Sunday, May 29, 2022

Lack of affordable childcare is still a burden for plastic surgery residents – Especially women


Peer-Reviewed Publication

WOLTERS KLUWER HEALTH

May 27, 2022 – Plastic surgery residents face persistent barriers accessing affordable childcare, with high costs and a major impact on surgical training – with most of the burden falling on women residents, reports a paper in the June issue of Plastic and Reconstructive Surgery®the official medical journal of the American Society of Plastic Surgeons (ASPS). Plastic and Reconstructive Surgery® is published in the Lippincott portfolio by Wolters Kluwer.

"Training institutions are not meeting the childcare needs of plastic surgery trainees," according to the survey study by Chelsea Cernosek Wallace, MD, and colleagues of University of Kentucky, Lexington. "If we wish to recruit and retain the top applicants, we must improve the childcare accommodations for residents."

Childcare carries high costs and impacts training for plastic surgery trainees

The researchers sent an anonymous survey to current plastic surgery residents. The survey focused on current childcare accommodations and availability, along with attitudes and issues surrounding childrearing during residency.

Of 32 residents responding to the survey, 21 were women. Thirty-eight percent of respondents had at least one child. Of these, 75% of men reported that their spouse was the primary source of childcare, compared to 12% of women.

"One hundred percent of respondents with children reported childcare creates a financial burden," Dr. Wallace and colleagues write. Median costs of childcare per child were $2,150 per month, or $25,800 per year. For married residents, median gross household income was $109,000 per year – thus these couples were paying nearly one-fourth of their income for childcare. Because of their inflexible work hours and the limited hours of daycare facilities, many residents had to use a nanny or other in-home child care.

None of the residents with children said their institution provided access to on-site childcare – but 75% said they would use this service if it were available. Most residents said that their institution didn't provide flexibility to accommodate childcare needs. Women residents were twice as likely to miss work due to problems with childcare arrangements, compared to men.

Two-thirds of women residents said that if they were choosing a plastic surgery training program, the availability of on-site childcare would influence their decision. One fourth of women residents with children said they had seriously considered leaving their residency program due to difficulties with childcare accommodations.

The challenges of raising children during plastic surgery residency have long been recognized. A 1994 editorial in Plastic and Reconstructive Surgery highlighted the need for adequate childcare facilities to promote a productive return to work. "Unfortunately, [more than] 25 years later, the lack of accessible and affordable childcare remains a dilemma faced by many plastic surgery trainees," the researchers write.

Noting the disproportionately high burden on women residents, Dr. Wallace and colleagues conclude: "[F]ailing to provide adequate access to affordable, reliable childcare truly creates a gender disparity, resulting in a negative impact on plastic surgery training....All institutions with plastic surgery residency programs should provide affordable, accessible childcare that accommodates the 24-hour natures of both patient care and parenthood."

Click here to read “Parenting in Plastic Surgery Residency“

DOI: 10.1097/PRS.0000000000009134

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About Plastic and Reconstructive Surgery

For over 75 years, Plastic and Reconstructive Surgery® (http://www.prsjournal.com/) has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair and cosmetic surgery, as well as news on medico-legal issues.

About ASPS

The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.

About Wolters Kluwer

Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

Wolters Kluwer reported 2020 annual revenues of €4.6 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,200 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

For more information, visit www.wolterskluwer.com, follow us on TwitterFacebookLinkedIn, and YouTube.

Comparing cancer-related spending, mortality rates in high-income countries

THE MOST EXPENSIVE HEALTHCARE MONEY CAN BUY

JAMA Health Forum

Peer-Reviewed Publication

JAMA NETWORK

About The Study: Researchers found in this study of 22 high-income countries that cancer care spending in 2020 was not associated with age-standardized cancer mortality rates, and that although the United States spent more on cancer care than any other country, this expenditure was not associated with substantially lower cancer mortality rates.

Authors: Cary P. Gross, M.D., of the Yale School of Medicine in New Haven, Connecticut, is the corresponding author.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamahealthforum.2022.1229)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

#  #  #

Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jama-health-forum/fullarticle/10.1001/jamahealthforum.2022.1229?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=052722

About JAMA Health Forum: JAMA Health Forum has transitioned from an information channel to an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.

FOR PROFIT HEALTHCARE USA

Analysis of household catastrophic health care expenditures associated with chronic disease

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK

About The Study: Changes in catastrophic health care expenditures associated with chronic diseases in U.S. households from 2008 to 2018 were evaluated in this study.

