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Carolyn Dickens, 76, was sitting at her dining room table, struggling to catch her breath as her physician looked on with concern. “What’s going on with your breathing?” asked Peter Gliatto, director of Mount Sinai’s Visiting Doctors Program. “I don’t know,” she answered, so softly it was hard to hear. “Going from here to the bathroom or the door, I get really winded. I don’t know when it’s going to be my last breath.” Dickens, a lung cancer survivor, lives in central Harlem, barely getting by. She has serious lung disease and high blood pressure and suffers regular fainting spells. In the past year, she’s fallen several times and dropped to 85 pounds, a dangerously low weight. And she lives alone, without any help — a highly perilous situation. Across the country, about 2 million adults 65 and older are completely or mostly homebound, while an additional 5.5 million seniors can get out only with significant difficulty or assistance. This is almost surely an undercount, since the data is from more than a dozen years ago. It’s a population whose numbers far exceed those living in nursing homes — about 1.2 million — and yet it receives much less attention from policymakers, legislators, and academics who study aging. Consider some eye-opening statistics about completely homebound seniors from a study published in 2020 in JAMA Internal Medicine: Nearly 40 percent have five or more chronic medical conditions, such as heart or lung disease. Almost 30 percent are believed to have “probable dementia.” Seventy-seven percent have difficulty with at least one daily task such as bathing or dressing. Almost 40 percent live by themselves. That “on my own” status magnifies these individuals’ already considerable vulnerability, something that became acutely obvious during the COVID-19 outbreak, when the number of sick and disabled seniors confined to their homes doubled. “People who are homebound, like other individuals who are seriously ill, rely on other people for so much,” said Katherine Ornstein, director of the Center for Equity in Aging at the Johns Hopkins School of Nursing. “If they don’t have someone there with them, they’re at risk of not having food, not having access to health care, not living in a safe environment.” Research has shown that older homebound adults are less likely to receive regular primary care than other seniors. They’re also more likely to end up in the hospital with medical crises that might have been prevented if someone had been checking on them. To better understand the experiences of these seniors, I accompanied Gliatto on some home visits in New York City. Mount Sinai’s Visiting Doctors Program, established in 1995, is one of the oldest in the nation. Only 12 percent of older U.S. adults who rarely or never leave home have access to this kind of home-based primary care. Gliatto and his staff — seven part-time doctors, three nurse practitioners, two nurses, two social workers, and three administrative staffers — serve about 1,000 patients in Manhattan each year. These patients have complicated needs and require high levels of assistance. In recent years, Gliatto has had to cut staff as Mount Sinai has reduced its financial contribution to the program. It doesn’t turn a profit, because reimbursement for services is low and expenses are high. First, Gliatto stopped in to see Sandra Pettway, 79, who never married or had children and has lived by herself in a two-bedroom Harlem apartment for 30 years. Pettway has severe spinal problems and back pain, as well as Type 2 diabetes and depression. She has difficulty moving around and rarely leaves her apartment. “Since the pandemic, it’s been awfully lonely,” she told me. When I asked who checks in on her, Pettway mentioned her next-door neighbor. There’s no one else she sees regularly. Pettway told the doctor she was increasingly apprehensive about an upcoming spinal surgery. He reassured her that Medicare would cover in-home nursing care, aides, and physical therapy services. “Someone will be with you, at least for six weeks,” he said. Left unsaid: Afterward, she would be on her own. (The surgery in April went well, Gliatto reported later.) The doctor listened carefully as Pettway talked about her memory lapses. “I can remember when I was a year old, but I can’t remember 10 minutes ago,” she said. He told her that he thought she was managing well but that he would arrange testing if there was further evidence of cognitive decline. For now, he said, he’s not particularly worried about her ability to manage on her own. ‘A fear of falling’ Several blocks away, Gliatto visited Dickens, who has lived in her one-bedroom Harlem apartment for 31 years. Dickens told me she hasn’t seen other people regularly since her sister, who used to help her out, had a stroke. Most of the neighbors she knew well have died. Her only other close relative is a niece in the Bronx whom she sees about once a month. Dickens worked with special-education students for decades in New York City’s public schools. Now she lives on a small pension and Social Security — too much to qualify for Medicaid. (Medicaid, the program for low-income people, will pay for aides in the home. Medicare, which covers people over age 65, does not.) Like Pettway, she has only a small fixed income, so she can’t afford in-home help. Every Friday, God’s Love We Deliver, an organization that prepares medically tailored meals for sick people, delivers a week’s worth of frozen breakfasts and dinners that Dickens reheats in the microwave. She almost never goes out. When she has energy, she tries to do a bit of cleaning. Without the ongoing attention from Gliatto, Dickens doesn’t know what she’d do. “Having to get up and go out, you know, putting on your clothes, it’s a task,” she said. “And I have the fear of falling.” Bruce Leff, director of the Center for Transformative Geriatric Research at the Johns Hopkins School of Medicine, is a leading advocate of home-based medical care. “It’s kind of amazing how people find ways to get by,” he said when I asked him about homebound older adults who live alone. “There’s a significant degree of frailty and vulnerability, but there is also substantial resilience.” With the rapid expansion of the aging population in the years ahead, Leff is convinced that more kinds of care will move into the home, everything from rehab services to palliative care to hospital-level services. “It will simply be impossible to build enough hospitals and health facilities to meet the demand from an aging population,” he said. But that will be challenging for homebound older adults who are on their own. Without on-site family caregivers, there may be no one around to help manage this home-based care.

