Despite a 1 percent increase in 2024, U.S. birthrates remained in a historic slump, a trend that worries demographers and cultural critics.Births in the United States increased by just 1 percent in 2024, still near the record low rates that have alarmed demographers and become a central part of the Trump administration’s cultural agenda, according to data released on Wednesday by the Centers for Disease Control and Prevention.More than 3.6 million babies were born in the United States last year, a meager rise from the record-setting low in 2023. The fertility rate, approximately 1.6 births per woman over her lifetime, is well below the 2.1 births needed to maintain the country’s population through births alone.The new data represent “the continuation of a long-term decline of births in the United States that began really with the Great Recession in 2007,” said Ken Johnson, a demographer at the University of New Hampshire.These numbers, and the reasons that they have experienced such a consistent decline, are widely seen as a problem that could affect the U.S. economy in coming decades, as fewer young workers support a growing aging population.President Trump has called for a “baby boom,” joining with a conservative “pronatalist” movement that aims to persuade more Americans to get married and have many babies.Vice President JD Vance and others in the pronatalist movement have criticized childless young Americans, arguing that they are contributing to the potential collapse of the U.S. population because of their disdain for nuclear families and traditional gender roles.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.

12 minutes agoShareSaveSarah HawleyBBC News, East MidlandsShareSaveSuppliedVanellope Hope Wilkins made medical history when she was born with her heart outside of her body in 2017. Described by experts as “one of a kind”, Vanellope had three operations to place her heart back in her chest due to an extremely rare condition called ectopia cordis.The hospital where she was born – Glenfield Hospital in Leicester – says it knows of no other case in the UK where the baby has survived.Now seven years old, Vanellope has undergone groundbreaking surgery to reconstruct a protective cage around her heart – using her ribs. The BBC was given exclusive access into theatre, when the operation took place at the East Midlands Congenital Heart Centre, based at the Leicester Royal Infirmary, last Wednesday.Warning: This story contains an image of surgeryGlenfield HospitalIt’s early morning outside theatre, and a team of specialist medical experts gather for a briefing to discuss the unprecedented surgery about to take place.Vanellope still has no breastbone, leaving her heart covered by just by a thin layer of skin. Surgeons have come up with a plan to use her ribs to form a protective cage inside her chest.Consultant paediatric surgeon Nitin Patwardhan was one of the 50-strong medical team at Vanellope’s birth on 22 November.Now he is set to play a leading role again in surgery, which has never been performed like this before.”I’d lie if I say I don’t get nervous,” he says. “But having been in this profession for so many years, you actually look forward to it because at the end of the day, you’re doing something that will change somebody’s life.”He remembers how “everything was unknown” when Vanellope was born, because no-one in the country had ever dealt with a similar case. A handful of children in the US have also survived this condition.Ectopia cordis affects only a few cases per million births – and Vanellope was given a less than 10% chance of survival. But she defied those odds and was allowed home after 14 months in hospital.Glenfield HospitalSince then, Vanellope has had to wear a brace around her chest to protect her heart. She has complex medical needs, which require one-to-one care, 24 hours a day. She is autistic and non-verbal.Mum Naomi Findlay, 39, who lives in Clifton, Nottinghamshire, described her daughter as “a happy little thing” who “brings a lot of joy and a lot of happiness”.She added: “It makes me extremely proud to see actually how how far she’s come, what she’s overcome and what she is achieving. It’s a real journey of strength and bravery… she’s so brave.” Having to kiss her daughter goodbye at the theatre door is difficult and the tears flow. “A lot of anxiety, a lot of worry and so many emotions,” she says. “For me, the biggest fear is handing her over and not getting her back.”The team waiting in theatre include specialists from the Congenital Heart Centre, Leicester Children’s Hospital and a visiting cardiothoracic surgeon from Great Ormond Street Hospital in London.Consultant congenital cardiac surgeon, Ikenna Omeje, operated on Vanellope just 50 minutes after she was born.He recalls there being a lot of “head scratching” among surgeons, because the condition was so rare. “It was exciting for everyone because it was something we had never seen before. So you made the news, not just within the UK, but all over