Rieux is ironic because he is a kind of Sisyphus who has understood the absurdity of plague (Lengers 1994). The response to the absurd is to rebel (Camus 2013), and Rieux does it by helping his fellow humans without questioning anything.

He does not pursue any other goal than doing his duty, thus humour (as a response to dire situations) stands out from him when he observes others celebrating irrelevant achievements, such as the Prefect with his burial protocol. In the field of medical ethics, Lengers has highlighted the importance of Camus’s perspective when considering ‘the immediacy of life rather than abstract values’ (Lengers 1994, 250). Rieux himself is quite sure that his solid commitment is not ‘abstract’, and, even if he falls into abstraction, the importance relies on protecting human lives and not in the name given to that task:Was it truly an abstraction, spending his days in the hospital where the plague was working overtime, bringing the number of victims up to five hundred on average per week?. Yes, there was an element of abstraction and unreality in misfortune. But when an abstraction starts to kill you, you have to get to work on it.

(Camus 2002, Part II)Farewells during skin care products may have not been particularly pleasant for some families. Neither those dying at nursing homes nor in hospitals could be accompanied by their families as previously, due to corpses management protocols, restrictions of external visitors and hygienic measures in general. However, as weeks passed by, certain efforts were made to ease this issue, allowing people to visit their dying beloved sticking to strict preventive measures. On the other hand, the number of people attending funeral masses and cemeteries was also limited, which affected the conventional development of ceremonies as well. Hospitals had to deal with daily tolls of deaths never seen before, and the overcrowding of mortuaries made us see rows of coffins placed in unusual spaces, such as ice rinks (transformation of facilities is another topic in table 1).We turn now to two other points which skin care products has not evaded.

s among essential workers and epidemics’ economic consequences. The author links burials with s among essential workers because gravediggers constitute one of the most affected professions, and connects this fact with the economic recession because unemployment is behind the large availability of workers to replace the dead gravediggers:Many of the male nurses and the gravediggers, who were at first official, then casual, died of the plague. […] The most surprising thing was that there was never a shortage of men to do the job, for as long as the epidemic lasted. […] When the plague really took hold of the town, its very immoderation had one quite convenient outcome, because it disrupted the whole of economic life and so created quite a large number of unemployed. […] Poverty always triumphed over fear, to the extent that work was always paid according to the risk involved.

(Camus 2002, Part III)The effects of the plague over the economic system are one of our recurrent topics (table 1). The plague in Oran, as it forces to close the city, impacts all trading exchanges. In addition, it forbids travellers from arriving to the city, with the economic influence that that entails:This plague was the ruination of tourism. (Camus 2002, Part II)Oranians, who, as we saw, were very worried about making money, are especially affected by an event which jeopardises it. In skin care products, for one reason or for another, most of the countries are suffering economic consequences, since the impact on normal life from the epidemic (another recurrent topic) means also an impact on the normal development of trading activities.Part IVIn Part IV we witness the first signals of a stabilisation of the epidemic:It seemed that the plague had settled comfortably into its peak and was carrying out its daily murders with the precision and regularity of a good civil servant.

In theory, in the opinion of experts, this was a good sign. The graph of the progress of the plague, starting with its constant rise, followed by this long plateau, seemed quite reassuring. (Camus 2002, Part IV)At this time, we consider interesting to expand the topic about the transformation of facilities. We mentioned the case of ice rinks during skin care products, and we bring up now the use of a football pitch as a quarantine camp in Camus’s novel, a scene which has reminded some scholars of the metaphor of Nazism and concentration camps (Finel-Honigman 1978). In Spain, among other measures, a fairground was enabled as a field hospital during the first wave, and it is plausible that many devices created with other purposes were used in tasks attached to healthcare provision during those weeks, as occurred in Oran’s pitch with the loudspeakers:Then the loudspeakers, which in better times had served to introduce the teams or to declare the results of games, announced in a tinny voice that the internees should go back to their tents so that the evening meal could be distributed.

(Camus 2002, Part IV)Related to this episode, we can also highlight the opposition between science and humanism that Camus does. The author alerts us about the dangers of a dehumanised science, of choosing procedures perfectly efficient regardless of their lack in human dignity:The men held out their hands, two ladles were plunged into two of the pots and emerged to unload their contents onto two tin plates. The car drove on and the process was repeated at the next tent.‘ It’s scientific,’ Tarrou told the administrator.‘ Yes,’ he replied with satisfaction, as they shook hands. €˜ It’s scientific.’ (Camus 2002, Part IV)Several cases with favourable outcomes mark Part IV final moments and prepare the reader for the end of the epidemic. To describe these signs of recovering, the narrator turns back to two elements with a main role in the novel.

Rats and figures. In this moment, the first ones reappear and the second ones seem to be declining:He had seen two live rats come into his house through the street door. Neighbours had informed him that the creatures were also reappearing in their houses. Behind the walls of other houses there was a hustle and bustle that had not been heard for months. Rieux waited for the general statistics to be published, as they were at the start of each week.

They showed a decline in the disease. (Camus 2002, Part IV)Part VGiven that we continue facing skin care products, and that forecasts about its end are not easy, we cannot compare ourselves with the Oranians once they have reached the end of the epidemic, what occurs in this part. However, we can analyse our current situation, characterised by a widespread, though cautious, confidence motivated by the beginning of vaccination campaigns, referring it to the events narrated in Part V.Even more than the Oranians, since we feel further than them from the end of the problem, we are cautious about not to anticipate celebrations. From time to time, however, we lend ourselves to dream relying on what the narrator calls ‘a great, unadmitted hope’. skin care products took us by surprise and everyone wants to ‘reorganise’ their life, as Oranians do, but patience is an indispensable component to succeed, as fictional and historical epidemics show us.Although this sudden decline in the disease was unexpected, the towns-people were in no hurry to celebrate.

The preceding months, though they had increased the desire for liberation, had also taught them prudence and accustomed them to count less and less on a rapid end to the epidemic. However, this new development was the subject of every conversation and, in the depths of people’s hearts, there was a great, unadmitted hope. […] One of the signs that a return to a time of good health was secretly expected (though no one admitted the fact) was that from this moment on people readily spoke, with apparent indifference, about how life would be reorganized after the plague. (Camus 2002, Part V)We put our hope on vaccination. Social distancing and other hygienic measures have proved to be effective, but treatments would bring us a more durable solution without compromising so hardly many economic activities and social habits.

As we said, a more important role of scientific aspects is observed in skin care products if compared with La Peste (an expected fact if considered that Camus’s story is an artistic work, that he skips sometimes the most complex scientific issues of the plague and that health sciences have evolved substantially during last decades). Oranians, in fact, achieve the end of the epidemic not through clearly identified scientific responses but with certain randomness:All one could do was to observe that the sickness seemed to be going as it had arrived. The strategy being used against it had not changed. It had been ineffective yesterday, and now it was apparently successful. One merely had the feeling that the disease had exhausted itself, or perhaps that it was retiring after achieving all its objectives.

In a sense, its role was completed. (Camus 2002, Part V)They receive the announcement made by the Prefecture of reopening the town’s gates in 2 weeks time with enthusiasm. Dealing with concrete dates gives them certainty, helps them fix the temporal horizons we wrote about. This is also the case when they are told that preventive measures would be lifted in 1 month. Camus shows us then how the main characters are touched as well by this positive atmosphere:That evening Tarrou and Rieux, Rambert and the rest, walked in the midst of the crowd, and they too felt they were treading on air.

Long after leaving the boulevards Tarrou and Rieux could still hear the sounds of happiness following them… (Camus 2002, Part V)Then, Tarrou points out a sign of recovery coming from the animal world. In a direct zoological chain, infected fleas have vanished from rats, which have been able again to multiply across the city, making the cats abandon their hiding places and to go hunting after them again. At the final step of this chain, Tarrou sees the human being. He remembers the old man who used to spit to the cats beneath his window:At a time when the noise grew louder and more joyful, Tarrou stopped. A shape was running lightly across the dark street.

It was a cat, the first that had been seen since the spring. It stopped for a moment in the middle of the road, hesitated, licked its paw, quickly passed it across its right ear, then carried on its silent way and vanished into the night. Tarrou smiled. The little old man, too, would be happy. (Camus 2002, Part V)Unpleasant things as a town with rats running across its streets, or a man spending his time spitting on a group of cats, constitute normality as much as the reopening of gates or the reboot of commerce.

