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Why Cristiano Ronaldo’s move to Saudi Arabia means so much for the Gulf monarchy’s sporting ambitions | CNN

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Abu Dhabi, UAE
CNN
 — 

It’s a partnership that’s been hailed as “history in the making.”

One of the world’s most famous soccer stars landed in the Saudi capital Riyadh on Tuesday, where Cristiano Ronaldo was received in an extravagant ceremony, with excited children sporting his new club’s yellow and blue jerseys.

Oil-rich Saudi Arabia’s success in luring the five-time Ballon d’Or winner on a two-year contract with the kingdom’s Al Nassr FC is the Gulf monarchy’s latest step in realizing its sporting ambitions – seemingly at any cost.

According to Saudi state-owned media, Ronaldo will earn an estimated $200 million a year with Al Nassr, making him the world’s highest-paid soccer player.

Shortly after the 37-year-old’s signing with Al Nassr, the club’s Instagram page gained over 5.3 million new followers. Its official website was inaccessible after exceeding its bandwidth limit due to the sudden surge in traffic, and the hashtag #HalaRonaldo – Hello, Ronaldo in Arabic – was trending for days across the Middle East on Twitter.

Analysts say that his recruitment in Saudi Arabia is part of a wider effort by the kingdom to diversify its sources of revenue and become a serious player in the international sporting scene.

It is also seen as a move by the kingdom to shore up its image after it was tarnished by the 2018 dismemberment and killing of Washington Post columnist Jamal Khashoggi at the hands of Saudi agents, and a devastating war it started in Yemen in 2015.

Critics have decried the kingdom for “sportswashing,” an attempt to burnish one’s reputation through sport.

“I think Saudi Arabia has recognized a couple of years ago that to be a powerful nation internationally, you cannot just rely on hard power,” Danyel Reiche, a visiting research fellow and associate professor at Georgetown University Qatar, told CNN.

“You also need to invest in soft power, and the case of Qatar shows that this can work pretty well,” he said, adding that Saudi Arabia is following in the Qatari approach with sport, but with a delay of around 25 years.

Neighboring Qatar has also faced immense criticism since it won the bid to hosting last year’s FIFA World Cup in 2010.

Despite the smaller Gulf state facing similar accusations of “sportswashing,” the tournament has largely been viewed as a success, not least in exposing the world to a different view of the Middle East, thanks in part to Morocco’s success in reaching the semifinals and Saudi Arabia beating eventual World Cup champion Argentina in their opening group game.

Gulf nations engage in fierce competition to become the region’s premier entertainment and sporting hubs. The UAE, Saudi Arabia, Qatar and Bahrain, in close proximity to each other, each have their own Formula One racing event. But their competition hasn’t been confined to the region. Qatar, Saudi Arabia and the UAE have also bought trophy European soccer teams.

Riyadh is playing catchup with neighbors who have long realized the importance of investing in sports, said Simon Chadwick, professor of sport and geopolitical economy at SKEMA Business School in Lille, France, especially as its main source of income – oil – is being gradually shunned.

“This is part of an ongoing attempt to create more resilient economies that are more broadly based upon industries other than those that are derived from oil and gas,” Chadwick told CNN.

Ronaldo’s new club Al Nassr is backed by Qiddiya Investment Company (QIC), a subsidiary of the kingdom’s wealth fund, the Public Investment Fund (PIF), which has played a pivotal role in Saudi Arabia’s diversification plans.

“It is also a sign of interconnectedness, of globalization and of opening up to the rest of the world,” said Georgetown University’s Reiche.

The move is part of “several recent high profile moves in the sports world, including hosting the Andy Ruiz Jr. and Anthony Joshua world heavywight boxing championship bout in 2019, and launching the LIV Golf championship,” said Omar Al-Ubaydli, director of research at the Bahrain-based Derasat think tank. “It is a significant piece of a large puzzle that represents their economic restructuring.”

The kingdom has been on a path to not only diversify its economy, but also shift its image amid a barrage of criticism over its human rights record and treatment of women. Saudi Arabia is today hosting everything from desert raves to teaming up with renowned soccer players. Argentina’s Lionel Messi last year signed a lucrative promotional deal with the kingdom.

Hailed as the world’s greatest player, 35-year-old Messi ended this year’s World Cup tournament in Qatar with his team’s win over France, making his ambassadorship of even greater value to the kingdom.

The acquisition of such key global figures will also help combat the monarchy’s decades-long reputation of being “secretive” and “ultra-conservative,” James Dorsey, a senior fellow at the S. Rajaratnam School of International Studies in Singapore and an expert on soccer in the Middle East, told CNN’s Eleni Giokos on Wednesday.

Al-Ubaydli said that the kingdom wants to use high profile international sports “as a vehicle for advertising to the world its openness.”

Saudi Arabia bought the English Premier league club Newcastle United in 2021 through a three-party consortium, with PIF being the largest stakeholder. The move proved controversial, as Amnesty International and other human rights defenders worried it would overshadow the kingdom’s human rights violations.

Ronaldo’s work with Saudi Arabia is already being criticized by rights groups who are urging the soccer player to “draw attention to human rights issues” in Saudi Arabia.

“Saudi Arabia has an image problem,” especially since Khashoggi’s killing, says Reiche. But the kingdom’s recent investments in sports and entertainment are “not about sportswashing but about developing the country, social change and opening up to the world.”

Saudi Arabia is reportedly weighing a 2030 World Cup bid with Egypt and Greece, but the kingdom’s tourism ministry noted in November that it has not yet submitted an official bid. Chadwick believes that Ronaldo’s deal with Al Nassr, however, may help boost the kingdom’s bid should it choose it pursue it.

Another way Saudi Arabia may benefit from Ronaldo’s acquisition is that it will be able to improve commercial performance, says Chadwick, especially if this collaboration attracts further international talent.

“It is important to see Ronaldo not just as a geopolitical instrument,” said Chadwick, “There is still a commercial component to him and to the purpose he is expected to serve in Saudi Arabia.”

What Ronaldo’s move to Saudi Arabia shows is that the kingdom aspires “to be seen as being the best” and that it wants to be perceived as a “contender and a legitimate member of the international football community,” said Chadwick.

UAE FM meets Syria’s Assad in Damascus in further sign of thawing ties

Syrian President Bashar al-Assad received the United Arab Emirates Foreign Minister Sheikh Abdullah bin Zayed in Damascus on Wednesday in the latest sign of thawing relations between Assad and the Gulf state. The meeting addressed developments in Syria and the wider Middle East, according to UAE state news agency WAM.

  • Background: It was Abdullah bin Zayed’s first visit since a November 2021 meeting with Assad that led to the resumption of relations. Months later, in March 2022, Assad visited the UAE, his first visit to an Arab state since the start of Syria’s civil war.
  • Why it matters: A number of Assad’s former foes have been trying to mend fences with his regime. Last week, talks between the Syrian and Turkish defense ministers were held in Moscow in the highest-level encounter reported between the estranged sides since the war in Syria began. The regional rapprochement is yet to improve the lives of average Syrians. Syria is still under Western sanctions.

Turkish President Erdogan says he could meet with Assad

Turkish President Recep Tayyip Erdogan said in a speech on Thursday that he could meet the Syrian leader “to establish peace.”

  • Background: Erdogan’s comments came after the Moscow talks between the two nations’ defense ministers and intelligence chiefs. “Following this meeting… we will bring our foreign ministers together. And after that, as leaders, we will come together,” Erdogan said on Thursday.
  • Why it matters: The meeting would mark a dramatic shift in Turkey’s decade-long stance on Syria, where Ankara was the prime supporter of political and armed factions fighting to topple Assad. The Turkish military maintains a presence across the Syrian border and within northern Syria, where it backs Syrian opposition forces. Erdogan has also pledged to launch yet another incursion into northern Syria, aiming at creating a 30-km (20-mile) deep “safe zone” that would be emptied of Kurdish fighters.

Iran shuts down French cultural center over Charlie Hebdo’s Khamenei cartoons

Iran announced on Thursday it had ended the activities of a Tehran-based French research institute, in reaction to cartoons mocking Ayatollah Ali Khamenei and fellow Shia Muslim clerics published by French satirical magazine Charlie Hebdo this week.

