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Oct 4

Community-Based Cycling Program Shows Positive Impact on Symptom Management in Parkinson Disease – AJMC.com Managed Markets Network

Location, cost, and transportation were cited as important factors regarding adherence and satisfaction with community-based exercise programs among patients with Parkinson disease.

A community-based exercise program was associated with positive responses among patients with Parkinson disease (PD) in regards to symptom management and overall enjoyment, according to study findings published in Complementary Therapies in Medicine.

Exercise has emerged as an important component of disease management in people with PD (PwP) over the past decade, as preliminary studies have shown that high-intensity aerobic exercise provides neuroprotective effects and may cause neuroplastic changes in the central nervous system.

However, researchers note that current evidence indicates that PwP are not meeting weekly benchmarks of aerobic exercise, with only 27% of PwP achieving the 150 minutes of moderate-vigorous physical activity per week recommended by the Parkinsons Foundation and the American College of Sports Medicine.

The low level of physical activity may be in part due to the barriers to exercise in PwP, which include low outcome expectations, lack of time, fear of falling, and lack of motivation, the study authors wrote. Community-based exercise classes may overcome barriers and encourage exercise compliance by fostering meaningful social interactions, providing external motivation via an exercise instructor, and being conveniently located close to ones home.

They conducted a cross-sectional survey analysis of PwP who were part of Pedaling for Parkinsons (PFP), a community-based cycling program, to explore personal beliefs, motivators, and barriers to participation over a 12-month period. Participants were recruited from 5 community-based facilities (2 in northern Washington and 3 in central Colorado) with established PFP programs.

Cycling classes were held 3 times per week over 45 to 60 minutes (including a 5-10 minute warm-up and cool-down), with the target pedaling cadence identified to be between 80 and 90 revolutions per minute, and an aerobic intensity between 60% and 80% of their age-estimated heart rate maximum or a rating of perceived exertion (RPE) between 4 and 7 on a 10-point RPE scale.

The survey administered at the end of the 12-month observational period was designed to capture the attitudes and beliefs of those participating in a PFP program, with survey responses rated on a 5-point Likert scale (1-5; higher number representing a more positive response) assessing the subdomains of Personal Beliefs and Knowledge, Health and Disability, Program, and Fitness Environment. The relationship between demographic variables and survey responses was also explored.

Insight into exercise attitudes and beliefs in successful community programs may assist in tailoring future programs for neurological populations, noted the researchers.

A total of 40 PwP completed the survey. Mean (SD) attendance from the observed cohort was 75.6 (26.4) sessions over the 12-month period.

Subdomain scores showed that PwP who attended a PFP program enjoyed the class, felt that their PD symptoms benefited from exercise, and were motivated to exercise by their PD diagnosis. The mean (SD) scores for the 4 subdomains were as follows:

No significant correlations were observed between survey subdomains and demographic variables (age, years of education, years since diagnosis, years attending the PFP program, and disease severity; P > .05) or subdomains and exercise behavior (cadence, attendance, and heart rate).

The Fitness Environment subdomain revealed that cost, parking and transportation, proximity to residence, and ease of gym navigation were important factors for participants regarding adherence to community-based programs.

With the growing body of PD literature supporting the role of exercise in potentially altering the disease trajectory, it is critical that communities adopt and implement exercise programs that meet the needs of PwP and facilitate compliance, the study authors concluded.

Reference

Rosenfeldt AB, Koop MM, Penko AL, Zimmerman E, Miller DM, Alberts JL. Components of a successful community-based exercise program for individuals with Parkinsons disease: Results from a participant survey. Complement Ther Med. Published online August 5, 2022. doi:10.1016/j.ctim.2022.102867

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Community-Based Cycling Program Shows Positive Impact on Symptom Management in Parkinson Disease - AJMC.com Managed Markets Network


Oct 4

Fee Saghafi Programs Workout to Honor Mahsa Amini, the Iranian Woman Killed for How She Wore Her Hijab – Morning Chalk Up

Photo Credit: Fee Saghafi (@fee.saghafi)

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When Fee Saghafis inbox was flooded with messages from Iranians in the middle of September, she felt immediately compelled to help be their voice, said the 2019 CrossFit Games athlete, who grew up in the United States but whose father is Iranian.

The messages were, of course, about Mahsa Amini, the 22-year-old woman who was arrested by Irans Law Enforcement Command for not wearing her hijab in accordance with government standards, and later died on September 16 after she was allegedly beaten by police. Her death has sparked ongoing worldwide protests that inspired Saghafi to speak up.

When you have a full inbox of messages asking for helpI needed to try to help the best way I can, Saghafi explained to the Morning Chalk Up.

On Instagram, she wrote: Even though my feet have never walked the life of oppressed Iranian women, my blood and my roots will always be like theirsEven though most of us cant understand and feel the oppression theyve experienced doesnt mean we cant stand with them and help be their voice.

Taking action: To show her support for Iranian women, and to honor Amini, Saghafi did what CrossFit athletes often do. She created a workout called MAHSA, a 22-minute AMRAP of 9 thrusters (135/95), 13 bar-facing burpees and a 200-meter run and posted the video of her tackling it.

The workout: Each component of MAHSA has a symbolic component to it, Saghafi explained, even the 22-minute time domain, which represents the age Amini was when she was killed.