Authors: Young-Rock Hong, Ph.D., M.P.H., of the University of Florida in Gainesville, is the corresponding author.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/ 

(doi:10.1001/jamanetworkopen.2022.14923)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

#  #  #

Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2022.14923?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=052722

About JAMA Network Open: JAMA Network Open is the new online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.

Examining association of registered nurse staffing with mortality risk of older patients with sepsis

JAMA Health Forum

Peer-Reviewed Publication

JAMA NETWORK

About The Study: The results of this analysis of 1,958 acute care hospitals and 702,000 patients suggest that hospitals that provide more registered nurse hours of care could likely decrease the likelihood of mortality in Medicare patients with sepsis.

Authors: Jeannie P. Cimiotti, Ph.D., of Emory University in Atlanta, is the corresponding author.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamahealthforum.2022.1173)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

#  #  #

Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jama-health-forum/fullarticle/10.1001/jamahealthforum.2022.1173?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=052722

About JAMA Health Forum: JAMA Health Forum has transitioned from an information channel to an international, peer-reviewed, online, open access journal that addresses health policy and strategies affecting medicine, health and health care. The journal publishes original research, evidence-based reports and opinion about national and global health policy; innovative approaches to health care delivery; and health care economics, access, quality, safety, equity and reform. Its distribution will be solely digital and all content will be freely available for anyone to read.

Legislation focused on obscenity and indecency will not help to keep children safe online, expert warns


Meeting Announcement

UNIVERSITY OF EXETER

Laws that are premised on the traditional notions of obscenity and indecency will not help to keep children safe online, a leading expert has warned.

Existing laws that are reliant on a standard of ‘morality’ and obscenity have proven to be ineffective for regulating adult pornography on the internet. They should instead be based around child protection and keeping them away from adult online content, Professor Abhilash Nair from the University of Exeter Law School said at the euCONSENT conference in Athens.

Regulation of lawful adult pornography should focus on access rather than content, he told delegates.

Professor Nair said: “Attempting to transpose traditional laws that centre on the obscenity and indecency of images is simply inappropriate for the internet. Laws that rely on moralistic notions of obscenity and indecency of images will not command the obedience or respect of cyberspace communities.

“We need to prevent children’s access to adult content. Any regulatory framework that has content controls premised on notions of obscenity and indecency, that interferes with the right of adults to consume content, will not succeed in cyberspace.

“The primary purpose of the law should be to ensure children do not access adult content, without hindering the rights of adults to access lawful pornography. It is a delicate balance that the law has failed to strike for nearly three decades in cyberspace. This balance can be achieved only by access-focused regulation, rather than content-focused regulation.”

Professor Nair is currently leading the academic research for the European Commission-funded euCONSENT research project, which aims to create an interoperable solution for age verification and parental consent for child protection on the internet.

At the conference he also warned the lack of regulation on adult pornography in the USA means there is little chance for other countries to rely on traditional obscenity laws to exert any meaningful control to regulate its access within their local jurisdictions.

Professor Nair’s research suggests age verification, whilst envisaged as one of the legitimate measures of protecting children online from harmful content in European legislation (Audiovisual Media Services Directive), has not been effectively used so far and children continue to have unfettered access to pornography, pointing to a potential lacuna in the law. 

He said: “Age verification is not a silver bullet for child protection or a substitute for parental/carer responsibility. The law envisages that other appropriate measures are in place to facilitate parental control, such as age ratings, age-gating options or filters, for content that poses a lower risk to children, but harmful content such as pornography calls for stricter measures encompassing age verification. It is also crucially important that age verification solutions are privacy preserving and secure so that adults can continue to exercise their rights to consume lawful pornography online.”

 

Critical race theory at center of UW study of unequal access to treatment for opioid addiction

Grant and Award Announcement

UNIVERSITY OF WASHINGTON

Opioid use disorder is an addiction crisis in the United States that has become increasingly lethal during the COVID-19 pandemic. To preserve access to life-saving treatment during the pandemic, federal drug agencies loosened requirements on physicians for treating these patients, including moving patient evaluations away from in-person exams to telemedicine.

This federal policy change focused primarily on buprenorphine, a highly effective treatment for opioid use disorder and one that is much less onerous and stigmatizing than methadone, the other most common but heavily monitored treatment. 

