As she struggled through her sophomore year in college, Zhenzhen spent hours in therapy, but it hadn’t addressed the central strain in her life: her parents.They called her at her Midwestern campus again and again, badgering her to fulfill their expectations — to study business, and to return to China, marry a wealthy man and raise children near them, she said. When she pushed back, her father screamed, she said, and her mother wept.The pressure made it hard to function, and Zhenzhen fended off thoughts of suicide. But when she brought this dynamic up with her therapists, she said, “they would always stand by reconciliation, and ‘family is everything.’ They would always look at the problem from the parent’s lens.”That’s when she discovered Patrick Teahan, a licensed social worker from Massachusetts with tousled hair and a massive YouTube following. Mr. Teahan’s videos introduced her to a new idea — that to heal from childhood trauma, it may be necessary to “go no contact” from abusive parents. Around half of Mr. Teahan’s clients restrict or sever ties with their families, which he describes as “brutally hard” but, when it is appropriate, deeply rewarding.On Mr. Teahan’s website, you can fill out a “Toxic Family Test,” which measures your family on a 100-point toxicity scale. You can access a webinar explaining how to write a “no-contact letter.” (He suggests: “I’m doing a family cutoff to get space to recover from this toxic and dysfunctional family.”) You can join his “Monthly Healing Community,” where clients support each other in the lonely endeavor of disconnecting from family.Zhenzhen, who asked to be identified by her first name in order to speak about a family conflict, took action as soon as she graduated and began to earn a paycheck. The relief was almost immediate, she said. It was lonely at first, but not for long. Through Mr. Teahan’s site, she found others — her “chosen family,” she calls them — who supported her decision.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

7 hours agoGetty ImagesThe new government has made tackling NHS waiting times a key priority – and this week

We’re reporting on the challenges that fertility clinics face as they store a growing number of frozen embryos.Across the United States, a growing number of families are paying to store embryos left over from fertility treatments. The New York Times is looking into how families make decisions about whether to continue paying for storage — and how clinics keep track of the one million or more embryos stored in liquid nitrogen tanks across the country.The Times is interested in connecting with patients and fertility clinic staff members about the challenges they face related to embryo storage.We will not publish any part of your response to this questionnaire without talking with you first. We will not share your contact information outside the Times newsroom, and we will use it only to reach out to you. If you would feel more comfortable sharing your story with us anonymously, please visit our tips page.

The cases, which have yet to be confirmed, were identified in farmworkers culling infected birds. The risk to the public remains low, health officials said.Three workers at a poultry farm in northeast Colorado have preliminarily tested positive for bird flu, according to state health officials.The workers had been culling birds from an infected population at the farm, the Colorado Department of Public Health and Environment said on Friday. All three workers had direct contact with infected birds and were experiencing mild symptoms, including conjunctivitis and “common respiratory infection symptoms,” the department said.The results are preliminary, and the tests have been sent to the Centers for Disease Control and Prevention for confirmation, the C.D.C. said.So far, four farmworkers in the United States have been infected with the virus, called H5N1, which is tied to a continuing outbreak among dairy cattle in several states.One case has been reported in Colorado, another in Texas and two more in Michigan, according to the C.D.C. All of those cases involved direct exposure to dairy cows, according to the state and federal health authorities, and officials have said that there is no evidence that the H5N1 virus spreads easily among humans.The risk to the public remains low, the C.D.C. said, but the agency added that it had sent a team to Colorado at the state’s request to help investigate.The C.D.C. said that it would look into whether workers were wearing personal protective equipment. Farmworkers are advised but not required to wear such equipment, including masks, safety goggles and gloves.“These preliminary results again underscore the risk of exposure to infected animals,” the C.D.C. said of the three new cases in Colorado. “There are no signs of unexpected increases in flu activity otherwise in Colorado, or in other states affected by H5 bird flu outbreaks in cows and poultry.”Avian influenza refers to a group of flu viruses primarily adapted to birds. The virus infecting farmworkers, H5N1, was first identified in 1996 in China and reported in people in 1997 in Hong Kong. A new form of H5N1, which surfaced in Europe in 2020, has rapidly spread around the world, and an outbreak in the United States has affected more than 99 million birds.The outbreak has been spreading among dairy farms since at least March, and 152 dairy herds in 12 states have tested positive for the virus. Scientists are researching how the virus is being transmitted through cows.The virus has also spread to a wide array of animals, including marine mammals like seals and bottlenose dolphins, skunks, squirrels and even domestic cats.

