Simone Biles Earns 6th U.S. All-Around Gymnastics Title With Historic Triple-Double
Simone Biles competes on the balance beam at the U.S. Gymnastics Championships on Sunday. The reigning world champion is the first woman to stick the landing after two flips and three full twists.
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Charlie Riedel/AP
The first time that Simone Biles performed a triple-double at the U.S. Gymnastics Championships in Kansas City, she wasn’t pleased. After soaring through the air to complete two flips and three full twists on Friday, she stumbled.
On Sunday, the 22-year-old did it again — and stuck the landing. It’s the first time a woman has done so in competition.
AIR BILES ?
The height on @Simone_Biles historic pass is INSANE. pic.twitter.com/TAwNxBw9Rr
— NBC Sports (@NBCSports) August 12, 2019
The reigning world champion finished the competition on Sunday with the U.S. all-around title. It’s her sixth.
Previously the only woman to win six U.S. all-around gold medals was Clara Schroth-Lomady, who won her titles between 1945 and 1952.
Biles also made history by performing a double-double dismount — two twists and two somersaults — off the balance beam on Friday.
Before competing last week, Biles criticized USA Gymnastics, the national governing body of the sport, for failing to protect its athletes against abuse. Biles revealed in 2018 that she was one of the many gymnasts abused by former national team doctor Larry Nassar.
“You had one job. You literally had one job and you couldn’t protect us,” Biles told reporters on Wednesday.
Simone Biles Wins 6th U.S. Women’s Gymnastics Title
After a historic triple-double flip in the floor exercise, Simone Biles collected her sixth title Sunday in Kansas City, Missouri. The Olympic champion is preparing for the 2020 games.
‘Baby Shark’ Takes Hold At Nationals Park
Fans of the Washington Nationals have a new reason to watch: they can enjoy a “Baby Shark” attack every time Gerardo Parra comes to bat, when the infectious children’s song starts playing.
LULU GARCIA-NAVARRO, HOST:
The music a baseball player picks to walk up to home plate is a careful choice. It anticipates the batter’s next hit, the one that could mean victory or the one that could turn a losing game around.
(SOUNDBITE OF SONG, “THIS IS HOW WE DO IT”)
MONTELL JORDAN: (Singing) This is how we do it.
(SOUNDBITE OF SONG, “GASOLINA”)
DADDY YANKEE: (Singing in Spanish).
(SOUNDBITE OF SONG, “FEELING GOOD”)
MICHAEL BUBLE: (Singing) It’s an new day. It’s a new life. It’s a new life for me. And I’m feeling good.
GARCIA-NAVARRO: Walk-up music is a staple of baseball culture. Recently, Gerardo Parra of the Washington Nationals mixed up that tradition with…
(SOUNDBITE OF SONG, “BABY SHARK”)
PINKFONG: (Singing) Baby shark, doo doo doo doo doo doo. Baby shark, doo doo doo doo doo doo. Baby shark, doo doo doo doo doo doo. Baby shark.
GARCIA-NAVARRO: …The insidious, yet joyful “Baby Shark.”
BLAKE FINNEY: To have “Baby Shark” come up at Nats Park has been something completely different and it’s absolutely taken it by storm.
GARCIA-NAVARRO: That’s Blake Finney. He writes about the Nationals for SB Nation’s website, Federal Baseball. Now, to be fair, this isn’t the first time a major league player has used “Baby Shark” as a walk-up song. Elvis Andrus of the Texas Rangers uses it, too, but it’s really taken off at Nationals Park thanks to Gerardo Parra. He chose the song because his 2-year-old daughter loves it. Now, it’s become his thing. Blake Finney says the center fielder has been quite the morale booster since he was traded to the Nats in May.
FINNEY: When he joined the team, they were down in the dumps. They were not meeting expectations. There were calls for the manager to be fired and the dugout didn’t seem to have that much life.
GARCIA-NAVARRO: Oh, it has a life now.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED ANNOUNCER: Gerardo Parra.
(SOUNDBITE OF SONG, “BABY SHARK”)
PINKFONG: (Singing) Baby shark, doo doo doo doo doo doo.
GARCIA-NAVARRO: The dugout, the entire stadium, even the opposing team, every time its Parra’s turn at the bat, few people can resist a “Baby Shark” attack.
CHRIS DENNING: Everybody in the audience, they just start clapping, and it’s almost like they’re anticipating it. Everybody’s got their hands in like – in their shark chomping motion ready to go. And then as soon as that music starts going, they start clapping their hands together and singing along.
(SOUNDBITE OF CROWD CLAPPING)
GARCIA-NAVARRO: Chris Denning has seen this action up close at Nats Park. He could only clap with one hand because he was recording on his phone with the other. He’s familiar with the song. He’s the father of seven, and he’s a longtime Nats fan.