The big picture: Even though a workout wont stop human rights abuses from happening, in Iran or elsewhere in the world, its representative of the freedom Saghafi has to pursue the life she wants to live, freedom Saghafi hopes all Iranian women will one day experience. But this wont happen in silence. Thats why Saghafi is using her social media platform to take a stand against something much bigger than fitness.

She added: I am an Iranian woman. I stand with Iranian women. I will be a voice for them, and I will keep honoring all of them.

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Fee Saghafi Programs Workout to Honor Mahsa Amini, the Iranian Woman Killed for How She Wore Her Hijab - Morning Chalk Up


Oct 4

Mayor Adams Announces $7.1 Million in Funding to Expand Hours at Nine Recreation Centers Citywide – nyc.gov

October 3, 2022

Sites With Expanded Hours Will Offer Additional Programming, Including City's Signature Saturday Night Lights Program

New York New York City Mayor Eric Adams and New York City Department of Parks and Recreation (NYC Parks) Commissioner Sue Donoghue today announced that starting today, nine recreation centers across the five boroughs will have expanded operating hours giving New Yorkers greater access to sports and fitness programming, indoor courts, exercise equipment, and more. The increase was made possible with $7.1 million in funding by Mayor Adams in the Fiscal Year 2023 budget. Sites with expanded hours will offer additional programming, including New York City's signature Saturday Night Lights program, for city youth.

"Recreation centers and the programming they offer change lives and ensure our young people are not left behind," said Mayor Adams. "Through our $7.1 million investment in expanded hours for recreation center, we are providing New Yorkers in all five boroughs positive programming and a safe space to grow, learn, and build community. Saturday Night Lights is a hallmark of this administration's investments and our commitment to free, high-quality activities for our youth, and I'm proud that these expanded hours will connect even more young people to this program."

"Our recreation centers serve all New Yorkers, young and old, all over the city. We need to be as flexible and adaptable as the city's residents. It only makes sense that we expand the hours of operation so that we can serve as many people as we can," said Deputy Mayor for Operations Meera Joshi. "This is a great step forward, and I thank NYC Parks for their dedication to make this happen."

"These nine recreation centers are anchors for the neighborhoods they serve and now New Yorkers of all ages will have expanded access to them on evenings and weekends," said NYC Parks Commissioner Sue Donoghue. "Thanks to $7.1 million in new funding from Mayor Adams, people who live in the areas most impacted by COVID-19 will benefit from safe, welcoming spaces and positive programming. And we're proud to partner with sister agencies to expand the Saturday Night Lights program, which has proved to have positive and lasting impacts on our youth."

The following recreation centers will now offer expanded evening and weekend hours:

Bronx

Brooklyn

Manhattan

Queens

Staten Island

Recreation centers with expanded operating hours will also offer additional programming, including Saturday Night Lights, organized in conjunction with the New York City Police Department, New York City Department of Youth and Community Development, New York City Department of Education, and the city's five District Attorney's Offices. Saturday Night Lights provides young people in underserved neighborhoods with safe and engaging activities and a productive place to gather during evening hours. Participating youth get free membership and access to the many programs and activities available at all recreation centers citywide.

Extended hours will also support other programs, including but not limited to volleyball, board game tournaments, high-intensity interval training, painting, double dutch, basketball, and strength training.

Since 1910, NYC Parks has provided the most affordable and extensive network of recreational services throughout New York City. NYC Parks' 36 recreation centers offer indoor pools, weight rooms, basketball courts, media labs, dance studios, art studios, game rooms, libraries, and more. All recreation centers also offer a range of programs for people of all ages.

Citywide memberships for adults ages 25-61 are $150 annually. Memberships are $25 per year for veterans, seniors, and those living with disabilities and free for youth and young adults 24 and under.

Hours of operation for recreation centers across the city vary by location. Please visit NYC Parks' Recreation Centers page for more information.

"Recreation centers are critical to a young New Yorker's life because of the programs and space they offer," said U.S Representative Carolyn Maloney. "This $7.1 million investment will be a direct infusion into our communities and the future of our city. Expanded recreation center hours provide New Yorkers an array of programming, as well as organized environments to engage and be a part of their community. I applaud Mayor Adams and Commissioner Donoghue for spearheading this initiative that will change lives and provide opportunity."

"Providing our teens and young adults with safe spaces to recreate is so critical to their early development into adulthood," said Bronx Borough President Vanessa L. Gibson. "In expanding the evening and weekend hours of the Hunts Point and Kwame Ture Recreational Facilities, children in neighborhoods with limited access to after school and weekend activities will now have access to fitness programming, exercise equipment, and so much more that will keep them engaged and out of harm's way. I want to thank Mayor Eric Adams and NYC Parks Commissioner Sue Donoghue for their commitment to ensuring our youth have the resources they need to live healthy and productive lives and investment in our recreational facilities."

"Parks are a vital part of solutions to public health concerns and serve as centers for community development. During the pandemic, we saw this vitality and desperate need for outdoor spaces and recreational centers as third places for the community to engage in safe conditions," said New York City Councilmember Carmen De La Rosa. "Expanded hours to parks and recreational centers continue to be a frequent request for constituents. Highbridge Recreation Center's new operating hours are an exciting and welcomed expansion of services in our district."

"Recreational centers provide communities access to safe and engaging activities, allowing people to learn a new skill or hone in on an existing one, make new friends, or just stay active for their health and wellbeing especially during the colder months, saidBrooklyn Borough President Antonio Reynoso. Thank you to Mayor Adams, NYC Parks Commissioner Donoghue,and other partners for helping extend hours in some of our citys recreational centers, including St. Johns Recreation Center in Crown Heights.

