Monday, May 23, 2022

Perspectives on racism in health care among Black veterans with chronic kidney disease

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK

About The Study: In this qualitative study of 36 Black veterans with chronic kidney disease, participants described feeling angry and resentful and experiencing stress as a result of encounters with racism. Some veterans also expressed a strong sense of distrust in the health care system coupled with a need to be hypervigilant during clinical encounters.

Authors: Shimrit Keddem, Ph.D., of the Corporal Michael J. Crescenz Veterans Affairs Medical Center in Philadelphia, 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.2022.11900)

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.

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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.2022.11900?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=051222

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.

Poll shows impact of menopause and other health issues on older women’s sex lives

Less than half of those experiencing menopause-related symptoms have talked to their health care provider about treatment, National Poll on Healthy Aging shows


Reports and Proceedings

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

Key findings on menopause and sexual health in women over 50 

IMAGE: KEY FINDINGS ABOUT SEXUAL HEALTH AND MENOPAUSE IN WOMEN AGES 50 TO 80, FROM THE NATIONAL POLL ON HEALTHY AGING view more 

CREDIT: UNIVERSITY OF MICHIGAN

Despite stereotypes to the contrary, many older women have active sex lives into their 70s, a new poll shows. But health concerns, including menopause symptoms, often get in the way of intimacy, according to the new results from the University of Michigan National Poll on Healthy Aging.

 

Even so, only 44% of women with menopause symptoms have discussed treatment with their health care provider. Among those who did receive treatment, 88% felt their symptoms were managed somewhat or very well.

 

Meanwhile, women over 50 who have other health issues, or who say their mental or physical health are fair or poor self-reported , were more likely to report less satisfaction with their sex lives. And 1 in 4 women over 50 said their partner’s health interfered with their own ability to be sexually active.

 

The poll is based at the U-M Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine, the University of Michigan’s academic medical center.

 

Daniel Morgan, M.D., a professor of obstetrics and gynecology at Michigan Medicine who studies and works to improve the quality of OB/Gyn care, worked with the poll team on the report.

 

“Women over 50 who experience menopause symptoms or other health concerns that interfere with sexual activity should absolutely speak up to their health care providers and find out what their options might be,” said Morgan. “Often women and their partners overlook the intertwined nature of physical and mental health, and sexual health and the ways menopause-related symptoms can have an impact on sexual activity. It’s important to understand what your treatment options are, and which ones might be appropriate for your needs and goals.”

 

Menopause symptoms affected 84% of the women in the past year, with 35% saying that they’d experienced four or more symptoms from a list of 8 symptoms. Sleep problems (56%) and weight gain or slow metabolism (55%) were the most common, followed closely by reduced sexual drive (48%).  Hot flashes and night sweats affected 41%, mood swings and irritability were reported by 38%, urinary tract infections by 16%, and smaller percentages reported other symptoms.

As expected, women between the ages of 50 and 64 were more likely to report menopause symptoms than those age 65 to 80, but 78% of the older group said they still experienced at least one symptom.

 

The effect of menopause symptoms on sexual health and other aspects of life isn’t often discussed, said poll director Preeti Malani, M.D., a Michigan Medicine infectious disease physician also trained in geriatrics.

 

“In all, 28% of women over 50 told us that their menopause symptoms interfere with their ability to be sexually active, and there was not a major difference between the two age groups,” she said. “Meanwhile, other types of health problems interfered with the sex lives of 17% of these women. Women reporting menopause symptoms or health problems were  less likely than other women to say their satisfied with their level of sexual activity.”

 

Sexual activity and satisfaction

 

The poll finds that 43% of women over 50 say they’ve been sexually active in the past year, using the poll’s definition of caressing, foreplay, masturbation, or intercourse. The percentages were higher among those aged 50 to 64 compared with those aged 65 to 80 (53% vs. 30%) and those who are married or have a partner compared with those who do not (58% vs. 26%).

 

The poll also shows that 52% of older women who are not sexually active said they’re satisfied with their sexual activity, compared with 74% of those who are sexually active. Among those who aren’t sexually active despite having a partner, 50% said they were satisfied with the level of intimacy in their relationship.