NEW YORK (AP) — Technology stocks pulled Wall Street to another record amid mixed trading. The S&P 500 rose 0.2% Monday after closing November at an all-time high. The Dow Jones Industrial Average fell 0.3%, and the Nasdaq composite gained 1%. Super Micro Computer, a stock that’s been on an AI-driven roller coaster, soared after saying an investigation found no evidence of misconduct by its management or the company’s board. Retailers were mixed coming off Black Friday and heading into what’s expected to be the best Cyber Monday on record. Treasury yields held relatively steady in the bond market. THIS IS A BREAKING NEWS UPDATE. AP’s earlier story follows below. NEW YORK (AP) — Technology stocks are pulling Wall Street toward another record amid mixed trading on Monday. The S&P 500 rose 0.2% in afternoon trading after closing its best month of the year at an all-time high . The Dow Jones Industrial Average was down 86 points, or 0.2%, with a little more than an hour remaining in trading, while the Nasdaq composite was 0.9% higher. Super Micro Computer, a stock that’s been on an AI-driven roller coaster, soared 31.1% to lead the market. Following accusations of misconduct and the resignation of its public auditor , the maker of servers used in artificial-intelligence technology said an investigation found no evidence of misconduct by its management or by the company's board. It also said it doesn’t expect to restate its past financials and that it will find a new chief financial officer, appoint a general counsel and make other moves to strengthen its governance. Big Tech stocks also helped prop up the market. Gains of 1.8% for Microsoft and 2.9% for Meta Platforms were the two strongest forces pushing upward on the S&P 500. Intel was another propellant during the morning, but it lost an early gain to fall 1.1% after the chip company said CEO Pat Gelsinger has retired and stepped down from the board. Intel is looking for Gelsinger’s replacement, and its chair said it’s “committed to restoring investor confidence.” Intel recently lost its spot in the Dow Jones Industrial Average to Nvidia, which has skyrocketed in Wall Street's frenzy around AI. Stellantis, meanwhile, skidded following the announcement of its CEO’s departure . Carlos Tavares steps down after nearly four years in the top spot of the automaker, which owns car brands like Jeep, Citroën and Ram, amid an ongoing struggle with slumping sales and an inventory backlog at dealerships. The world’s fourth-largest automaker’s stock fell 6.3% in Milan. The majority of stocks in the S&P 500 likewise fell, including California utility PG&E. It dropped 3.7% after saying it would sell $2.4 billion of stock and preferred shares to raise cash. Retailers were mixed amid what’s expected to be the best Cyber Monday on record and coming off Black Friday . Target, which recently gave a forecast for the holiday season that left investors discouraged , fell 1.6%. Walmart , which gave a more optimistic forecast, rose 0.3%. Amazon, which looks to benefit from online sales from Cyber Monday, climbed 1.3%. The stock market largely took Donald Trump’s latest threat on tariffs in stride. The president-elect on Saturday threatened 100% tariffs against a group of developing economies if they act to undermine the U.S. dollar. Trump said he wants the group, headlined by Brazil, Russia, India and China, to promise it won’t create a new currency or otherwise try to undercut the U.S. dollar. The dollar has long been the currency of choice for global trade. Speculation has also been around a long time that other currencies could knock it off its mantle, but no contender has come close. The U.S. dollar’s value rose Monday against several other currencies, but one of its strongest moves likely had less to do with the tariff threats. The euro fell amid a political battle in Paris over the French government’s budget . The euro sank 0.7% against the U.S. dollar and broke below $1.05. In the bond market, Treasury