Recreational Centers provide safety, refuge, and a place to grow for the youth of our city," said New York State Assemblymember Jenifer Rajkumar. "Youth in extracurricular activities are 57% less likely to drop out of school and 49% less likely to use drugs. Today, Mayor Adams expands recreation center hours, makes membership free up to age 24, and adds sports and arts programming, creating a nurturing environment for our children to flourish during the after-school hours. This is a game-changing opportunity for at-risk youth to become healthy in mind and body, succeed in school, and foster lifelong friendships, setting them on a path to success.

An investment in our recreation centers is an investment in public safety, an investment in public health, and an investment in youth development," said New York City Councilmember Kamillah Hanks. "I am glad to see that funds are being prioritized for expanded hours and engaging programming that all members of our communities can benefit from, particularly in underserved neighborhoods like Tompkinsville in my home district.

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Mayor Adams Announces $7.1 Million in Funding to Expand Hours at Nine Recreation Centers Citywide - nyc.gov


Oct 4

Herms hosts fitness classes that use luxury accessories as exercise gear – Sporting News

Silk scarf as a yoga strap? Leather bracelets as weights? French luxury house Herms finds fitness inspiration from its iconic range of accessories with Herms Fit, a series of classes set to take place in Hong Kong between October 2 and 9. Transforming Tai Kwun, the former police quarters-turned cultural hub, into a fitness studio, into the Herms Gym, the brand is putting a playful and fashionable spin on everything from yoga to kickboxing.

During these free fitness classes, participants will get a chance to exercise using silk squares, leather bracelets, belts, and the houses range of custom fitness gear, including barbells and kettlebells.

Classes open to the public include silk scarf yoga, boxing, wall climbing, and a callisthenics course that incorporates the houses iconic silk squares. Students get to pick out a leather belt to use during the Belt Stretching class, and bracelets double as weights in Ballet Arms class.

Other classes that playfully incorporate the houses accessories include the Small Leather Goods Workout, where students use wallets and other leather accessories to train their strength and flexibility, and Shoes HIIT, where leather footwear takes the place of weights.

Those who are more curious about the equipment and the workout can sign up for a tour of the Herms Gym for a look at the brands designs as well as its history as a sporting brand.

Visit their website to sign up for a class or a tour.

Also see:How sports inspired the world's biggest names in luxury fashion

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Herms hosts fitness classes that use luxury accessories as exercise gear - Sporting News


Oct 4

New Grant Sharpens Focus on Whole-Person Health at St. Thomas – Newsroom | University of St. Thomas – University of St. Thomas Newsroom

One of Minnesotas leading foundations focused on integrative care and healing is helping the University of St. Thomas expand opportunities for students, researchers and professionals to transform their communities through whole-person care.

The foundations largest ever gift to St. Thomas includes a plan to offer underserved Twin Cities populations access to nursing and exercise science services as part of a widely used pro bono program that already offers counseling and legal services. The grant also will allow St. Thomas to develop more educational and research programs focused on whole-person care at the College of Health.

When St. Thomas launched the Morrison Family College of Health in 2019, its stated mission was to produce health care professionals who could provide whole-person care that keeps people well physically, mentally, spiritually and socially. That vision caught the attention of Penny and Bill George (former Medtronic CEO), who as co-chairs and founders of the George Family Foundation are passionate about investing in people, programs and initiatives that foster wholeness in mind, body, spirit and community.

The transformative vision of the Morrison Family College of Health and the mission of our foundation are perfectly aligned, said Penny and Bill George. We are pleased to support MayKao and her colleagues in finding innovative ways to address community health needs while pointing the way toward solutions in health care more broadly.

The new grant will establish the George Family Whole-Person Health Initiative at St. Thomas, which is creating a national model for whole-person, integrative health programming. Dr. MayKao Y. Hang, founding dean of the Morrison Family College of Health, said these initiatives are required to avoid fragmentation in health care and other support systems that currently do not support whole-person, community-engaged approaches.

We need to equip students with the knowledge and skills to do things differently as a sustainable change that can advance healthier outcomes for everyone, Hang said. When it comes to addressing the needs of individuals, families and communities, we need to understand that physical, mental, social and spiritual factors are inseparable.

Through the George Family Whole-Person Health Initiative, St. Thomas will:

The George Family Whole-Person Health Initiative will accelerate our vision of changing how we educate our next generation of leaders, Hang said. Through this partnership, we will also design new pathways for interprofessional teaching and practice in our community to help reduce health disparities.

The initiative is scheduled to officially launch in early 2023. To hear more from Bill George, you can join the University of St. Thomas First Friday event on Oct. 7, during which Hang will sit down with George for a discussion about his new book, True North: Emerging Leader Edition.

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New Grant Sharpens Focus on Whole-Person Health at St. Thomas - Newsroom | University of St. Thomas - University of St. Thomas Newsroom


Oct 4

FACT SHEET: The Biden-Harris Administration Announces More Than $8 Billion in New Commitments as Part of Call to Action for White House Conference on…

Today, for the first time in more than half a century, President Biden is hosting the White House Conference on Hunger, Nutrition, and Health to catalyze action for the millions of Americans struggling with food insecurity and diet-related diseases like diabetes, obesity, and hypertension. The Conference will lay out a transformational vision for ending hunger and reducing diet-related disease by 2030 all while closing disparities among the communities that are impacted most.