With a $2.5 million National Institutes of Health grant, researchers at the University of Washington will explore one of the most important questions related to this emergency policy change: whether those changes helped with another opioid-related crisis — the unequal access experienced by Black and Latinx patients to buprenorphine.

“There are a lot of clinical champions these days who think buprenorphine should be offered routinely in primary care to people who have opioid use disorder, and this policy change helps that,” said Emily Williams, professor of health systems and population health in UW School of Public Health. “However, we’ve seen systematically that Black and Latinx patients were much less likely to get the less-stigmatized buprenorphine than white patients.”

Williams and co-principal investigator Jessica Chen, assistant professor of psychiatry and behavioral sciences at the UW School of Medicine, want to find out if this inequity remained, improved or potentially got worse under the new policies since telemedicine itself can be a barrier to access. The researchers, who also have appointments at the Denver-Seattle Center of Innovation for Veteran-Centered Value-Driven Care, will use national data from U.S. Veterans Affairs to explore this question. 

“I work primarily in a chronic pain clinic. We’ve known for a long time that pain is undertreated among certain racial minority populations. That’s really clear,” said Chen. “And what is becoming increasingly obvious to us as a country is that opioid use disorder is a huge epidemic, and what I am seeing is that the life-saving treatments we have for opioid use disorder are also being under-received by patients of color and other minoritized groups.”

To understand how and why these disparities exist, the researchers will undertake a unique study effort to use critical race theory and its related public health praxis developed by Chandra Ford, UCLA, and Collins Airhihenbuwa, Georgia State University, to “examine the structural mechanisms of disparities” in treating opioid use disorder, the researchers stated in their grant application.

“This situation provides an excellent opportunity to begin applying critical race theory and the practice of ‘centering the margins’ into a research design that focuses on the lived experiences of marginalized populations,” Williams said. “A lot of research focuses on what is happening for minoritized groups relative to white people and then figuring out those mechanisms. But when we center the margins, we’re caring specifically about what’s happening to these minoritized groups that are not getting what they need.”

The researchers plan to conduct phone interviews with Black and Latinx patients for this part of the study. They intend to look beyond the health care system and into patients’ communities to learn more about the policies society has enacted that affect them. For example, the war on drugs is a policy initiated by President Nixon in 1971 that has differentially impacted minoritized communities, including in ways that serve as barriers to adequate substance use treatment. 

“One of the key variables we are looking at is differential police presence in communities as one of the things that might modify community members’ ability to access buprenorphine versus methadone,” said Chen. “The more that any specific behavior is criminalized, the more that we expect that people will go through the court system and a treatment pathway that involves a lot of monitoring, as methadone does. Then of course that treatment itself becomes more disruptive of the person’s life, which then has impacts for family, as well as economic and occupational opportunities.”

The researchers hope their findings will show who benefited from easier access to buprenorphine and whether those temporary policy changes to access should be made permanent. They also hope to encourage the larger health care system to review and change the social policies that have such a big impact on individual outcomes.

“There are just so many horrible and sad ways that our society is structured to limit access to resources for some groups and to privilege others,” Williams said, “And the way that trickles into health care and in particular care for stigmatized conditions like opioid use disorder is, for me, heartbreaking.”

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For more information, contact Williams at emwilli@uw.edu and Chen at chenj4@uw.edu


Fastest carbon dioxide catcher heralds new age for direct air capture

New carbon sorbent is 99% efficient, lightning fast, and easily recyclable

Peer-Reviewed Publication

TOKYO METROPOLITAN UNIVERSITY

New DAC system based on liquid-solid phase separation. 

IMAGE: ATMOSPHERIC AIR WITH LOW CONCENTRATIONS OF CARBON DIOXIDE IS PASSED THROUGH AN AQUEOUS SOLUTION OF IPDA, WHERE THE CARBON DIOXIDE RAPIDLY REACTS TO CREATE A SOLID PRODUCT. CARBON DIOXIDE IS SUBSEQUENTLY RE-RELEASED WITH MILD HEATING OF THE PRODUCT IN SUSPENSION, FOR STORAGE OR NEW APPLICATIONS. view more 

CREDIT: TOKYO METROPOLITAN UNIVERSITY

Tokyo, Japan – Researchers from Tokyo Metropolitan University have developed a new carbon capture system which removes carbon dioxide directly from the atmosphere with unprecedented performance. Isophorone diamine (IPDA) in a “liquid-solid phase separation” system was found to remove carbon dioxide at the low concentrations contained in the atmosphere with 99% efficiency. The compound is reusable with minimal heating and at least twice as fast as existing systems, an exciting new development for direct air capture.