However, when Camus speaks directly about normality, he highlights more appealing habits. He proposes common leisure activities (restaurants, theatres) as symbols of human life, since he opposes them to Cottard’s life, which has become that of a ‘wild animal’:At least in appearance he [ Cottard ] retired from the world and from one day to the next started to live like a wild animal. He no longer appeared in restaurants, at the theatre or in his favourite cafés. (Camus 2002, Part V)We do not disclose why Cottard’s reaction to the end of the epidemic is different from most of the Oranians’. In any case, the narrator insists later on the assimilation between common pleasures and normality:‘ Perhaps,’ Cottard said, ‘ Perhaps so.

But what do you call a return to normal life?. €™ ‘ New films in the cinema,’ said Tarrou with a smile. (Camus 2002, Part V)Cinema, as well as theatre, live music and many other cultural events have been cancelled or obliged to modify their activities due to skin care products. Several bars and restaurants have closed, and spending time in those who remain open has become an activity which many people tend to avoid, fearing contagion. Thus, normality in our understanding is linked as well to these simple and pleasant habits, and the complete achievement of them will probably signify for us the desired defeat of the renova.In La Peste, love is also seen as a simple good to be fully recovered after the plague.

While Rieux goes through the ‘reborn’ Oran, it is lovers’ gatherings what he highlights. Unlike them, everyone who, during the epidemic, sought for goals different from love (such as faith or money, for instance) remain lost when the epidemic has ended:For all the people who, on the contrary, had looked beyond man to something that they could not even imagine, there had been no reply. (Camus 2002, Part V)And this is because lovers, as the narrator says:If they had found that they wanted, it was because they had asked for the only thing that depended on them. (Camus 2002, Part V)We have spoken before about language manipulation, hypocrisy and public figures’ roles during epidemics. Camus, during Dr Rieux’s last visit to the old asthmatic man, makes this frank and humble character criticise, with a point of irony, the authorities’ attitude concerning tributes to the dead:‘ Tell me, doctor, is it true that they’re going to put up a monument to the victims of the plague?.

€™â€˜ So the papers say. A pillar or a plaque.’‘ I knew it!. And there’ll be speeches.’The old man gave a strangled laugh.‘ I can hear them already. €œ Our dead…” Then they’ll go and have dinner.’ (Camus 2002, Part V)The old man illustrates wisely the authorities’ propensity for making speeches. He knows that most of them usually prefer grandiloquence rather than common words, and seizes perfectly their tone when he imitates them (‘Our dead…’).

We have also got used, during skin care products, to these types of messages. We have also heard about ‘our old people’, ‘our youth’, ‘our essential workers’ and even ‘our dead’. Behind this tone, however, there could be an intention to hide errors, or to falsely convey carefulness. Honest rulers do not usually need nice words. They just want them to be accurate.We have seen as well some tributes to the victims during skin care products, some of which we can doubt whether they serve to victims’ relief or to authorities’ promotion.

We want rulers to be less aware of their own image and to stress truthfulness as a goal, even if this is a hard requirement not only for them, but for every single person. Language is essential in this issue, we think, since it is prone to be twisted and to become untrue. The old asthmatic man illustrates it with his ‘There’ll be speeches’ and his ‘Our dead…’, but this is not the only time in the novel in which Camus brings out the topic. For instance, he does so when he equates silence (nothing can be thought as further from wordiness) with truth:It is at the moment of misfortune that one becomes accustomed to truth, that is to say to silence. (Camus 2002, Part II)or when he makes a solid statement against false words:…I understood that all the misfortunes of mankind came from not stating things in clear terms.

(Camus 2002, Part IV)The old asthmatic, in fact, while praising the deceased Tarrou, remarks that he used to admire him because ‘he didn’t talk just for the sake of it.’ (Camus 2002, Part V).Related to this topic, what the old asthmatic says about political authorities may be transposed in our case to other public figures, such as scholars and researchers, media leaders, businessmen and women, health professionals… and, if we extend the scope, to every single citizen. Because hypocrisy, language manipulation and the fact of putting individual interests ahead of collective welfare fit badly with collective issues such as epidemics. Hopefully, also examples to the contrary have been observed during skin care products.The story ends with the fireworks in Oran and the depiction of Dr Rieux’s last feelings. While he is satisfied because of his medical performance and his activity as a witness of the plague, he is concerned about future disasters to come. When skin care products will have passed, it will be time for us as well to review our life during these months.

For now, we are just looking forward to achieving our particular ‘part V’.AbstractThis study addresses the existing gap in literature that ethnographically examines the experiences of Spanish-speaking patients with limited English proficiency in clinical spaces. All of the participants in this study presented to the emergency department (ED) for evaluation of non-urgent health conditions. Patient shadowing was employed to explore the challenges that this population face in unique clinical settings like the ED. This relatively new methodology facilitates obtaining nuanced understandings of clinical contexts under study in ways that quantitative approaches and survey research do not. Drawing from the field of medical anthropology and approach of narrative medicine, the collected data are presented through the use of clinical ethnographic vignettes and thick description.

The conceptual framework of health-related deservingness guided the analysis undertaken in this study. Structural stigma was used as a complementary framework in analysing the emergent themes in the data collected. The results and analysis from this study were used to develop an argument for the consideration of language as a distinct social determinant of health.emergency medicinemedical anthropologymedical humanitiesData availability statementData sharing not applicable as no datasets were generated and/or analysed for this study..

IntroductionLa Peste (Camus 1947) has served as a renova discount coupon basis for several critical works, including some in the field of medical humanities (Bozzaro 2018 http://www.ec-rodolphe-reuss-strasbourg.site.ac-strasbourg.fr/wp/?p=366. Deudon 1988. Tuffuor and Payne renova discount coupon 2017). Frequently interpreted as an allegory of Nazism (with the plague as a symbol of the German occupation of France) (Finel-Honigman 1978. Haroutunian 1964), it has also received philosophical readings beyond the sociopolitical context in which it was written (Lengers 1994).

Other scholars, on the other hand, have centred their analyses on its renova discount coupon literary aspects (Steel 2016).The skin care products renova has increased general interest about historical and fictional epidemics. La Peste, as one of the most famous literary works about this topic, has been revisited by many readers during recent months, leading to an unexpected growth in sales in certain countries (Wilsher 2020. Zaretsky 2020). Apart from that, commentaries about the novel, especially among health sciences scholars, have emerged with a renewed interest (Banerjee et al renova discount coupon. 2020.

Bate 2020. Vandekerckhove 2020 renova discount coupon. Wigand, Becker, and Steger 2020). This sudden curiosity is easy to understand if we consider both La Peste’s literary value, and people’s desire to discover real or fictional situations similar to theirs. Indeed, Oran inhabitants’ experiences are not quite far from our own, even if geographical, chronological and, specially, scientific factors (two different diseases occurring at two different stages in the history of medical development) prevent us from establishing too close resemblances between both situations.Furthermore, it will not be strange if skin care products serves as a frame for fictional works in the renova discount coupon near future.

Other narrative plays were based on historical epidemics, such as Daniel Defoe’s A Journal of the Plague Year or Giovanni Boccaccio’s Decameron (Wigand, Becker, and Steger 2020. Withington 2020). The biggest renova in the last century, the so-called ‘Spanish Influenza’, renova discount coupon has been described as not very fruitful in this sense, even if it produced famous novels such as Katherine A Porter’s Pale Horse, Pale Rider or John O’Hara’s The Doctor Son (Honigsbaum 2018. Hovanec 2011). The overlapping with another disaster like World War I has been argued as one of the reasons explaining this scarce production of fictional works (Honigsbaum 2018).

By contrast, we may think that skin care products is having a global impact hardly overshadowed by other events, and that it will leave a significant mark on the collective memory.Drawing on the reading of La Peste, we point out in this essay different aspects of living under an epidemic that can be identified both in Camus’s work and in renova discount coupon our current situation. We propose a trip throughout the novel, from its early beginning in Part I, when the Oranians are not aware of the threat to come, to its end in Part V, when they are relieved of the epidemic after several months of ravaging disasters.We think this journey along La Peste may be interesting both to health professionals and to the lay person, since all of them will be able to see themselves reflected in the characters from the novel. We do not skip critique of some aspects related to the authorities’ management of skin care products, as Camus does concerning Oran’s rulers. However, what we want to foreground is La Peste’s intrinsic value, its suitability to be read now and after skin care products has passed, when Camus’s novel endures as a solid art work and skin care products remains only as a defeated plight.MethodsWe confronted our own experiences about skin care products with a conventional reading renova discount coupon of La Peste. A first reading of the novel was used to establish associations between those aspects which more saliently reminded us of skin care products.