DENNING: For me, I look at this and I’m kind of hopeful that this is a moment in which the fans really kind of grow together. You know, it’s silly to think that it’s just, you know, the song is the thing that’s doing it for us.
ANNIE DINEEN: The first time I saw people doing the shark thing, I was a little bit skeptical to be completely honest.
GARCIA-NAVARRO: That’s Annie Dineen. She’s 28 years old, no kids, and she thought she was immune to the power of “Baby Shark.”
DINEEN: But I was sitting in a section where there were, like – there must have been a summer camp. There were, like, 10 or 15, like, 4-year-olds and their faces – they were so excited. And I was like, well, OK, this is kind of fun. And then I was hooked, and now I’m an avid shark supporter.
GARCIA-NAVARRO: And Dineen, along with many other shark supporters, now considers this song a true sports anthem.
(SOUNDBITE OF SONG, “BABY SHARK”)
PINKFONG: (Singing) Baby shark, doo doo doo doo doo doo. Baby shark, doo doo doo doo doo doo. Baby shark, doo doo doo doo doo doo.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
Simone Biles Continues To Break Records
Simone Biles became the first person in history to land a double twisting, double somersault in competition at the U.S. Gymnastics Championship.
LULU GARCIA-NAVARRO, HOST:
We’re in awe of Simone Biles. She’s already broken a bundle of records, and she’s made history again. At the U.S. gymnastics championship on Friday, she became the first gymnast to land a double-double in competition. In her dismount from the balance beam, she soared in a double twisting, double somersault dismount.
(SOUNDBITE OF ARCHIVED RECORDING)
UNIDENTIFIED ANNOUNCER: Here it comes – two flips, two twists, never been done in competition.
(CHEERING)
UNIDENTIFIED ANNOUNCER: That makes everything just a little bit more palatable.
GARCIA-NAVARRO: It does make everything more palatable, doesn’t it? If Biles can complete the double-double in international competition, they’re going to name it after her. It would be the third move with her name on it.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
At ‘High Five’ Camp, Struggling With A Disability Is The Point
At Nashville’s “High Five” camp, 12-year-old Priceless Garinger (center), whose right side has been weakened by cerebral palsy, wears a full-length, bright pink cast on her left arm — though that arm’s strong and healthy. By using her weaker right arm and hand to decorate a cape, she hopes to gain a stronger grip and fine motor control.
Blake Farmer/Nashville Public Radio
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Blake Farmer/Nashville Public Radio
There’s a summer camp for kids with disabilities in Nashville that does things a little differently. Instead of accommodating the campers’ physical challenges, therapists make life a bit tougher, in hopes of ultimately strengthening the kids’ ability to navigate the world.
Priceless Garinger’s left arm is wrapped from shoulder to fingertips in a neon pink cast on the day I visit. The left is actually the 12-year-old’s strong hand. It’s her other arm and hand that’s been the problem since she was born with cerebral palsy. She can move her right arm but has difficulty grasping anything.
“Right there, where you bend your arm, it itches right there,” she says, using a plastic spoon to scratch her elbow, which is out of reach.
This day camp is organized by Vanderbilt Children’s Hospital. Some campers, like Priceless, have cerebral palsy; others have had a brain tumor removed, or had a stroke. All of them have a weak side of the body they rarely use. At High Five Constraint Camp the children are forced to try to strengthen that weak side.
“Yeah, there it is,” Priceless says as she bumps bare arms with a fellow camper — an improvised fist bump.
This kind of rehab is known as constraint-induced movement therapy. Similar camps are run by children’s hospitals all around the U.S. during the summer, based on research by Edward Taub at the University of Alabama at Birmingham. He hypothesized years ago that the affected limbs suffer from “learned nonuse.”
Priceless takes her turn on the indoor obstacle course at the hospital’s pediatric rehab facility, located at a Vanderbilt satellite campus on Nashville’s outskirts. She rides a modified zipline, wrapping her long legs around the swinging seat — swooping along and then dropping into a pit of overstuffed pillows.
The occupational therapists prompt her to climb out. They cheer her on but don’t immediately help. The struggle is the point.
Priceless finds her way out, and next plops down on a scooter. She grunts as she tries to propel herself with a hand that she can barely control.
“I’m not going anywhere,” she says.
Her therapist gives her a little boost toward the finish line, where Priceless hits a buzzer that sounds an alarm and draws cheers from the other campers.
Constraint-induced therapy
The restrictive rehab techniques are increasingly used with kids who have cerebral palsy, though there hasn’t been much research showing the approach is all that much better than traditional physical therapy. And some kids become overly frustrated or even refuse to cooperate.
To outsiders, the strategy can seem mean.
“If the families have never heard of it before, it’s kind of like, ‘What? You’re going to cast their good arm and take away their really functional hand?’ ” says occupational therapist Stephanie Frazer.
This particular day camp started a decade ago as part of a research project at Vanderbilt University. When the study concluded, the camp shut down. But Frazer revived it in recent years because she believes the approach, and the setting, are effective.
