medical

SAMANTHA Fox has been forced to cancel her upcoming show on ‘medical advice’ after suffering from ‘ongoing pain.’

She became one of the country’s most famous women almost overnight after her debut on The Sun in February 1983.

Her Page 3 career also became the launch pad to a world of lavish celebrity parties and later for her global success as a pop star, with 30million record sales.

Samantha, 60, continues to perform and was set to appear at Hard Rock Live in Florida at the end of August alongside a string of other stars.

However, she has cancelled her appearance and took to Instagram to share a statement with fans.

She captioned the image: “Sorry, I’m truly so upset about doing this, I think in 40 years this is only the 3rd time I’ve had to cancel a show.

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“Getting the right treatment now but the worst is the pain, love you Foxys. I’ll be fighting fit soon love Sammy.”

In the statement, Samantha explained that she had been struggling with ongoing back and hip pain for some time and following medical advice, it wasn’t possible for her to make a long-haul journey.

She explained: “I absolutely hate letting my fans down, as well as everyone who worked so hard and was looking forward to the show.”

Samantha also revealed she was heartbroken to withdraw from the event as she was so excited to be back performing in America.

She added: “This isn’t goodbye America, I am determined to get myself properly fit and well.

“I very much hope to return to the USA for a live show again very soon.”

Fans flocked to comment and one wrote: “I hope you get better soon and sending you so much love and positive energy!

“Us fans in the US will be here with open arms when you return someday, until then, I hope you stay healthy and get well.”

Another said: “Sending lots of love and well wishes!”

“Your health is the most important! I wish a speedy recovery for you,” wrote another fan.

A fourth added: “I am so sorry that you have to cancel but your health is the most important! Get well soon.”

Most documentaries urge you to not turn away from the horrors they chronicle, but few make that request as explicitly as “American Doctor.”

Near the start of her despondent film, director Poh Si Teng spends time with Mark Perlmutter, a North Carolina surgeon who, like Teng’s other subjects, volunteers in Gaza, treating the many who have been severely injured in the ongoing Israeli-Palestinian conflict. Furious at the attacks on innocent Palestinian children, Perlmutter shows Teng photos of dead bodies. She says she may need to blur them for the movie. Perlmutter becomes indignant: “You’re not doing them a service by not showing them,” he says. “You have the responsibility, as I do, to tell the truth.”

Teng does reveal those stark faces and much more — not just the terrible human toll of Israel’s shelling of the Palestinian territories but also the strain on the doctors fighting to save lives while spreading the word about the atrocities they’ve witnessed.

Perlmutter, who is Jewish, is one of three American physicians at the center of Teng’s documentary. The other two are Thaer Ahmad, a Palestinian, and Feroze Sidhwa, who is Zoroastrian. Each of them resides in the U.S. but is drawn to lending a hand at Gazan hospitals — that is, when they’re actually allowed entry into the region. (Because of Ahmad’s Palestinian heritage, he’s been barred by the Israeli government.) As part of their humanitarian efforts, Perlmutter and his colleagues go on Western media, such as CNN, to decry the conditions of the Palestinian people. They are often met with resistance, if not outright hostility. The casualties keep piling up, and nobody outside the walls of the hospital seems to care.

Teng, who produced the 2019 Oscar-nominated documentary short “St. Louis Superman,” a portrait of a local Black activist, once again ponders how much any one person can do to bring about change. She gracefully balances between a three-pronged character study and a larger examination of the unending war. We come to admire Ahmad, Perlmutter and Sidhwa, but Teng provides just enough shading so that subtle cultural tensions between the men start to emerge.

That strain is particularly evident during the bighearted but strident Perlmutter’s impolitic media appearances, in which he brandishes impassioned criticism of Zionism that angers the Palestinian Ahmad. “We’ll be guilty by association and we’ll just get crushed for it,” he worries. It’s a documentary with a paucity of inspirational moments. Teng and her subjects are embedded in a world of tough choices and grim conditions.

With Ahmad largely sidelined in the U.S., though still advocating for the Palestinian people, Sidhwa ultimately becomes “American Doctor’s” most striking figure. Armed with an eloquent, righteous fury, he speaks to journalists with a stirring moral authority. Teng mostly avoids on-camera interviews with her subjects, preferring to watch them interacting with patients or in the operating room. In the process, we come to know Sidhwa, who projects a calm confidence, even when he’s nearly killed by a missile.