 

Just over a third (35%) of women who said their mental health was fair or poor said they were satisfied with their sexual activity, compared with 65% of those reporting better mental health.

 

“We’ve found in previous AARP research that women don’t know as much as they should about the conditions leading up to menopause and healthcare providers are not proactive in initiating the conversation about this life transition,” said Teresa A. Keenan, Ph.D., Director of Health Security Research, AARP Research.  “As this new report notes, it’s important for women to feel empowered to take control of their own health and to initiate discussions with their health care provider, including discussions around sex and intimacy, to contemplate potential treatment options. With many years of post-menopausal life ahead, their concerns are too important to ignore.”

 

The poll report is based on findings from a nationally representative survey conducted by NORC at the University of Chicago for IHPI, and administered online and via phone in January and February 2022 among 1,206 women age 50–80. The sample was subsequently weighted to reflect the U.S. population. Read past National Poll on Healthy Aging reports and about the poll methodology

 

Women’s Health: Sex, Intimacy, and Menopause. University of Michigan National Poll on Healthy Aging. May/June 2022. Available at: https://dx.doi.org/10.7302/4451

 

Uneven distribution of emergency physician residency programs can impact workforce challenges, new analysis finds

Peer-Reviewed Publication

AMERICAN COLLEGE OF EMERGENCY PHYSICIANS

WASHINGTON, D.C.—A new analysis of the emergency physician resident workforce in Annals of Emergency Medicine finds that while the number of residency programs is increasing, new residency programs are disproportionately located in urban areas in states with existing programs, rather than rural communities with limited access to emergency care.

“Predictions of an oversupply of emergency physicians in the next decade may not apply to every part of the country,” said Christopher L. Bennett, MD, MA, assistant professor of emergency medicine at Stanford University School of Medicine and lead study author. “Regional differences over time need to be considered in any discussions of workforce challenges—these findings underscore the likelihood that rural emergency physician shortages will persist.”

A small number of states with an already high number of residency programs gained the most programs between 2013 and 2020, according to the study. At the same time, there is an emergency physician “desert” in the rural United States characterized by a lack of residents and residency training programs.

The six states with the largest increase in residency programs were Florida (increased from five to 19), Michigan (increased from 11 to 25), New York (21 to 31), Ohio (nine to 18), Pennsylvania (12 to 21), and California (14 to 22). Twenty states did not gain a program and some states do not have any emergency medicine residency programs, including Idaho, Montana, North Dakota, South Dakota, and Wyoming.

The number of emergency medicine residencies expanded from 160 to 265 between 2013 and 2020, according to Accreditation Council for Graduate Medical Education (ACGME) data analyzed. The study also notes that of 6,993 emergency medicine residents in the 2020 American Medical Association data set, 98% were in urban areas.

This analysis of residencies is consistent with a 2020 study by the same authors that found most emergency physicians (92%) were in urban areas and that clinically active emergency physicians in rural communities skewed older and closer to retirement than their urban area peers.

Urban residency programs that can expand opportunities for rural training rotations may be able to help solve aspects of the projected workforce challenges, the authors note.

“Emergency physicians tend to practice where they train,” said Dr. Bennett. “As newer physicians seek footing in a challenging job market, exposing residents to rural emergency medicine can open doors to rewarding career paths while addressing the critical need to improve access to emergency services in these communities.”

### 

Annals of Emergency Medicine is one of the peer-reviewed scientific journals for the American College of Emergency Physicians (ACEP), the national medical society representing emergency medicine. Annals of Emergency Medicine is the largest and most frequently cited circulation peer-reviewed journal in emergency medicine and publishes original research, clinical reports, opinion, and educational information related to the practice, teaching, and research of emergency medicine.

Contact: Steve Arnoff | sarnoff@acep.org | Twitter: @emergencydocs 

New study finds global adolescent vaping is low

Peer-Reviewed Publication

SOCIETY FOR THE STUDY OF ADDICTION

A new study published today in the scientific journal Addiction has found that approximately 8.6% of adolescents reported using e-cigarettes (vaping) in the past 30 days, but only 1.7% engaged in frequent vaping. This suggests most adolescents who vape are experimenting but not making it a habit.