  • Background: Iran summoned the French ambassador to Tehran on Wednesday to protest cartoons published by satirical magazine Charlie Hebdo. More than 30 cartoons poking fun at Iran’s supreme leader were published by the magazine on Wednesday, in a show of support for the Iranian people who have been protesting the Islamic Republic’s government and its policies.
  • Why it matters: French-Iranian relations have deteriorated significantly since protests broke out in Iran late last year. Paris has publicly supported the protests and spoken out against Iran’s response to them. French Foreign Minister Catherine Colonna criticized Iran’s freedom of press and judicial independence on Thursday, saying “press freedom exists, contrary to what is going on in Iran and… it is exercised under the supervision of a judge in an independent judiciary – and there too it’s something that Iran knows little of.”

The prized legacy of iconic Egyptian singer Umm Kulthum re-emerged this year when Rolling Stone magazine featured her in its “200 Greatest Singers of All Time.”

Ranking 61st, Umm Kulthum was the only Arab artist to make it to the list, with the magazine saying that she “has no real equivalent among singers in the West.”

Born in a small village northeast of the Egyptian capital Cairo, Umm Kulthum rose to unmatched fame as she came to represent “the soul of the pan-Arab world,” the music magazine said.

“Her potent contralto, which could blur gender in its lower register, conveyed breathtaking emotional range in complex songs that, across theme and wildly-ornamented variations, could easily last an hour, as she worked crowds like a fiery preacher,” it wrote.

Nicknamed “the lady of Arab singing,” her music featured both classical Arabic poetry as well as colloquial songs still adored by younger generations. Her most famous pieces include “Inta Uumri” (you are my life), “Alf Leila Weileila” (a thousand and one nights), “Amal Hayati” (hope of my life) and “Daret al-Ayyam” (the days have come around). Some of her songs have been remixed to modern beats that have made their way to Middle Eastern nightclubs.

The singer remains an unmatched voice across the Arab World and her music can still be heard in many traditional coffee shops in Old Cairo’s neighborhoods and other parts of the Arab world.

Umm Kulthum’s death in 1975 brought millions of mourners to the streets of Cairo.

By Nadeen Ebrahim

Women athletes aim their air rifles while competing in a local shooting championship in Yemen's Houthi rebel-held capital Sanaa on January 3.



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Myths and facts about treating a hangover | CNN

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Editor’s Note: Get inspired by a weekly roundup on living well, made simple. Sign up for CNN’s Life, But Better newsletter for information and tools designed to improve your well-being.



CNN
 — 

Are you celebrating the first day of 2023 with a hangover?

If so, you might be looking for a method to ease your misery. There are certainly a lot of so-called hangover cures, some dating back centuries.

“The ancient Greeks believed that eating cabbage could cure a hangover, and the Romans thought that a meal of fried canaries would do the trick,” said Dr. John Brick, former chief of research at the Center of Alcohol Studies, Education and Training Division at Rutgers University in New Jersey, who authored “The Doctor’s Hangover Handbook.”

“Today, some Germans believe that a hearty breakfast of red meat and bananas cures hangovers. You might find some French drinking strong coffee with salt, or some Chinese drinking spinach tea,” he said. “Some of the more unusual hangover cures are used by some people in Puerto Rico, who rub half a lemon under their drinking arm.”

In truth, the only cure for a hangover is time, according to the National Institute on Alcohol Abuse and Alcoholism.

“A person must wait for the body to finish clearing the toxic byproducts of alcohol metabolism, to rehydrate, to heal irritated tissue, and to restore immune and brain activity to normal,” according to the institute. That recovery process can take up to 24 hours.

Are there things you can do to ease your transition? Possibly, experts say, but many common hangover “cures” may make your hangover worse. Here’s how to separate fact from fiction.

Having another drink, or the “hair of the dog that bit you,” is a well-known cure for a hangover, right? Not really, experts say.

The reason some people believe it works is because once the calming effects of alcohol pass, the brain on a hangover is overstimulated. (It’s also the reason you wake up in the middle of the night once your body has metabolized alcohol.)

“You’ve got this hyperexcitability in the brain after the alcohol is gone,” said Dr. Robert Swift, a professor of psychiatry and human behavior at Brown University’s Warren Alpert Medical School in Providence, Rhode Island.

“If you look at the brain of somebody with a hangover, even though the person might feel tired, their brain is actually overexcited,” he said.

Consuming more alcohol normalizes the brain again, “because you’re adding a sedative to your excited brain,” Swift said. “You feel better until the alcohol goes away and the cycle repeats in a way.”

The answer is yes, depending on hangover symptoms, Brick said. If you’re a coffee drinker, skipping your morning cup of joe may lead to caffeine withdrawal on top of your hangover.

But coffee can irritate the stomach lining, which is already inflamed by alcohol, Brick said. So if you are queasy and nauseous, coffee may only make matters worse.

“If you have a hangover, have a quarter of a cup of coffee,” Brick suggested. “See if you feel better — it takes about 20 minutes for the caffeine to start to have some noticeable effect.

“If coffee doesn’t make you feel better, don’t drink anymore. Obviously, that’s not the cure for your hangover.”

Forget eating a greasy breakfast in the wee hours after a night of drinking — you’re adding insult to injury, Swift said: “Greasy food is harder to digest, so it’s probably good to avoid it.”

Eating greasy food also doesn’t make much sense. The alcohol we drink, called ethyl alcohol or ethanol, is the byproduct of fermenting carbohydrates and starches, usually some sort of grain, grape or berry. While it may create some tasty beverages, ethanol is also a solvent, Brick said.

“It cuts through grease in your stomach much the same way it cleans grease off oily car parts,” he said.

Instead, experts suggest using food to prevent hangovers, by eating before you have that first drink.

“Eating food loaded with protein and carbohydrates can significantly slow down the absorption of alcohol,” Brick said. “The slower the alcohol gets to your brain, the less rapid the ‘shock’ to your brain.”

Alcohol dehydrates, so a headache and other hangover symptoms may be partly due to constricted blood vessels and a loss of electrolytes, essential minerals such as sodium, calcium and potassium that your body needs.

If you’ve vomited, you’ve lost even more electrolytes, and all of this can lead to fatigue, confusion, irregular heart rate, digestive problems and more.

Replacing lost fluids with water or a type of sports drink with extra electrolytes can help boost recovery from a hangover, Swift said.

Taking over-the-counter pain meds can be dangerous, especially if you take too many while intoxicated, experts say. Taking an acetaminophen, such as Tylenol, can further damage your overtaxed liver, while aspirin and ibuprofen can irritate your stomach lining.

“You should never, never take alcohol with acetaminophen or Tylenol,” Swift said. “You can actually cause liver damage from an overdose of Tylenol.”

But aspirin, ibuprofen and naproxen are “theoretically” OK, he added.

“Even though they tend to be anti-inflammatory in the body, they can cause inflammation in the stomach,” Swift said. “Don’t take them on an empty stomach; always take anti-inflammatories with food.”

While most alcohol is handled by the liver, a small amount leaves the body unchanged through sweat, urine and breathing.

Get up, do some light stretching and walking, and drink plenty of water to encourage urination, Brick said.

“Before you go to sleep and when you wake up, drink as much water as you comfortably can handle,” he said. You can also take a multivitamin “before you hit the shower in the morning (to) replenish lost vitamins, minerals and other nutrients.”

If you would rather have something warm and soothing, Brick suggested broth or other homemade soups.

“These will also help to replace lost salts, including potassium and other substances,” he said, “but will not make you sober up faster or improve impairment due to intoxication or hangover.”

Store shelves are packed with so-called hangover cures. Unfortunately, there’s no proof they work. In 2020, researchers published what they called the “world’s largest randomised double-blind placebo-controlled” trial of supplements containing vitamins, minerals, plant extracts and antioxidants and found no real improvement in hangover symptoms.

Even if one solution works, it likely won’t fix all your symptoms, experts say.

“The effects of alcohol and alcoholic beverages are so complicated, so complex,” Swift said, “that any solution might address one or two of the symptoms but won’t address them all.”

What does work for a hangover? Time. It will take time for your body to release all the toxins causing your misery, experts say. And the only way to prevent a hangover is to abstain.

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How to beat that New Year’s hangover before it starts | CNN

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CNN
 — 

Toasting the birth of the new year is an age-old ritual, and for many, so is that dreaded morning aftermath — a hangover.

What seemed like great fun at the time is now causing your hands to shake, your head to pound and your heart to race, not to mention other unpleasant symptoms such as dizziness, nausea, vomiting, light sensitivity and excruciating thirst.

Why are you suffering? Because the liquor that smoothly passed your lips is now wreaking havoc in your body, causing dehydration, stomach distress and inflammation. These ailments peak about the time all the alcohol leaves your body.