In a second reading, we searched for some examples to illustrate those aspects and tried to detect new associations. Subsequent readings of certain parts were done to integrate the information renova discount coupon collected. Neither specific methods of literary analysis, nor systematic searches in the novel were applied. Selected paragraphs and ideas from Part I to Part V were prepared in a draft copy, and this manuscript was written afterwards.Part ISome phrases in the novel could be transposed word by word to our situation. This one pertaining to its start, for instance, may make us remember the first months of 2020:By renova discount coupon now, it will be easy to accept that nothing could lead the people of our town to expect the events that took place in the spring of that year and which, as we later understood, were like the forerunners of the series of grave happenings that this history intends to describe.

(Camus 2002, Part I)By referring from the beginning to ‘the people of our town’, Camus is already suggesting an idea which is repeated all along the novel, and which may be well understood by us as skin care products’s witnesses. Epidemics affect the community as a whole, they are present in everybody’s mind and their joys and sorrows are not individual, but collective. For example (and we are anticipating Part II), the narrator renova discount coupon says:But, once the gates were closed, they all noticed that they were in the same boat, including the narrator himself, and that they had to adjust to the fact. (Camus 2002, Part II)Later, he will insist in this opposition between the concepts of ‘individual’, which used to prevail before the epidemic, and ‘collective’:One might say that the first effect of this sudden and brutal attack of the disease was to force the citizens of our town to act as though they had no individual feelings. (Camus 2002, Part II)There were no longer any individual destinies, but a collective history that was the plague, and feelings shared by all.

(Camus 2002, Part III)This distinction is not trivial, since the story will display a strong confrontation between those who get involved and help renova discount coupon their neighbours and those who remain behaving selfishly. Related to this, Claudia Bozzaro has pointed out that the main topic in La Peste is solidarity and auistic love (Bozzaro 2018). We may add that the disease is so attached to people’s lives that the epidemic becomes the new everyday life:In the morning, they would return to the pestilence, that is to say, to routine. (Camus 2002, Part III)Being collective issues does not mean that renova discount coupon epidemics always enhance auism and solidarity. As said by Wigand et al, they frequently produce ambivalent reactions, and one of them is the opposition between auism and maximised profit (Wigand, Becker, and Steger 2020).

Therefore, the dichotomy between individualism and collectivism, a central point in the characterisation of national cultures (Hofstede 2015), could play a role in epidemics. In fact, concerning skin care products, some authors have described a greater impact of the renova in those countries with higher levels of renova discount coupon individualism (Maaravi et al. 2021. Ozkan et al. 2021).

However, this finding should be complemented with other national cultures’ aspects before concluding that collectivism itself exerts a protective role against epidemics. Concerning this, it has been shown how ‘power distance’ frequently intersects with collectivism, being only a few countries in which the last one coexists with a small distance to power, namely with a capacity to disobey the power authority (Gupta, Shoja, and Mikalef 2021). Moreover, those countries classically classified as ‘collectivist’ (China, Japan, South Korea, India, Vietnam, etc.) are also characterised by high levels of power distance, and their citizens have been quite often forced to adhere to skin care products restrictions and punished if not (Gupta, Shoja, and Mikalef 2021). Thus, it is important to consider that individualism is not always opposed to ‘look after each other’ (Ozkan et al. 2021, 9).

For instance, the European region, seen as a whole as highly ‘individualistic’, holds some of the most advanced welfare protection systems worldwide. It is worth considering too that collectivism may hide sometimes a hard institutional authority or a lack in civil freedoms.Coming back to La Peste, we may think that Camus’s Oranians are not particularly ‘collectivist’. Their initial description highlights that they are mainly interested in their own businesses and affairs:Our fellow-citizens work a good deal, but always in order to make money. They are especially interested in trade and first of all, as they say, they are engaged in doing business. (Camus 2002, Part I)And later, we see some of them trying selfishly to leave the city by illegal methods.

By contrast, we observe in the novel some examples of more ‘collectivistic’ attitudes, such as the discipline of those quarantined at the football pitch, and, over all, the main characters’ behaviour, which is generally driven by auism and common goals.Turning to another topic, the plague in Oran and skin care products are similar regarding their animal origin. This is not rare since many infectious diseases pass to humans through contact with animal vectors, being rodents, especially rats (through rat fleas), the most common carriers of plague bacteria (CDC. N.d.a, ECDC. N.d, Pollitzer 1954). Concerning skin care, even if further research about its origin is needed, the most recent investigations conducted in China by the WHO establish a zoonotic transmission as the most probable pathway (Joint WHO-China Study Team 2021).

In Camus’s novel, the animal’s link to the epidemic seemed very clear since the beginning:Things got to the point where Infodoc (the agency for information and documentation, ‘ all you need to know on any subject’) announced in its free radio news programme that 6,231 rats had been collected and burned in a single day, the 25th. This figure, which gave a clear meaning to the daily spectacle that everyone in town had in front of their eyes, disconcerted them even more. (Camus 2002, Part I)This accuracy in figures is familiar to us. People nowadays have become very used to the statistical aspects of the renova, due to the continuous updates in epidemiological parameters launched by the media and the authorities. Camus was aware about the relevance of figures in epidemics, which always entail:…required registration and statistical tasks.

(Camus 2002, Part II)Because of this, the novel is scattered with numbers, most of them concerning the daily death toll, but others mentioning the number of rats picked up, as we have seen, or combining the number of deaths with the time passed since the start of the epidemic:“ Will there be an autumn of plague?. Professor B answers. €˜ No’ ”, “ One hundred and twenty-four dead. The total for the ninety-fourth day of the plague.” (Camus 2002, Part II)We permit ourselves to introduce here a list of recurring topics in La Peste, since the salience of statistical information is one of them. These topics, some of which will be treated later, appear several times in the novel, in various contexts and stages in the evolution of the epidemic.

We synthesise them in Table 1, coupled with a skin care products parallel example extracted from online press. This ease to find a current example for each topic suggests that they are not exclusive of plague or of Camus’s mindset, but shared by most epidemics.View this table:Table 1 Recurring topics in La Peste. Each topic is accompanied by two examples from the novel and one concerning skin care products, extracted from online press.Talking about journalism and the media (one of the topics above), we might say that skin care products’s coverage is frequently too optimistic when managing good news and too alarming when approaching the bad. Media’s ‘exaggerated’ approach to health issues is not new. It was already a concern for medical journals’ editors a century ago (Reiling 2013) and it continues to be it for these professionals in recent times (Barbour et al.

2008). It is well known that media tries to attract spectators’ attention by making the news more appealing. However, they deal with the risk of expanding unreliable information, which may be pernicious for the public opinion. Related to the intention of ‘garnishing’ the news, Aslam et al. (2020) have described that 82% of more than 100 000 pieces of information about skin care products appearing in media from different countries carried an emotional, either negative (52%) or positive (30%) component, with only 18% of them considered as ‘neutral’ (Aslam et al.

2020). Some evidence about this tendency to make news more emotional was described in former epidemics. For instance, a study conducted in Singapore in 2009 during the H1N1 crisis showed how press releases by the Ministry of Health were substantially transformed when passed to the media, by increasing their emotional appeal and by changing their dominant frame or their tone (Lee and Basnyat 2013). In La Peste, this superficial way of managing information by the media is also observed:The newspapers followed the order that they had been given, to be optimistic at any cost. (Camus 2002, Part IV)At the first stages of the epidemic in Oran, journalists proclaim the end of the dead rats’ invasion as something to be celebrated.