Researchers from the University of Queensland (Australia) wanted to estimate as far as possible the global prevalence of adolescent vaping.  The researchers analysed data from 151,960 adolescents in 47 countries who participated in the World Health Organization’s (WHO’s) Global Youth Tobacco Survey between 2015 and 2018.  The overall weighted prevalence of adolescent vaping and frequent vaping in the past 30 days was 8.6% and 1.7% respectively.

Lead author Dr. Gary Chan says “There are two likely explanations for the low levels of frequent vaping among young people.  First, e-cigarettes are relatively new and are often sold in colourful packages with highly palatable flavours that could appeal to adolescents, thus leading to experimentation but not continued use. Second, while some e-cigarettes contain high levels of nicotine, adolescents can also vape non-nicotine or low nicotine e-cigarettes and avoid becoming addicted. Future WHO surveys should ask participants to disclose whether nicotine is in the vaping liquids they use.”

The researchers also wanted to test the association between the implementation of World Health Organization (WHO) tobacco control policies and adolescent vaping.  In 2008, WHO introduced the MPOWER policy package, with six policies to reduce tobacco use: monitoring, smoke-free environments, cessation programs, health warnings, advertising bans, and taxation.  Implementation of these policies has reduced tobacco use; however, it is unclear if these policies have had any impact on youth uptake of e-cigarettes.

Using data from the 44 countries where implementation data were available, the researchers found inconclusive evidence that implementation of five of the MPOWER policies was associated with lower adolescent vaping.  Implementation of the sixth policy – higher taxes on tobacco products – was curiously associated with more adolescent vaping. This suggests that some adolescents in countries with a higher tobacco tax may be substituting cigarettes with e-cigarettes.

-- Ends –

For editors:

This paper is free to read for one month after the embargo lifts from the Wiley Online Library: https://onlinelibrary.wiley.com/doi/10.1111/add.15892 or by contacting Jean O’Reilly, Editorial Manager, Addictionjean@addictionjournal.org.

To speak with lead author Dr Gary Chan, please contact him at the The University of Queensland by telephone (+61 7 344 32533) or email (c.chan4@uq.edu.au).

Full citation for article: Chan GCK, Gartner C, Lim C, Sun T, Hall W, Connor J, Stjepanović D, and Leung J (2022) Association between the implementation of tobacco control policies and adolescent vaping in 44 lower-middle, upper-middle, and high-income countries. Addiction: doi: 10.1111/add.15892

Funding: GCKC was funded by a National Health and Medical Research Council (NHMRC) Investigator Grant (GNT1176137). CG was funded by NHMRC Centre of Research Excellence Grant. CL was funded by National Health and Medical Research Council Postgraduate Scholarship (GNT2005317). TS, WH and JC were funded by Department of Health, Australia. The funders have no role in any stage of this study.

Declaration of interests:  The authors declare no competing interest.

Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, substances, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884.

Smokers who switch to e-cigarettes may adopt other healthy routines

Peer-Reviewed Publication

UNIVERSITY OF WASHINGTON

Adult smokers who shift to using to e-cigarettes may have more chances to improve health and well-being, according to new research from the University of Washington.

The study monitored changes in health and social functioning among smokers at two stages in adulthood, age 30 and again at 39. Approximately one-third of smokers shifted to vaping some or all the time by age 39. This group reported better physical health, exercised more and had more active social engagement, the study found.

“Despite the obvious risks to nonsmokers, e-cigarettes have the potential to play a health-promoting role in the lives of smokers,” said study co-author Marina Epstein, a research scientist with the Social Development Research Group in the UW School of Social Work.

The study, which recently published in Drug and Alcohol Dependence, drew from a larger longitudinal study, the Seattle Social Development Project, which in 1985 began following some 800 children as fifth-graders in Seattle elementary schools. The sample for the current study focused on 156 of those participants who reported smoking at age 30 and smoking or vaping at age 39.