Achieving our goals will require more than just the resources of the federal government. Thats why, this summer, the White House launched a nationwide call to action to meet the ambitious goals laid out by the President. Across the whole of society, Americans responded and advanced more than $8 billion in private- and public-sector commitments. These range from bold philanthropic contributions and in-kind donations to community-based organizations, to catalytic investments in new businesses and new ways of screening for and integrating nutrition into health care delivery. At least $2.5 billion will be invested in start-up companies that are pioneering solutions to hunger and food insecurity. Over $4 billion will be dedicated toward philanthropy that improves access to nutritious food, promotes healthy choices, and increases physical activity.

Today, the White House announces a historic package of new actions that business, civic, academic, and philanthropic leaders will take to end hunger and to reduce diet-related disease.

Pillar 1 Improve Food Access and Affordability

Pillar 2 Integrate Nutrition and Health

Pillar 3 Empower Consumers to Make and Have Access to Healthy Choices

Pillar 4 Support Physical Activity for All

Pillar 5 Enhance Nutrition and Food Security Research

Each of these commitments demonstrates the tremendous impact that is possible when all sectors of society come together in service of a common goal. The Biden-Harris Administration looks forward to working with all of these extraordinary leaders and to the many more that will come forward to end hunger and reduce diet-related disease by 2030.

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FACT SHEET: The Biden-Harris Administration Announces More Than $8 Billion in New Commitments as Part of Call to Action for White House Conference on...


Oct 4

Faith centres and their role in keeping communities active – Sport England

Black Majority Churches in the West Midlands

A YMCA in Wolverhampton hosted the first BMC in the West Midlands in 1953. Known as the Black Country, due to the rich coal seam that sat just below the surface of the ground, the increasingly industrial region attracted a range of communities seeking work opportunities.

Today, the percentage of Black and South Asian people living in the Black Country is higher than the national average.

These are communities who are more likely to report living with impairments or long-term health conditions and more likely to experience discrimination than their white British peers.

As a result, its perhaps unsurprising that activity levels have historically been low in the region. However, a thriving network of Black Majority Churches came together with the local Active Partnership, Active Black Country(ABC) to change this through the Get Out, Get Active(GOGA) approach in 2020.

GOGA is a national programme that has helped more than 30,000 disabled and non-disabled people enjoy the benefits of being active together.

Delivered in partnership with Activity Alliance and a range of other organisations, GOGA takes place in 21 location across the UK, including the Black Country.

ABC is running a three-year GOGA programme that explores the potential of faith centres to reach the most inactive disabled and non-disabled residents.

Set to launch in early 2020, the project had to rapidly adapt to changing needs of local communities amid the first wave of coronavirus (Covid-19.

In its early stages, Bethune Smith (ABCs faith and activity co-ordinator) worked alongside the newly formed consortium of black-led churches (Churches 4 Positive Change) to oversee the distribution of activity packs and exercise guides to help local congregations stay active during lockdown.

The programme expanded significantly throughout the course of the pandemic, engaging faith leaders from a range of backgrounds and cultures.

Resulting in yoga classes in Sikh gurdwaras, chair-based exercise classes in Black Majority Churches, and a range of cross-community outdoor activities when coronavirus restrictions allowed.

Over the summer, Sport England hosted webinars with colleagues from Active Black Country and the GOGA national programme as part of our #CloseTheGap2022 events - a series of workshops and conversations dedicated to tackling inequalities in the sport and physical activity sector.

In the Active Black Country webinar, we heard how GOGA harnessed the potential of faith-based networks to engage black communities who had otherwise struggled to be active.

Were so impressed with the cultural competency demonstrated by Bethune, Mike and the team that we wanted to celebrate their successes as part of this years Black History Month.

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Faith centres and their role in keeping communities active - Sport England


Oct 4

2023: The Year of the Privacy and Security Compliance Program CBIA – CBIA

State legislatures throughout the country were busy in 2022 introducing comprehensive data privacy bills.

Despite the widespread legislative activity, Connecticut and Utah were the only two states to successfully enact privacy laws this year.

In doing so, they joined California, Colorado, and Virginia, adding to a complex patchwork of state privacy laws enacted over the past few years, and with which companies will be busy complying throughout 2023.

Depending upon which of these state privacy laws apply to your business, your time between now and the end of next year could be spent assessing and implementing information governance controls in order to comply with the California Privacy Rights Act or the Virginia Consumer Data Protection Act by Jan.1, 2023; Connecticuts Act Concerning Personal Data Privacy and Online Monitoring or the Colorado Privacy Act by July 1, 2023; and the Utah Consumer Privacy Act by Dec 31.

This update will discuss some of the core provisions in common among the five states privacy laws, and provide advice for navigating through them.

In general, each state law applies to for-profit entities, generally referred to as controllers, conducting business or offering products or services targeted to residents of the particular state and meeting certain thresholds with respect to revenue and/or the volume of consumer data within their control.

The CPRA, for example, amends the California Consumer Protection Act, which went into effect on Jan. 1, 2020, to apply to entities that collect personal data from California residents and either: (1) have at least $25M in gross annual revenue; (2) buy, sell or share personal data of 100,000 or more state residents or households; or (3) derive 50% or more of annual revenue from selling or sharing California personal data.

In Connecticut, the CTDPA applies to certain for-profit entities that either: (1) control or process personal data of at least 100,000 consumers; or control or process personal data of at least 25,000 consumers and derive more than 25% gross revenue from the sale of personal data.