Dr Rieux, the character through which Camus symbolises caution (and comparable nowadays to trustful scientists, well-informed journalists or sensible authorities), exposes then his own angle, quite far from suggesting optimism:The vendors of the evening papers were shouting that the invasion of rats had ended. But Rieux found his patient lying half out of bed, one hand on his belly and the other around his neck, convulsively vomiting reddish bile into a rubbish bin. (Camus 2002, Part I)Camus, who worked as a journalist for many years, insists afterwards on this cursory interest that some media devote to the epidemic, more eager to grab the noise than the relevant issues beneath it:The press, which had had so much to say about the business of the rats, fell silent. This is because rats die in the street and people in their bedrooms. And newspapers are only concerned with the street.

(Camus 2002, Part I)By then, Oranians continue rejecting the epidemic as an actual threat, completely immersed in that phase that dominates the beginning of all epidemics and is characterised by ‘denial and disbelief’ (Wigand, Becker, and Steger 2020, 443):A pestilence does not have human dimensions, so people tell themselves that it is unreal, that it is a bad dream which will end. […] The people of our town were no more guilty than anyone else, they merely forgot to be modest and thought that everything was still possible for them, which implied that pestilence was impossible. They continued with business, with making arrangements for travel and holding opinions. Why should they have thought about the plague, which negates the future, negates journeys and debate?. They considered themselves free and no one will ever be free as long as there is plague, pestilence and famine.

(Camus 2002, Part I)Probably to avoid citizens' disapproval, among other reasons, the Oranian Prefecture (health authority in Camus' novel) does not want to go too far when judging the relevance of the epidemic. While not directly exposed, we can guess in this fragment the tone of the Prefect’s message, his intention to convey confidence despite his own doubts:These cases were not specific enough to be really disturbing and there was no doubt that the population would remain calm. None the less, for reasons of caution which everyone could understand, the Prefect was taking some preventive measures. If they were interpreted and applied in the proper way, these measures were such that they would put a definite stop to any threat of epidemic. As a result, the Prefect did not for a moment doubt that the citizens under his charge would co-operate in the most zealous manner with what he was doing.

(Camus 2002, Part I)The relevant role acquired by health authorities during epidemics is another topic listed in our table. Language use, on the other hand, is an issue linkable both with the media topic and with this one. As in La Peste, during skin care products we have seen some public figures using words not always truthfully, carrying out a careful selection of words that serves to the goal of conveying certain interests in each moment. Dr Rieux refers in Part I to this language manipulation by the authorities:The measures that had been taken were insufficient, that was quite clear. As for the ‘ specially equipped wards’, he knew what they were.

Two outbuildings hastily cleared of other patients, their windows sealed up and the whole surrounded by a cordon sanitaire. (Camus 2002, Part I)He illustrates the need of frankness, the preference for clarity in language, which is often the clarity in thinking:No. I phoned Richard to say we needed comprehensive measures, not fine words, and that either we must set up a real barrier to the epidemic, or nothing at all. (Camus 2002, Part I)At the end of this part, his fears about the inadequacy of not taking strict measures are confirmed. Oranian hospitals become overwhelmed, as they are now in many places worldwide due to skin care products.Part IILeft behind the phases of ‘denial and disbelief’ and of ‘fear and panic’, it appears among the Oranians the ‘acceptance paired with resignation’ (Wigand, Becker, and Steger 2020, 443):Then we knew that our separation was going to last, and that we ought to try to come to terms with time.

[…] In particular, all of the people in our town very soon gave up, even in public, whatever habit they may have acquired of estimating the length of their separation. (Camus 2002, Part II)In skin care products as well, even if border closure has not been so immovable as in Oran, many people have seen themselves separated from their loved ones and some of them have not yet had the possibility of reunion. This is why, in the actual renova, the idea of temporal horizons has emerged like it appeared in Camus’s epidemic. In Spain, the general lockdown in March and April 2020 made people establish the summer as their temporal horizon, a time in which they could resume their former habits and see their relatives again. This became partially true, and people were allowed in summer to travel inside the country and to some other countries nearby.

However, there existed some reluctance to visit ill or aged relatives, due to the fear of infecting them, and some families living in distant countries were not able to get together. Moreover, autumn brought an increase in the number of cases (‘the second wave’) and countries returned to limit their internal and external movements.Bringing all this together, many people nowadays have opted to discard temporal horizons. As Oranians, they have noted that the epidemic follows its own rhythm and it is useless to fight against it. Nonetheless, it is in human nature not to resign, so abandoning temporal horizons does not mean to give up longing for the recovery of normal life. This vision, neither maintaining vain hopes nor resigning, is in line with Camus’s philosophy, an author who wrote that ‘hope, contrary to what it is usually thought, is the same to resignation.’ (Camus 1939, 83.

Cited by Haroutunian 1964, 312 (translation is ours)), and that ‘there is not love to human life but with despair about human life.’ (Camus 1958, 112–5. Cited by Haroutunian 1964, 312–3 (translation is ours)).People nowadays deal with resignation relying on daily life pleasures (being not allowed to make further plans or trips) and in company from the nearest ones (as they cannot gather with relatives living far away). Second, they observe the beginning of vaccination campaigns as a first step of the final stage, and summer 2021, reflecting what happened with summer 2020, has been fixed as a temporal horizon. This preference for summers has an unavoidable metaphorical nuance, and their linking to joy, long trips and life in the streets may be the reason for which we choose them to be opposed to the lockdown and restrictions of the renova.We alluded previously to the manipulation of language, and figures, as relevant as they are, they are not free from manipulation either. Tarrou, a close friend to Dr Rieux, points out in this part of the novel how this occurred:Once more, Tarrou was the person who gave the most accurate picture of our life as it was then.

Naturally he was following the course of the plague in general, accurately observing that a turning point in the epidemic was marked by the radio no longer announcing some hundreds of deaths per week, but 92, 107 and 120 deaths a day. €˜The newspapers and the authorities are engaged in a battle of wits with the plague. They think that they are scoring points against it, because 130 is a lower figure than 910.’ (Camus 2002, Part II)Tarrou collaborates with the health teams formed to tackle the plague. Regarding these volunteers and workers, Camus refuses to consider them as heroes, as many essential workers during skin care products have rejected to be named as that. The writer thinks their actions are the natural behaviour of good people, not heroism but ‘a logical consequence’:The whole question was to prevent the largest possible number of people from dying and suffering a definitive separation.

There was only one way to do this, which was to fight the plague. There was nothing admirable about this truth, it simply followed as a logical consequence. (Camus 2002, Part II)We consider suitable to talk here about two issues which represent, nowadays, a great part of skin care products fears and hopes, respectively. New genetic variants and treatments. Medical achievements are another recurrent issue included in table 1, and we write about them here because it is in Part II where Camus writes for the first time about treatments, and where it insists on an idea aforementioned in Part I.

That the plague bacillus affecting Oran is different from previous variants:…the microbe differed very slightly from the bacillus of plague as traditionally defined. (Camus 2002, Part II)Related to skin care products new variants, they represent a challenge because of two main reasons. Their higher transmissibility and/or severity and their higher propensity to skip the effect of natural or treatment-induced immunity. Public health professionals are determining which is the actual threat of all the new variants discovered, such as those first characterised in the UK (Public Health England 2020), South Africa (Tegally et al. 2021) or Brazil (Fujino et al.

2021). In La Peste, Dr Rieux is always suspecting that the current bacteria they are dealing with is different from the one in previous epidemics of plague. Since several genetic variations for the bacillus Yersinia pestis have been characterised (Cui et al. 2012), it could be possible that the epidemic in Oran originated from a new one. However, we should not forget that we are analysing a literary work, and that scientific accuracy is not a necessary goal in it.

In fact, Rieux’s reluctances have to do more with clinical aspects than with microbiological ones. He doubts since the beginning, relying exclusively on the symptoms observed, and continues doing it after the laboratory analysis:I was able to have an analysis made in which the laboratory thinks it can detect the plague bacillus. However, to be precise, we must say that certain specific modifications of the microbe do not coincide with the classic description of plague. (Camus 2002, Part II)Camus is consistent with this idea and many times he mentions the bacillus to highlight its oddity. Insisting on the literary condition of the work, and among other possible explanations, he is maybe declaring that that in the novel is not a common (biological, natural) bacteria, but the Nazism bacteria.Turning to treatments, they constitute the principal resource that the global community has to defeat the skin care products renova.

Vaccination campaigns have started all over the world, and three types of skin care products treatments are being applied in the European Union, after their respective statements of efficacy and security (Baden et al. 2021 discount renova. Polack et al. 2020. Voysey et al.