E-cigarettes first appeared in the United States in the mid-2000s, right around the time the participants in the study sample turned 30. By 2018, 10% of adult smokers nationally also used e-cigarettes. Vaping is especially popular among teens and young adults; the Centers for Disease Control and Prevention identifies e-cigarettes as the most popular tobacco product among young people in the U.S., estimating that nearly 21% of youth use e-cigarettes. Previous research, from the UW and others, found that adolescent and young adult vaping can lead to later cigarette use. "In this way, e-cigarettes have been a public health disaster," said study lead author Rick Kosterman, a research scientist with the Social Development Research Group.

At the same time, while vaping carries certain risks — the aerosol contains nicotine, small amounts of heavy metals and other ultrafine and cancer-causing particles that can enter the lungs — the CDC considers them safer than traditional, or combustible, cigarettes.

Given the common perception of e-cigarettes as a “healthier” alternative, the researchers wanted to examine behavior among smokers who switch to e-cigarettes some or all the time as they approach midlife. The research team collected a series of accepted measures of healthy aging and well-being, such as overall physical and mental health, engaging in healthy behaviors and social activities, and education and income levels. They then surveyed participants, at ages 30 and 39, about this information and how often they engaged in certain activities.

Of the 156 study participants, 64% smoked only combustible cigarettes at age 39; 28% smoked and vaped; and 8% only vaped. Results from the surveys showed that more frequent vaping — relative to smoking — was associated with better physical health, more exercise, more active social engagement and higher socioeconomic status.

“Although the study cannot show a causal relationship, we think that because e-cigarettes have less stigma, less odor and are less physically harmful, they may increase health-promoting opportunities among smokers. E-cigarette users may be more likely to be in settings that promote physical activity and have more opportunities to interact with nonsmokers,” said Kosterman.

No association was found between switching to vaping and better mental health, less-frequent use of other substances such as alcohol, or whether one's partner or closest peers smoke (though vapers' broader social environment may be healthier).

Overall, the researchers stress that e-cigarettes still have substantial public health downsides, but this study shows that smokers who turn to vaping, whether occasionally or instead of cigarettes, may have more opportunities for healthier lifestyle choices. That doesn’t mean vaping is healthy, they say, but that for people who already smoke — and are unable to quit — it can be associated with other healthy routines.

The study was funded by the National Cancer Institute, the National Institute on Aging and the National Institute on Drug Abuse.

Co-authors were Jennifer Bailey and J. David Hawkins of the Social Development Research Group.

 

For more information, contact Kosterman at rickk@uw.edu or Epstein at marinae@uw.edu.

Hundreds of patient data breaches are left unpunished, reveals The BMJ


Private companies and universities among those that may be failing to protect patient confidentiality. A major policy shift and investment is needed, say experts

Peer-Reviewed Publication

BMJ

Hundreds of organisations including drug companies, NHS commissioners, and universities have breached patient data sharing agreements in the past seven years, reveals an investigation by The BMJ today.

GlaxoSmithKline (GSK) and Imperial College London are among those that have carried out “high risk” breaches according to NHS Digital audits examined by investigative reporter Esther Oxford. This means that they are handling information outside of agreed data contracts and may be failing to protect confidentiality.

In one instance of a high risk breach, clinical care commissioners allowed sensitive, identifiable patient data to be released to Virgin Care without permission from NHS Digital. When NHS Digital’s audit team tried to get access to Virgin Care to check their compliance, it was denied access for several weeks and the company refused to delete the patient data.

“It is outrageous that private companies and university research teams are failing to comply,” says Kingsley Manning, former chair of NHS Digital. “How is it that these organisations can be so lax with data?”

Yet Oxford explains that none of the organisations have had their access to NHS Digital’s data curtailed in light of the breaches. Instead, NHS Digital said it works with the organisations to rectify problems.

NHS Digital has the power to suspend the provision of data but any decision to curtail access to data would “need to be balanced against any negative impact to patient care”, a spokesperson said. Clinical Commissioning Groups (CCGs) would be unable to commission services if they had to return data, and ceasing access to data for clinical trials would mean their benefits would not be achieved, they added.