the world,” he says.Explaining the current procedure, he points to a 3D scan of Vanellope’s chest, and describes how her heart has attached to the thin layer of skin protecting it. Detaching it “is risky”, he confesses. “You can damage the vessel trying to get into the chest cavity,” he said.Now aged seven, surgeons decided Vanellope had reached the right age for reconstructive surgery to form a permanent structure around her heart.University Hospitals of Leicester NHS TrustVanellope is first placed on a bypass machine, which temporarily takes over the functions of the heart and lungs. This allows her heart to deflate, allowing the “very tricky” procedure to detach part of her heart – the right ventricular outflow tract – and the pulmonary artery from where it has stuck to her skin.Next, the bilateral rib osteotomy takes place, which involves breaking Vanellope’s ribs on both sides to move them in order to form the protective cage around her heart.Carrying out all of the procedures at once, on a patient with ectopia cordis, has never been done in this country before, the team says.The extremely complex procedure lasts more than nine hours. And it’s a success. The surgeons are delighted. Mr Omeje is beaming as he says it “went a lot better than we expected”. He describes how he examined an X-ray of Vanellope’s chest after the operation, and called it “really beautiful”.Mr Omeje called Vanellope “one of a kind” and explained how fulfilling it was to have everything go so well. “The best satisfaction we derive from this is when you get a text message from the mum to say ‘thank you, you guys are amazing’,” he says. “I think personally, I have just done my job, but it has made a difference to someone and that is very satisfying.”SuppliedVanellope is taken to the children’s paediatric intensive care unit and will spend some time in hospital recovering. After a few weeks, she will be able to take off her protective chest brace and won’t require any further surgery in the future.Her mum called the NHS “amazing”, and says she can’t wait to take her home to her older brothers and little sister.Looking to the future, she hopes this surgery will improve Vanellope’s “already really, really good quality of life”. And Naomi says this time, she’s ready for the long journey ahead. “When [Vanellope] was born I was fearful. It was very scary for me, but this time round I’m ready. “We’ve got this,” she added.More on this storyRelated internet links

2 days agoShareSaveNatalia ZuoBBC Eye, World Service InvestigationsShareSaveBBCAbby Wu was just 14 when she had cosmetic surgery for the first time.After receiving hormone treatment for an illness, Abby’s weight increased from 42kg (6 stone 8lbs) to 62kg (9 stone 11lbs) in two months.The change hadn’t gone unnoticed by her drama teacher.”My teacher said, ‘You were our star but now you’re too fat. Either give up or lose weight fast,'” recalls Abby, who was preparing for her drama exams at the time.Abby’s mother stepped in, taking her to get liposuction to remove fat from her belly and legs.Abby remembers her mother’s words as she waited in the clinic in a hospital gown, nervous about the impending operation. “Just be brave and walk in. You’ll become pretty once you’re out.”The surgery was traumatic. Abby was only given partial anaesthesia and remained conscious throughout.”I could see how much fat was extracted from my body and how much blood I was losing,” she says.Family handoutNow 35, Abby has gone on to have more than 100 procedures, costing half a million dollars.She co-owns a beauty clinic in central Beijing and has become one of the most recognisable faces of China’s plastic surgery boom.But the surgeries have come at a physical cost.Sitting in front of a mirror inside her luxury duplex apartment in Beijing, she gently dabs concealer onto bruises from a recent face-slimming injection – a procedure she undergoes monthly to help her face appear “firmer and less chubby” after three jaw reduction surgeries removed too much bone.But she insists she has no regrets about the surgeries and believes her mother made the right decision all those years ago.”The surgery worked. I became more confident and happier, day by day. I think my mum made the right call.”Abby WuOnce seen as taboo, plastic surgery has exploded in popularity over the last 20 years in China, fuelled by rising disposable incomes and shifts in social attitudes, in large part driven by social media.Every year, 20 million Chinese people pay for cosmetic procedures.Overwhelmingly, it is young women who seek surgery. Eighty per cent of patients are women and the average age of someone receiving surgery is 25.While appearance has always been important in Chinese culture, particularly for women, beauty standards in the country are changing.For years, the most sought-after features were a blend of Western ideals, anime fantasy and K-Pop inspiration: The double eyelid, the sculpted jawline, the prominent nose, and the symmetrical face.But lately, more disturbing