2021), while a fourth treatment has just recently been approved (EMA 2021a). Although some concerns regarding the safety of two of these treatments have been raised recently (EMA 2021b. EMA 2021c), vaccination plans are going ahead, being adapted according to the state of knowledge at each moment. Some of these treatments are mRNA-based (Baden et al. 2021.

Polack et al. 2020), while others use a viral vector (Bos et al. 2020. Voysey et al. 2021).

They are mainly two-shot treatments, with one exception (Bos et al. 2020), and complete immunity is thought to be acquired 2 weeks after the last shot (CDC. N.d.b, Voysey et al. 2021). Other countries such as China or Russia, on the other hand, were extremely early in starting their vaccination campaigns, and are distributing among their citizens different treatments than the aforementioned (Logunov et al.

2021. Zhang et al. 2021).Even if at least three types of plague treatments had been created by the time the novel takes place (Sun 2016), treatments do not play an important role in La Peste, in which therapeutic measures (the serum) are more important than prophylactic ones. Few times in the novel the narrator refers to prophylactic inoculations:There was still no possibility of vaccinating with preventive serum except in families already affected by the disease. (Camus 2002, Part II)Deudon has pointed out that Camus mixes up therapeutic serum and treatment (Deudon 1988), and in fact there exists a certain amount of confusion.

All along the novel, the narrator focuses on the prophylactic goals of the serum, which is applied to people already infected (Othon’s son, Tarrou, Grand…). However, both in the example above (which can be understood as vaccinating household contacts or already affected individuals) and in others, the differences between treating and vaccinating are not clear:After the morning admissions which he was in charge of himself, the patients were vaccinated and the swellings lanced. (Camus 2002, Part II)In any case, this is another situation in which Camus stands aside from scientific matters, which are to him less relevant in his novel than philosophical or literary ones. The distance existing between the relevance of treatments in skin care products and the superficial manner with which Camus treats the topic in La Peste exemplifies this.Part IIIIn part III, the plague’s ravages become tougher. The narrator turns his focus to burials and their disturbance, a frequent topic in epidemics’ narrative (table 1).

Camus knew how acutely increasing demands and hygienic requirements affect funeral habits during epidemics:Everything really happened with the greatest speed and the minimum of risk. (Camus 2002, Part III)Like many other processes during epidemics, the burial process becomes a protocol. When protocolised, everything seems to work well and rapidly. But this perfect mechanism is the Prefecture’s goal, not Rieux’s. He reveals in this moment an aspect in his character barely shown before.

Irony.The whole thing was well organized and the Prefect expressed his satisfaction. He even told Rieux that, when all was said and done, this was preferable to hearses driven by black slaves which one read about in the chronicles of earlier plagues. €˜ Yes,’ Rieux said. €˜ The burial is the same, but we keep a card index. No one can deny that we have made progress.’ (Camus 2002, Part III)Even if this characteristic may seem new in Dr Rieux, we must bear in mind that he is the story narrator, and the narration is ironic from time to time.

For instance, speaking precisely about the burials:The relatives were invited to sign a register –which just showed the difference that there may be between men and, for example, dogs. You can keep check of human beings-. (Camus 2002, Part III)In Camus’s philosophy, the absurd is a core issue. According to Lengers, Rieux is ironic because he is a kind of Sisyphus who has understood the absurdity of plague (Lengers 1994). The response to the absurd is to rebel (Camus 2013), and Rieux does it by helping his fellow humans without questioning anything.

He does not pursue any other goal than doing his duty, thus humour (as a response to dire situations) stands out from him when he observes others celebrating irrelevant achievements, such as the Prefect with his burial protocol. In the field of medical ethics, Lengers has highlighted the importance of Camus’s perspective when considering ‘the immediacy of life rather than abstract values’ (Lengers 1994, 250). Rieux himself is quite sure that his solid commitment is not ‘abstract’, and, even if he falls into abstraction, the importance relies on protecting human lives and not in the name given to that task:Was it truly an abstraction, spending his days in the hospital where the plague was working overtime, bringing the number of victims up to five hundred on average per week?. Yes, there was an element of abstraction and unreality in misfortune. But when an abstraction starts to kill you, you have to get to work on it.

(Camus 2002, Part II)Farewells during skin care products may have not been particularly pleasant for some families. Neither those dying at nursing homes nor in hospitals could be accompanied by their families as previously, due to corpses management protocols, restrictions of external visitors and hygienic measures in general. However, as weeks passed by, certain efforts were made to ease this issue, allowing people to visit their dying beloved sticking to strict preventive measures. On the other hand, the number of people attending funeral masses and cemeteries was also limited, which affected the conventional development of ceremonies as well. Hospitals had to deal with daily tolls of deaths never seen before, and the overcrowding of mortuaries made us see rows of coffins placed in unusual spaces, such as ice rinks (transformation of facilities is another topic in table 1).We turn now to two other points which skin care products has not evaded.

s among essential workers and epidemics’ economic consequences. The author links burials with s among essential workers because gravediggers constitute one of the most affected professions, and connects this fact with the economic recession because unemployment is behind the large availability of workers to replace the dead gravediggers:Many of the male nurses and the gravediggers, who were at first official, then casual, died of the plague. […] The most surprising thing was that there was never a shortage of men to do the job, for as long as the epidemic lasted. […] When the plague really took hold of the town, its very immoderation had one quite convenient outcome, because it disrupted the whole of economic life and so created quite a large number of unemployed. […] Poverty always triumphed over fear, to the extent that work was always paid according to the risk involved.

(Camus 2002, Part III)The effects of the plague over the economic system are one of our recurrent topics (table 1). The plague in Oran, as it forces to close the city, impacts all trading exchanges. In addition, it forbids travellers from arriving to the city, with the economic influence that that entails:This plague was the ruination of tourism. (Camus 2002, Part II)Oranians, who, as we saw, were very worried about making money, are especially affected by an event which jeopardises it. In skin care products, for one reason or for another, most of the countries are suffering economic consequences, since the impact on normal life from the epidemic (another recurrent topic) means also an impact on the normal development of trading activities.Part IVIn Part IV we witness the first signals of a stabilisation of the epidemic:It seemed that the plague had settled comfortably into its peak and was carrying out its daily murders with the precision and regularity of a good civil servant.

In theory, in the opinion of experts, this was a good sign. The graph of the progress of the plague, starting with its constant rise, followed by this long plateau, seemed quite reassuring. (Camus 2002, Part IV)At this time, we consider interesting to expand the topic about the transformation of facilities. We mentioned the case of ice rinks during skin care products, and we bring up now the use of a football pitch as a quarantine camp in Camus’s novel, a scene which has reminded some scholars of the metaphor of Nazism and concentration camps (Finel-Honigman 1978). In Spain, among other measures, a fairground was enabled as a field hospital during the first wave, and it is plausible that many devices created with other purposes were used in tasks attached to healthcare provision during those weeks, as occurred in Oran’s pitch with the loudspeakers:Then the loudspeakers, which in better times had served to introduce the teams or to declare the results of games, announced in a tinny voice that the internees should go back to their tents so that the evening meal could be distributed.

(Camus 2002, Part IV)Related to this episode, we can also highlight the opposition between science and humanism that Camus does. The author alerts us about the dangers of a dehumanised science, of choosing procedures perfectly efficient regardless of their lack in human dignity:The men held out their hands, two ladles were plunged into two of the pots and emerged to unload their contents onto two tin plates. The car drove on and the process was repeated at the next tent.‘ It’s scientific,’ Tarrou told the administrator.‘ Yes,’ he replied with satisfaction, as they shook hands. €˜ It’s scientific.’ (Camus 2002, Part IV)Several cases with favourable outcomes mark Part IV final moments and prepare the reader for the end of the epidemic. To describe these signs of recovering, the narrator turns back to two elements with a main role in the novel.

Rats and figures. In this moment, the first ones reappear and the second ones seem to be declining:He had seen two live rats come into his house through the street door. Neighbours had informed him that the creatures were also reappearing in their houses. Behind the walls of other houses there was a hustle and bustle that had not been heard for months. Rieux waited for the general statistics to be published, as they were at the start of each week.