“Whenever we’re casting that good arm, the brain is like, ‘I have this other arm here.’ And they start using it more and it starts creating pathways,” she says. “They actually make a lot of progress in a short amount of time.”
The kids’ temporary casts end in a mitten shape to minimize any wiggle room and attempts to rely on that stronger hand while at camp.
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Blake Farmer/Nashville Public Radio
Even snacktime can be turned into a therapeutic experience. Playing with food is required at this camp. The kids take pretzels and stab them into blocks of cheese.
Some blow bubbles in their juice, partly out of frustration. Some resort to using the arm that’s in a cast to feed themselves.
Seeking independence
This is the third summer of camp for Priceless, who wasn’t exactly enthusiastic when she started. But she’s beginning to see how helpful it would be to be able to rely on both hands to do things like manipulate a remote control.
“I want to play with my iPad and watch TV,” she says.
The parents of the campers are even more motivated, because they understand how the use of two hands could make independence in adulthood much more feasible for their children.
“She talks about wanting to drive,” says Laura Garinger, Priceless’ mom.
From past experience, Garinger says she suspects that for the first few months after this camp session, Priceless will use her weak hand more often. But in past summers she has eventually reverted to relying on her strong side.
Still, Garinger says, she has witnessed lots of other, permanent successes.
Garinger, who is a special education teacher, met Priceless when the little girl was 3 years old; she adopted Priceless two years later. The preschooler needed to use a walker at the time. Now she walks on her own.
Being able to rely on both hands would go a long way toward helping Priceless achieve her dreams, her mom says.
“She hopes to be a police officer, so the sky’s the limit. We’ll see,” Garinger says, pausing as her voice shakes with emotion. “I mean, it’s probably not realistic, but I always tell her she can do what she wants when she grows up.”
Garinger says the first step for Priceless is strengthening her arm enough to give a high-five — and a two-arm hug.
This story is part of NPR’s reporting partnership with Nashville Public Radio and Kaiser Health News.
Former NFL Player Chris Borland Asks Catholic Church To Take Stand On Gun Control
Former NFL player Chris Borland grew up Catholic in Dayton. He talks with host Sacha Pfeiffer about his call for the church to take a stronger stand for gun control and against white supremacy.
SACHA PFEIFFER, HOST:
Chris Borland is another athlete who’s taking a stand, and he’s asking other athletes to join him. He’s a former NFL player who grew up in Kettering, Ohio, a suburb of Dayton. After the mass shootings there and in El Paso and in Gilroy, Calif., he wrote an open letter to the archbishop of Cincinnati urging the Catholic Church to, quote, “lead as Christ would.” I asked Borland why he wanted to single out the Catholic Church…
CHRIS BORLAND: It’s what I know, and I grew up within the church. And I see a concerning lack of assertiveness in addressing what’s going on in our country. And to have, you know, what happened in Dayton be met with what I’d consider just the minimal reaction thoughts and prayers to me isn’t enough.
PFEIFFER: What exactly do you want the church to do?
BORLAND: To firstly name and condemn white supremacy – two of the three terrorist attacks were carried out in the name of white supremacy. Secondly, to frame gun control for what it is, a pro-life stance. And thirdly, to hold accountable politicians who are parishioners who use the lord’s name and talk about God in Christ to get elected and then don’t act once in office and embody those values.
PFEIFFER: Last week, the archbishop of San Antonio, Texas, on Twitter was critical of President Trump. He said to him, stop your hatred. And he got heavily criticized for that – the archbishop did – kind of had to backtrack a little. If the archbishop and a part of the country that’s been right at the center of both the crisis on the border and now this attack can’t come out strongly and explicitly call out people that he thinks are promoting racism and violence, do you think it’s realistic to expect other Catholic leaders to do the same?
BORLAND: I don’t know that it’s realistic. This may be entirely naive. I’ve emailed and called and left messages to the Archdiocese of Cincinnati, you know, a half dozen or more over the past few days, and have gotten minimal response. So we do have a lot of power in the voice and the numbers of athletes that have competed in the greater Catholic League and we’re going to start there. Maybe it falls on deaf ears, but I think it’s better than doing nothing.
PFEIFFER: You mentioned that you’re trying to build a coalition in a sense of other athletes with prominent public platforms to speak out and join you. Have you been able to get other professional athletes to join you in calling out the Catholic Church?
BORLAND: It’s starting. We’ve had a few, you know, retweet and like the tweets that I put out a couple days ago. You know, there’s a handful of text conversations between men and women that have played at a high-level and email chains. And we’re figuring out the best way to do that. But the sad nature of gun violence in America and of hatred is that if you wait very long, there’s likely be another atrocity. So although it’s imperfect right now, we want to act and figure this out as we go. But, you know, when it happens in your backyard, you have to do something.