There is no scientifically proven way to cure a hangover, but experts say you can prevent one — or at least keep that morning-after misery to a minimum. Here’s how.

Forget a late-night meal after a night of drinking — that’s much too late, experts say. Instead, eat before your first drink and keep noshing as the night goes on.

“Food in the stomach slows gastric emptying and can reduce hangover symptoms,” said Dr. Robert Swift, a professor of psychiatry and human behavior at Brown University’s Warren Alpert Medical School in Providence, Rhode Island.

Why does food help? Because most alcohol isn’t absorbed by an empty stomach but via the intestinal tract just below it, Swift said.

“If somebody does shots on an empty stomach, for example, all that pure alcohol is not diluted by the stomach and is passed to the intestine very quickly,” said Swift, who has studied alcohol abuse since the 1990s.

“If the stomach contains food, however, there are gastric juices and enzymes that mix the food and the alcohol, and only small amounts of food are passed into the intestine,” he said. “Now the alcohol is diluted in the stomach, and only a small quantity of alcohol is absorbed at any time.”

The same principle applies to water and other nonalcoholic beverages, Swift said. “If alcohol is mixed with fluid, it’s diluted, so when it goes into your intestines, it’s not as irritating. You’re less likely to have inflamed intestines or an inflamed stomach lining.”

Drinking water can help reduce the dehydration that occurs from downing too many alcoholic drinks.

There’s another benefit to downing water between drinks, said Dr. John Brick, former chief of research at the Center of Alcohol Studies, Education and Training Division at Rutgers University in New Jersey.

“The primary cause of hangovers is dehydration and the loss of fluids, along with vitamins and minerals,” said Brick, who authored “The Doctor’s Hangover Handbook” and published scientific papers on the biobehavioral effects of alcohol and other drugs.

Downing just 3½ alcoholic drinks can result in the loss of up to a quart of water over several hours, Brick added. “That’s a good amount of water that has to be replenished.”

Dehydration from alcohol may affect a woman even more, and she is more likely to suffer a hangover, even if she drinks less than a man, Swift said. That’s because a man has a higher percentage of body water than a woman of the same height and weight, so the same amount of alcohol will be more diluted in a man, he said.

“The woman will have a higher concentration of blood alcohol because her body contains less water to dilute it,” he said. “Women are much more susceptible to the deleterious effects of alcohol (and they) get more intoxicated and develop alcohol liver disease sooner in life than men do.”

The alcohol we drink, called ethyl alcohol or ethanol, is the byproduct of fermenting carbohydrates and starches, usually some sort of grain, grape or berry. We use byproducts of fermentation in other ways: Ethanol is added to the gasoline in our cars, and methyl alcohol or methanol — a toxic substance — is used as a solvent, pesticide and alternative fuel source. Also called wood alcohol, methyl alcohol made by bootleggers blinded or killed thousands of people during Prohibition.

That’s not all — the list of byproducts or chemicals added by manufacturers for flavor and taste can read like a list of supplies at an industrial warehouse: ethyl formate, ethyl acetate, n-propanol, isobutanol, n-butanol, isopentanol and isoamyl alcohols. While these congeners, as they are called, are added in small, nontoxic amounts, some people are overly sensitive to their effects.

Overall, dark-colored beer and spirits tend to contain more congeners and thus may be more likely to cause hangovers, experts say. A 2010 study investigated the intensity of hangovers in people who drank the darker-colored liquor bourbon versus clear vodka.

“Congeners in bourbon … significantly increased hangover intensity, which is not too surprising since bourbon has about 37 times the amount of congeners as vodka,” Brick said.

Chemical preservatives called sulfites, known to cause allergic reactions in sensitive people, are also a natural byproduct of fermentation in small quantities. However, many manufacturers of beer and wine add sulfites to their products to extend shelf life. (Sulfites are also added to soda, cereals, sweeteners, canned and ultra-processed foods, medications and more.)

Sweet and white wines tend to have more sulfites than red, but red wines contain more tannins, which are bitter or astringent compounds found in the skin and seeds of grapes. Like sulfites, tannins can trigger allergic reactions in people who are sensitive.

As a result, limiting your drinking to light beers, clear liquors and white wine might help keep hangovers at bay.

In the end, however, experts say there is only one true preventive — or cure — for a hangover: Don’t drink.

“There’s no simple cure because there are so many complex factors that are producing the multiple symptoms of a hangover,” Swift said. “And that’s why the only real cure for a hangover is to not drink alcohol or drink such a low amount of alcohol that it won’t trigger a hangover.”

Correction: A previous version of this story misstated the process through which alcohol is absorbed in the body.

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What older Americans need to know before undergoing major surgery | CNN

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KHN
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Larry McMahon is weighing whether to undergo a major surgery. Over the past five years, his back pain has intensified. Physical therapy, muscle relaxants, and injections aren’t offering relief.

“It’s a pain that leaves me hardly able to do anything,” he said.

Should McMahon, an 80-year-old retired Virginia state trooper who now lives in Southport, North Carolina, try spinal fusion surgery, a procedure that can take up to six hours? (Eight years ago, he had a lumbar laminectomy, another arduous back surgery.)

“Will I recover in six months — or in a couple of years? Is it safe for a man of my age with various health issues to be put to sleep for a long period of time?” McMahon asked, relaying some of his concerns to me in a phone conversation.

Older adults contemplating major surgery often aren’t sure whether to proceed. In many cases, surgery can be lifesaving or improve a senior’s quality of life. But advanced age puts people at greater risk of unwanted outcomes, including difficulty with daily activities, extended hospitalizations, problems moving around, and the loss of independence.

I wrote in November about a new study that shed light on some risks seniors face when having invasive procedures. But readers wanted to know more. How does one determine if potential benefits from major surgery are worth the risks? And what questions should older adults ask as they try to figure this out? I asked several experts for their recommendations. Here’s some of what they suggested.

Ask your surgeon, “How is this surgery going to make things better for me?” said Dr. Margaret “Gretchen” Schwarze, an associate professor of surgery at the University of Wisconsin School of Medicine and Public Health. Will it extend your life by removing a fast-growing tumor? Will your quality of life improve by making it easier to walk? Will it prevent you from becoming disabled, akin to a hip replacement?

If your surgeon says, “We need to remove this growth or clear this blockage,” ask what impact that will have on your daily life. Just because an abnormality such as a hernia has been found doesn’t mean it has to be addressed, especially if you don’t have bothersome symptoms and the procedure comes with complications, said Drs. Robert Becher and Thomas Gill of Yale University, authors of that recent paper on major surgery in older adults.

Schwarze, a vascular surgeon, often cares for patients with abdominal aortic aneurysms, an enlargement in a major blood vessel that can be life-threatening if it bursts.

Here’s how she describes a “best case” surgical scenario for that condition: “Surgery will be about four to five hours. When it’s over, you’ll be in the ICU with a breathing tube overnight for a day or two. Then, you’ll be in the hospital for another week or so. Afterwards, you’ll probably have to go to rehab to get your strength back, but I think you can get back home in three to four weeks, and it’ll probably take you two to three months to feel like you did before surgery.”

Among other things people might ask their surgeon, according to a patient brochure Schwarze’s team has created: What will my daily life look like right after surgery? Three months later? One year later? Will I need help, and for how long? Will tubes or drains be inserted?

A “worst case” scenario might look like this, according to Schwarze: “You have surgery, and you go to the ICU, and you have serious complications. You have a heart attack. Three weeks after surgery, you’re still in the ICU with a breathing tube, and you’ve lost most of your strength, and there’s no chance of ever getting home again. Or, the surgery didn’t work, and still you’ve gone through all this.”

“People often think I’ll just die on the operating table if things go wrong,” said Dr. Emily Finlayson, director of the UCSF Center for Surgery in Older Adults in San Francisco. “But we’re very good at rescuing people, and we can keep you alive for a long time. The reality is, there can be a lot of pain and suffering and interventions like feeding tubes and ventilators if things don’t go the way we hope.”

Once your surgeon has walked you through various scenarios, ask, “Do I really need to have this surgery, in your opinion?” and “What outcomes do you think are most likely for me?” Finlayson advised. Research suggests that older adults who are frail, have cognitive impairment, or other serious conditions such as heart disease have worse experiences with major surgery. Also, seniors in their 80s and 90s are at higher risk of things going wrong.

“It’s important to have family or friends in the room for these conversations with high-risk patients,” Finlayson said. Many seniors have some level of cognitive difficulties and may need assistance working through complex decisions.