yields gave up early gains to hold relatively steady. The yield on the 10-year Treasury climbed above 4.23% during the morning before falling back to 4.19%. That was just above its level of 4.18% late Friday. A report in the morning showed the U.S. manufacturing sector contracted again last month, but not by as much as economists expected. This upcoming week will bring several big updates on the job market, including the October job openings report, weekly unemployment benefits data and the all-important November jobs report. They could steer the next moves for Federal Reserve, which recently began pulling interest rates lower to give support to the economy. Economists expect Friday's headliner report to show U.S. employers accelerated their hiring in November, coming off October's lackluster growth that was hampered by damaging hurricanes and strikes. “We now find ourselves in the middle of this Goldilocks zone, where economic health supports earnings growth while remaining weak enough to justify potential Fed rate cuts,” according to Mark Hackett, chief of investment research at Nationwide. In financial markets abroad, Chinese stocks led gains worldwide as monthly surveys showed improving conditions for manufacturing, partly driven by a surge in orders ahead of Trump’s inauguration next month. Both official and private sector surveys of factory managers showed strong new orders and export orders, possibly partly linked to efforts by importers in the U.S. to beat potential tariff hikes by Trump once he takes office. Indexes rose 0.7% in Hong Kong and 1.1% in Shanghai. AP Business Writers Matt Ott and Elaine Kurtenbach contributed.AP Business SummaryBrief at 4:32 p.m. ESTNoneGary Neville has aimed a cheeky dig at Pep Guardiola after Manchester City were drawn against Salford in the FA Cup . The reigning Premier League champions will host local fourth-tier opposition in the third round in January after the two clubs were paired together in Monday night’s draw at Old Trafford . Such a fixture is certainly not short on narrative, with League Two side Salford co-owned by United’s famous ‘Class of 92’ stars in Gary Neville, David Beckham, Paul Scholes, Ryan Giggs, Phil Neville and Nicky Butt. And Neville could not resist a playful jab at Guardiola on social media straight after Monday’s draw, writing on X: “He’s getting sacked in the morning @SalfordCityFC.” That is a reference to the chants aimed at the Catalan - to which he responded by holding up six fingers as a reminder of how many Premier League titles he has won - by the gleeful home fans at Anfield as Premier League leaders Liverpool deepened the sense of crisis at City with a 2-0 win on Sunday that moved them nine points clear at the top of the table. City are now winless in their last seven matches across all competitions, having last tasted victory at home to struggling Southampton on October 26. Their recent uncharacteristic slump has included an initial run of five successive defeats and now four consecutive Premier League losses, while they also inexplicably threw away a 3-0 lead at home to Feyenoord in the Champions League to draw 3-3. By far the worst run of his illustrious managerial career to date has taken its toll on Guardiola, who said before watching his team fall 11 points off the Premier League title pace on Merseyside: “I don’t like it. I don’t enjoy it at all. “I don’t sleep as good as when I won every game. Maybe it’s more unusual to win four Premier League titles in a row. In that moment I was stable enough, I was happy because I eat better and sleep better.” Among the multitude of other compelling narratives to emerge from Monday’s FA Cup third round draw was League One Peterborough being handed a trip to face Premier League strugglers Everton at Goodison Park - a match that could see the Toffees’ veteran winger Ashley Young go up against his son Tyler, 18. “WOW.......... Dreams Might Come True #FaCup #GoosebumpsMoment #YoungVsYoung,” Young Sr wrote on X.