procedures are on the rise – chasing an unrealistic, hyper-feminine, almost infantile ideal.Details of help and support with body image concerns are available in the UK at BBC Action Line Botox is now injected behind the ears to tilt them forward, creating the illusion of a smaller, daintier face. Lower eyelid surgery, inspired by the glassy gaze of anime heroines, widens the eyes for an innocent, childlike look. Upper lip shortening narrows the space between lip and nose, thought to signal youth.But much of this beauty is built for the screen. Under filters and ring lights, the results can look flawless. In real life, the effect is often uncanny – a face not quite human, not quite child.TikTokSoYoungCosmetic surgery apps like SoYoung (New Oxygen) and GengMei (More Beautiful) – claiming to offer algorithm-driven analysis of “facial imperfections” – have been surging in popularity.After scanning and assessing users’ faces, they provide surgery recommendations from nearby clinics, taking a commission from each operation.These and other beauty trends are shared and promoted by celebrities and influencers on social media, rapidly changing what’s considered desirable and normal.As one of China’s earliest cosmetic surgery influencers, Abby has documented her procedures across major social media platforms and joined SoYoung soon after it launched.Yet despite having undergone more than 100 procedures, when she scans her face using SoYoung’s “magic mirror” feature, the app still points out “imperfections” and suggests a long list of recommended surgeries.”It says I have eye bags. Get a chin augmentation? I’ve done that.” Abby seems amused.”Nose-slimming? Should I get another nose surgery?”Unlike typical e-commerce sites, beauty apps like SoYoung also offer a social media function. Users share detailed before-and-after diaries and often ask superusers like Abby for their advice.’My skin felt like there was cement underneath’To meet surging demand, clinics are opening up rapidly across China.But there’s a shortage of qualified practitioners and large numbers of clinics are operating without a licence.According to a report by iResearch, a marketing research firm, as of 2019, 80,000 venues in China were providing cosmetic procedures without a licence and 100,000 cosmetic practitioners were working without the right qualifications.As a result, it’s estimated that hundreds of accidents are happening every day inside Chinese cosmetic surgery clinics.Dr Yang Lu, a plastic surgeon and owner of a licensed cosmetic surgery clinic in Shanghai, says in recent years the number of people coming for surgeries to repair botched operations has been growing.”I’ve seen many patients whose first surgery was botched because they went to unlicensed places,” Dr Yang says.”Some even had surgery inside people’s homes.”Yue Yue, 28, is among those to have had surgery that went badly wrong.In 2020 she received baby face collagen injections – designed to make the face appear more plump – from an unlicensed clinic opened by a close friend. But the fillers hardened.”My skin felt like there was cement underneath,” she says.Desperate to undo the damage, Yue Yue turned to clinics she found through social media – well-known names – but the repairs only made things worse.One clinic attempted to extract the filler using syringes. Instead of removing the hardened material, they extracted her own tissue, leaving her skin loose.Another clinic tried lifting the skin near her ears to reach the filler underneath, leaving her with two long scars and a face that looked unnaturally tight.”My entire image collapsed. I lost my shine and it’s affected my work [in human resources for a foreign company in Shanghai] too.”She found Dr Yang through SoYoung last year and has since undergone three repair surgeries, including for her eyelids which were damaged during a previous operation by another clinic.But while Dr Yang’s surgeries have brought visible improvements, some of the damage from the botched procedures may be permanent.”I don’t want to become prettier any more,” she says.”If I could go back to how I looked before surgery, I’d be quite happy.”‘It ruined my career’Every year, tens of thousands like Yue Yue fall victim to unlicensed cosmetic clinics in China.But even some licensed clinics and qualified surgeons aren’t following the rules strictly.In 2020, actress Gao Liu’s botched nose operation – in which the tip of her nose turned black and died – went viral.”My face was disfigured and I was very down. It ruined my acting career.”She had received the nose surgery at a licensed Guangzhou clinic called She’s Times from Dr He Ming, who was described as its “chief surgeon” and a nose surgery expert.But in reality Dr He was not fully qualified to perform the surgery without supervision and had not obtained his licensed plastic surgeon status from the Guangdong Provincial Health Commission.Authorities fined the clinic, which closed soon after the scandal, and barred Dr He from practising for six months.However, weeks