Make sure your physician tells you what the nonsurgical options are, Finlayson said. Older men with prostate cancer, for instance, might want to consider “watchful waiting” — ongoing monitoring of their symptoms — rather than risk invasive surgery. Women in their 80s who develop a small breast cancer may opt to leave it alone if removing it poses a risk, given other health factors.

Because of McMahon’s age and underlying medical issues (a 2021 knee replacement that hasn’t healed, arthritis, high blood pressure), his neurosurgeon suggested he explore other interventions, including more injections and physical therapy, before surgery. “He told me, ‘I make my money from surgery, but that’s a last resort,” McMahon said.

“Preparing for surgery is really vital for older adults: If patients do a few things that doctors recommend — stop smoking, lose weight, walk more, eat better — they can decrease the likelihood of complications and the number of days spent in the hospital,” said Dr. Sandhya Lagoo-Deenadayalan, a codirector in Duke University Medical Center’s Perioperative Optimization of Senior Health (POSH) program.

When older patients are recommended to POSH, they receive a comprehensive evaluation of their medications, nutritional status, mobility, preexisting conditions, ability to perform daily activities, and support at home. They leave with a “to-do” list of recommended actions, usually starting several weeks before surgery.

If your hospital doesn’t have a program of this kind, ask your physician, “How can I get my body and mind ready” before having surgery, Finlayson said. Also ask: “How can I prepare my home in advance to anticipate what I’ll need during recovery?”

There are three levels to consider: What will recovery in the hospital entail? Will you be transferred to a facility for rehabilitation? And what will recovery be like at home?

Ask how long you’re likely to stay in the hospital. Will you have pain, or aftereffects from the anesthesia? Preserving cognition is a concern, and you might want to ask your anesthesiologist what you can do to maintain cognitive functioning following surgery. If you go to a rehab center, you’ll want to know what kind of therapy you’ll need and whether you can expect to return to your baseline level of functioning.

During the Covid-19 pandemic, “a lot of older adults have opted to go home instead of to rehab, and it’s really important to make sure they have appropriate support,” said Dr. Rachelle Bernacki, director of care transformation and postoperative services at the Center for Geriatric Surgery at Brigham and Women’s Hospital in Boston.

For some older adults, a loss of independence after surgery may be permanent. Be sure to inquire what your options are should that occur.

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Pandemic fueled alcohol abuse, especially among women, but there are treatment options | CNN

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Editor’s Note: In the final two episodes of “This Is Life With Lisa Ling,” the series explores alcoholism in America (at 9 p.m. ET Sunday) and interracial marriages (at 10 p.m. ET Sunday).



CNN
 — 

Brook was 34 years old when her use of alcohol escalated, a way of coping with a breast cancer diagnosis.

“I just decided I’m not gonna go through this straight,” she told Lisa Lang in an episode of “This Is Life With Lisa Ling,” airing at 9 p.m. ET Sunday on CNN.

“I would drink before I went to my chemo sessions. It became more and more of a coping mechanism,” said Brook, who did not want to use her last name.

Brook survived the bout with cancer but says she became dependent on alcohol — and the pandemic only made it worse.

“When Covid started and I was home, I started drinking more and more and more,” said Brook, now 42. “I started not being able to eat, I started throwing up more often, and then I started throwing up blood.”

She recently ended up in the hospital, diagnosed with cirrhosis of the liver and a bad bleed from ulcers, which doctors said could take her life if not quickly treated.

“When they were talking to me afterwards, they said, ‘If you keep going like this, you’ll be dead in a year,’ ” Brook told Ling.

Alcohol use disorder is defined as compulsively using alcohol despite negative consequences on relationships and one’s ability to function at work, school or in the community. Over time, excessive alcohol use may even rewire the brain, making booze as desirable as natural rewards such as food or sex, experts say.

Researchers at University of California, Los Angeles showed pictures of alcoholic drinks to people who are and are not addicted while scanning their brains. Regions of the brain associated with craving, pleasure and reward lit up significantly more in those with an alcohol use disorder.

“It’s much more of a medical and brain disease than we initially thought,” Lara Ray, a clinical psychologist who runs the UCLA Addictions Lab, told Ling.

In addition, just one pint of beer or average glass of wine a day may begin to shrink the overall volume of the brain. The brains of nondrinkers who began consuming an average of one alcohol unit a day showed the equivalent of half a year of aging, according to a study published in March.

The damage worsens as the number of daily drinks rises, the study found — drinking four alcohol units a day aged a person’s brain by more than 10 years.

Alcohol use disorder is a growing problem in the United States, which experts say has been enhanced by the pandemic, especially among women.

“Last year, I took care of two women who were in their early 20s who had cirrhosis and needed liver transplants, and I’ve never seen that before in my entire career,” Dr. James Burton, medical director of liver transplantation at the University of Colorado School of Medicine in Aurora, told Ling.

A recent study found a significant increase in alcohol-associated liver disease and a 15% higher rate of waiting lists and subsequent liver transplants between 2020 and 2021 — the greatest increase occurred in young adults.

Since the pandemic’s onset, statistics show an overall 14% increase in the number of drinking days per month, but a “41% increase in heavy drinking days among women,” Dr. Sarah Wakeman, medical director of the Substance Use Disorders Initiative at Massachusetts General Hospital, told CNN in January.

Why? Pre-pandemic mom wine culture, which “normalized and even glorified” drinking, is partly to blame, said Dr. Leena Mittal, chief of the women’s mental health division in the department of psychiatry at Brigham and Women’s Hospital in Boston.

In addition, “studies have shown the complexities of balancing home, work and caregiving responsibilities during the pandemic have fallen disproportionately on women,” Mittal said earlier.

Women are especially sensitive to the effects of alcohol, according to the National Institute on Alcohol Abuse and Alcoholism. Alcohol-related problems appear sooner and at lower drinking levels than in men, said the institute, part of the US National Institutes of Health.

Women are more susceptible to alcohol-related brain damage and heart disease than men, and studies show women who have one drink a day increase their risk of breast cancer by 5% to 9% compared with those who abstain.

Pandemic lockdowns also forced many people to live and work from home — sometimes alone. A July study found drinking alone during adolescence and young adulthood can strongly increase the risk for alcohol abuse later in life, especially if you are a woman.

Victoria, who also did not want to use her last name, told Ling she began drinking as a teenager. Now 55, she still “can’t control it. It’s like a tension that builds up. And so then when I do drink, it’s like, ‘Ah! I’m drinking,’ you know, so it’s way too much, way too fast.”

Victoria says she continues to crave alcohol but goes regularly to support meetings for addiction recovery after moving in with her mother during the pandemic.

Binge drinking — defined as more than four drinks for women and five for men within a few hours — is on the rise. According to a study published in June, even older people who consider themselves moderate users of alcohol are downing multiple drinks in one sitting.

People who binged were about five times more likely to experience numerous alcohol problems, including injuries, emotional or psychological issues, and alcohol dependence at work or school or while caring for children, the study found.

“What this means is that an individual whose total consumption is seven drinks on Saturday night presents a greater risk profile than someone whose total consumption is a daily drink with dinner, even though their average drinking level is the same,” study coauthor Charles Holahan, professor of psychology at the University of Texas at Austin, told CNN previously.

The US Food and Drug Administration has approved only three drugs designed to reduce alcohol use since 1951: disulfiram, which causes headaches, nausea and vomiting when mixed with alcohol; acamprosate, which works on the reward centers of the brain to reduce alcohol cravings; and naltrexone, which reduces cravings and appears to help with heavy drinking.

There is help. Find it here

  • The National Institute on Alcohol Abuse and Alcoholism has a tool called the NIAA Alcohol Treatment Navigator that “helps adults find alcohol treatment for themselves or an adult loved one.” For teens, the institute recommends these resources.
  • The Substance Abuse and Mental Health Services Administration has a free, confidential National Helpline active 24/7/ 365 days a year to provide information and treatment referrals to local treatment facilities, support groups and community-based organizations: 800-662-HELP (4357) and 800-487-4889 (TTY option).

    • All three have significant side effects that can deter people from using them consistently.

    Researchers continue to experiment with various drugs to see if they can help cure cravings without major side effects. While not FDA-approved, the anticonvulsant drug topiramate has shown promise in some clinical trials but may affect cognition and memory. Other anticonvulsant drugs, such as zonisamide and gabapentin, and a smoking cessation drug called varenicline have shown mixed results.