The devastating effects of climate change are being felt around the world, with an urgent need for new policies, lifestyles and technologies that will lead to reduced carbon emissions. However, many scientists are looking further ahead than a net-zero emission goal, to a future “beyond zero” where we can actively reduce the amount of carbon dioxide in the atmosphere. The field of carbon capture, the removal and subsequent storage or conversion of carbon dioxide, is developing rapidly, but hurdles remain before it can be deployed at scale.

The biggest challenges come from efficiency, particularly in processing atmospheric air directly in so-called direct air capture (DAC) systems. The concentrations of carbon dioxide are such that chemical reactions with sorbents are very slow. There is also the difficulty of getting the carbon dioxide out again in more sustainable capture-and-desorption cycles, which can be very energy intensive in itself. Even leading efforts to build DAC plants, such as those using potassium hydroxide and calcium hydroxide, suffer serious efficiency issues and recovery costs, making the hunt for new processes notably urgent.

A team led by Professor Seiji Yamazoe of Tokyo Metropolitan University have been studying a class of DAC technology known as liquid-solid phase separation systems. Many DAC systems involve bubbling air through a liquid, with a chemical reaction occurring between the liquid and the carbon dioxide. As the reaction proceeds, more of the reaction product accumulates in the liquid; this makes subsequent reactions slower and slower. Liquid-solid phase separation systems offer an elegant solution, where the reaction product is insoluble and comes out of solution as a solid. There is no accumulation of product in the liquid, and the reaction speed does not slow down much.

The team focused their attention on liquid amine compounds, modifying their structure to optimize reaction speed and efficiency with a wide range of concentrations of carbon dioxide in air, from around 400ppm to up to 30%. They found that an aqueous solution of one of these compounds, isophorone diamine (IPDA), could convert 99% of the carbon dioxide contained in the air to a solid carbamic acid precipitate. Crucially, they demonstrated that the solid dispersed in solution only required heating to 60 degrees Celsius to completely release the captured carbon dioxide, recovering the original liquid. The rate at which carbon dioxide could be removed was at least twice as fast as that of the leading DAC lab systems, making it the fastest carbon dioxide capture system in the world at present for processing low concentration carbon dioxide in air (400ppm).

The team’s new technology promises unprecedented performance and robustness in DAC systems, with wide implications for carbon capture systems deployed at scale. Beyond improving their system further, their vision of a “beyond zero” world now turns to how the captured carbon may be effectively used, in industrial applications and household products.

This work was supported by Project Number P14004 of the New Energy and Industrial Technology Development Organization (NEDO).

ELDERADO
FBI records on search for fabled gold raise more questions

By MICHAEL RUBINKAM

FILE - FBI agents and representatives of the Pennsylvania Department of Conservation and Natural Resources set up a base in March, 2018, in Benezette Township, Elk County, Pa. A scientific report commissioned by the FBI shortly before agents went digging for buried treasure suggested that a huge quantity of gold was below the surface, according to newly released government documents. 
(Katie Weidenboerner/The Courier-Express via AP, File)


A scientific analysis commissioned by the FBI shortly before agents went digging for buried treasure suggested that a huge quantity of gold could be below the surface, according to newly released government documents and photos that deepen the mystery of the 2018 excavation in remote western Pennsylvania.

The report, by a geophysicist who performed microgravity testing at the site, hinted at an underground object with a mass of up to 9 tons and a density consistent with gold. The FBI used the consultant’s work to obtain a warrant to seize the gold — if there was any to be found.

The government has long claimed its dig was a bust. But a father-son pair of treasure hunters who spent years hunting for the fabled Civil War-era gold — and who led agents to the woodland site, hoping for a finder’s fee — suspect the FBI double-crossed them and made off with a cache that could be worth hundreds of millions of dollars.

The newly revealed geophysical survey was part of a court-ordered release of government records on the FBI’s treasure hunt at Dent’s Run, about 135 miles (220 kilometers) northeast of Pittsburgh, where legend says an 1863 shipment of Union gold was either lost or stolen on its way to the U.S. Mint in Philadelphia.