before She’s Times was officially dissolved, a new clinic, Qingya, requested to register at the same address.Gao LiuBBC Eye has found strong links between She’s Times and Qingya, such as the same Weibo account and the retention of several staff, including Dr He.The BBC has also learned that Dr He only obtained the licensed plastic surgeon qualification in April 2024, even though he was technically barred from applying for the status for five years from the date he was sanctioned in 2021.Qingya now claims to have opened 30 branches.Dr He, Qingya and Guangdong Provincial Health Commission did not respond to the BBC’s requests for comment.The Chinese Embassy in the UK said: “The Chinese government consistently requires enterprises to operate in strict compliance with national laws, regulations, and relevant policy provisions.”Four years and two repair operations later, Gao Liu’s nose remains uneven. “I really regret it. Why did I do it?”China’s Central Health Commission has been trying to crack down on the issue of under-qualified health practitioners performing tasks beyond their expertise in recent years – including ordering local health bodies to improve regulation and issuing stricter guidelines – but problems persist.From job offer to debt and surgery – within 24 hoursIn today’s China, looking good is important for professional success.A quick search on popular job recruitment platforms reveals many examples of employers listing physical requirements for roles, even when they have little to do with the actual work.One receptionist role asks for candidates to be “at least 160cm tall and aesthetically pleasing”, while an administrative job demands “an appealing look and an elegant presence”.And now that pressure is being exploited by a growing scam in some Chinese clinics in which vulnerable young women are offered jobs, but only if they pay for expensive surgeries carried out by their would-be employers.Da Lan, not her real name, applied for a “beauty consultant” job at a clinic in Chengdu, south-western China, on a popular recruitment website in March 2024.After the interview, she was offered the position that same evening.But she says when she began her role the next morning, she was taken to a small room by her manager, who scanned her up and down and gave her an ultimatum – get cosmetic work done or lose out on the job.Da Lan says she was given less than an hour to decide.Under pressure, she agreed to undergo double eyelid surgery – priced at over 13,000 yuan (£1,330) – more than three times the monthly salary of the role – with more than 30% annual interest.She says staff took her phone and used it to apply for a so-called “beauty loan,” falsifying her income details. Within a minute, the loan was approved.By noon, she was undergoing medical tests. An hour later, she was on the operating table.From job offer to debt and surgery – all within 24 hours.The surgery did nothing for her job prospects. Da Lan says her manager belittled her, shouting her name in public and swearing at her.She quit after just a few weeks. Looking back, she believes the job was never real.”They wanted me to leave from the beginning,” she says.Despite having worked there for more than 10 days, she was paid only 303 yuan ($42). With help from her friends, Da Lan paid off the debt for her surgery after six months.BBC Eye spoke to dozens of victims, and met three including Da Lan in Chengdu, a city that has set out to become China’s “capital of cosmetic surgery”. Some have been trapped in much larger debt for years.The clinic Da Lan says scammed her had previously been reported by other graduates and exposed by local media, but it remains open and is still recruiting for the same role.This scam isn’t limited to clinic jobs – it’s creeping into other industries.Some live-streaming companies pressure young women to take out loans for surgery, promising a shot at influencer fame. But behind the scenes, these firms often have undisclosed agreements with clinics – taking a cut from every applicant they send to the operating table.In a bohemian-style café in Beijing, the perfect setting for a selfie, Abby meets her friends for coffee.The trio adjust their poses and edit their faces in great detail – extending eyelashes and reshaping their cheekbones.When asked what they like most about their facial features, they hesitate, struggling to name a single part they wouldn’t consider altering.The conversation turns to chin implants, upper-lip shortening, and nose surgery.Abby says she’s thinking about another nose job – her current one is six years old – but surgeons are finding it difficult to operate.”My skin isn’t as stretchable after so many procedures. The doctors don’t have much to work with. You can’t give them enough fabric for a vest and expect a wedding dress.”The metaphor lingers in the air, underscoring the toll taken by all of the operations.But despite everything, Abby has no plans to stop.”I don’t think I’ll ever stop my journey of becoming more beautiful.”