PFEIFFER: That’s Chris Borland, a former NFL linebacker who grew up in Dayton. We reached out to the Cincinnati Archdiocese for comment on Borland’s letter, and we were told that the archbishop has read it but hasn’t yet sent Borland a formal response.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
Saturday Sports: Yankees, Simone Biles
NPR’s Sacha Pfeiffer talks about the growing role of personal politics in sports and more with Howard Bryant of ESPN.
SACHA PFEIFFER, HOST:
And now it’s time for sports.
(SOUNDBITE OF MUSIC)
PFEIFFER: The New York Yankees remain one of the hottest teams in Major League Baseball, and politics continues to creep its way into the sports world. ESPN’s Howard Bryant joins us now to talk about all of that. Good morning, Howard.
HOWARD BRYANT: Good morning. How are you?
PFEIFFER: I’m good. So the Yankees – also very good for them – although it’s been 10 years since they’ve won a World Series, you’re saying that fans have good reason to be excited that they could do it this season.
BRYANT: Well, I think they do. And I think one of the reasons is their depth. It’s unbelievable how many players the Yankees have had injured this year, whether it’s Aaron Judge, whether it’s Giancarlo Stanton – virtually everybody in their lineup – Gary Sanchez. They’ve all been hurt. They’ve used the injured list a ridiculous number of times this year in terms of number of players that they’ve had hurt. And yet, they still have the best record and – in the American League. And they are still the team that has somehow run away with the American League East.
They’ve been knocking on the door the last couple years. They went to the American League Championship Series in 2017. They lost to the Red Sox in the playoffs last year. And this year, they look like they’re really close. And it’s kind of interesting, too, because, when you think about the Yankees, you think about them winning all the time and not being the underdog. But when you put Red Sox-Yankees next to each other, ever since 2004, the Red Sox have three championships, and the Yankees have one.
PFEIFFER: Right. And what do you think is making the Yankees so good this year?
BRYANT: It’s their depth. They’ve got so many players that you’ve never heard of, whether it’s Gio Urshela or the young Gleyber Torres. They’ve had so many injuries. You look at a – even a kid like Andujar last year who was playing great for them – he got hurt. And just every new player that comes into the lineup steps in, does something great. That kid Ford is hitting home runs now. Tauchman’s got 12 home runs. It’s just amazing. And you’re like, who are these guys? And yet, every player they put into the lineup produces. And that’s that magic that you have with championship teams where everybody contributes. And before you know it, they’re the ones at the end of the finish line.
PFEIFFER: Howard, there’s been a lot of noteworthy sports news happening off the playing field lately, athletes and activism. I know that Simone Biles, the Olympic gymnast, has been very outspoken, and that’s really caught your attention.
BRYANT: Well, absolutely, it has, considering that now you’re looking at these federations with – whether it’s the U.S. gymnastics with the Larry Nassar scandal and the sexual assault of those young gymnasts and how many over how many years – 300. And you look at these federations, and their job is to protect these athletes. Their job is not simply to profit off of them.
And when you look at what’s happening to them or you’re talking about the equal pay situations, whether it’s the U.S. women’s national hockey team or the U.S. women’s soccer team, or whether it’s equal pay in tennis, the athletes are recognizing that they have more power than they have been exercising over the past several years. And you’re starting to see now the athletes recognizing and saying and using their power, whether they get criticized for it or not – that they’ve got a stake in this, and they’re going to make sure everybody hears them.
PFEIFFER: Well, speaking of criticism, do you have a sense of the ratio of fans who like outspoken athletes versus fans who take a shut-up-and-just-play-the-game stance?
BRYANT: Well, I think that sports has never been anything but political. It’s always had a political element to it. And so people who don’t like this are usually saying, I don’t like what you’re saying. And they don’t have much of a great sense of history. I also understand the need for sports to be the place where you can get away from your problems. But there’s a separation here. Part of it is your entertainment, but part of it is their job.
PFEIFFER: That’s ESPN’s Howard Bryant. Howard, thank you.
BRYANT: Thank you.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
Trump Team Hits Brakes On Law That Would Curb Unneeded Medicare CT Scans, MRIs
If a doctor is found to be ordering too many MRI or CT scans or other imaging tests for Medicare patients, a federal law is supposed to require the physician to get federal approval for all diagnostic imaging. But the Trump administration has stalled the law’s implementation.
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Five years after Congress passed a law to reduce unnecessary MRIs, CT scans and other expensive diagnostic imaging tests that could harm patients and waste money, federal officials have yet to implement it.
The law requires that doctors consult clinical guidelines set by the medical industry before Medicare will pay for many common medical scans for enrollees. Health care providers who go way beyond clinical guidelines in ordering these scans (the 5 percent who order the most tests that are inappropriate) will, under the law, be required after that to get prior approval from Medicare for their diagnostic imaging.
But after physicians argued the provision would interfere with their practices, the Trump administration delayed putting the 2014 law in place until January 2020 — two years later than originally planned.