    At Ray’s lab at UCLA, small clinical trials have found promising results from the neuromodulator ibudilast, which hindered cravings and reduced the odds of heavy drinking for some people by 45%.

    For Billy Flores, 45, the change happened quickly.

    “In the first two days, I was upset in the stomach, but by the third day I was on it, I was off of alcohol, which is pretty amazing I thought,” he told Ling about using ibudilast.

    Bill has struggled with alcohol but says he has found hope with a clinical trial.

    Additional studies are needed to see if the benefits hold true for larger populations.

    In the meantime, there are gold standard treatments for alcohol use disorder that don’t involve medications. Those include Alcoholics Anonymous and Self-Management and Recovery Training 12-step programs, cognitive behavioral treatments and mindfulness-based approaches.

    A large 2006 clinical trial found behavioral interventions can be as effective as drugs — in fact, most of the medication clinical trials done to date have also included some form of social or behavioral treatment in combination with drugs.

    Having support is critical to keeping a positive mindset that will ultimately win the battle with alcohol, experts say.

    Brook agrees.

    “When I was doing my therapy intake for rehab, one of the questions was, ‘What made you decide to do this?’ And I said, ‘I’m better than this,’ ” she told Ling.

    “I still like to think that even with the relapses, I’m gonna still be that person who gets right back up and tries again.”

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    Making the case for an underappreciated but full-of-flavor ingredient | CNN

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    Editor’s Note: Sign up for CNN’s Eat, But Better: Mediterranean Style. Our eight-part guide shows you a delicious expert-backed eating lifestyle that will boost your health for life.



    CNN
     — 

    Among foods that spark a strong reaction, anchovies are at the top of the food chain.

    Whether they’re adored or abhorred, it’s difficult to find someone who doesn’t have a strong opinion about these small silvery swimmers.

    Food writer Alison Roman wants the haters to think differently. Anchovies are more versatile than most people think and deserve to be approached with an open mind, according to Roman.

    She might be biased — anchovies are one of her all-time favorite foods — but she has a strategy to change cooks’ minds.

    “They’re more of a condiment than an ingredient,” Roman said. “To cook with them, you don’t need to eat them whole.” She incorporates anchovies into many of her dishes in the same way that she would add garlic, herbs or other flavorful aromatics. “Most of the time when I’m eating (anchovies), I can’t even see them.”

    Even if you think your taste buds will rebel if you try an anchovy, your brain and heart will be happier if you do. “Anchovies are a small but mighty fish,” said Michelle Dudash, registered dietitian, nutritionist and author of “The Low-Carb Mediterranean Cookbook.”

    “They’re packed with the omega-3 fatty acids DHA and EPA, which are important for brain, cardiovascular and skin health,” she added. Anchovies are on par with salmon and tuna as one of the fish with the highest amounts of omega-3s per serving, and are a good source of protein, niacin and vitamin B12.

    Following Roman’s lead of using anchovies as one of many elements in a dish instead of as the spotlight ingredient, cooks who want to incorporate anchovies into meals “can start small,” Roman suggested. “They don’t have to dump a whole jar into their salad.”

    Here are three ways Roman likes to introduce anchovies to the wary but curious. Ready to change your “anchoview”? Read on.

    Move over, ranch dressing — there’s another dip in town. Bagna cauda, the Italian dipping sauce made from anchovies, garlic, butter and olive oil, is traditionally served with crudités as an appetizer.

    Roman loves using bagna cauda as a vehicle to introduce unsuspecting dinner guests to anchovies because it hits the taste trifecta of “salty, buttery, garlicky” flavors. “It’s mostly about garlic and vegetables,” Roman said. In addition to the traditional accompaniment of raw, crunchy vegetables, she likes to include steamed artichoke hearts and tender cooked potato slices.

    Bagna cauda is also an answer to the ever-present question about anchovies: What about the bones? “They are so tiny, they mostly all melt” and dissolve into the dish when heat is applied, Roman said. “They’re not going to choke you.”

    “High-quality anchovies shouldn’t have many bones,” she added, and they should not be noticeable like they would be in larger fish, such as a salmon fillet. If you happen to see many bones in your anchovies, “spring for a more expensive tin,” Roman said.

    If the presence of whole anchovies resting atop a bed of romaine in a Caesar salad has been historically too much to handle, Roman’s Caesar-adjacent salad will be a refreshing revelation.

    Roman likes to pair bitter greens from the chicory family, such as radicchio, with a dressing that can stand up to their strong flavors. “I put anchovies in my salads all the time,” she said, but when hidden in the dressing, they add body and nuance without overpowering any of the other ingredients with which they’re paired.

    Anchovies in a dressing can add body and nuance to a salad without overpowering other ingredients.

    Her preferred dressing blends finely chopped anchovies and capers with lemon, whole grain or Dijon mustard, and good quality olive oil. “It’s anchovy-heavy but more about the mustard and the garlic,” Roman explained, which she finds “meatier and saltier and more interesting” than the usual Caesar dressing.

    Finally, the same strategy of dissolving the umami flavors of anchovies in a sauce comes into play when making a rich and comforting pasta. Based on the Venetian dish bigoli in salsa, in which long strands of thick bigoli pasta are tossed with slow-simmered onions and anchovies, Roman’s version can be used with any long, thin pasta.

    Pasta alla puttanesca features garlic, olives, capers, tomatoes and anchovies.

    Roman adds whole anchovies and chopped dried chili pepper to a skillet of sliced onions, garlic and fennel caramelized in olive oil. The whole fillets might look intimidating, but as with the bagna cauda, the anchovies melt and dissolve as the sauce simmers, leaving only a rich and meaty undertone. Finishing the dish with freshly squeezed lemon juice and parsley brightens up the intense sauce.

    A free-form pasta sauce such as this lets you adjust the flavor balance based on what you like best. If you love lemon, squeeze more on. If fennel isn’t your favorite, use more onions instead. If you like it spicy? Amp it up with more chili pepper. “Gauge your own personal preferences,” Roman recommended.

    When choosing a tin or jar of anchovies, Roman said to make sure the anchovies are oil-packed, salt-cured anchovy fillets, not brined, pickled or whole anchovies. The former is the most common style of jarred or canned anchovies on the market, but it always pays to double-check the label.

    Second, “always try a bunch of brands. They really are all different,” Roman said. Though the ingredients in each container should be the same — anchovies, salt and olive oil — the fillets will vary in saltiness, taste and texture. “Ortiz and Cento are available nationally,” she said, and many other brands are available in brick-and-mortar and online specialty food stores.

    One note on the salt-curing: “The only downside of anchovies is the sodium,” Dudash noted, since they are packed in salt during the curing process. “If you are concerned about your sodium intake or if you simply prefer less salty food, briefly rinse the anchovies and pat dry with a paper towel” before using them.

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    Home delivery of medications can help improve access, especially when time is tight | CNN

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    CNN
     — 

    Covid-19 hospitalizations are on the rise in the United States, with more than 34,000 new admissions last week, but millions of vaccines and doses of antiviral treatments that could help prevent severe outcomes from the virus remain unused.

    Research has found that many who could benefit most from the Covid-19 medication Paxlovid – including the elderly and Black and Hispanic people, groups that have disproportionately had the most severe illness – are less likely to take it.

    As the supply of Paxlovid has grown, efforts have been made to improve timely, equitable access to the treatment.

    “The driving distance to the nearest site or the geographic accessibility of the places where Paxlovid is being offered doesn’t seem to be the primary driver of why these populations are not getting the treatments they need,” said Dr. Rohan Khazanchi, a resident at Harvard Medical School and health equity consultant for the New York City health department.

    Transportation is one significant barrier to health care access for many people, experts say, but creating equitable outcomes will involve a much more comprehensive approach.

    In response to the White House’s call for pharmacies to help make this winter a healthier one for Americans, Walgreens launched a program Thursday in partnership with DoorDash and Uber Health that offers free home delivery of Paxlovid for those with a prescription. The initiative is meant to increase access to Covid-19 treatment, particularly for those in socially vulnerable or medically underserved communities.

    Millions of Americans get prescriptions through the mail, a service that research has shown is used more frequently among seniors, adults with poor health and others who are also at high risk of severe outcomes for Covid-19.

    But Paxlovid is most effective when taken within five days of symptoms starting, making timely treatment a critical piece of the puzzle and traditional mail-order delivery too slow.

    Walgreens also plans to expand the service to include HIV treatment – in line with the Biden administration’s goals to accelerate efforts to end the HIV/AIDS epidemic in the US.