The agency targeted grants focused on diversity, equity and inclusion, as well as research on misinformation.Casey Fiesler, an information science professor at the University of Colorado Boulder, learned late on Friday evening that one of the three grants she had been awarded by the National Science Foundation was being terminated.“It was a total surprise,” Dr. Fiesler said. “This is the one that I thought was totally safe.”The grant supported Dr. Fiesler’s research on building A.I. literacy. She received no official explanation for why the grant was being terminated more than a year ahead of its scheduled end. But Dr. Fiesler speculated that it had something to do with the word “misinformation” in the award’s abstract.Dr. Fiesler was not alone. As of Monday, the National Science Foundation had canceled more than 400 active awards, according to a list obtained by The New York Times. The decision comes after months of scrutiny of the agency, including a report released by Senator Ted Cruz, Republican of Texas, last October and, in February, an internal review of awards containing words related to diversity, equity and inclusion, or D.E.I.In January, the Trump administration attempted to freeze grant payments for existing awards at the N.S.F.. A temporary restraining order lifted the freeze. The order also said that the agency could not terminate active awards to comply with President Trump’s executive orders, one of which called for an end to “illegal and immoral discrimination programs” under the premise of D.E.I. across the federal government.In a statement on Friday, the N.S.F. said that its grant cancellations were not in violation of the temporary restraining order. When asked by The Times to provide clarification on the legality of the grant cancellations, the agency declined to comment.The National Science Foundation, established in 1950, finances much of the scientific research that takes place in the United States, ranging from astronomy and quantum computing to microbiology and education in science technology, engineering and mathematics, or STEM.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.

Growing case numbers suggest that national total will surpass that seen during the last large outbreak in 2019.The spread of measles in the Southwest now constitutes the largest single outbreak since the United States declared the disease eliminated in 2000, federal scientists told state officials in a meeting on Monday.The New York Times obtained a recording of the meeting. Until now, the Centers for Disease Control and Prevention had not publicly described the outbreak in such stark terms.More measles cases were reported mostly in Orthodox Jewish communities in New York City and New York State in 2019. But health officials regard those as separate outbreaks, because they were fueled by multiple introductions of the virus by international travelers.C.D.C. officials now view the spread of measles in Texas, Oklahoma and New Mexico as a single outbreak, Dr. Dan Filardo, who leads the agency’s task force for the measles response, told state health officials at the meeting.“This is the largest outbreak in the U.S. since measles elimination was declared in 2000,” he said. The agency was sending seven additional officials to Texas, epicenter of the escalating crisis, he added.

I did not know that anything was unusual until I was seven months pregnant. Inside the exam room, the technician dimmed the lights and stood astride her mysterious station. She worked her probe into the hard rind of my belly and offered selections from her trove of professional small talk: Do you know the sex? Have you picked a name? I wanted to slice the technician out of the scene, to watch my baby on the screen with silent focus, but I also wanted to seem normal and good. So when she said, “He’s sticking his tongue out,” I said: “Awwww. … ”The technician fussed with the machine. She twisted its dials and clacked at its keys and then left the room. The gel felt thick on my skin. I missed my phone. I wondered if there were any new work emails in there. When the technician returned, she ordered more poses and captured more shots. I had reported to the doctor’s office for a routine scan, but as in a dream, the routine kept repeating. I watched the technician map my baby’s face for secret reasons. For an hour I lay on her table, cold dread pooling inside my body.The doctor rapped on the door. He told me that he had seen something he did not like. He wondered if it could be a case of — he said a strange word, then another, then the word “syndrome.” The kidneys and torso were measuring large, he explained. The baby was growing very fast. The tongue was protruding from the mouth. It’s not supposed to do that. The information passed uncomprehendingly through me. I would be assigned a genetic counselor, a prenatal psychologist, an obstetrician who specialized in high-risk pregnancies. Amniotic fluid would be extracted from my uterus and sent for a battery of genetic tests. I asked the doctor to write the syndrome’s name on a