They showed a decline in the disease. (Camus 2002, Part IV)Part VGiven that we continue facing skin care products, and that forecasts about its end are not easy, we cannot compare ourselves with the Oranians once they have reached the end of the epidemic, what occurs in this part. However, we can analyse our current situation, characterised by a widespread, though cautious, confidence motivated by the beginning of vaccination campaigns, referring it to the events narrated in Part V.Even more than the Oranians, since we feel further than them from the end of the problem, we are cautious about not to anticipate celebrations. From time to time, however, we lend ourselves to dream relying on what the narrator calls ‘a great, unadmitted hope’. skin care products took us by surprise and everyone wants to ‘reorganise’ their life, as Oranians do, but patience is an indispensable component to succeed, as fictional and historical epidemics show us.Although this sudden decline in the disease was unexpected, the towns-people were in no hurry to celebrate.

The preceding months, though they had increased the desire for liberation, had also taught them prudence and accustomed them to count less and less on a rapid end to the epidemic. However, this new development was the subject of every conversation and, in the depths of people’s hearts, there was a great, unadmitted hope. […] One of the signs that a return to a time of good health was secretly expected (though no one admitted the fact) was that from this moment on people readily spoke, with apparent indifference, about how life would be reorganized after the plague. (Camus 2002, Part V)We put our hope on vaccination. Social distancing and other hygienic measures have proved to be effective, but treatments would bring us a more durable solution without compromising so hardly many economic activities and social habits.

As we said, a more important role of scientific aspects is observed in skin care products if compared with La Peste (an expected fact if considered that Camus’s story is an artistic work, that he skips sometimes the most complex scientific issues of the plague and that health sciences have evolved substantially during last decades). Oranians, in fact, achieve the end of the epidemic not through clearly identified scientific responses but with certain randomness:All one could do was to observe that the sickness seemed to be going as it had arrived. The strategy being used against it had not changed. It had been ineffective yesterday, and now it was apparently successful. One merely had the feeling that the disease had exhausted itself, or perhaps that it was retiring after achieving all its objectives.

In a sense, its role was completed. (Camus 2002, Part V)They receive the announcement made by the Prefecture of reopening the town’s gates in 2 weeks time with enthusiasm. Dealing with concrete dates gives them certainty, helps them fix the temporal horizons we wrote about. This is also the case when they are told that preventive measures would be lifted in 1 month. Camus shows us then how the main characters are touched as well by this positive atmosphere:That evening Tarrou and Rieux, Rambert and the rest, walked in the midst of the crowd, and they too felt they were treading on air.

Long after leaving the boulevards Tarrou and Rieux could still hear the sounds of happiness following them… (Camus 2002, Part V)Then, Tarrou points out a sign of recovery coming from the animal world. In a direct zoological chain, infected fleas have vanished from rats, which have been able again to multiply across the city, making the cats abandon their hiding places and to go hunting after them again. At the final step of this chain, Tarrou sees the human being. He remembers the old man who used to spit to the cats beneath his window:At a time when the noise grew louder and more joyful, Tarrou stopped. A shape was running lightly across the dark street.

It was a cat, the first that had been seen since the spring. It stopped for a moment in the middle of the road, hesitated, licked its paw, quickly passed it across its right ear, then carried on its silent way and vanished into the night. Tarrou smiled. The little old man, too, would be happy. (Camus 2002, Part V)Unpleasant things as a town with rats running across its streets, or a man spending his time spitting on a group of cats, constitute normality as much as the reopening of gates or the reboot of commerce.

However, when Camus speaks directly about normality, he highlights more appealing habits. He proposes common leisure activities (restaurants, theatres) as symbols of human life, since he opposes them to Cottard’s life, which has become that of a ‘wild animal’:At least in appearance he [ Cottard ] retired from the world and from one day to the next started to live like a wild animal. He no longer appeared in restaurants, at the theatre or in his favourite cafés. (Camus 2002, Part V)We do not disclose why Cottard’s reaction to the end of the epidemic is different from most of the Oranians’. In any case, the narrator insists later on the assimilation between common pleasures and normality:‘ Perhaps,’ Cottard said, ‘ Perhaps so.

But what do you call a return to normal life?. €™ ‘ New films in the cinema,’ said Tarrou with a smile. (Camus 2002, Part V)Cinema, as well as theatre, live music and many other cultural events have been cancelled or obliged to modify their activities due to skin care products. Several bars and restaurants have closed, and spending time in those who remain open has become an activity which many people tend to avoid, fearing contagion. Thus, normality in our understanding is linked as well to these simple and pleasant habits, and the complete achievement of them will probably signify for us the desired defeat of the renova.In La Peste, love is also seen as a simple good to be fully recovered after the plague.

While Rieux goes through the ‘reborn’ Oran, it is lovers’ gatherings what he highlights. Unlike them, everyone who, during the epidemic, sought for goals different from love (such as faith or money, for instance) remain lost when the epidemic has ended:For all the people who, on the contrary, had looked beyond man to something that they could not even imagine, there had been no reply. (Camus 2002, Part V)And this is because lovers, as the narrator says:If they had found that they wanted, it was because they had asked for the only thing that depended on them. (Camus 2002, Part V)We have spoken before about language manipulation, hypocrisy and public figures’ roles during epidemics. Camus, during Dr Rieux’s last visit to the old asthmatic man, makes this frank and humble character criticise, with a point of irony, the authorities’ attitude concerning tributes to the dead:‘ Tell me, doctor, is it true that they’re going to put up a monument to the victims of the plague?.

€™â€˜ So the papers say. A pillar or a plaque.’‘ I knew it!. And there’ll be speeches.’The old man gave a strangled laugh.‘ I can hear them already. €œ Our dead…” Then they’ll go and have dinner.’ (Camus 2002, Part V)The old man illustrates wisely the authorities’ propensity for making speeches. He knows that most of them usually prefer grandiloquence rather than common words, and seizes perfectly their tone when he imitates them (‘Our dead…’).

We have also got used, during skin care products, to these types of messages. We have also heard about ‘our old people’, ‘our youth’, ‘our essential workers’ and even ‘our dead’. Behind this tone, however, there could be an intention to hide errors, or to falsely convey carefulness. Honest rulers do not usually need nice words. They just want them to be accurate.We have seen as well some tributes to the victims during skin care products, some of which we can doubt whether they serve to victims’ relief or to authorities’ promotion.

We want rulers to be less aware of their own image and to stress truthfulness as a goal, even if this is a hard requirement not only for them, but for every single person. Language is essential in this issue, we think, since it is prone to be twisted and to become untrue. The old asthmatic man illustrates it with his ‘There’ll be speeches’ and his ‘Our dead…’, but this is not the only time in the novel in which Camus brings out the topic. For instance, he does so when he equates silence (nothing can be thought as further from wordiness) with truth:It is at the moment of misfortune that one becomes accustomed to truth, that is to say to silence. (Camus 2002, Part II)or when he makes a solid statement against false words:…I understood that all the misfortunes of mankind came from not stating things in clear terms.

(Camus 2002, Part IV)The old asthmatic, in fact, while praising the deceased Tarrou, remarks that he used to admire him because ‘he didn’t talk just for the sake of it.’ (Camus 2002, Part V).Related to this topic, what the old asthmatic says about political authorities may be transposed in our case to other public figures, such as scholars and researchers, media leaders, businessmen and women, health professionals… and, if we extend the scope, to every single citizen. Because hypocrisy, language manipulation and the fact of putting individual interests ahead of collective welfare fit badly with collective issues such as epidemics. Hopefully, also examples to the contrary have been observed during skin care products.The story ends with the fireworks in Oran and the depiction of Dr Rieux’s last feelings. While he is satisfied because of his medical performance and his activity as a witness of the plague, he is concerned about future disasters to come. When skin care products will have passed, it will be time for us as well to review our life during these months.

For now, we are just looking forward to achieving our particular ‘part V’.AbstractThis study addresses the existing gap in literature that ethnographically examines the experiences of Spanish-speaking patients with limited English proficiency in clinical spaces. All of the participants in this study presented to the emergency department (ED) for evaluation of non-urgent health conditions. Patient shadowing was employed to explore the challenges that this population face in unique clinical settings like the ED. This relatively new methodology facilitates obtaining nuanced understandings of clinical contexts under study in ways that quantitative approaches and survey research do not. Drawing from the field of medical anthropology and approach of narrative medicine, the collected data are presented through the use of clinical ethnographic vignettes and thick description.