Connecticuts new privacy law applies to certain for-profit entities that control or process consumer data.

In addition to the types of entity-level applicability provisions described above, certain data categories may also be exempt.

All five states currently exclude certain data that are already protected by other state or federal laws, such as health information protected by the Health Insurance Portability and Accountability Act.

Employee human resource data and business-to-business contact data will become subject to protection in California beginning on Jan. 1, when the CPRA takes effect, but is exempt or effectively exempt from each of the other states laws.

Each state law, in varying degrees, requires a controller to honor certain consumer rights with respect to their personal data.

These rights include the right to: access their personal data and confirm whether it is being processed; correct inaccuracies in their personal data; delete personal data; obtain a copy of their personal data in a transmittable format; and to opt-out of targeted advertising and the sale of their personal data.

Controllers subject to one or more state privacy laws must ensure they have procedures in place to fulfill their obligations to consumers on or before the applicable 2023 effective date.

In addition to consumer rights, state privacy laws obligate controllers to, among other things, provide a privacy notice to consumers, implement administrative, technical, and physical data security practices to protect personal data, implement certain contracting requirements with vendors responsible for processing personal data on their behalf, and conduct data security assessments.

While there is variation among each states requirements in these areas, they are similar in their fundamentals and should be familiar in concept to any organization that has already been subject to the vanguard General Data Protection Regulation that came into force in the European Union in 2018.

In Connecticut consumers must be given a privacy notice describing the categories of personal data processed.

In Connecticut, for example, controllers must provide consumers with a privacy notice describing the categories of personal data processed, the purposes for which each category of data are processed, how a consumer may exercise a right, the categories of personal data shared with third parties and the categories of those third parties, and how the consumer may contact the controller.

The CTDPA also requires controllers to enter into written contracts with third parties to govern their processing of personal data, and to conduct and document data protection assessments for each of its activities presenting a heightened risk of harm to a consumer, including targeted advertising, sale of personal data, and the processing of sensitive data.

Depending on your existing information governance infrastructure, implementing the operational processes required to comply with the various state privacy laws coming into effect next year may require anywhere from a full compliance program build to a series of policy and procedure modifications or enhancements.

Regardless, it is important not only to start the process as soon as possible, but to begin to incorporate the principles of privacy, cybersecurity, and good information governance into your corporate culture at all levels.

As a preliminary step, consult with an attorney in order to determine which state law(s) apply to your business.

This will then help to assess whether it is most effective and efficient to take a universal approach to compliance, whereby compliance with the most stringent applicable requirement is built into a standardized process, or jurisdictional approach, in which processes may vary depending on the applicable rules.

During the period leading up to the first applicable effective date in 2023, focus on the following:

The privacy law landscape will continue to evolve in 2023, with the potential for federal rulemaking and a federal law.

As the compliance deadline approaches:

Finally, keep in mind that any effective compliance program is always a work in progress.

The privacy law landscape will likely continue to evolve in 2023, with potential for rulemaking by the Federal Trade Commission and for a federal data privacy law (the American Data Privacy and Protection Act) to gain additional momentum in Congress for passage or amendment after the mid-term elections.

It is a best practice to revisit your policies and procedures on a regular basis in order to update them in response to legislative developments, andmore importantlyyour own lessons learned.

About the authors: Marc Lombardi and Damian Privitera are lawyers at Shipman & Goodwin LLP, both practicing in the firms Privacy, Cybersecurity and Data Innovation practice. Lombardi and Privitera, along with Shipmans team of privacy and cybersecurity lawyers, regularly assist manufacturers and other businesses with privacy and cybersecurity issues.For more information about Shipmans manufacturing practice, please contact Alfredo Fernndez (860).251.5353; afernandez@goodwin.com).

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2023: The Year of the Privacy and Security Compliance Program CBIA - CBIA


Oct 4

Wildfire Smoke Is Hurting Pregnant People And Babies. Can California Cities Protect Them? – California Health Report

Tania Pacheco-Werner put on her walking shoes. She was halfway through her first pregnancy and had just been diagnosed with gestational diabetes. Her doctors advice? Stay active.

But Pacheco-Werner lives just outside Fresno. It was summer, and well over 100 degrees. The air outside was also thick with wildfire smoke from nearby forest fires an increasingly common occurrence due to climate change.

The expectant mother wanted to do everything right, but was getting conflicting advice. On the one hand, she needed to walk and stay active to prevent complications from gestational diabetes; on the other, public health messaging about wildfires told her to stay inside and reduce her exposure to the smoke. So, what did she do?

Pacheco-Werner went to Walmart. Every day, her husband drove her to the nearby superstore so she could walk around and exercise indoors where the air felt cool and clean thanks to air-conditioning and filtration.

Her doctors hadnt instructed her to come up with this solution. In fact, her doctors never advised her about the potential effects of wildfire smoke on her pregnancy. But Pacheco-Werner holds a PhD in medical sociology, is the co-director of the Central Valley Health Policy Institute, and also serves on the Board of the California Air Resources Board for the San Joaquin Valley. She had been closely following a growing body of scientific literature about the impacts of wildfire smoke on preterm birth and adverse birth outcomes.

Thanks to her own research, Pacheco-Werner knew to buy an air filter to make her home safer for herself and her baby. She knew that finding a safe space to exercise was important for a healthy pregnancy. But looking at the cloud of smoke hanging over Fresno, Pacheco-Werner suspected many other pregnant people were also in danger.