Dennis and Kem Parada, who co-own the treasure-hunting outfit Finders Keepers, successfully sued the Justice Department for the records after being stonewalled by the FBI. Finders Keepers provided the FBI records to The Associated Press. The FBI subsequently posted them on its website.

The technical survey data collected by geophysical consulting firm Enviroscan gave credence to the treasure hunters’ own extensive fieldwork at the site — and prompted the FBI to excavate in a massive, secretive operation that lasted for several frigid days in late winter of 2018.

John Louie, a geophysics professor at the University of Nevada, Reno, unconnected to the dig, reviewed Enviroscan’s report at the request of the AP and said the firm’s “methods were very good,” and “their conclusions represent a physically reasonable hypothesis” that gold was buried at the site.

But he cautioned the subsurface gravity anomaly that Enviroscan identified did not definitively establish the presence of gold. There are other technical reasons why Enviroscan’s data could have turned out the way it did, Louie said.

“Thus, it is also entirely reasonable that the FBI did not find anything at the site, because there was not really any gold there,” he said via email.

Enviroscan co-founder Tim Bechtel declined to comment about his work at Dent’s Run, saying the FBI has not given him permission to talk. The FBI would not discuss Bechtel this week but said that after the dig, agents “did not take any subsequent steps to reconcile the geophysical-survey findings with the absence of gold or any other metal.”

Other documents in the just-released FBI case file raise still more questions.

A one-paragraph FBI report, dated March 13, 2019 — exactly one year after the dig — asserted agents found nothing at Dent’s Run. No “metals, items, and/or other relevant materials were found,” the report said. “Due to other priority work ... the FBI will close the captioned case.”

Anne Weismann, a lawyer for Finders Keepers, cast doubt on the FBI report’s credibility. She cited its brevity, as well as its timing — it was written after Finders Keepers began pressing the government for records.

“It does not read like one would expect,” said Weismann, a former Justice Department lawyer. “If that is the official record in the file of what they did and why they did it, it says almost nothing, and it’s crazy.”

She added that if the government does not produce a fuller, more contemporaneous accounting of its search for the gold, it “will heighten my view that this is not an accurate record and this was created as a cover-up. And I don’t say that lightly.”

In response, the FBI said the single-page document “is representative of the standard summaries filed when formally closing an FBI investigation.”

The agency has consistently denied it found anything.

Agents acted on information that Dent’s Run “may have been a cultural heritage site containing gold belonging to the United States government,” the FBI said in a statement, but “that possibility was not borne out by the excavation. The FBI continues to unequivocally reject any claims or speculation to the contrary.”

The trove of documents turned over to Finders Keepers also included nearly 1,000 photos, in grainy black-and-white, that show some — but certainly not all — of what the FBI was doing at the dig site, according to the treasure hunters.

Residents have previously told of hearing a backhoe and jackhammer overnight between the first and second days of the dig — when the work was supposed to have been paused — and seeing a convoy of FBI vehicles, including large armored trucks.

The FBI denied any work took place at the site after hours, saying the “only nighttime activity was ATV patrols by FBI Police personnel, who secured the site around the clock for the duration of the excavation.”

Parada suspects the FBI retrieved the gold in the middle of the night and then showed the treasure hunters an empty hole on the afternoon of the second day.

“It’s very curious why the FBI is going to such an extent to misdirect and be so obstructionist on this,” said Warren Getler, who has worked closely with the treasure hunters. “They worked that night under cover of darkness to evade, escape our knowledge of something we’re supposed to be partners in.”

Many of the FBI photos are seemingly irrelevant, including the hundreds of images of random trees and a woodland road leading to the dig site, while others simply don’t add up or raise additional questions, assert Parada and Getler, author of “Rebel Gold,” a book exploring the possibility of buried Civil War-era caches of gold and silver.

FBI agents are shown standing around the hole in photos that appear earlier in the series, but they are absent from nearly all of the later images at the dig site.

Getler and Parada say the lead FBI agent told them the hole was filled with water the morning of the second day, but the low-quality images released by the government show only a small puddle or perhaps a bit of snow. They said that same agent spent most of the second day at base camp — where Getler and the treasure hunters say they were largely confined to their car — and not at the dig site.

The FBI said it’s standard for photos to “document site conditions before, during, and after FBI operations,” Parada claims it all points to a clandestine overnight dig and a second-day excavation that was just for show.