piece of paper. “Don’t Google it,” he advised me. Of course, as soon as I seized my phone, I did.Beckwith-Wiedemann Syndrome, or BWS, is an overgrowth disorder that affects one in 10,000 births. Its features manifest most significantly in childhood. Babies born with BWS may exhibit macrosomia, or excessive growth; they may have hemihypertrophy, or asymmetrical growth; most of them have macroglossia, or an enlargement of the tongue. They may have pink capillary abnormalities on the forehead, creases on the ears, an abdominal wall defect that causes organs to develop partly outside the body and an elevated risk of certain childhood cancers. I first read this list on an officious-looking website, on my phone in the car outside the prenatal-imaging center. The site offered the caveat that not every child exhibited every trait, but my tears short-circuited the screen and it kept jumping back to the list: baby cancer, baby cancer, baby cancer.For seven months, pregnancy books, and the apps that vie to replace them, had offered me abundant scenarios on which to focus my anxieties. They drilled me on the importance of intentional movement and calculated nutrition, on the dangers of deli meats and cat litter, the risks and benefits of amniocentesis. But now my prenatal helpmeets had little to say. When I typed “birth defect” and “fetal abnormality” into my pregnancy app, it replied: “Please try searching for something else.” The last section of the fourth edition of “What to Expect When You’re Expecting” is titled “The Complicated Pregnancy,” and when I flipped to its end, I found that it did not discuss this syndrome or any other, though it did acknowledge how important it was not to discuss syndromes. “Most women sail through pregnancy and childbirth without any complications,” it says. A reader with a “problem-free pregnancy” was told to “save yourself some unneeded worry” by closing her book now. My pregnancy was the idea from which other pregnant women needed to be spared.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.

Estrogen is the Meryl Streep of hormones, its versatility renowned among scientists. Besides playing a key role in sexual and reproductive health, it strengthens bones, keeps skin supple, regulates sugar levels, increases blood flow, lowers inflammation and supports the central nervous system.“You name the organ, and it promotes the health of that organ,” said Roberta Brinton, a neuroscientist who leads the Center for Innovation in Brain Science at the University of Arizona.But appreciation for estrogen’s more expansive role has been slow in coming. The compound was first identified in 1923 and was henceforth known as the “female sex hormone” — a one-dimensional reputation baked into its very name.“Estrogen” comes from the Greek “oestrus,” a literal gadfly known for whipping cattle into a mad frenzy. Scientifically, estrus has come to mean the period in the reproductive cycles of some mammals when females are fertile and sexually active.Women don’t enter estrus; they menstruate. Nevertheless, when researchers named estrogen, these were the roles it was cast in: inducing a frenzy and supporting female sexual health. Now, estrogen is gaining recognition for what may be its most important role yet: influencing the brain.Neuroscientists have learned that estrogen is vital to healthy brain development but that it also contributes to conditions including multiple sclerosis and Alzheimer’s. Changes in estrogen levels — either from the menstrual cycle or external sources — can exacerbate migraines, seizures and other common neurological symptoms.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.

In 2018, Timberline Knolls, an upscale mental health center for women that once attracted pop stars like Demi Lovato, was in trouble. At least four residents said a therapist had sexually assaulted them on the facility’s wooded campus outside Chicago.The therapist was arrested, and the center’s corporate owner, the large national chain Acadia Healthcare, said it had made changes “to assure that it won’t happen again.”But dangerous conditions persisted for years at Timberline Knolls, an investigation by The New York Times found, in part because of pressure to enroll more patients without hiring enough employees.Two former residents sued Timberline Knolls last year, claiming that an aide had raped them. Acadia had hired the aide despite a criminal record that included domestic violence and gun charges.Another resident — a child who was a ward of the state — nearly died after she overdosed on medication that had been left out in a common area, according to former staff members. And two other women died by suicide after being left unsupervised, a rare occurrence at mental health facilities.“We were extremely understaffed,” said Cecilia Del Angel, who worked as a behavioral health aide at Timberline Knolls until last July. Several other former employees echoed that sentiment. The patient deaths, Ms. Del Angel said, were “entirely preventable.”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.