The conceptual framework of health-related deservingness guided the analysis undertaken in this study. Structural stigma was used as a complementary framework in analysing the emergent themes in the data collected. The results and analysis from this study were used to develop an argument for the consideration of language as a distinct social determinant of health.emergency medicinemedical anthropologymedical humanitiesData availability statementData sharing not applicable as no datasets were generated and/or analysed for this study..

Timberland pro renova slip on

Owing to the multiphase transformations in economy, society, natural environment, lifestyles and healthcare system that China has been experiencing over the past three decades, coupled with the rapid population ageing, China’s burden of non-communicable disease, particularly cardiovascular disease (CVD) where can i get renova and cancer, has been rising drastically.1 Both the incidence of and mortality from ischaemic heart disease (IHD) have been increasing dramatically since 1980s in China.1 In 2019, timberland pro renova slip on IHD was the second cause of deaths in the Chinese population, which counted for 17.6% of all deaths and 9.1% of disability-adjusted life years.2 Although there are ample evidence on the socioeconomic disparities in CVD in high-income countries, evidence is still limited in low- and middle-income countries such as China.3The paper by Chen et al is the first comprehensive report on the educational disparities in IHD incidence, case fatality and mortality in China, using data from the large prospective cohort study of China Kadoorie Biobank. The study supplements findings of a robust inverse educational gradient in IHD case fatality …The skin care products renova has provided limitless opportunities to compare renova policies across countries and over time timberland pro renova slip on. When the aim is to assess the comparative success of these policies, the comparison requires thinking counterfactually about ‘what would have been’ in some unrealised hypothetical (counterfactual) scenario. Whether generating modelling projections,1 making data-driven comparisons across countries2 or attributing excess harms,3 causal inference often rests on counterfactual comparisons, even if those comparisons are timberland pro renova slip on only implicit.

However, in the renova, counterfactual analyses that are overly simplistic, uninformative or outright flawed have been an epidemic in their own right. The examples I explore here are not the worst offenders and my aim is not to criticise them but to timberland pro renova slip on use them to illustrate cautionary lessons. By exploring the theory of counterfactuals and common problems with their use, we can learn to do better. Slow conceptual thinking is needed even in times of fast science.Counterfactuals have played a central role in timberland pro renova slip on discussions of causation in philosophy4 and in the health sciences5 and social sciences6 over the past 50 years.

According to a framework popular in these disciplines, an intervention causes some outcome if that outcome represents a difference between two hypothetical scenarios in which only the intervention differs. Because the scenarios are mutually incompatible, timberland pro renova slip on at least one of them is ‘counterfactual’—that is, contrary to what actually occurs or ‘counter to fact’. Philosophers sometimes think about a counterfactual scenario as an imaginary world that is perfectly identical to the actual world except that the intervention is miraculously altered or manipulated with surgical precision. For instance, if the number of skin care products cases would be greater in a possible world that is identical to the real world but in which no renova policies were implemented, then we can conclude that those policies prevented skin care products in the actual world.Scientists and policy-makers cannot make a counterfactual comparison directly because other possible worlds are a fiction (or if they are real then they are inaccessible to us), although they can approximate such timberland pro renova slip on a comparison through modelling or using real-world data.

A key to doing this well is to first explicitly consider what counterfactual comparison we wish to learn about and then ask what modelling or data would faithfully or usefully represent it. Unfortunately, it timberland pro renova slip on is easy to lose sight of the relevance of the available data for the intended counterfactual comparison and of the relevance of the counterfactual comparison for decision-making.For instance, skin care products model predictions have frequently been criticised as inaccurate7 and no doubt many of them are. However, it is important to distinguish ‘projections’ of what would occur under a hypothetical scenario (which may be counterfactual) from ‘forecasts’ of what will actually occur8—a distinction that has not always been marked. Unlike forecasts (such timberland pro renova slip on as weather predictions), the accuracy of a counterfactual projection cannot be accurately judged by comparing it to what actually occurred.

Schroeder9 identifies ambiguities in the way that modellers at the Institute for Health Metrics and Evaluation at the University of Washington presented predictions from their epidemic model early on, which sometimes appeared to be projections and sometimes appeared to be forecasts. This kind of ambiguity makes it difficult to evaluate the performance of a model and to know what upshots to draw from its timberland pro renova slip on predictions. For instance, while forecasts can help planners anticipate healthcare resource usage, projections can help decision-makers choose from among alternative public health policies.10Compartment models like one used by Imperial timberland pro renova slip on College London1 are more clearly ‘projection models’.8 However, the hypothetical nature of projections allows us to entertain scenarios that realistically would not occur, renova best buy creating comparisons with questionable relevance for decision-making. In March 2020, Imperial College modellers claimed that ‘38.7 million lives could be saved’1 by an aggressive viral-suppression strategy after modelling that scenario (among others) and comparing it to an unmitigated renova scenario in which no new actions are taken to contain viral spread.

But for evaluating the aggressive suppression strategy, the unmitigated scenario is an unrealistic counterfactual because in that scenario everyone—including governments and the people—behaves as if timberland pro renova slip on there were not a renova raging. More informative comparisons contrast alternate anticontagion policies or account for the likelihood of evolving anticontagion behaviour even in the absence of aggressive anticontagion policies.With country-level case data available at a click, many people have made policy comparisons across countries along with inferences regarding the effectiveness of those policies. But comparing one country to another to infer the comparative effectiveness of stricter and laxer (or simply different) anticontagion policies is fraught because it may not faithfully represent a relevant counterfactual comparison.For example, Bendavid et al2 compared eight countries, including the USA and England, timberland pro renova slip on that implemented mandatory stay-at-home orders and business closures with Sweden and South Korea, which did not. To evaluate the effect of these policies on the growth of skin care products cases, they subtracted case data in Sweden and South Korea from case data in the other eight countries.

In this study, Sweden and South Korea are essentially being used to represent a counterfactual USA or England that does not implement timberland pro renova slip on restrictive policies. However, there are important differences between the USA/England and Sweden/South Korea, including social and geographic differences and differences in implementation of other renova interventions. Therefore, it seems highly plausible that a cross-country comparison involving the USA or England on one side and Sweden or South Korea on the other fails to accurately represent the outcomes in a ‘USA versus timberland pro renova slip on counterfactual USA’ or ‘England versus counterfactual England’ comparison. Other studies (which are by no means infallible) seek to mitigate this problem by making before-and-after comparisons within a country, pooling data from many countries and attempting to adjust for their differences or running sensitivity analyses to test various assumptions.11 12Finally, many have calculated or estimated excess harms in 2020–2021 and beyond such as excess all-cause mortality13 or excess ‘deaths of despair’.14 Excess harms are typically estimated by measuring a stable baseline level of harm (or a stable trend) in recent years and comparing it to the amount of harm measured since the renova began or the amount of harm estimated to occur in future years.

It is often reasonable to interpret excess harm figures as the increase in timberland pro renova slip on harm compared with a counterfactual scenario in which the renova never happened. However, it is often more challenging to attribute this increase to a specific factor such as particular policies. Such a harm attribution relies on a different counterfactual comparison between two worlds in which the skin care products renova is similarly occurring but in which different timberland pro renova slip on policies are undertaken. As when measuring beneficial effects, the relevant modelling or data might compare different countries that naturally implemented different polices in 2020–2021 or the same countries before and after the implementation of certain policies.To illustrate, Niedzwiedz et al3 sought to measure the impact of lockdowns in the UK during 2020 on mental health outcomes through survey results in a longitudinal cohort study.

By comparing the prevalence of outcomes such as psychological distress in timberland pro renova slip on April 2020 to its prevalence in 2017–2019, they calculated increases or decreases in these outcomes. However, one cannot attribute changes in these outcomes to particular policies from the time trend data alone because, again, in the relevant counterfactual comparison the presence of the renova is kept constant and only particular policies are allowed to vary.Faced with a devastating renova rife with examples of countries that followed different paths, regrets about past choices and new decisions to be made, scientists, policy-makers and the public entertain counterfactual comparisons, comparing what did occur to what would have occurred or what could occur in the future under different scenarios. The ubiquity of models and data available to us makes it possible to timberland pro renova slip on provide (more or less reliable) representations of our imagined counterfactual comparisons. But in thinking counterfactually, we must be wary of letting our imagination exceed our data.Ethics statementsPatient consent for publicationNot required.AcknowledgmentsThe author thanks Sander Greenland for extensive and thoughtful input on multiple drafts of this manuscript as well as anonymous reviewers..