Those most at risk were likely the people living in substandard housing, a problem tied to historically exclusionary policies in the region. As research increasingly shows how wildfire smoke and poor air quality hurt pregnant people and the children they carry, cities across California are working to curb these effects through ventilation centers and weatherization programs. In Fresno, where the air quality is routinely some of the worst in the country, the city and its residents are grappling with how to keep up with the increased risk of severe wildfire smoke.

Since the beginning of the 20th century, the bulk of Fresnos affordable housing and, in turn, its low-income populations and many people of color have been located on the citys west side. Government policies codified housing discrimination in the 1930s with residential safety maps that aimed to help investors decide which areas were safe investments. They marked the least desirable neighborhoods in red, which became the basis for the term redlining. In many instances, Black people living in these redlined neighborhoods were denied home loans altogether. West Fresno was one of these redlined districts, and the homeowners there have been feeling the repercussions ever since.

The idea that present-day health problems can be traced back to redlining is not new, nor is it exclusive to wildfire smoke. In a 2020 study by the UC BerkeleyUC San Francisco Joint Medical Program, researchers found that historically redlined areas of eight cities in California including Fresno have significantly higher rates of emergency department visits due to asthma. The study analyzed several factors that might contribute to health problems in redlined areas, including emissions from highways, which are found more frequently near low-income neighborhoods. The study also briefly noted that, under racially exclusionary housing practices, Black families lacked access to well-constructed housing.

Areas that were redlined have been shown to have houses that are of poor quality, said Rachel Sklar, a post-doctoral researcher at the UC San Franciscos Program on Reproductive Health and the Environment. Sklar is trying to understand the links between redlining and birth complications for pregnant people in California. She explained that, because older houses tend to have older windows, poor-quality insulation and no air conditioning (requiring inhabitants to open windows), these homes likely also harbor more air pollution, including wildfire smoke. That means residents of these homes might face higher rates of pollution exposure.

A 2005 study from the University of California Berkeley analyzed housing characteristics that may lead to leakage of air pollution into the home. The study found that older and smaller houses tended to have more leakage than newer and larger ones, which are more likely to have weather-stripped windows and incorporate modern building techniques. Another study, from 2001, found that there could be a tenfold difference in leakage between the homes with the best air tightness and those with the worst.

Air pollution of all types is a problem for these leaky homes. But as wildfire smoke increases in both severity and intensity in places like Fresno, public health messages are failing to address inequalities in housing standards. According to a report titled Wildfire Smoke: A Guide for Public Health Professionals compiled by the Environmental Protection Agency, the most common advisory during a smoke episode is to stay indoors, where people can better control their environment. However, the authors explained that the effectiveness of staying indoors as a strategy depends on how well the building limits smoke from coming indoors. The authors acknowledged that access to air conditioning is helpful to reduce indoor smoke, but many low-income households dont have access to it.

In very leaky homes, the report said, outdoor particles can easily infiltrate the indoor air, so guidance to stay inside may offer little protection.

In the summer of 2018, when Pacheco-Werner was pregnant, the county of Fresno issued a health advisory about the wildfire smoke and extreme heat. In this advisory, the county advised people with existing respiratory conditions, young children, and the elderly to remove themselves from smoke. The California Department of Public Health (CDPH) has issued similar warnings in summer months, urging people living near wildfires to stay indoors if possible. While the CDPH notices do state that pregnant people like Pacheco-Werner are especially vulnerable, no alternatives are given to account for variations in indoor air quality or access to filtered air.

Exposure to dangerous levels of wildfire smoke has increased significantly over the last decade. This is true for most of California and much of the western United States, but Fresno has been hit particularly hard. According to the air quality tracking website IQAir: Smoke that travels from wildfires throughout the state often reaches the Fresno area and worsens the citys already poor air quality, often increasing air pollution levels significantly.

Researchers are studying the impact of Fresnos poor air quality on children, including those exposed prenatally. The Childrens Health & Air Pollution Study is a collaboration between Stanford University and UC Berkeley that has published numerous studies assessing the effects of various sources of air pollution on childrens health, including a 2020 review of the effects of wildfire smoke. The authors cited a single day in 2018 when over 1 million school children in California had classes canceled due to wildfires. Children are particularly susceptible to smoke, they wrote, because they tend to spend more time outside, breathe more air relative to their body weight, and are still growing and developing. The researchers advised that ventilation and filtration be improved in all buildings in which children spend time. They also noted that childrens risk of health problems due to wildfire smoke doesnt just start when they head off to school: Problems can arise while theyre still in the womb.

Researchers have recently sought to better understand the effects of wildfire smoke on pregnant people. In 2021, Stanford researchers, led by Sam Heft-Neal, published a study that linked wildfire smoke to preterm births across California. Heft-Neal and his team were able to demonstrate that every additional day of smoke exposure was linked to an increased risk of preterm birth, concluding that nearly 7,000 excess preterm births in California could be attributed to wildfire smoke exposure in the studys five-year period.

Preterm birth is typically defined as birth before 37 weeks of pregnancy. According to the Centers for Disease Control and Prevention, babies born prematurely are at risk of a variety of health complications, including breathing problems, feeding difficulties, vision and hearing problems, and developmental delays. Additionally, one-third of infant deaths across the state are related to prematurity.

