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Yahoo
11 minutes ago
- Yahoo
US Supreme Court expected to rule on Obamacare preventive care task force
By John Kruzel WASHINGTON (Reuters) -The U.S. Supreme Court is expected to rule on Friday on the legality of a key element of the Obamacare law, formally called the Affordable Care Act, that helps guarantee that health insurers cover preventive medical care such as cancer screenings at no cost to patients. The federal government has appealed a lower court's determination that the U.S. Preventive Services Task Force, which under Obamacare has a major role in choosing what services will be covered, is composed of members who were not validly appointed. Its 16 members are appointed by the U.S. secretary of health and human services without Senate confirmation. Several individual Christian plaintiffs and two small businesses sued in federal court in Texas in 2020 to challenge the task force's structure. It was the latest in a years-long series of challenges to Democratic former President Barack Obama's signature legislative achievement to reach the Supreme Court. Before the case was narrowed to the appointments issue, the plaintiffs had included a religious objection to being required to cover pre-exposure prophylaxis for HIV. They claimed that such drugs "facilitate and encourage homosexual behavior, prostitution, sexual promiscuity and intravenous drug use." The U.S. government's appeal of the decision by the New Orleans-based 5th U.S. Circuit Court of Appeals initially was filed by Democratic former President Joe Biden's administration before being taken up by Republican President Donald Trump's administration. Public health advocates had warned that life-saving tests and treatments that have been cost-free under most insurance plans may become subject to co-pays and deductibles, deterring many Americans from obtaining them, if the justices upheld the 5th Circuit's ruling. A key question in the case was whether the task force wields power to such an extent that its members, under the Constitution's "appointments clause," are "principal officers" who must be appointed by the president and confirmed by the U.S. Senate or "inferior officers" not subject to these requirements. The task force is made up of medical experts who serve four-year terms on a volunteer basis. It reviews medical evidence and public feedback and issues recommendations about which preventive services would be most effective for detecting illnesses earlier or addressing ailments before a patient's condition worsens. The task force has identified dozens of preventive services as having a high or moderate net benefit to patients including screenings to detect diabetes and various types of cancer, statin medications to lower the risk of heart disease and stroke, and interventions to help patients quit smoking or unhealthy alcohol use. The 5th Circuit ruled in 2024 that the task force's structure violates the Constitution, as the plaintiffs claimed. The justices during April 21 arguments in the case posed questions over whether the law gives the HHS secretary the appropriate level of supervision over the task force, including the power to influence its recommendations and fire members at will, or if it operates as a largely independent governmental body whose recommendations effectively have the force of law. The Justice Department urged the justices to view the task force's members as "inferior officers." Hashim Mooppan, a Justice Department lawyer, told the justices that the HHS secretary can remove task force members at will, review their recommendations and prevent them from taking effect, and can require the task force to obtain his approval before it issues any recommendations. The plaintiffs contended that the task force's lack of supervision and insulation from removal makes its members "principal officers." The 5th Circuit's ruling also rejected the government's request to remove certain offending words from the Obamacare provision at issue - a process called severing - in order to make that part of the law conform to the Constitution.
Yahoo
21 minutes ago
- Yahoo
How Barefoot Training Can Make You Stronger, More Athletic, and Injury-Resistant
It might be surprising in a world full of cushioned trainers, gel inserts, and carbon-plated soles, but one of the best things you can do for your body might be taking off your shoes. Barefoot training, which involves lifting, running, or moving without traditional footwear, isn't some fleeting TikTok trend. It's a smart, science-backed strategy to improve movement, stability, and long-term joint health. According to MUSC Health, barefoot workouts can increase muscle strength, endurance, stability, and coordination—all while reducing injury risk. Think of it like this: Your feet are the foundation of every lift, sprint, and jump your body performs. Research suggests that most modern shoes restrict natural motion, weaken stabilizing muscles, and dull the sensory feedback your body uses to stay balanced and aligned. Going barefoot changes that. In this article, we'll explore the benefits of barefoot training, how to ease into it safely, and how ditching your sneakers could be the game-changer your training has been training involves performing exercises (typically strength, mobility, or bodyweight movements) without traditional shoes. That could mean going completely barefoot or wearing minimalist footwear designed to replicate the barefoot experience: minimal cushioning, zero heel drop, and enough room for your toes to spread out naturally. You don't need to ditch shoes entirely or go barefoot in every workout. Most barefoot training happens in controlled environments like home gyms, yoga studios, or strength sessions on rubber mats or turf. In these settings, training without shoes can sharpen proprioception (your body's sense of position and movement), strengthen foot and ankle muscles, and build better biomechanics. 