The Death Of A Legend: How Jimmy Carter Influenced The Auto Industry3. What are the main challenges facing the Chinese economy in the coming years?Unlike scores of people who scrambled for the blockbuster drugs Ozempic and Wegovy to lose weight in recent years, Danielle Griffin had no trouble getting them. The 38-year-old information technology worker from New Mexico had a prescription. Her pharmacy had the drugs in stock. And her health insurance covered all but $25 to $50 of the monthly cost. For Griffin, the hardest part of using the new drugs wasn’t access. It was finding out that the much-hyped medications didn’t really work for her. “I have been on Wegovy for a year and a half and have only lost 13 pounds,” said Griffin, who watches her diet, drinks plenty of water and exercises regularly. “I’ve done everything right with no success. It’s discouraging.” In clinical trials, most participants taking Wegovy or Mounjaro to treat obesity lost an average of 15% to 22% of their body weight — up to 50 pounds or more in many cases. But roughly 10% to 15% of patients in those trials were “nonresponders” who lost less than 5% of their body weight. Now that millions of people have used the drugs, several obesity experts told The Associated Press that perhaps 20% of patients — as many as 1 in 5 — may not respond well to the medications. It's a little-known consequence of the obesity drug boom, according to doctors who caution eager patients not to expect one-size-fits-all results. “It's all about explaining that different people have different responses,” said Dr. Fatima Cody Stanford, an obesity expert at Massachusetts General Hospital The drugs are known as GLP-1 receptor agonists because they mimic a hormone in the body known as glucagon-like peptide 1. Genetics, hormones and variability in how the brain regulates energy can all influence weight — and a person's response to the drugs, Stanford said. Medical conditions such as sleep apnea can prevent weight loss, as can certain common medications, such as antidepressants, steroids and contraceptives. “This is a disease that stems from the brain,” said Stanford. “The dysfunction may not be the same” from patient to patient. Despite such cautions, patients are often upset when they start getting the weekly injections but the numbers on the scale barely budge. “It can be devastating,” said Dr. Katherine Saunders, an obesity expert at Weill Cornell Medicine and co-founder of the obesity treatment company FlyteHealth. “With such high expectations, there’s so much room for disappointment.” That was the case for Griffin, who has battled obesity since childhood and hoped to shed 70 pounds using Wegovy. The drug helped reduce her appetite and lowered her risk of diabetes, but she saw little change in weight. “It’s an emotional roller coaster,” she said. “You want it to work like it does for everybody else.” The medications are typically prescribed along with eating behavior and lifestyle changes. It’s usually clear within weeks whether someone will respond to the drugs, said Dr. Jody Dushay, an endocrine specialist at Beth Israel Deaconess Medical Center. Weight loss typically begins right away and continues as the dosage increases. For some patients, that just doesn't happen. For others, side effects such as nausea, vomiting and diarrhea force them to halt the medications, Dushay said. In such situations, patients who were counting on the new drugs to pare pounds may think they’re out of options. “I tell them: It's not game over,” Dushay said. Trying a different version of the new class of drugs may help. Griffin, who didn't respond well to Wegovy, has started using Zepbound, which targets an additional hormone pathway in the body. After three months of using the drug, she has lost 7 pounds. “I'm hoping it's slow and steady,” she said. Other people respond well to older drugs, the experts said. Changing diet, exercise, sleep and stress habits can also have profound effects. Figuring out what works typically requires a doctor trained to treat obesity, Saunders noted. “Obesity is such a complex disease that really needs to be treated very comprehensively,” she said. “If what we’re prescribing doesn’t work, we always have a backup plan.” The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.Mexican President Claudia Sheinbaum told reporters Thursday the country has a plan to receive any Mexicans that U.S. President-elect Donald Trump deports en masse, according to Reuters. She also reportedly said during the press conference that Mexico will try to show that its citizens living illegally in the U.S. help the American economy. “We will receive Mexicans, and we have a plan for it, but before that, we will work to demonstrate that they do not have to deport our compatriots who are on the other side of the border,” Reuters quoted Sheinbaum as saying. “On the contrary, they even benefit the economy of the United States.” Trump confirmed Monday that his incoming administration will use the U.S. military to carry out a “mass deportation program.” In September, the president-elect pledged to have the “largest deportation in the history of our country” and suggested that over 20 million people are living in the U.S. illegally. “We have the worst border in the history of the world. There’s never been a border like this,” he said. “And I want to be the border president, and I hope you call me the border president because I’ll show you what a border security job we can do. And we’re gonna do a job like never has been done before.” Trump added that the “mass deportation” would begin in Colorado and Ohio, states he claimed saw taken over. He discussed both states during a September debate against Vice President Kamala Harris and claimed Haitian migrants in Springfield, Ohio, had eaten household pets, a rumor that local officials repeatedly rejected. Colorado Gov. Jared Polis said in an interview with Colorado Public Radio that he would welcome the federal government’s help in finding people who have committed crimes but cautioned against pursuing those who haven’t broken the law. “Obviously, the fear is he’s talking about going after law-abiding Coloradans who might’ve lived here for 20, 30 years, who are working as construction workers or in ag [agriculture] or in the hospitality industry,” Colorado Public Radio quoted him as saying. “And obviously it would devastate our economy and our society if someone were to come in and forcibly take our neighbors away from us.” Have a news tip? Contact Ray Lewis at rjlewis@sbgtv.com or at x.com/rayjlewis . Content from The National Desk is provided by Sinclair, the parent company of FOX45 News.