“I think we were expecting a couple hundred photos of the night dig, and I think we were expecting pictures of metal coins or bars,” Parada said. “I think there were pictures, but they disappeared.”

The FBI records also show that several weeks before the excavation, an agent with the agency’s art crime team approached Wells Fargo to ask whether it shipped gold by stagecoach for the U.S. Mint in 1863.

Wells Fargo historians turned up no evidence of it but said records from the era are incomplete. Wells Fargo did ship gold by stagecoach, a corporate archivist wrote in an email to the FBI, but large quantities of the precious metal, as well as gold that had to be carried long distances, were “better transported by ship or train.”

Getler said the gold might have been transported by wagon, not stagecoach.

Additional FBI releases are expected over the coming months.
A doll brings pride, identity for Brazil Indigenous woman
By DIANE JEANTET
Today

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Atyna Pora, of Brazil's Anambe indigenous group, clips the hair made of yarn of an indigenous doll, at a sewing workshop in Rio de Janeiro, Brazil, Tuesday, May 24, 2022. Pora and her mother Luakam Anambe who make the dolls bearing faces and body paints of different Indigenous groups, have sold more than 5,000 of their dolls. (AP Photo/Silvia Izquierdo)


RIO DE JANEIRO (AP) — Luakam Anambé wanted her newborn granddaughter to have a doll — something she’d never owned as a child working in slave-like conditions in Brazil’s Amazon rainforest. But she wanted the doll to share their Indigenous features, and there was nothing like that in stores. So she sewed one herself from cloth and stuffing.

The doll had brown skin, long, dark hair, and the same face and body paint used by the Anambé people. It delighted passersby; while Indigenous dolls can be found elsewhere in Latin America, they remain mostly absent in Brazil, home to nearly 900,000 people identifying as Indigenous in the last census.

A business idea was born, and her modest home now doubles as a workshop where she and her daughter produce dolls for a growing clientele.

Dolls bearing faces and body paints of different Indigenous groups are displayed on a table at a sewing workshop in Rio de Janeiro. (AP Photo/Silvia Izquierdo)

“Before, only white dolls existed, then came the Black ones, but Indigenous ones didn’t appear,” said Anambé, 53, wearing a beaded necklace and a headdress of delicate orange feathers. “When Indigenous women see the dolls, they sometimes cry.”

Since 2013, Anambé has sold more than 5,000 dolls at local fairs and through social media, mailing them across the country, and she is fundraising to attend a German fair with the aim of exporting to Europe. Her burgeoning business in Rio de Janeiro is a world removed from the Amazonian state of Para, where her life of hardship began.


Luakam Anambe poses for a photo in her sewing workshop.
(AP Photo/Silvia Izquierdo)

She was one of 15 children and Anambé’s parents sent her and two sisters to live and work at a plantation. Just 7 years old, she was charged with looking after the plantation owner’s toddler. She remembers being rebuked after asking the owner’s wife for a doll; she should work, not play, Anambé recalls being told. And she received no compassion when telling the woman that she had been sexually abused. She never received any pay, and complaints often ended with young Anambé locked in a dark tobacco storeroom, alone.

Anambé said she was 15 when the plantation owner forced her to marry his friend, a man two decades her senior, with whom she had a daughter. Anambé soon fled her violent husband, leaving her baby with family.

“We’re fighters, in a fight to survive,” she said, referring to Indigenous people who regularly face peril from Amazon land grabbers, loggers, ranchers and miners. Before colonization, “there were millions of Indigenous people in Brazil. Today, there are far fewer. And every passing day, less and less.”

 



Anambé worked for years as a cleaning lady in Belem, Para state’s capital. But she felt life had more in store for her and that she should seek opportunities in one of Brazil’s biggest cities. She hitched an eight-day ride to Rio with a long-haul trucker and thought of him as a godsend, especially because he didn’t abuse her.

Her Indigenous features stood out in Rio, and she experienced prejudice. Eventually, she landed a job in a bikini factory and was able to send for her daughter, by then in her twenties. Little by little, they saved enough money to move from their one-room shack to a small home, where she started making clothes for some fashionable Rio brands. With the skills she developed sitting behind her sewing machine, she made her first doll.