Owing to the multiphase transformations in economy, society, natural environment, lifestyles and healthcare system that China has been experiencing over the past three decades, coupled with the rapid population ageing, China’s burden of non-communicable disease, particularly cardiovascular disease (CVD) and cancer, has been rising drastically.1 Both the incidence of and mortality from ischaemic heart disease (IHD) have been increasing dramatically since 1980s in China.1 In 2019, IHD was the second cause of deaths in the Chinese population, which counted for Get More Information 17.6% of all deaths and 9.1% of disability-adjusted life years.2 Although there are ample evidence on the socioeconomic disparities in CVD in renova discount coupon high-income countries, evidence is still limited in low- and middle-income countries such as China.3The paper by Chen et al is the first comprehensive report on the educational disparities in IHD incidence, case fatality and mortality in China, using data from the large prospective cohort study of China Kadoorie Biobank. The study renova discount coupon supplements findings of a robust inverse educational gradient in IHD case fatality …The skin care products renova has provided limitless opportunities to compare renova policies across countries and over time. When the aim is to assess the comparative success of these policies, the comparison requires thinking counterfactually about ‘what would have been’ in some unrealised hypothetical (counterfactual) scenario.

Whether generating renova discount coupon modelling projections,1 making data-driven comparisons across countries2 or attributing excess harms,3 causal inference often rests on counterfactual comparisons, even if those comparisons are only implicit. However, in the renova, counterfactual analyses that are overly simplistic, uninformative or outright flawed have been an epidemic in their own right. The examples I explore here are not the worst offenders and my aim is not to criticise them but to use them to illustrate cautionary renova discount coupon lessons.

By exploring the theory of counterfactuals and common problems with their use, we can learn to do better. Slow conceptual thinking is needed even in times of fast renova discount coupon science.Counterfactuals have played a central role in discussions of causation in philosophy4 and in the health sciences5 and social sciences6 over the past 50 years. According to a framework popular in these disciplines, an intervention causes some outcome if that outcome represents a difference between two hypothetical scenarios in which only the intervention differs.

Because the scenarios are mutually incompatible, at least one of them is ‘counterfactual’—that is, contrary to what actually occurs renova discount coupon or ‘counter to fact’. Philosophers sometimes think about a counterfactual scenario as an imaginary world that is perfectly identical to the actual world except that the intervention is miraculously altered or manipulated with surgical precision. For instance, if the number of skin care products cases would be greater in a possible world that renova discount coupon is identical to the real world but in which no renova policies were implemented, then we can conclude that those policies prevented skin care products in the actual world.Scientists and policy-makers cannot make a counterfactual comparison directly because other possible worlds are a fiction (or if they are real then they are inaccessible to us), although they can approximate such a comparison through modelling or using real-world data.

A key to doing this well is to first explicitly consider what counterfactual comparison we wish to learn about and then ask what modelling or data would faithfully or usefully represent it. Unfortunately, it is easy to lose sight of the relevance of the available data renova discount coupon for the intended counterfactual comparison and of the relevance of the counterfactual comparison for decision-making.For instance, skin care products model predictions have frequently been criticised as inaccurate7 and no doubt many of them are. However, it is important to distinguish ‘projections’ of what would occur under a hypothetical scenario (which may be counterfactual) from ‘forecasts’ of what will actually occur8—a distinction that has not always been marked.

Unlike forecasts (such as weather predictions), renova discount coupon the accuracy of a counterfactual projection cannot be accurately judged by comparing it to what actually occurred. Schroeder9 identifies ambiguities in the way that modellers at the Institute for Health Metrics and Evaluation at the University of Washington presented predictions from their epidemic model early on, which sometimes appeared to be projections and sometimes appeared to be forecasts. This kind of ambiguity makes it difficult to evaluate the performance of a model and to know what upshots renova discount coupon to draw from its predictions.

For instance, while forecasts can help planners anticipate healthcare resource usage, projections can help decision-makers choose from among alternative public health policies.10Compartment models like one used by renova discount coupon Imperial College London1 are more clearly ‘projection models’.8 However, the hypothetical nature of projections allows us to entertain scenarios that realistically would not occur, creating comparisons with questionable relevance for decision-making. In March 2020, Imperial College modellers claimed that ‘38.7 million lives could be saved’1 by an aggressive viral-suppression strategy after modelling that scenario (among others) and comparing it to an unmitigated renova scenario in which no new actions are taken to contain viral spread. But for evaluating the aggressive suppression strategy, the unmitigated scenario is an unrealistic counterfactual because in that scenario everyone—including renova discount coupon governments and the people—behaves as if there were not a renova raging.

More informative comparisons contrast alternate anticontagion policies or account for the likelihood of evolving anticontagion behaviour even in the absence of aggressive anticontagion policies.With country-level case data available at a click, many people have made policy comparisons across countries along with inferences regarding the effectiveness of those policies. But comparing renova discount coupon one country to another to infer the comparative effectiveness of stricter and laxer (or simply different) anticontagion policies is fraught because it may not faithfully represent a relevant counterfactual comparison.For example, Bendavid et al2 compared eight countries, including the USA and England, that implemented mandatory stay-at-home orders and business closures with Sweden and South Korea, which did not. To evaluate the effect of these policies on the growth of skin care products cases, they subtracted case data in Sweden and South Korea from case data in the other eight countries.

In this study, Sweden and South Korea are essentially being used to represent a counterfactual USA or England that does renova discount coupon not implement restrictive policies. However, there are important differences between the USA/England and Sweden/South Korea, including social and geographic differences and differences in implementation of other renova interventions. Therefore, it seems renova discount coupon highly plausible that a cross-country comparison involving the USA or England on one side and Sweden or South Korea on the other fails to accurately represent the outcomes in a ‘USA versus counterfactual USA’ or ‘England versus counterfactual England’ comparison.

Other studies (which are by no means infallible) seek to mitigate this problem by making before-and-after comparisons within a country, pooling data from many countries and attempting to adjust for their differences or running sensitivity analyses to test various assumptions.11 12Finally, many have calculated or estimated excess harms in 2020–2021 and beyond such as excess all-cause mortality13 or excess ‘deaths of despair’.14 Excess harms are typically estimated by measuring a stable baseline level of harm (or a stable trend) in recent years and comparing it to the amount of harm measured since the renova began or the amount of harm estimated to occur in future years. It is often reasonable to interpret excess harm figures as the increase in harm compared with a counterfactual scenario in which the renova never renova discount coupon happened. However, it is often more challenging to attribute this increase to a specific factor such as particular policies.

Such a harm attribution relies on a different counterfactual comparison between two worlds in which renova discount coupon the skin care products renova is similarly occurring but in which different policies are undertaken. As when measuring beneficial effects, the relevant modelling or data might compare different countries that naturally implemented different polices in 2020–2021 or the same countries before and after the implementation of certain policies.To illustrate, Niedzwiedz et al3 sought to measure the impact of lockdowns in the UK during 2020 on mental health outcomes through survey results in a longitudinal cohort study. By comparing the prevalence of outcomes such as psychological distress in April 2020 to its prevalence in 2017–2019, they calculated increases or decreases in these renova discount coupon outcomes.

However, one cannot attribute changes in these outcomes to particular policies from the time trend data alone because, again, in the relevant counterfactual comparison the presence of the renova is kept constant and only particular policies are allowed to vary.Faced with a devastating renova rife with examples of countries that followed different paths, regrets about past choices and new decisions to be made, scientists, policy-makers and the public entertain counterfactual comparisons, comparing what did occur to what would have occurred or what could occur in the future under different scenarios. The ubiquity of models and data available to us makes it possible renova discount coupon to provide (more or less reliable) representations of our imagined counterfactual comparisons. But in thinking counterfactually, we must be wary of letting our imagination exceed our data.Ethics statementsPatient consent for publicationNot required.AcknowledgmentsThe author thanks Sander Greenland for extensive and thoughtful input on multiple drafts of this manuscript as well as anonymous reviewers..