PHILADELPHIA (AP) — Jamal Mashburn Jr. scored 18 points as Temple beat Buffalo 91-71 on Sunday. Mashburn shot 6 for 10 (3 for 6 from 3-point range) and 3 of 4 from the free-throw line for the Owls (8-5). Zion Stanford scored 15 points while going 4 of 9 and 6 of 7 from the free-throw line. Quante Berry had 15 points and shot 7 of 8 from the field and 0 for 4 from the foul line. The Bulls (5-7) were led by Tyson Dunn, who posted 11 points and four assists. Anquan Boldin Jr. added 11 points and three steals for Buffalo. Noah Batchelor also had nine points and six rebounds. Temple took the lead with 5:38 remaining in the first half and never looked back. The score was 39-29 at halftime, with Shane Dezonie racking up seven points. Temple outscored Buffalo in the second half by 10 points, with Mashburn scoring a team-high 13 points after intermission. The Associated Press created this story using technology provided by Data Skrive and data from Sportradar .US lawmakers back Covid Chinese lab leak theory after two-year probe

'Best feeling ever'In conclusion, while Aryna Sabalenka may have been crowned the WTA Player of the Year, let us not forget the impressive accomplishments and promising future of talented players like Zheng Qinhui. The world of women's tennis is brimming with talent and potential, and as we look ahead to the 2022 season, we can expect to see even more thrilling matches, remarkable performances, and inspiring stories unfold on the court.

High school exit exams dwindle to about half a dozen states

Nvidia Under Investigation: Self-Inflicted or Sacrificial Lamb in US-China Tech War?India News | Union Minister Manohar Lal Launches NTPC's Green Hydrogen Buses in Leh

A smoke signaller writes on the deep sea mining issue: “Only 60 people turned up out of over 5,000 Cook Islanders in Wellington for the Mark Brown political bandwagon show. It confirms the majority are against the destruction of our fragile ocean and ecosystems. Are Tou, George, Pere and the Hermans on the payroll and receiving $$$ from government? Sophie Benbow, director of marine programme at a Conservation Charity, warned of the potentially irreversible losses of ocean biodiversity. A study led by Travis Washburn, a researcher at the Geological Survey of Japan, highlights the destructive effects of deep-sea mining on marine ecosystems. The study shows that mining operations lead to the disappearance of marine life from both the immediate area and surrounding regions.” fine fire spreaders In response to yesterday’s front page story ‘Fires continue despite warnings’ – and lots of fire engine sirens yesterday – a smoke signaler writes: “Government should impose a total fire ban and police it, starting with a $2000 fine for anyone starting a fire that leads to a callout. No leniency, stop fires altogether, whatever it takes. The island doesn't have water let alone enough pressure to squirt hoses or fill water tankers.” where’s the rain? We’ve all got our favourite online weather websites and they seem to have one thing in common these days – they’re all great at shifting rain predictions from one week to the next! The weather computers yesterday are predicting rain – sorely needed to reduce the island’s fire risk – from next Wednesday morning November 27 and continuing for six days. Let’s hope this happens! COME ON, SMOKE IT! TEXT 80-999 If you feel there are wrongs that need righting, something that’s escaped public attention and needs airing, or just an interesting observation, send us a Smokie by email to editor@cookislandsnews.com , or Messenger messages via Facebook to Cook Islands News. And we now have a cool new mobile number that you can text Smoke Signals and news leads to: 80-999 . C’mon, Smoke it!

This incident should serve as a wake-up call for all netizens to exercise caution and empathy in their interactions online. The digital space should be a platform for positivity and empowerment, not a breeding ground for hate and negativity. As responsible individuals, we must strive to create a supportive and respectful online community that fosters understanding and compassion.

College Football Playoff & Bowl Game TV Schedule 2024

The YU7 is not just a car; it's a symbol of Xiaomi's never-ending pursuit of excellence. With Lei Jun at the helm, Xiaomi is set to continue pushing boundaries and redefining what's possible in the world of technology and beyond.Tiny council pushing for fibre connectivity for inland residents