But his self-assurance is intriguingly undercut during an unguarded exchange in which he acknowledges that no prospective romantic partner has been comfortable with his desire to keep returning to Gaza. “I think I’m just probably a hard person to get along with,” he admits, laughing. “I wish I could blame the fact that no woman can put up with me on the Israel-Palestine conflict, but I don’t think that’s the issue.”

There are myriad ways to document the violence in Gaza, and it’s telling that Teng includes only a very brief news clip of President Trump and Israeli Prime Minister Benjamin Netanyahu, the phantom figures hovering far above the film’s unfolding tragedy, even though they are among its chief architects. Instead, “American Doctor” focuses on the micro, giving voice to the doctors and caregivers who traditionally have been spared during armed conflicts, as laid out by the Geneva Conventions. In defiance of such norms, though, Israel’s government seems to be targeting hospitals, creating psychic wounds alongside mass casualties.

A closing text card indicates that more than 1,700 healthcare workers have died in Gaza, laying culpability at the feet of Israel and the United States. But it’s a testament to the physicians featured in “American Doctor” that none of them would suggest that this is the greatest crime occurring in the region. We observe them lamenting how powerless they feel: Their medical skills can do some good, but not nearly enough. And when they reluctantly return to America, they agonize over their guilt at not being able to do more — and what of Gaza will remain when they eventually get back.

Aug. 18 (UPI) — Medical experts and a family member testified in a Massachusetts courtroom Tuesday that Lindsay Clancy’s mental health was so precarious that she cannot be held responsible for the strangulation deaths of her three children.

A trio of doctors and Clancy’s former mother-in-law, Susan Clancy, each testified in her defense as her attorneys sought to show the 36-year-old defendant is not guilty of murdering her children — 5-year-old Cora, 3-year-old Dawson and 8-month-old Callan — at their Duxbury, Mass., home on Jan. 24, 2023 due to mental illness.

While not denying she killed the children, they contend she is not criminally responsible because she was suffering from bipolar disorder and postpartum psychosis.

The Plymouth County, Mass., District Attorney’s Office, however, argues that Clancy was not experiencing psychosis when she strangled the children and jumped from a window, suffering permanent paralysis from the waist down.

After the prosecution rested its case last week, the defense continued with its own case.

Among the medical experts taking the stand Tuesday was Dr. Paul Zeizel, a clinical and forensic psychologist who testified about meeting with Clancy at the hospital after the killings.

After testifying that Clancy told him she had “fuzzy” memories of the killings, he said she told him she heard a man’s demanding she kill the children and then herself.

Zeizel forcefully suggestions of having “planted” that story with Clancy.

Also testifying for the defense was another medical expert, former medical examiner Dr. Elizabeth Laposata, who spoke about the injuries Clancy suffered in her suicide attempt in an apparent effort to counter prosecutors’ suggestions that she had not jumped out a window.

Another medical witness, Dr. Donald Condie, testified that Clancy exhibited symptoms consistent with postpartum depression, such as brain fog and anxiety.

The day’s testimony also included emotional words from Susan Clancy, the mother of Patrick Clancy, who said the couple had a “very good relationship,” WBTS-TV reported.

“She was very nurturing, very loving, she was a wonderful mother. Wonderful,” she said of Lindsay. “She loved her children, all of them, very, very much.”

A former nurse, Susan Clancy she said she noticed a change in Lindsay’s personality after the birth of Callan, the youngest child.

“She reached out to me in November and told me that she felt unwell,” she said. “Mostly, she had insomnia, she was losing her appetite, she was very anxious and sad.”

It’s right there in the medical books, along with Belsey fundoplication, Heineke-Mikulicz pyloroplasty and Keller’s excision arthroplasty: Tommy John surgery.

Purists might refer to it as ulnar collateral ligament reconstruction, but the rest of the world knows it as the career-saving surgery named for a sore-armed left-handed Dodgers pitcher.

Tommy John was facing the bleak reality that his career was likely over when he ruptured a ligament in his left elbow on a summer night in 1974, an injury that had sent so many pitchers into an early retirement. But a then-radical surgery not only saved but revived his career, as well as the careers of hundreds of baseball players ranging from Tom Candiotti to John Smoltz to Shohei Ohtani in the 50 years since.