Phil Booth, coordinator of campaigning group medConfidential, says there needs to be real consequences if companies, commissioners, and research teams breach their agreements, otherwise data sharing contracts are meaningless. “These contractual requirements aren’t just for fun: a single data breach could include sensitive information about millions of patients,” he said. 

Natalie Banner, former lead for the Understanding Patient Data initiative hosted by Wellcome agrees that the current system “is failing to protect data adequately and a major policy shift and investment is needed.”

Oxford explains that NHS Digital also has the power to report an organisation to the Information Commissioner’s Office (ICO) if there has been a personal data breach.

But the ICO said it could not tell The BMJ if NHS Digital had ever reported a pharmaceutical company, university, or organisation for breaching a data sharing agreement, and there are no examples of enforcement action against these entities published on the ICO website.

NHS Digital has plans to provide a more secure system - known as a trusted research environment (TRE) - for organisations wanting to access health and social care data, notes Oxford. But there are fears about how TREs will work if taken up by the NHS, including how they will be made accountable and transparent.

Many are also worried about the government’s plan to abolish NHS Digital and allow NHS England to take on its powers and responsibilities.

“The move is alarming,” says Philip Hunt, member of the House of Lords. “NHS England has so many roles and motivations it is never going to be able to protect patient information in the way an independent body with specific responsibilities to do so would.”

A spokesperson from the Department of Health and Social Care said, “The obligations that NHS Digital currently has to safeguard patient data will become those of NHS England. This will include the same level of transparency as to how data are disseminated and used.”

It will take time to decide on the correct policy and to arrange the new data infrastructure, says Banner. “What’s being done about NHS Digital’s audits and those failures in the meantime?”

[Ends]

 

Elderly Hong Kong cardinal in court over protest defence fund



Hong Kong cardinal arrives in court over protest defence fund
 (AFP/Daniel SUEN)

Xinqi SU
Mon, May 23, 2022

Ninety-year-old retired Catholic cardinal Joseph Zen appeared in a Hong Kong court Tuesday charged with failing to properly register a protest defence fund, after he was initially arrested under the city's national security law.

Zen, one of Asia's highest-ranking Catholic clerics, was among five prominent democracy advocates -- including activist and singer Denise Ho and veteran human rights barrister Margaret Ng -- who were detained earlier this month.

The group acted as trustees of a now-defunct fund that helped pay legal and medical costs for those arrested during huge and sometimes violent democracy protests three years ago.

They were arrested for "conspiracy to collude with foreign forces" but have not yet been charged with that offence, which can carry a life sentence under the sweeping security law imposed by Beijing in 2020.


Instead, all five of the fund's former trustees and its secretary were charged Tuesday with failing to register the fund as a "society" with police -- a non-national security offence that can incur a fine of up to HK$10,000 (US$1,274) for a first conviction.

Each of the defendants, apart from activist Cyd Ho, who is already serving a jail sentence for unauthorised assembly, was present in court on Tuesday.

All entered a plea of not guilty. The trial will begin September 19.

The investigation into the "612 Humanitarian Relief Fund" was triggered when one of the group, cultural studies scholar Hui Po-keung, was intercepted at Hong Kong's airport on May 10 as he tried to leave to take up an academic post in Europe.

The investigation of the fund has also led to the first complaint made by the city's national security police about "professional misconduct" by the lawyers and barristers hired by the fund's beneficiaries.

- 'Classic smearing campaign' -

Diplomats from multiple European countries including Germany, France, Sweden and Italy attended Tuesday's hearing.

Zen's arrest in particular has triggered outrage from Western nations, who have accused China of eviscerating the freedoms it once promised Hong Kong.

But on Monday, the city's security minister told local media the criticism was a "classic smearing campaign".

"To my understanding, the Vatican is a place to pursue justice and peace. If we did not act in accordance with the law because of one's role in the Holy See, then I think it would actually breach the Vatican’s principle of justice," said Chris Tang in an interview with the South China Morning Post.

China's foreign affairs commissioner in Hong Kong said the criticism proved Western nations were concerned about the "agents they deliberately cultivated".