And even then, the Centers for Medicare & Medicaid Services has slated next year as a “testing” period, which means even if a physician doesn’t check the guidelines, Medicare will still pay for the scan. CMS also said it won’t decide until 2022 or 2023 when exactly physician penalties will begin.
Critics worry the delays come at a steep cost: Medicare is continuing to pay for millions of unnecessary exams and patients are being subjected to radiation for no medical benefit.
A Harvard study published in 2011 in the Journal of Urology found “widespread overuse” of imaging tests for men on Medicare who were at low risk of getting prostate cancer. And a University of Washington study in the Journal of the American College of Radiology that reviewed 459 CT and MRI exams at a large academic medical center found 26% of the tests were inappropriate.
“These delays mean that many more inappropriate imaging procedures will be performed, wasting financial resources and subjecting patients to services they do not need,” says Gary Young, director of the Northeastern University Center for Health Policy and Healthcare Research in Boston. “If this program were implemented stringently, you would certainly reduce inappropriate imaging to some degree.”
Doctors order unnecessary tests for a variety of reasons: to seize a potential financial advantage for them or their health system, to ease fears of malpractice suits or to appease patients who insist on the tests.
The law applies to doctors treating patients who are enrolled in the traditional fee-for-service Medicare system. Health insurers, including those that operate the private Medicare Advantage plans, have for many years refused to pay for the exams unless doctors get authorization from them beforehand. That process can take days or weeks, which irks physicians and patients.
CMS Administrator Seema Verma has sought to reduce administrative burdens on doctors with her “patients over paperwork” initiative.
CMS would not make Verma or other officials available for an interview for this story, and answered questions only by email.
A spokeswoman says CMS has no idea how many unnecessary imaging tests are ordered for Medicare beneficiaries.
“CMS expects to learn more about the prevalence of imaging orders identified as ‘not appropriate’ under this program when we begin to identify outlier ordering professionals,” she says.
“It takes four clicks on a computer”
An influential congressional advisory board in 2011 cited the rapid growth of MRIs, CT scans and other imaging, and recommended requiring doctors who order more tests than their peers to be forced to get authorization from Medicare before sending patients for such exams. In the 2014 law, Congress tried to soften that recommendation’s effect by asking doctors billing Medicare to follow protocols to confirm that imaging would be appropriate for the patient.
Studies show a growing number of health systems have used clinical guidelines to better manage imaging services. The University of Virginia Health System found that unnecessary testing fell by between 5% and 11% after implementing such recommendations.
Virginia Mason Health System in Seattle in 2011 set up a system requiring its physicians — most of whom are on salary — to consult imaging guidelines. It would deny claims for any tests that did not meet appropriate criteria, except in rare circumstances. A study found the intervention led to a 23% drop in MRIs for lower back issues and headaches.
Dr. Craig Blackmore, a radiologist at Virginia Mason, says he worries that, unlike the efforts at his hospital, many doctors could be confused by the Medicare program because they have not received the proper training about the guidelines.
“My fear is that it will be a huge disruption in workflow and show no benefit,” he says.
In 2014, AtlantiCare, a large New Jersey hospital system, began grading physicians on whether they consult its guidelines.
“Some doctors see this tool as additional work, but it takes four clicks on a computer — or less than a minute,” says Ernesto Cerdena, director of radiology services at AtlantiCare.
Not all Medicare imaging tests will be subject to the requirements. Emergency patients are exempt, as well as patients admitted to hospitals. CMS has identified some of the most common conditions for which doctors will have to consult guidelines. Those include heart disease, headache and pain in the lower back, neck or shoulders.
Robert Tennant, director of health information technology for the Medical Group Management Association, which represents large physician groups, says the law will unfairly affect all doctors merely to identify the few who order inappropriately.
“For the most part, doctors are well trained and know exactly what tests to perform,” Tennant says.
The association is one of several medical groups pushing Congress to repeal the provision.
American College of Radiology’s role
The law required the federal government to designate health societies or health systems to develop guidelines and companies that would sell software to embed that guidance into doctors’ electronic health record systems.
Among the leaders in that effort is the American College of Radiology, which lobbied for the 2014 law and has been issuing imaging guidelines since the 1990s. It is one of about 20 medical organizations and health systems certified by CMS to publish separate guidelines for doctors.
The college wanted “to get ahead of the train and come up with a policy that was preferable to prior authorization,” says Cynthia Moran, an executive vice president of the radiology group. About 2,000 hospitals use the college’s licensed guidelines — more than any others, she says. And the college profits from that use.
Moran the licensing money helps the college mitigate the costs of developing the guidelines, which must be updated regularly, based on new research. She the college gives away the guidelines to individual doctors upon request and sells them only to large institutions, although she notes they are not as easy to access that way, compared with being embedded in a doctor’s medical records.
Kaiser Health News a nonprofit, editorially independent program of the Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente.