Atyna Pora, of Brazil's Anambe indigenous group, paints an indigenous doll. 
(AP Photo/Silvia Izquierdo)

“It’s like a mirror,” said her daughter, Atyna Porã, who now works with her mother. “Through the doll, we see ourselves, and we have to break down the taboo behind it, because we have always been very discriminated against.”

Anambé and Porã have expanded their portfolio to include dolls bearing face and body paints of five other Indigenous groups. Each is handsewn, dressed in traditional clothes and carefully painted with a sharpened branch from a tree in their backyard, following Indigenous custom.

Atyna Pora adds black yarn hair to an indigenous doll. (AP Photo/Silvia Izquierdo)

While they were the first to reach a broad audience using social media, others have followed in their footsteps.

Indigenous fashion designer We’e’ena Tikuna, also born in the Amazon rainforest and now based in Rio, started making Indigenous dolls to dress them in her creations. “I admire her work, like that of other Indigenous women,” Tikuna said of Anambé. “We need that Indigenous representation.”

Anambé named her first doll after Atyna’s daughter, Anaty, which became her company’s name. And 20% of proceeds go to her nonprofit, Maria Vicentina, named for her mother and grandmother. Based in Para, it will provide seamstress training to women under duress, growing the Anaty doll operation while helping provide them financial independence.

“When I left the state of Para, I didn’t leave just for myself. I went for other women, too,” Anambé said. “Anaty came to give this empowerment to us, Indigenous women.”


Dolls bearing faces and body paints of different Indigenous groups are displayed.
 (AP Photo/Silvia Izquierdo)

Dolls bearing faces and body paints of different Indigenous groups are displayed on a table at a sewing workshop. 
(AP Photo/Silvia Izquierdo)
THEOCRATIC THUGS
Christian nationalism on the rise in some GOP campaigns

By PETER SMITH and DEEPA BHARATH

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FILE - State Sen. Doug Mastriano, R-Franklin, a Republican candidate for governor of Pennsylvania, takes part in a primary night election gathering in Chambersburg, Pa., Tuesday, May 17, 2022. (AP Photo/Carolyn Kaster, File)


PITTSBURGH (AP) — The victory party took on the feel of an evangelical worship service after Doug Mastriano won Pennsylvania’s Republican gubernatorial primary this month. As a Christian singer led the crowd in song, some raised their arms toward the heavens in praise.

Mastriano opened his remarks by evoking Scripture: “God uses the foolish to confound the wise.” He claimed Pennsylvanians’ freedom would be “snatched away” if his Democratic opponent wins in November, and cast the election in starkly religious terms with another biblical reference: “Let’s choose this day to serve the Lord.”

Mastriano, a state senator and retired Army colonel, has not only made faith central to his personal story but has woven conservative Christian beliefs and symbols into the campaign — becoming the most prominent example this election cycle of what some observers call a surge of Christian nationalism among Republican candidates.

Mastriano — who has ignored repeated requests for comment from The Associated Press, including through his campaign last week — has rejected the “Christian nationalist” label in the past. In fact, few if any prominent candidates use the label. Some say it’s a pejorative and insist everyone has a right to draw on their faith and values to try to influence public policy.

But scholars generally define Christian nationalism as going beyond policy debates and championing a fusion of American and Christian values, symbols and identity.

Christian nationalism, they say, is often accompanied by a belief that God has destined America, like the biblical Israel, for a special role in history, and that it will receive divine blessing or judgment depending on its obedience.

That often overlaps with the conservative Christian political agenda, including opposition to abortion, same-sex marriage and transgender rights. Researchers say Christian nationalism is often also associated with mistrust of immigrants and Muslims. Many Christian nationalists see former President Donald Trump as a champion despite his crude sexual boasts and lack of public piety.

Candidates seen as Christian nationalists have had mixed success in this year’s Republican primaries, which typically pitted staunch conservatives against opponents even further to the right.

There were losses by some high-profile candidates, such as U.S. Rep. Madison Cawthorn and an Idaho gubernatorial hopeful, Lt. Gov. Janice McGeachin. The former spoke of a “spiritual battle” on Capitol Hill and a need for “strong, God-fearing patriots.” The latter was photographed holding a gun and a Bible and said, “God calls us to pick up the sword and fight, and Christ will reign in the state of Idaho.”

Some of Idaho’s Republican primaries for the Legislature were won by candidates touting Christian values or sharing priorities with Christian nationalists, such as sports bans for transgender athletes. U.S. Rep. Marjorie Taylor Greene, R-Ga., who uses biblical phrasing to “be a watchman on the wall” against those seeking to “destroy our faith,” easily won her primary.