'Barefoot training helps you build strength from the ground up,' says certified personal trainer Amanda Dvorak. 'Your feet have muscles that need to be trained just like any other part of your body. When they're stronger and more engaged, your balance, control, and overall force output improve, which carries over to your lifting exercises and athletic movement.'Modern shoes often restrict natural movement and reduce the workload of your feet. Over time, studies suggest this can weaken the small stabilizing muscles in your feet and ankles. Training barefoot reactivates those muscles, helping you build a stronger, more stable foundation for athletic performance. Training barefoot helps train and strengthen those muscles in your feet and ankles,' says Caine Wilkes, OLY, CNC, an Olympian and certified USA weightlifting coach. 'Better balance and a solid foundation help athletes perform during activities like sprinting, jumping, and more.' Barefoot training enhances sensory feedback from the ground, which helps you move with greater awareness and precision. This can lead to better balance, improved posture, and cleaner movement patterns, all of which can boost performance and reduce injury risk. 'Shoes can mask poor mechanics,' Dvorak explains. 'When you're barefoot, your body has to stabilize itself, which teaches it better alignment and joint positioning.' Wilkes adds, 'Your feet can feel the ground, allowing your toes to splay naturally and your feet, ankles, and legs to react naturally as well. This feedback can help you adjust your posture and alignment in real time.' Without thick midsoles or cushioned soles getting in the way, your feet have direct contact with the ground. This helps with force transfer during lifts, especially deadlifts, squats, and kettlebell work. The result is more efficient movement, increased strength, and reduced injury most common mistake beginners make is not easing into barefoot training. Your feet need time to adapt, especially if you've spent years in padded shoes. 'Most people go too hard too soon,' Dvorak says. 'Their feet aren't used to being unsupported, and they'll get sore if you don't ease in.' Here's how to slowly transition to barefoot training: Go barefoot during warmups and at home. Walk around your house without shoes to build tolerance. Try ankle circles, toe mobility drills, or light bodyweight squats. 'Once comfortable, you can incorporate barefoot exercises like squats, lunges, or hip bridges into your warmup,' Wilkes says. Add light barefoot strength work to your fitness routine. Think goblet squats, kettlebell deadlifts, or hip hinges. 'Slow, controlled strength work like deadlifts, Turkish get-ups, or stability exercises work great barefoot,' says Dvorak. 'You want to focus on form and control.' Incorporate full barefoot sessions. If you're comfortable, begin training fully barefoot during strength training workouts on safe, stable surfaces. Avoid high-impact movements until your feet are ready. Keep in mind that not every workout is ideal for barefoot training. Stick to these exercises when starting: Deadlifts Kettlebell swings Goblet or bodyweight squats Lunges and step-ups Stability drills (e.g., single-leg balances) Mobility flows and ground-based core work 'Ground-based lifting such as deadlifts, squats, kettlebell work, and bodyweight movements are great for barefoot training,' says Wilkes. 'Any movements that allow you to feel rooted and balanced work well.' Avoid jumping into running or plyometrics without months of barefoot prep. 'I wouldn't run on pavement or do plyometrics barefoot until you've built up some strength and tolerance first,' Wilkes cautions.'If you have a history of foot problems, like plantar fasciitis or flat feet, you should talk to a professional before training barefoot,' Wilkes advises. 'If you notice pain in your arches or heels, you're probably pushing too hard and too fast.' Dvorak adds, 'Anyone with foot injuries, diabetes, or serious balance issues should be cautious. If you feel sharp pain in your feet or knees, or your form breaks down while you're training barefoot, those are signs to scale back or get some guidance.' Barefoot training isn't a magic fix, but it's one of the simplest, most effective ways to boost balance, increase strength, and move better every day. Start slow, stay consistent, and let your feet do the work. So next time you train, try skipping the sneakers for a bit—you might just uncover a stronger, more athletic version of yourself. How Barefoot Training Can Make You Stronger, More Athletic, and Injury-Resistant first appeared on Men's Journal on Jun 26, 2025
Medscape
39 minutes ago
- Medscape
Canadian Physicians Report Happiness, Acknowledge Challenges