    As with Paxlovid, early uptake is key with HIV treatment. And people who miss doses of HIV treatment risk developing drug resistance, making it crucial that they stick with the prescription.

    “There are places across the patient journey that would divert a patient from being able to get treated and back to feeling better. But that’s where our teams have been working on really understanding that patient journey and then offering and identifying solutions to help address that,” said Rina Shah, vice president of pharmacy strategy at Walgreens.

    Rite Aid adopted a prescription delivery program during the Covid-19 pandemic through a partnership with ScriptDrop. Service fees are currently waived for all eligible prescriptions, which excludes controlled substances and refrigerated medications but includes Paxlovid.

    CVS also has one- or two-day delivery in most locations and on-demand delivery at some, which is provided free to people enrolled in the membership program.

    In March, the Biden administration launched a federal Test-to-Treat initiative that streamlined access to Paxlovid for people who had Covid-19, with testing and prescribing all happening in one visit. In May, the program was broadened to specifically reach more vulnerable communities.

    Khazanchi was author of a study published last month that found that Black and Hispanic people were more likely to live closer to Test-to-Treat sites than White people. But despite the physical proximity, these groups were less likely to get outpatient Covid-19 therapeutics – even though they’re at elevated risk of infection and severe disease.

    Even if someone has a car or another way to get to the doctor’s office, pharmacy or other Test-to-Treat location, they’re often challenged by the time required to make that trip, said Dr. Rachel Werner, executive director of the University of Pennsylvania’s Leonard Davis Institute of Health Economics.

    “It’s a combination of things that prevent access to care,” said Werner, whose research has focused on health equity. “Often, people have to take time off of work to do that, and they don’t always have paid sick leave. Everyone’s lives are complicated, and sometimes it’s hard to balance competing priorities.”

    According to a report from health analytics company IQVIA, 9% of all new prescriptions in 2019 were “abandoned” at pharmacies, representing a gap in physician-recommended care that was not received by the patient. But home delivery programs that have expanded throughout the Covid-19 pandemic may help.

    “I think it may be important to think about other medications or conditions where the time to treatment really matters. And those may be the ones that I think would be ripe for this kind of home-based delivery system,” Werner said. “These are urgent things that people might otherwise show up to an urgent clinic or ER for and instead could just get a medication.”

    With the expansion of things like telehealth and options for home care, experts say, the Covid-19 pandemic helped widen the picture of what health care can look like.

    “For far too long, we’ve been bound by the idea that health care is something that occurs within the four walls of a hospital or clinic,” Werner said. “What the Covid pandemic really did, which is important, is it made people realize that health care should be accessible where and when people need it, and it doesn’t have to be delivered in the physical structure of a health care setting.”

    Experts say that while it’s critical to break down barriers in terms of access to medication, it’s important to also address the issue of trust.

    In the research about accessibility to Test-to-Treat sites, Khazanchi and his co-authors suggested that programs should leverage trusted community stakeholders like local health-care providers for in-person outreach and other “low-tech, high-touch” methods to ensure equitable use.

    Dr. Kedar Mate, president and CEO of the Institute for Healthcare Improvement and assistant professor at Weill Cornell Medical College, thinks about it in terms of supply and demand.

    “Getting treatments to people who need them is principally an issue around access and ensuring that the supply goes to where the people are,” he said. “There’s a different problem, though, on the demand side. Are patients willing or interested to get tested and then get treated if they are found to be positive? That has everything to do with a totally different set of challenges which have to do with trust, information, disinformation, misinformation and belief in the health system overall.”

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    LeBron James and Billie Jean King lead tributes to American journalist Grant Wahl | CNN

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    CNN
     — 

    The death of prominent journalist Grant Wahl at the World Cup in Qatar has led to an outpouring of shock and grief across the sports world, with NBA star LeBron James and tennis great Billie Jean King leading the tributes to the American.

    Prominent American journalist Grant Wahl has died in Qatar after collapsing while covering the World Cup, sparking an outpouring of shock and grief across the sports world. He was 49.

    King said Wahl’s death was “heartbreaking.”

    “A talented journalist, Grant was an advocate for the LGBTQ community & a prominent voice for women’s soccer,” King tweeted Saturday. “He used his platform to elevate those whose stories needed telling. Prayers for his family.”

    On Friday in Philadelphia, basketball star James said he had been “very fond of Grant.” While Wahl was at Sports Illustrated, he did a cover story on James when James was in high school.

    “I’ve always kind of watched from a distance even when I moved up in ranks and became a professional, and he went to a different sport,” said James, speaking at a postgame press conference. “Any time his name would come up I’ll always think back to me as a teenager and having Grant in our building … It’s a tragic loss.”

    Tyler Adams, the captain of the US men’s national soccer team, which was knocked out of the World Cup by the Netherlands in the last 16, sent his “deepest sympathy” to Wahl’s wife, Celine Gounder, and to those who knew him.

    “As players we have a tremendous amount of respect for the work of journalists, & Grant’s was a giant voice in soccer that has tragically fallen silent,” Adams wrote on Twitter.

    Qatar’s World Cup organizers said on Saturday that Wahl “fell ill” in the press area, where he received “immediate medical treatment on site.”

    He was then transferred to Hamad General Hospital, said a spokesperson for the Supreme Court Committee for Delivery and Legacy, the body responsible for planning the tournament.

    Wahl was treated in the stadium “for about 20-25 minutes” before he was moved to the hospital, Keir Radnedge, a columnist at World Soccer Magazine, told CNN Saturday.

    “This was towards the end of extra time in the match. Suddenly, colleagues up to my left started shouting for medical assistance. Obviously, someone had collapsed. Because the chairs are freestanding, people were able to move the chairs, so it’s possible to create a little bit of space around him,” Radnedge said.

    He added that the medical team were there “pretty quickly and were able to, as best they could, give treatment.”

    White House Press Secretary Karine Jean-Pierre reacted to Wahl’s death on Saturday, adding that senior State Department officials were in touch with Qatari officials and Grant’s family.

    “Grant Wahl was an inspiration to many. Our thoughts are with his wife Dr. Céline Gounder and all those who loved him. State Department officials are in touch with Grant’s family and with senior officials in the government of Qatar to ensure his family gets the support they need,” Jean-Pierre wrote on Twitter.

    “Only some days ago, Grant was recognized by FIFA and AIPS (the International Sports Press Association) for his contribution to reporting on eight consecutive FIFA World Cups,” said FIFA President Gianni Infantino in a statement.

    Infantino and FIFA media director Bryan Swanson were at the hospital on Saturday to offer any kind of support needed for the family, friends, and the journalists who were also his housemates in Qatar.

    The co-editors in chief of Sports Illustrated, the publication where Wahl spent the majority of his career, said in a joint statement they were “shocked and devastated at the news of Grant’s passing.”

    “We were proud to call him a colleague and friend for two decades – no writer in the history of (Sports Illustrated) has been more passionate about the sport he loved and the stories he wanted to tell,” said the statement.

    It added that Wahl had first joined the publication in November 1996. He had volunteered to cover the sport as a junior reporter – back before it reached the heights of global popularity it now enjoys – eventually becoming “one of the most respected soccer authorities in the world,” it said.

    The statement said that Wahl also worked with other media outlets including Fox Sports. After leaving Sports Illustrated in 2020, he began publishing his podcast and newsletter.

    Other current and former US soccer players, including Ali Krieger and Tony Meola, shared their condolences, as did sporting bodies such as Major League Soccer and the National Women’s Soccer League.

    Wittyngham, Wahl’s podcast co-host, told CNN on Saturday the news of his death had been hard to fathom.

    “For Americans, Grant Wahl is the first person you read covering soccer. He was kind of the only person for a while … Grant was the first person who really paid genuine attention to this sport in a meaningful way,” Wittyngham said.

    Several journalists shared stories of reporting alongside Wahl, and having encountered him at multiple World Cups over the years.

    “Before he became the best covering soccer he did hoops and was so kind to me,” wrote famed broadcaster Dick Vitale.

    Timmy T. Davis, the US Ambassador to Qatar, tweeted that Wahl was “a well known and greatly respected reporter who focused on the beautiful game.”

    “The entire US Soccer family is heartbroken to learn that we have lost Grant Wahl,” US Soccer said in a statement on its official Twitter account.

    “Grant made soccer his life’s work, and we are devastated that he and his brilliant writing will no longer be with us.”