MLB’s Yankees And White Sox To Play At ‘Field Of Dreams’ Farm
In Iowa, a temporary ballpark will be built to host a game between the New York Yankees and Chicago White Sox next summer.
Major League Baseball
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Major League Baseball
If they appear, “Shoeless” Joe Jackson and Archibald “Moonlight” Graham will only be there in spirit. But for one night, big leaguers will play baseball at the Iowa farm that was made famous in the beloved film Field of Dreams.
The New York Yankees and Chicago White Sox will face off at the Dyersville, Iowa, farm next August, Major League Baseball announced Thursday. The game will count as part of the regular season — starting a three-game series between the Yankees and White Sox. The two teams will then have one day off as they travel to Chicago to finish out the series.
The game is slated for the night of Aug. 13, 2020 — three decades after Field of Dreams debuted in 1989. But Aaron Judge and his fellow MLB stars won’t be playing on the same diamond that was created for the Kevin Costner movie. Instead, they’ll play at a temporary 8,000-seat ballpark.
“As a sport that is proud of its history linking generations, Major League Baseball is excited to bring a regular season game to the site of Field of Dreams,” MLB Commissioner Robert D. Manfred Jr. said. “We look forward to celebrating the movie’s enduring message of how baseball brings people together at this special cornfield in Iowa.”
According to MLB, the facility will be built adjacent to rows of corn like those that lined the outfield in the movie — and from which the mythical players appeared, fulfilling the whispered prophecy, “If you build it, he will come.” A pathway will connect the site with the movie location.
Celebrating the plan for what will be the first MLB game ever played in her state, Iowa Gov. Kim Reynolds echoed a famous exchange from the film:
“Hey! Is this heaven?”
“No, it’s Iowa.”
In a tweet from MLB, that exchange has now been reedited to show the Yankees’ Judge asking that question of Costner’s character.
Is this heaven?@Yankees–@WhiteSox, see you in Iowa on 8.13.20. pic.twitter.com/5GGbH7TWuq
— MLB (@MLB) August 8, 2019
In addition to the prediction that legendary ballplayers would come to play ball in an Iowa cornfield, Field of Dreams also predicted people would flock to the site. And for years, they’ve done just that, making pilgrimages to soak in the field’s timeless character and to feel the buoyancy that sports can bring.
Now, MLB is hoping fans will want to watch baseball at the Iowa farm. The idea, as James Earl Jones said when he portrayed the character Terence Mann, is that people will come to see their heroes:
“And they’ll watch the game, and it’ll be as if they’ve dipped themselves in magic waters,” Jones said in the film. “The memories will be so thick they’ll have to brush them away from their faces.”
How The CDC’s Reluctance To Use The ‘F-Word’ — Firearms — Hinders Suicide Prevention
In the U.S., firearms kill more people through suicide than homicide.
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The nation’s foremost public health agency shies away from discussing the important link in this country between suicide and access to guns.
That’s according to documents obtained by NPR that suggest the Centers for Disease Control and Prevention instead relies on vague language and messages about suicide that effectively downplay and obscure the risk posed by firearms.
Guns in the United States kill more people through suicide than homicide.
Almost 40,000 people died from guns in 2017 alone — 60% of those deaths were suicides. Guns are the most common method used for suicide.
If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.
Suicide rates are going up in nearly every state, even though research shows that suicide is preventable. Access to guns is such an important risk factor that any effective public education campaign to prevent suicide would surely need to address it.
The trouble is, the CDC is operating under something known as the Dickey Amendment, legislation passed by Congress in 1996 that prohibits the CDC from spending any of its funds to “advocate or promote gun control.”
A lot of attention has been paid to how this has stopped the CDC from funding certain kinds of gun violence research. The law also had another effect: It led the CDC to tiptoe around guns as it tries to tackle the increase in suicides.
“CDC staff do their best to provide the very latest science and evidence-based data to the public so they can protect their health,” a CDC spokesperson told NPR, declining to make any agency official available for an interview.
NPR reviewed early drafts and editing notes of a major 2018 CDC suicide report and a guide on suicide prevention, obtained through a Freedom of Information Act request, along with the agency’s public anti-suicide messages.
The internal documents reveal detailed staff deliberations over wording that resulted in the agency weakening language that might suggest restricting access to guns as a way to prevent suicides.
“Lethal means”
Guns get used in slightly more than half of all suicides. And people who try to kill themselves with a gun almost always die.
But the word “gun” is frequently absent when the CDC presents information on suicide prevention.
A CDC fact sheet published in 2018 on “Preventing Suicide” does not include the word “gun” or “firearm.” Instead, it advises people to “reduce access to lethal means among persons at risk of suicide.”
Where the CDC’s website lists the risk factors for suicide, it also does not include the word “gun.” It says instead “easy access to lethal methods.”