Hong Kong's vicar general, Joseph Chan, was present in court but said he was not there as a representative of the Diocese.

"He (Zen) was my teacher, so I came," he told AFP.

Chan said he is mainly worried about Zen’s health but that he has so far appeared in good spirits.

The cardinal has arranged a nighttime mass to pray for China on Tuesday night.

su/reb/cwl
Sole survivor relives terror of Yemenia Airways crash at French trial


Bahia Bakari was just 12 when Yemenia Flight 626 crashed when trying to land in the Comoros in 2009 (AFP/Thomas SAMSON) 

Anne LEC'HVIEN
Mon, May 23, 2022, 

A woman who was just 12 when she survived the 2009 Yemenia Airways crash in the Comoros islands that killed all 152 others onboard described Monday the terrifying moments leading up to her plunge into the ocean and subsequent miraculous rescue, in the French trial against the airline.

Bahia Bakari, now 25, has sat through several hearings with her father but had not testified or spoken to journalists attending the trial that opened this month.

"I didn't see how I was going to get through this," Bakari told the court of her hours spent in the water holding on to a piece of debris, with "the taste of jet fuel" in her mouth.

Bakari and her mother left Paris on June 29, 2009, for her grandfather's wedding in the Comoros, changing planes in the Yemeni capital of Sanaa for the final leg of the trip.

"It was a smaller plane, there were flies inside and it smelled strongly like a bathroom," she said, but "the flight went normally" -- until the beginning of the landing descent.

During the night-time approach of Yemenia Flight 626 to Moroni, the capital of the Comoros islands that lie between Mozambique and Madagascar, the Airbus A310 jet plunged into the Indian Ocean with its engines running at full throttle.

"I started to feel the turbulence, but nobody was reacting much, so I told myself it must be normal," Bakari said as over 100 family members or friends of the victims listened in silence.

Suddenly "I felt something like an electric shock go through my body", she told the court.

- 'Couldn't see anyone' -

"There's a black hole between the moment when I was seated in the plane and the moment I found myself in the water."

France's overseas territory of Mayotte is part of the Comoros archipelago, and 66 French citizens were among the 142 passengers and 11 crew members aboard.

Investigators and experts found there was nothing wrong with the aircraft, blaming instead "inappropriate actions by the crew during the approach to Moroni airport, leading to them losing control".

No one from Yemenia Airlines has appeared at the trial, where prosecutors have accused the company of pilot training programmes "riddled with gaps" and of continuing to fly to Moroni at night despite its non-functioning landing lights.

Yemenia is charged with involuntary homicide and injuries. The company's lawyers have denied any wrongdoing.

Bakari, regaining consciousness in choppy waters, recalled waiting for hours in the water, trying to climb atop the largest piece of debris she could reach, but without the strength to succeed.

"I realised that voices were calling for help in Comorian, and I cried out a bit but without much hope, because there's was nothing but water around me and I couldn't see anyone," she said.

"I ended up falling asleep while holding onto the plane debris," and while she could see the coast when she woke up, "the water was really choppy."

- 'Hardest thing' -

It was thinking of her "incredibly protective" mother that helped her to hold on until she was rescued by a boat after a dozen hours in the water.

Initially she was convinced "that I was the only one who fell" and that the other passengers had arrived safely, before a psychologist at the hospital told her she was the only survivor.

"The hardest thing for me has been dealing with the grief for my mother, I was very close to her," Bakari said, her voice breaking and tears flowing for the first time during her testimony.

The Yemeni national airline, whose representatives said they could not attend the trial amid the long-running civil war in their country, faces a maximum fine of 225,000 euros ($240,000).

"It's really a shame. Even if the current management wasn't in charge at the time, it's still their company. And I and these families would have liked them to listen to us," Bakari told reporters after leaving the courtroom.