In the United States, the average rate of preterm births is one in 12. But there is a stark divide along racial lines, especially for pregnant people in Fresno County, home to the highest rate of preterm births in California. At least in part due to societal inequities and institutional racism, Black people in Fresno County are nearly 75 percent more likely to have a preterm birth than white people. This statistic led researchers, health experts, physicians and community members to launch the California Preterm Birth Initiative to conduct and fund research on racial disparities in birth outcomes while centering BIPOC lived experiences. According to the Fresno County Department of Public Health, in 2020, the preterm birth rate for white pregnant people in Fresno County was just under 9 percent, but the rate for Black pregnant people was approximately 13.5 percent. For Hispanic pregnant people, like Tania Pacheco-Werner, it was 10 percent, though Hispanic preterm births make up the highest total number in Fresno County, at 821 reflecting the areas large Hispanic population. Of the total 1,378 preterm births in Fresno County in 2020, 59.5 percent of them were Hispanic.

Linking preterm birth rates to wildfire smoke exposure is complicated, Kendalyn Mack-Franklin of the California Preterm Birth Initiative explained. People of color in Fresno have reported a number of variables that contribute to their high rates of preterm birth, from lack of access to prenatal care, to racism within medical facilities. Environmental exposure likely played a role before the significant increase in wildfire smoke too, since redlined neighborhoods in Fresno are closer to freeways and pollution-emitting industrial zones.

Preterm birth has a lot of confounding variables, Mack-Franklin said. Its very difficult to say that its for one particular reason, unless that reason is racism.

In 2019, the California Legislature approved the Wildfire Smoke Clean Air Centers for Vulnerable Populations Incentive Pilot Program. The program, administered by the California Air Resources Board, will build a system of clean air centers by funding ventilation system upgrades in schools, community centers, senior centers, sports centers and libraries. Funding will be divided between Californias three air quality districts (Bay Area Air Quality Management District, San Joaquin Valley Air Pollution Control District and South Coast Air Quality Management District) and the California Air Pollution Control Officers Association which oversees all 35 local air quality agencies across the state. In the San Joaquin Valley District, applications for funding opened on Aug. 17.

Clean air centers are one way to tackle the problem of indoor air quality, but to Rachel Sklar housing is still at the center of smokes disproportionate effects on low-income people of color. The problem is that people have no choice but to live in poorly maintained homes, she said.

Sklar added that while coastal cities like those in the Bay Area might routinely have better air quality than inland regions, low-income residents of those cities are being pushed inward to places like Fresno as their housing costs become untenable. In her most recent paper, published Aug. 28 in the International Journal of Gynecology & Obstetrics, Sklar calls for housing policy reform, writing, The rapid population growth in inland areas with high fire risks, as well as the disproportionate share of low-income black and Hispanic people that are migrating to these areas and experiencing the downstream health effects of living in those areas must be addressed.

While redlining and residential safety maps may technically be relics of the past, Sklar noted that todays housing crisis is pushing low-income people to sub-optimal living situations where their health is going to be affected.

Who would think that urban housing policy would have anything to do with preterm birth rates? said Sklar. Well, you wouldnt, unless you connect the dots.

Air quality districts around the state are starting to realize the importance of healthy air in homes and have piloted a variety of incentives to find solutions, though improvements in air quality are often one of many benefits of energy-focused programs. The Fresno Economic Opportunities Commission has a weatherization program aimed at helping homeowners and renters cut down on energy costs and prepare their homes for extreme weather by weather-stripping doors, caulking windows and gaps, insulating exterior walls, and repairing and replacement ducts. Of the residents served within the past year, 56% lived in homes 50 years or older, said Fresno EOC Energy Manager Matt Contrestano. In addition, almost 23% of the homes assessed were deferred services due to the condition of the home including structural, electrical, plumbing, sewage and water leaks or clutter and pest infestation issues.

In 2021, Fresno EOCs Transform Fresno project, which focuses on downtown, Chinatown, and southwest corners of Fresno, provided energy-efficient upgrades to 12 homes; in 2020, they reached 34 homes. According to Contrestano, these programs help residents by reducing utility bills, maximizing energy efficiency, and allowing each resident to live in a healthier and more comfortable environment.

In 2021, Santa Barbara County Air Pollution Control District launched a program to give hundreds of free air purifiers to residents in the towns of Guadalupe and Casmalia. This year, the San Joaquin Valley District followed suit, approving a similar program to give 1,500 families free in-home air purifiers to mitigate the in-home risks of wildfire smoke exposure.

Despite the grueling summer months, Pacheco-Werner had a healthy pregnancy and carried her baby to full term. But her son, now 4 years old, has developed asthma, which has been difficult for Pachecho-Werners family to manage. Theres no way to know if his asthma is related to the wildfire smoke his mother breathed in when he was growing in her womb.

This past spring, Pacheco-Werner became pregnant again, and she worried that shed have to endure another summer of hot, smoky weather. So far, the pollution has been moderate, but Pacheco-Werner ended up facing another challenge: Her second baby was born preterm, at 36 weeks. Although she and the newborn are recovering well, Pacheco-Werner is concerned he too will develop asthma like his brother.

Even so, Pacheco-Werner is well aware of the privilege that her fluent English and health insurance afford her. But as a Mexican immigrant who spent much of her life in Fresnos most impacted neighborhoods, she continues to use her personal experiences to inform her research on the relationships between neighborhoods and health, fighting for every Californian to have equal access to clean air.

When we dont pay attention to inequality, she said, it affects us all.

This story is published collaboratively with GristandNext City as part of theEquitable Cities Reporting Hub for Environmental Justice.