Internal texts exchanged between CDC suicide researchers show why a generic term like “lethal means” is preferred: It “is probably less likely to create issues compared to using the f-word,” which is firearms. A phrase like “access to firearms” would “raise a few red flags.”
Here is one text exchange:
LiKamWa, Wendy (CDC/CCEHIP/NCIPC) 2:56 PM:
haha one of the police articles I saw listed “access to firearms” and I was like, that would raise a few red flags!
Stone, Deborah (CDC/ONDIEH/NCIPC) 2:56 PM:
it’s ok. that’s fair territory!
that’s a big reason why their rates are so high.
we aren’t saying take away their guns!
at least not explicitly!
LiKamWa, Wendy (CDC/CCEHIP/NCIPC) 2:57 PM:
actually, the tiesman et al article (i.e. NIOSH) talks about firearms and access to firearms a lot
Stone, Deborah (CDC/ONDIEH/NCIPC) 2:59 PM:
yeah, it’s more of an issue if we are advocating for gun control. it’s a fact that access is a risk factor.
LiKamWa, Wendy (CDC/CCEHIP/NCIPC) 3:00 PM:
still, “lethal means” is probably less likely to create issues compared to using the F-word
Stone, Deborah (CDC/ONDIEH/NCIPC) 3:00 PM:
very true.
In the past, members of Congress have asked the CDC if agency staffers were told to avoid using the word “gun.” Here’s how the CDC replied:
“To ensure scientific integrity, technical accuracy, consistency with appropriations language, and usefulness to the intended audience, CDC has a standard agency review process for any manuscript or report produced by CDC scientists. … In the course of reviewing manuscripts or reports on firearm violence, CDC has asked employees to use correct terminology — for example, to say ‘died as a result of a firearm-related injury’ vs. ‘died from a firearm’ in the same way as one would write ‘died as a result of a motor-vehicle crash’ vs. ‘died from a car.’ “
But one former CDC official told NPR that of course employees know to censor themselves when it comes to guns.
“There were staff who would say you couldn’t even say the word ‘gun,’ ” recalls Linda Degutis, who used to serve as director of the CDC’s National Center for Injury Prevention and Control. “They would tell other people, or even new people sometimes, you can’t say the word ‘gun’ here.”
She says higher-ups would review documents, “because there would be a thought that if guns were mentioned too often, that would be violating this intent not to do any kind of research or work around guns.”
She says the problem with language like “lethal means” is that it doesn’t convey what people should actually be worried about and what actions they should take when it comes to suicide prevention, such as offering to remove guns from the home of a friend or relative who is going through a personal crisis.
“I think when you say ‘lethal means’ to the general public, they don’t know what you’re saying,” adds Degutis. “They don’t know that you might mean guns.”
“Safe storage” vs. “restricting access”
Another noticeable feature of the CDC’s suicide prevention messaging is the emphasis on “safe storage.”
By that, the agency means keeping guns and ammunition securely locked in a safe. Unlike other measures that could make it more difficult to obtain a gun, “safe storage” isn’t likely to be politically controversial.
Consider the edits made to one internal document prepared to help guide CDC staff in responding to questions about suicide.
The original answer included the words “restricting access to lethal means among those at risk for suicide has been proven effective for preventing suicide.”
One passage got edited to remove any reference to “restricting access.” Instead, the revised answer focused on “safe storage,” saying, “safe storage practices can help reduce the risk for suicide by separating vulnerable populations from easy access to lethal means.”
In a teleconference that the CDC held with reporters in June 2018, when the CDC released a report on rising suicide rates, CDC Principal Deputy Director Anne Schuchat said that “one of our recommendations is assuring safe storage of medications and firearms as one of the approaches to prevention. Very important to — you know, have safe storage.”
Research does show that locking up guns and ammunition can prevent suicidal adolescents from being able to access their parents’ guns.
But the “safe storage” approach doesn’t address the suicide risk that a gun poses to its owner, who presumably has the key or combination to a locked safe or cabinet.
And most gun suicides happen when the owner of the gun turns it on himself or herself.
“I’m a little bit dubious that safe storage will be relevant to the vast majority of suicides with firearms. Because the owners of those firearms are the ones storing the guns and locking the guns,” says Daniel Webster, director of the Johns Hopkins Center for Gun Research and Policy. “I certainly don’t know of any research that shows that safe storage of firearms reduces risks for adult suicide.”
David Gunnell, an epidemiologist at the University of Bristol, was perplexed by the CDC’s focus on safe storage.
“It was all about, if you like, putting the blame on the owners, making them store their firearms safely,” says Gunnell, “rather than seeing this large pool of firearms available in the community in the United States contributing to the heightened use of firearms for suicide.”
In his research on a common means of suicide in Sri Lanka, pesticide ingestion, Gunnell has found that providing locked storage boxes hasn’t been an effective form of prevention. Eventually, he says, families just stop bothering to use the secure box.