Always more famous for the surgical procedure than his career stats, John died Saturday, the Dodgers announced. He was 83.

“We are saddened to hear the news of Tommy John’s passing,” Dodgers president and CEO Stan Kasten said in a statement. “… Tommy was an exceptional pitcher throughout his career in Major League Baseball and his courageous role in becoming the first to have surgery that would go on to bear his name can’t be overstated. His impact both on and off the field has been felt by ballplayers of all ages and will be for generations to come.”

A good pitcher before the surgery with 124 wins in 12 seasons with three teams, he won 164 more afterward — only one fewer than Sandy Koufax during his entire career, he liked to point out — in 14 more seasons with four teams, finally retiring at 46 with a 288-231 record and a 3.34 earned-run average.

“Dr. Jobe made it so I could throw a baseball again,” John told The Times’ Sam Farmer in 2023 from his home in Sarasota, Fla. “After surgery, I never missed a start, and I even pitched out of the bullpen every once in a while.”

He pitched for the Dodgers and the Angels and had two successful stints with the New York Yankees but it was with the Dodgers that he had his greatest success, an 87-42 record and a 2.97 ERA, helping them to consecutive World Series appearances.

It was also as a Dodger that he had his history-making operation.

He came to the Dodgers in a trade from the Chicago White Sox in December 1971 with an 84-91 record, a good curveball and a less than intimidating fastball. Pitching coach Red Adams convinced him that precision location and ball movement were more effective than raw speed and John went 11-5 the following season. He also became well acquainted with orthopedist Frank Jobe, the team physician.

Late in the season, he jammed his left elbow sliding into home plate, jarring loose some bone chips. Jobe cleaned things up for John during the offseason.

Dodgers manager Tommy Lasorda congratulates Tommy John after John shut out the Phillies during 1978 National League Championship Series.

(Associated Press)

Then in July 1974, by which time John had become a mainstay in the pitching rotation, he threw a pitch to Hal Breeden of the Montreal Expos that changed his life, and ultimately the lives of many others.

“Right at the point where I put force on the pitch, the point where my arm is back and bent, something happened,” he told Sports Illustrated. “It felt as if I had left my arm somewhere else. It was as if my body continued to go forward and my left arm had just flown out to right field, independent of the rest of me.

“I heard this thudding sound in my elbow, then I felt a sharp pain.”

John had ruptured the medial ulnar collateral ligament in his left elbow, although he didn’t know that then. The pitch, of course, was nowhere near the strike zone and, despite the pain and in an effort to see if that was a fluke, he tried to throw another. It bounced off the plate, ending his outing and, for all anyone knew, his pitching career.

Jobe recommended total rest but after a month, with no sign of healing, he came up with an outside-the-box suggestion. Earlier, Jobe had grafted a tendon to a recovered polio patient’s ankle to provide stabilization. He thought maybe a tendon could be grafted to a pitcher’s elbow as well.

He gave John a grim choice: Do nothing and never pitch again, or try the surgery at 100-1 odds against success.

“I told Dr. [Frank] Jobe if you do your job I will do more than mine,” John told The Times last year. I just happened to be in the right place at the right time with the right doctor and team.”

So, on Sept. 25, 1974, Jobe took a tendon from John’s right arm, threaded it through holes he had drilled in John’s left elbow and hoped it all would work.

Nerve damage necessitated a second surgery several months later and the prospects were not promising. John’s left arm had atrophied, his hand now basically a claw, and two of his fingers were numb.

Even so, he began rehab, knowing he would miss the entire 1975 season. He taped the unfeeling fingers to the functioning ones so that he could grip a baseball, then, resembling “a little boy throwing against the steps of his back porch,” threw against a wall. He squeezed Silly Putty and strictly adhered to a physical therapy regimen.

By June 1975 he had regained the use of his entire hand and in late September pitched three innings in an exhibition game. He continued his routine through the offseason and into spring training, once joking, “When they operated on my arm, I asked them to put in a Koufax fastball. They did but it turned out to be Mrs. Koufax.”