18 minutes agoShareSaveJosh ParryLGBT & identity reporterShareSaveGetty ImagesThe sister of James Lee Williams, better known as The Vivienne, says her family only learned of the drag performer’s battle with ketamine addiction after watching Drag Race UK.In an interview with BBC Newsnight, Chanel Williams, 35, says James had kept the struggle – including being hospitalised because of the drug – a secret from the family “to protect them”.The 32-year-old died in January, with the family later announcing the cause of death as a cardiac arrest caused by taking ketamine.Chanel says her brother had “a really long period of sobriety” before relapsing, something she says the family only discovered after James’s death.”A big thing for me now is, had I asked the questions or just looked for the signs, would the outcome be different?” she says.The Vivienne was praised for speaking openly about ketamine abuse and the struggle of becoming sober while appearing on Drag Race UK, which aired in 2019.Chanel is now hoping to continue that legacy by campaigning to encourage people to talk openly about substance abuse.She believes the stigma around addiction, and her brother’s successful career on stage and TV, meant James didn’t seek professional help.”He’d spoken openly on Drag Race about the battles he’d had with addiction, and he’d come through the other side of that,” she says.”He was at the height of everything he was doing and I think because he’d said it in such a open platform, it’s really difficult to come back and say you’re struggling again.”Chanel says she’s concerned about the rise in young people taking ketamine, which she believes is in part because the drug is cheap and easily accessible.James’s body was found in Chorlton-by-Backford, near Chester, on 5 January.Police confirmed there were no suspicious circumstances surrounding the death, and a post-mortem examination revealed an “unnatural cause of death.”A full inquest is scheduled for June 30. But in March, the family told BBC News that the star died from cardiac arrest caused by the effects of taking ketamine.Since making the announcement, they’ve been working with substance abuse charity Adferiad to raise awareness and tackle stigma around the drug, something Chanel says is an “important step” in those facing addiction.”It’s hard for me because I think if that stigma wasn’t there, would my brother have sought the help he needed?” she says.”To think that if we’d known, or if he’d have felt able to talk and really reach out for the help that was needed, the outcome could’ve been different.”That’s why we’ve shared James’s story.”Chanel and her family are also campaigning for the government to re-classify ketamine from its current status as a Class B drug to Class A, which would put it in the same category as heroin and cocaine.”There’s a portion of younger people that maybe look at that classification and think it’s less harmful than other drugs,” she says.”But it’s not just about reclassification […] it needs to include education, police, health, to really raise awareness. We need a strategy around drug usage and drug deaths in the UK.”Chanel WilliamsThe UK government is currently seeking experts’ advice on the re-classification of ketamine, with Policing Minister Dame Diana Johnson writing to the Advisory Council on the Misuse of Drugs (ACMD) expressing concern over the rise in young people taking the drug.A spokesperson for the Home Office said: “Our thoughts are with James’s family and friends, and all those affected by this tragic death, which has sadly reinforced once again the serious dangers of taking ketamine.”We will not hesitate to act when the ACMD reports back, and in the meantime, we will continue to work across health, policing and wider public services to drive down drug use and stop those who profit from its supply.”Chanel said it had been difficult to share the information about how James had passed away but that the family “talked about what we can do”.”The Vivienne left a legacy as a trailblazing icon and this, I feel, is James’s legacy. To help other people,” she says.”If I can help one family to not feel what we are feeling, then it’s all worth it.”You can see the full interview with The Vivienne’s sister Chanel on BBC Newsnight at 10:30 on BBC Two and BBC iPlayer.

The justices heard arguments in a constitutional challenge to a task force that decides what treatments are covered at no cost.The Supreme Court appeared divided during arguments on Monday over the constitutionality of a provision of the Affordable Care act that can require insurance companies to offer some types of preventive care for free.At issue is a part of the 2010 health care law that established a task force that determines certain kinds of preventative health measures that insurance companies are required to cover.Two small Christian businesses that provide health insurance to their employees, along with some Texas residents, had sued the federal government, challenging the constitutionality of the task force.In particular, they had objected on religious grounds to the task force’s approval of no-cost H.I.V. medications, claiming the drugs “encourage and facilitate homosexual behavior.”But the case, Kennedy v. Braidwood Management, could have broader implications for tens of millions of Americans who receive a wide array of free health care services, including cancer and diabetes screenings, medications to reduce heart disease and strokes, and eye ointment for newborns to prevent infections causing blindness.A ruling in favor of the challengers could mean that insurers would no longer be required to offer these health services for free.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.