Frank and funny, the taboo-breaking psychologist said things on television and radio that would have been shocking coming from almost anyone else.Ruth Westheimer, the grandmotherly psychologist who as “Dr. Ruth” became America’s best-known sex counselor with her frank, funny radio and television programs, died on Friday at her home in New York City. She was 96. Her death was announced by a spokesman, Pierre Lehu.Dr. Westheimer was in her 50s when she first went on the air in 1980, answering listeners’ mailed-in questions about sex and relationships on the radio station WYNY in New York. The show, called “Sexually Speaking,” was only a 15-minute segment heard after midnight on Sundays. But it was such a hit that she quickly became a national media celebrity and a one-woman business conglomerate.At her most popular, in the 1980s, she had syndicated live call-in shows on radio and television, wrote a column for Playgirl magazine, lent her name to a board game and its computer version, and began rolling out guidebooks on sexuality that covered the field from educating the young to recharging the old. College students loved her; campus speaking appearances alone brought in a substantial income. She appeared in ads for cars, soft drinks, shampoo, typewriters and condoms.She even landed a role in the 1985 French film “One Woman or Two,” starring Gérard Depardieu and Sigourney Weaver and released in the United States in 1987. (“Dr. Ruth will never be mistaken for an actress,” Janet Maslin wrote in her New York Times review, “but she does have pep.”)Dr. Westheimer with Gérard Depardieu, left, and Michel Aumont in the 1985 movie “One Woman or Two.” “Dr. Ruth will never be mistaken for an actress,” one critic wrote of her performance, “but she does have pep.”Moune Jamet/Orion Pictures Corp., via Everett CollectionThese days, some effort may be needed to recall that Ruth Westheimer had a radical formula and considerable influence on social mores. Talk shows abounded in the 1980s, but until she came along none had dealt so exclusively and clinically with sex. Nor could anyone have anticipated that the messenger of Eros would be a 4-foot-7 middle-aged teacher with a delivery that The Wall Street Journal described as “something like a cross between Henry Kissinger and a canary.” We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

The Apgar test grades infants in five areas, including skin tone. Babies of color score lower, and may be subjected to unnecessary treatment.Shortly after they’re born, infants are assigned an Apgar score, a measure of how well they’re adapting to life outside the womb. It’s the first time a child is graded: on a scale from 0 to 10, with up to two points awarded for each of five metrics.One of them is skin color, an indication of how much oxygen the baby is getting. A newborn gets two points only if he or she is pink all over. Pale or blue fingers and toes earn one point; a baby who is white, gray or blueish all over gets none.Some doctors regard the tool as a quick, simple way to assess a newborn’s need for urgent care. But an accumulating body of research has found that Black infants and other babies of color don’t score as well on the Apgar as white infants.Now a growing number of experts are calling for changes, worried that relying on the widely used scale could make some newborns seem sicker than they are and expose them to unnecessary medical treatment.Not only is color perception subjective, critics say, but skin tone is a discomfiting and discriminatory measure to include in a medical screening tool.“Skin color as a determination of someone’s well-being needs to go out of the window,” said Dr. Amos Grünebaum, a professor of obstetrics and gynecology at the Zucker School of Medicine at Hofstra University. “It should not be a part of a health evaluation.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

46 minutes agoNHS EnglandThousands of people with multiple sclerosis (MS) in England, Wales and Northern Ireland will be offered a a new 10-minute injection that can help slow progression of the disease, NHS England says.