    US Soccer praised Wahl’s passion and “belief in the power of the game to advance human rights,” and shared its condolences with Wahl’s wife, Celine Gounder, and his loved ones.

    Gounder also posted the US Soccer statement on Twitter.

    “I am so thankful for the support of my husband Grant Wahl’s soccer family and of so many friends who’ve reached out tonight. I’m in complete shock,” wrote Gounder, a former CNN contributor who served on the Biden-Harris transition Covid-19 advisory board.

    US State Department spokesperson Ned Price said the department was in “close communication” with Wahl’s family. The World Cup organizers also said they were in touch with the US embassy “to ensure the process of repatriating the body is in accordance with the family’s wishes.”

    Wahl wearing a rainbow-colored t-shirt while working at Qatar 2022.

    Wahl had covered soccer for more than two decades, including 11 World Cups — six men’s, five women’s – and authored several books on the sport, according to his website.

    He had just celebrated his birthday earlier this week with “a great group of media friends at the World Cup,” according to a post on his official Twitter account, which added: “Very thankful for everyone.”

    In an episode of the podcast Futbol with Grant Wahl, published days before his death on December 6, he had complained of feeling unwell.

    “It had gotten pretty bad in terms of like the tightness in my chest, tightness, pressure. Feeling pretty hairy, bad,” Wahl told co-host Chris Wittyngham in the episode. He added that he sought help at the medical clinic at the World Cup media center, believing he had bronchitis.

    He was given cough syrup and ibuprofen, and felt better shortly afterward, he said.

    Wahl also said he experienced an “involuntary capitulation by my body and mind” after the US-Netherlands game on December 3.

    “This isn’t my first rodeo. I’ve done eight of these on the men’s side,” he said at the time. “And so like, I’ve gotten sick to some extent at every tournament, and it’s just about trying to find a way to like get your work done.”

    He further described the incident in a recent newsletter published on December 5, writing that his body had “broke down” after he had little sleep, high stress and a heavy workload. He’d had a cold for 10 days, which “turned into something more severe,” he wrote, adding that he felt better after receiving antibiotics and catching up on sleep.

    Wahl had made headlines in November by reporting that he was detained and briefly refused entry to a World Cup match because he was wearing a rainbow t-shirt in support of LGBTQ rights.

    He said security staff had told him to change his shirt because “it’s not allowed,” and had taken his phone. Wahl said he was released 25 minutes after being detained and received apologies from a FIFA representative and a senior member of the security team at the stadium.

    Afterward, Wahl told CNN he “probably will” wear the shirt again.



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    Inside Christine McVie’s and Stevie Nicks’ decades-long friendship | CNN

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    CNN
     — 

    Throughout the various personal turmoils for which the members of Fleetwood Mac are known, one relationship buoyed the band for decades: the friendship between its two frontwomen, Christine McVie and Stevie Nicks.

    McVie joined the band in 1970 during one of its early lineup changes and for years was its only woman. When Nicks was added to the lineup in 1975, the two became fast friends.

    Theirs was not a competitive relationship, but a sisterly one – both women were gifted songwriters responsible for crafting many of the band’s best-known tunes. Though the two grew apart in the 1980s amid Nicks’ worsening drug addiction and the band’s growing internal tension, they came back together when McVie returned to Fleetwood Mac in 2014.

    At a concert in London, shortly before McVie officially rejoined the band, Nicks dedicated the song “Landslide” to her “mentor. Big sister. Best friend.” And at the show’s end, McVie was there, accompanying her bandmates for “Don’t Stop.”

    “I never want her to ever go out of my life again, and that has nothing to do with music and everything to do with her and I as friends,” Nicks told the Minneapolis Star-Tribune in 2015.

    On Wednesday, McVie, the band’s “songbird,” died after a brief illness at age 79. Below, revisit McVie’s and Nicks’ years-long relationship as bandmates, best friends and “sisters.”

    The story of Nicks joining Fleetwood Mac is legend now: Band founder and drummer Mick Fleetwood wanted to recruit guitarist Lindsey Buckingham, who stipulated that he would only join if his girlfriend and musician Nicks could join, too. McVie cast the deciding vote, and the rest is history.

    “It was critical that I got on with her because I’d never played with another girl,” McVie told the Guardian in 2013. “But I liked her instantly. She was funny and nice but also there was no competition. We were completely different on the stage to each other and we wrote differently too.”

    Throughout the band’s many personal complications – McVie married and divorced Fleetwood Mac bassist John McVie and had an affair with the band’s lighting director, while Nicks had rollercoaster romances with Buckingham and Fleetwood – they were each other’s center.

    “To be in a band with another girl who was this amazing musician – (McVie) kind of instantly became my best friend,” Nicks told the New Yorker earlier this year. “Christine was a whole other ballgame. She liked hanging out with the guys. She was just more comfortable with men than I had ever been.”

    The two protected each other, Nicks said, in a male-dominated industry: “We made a pact, in the very beginning, that we would never be treated with disrespect by all the male musicians in the community.

    “I would say to her, ‘Together, we are a serious force of nature, and it will give us the strength to maneuver the waters that are ahead of us,’” Nicks told the New Yorker.

    “Rumours” was the band’s greatest success to date when it was released in 1977. But the band’s relationships with each other were deteriorating, save for the one between McVie and Nicks. While the pair were enduring breakups with their significant others, Nicks and McVie spent their time offstage together.

    The Guardian asked McVie if she was trying to offset the band’s tumult with her songs on “Rumours,” including the lighthearted “You Make Lovin’ Fun” and optimistic “Don’t Stop.” She said she likely had been.

    As multiple members’ drug use intensified, the band’s dynamic grew tense. McVie distanced herself from the group in 1984 amid her bandmates’ addictions, telling the Guardian she was “just sick of it.” Nicks, meanwhile, was becoming dependent on cocaine.

    After Fleetwood Mac was inducted into the Rock & Roll Hall of Fame in 1998, Christine McVie (third from left) quit the band.

    McVie told Rolling Stone that year that she’d grown apart from Nicks: “She seems to have developed her own fantasy world, somehow, which I’m not part of. We don’t socialize much.”

    In 1986, Nicks checked into the Betty Ford Center to treat her addiction, though she later became addicted to Klonopin, which she said claimed years of her life. She quit the prescription drug in the 1990s.

    After recording some solo works, McVie returned to Fleetwood Mac for their 1987 album “Tango in the Night,” and two of her songs on that record – “Little Lies” and “Everywhere” – became major hits. But Nicks departed the band soon after, and the band’s best-known lineup wouldn’t officially reunite until 1997 for “The Dance” tour and subsequent live album.

    The reunion was short-lived: After the band was inducted into the Rock & Roll Hall of Fame in 1998, McVie officially quit Fleetwood Mac, citing a fear of flying and exhaustion of life on the road.

    In the 2010s, after more than a decade of retirement, McVie toyed with returning to performing. She officially rejoined Fleetwood Mac after calling Fleetwood himself and gauging what her return would mean for the group.

    “Fortunately Stevie was dying for me to come back, as were the rest of the band,” she told the Arts Desk.

    In 2015, a year after she’d rejoined Fleetwood Mac, McVie hit the road with her bandmates. Touring with the group was tiring but fun, the first time they’d performed together in years.

    “I’m only here for Stevie,” she told the New Yorker that year.

    Christine McVie (left) and Stevie Nicks perform together at Radio City Music Hall in 2018.

    Nicks concurred: “When we went on the road, I realized what an amazing friend she’d been of mine that I had lost and didn’t realize the whole consequences of it till now,” she told the Minneapolis Star-Tribune in 2015.

    During that tour, McVie wore a silver chain that Nicks had given her – a “metaphor,” McVie told the New Yorker, “that the chain of the band will never be broken. Not by me, anyways. Not again by me.”

    McVie told the Arts Desk in 2016 that she and Nicks were “better friends now than (they) were 16 years ago.”

    Touring with Buckingham and Fleetwood could quickly get tumultuous for Nicks, McVie said, due to their shared history. “But with me in there, it gave Stevie the chance to get her breath back and not have this constant thing going on with Lindsey: her sister was back,” she said.

    Their mutual praise continued: In 2019, McVie said Nicks was “just unbelievable” onstage: “The more I see her perform on stage the better I think she is. She holds the fort.”

    When their 2018-2019 tour ended, though – without Buckingham, who was fired – the band “kind of broke up,” McVie told Rolling Stone earlier this year. She added that she didn’t speak with Nicks as often as she did when they toured together.