Canadian physicians reported a high rate of happiness at work and in their home life in a new physician wellness survey conducted by Medscape Medical News . At the same time, many physicians acknowledged experiencing work-related burnout and depression. The national survey included information submitted by 744 respondents (66% specialists, 34% general practitioners [GPs]). Most respondents lived in Manitoba (42%), followed by Alberta (17%), Prince Edward Island (13%), and Newfoundland/Labrador (12%). Smaller proportions came from Ontario and Quebec, the country's most populated provinces. While 37% of respondents reported working in hospitals, 24% were based in GP groups or private practice settings, 19% were based in clinics, 15% were based in other settings (including virtually, working from home, and long-term care), and 5% were in academic settings. More than half (57%) of respondents identified as men and 41% as women. The majority (91%) were aged 45 years or older, including 24% who were aged 70 years or older. Widespread Happiness While most respondents reported being very or somewhat happy with their work life (68%) and personal life (74%), 24% reported experiencing burnout, 3% reported depression, and 11% reported both. The remaining 62% reported experiencing neither condition. Burnout was more commonly reported by respondents younger than 45 years (about 40%) compared with older respondents (23%). Women reported a higher rate of burnout than men (35% vs 17%), and respondents based in an office practice were more likely to report burnout than those working in a hospital setting (33% vs 23%). While 57% of physicians who reported burnout or depression attributed some of it to personal life, 73% attributed all or most of it to work. About 69% said that work burnout had negatively affected their personal relationships. This effect on personal relationships was most evident in respondents younger than 45 years (90%), compared with those aged 45 years or older (65%). Health and wellness were a priority or somewhat of a priority for 91% of respondents, with exercise being a commonly reported activity to achieve them (72%). Exercise was a daily activity for 17% of respondents. About 30% reported engaging in it two or three times a week, and 26% reported exercising four to five times weekly. Slightly more respondents (73%) reported spending time with family and friends and pursuing hobbies as their way to stay well. Healthy eating was reported by 64%, and 58% reported getting enough sleep. Yearly vacation time totals of 3-4 weeks were common (36%), and many respondents (42%) had more weeks of vacation than that. Almost half (48%) of respondents said that they would take a salary reduction to achieve better work-life balance, while 27% said that they would not, and 25% said that they were not sure. Respondents younger than 45 years were more likely to endorse this option than older respondents (61% vs 47%). A desire to spend less personal time online was reported by 49% of respondents, with 56% reporting spending 2-4 hours a day online for personal reasons, including social media, texting, movies, news, and other interests. Poor Self-Assessment? Commenting on the survey results for Medscape Medical News , Catherine Pound, MD, director of Physician Support and Wellness at the Canadian Medical Protective Association (CMPA), said the rate of burnout and depression in the survey is likely an underestimate. The CMPA recently launched the Physician Well-Being Index, a validated tool that has found higher rates of physician depression and burnout, said Pound. 'The level of distress we are seeing is about two thirds of physicians who are struggling or in distress, and that level was a bit lower in the Medscape survey. 'What was super interesting to me is that the Medscape survey asked people to self-assess, as opposed to the Well-Being Index, which gives you a result of well-being based on the questions they ask,' Pound added. Physicians are not good at assessing their own mental states, she said. 'If I ask a physician if they're distressed, they may say no, but if I give them a validated tool, the result may be different.' The Well-Being Index has thus far collected almost 4000 responses from 117,000 CMPA members. While those responses might reflect a self-selection bias of respondents who are feeling higher than average levels of distress, Pound said that the findings dovetail with the results of the Medscape survey. 'All across Canada, there's a human resource crisis. We know that physicians are working really hard. They're working long hours, and we know that there's a lot of emotional distress and burnout. Physician wellness is a pillar of the healthcare system. If you don't have physician well-being, then we know there's an increased risk of patient dissatisfaction, there's an increased risk of patient safety events, and there's an increased risk of burnout, and the more physicians who leave the system because they're burnt out. It's a vicious cycle.' Small Numbers Margot Burnell, MD, president of the Canadian Medical Association, said the Medscape survey provides more information on this area and is consistent with research underway by her organization, but it includes a relatively small sample size. 'We will be releasing our national physician health survey results in the fall, so seeing something a little more robust will be good to add to all of these data points on this important topic,' she told Medscape Medical News. Burnell identified four main opportunities to alleviate physician burnout and improve well-being, including facilitating physician autonomy, easing administrative burden, streamlining team-based care models, and improving access to patient health data through electronic medical health records. 'There were several bills that died when government was prorogued, and one was on connected care and data interoperability,' she explained. 'There is an imperative to get that back onto the legislative table. We will be working with all parties to identify solutions that we can move through with our stakeholders — federal, provincial, and territorial medical societies and governments — to keep healthcare at the forefront.' Pound and Burnell reported having no relevant financial relationships.