Watchers of Christian nationalism consider Mastriano’s win — in a rout, with 44% in a crowded field despite opposition from the state party establishment — by far the highest-profile victory for the movement.

Mastriano has called the separation of church and state a “myth.”

After his victory, the comments section of his campaign Facebook page had the feel of a revival tent:

“Praise Jesus!” “God is smiling on us and sending His blessings.” “Thank you Father God!!”

Mastriano “is a unique case where he really does in his speeches highlight this apocalyptic idea” where his supporters and causes are on God’s side, said Andrew Whitehead, sociology professor at Indiana University-Purdue University Indianapolis and co-author of “Taking America Back for God: Christian Nationalism in the United States.”

“It literally is good and evil,” he continued. “There’s no room for compromise, so that is the threat to democracy.”

In the book, Whitehead and co-author Samuel Perry measured rates of Christian nationalism by drawing on a 2017 Baylor University survey. It gauged opinions on such things as America’s role in God’s plan and whether the U.S. should be declared a Christian nation, advance biblical values and allow school prayer and religious displays in public places.

Their research found about one in five Americans align with many of those views. That’s down from nearly one in four a decade earlier, just as Americans have become less religious overall. But Whitehead said Christian nationalists, who are more numerous among Republicans, can be expected to maintain their fervor.

Christian nationalism is emerging alongside and in some cases overlapping with other right-wing movements, such as the conspiratorial QAnon, white supremacy, and denialism over COVID-19 and the 2020 election. Christian prayers and symbols featured prominently in and around the U.S. Capitol during the Jan. 6, 2021, insurrection there.

Mastriano, who sought to overturn Pennsylvania’s vote for Joe Biden in 2020, attended the rally preceding the attack and chartered buses to bring others. Though he says he left when things turned violent, video showed he passed through “breached barricades and police lines,” according to a Senate Judiciary Committee report.

Robert Jones, CEO of the Public Religion Research Institute, said those Jan. 6 displays were not surprising.

According to a recent survey by the institute, white evangelical Christians were among the strongest supporters of the assertion that God intended America as a “promised land” for European Christians. Those who backed that idea were far more likely to agree that “true American patriots may have to resort to violence ... to save our country.”

“To my mind, white Christian nationalism is really the threat,” Jones said.

Conservative Christian themes are also playing a role in local elections, including in blue states, although many proponents say they view it not as nationalism but as supporting their religious freedom and values.

Pastor Tim Thompson of 412 Church in Murrieta, California, who hosts a YouTube channel with more than 9,600 subscribers and envisions a conservative future for the state, recently started a political action committee aiming to “take back our school boards” and give parents authority over curriculum.

“We don’t want teachers or any other adults talking to our kids about sex,” Thompson said. “We don’t want teachers categorizing our kids into oppressed or oppressor. These are not political issues. They are moral and biblical issues.”

Judeo-Christian values are the foundation of America, he argued.

“People are afraid to speak up for these values because they are afraid that the left is going to slap a label like ‘racist’ or ‘Christian nationalist’ on them,” Thompson said. “I don’t care about those labels, because my wife, children, church and community know who I am.”

Pastor Jack Hibbs of Calvary Chapel Chino Hills in Chino Hills, California, has also sought to influence local elections. While he does not let candidates campaign at the church, he frequently offers endorsements as a way of signaling to his flock those who are “pro-family, pro-life and pro-freedom.”

But “the hair on my neck goes up” when he hears the term “Christian nationalism,” he said. And he was embarrassed to see Christian imagery during the Jan. 6 riot: “That was a sad day, to see those sacred symbols and words pimped like that.”

Elizabeth Neumann, chief strategy officer for Moonshot, a tech company that aims to counter online violent extremism, disinformation and other harms, said Christian nationalism began picking up steam around 2015 amid a rising narrative of purported persecution of Christians.

Neumann, who served in the George W. Bush and Trump administrations and grew up in an evangelical Christian household, called the movement “heretical and idolatry” and an “apocalyptic vision (that) very often leads to violence.” Many pastors are pushing back against it, she added.

“I see Christian nationalism as the gasping, dying breath of the older generation in America that is afraid that Christians are going to be replaced,” she said.

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Bharath reported from Los Angeles.

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Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.