    As for a reunion, McVie told Rolling Stone that while it wasn’t off the table, she wasn’t feeling “physically up for it.”

    “I’m getting a bit long in the teeth here,” she said. “I’m quite happy being at home. I don’t know if I ever want to tour again. It’s bloody hard work.”

    News of McVie’s death rattled Nicks, who wrote that she had only found out McVie was sick days earlier. She called McVie her “best friend in the whole world since the first day of 1975.”

    On her social media accounts, Nicks shared a handwritten note containing lyrics from the Haim song “Hallelujah,” some of which discusses grief and the loss of a best friend.

    “See you on the other side, my love,” Nicks wrote. “Don’t forget me – Always, Stevie.”



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    ‘Living in despair and hopelessness’: A lack of affordable housing can put people’s health at risk | CNN

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    KHN
     — 

    When Louana Joseph’s son had a seizure because of an upper respiratory infection in July, she abandoned the apartment her family had called home for nearly three years.

    She suspected the gray and brown splotches spreading through the apartment were mold and had caused her son’s illness. Mold can trigger and exacerbate lung diseases such as asthma and has been linked to upper respiratory tract conditions.

    But leaving the two-bedroom Atlanta apartment meant giving up a home that rented for less than $1,000 a month, a price that is increasingly hard to find even in the nation’s poorest neighborhoods.

    “I am looking everywhere,” said Joseph, who is 33. “Right now, I can’t afford it.”

    Since then, Joseph, her 3-year-old son, and infant daughter have teetered on the edge of homelessness. They have shuffled between sleeping in an extended-stay motel and staying with relatives, unsure when they might find a permanent place to live.

    A nationwide affordable housing crisis has wreaked havoc on the lives of low-income families, like Joseph’s, who are close to the brink. Their struggle to stay a step ahead of homelessness is often invisible.

    Rents soared during the pandemic, exacerbating an already-severe shortage of available housing in most U.S. cities. The result will be growing numbers of people stuck in substandard housing, often with environmental hazards that put them at higher risk for asthma, lead poisoning, and other medical conditions, according to academic researchers and advocates for people with low incomes. These residents’ stress levels are heightened by the difficulties they face paying rent.

    “People are living in despair and hopelessness,” said Ma’ta Crawford, a member of the Human Relations Commission in Greenville County, South Carolina, who works with families living in extended-stay motels.

    Housing instability — such as having trouble paying rent, living in crowded conditions, or moving frequently — can have negative consequences on health, according to the federal Office of Disease Prevention and Health Promotion.

    In addition to potentially facing environmental risks, people who struggle with housing insecurity put off doctor visits, can’t afford food, and have trouble managing chronic conditions.

    Losing a home can also trigger a mental health crisis. The suicide rate doubled from 2005 to 2010, when foreclosures, including those on rental properties, were historically high, according to a 2014 analysis, published in the American Journal of Public Health, that looked at 16 states.

    Rents jumped 18% nationally from the first three months of 2021 to early 2022. And there is no county in the country where a minimum-wage worker could afford a two-bedroom rental home, according to an August report from the National Low Income Housing Coalition. Nationwide, only 36 affordable housing units are available for every 100 people in need, forcing many families to cobble together temporary shelter.

    “It’s a vicious cycle,” Crawford said. “Every motel here has a school bus stop.”

    In the Southeast, evictions are more common than anywhere else in the nation, says an analysis published this year in the Proceedings of the National Academy of Sciences.

    Georgia has 19 evictions for every 100 renter households, according to data from the Eviction Lab at Princeton University. There are 23 evictions for every 100 renter households in South Carolina, and Virginia has 15 evictions per 100 renter households. The national rate is about eight evictions per 100.

    Despite President Joe Biden’s promises to address the affordable housing shortage, researchers and activists say inflation — and Democratic deal-making — is only worsening the health threat.

    Last year, the Biden administration included billions of dollars in the “Build Back Better” bill to increase the number of Housing Choice vouchers — a difficult-to-get benefit that helps people with low incomes pay rent. Under the voucher program, also known as Section 8, recipients put 30% of their income toward rent, and the federal government pays the remainder. Currently only 1 in 4 people who qualify receive the vouchers because of limited funding.

    But lawmakers stripped out the provision that raised the number of vouchers, a compromise to pass the bill that became known as the Inflation Reduction Act.

    About 2.3 million households rely on the program to help pay rent. Joseph applied years ago but has yet to receive any benefits.

    The day before her son was born in September 2019, Joseph moved into an apartment complex in southwestern Atlanta, one of the poorest sections of the city. A year later, she upgraded to a two-bedroom unit in the same complex that cost $861 a month, far less than the typical apartment in metro Atlanta.

    Recently, Joseph returned to the two-bedroom apartment to show KHN its condition. What appeared to be mold surfaced after a pipe burst and the air conditioning broke, but the complex owners did little to fix the situation, Joseph said.

    The gray and brown splotches were on her mattress, sofa, and other plastic-wrapped belongings. They covered boxes of diapers stacked on dressers, an Elmo doll lying facedown, a child’s sneaker, and pink onesies.

    After a pipe burst and the air conditioning broke in Louana Joseph's apartment, gray and black splotches covered a ventilation grille.

    A property manager at Seven Courts Apartments, where Joseph lived, declined to comment when reached by phone. The management company did not respond to repeated requests for comment.

    A few months after leaving the apartment, Joseph and her two children moved in with her sister in Orlando, Florida, with their remaining possessions — a car and some clothes.

    A lack of affordable housing can force families with low incomes, like Joseph’s, to endure health risks such as mold, vermin, and water leaks, said Alex Schwartz, a housing expert at the New School in New York City. And the trauma of evictions, foreclosures, and homelessness can undermine physical and mental well-being, Schwartz said.

    For five years, Nancy Painter lived in an apartment in Greenville, South Carolina, that had mold and cracks in the walls, ceiling, and floor. Sometimes, Painter said, she carried a can of bug killer in both hands to fend off roaches.

    An autoimmune disease makes her extremely susceptible to colds and other respiratory illnesses, and arthritis causes her crippling pain. But she stayed in the apartment until last year because the rent was $325 a month. Painter moved out only after the landlord made plans to renovate the unit and raise the rent.

    Painter, 64, now lives on about $1,100 in Social Security disability benefits. Her poor health left her unable to keep working in a fast-food job. She pays more than 70% of her income for a room in a house she shares with other adults who can’t find affordable housing.

    Such renters should put no more than 30% of their income toward housing so they have enough left over for other basic needs, according to federal government formulas. “My options are so slim,” Painter said. “All I want is a small place where I can have a garden.”

    In August, Louana Joseph's son, M.J., developed an upper respiratory infection that his mother suspects was caused by mold that was spreading in their apartment.

    The problems are especially acute among Black people and other groups that have been denied good jobs, mortgages, and opportunities long beyond the Jim Crow era, said Dr. Steven Woolf, a professor of population health and health equity at Virginia Commonwealth University. Life expectancy can vary by 15 to 20 years between different neighborhoods in the same city, he said.

    Federal lawmakers routinely fail to prioritize the nearly 50-year-old housing voucher program, said Kirk McClure, a professor emeritus of urban planning at the University of Kansas. The U.S. offers less help with housing than do other rich countries, like the United Kingdom and Australia, where voucher programs allow everyone who meets income requirements to get help, McClure said.

    “In the wealthiest society in the world, we could give every poor person a voucher,” McClure said. “This doesn’t require anything magical.”

    Officials from the U.S. Department of Housing and Urban Development, which oversees the voucher program, did not respond when asked whether the administration planned to push for more housing vouchers.

    Joseph’s prospects of finding another home remain dim as rents skyrocket.

    The fair-market rent — which is determined annually by the federal government based on a rental home’s size, type, and location — for a two-bedroom home in the U.S. reached $1,194 a month, on average, in 2019, according to a 2020 report from the National Low Income Housing Coalition. A family of four living on poverty-level income could afford $644 a month, the report said. In the city of Atlanta, the median rent for apartments of all sizes is $2,200, up nearly 30% since January 2021, according to the real estate website Zillow.

    A lack of child care has kept Joseph from pursuing full-time jobs. But she can’t qualify for one state child care assistance program since she doesn’t have full-time employment, and another state program she sought out won’t have openings until next year.

    She sued the Seven Courts Apartments’ owner in small claims court in June for $5,219 to compensate her for the ruined belongings and rent she has already paid. A settlement could allow her to move into a new home.

    “I am stuck because I have nowhere else to go,” Joseph said.

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