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Originally posted here:
Wildfire Smoke Is Hurting Pregnant People And Babies. Can California Cities Protect Them? - California Health Report


Oct 4

In the Upper Valley, fighting back against Parkinson’s with a one-two punch – Maine Public

Parkinsons disease affects the nervous system. It muddles how the brain sends signals that coordinate movement. In Vermont, it's estimated that one out of a thousand people over age 55 have it.

It's a lifelong condition, and there's no cure. But research shows vigorous exercise and even a punch or two can help those with Parkinson's slow the disease.

At the Carter Community Building Association, a nonprofit recreational center in Lebanon, New Hampshire, Ann Harvey, Tom O'Quinn and Suzanne Serat are slipping on brightly-colored padded gloves.

They use them in a special boxing class designed to help people fight Parkinsons.

Nina Keck

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Vermont Public

"Theres this thing in Parkinson's that says if you have a positive attitude, youll be better, and thats true," Serat says. "But, you also need to acknowledge that its really hard, and youre sort of losing your life basically drop by drop, and youre mad about it."

"And," she gestures to the bright blue boxing gloves on her hand, "it feels good to just hit that bag as hard as you can.

The group heads into a small gymnasium where punching bags hang from the ceiling.

Alright guys, were going to get started," calls out instructor Samantha Duford. "So boxing stance, hands up. Were going to throw a jab jab, hook hook, upper upperOkay? Lets go

The dangling bags suddenly come to life, rocked by jabs from either side.

Nina Keck

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Vermont Public

Betsy Warren of West Lebanon smiles behind her mask as she gives her bag a one-two combo.

Warren was diagnosed with Parkinson's in April 2021. Eight months later, she was diagnosed with cancer. She wrapped up chemo this summer, and is in remission. So now, she says, shes back to focusing on her Parkinsons.

This class, called Rock Steady Boxing, is based on a nationally-recognized curriculum, and Warren says its helping.

Oh, its the greatest workout," Warren gushes, breathing hard during a break. "Theres like 23 different things that we do, and its all good for Parkinson's, from yelling, using our voice, to big movements."

She adds: "The thought of hitting something seemed like a good idea, especially early on when youre trying to get used to a diagnosis.

Nina Keck

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Vermont Public

Parkinsons disease affects how people move. It slows them down and can make people stoop and shuffle. Tremors are common. The disorder can also weaken a persons voice, affect eyesight and balance, and can hamper fine motor skills, which can make everyday tasks like buttoning a shirt difficult.

More from Brave Little State: How can older Vermonters 'age in place'?

Physical therapist Samantha Duford is president and cofounder of Upper Valley Programs for Parkinson's. She says her 90-minute Rock Steady Boxing classes target all of those things.

Nina Keck

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Vermont Public

We incorporate balance, coordination and dual-task walking," Duford says. "We really try totarget deficits specific to Parkinson's in everything we do.

Boxing she says is great for big arm movements and getting heart rates up. But the class also includes yoga stretches, core strength training, brain teasers and hand-eye work. For instance, one of this afternoon's activities involves moving lettered clothes pins from one ribbon to another in alphabetical order while balancing on a cushion.

Suzanne Serat and others in the class say the benefits are immediate.

"Absolutely, when I came into class, I was having something called dyskinesia, which is a random movement and side effect from the medication," Serat says. "And because of doing this, it stopped. So this leg is now still.

Nina Keck

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Vermont Public

That's not uncommon. Dr. Jim Boyd is director of the Binter Center for Parkinson's Disease and Movement Disorders at the University of Vermont. He says that while intense activity wont stop symptoms, it can slow them down and make them go away temporarily. Its why he says classes like this are so important.

"As a practicing neurologist for nearly 20 years now, you do see a distinct difference between those who become engaged in physical activity early in their course, and develop good habits of exercise, to those that do not," he says.

If boxings not your thing, Boyd says there are dance classes, Tai chi and other workouts specifically designed for people with movement disorders that can help. And since COVID, many are now offered virtually.

Gary Martin lives in Jonesville, Vermont, and was diagnosed with a movement disorder similar to Parkinsons 10 years ago. Martin takes a regular dance class for people with Parkinsons taught by his wife Sara McMahon. He also does a specialized workout called Push Back several times a week.

While hes now using a walker and wheelchair more often, he says the weekly classes have helped his balance, strength and outlook.

"The tendency for most people with Parkinson's [is] to just hang back and not become involved in life," Martin says. "And this has really been helpful in that regard.

Nina Keck

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Vermont Public

Back at the Rock Steady Boxing class, the group wraps up its weekly workout in a circle.

Earnest Schori says he was diagnosed with Parkinson's in 2018, and besides boxing, he does Tai chi and core strength training. The physical outlet helps, he says, but so does the camaraderie.

"To know that I'm not alone," Schori says, is important.

Suzanne Serat nods. The workouts feel great, but she says the teasing and support that are part of every class the catching up with each other, the understanding and honesty may be even more important.

"You dont have to explain anything. There's none of you that needs to be embarrassed," Serat says."I dont know why, but theres a shame that comes from having a chronic illness, one that shows, and theres none of that when were all together."

Pointing to the clusters of others in the group who are chatting and laughing after class, she says: "You can just sort of sit there and say, 'Its not a good day,' and theyll go 'Yeah.' They get it.

Have questions, comments or tips?Send us a messageor get in touch with reporter Nina Keck:

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In the Upper Valley, fighting back against Parkinson's with a one-two punch - Maine Public



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