For hours, John A. Pernorio repeatedly mashed the call button at his bedside in the Heritage Hills nursing home in Rhode Island. A retired truck driver, he had injured his spine in a fall on the job decades earlier and could no longer walk. The antibiotics he was taking made him need to go to the bathroom frequently. But he could only get there if someone helped him into his wheelchair.By the time an aide finally responded, he’d been lying in soiled briefs for hours, he said. It happened time and again.“It was degrading,” said Mr. Pernorio, 79. “I spent 21 hours a day in bed.”Payroll records show that during his stay at Heritage Hills, daily aide staffing levels were 25 percent below the minimums under state law. The nursing home said it provided high-quality care to all residents. Regardless, it wasn’t in trouble with the state, because Rhode Island does not enforce its staffing rule.An acute shortage of nurses and aides in the nation’s nearly 15,000 nursing homes is at the root of many of the most disturbing shortfalls in care for the 1.2 million Americans who live in them, including many of the nation’s frailest old people.They get festering bedsores because they aren’t turned. They lie in feces because no one comes to attend to them. They have devastating falls because no one helps them get around. They are subjected to chemical and physical restraints to sedate and pacify them.California, Florida, Massachusetts, New York and Rhode Island have sought to improve nursing home quality by mandating the highest minimum hours of care per resident among states. But an examination of records in those states revealed that putting a law on the books was no guarantee of better staffing. Instead, many nursing homes operated with fewer workers than required, often with the permission of regulators or with no consequences at all.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Here are the telltale signs to look for in nursing homes to avoid, and resources that can point to better places.Few people want to go into a nursing home, but doing so can be the right choice if you or a loved one is physically or cognitively disabled or recovering from surgery. Unfortunately, homes vary greatly in quality, and many don’t have enough nurses and aides to give residents the care they need.How do I find nursing homes worth considering?Start with Medicare’s online comparison tool, which you can search by city, state, ZIP code or home name. Ask for advice from people designated by your state to help older and disabled people searching for a nursing home. Every state has a “no wrong door” contact for such inquiries.You can also reach out to your local area agency on aging, a public or nonprofit resource, and your local long-term care ombudsman, who helps residents resolve problems with their nursing home.You can find your area agency on aging and ombudsman through the federal government’s Eldercare Locator website or by calling 1-800-677-1116. Identify your ombudsman through the National Consumer Voice for Quality Long-Term Care, an advocacy group. Some people use private placement agencies, but they may refer you only to homes that pay them a referral fee.What should I find out before visiting a home?Search online for news coverage and for reviews posted by residents or their families.Call the home to make sure beds are available. Well-regarded homes can have long waiting lists.Figure out how you will pay for your stay. Most nursing home residents rely primarily on private long-term care insurance, Medicare (for rehabilitation stays) or Medicaid (for long-term stays if you have few assets). In some cases, the resident pays entirely out of pocket. If you’re likely to run out of money or insurance coverage during your stay, make sure the home accepts Medicaid. Some won’t admit Medicaid enrollees unless they start out paying for the care themselves.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

More than a million public records were used to assess whether nursing homes were meeting state staffing minimums.The KFF Health News data analysis focused on five states with the most rigorous staffing requirements: California, Florida, Massachusetts, New York and Rhode Island.To determine staffing levels, the analysis used the daily payroll journals that each nursing home is required to submit to the federal government. These publicly available records include the number of hours each category of nursing home employee, including registered nurses and certified nursing assistants, worked each day and the number of residents in each home. We used the most recent data, which included a combined 1.3 million records covering the final three months of 2023.We calculated staffing levels by following each state’s rules, which specify which occupations are counted and what minimums homes must meet. The analysis differed for each state. Massachusetts, for instance, has a separate requirement for the minimum number of hours of care registered nurses must provide each day.In California, we used state enforcement action records to identify homes that had been fined for not meeting its law. We also tallied how many California homes had been granted waivers from the law because they couldn’t find enough workers to hire.For each state and Washington, D.C., we calculated what proportion of homes complied with state or district law. We shared our conclusions with each state’s nursing home regulatory agency and gave them an opportunity to respond.This analysis was done by Jordan Rau, a senior correspondent, and Holly K. Hacker, a data editor, both with KFF Health News, part of KFF, a nonprofit health-policy research, polling and news organization.