"Because often we talk about the little girl who survived, but this was first and foremost a tragedy."

alv/js/sjw/jj
AN ACOLYTE OF TRUMP
Kim Jong Un carries coffin at N. Korean military officer's funeral



North Korean leader Kim Jong Un (L) carried the coffin at the state funeral for a top military officer (AFP/STR) (STR)


Mon, May 23, 2022

A maskless Kim Jong Un was one of the pallbearers at the state funeral for a top military officer, North Korean state media reported Monday, days after Pyongyang claimed the country's Covid-19 outbreak was now under control.

Kim on Sunday attended the funeral of Hyon Chol Hae, a Korean People's Army marshal who reportedly mentored the North Korean leader to take over from his father Kim Jong Il.

The official Korean Central News Agency (KCNA) released photos of Kim, not wearing a face mask, hoisting up Hyon's casket along with other regime officials, who were masked.

Hyon died of multiple organ failure at the age of 87, according to KCNA.

The North Korean leader has put himself front and centre of his country's Covid response, blaming lazy state officials for worsening the Omicron variant-fuelled outbreak.

Over the weekend, KCNA said the epidemic was now "being stably controlled", and reported the death toll "sharply decreased day by day".

Experts question the official claim and tally, given that the impoverished country has one of the world's worst healthcare systems and no Covid-19 drugs or mass testing ability.

It has not vaccinated any of its roughly 25 million people, having rejected jabs offered by the World Health Organization.

North Korea announced its first coronavirus case on May 12, despite a two-year blockade maintained since the start of the pandemic.

Pyongyang reported 167,650 "fever" cases on Monday via KCNA, a notable drop from the peak of around 390,000 reported about a week before.

It reported one more death and claimed the fatality rate for the "fever" was 0.002 percent.

State media reports do not specify how many of the cases and deaths have tested positive for the coronavirus.

Pyongyang has so far not responded to an offer of help from Seoul, according to South Korea's unification ministry.

During his visit to Seoul at the weekend, US President Joe Biden said Washington had also offered Covid-19 vaccines to Pyongyang but "got no response".

Despite the virus outbreak, new satellite imagery has indicated North Korea has resumed construction at a long-dormant nuclear reactor.

The United States and South Korea have both warned that Kim is poised to conduct another nuclear test, which would be the country's seventh.

cdl/lb

WORLD TURTLE DAY

Hundreds of endangered baby giant turtles released into Cambodian river

Hundreds of critically endangered baby giant turtles were released into Cambodia's Mekong River to mark World Turtle Day
Hundreds of critically endangered baby giant turtles were released into Cambodia's Mekong
 River to mark World Turtle Day.

Hundreds of critically endangered baby giant turtles were released into Cambodia's Mekong River to mark World Turtle Day on Monday.

Cantor's giant softshell turtles have all but vanished across their former territory in Vietnam and Thailand thanks to poaching and , and were only rediscovered in the Southeast Asian country in 2007.

The Wildlife Conservation Society coordinated the release of 580 hatchlings, which can grow to a length of up to 200cm (78 inches) and mainly live buried in the sand and the water, surfacing only twice a day to breathe.

Monks blessed the baby reptiles—also known as "frog-faced turtles" for their distinctive appearance—before helping conservationists and eager children send the stout-nosed snappers into the Mekong's muddy waters.

The creatures are among a batch of 982 turtles rescued as eggs—to protect them from the dangers which threaten the species' numbers—carefully incubated, hatched, and then released.

Ken Sereyrotha, country program director for WCS Cambodia, said significant progress had been made in protecting the animal in the country but more work was needed.

"This species is being threatened by  and trafficking," he said.

Monks blessed the baby 'frog-faced turtles' before helping conservationists and eager children send them into the Mekong
Monks blessed the baby 'frog-faced turtles' before helping conservationists and eager 
children send them into the Mekong.

The WCS and Cambodia's department of fisheries conservation of fisheries administration has found and rescued more than 2,000 eggs this year—with the teams hopeful the remainder will eventually hatch.

Ouk Vibol, director of the fisheries department, urged local stakeholders to continue the conversation work, and promised that "those who still trade  will face legal action."

Last year, the teams managed to nurture and then release around 1,300 hatchlings into the wild.Nest of endangered giant softshell turtle found in Cambodia

© 2022 AFP