What has produced dramatic reductions in suicide rates, he says, has been regulatory bans that took the most dangerous pesticides off the market in certain places.
“So there’s a body of evidence that if you regulate, to make the environment safer by taking out of the broader environment the most toxic products, that results in a fall in deaths,” says Gunnell, because suicide research shows that people do not tend to substitute one suicide method for another.
In fact, Gunnell says, most international reviews of the research literature on suicide have found that the strongest evidence about how to bring down death rates “is around those interventions that restrict access to commonly used, high lethality suicide methods.”
In other countries, that approach has lowered suicide rates by as much as 30% to 50%.
These dramatic decreases are not mentioned in the CDC’s main guide to preventing suicide, described as “a resource to guide and inform prevention decision-making in communities and states.”
It does talk about the need to create “protective environments” and includes the example of “safe storage” of guns. But as the document got edited inside the CDC, its message about the importance of restricting access to “lethal means” got weakened. One early draft stated:
“The evidence for the effectiveness of means restriction and other ways to establish protective environments is some of the strongest in the field.”
The sentence got changed to:
“The evidence for the effectiveness of preventing suicide by reducing access to lethal means and otherwise establishing protective environments for individuals at risk of suicide is strong, particularly compared to existing evidence for other prevention strategies.”
Additional changes produced the final, published version, in which the evidence merely “suggests”:
“The evidence suggests that creating protective environments can reduce suicide and suicide attempts and increase protective behaviors.”
What’s missing?
It’s possible to read the CDC’s materials on suicide and come away not understanding what science shows about how to significantly reduce suicide rates, and the important connection between guns and suicide.
“Half of all suicide deaths in the states are from firearms,” says Gunnell, “and so, as a policymaker, my first step would be to say, ‘Well, what can we do to restrict access to firearms?’ ”
The CDC’s own research shows that simply having a gun in the home is associated with increased risk for suicide, but that isn’t highlighted in its public messages about suicide.
In addition, states that have higher gun ownership rates see higher rates for suicide, “even after you’ve controlled for a range of other factors known to be correlated with suicide risk,” says Webster. “Access to firearms does increase suicide risk. I recognize that is a conclusion that will make people uncomfortable. But that is simply what the facts are.”
When people are going through difficult times or grappling with substance use or mental health issues, says Webster, “it could be, at least temporarily, you can mitigate that risk by having someone else hold the firearms for them.”
Other possible measures might include waiting periods before purchasing guns, licensing processes for gun buyers, or laws that keep firearms from those who are deemed a risk to themselves or others (“red flag” laws).
None of those legislative options get mentioned in the CDC’s guide to strategies for suicide prevention for states and communities.
A spokesperson for the CDC told NPR that “some laws or policies to potentially reduce firearm suicides (e.g., red flag laws) have not been rigorously evaluated. CDC selected examples with ample evaluation using the criteria for inclusion in the front of the technical package. We are always reassessing the evidence and will update the evidence as it becomes available.”
She pointed to one CDC study of firearms and suicides in major metropolitan areas that does briefly mention “safely storing firearms or temporarily removing them from the home.” It also mentions policies to keep firearms away from people under a restraining order for domestic violence, as well as efforts to strengthen the background check system for gun purchases.
Draft documents of the CDC’s guide to suicide prevention show that some researchers at the agency feel that suicide prevention has been hindered by “hesitation to take up strategies known to be effective but perhaps unpopular”:
“Unfortunately, suicide prevention is impeded by barriers including: stigma related to help-seeking, mental illness, being a survivor, or someone with lived experience; fear related to asking about suicidal thought, hesitation to take up strategies known to be effective but perhaps unpopular; misinformation about suicide preventability, harmful messaging about suicide, and disproportionate funding given its public health burden.”
In the final version of that section that was published, some of those barriers to reducing suicide rates go unmentioned:
“There are a number of barriers that have impeded progress, including, for example, stigma related to help-seeking, mental illness, being a survivor and fear related to asking someone about suicidal thoughts.”
What’s actually allowed?
Webster believes that CDC officials have made the choice that it is safest for the agency to tread lightly when it comes to anything related to guns, since Congress controls the CDC’s funding.
“I think that’s a very unfortunate environment that they’ve had to operate in,” says Webster. “But I want people to understand that there is no law in place now that says that CDC can’t talk about the research and what’s been learned about the connection between firearms and suicide risk.”
The exact meaning of what the CDC is or is not allowed to do under the Dickey Amendment has been ambiguous ever since Congress passed the legislation decades ago.
Officials seem inclined to err on the side of caution. The minutes of one meeting to review a report on rising suicide rates showed that one CDC employee told researchers not to mention the often impulsive nature of suicides.
Apparently the official worried that mentioning this fact might turn “it into a removal of lethal means issue,” given that about half the people in the study who killed themselves were not previously known to have a mental health issue. She noted, “I don’t want it to be overly politicized.”