Surprising many, who considered it at least a minor miracle, he was back in the rotation at the start of the 1976 season and went five innings in his first start, giving up five hits and three runs in a loss to the Braves in Atlanta. He finished the season at 10-10 with a 3.09 ERA, and if anyone was still wondering about his comeback, he put doubts to rest in 1977.

In one of his best seasons, he won 20 games, had a 2.78 ERA and finished second in National League Cy Young award voting for the pennant-winning Dodgers. In a 4-1 win over the Philadelphia Phillies in the clinching Game 4 of the NL Championship Series — then a best-of-five format — John pitched a complete game, striking out eight in a 130-pitch effort.

Dodgers pitcher Tommy John celebrates after the final out in a 4-1 victory over the Phillies in Game 4 of the 1977 NLCS that clinched the pennant for the Dodgers.

(Associated Press)

He came back with a 17-victory season in ’78 and the Dodgers won the pennant again but again lost to the Yankees in the World Series, with John winning a game in both the NLCS and World Series. After the season, he signed with New York as a free agent.

He was an immediate hit with the Yankees, winning 21 games in 1979 and finishing second in the American League Cy Young voting, then won 22 in ’80. In 1981, the Yankees reached the World Series, once again facing the Dodgers — and John was at the center of the most controversial decision in the series that ultimately sealed New York’s fate.

John was the starter in Game 6 at Yankee Stadium with the Dodgers leading the series, 3-2. The left-hander had won Game 2, giving up three hits over seven innings in a 3-0 victory, and had completed four innings of one-run ball when Yankees manager Bob Lemon elected to pinch-hit for John with two runners on in a 1-1 game. ABC, which broadcast the World Series that year, showed John looking visibly upset and surprised as he paced the dugout.

Bobby Murcer flied out to right to end the inning, and the Dodgers would score eight runs over the next four innings against an ineffective Yankees bullpen to secure a 9-2 victory and win the franchise’s first World Series since 1965.

“At the time my reaction was, ‘why is he doing this?’ I was pitching fine and you don’t pull someone out in the fourth inning just because you need a hit at the time,” John said last year. “I was not happy, but that was so long ago in retrospect could we have won? I think so. Does it matter now? No.”

In John’s two stints with the Yankees — he had four seasons with the Angels in between — he was 91-60 with a 3.59 ERA.

And it was with the Yankees that he made the record book, in a way no player would ever want. He committed three errors in an inning, all on the same play during a game July 27, 1988.

With the Yankees leading the Milwaukee Brewers 4-0 and Jim Gantner on first for the Brewers, John charged a slow roller by Jeffrey Leonard to the first-base side of the mound. First, he bobbled the ball. Then, he sailed it past first baseman Don Mattingly, bouncing it off the right-field ballboy. Dave Winfield made a nice play on the ball and fired a strong throw home. It was on line and probably would have nailed the hustling Gantner but John cut it off, then threw wildly past catcher Don Slaught and into the Brewers’ dugout as Gantner scored.

John’s summation, according to Newsday? “I must have had a metal cup on. It glitched the ions in the air.”

After his playing days, John did some broadcasting, some minor league managing and became a strong advocate for suicide prevention after one of his sons took his own life. And after seeing many young pitchers, some still in their teens, undergo the surgery named for him, he spoke out against arm overuse, recommending less than year-round pitching by young arms.

But regardless of the context, John is forever linked to the operation that continues to be performed by orthopedic surgeons such as Dr. Neal ElAttrache, who began learning how to perform the procedure when he was a fellow at the Kerlan-Jobe Orthopedic Clinic in 1990 from Jobe himself. The two would operate together twice a week throughout the 1990s and were close friends until Jobe’s death in 2014.

“It should have been called the Frank Jobe operation,” ElAttrache told The Times in 2023. “But with Frank being the man he was, it was all about the person he was treating. It wasn’t about him.”

By ElAttrache’s estimation, he has performed the operation between 50 and 75 times per year over his career — including the two he has done on Ohtani, one in 2018 and one in 2023. And although ElAttrache has put his own signatures on the surgery — including a second graft to further fortify Ohtani’s elbow — the operation has remained largely the same since Jobe first performed it in 1974.

John is survived by his wife, Cheryl, and his children, Tommy, Travis and Tamara. A private celebration of his life will be held in Florida.

Leeds United have agreed an £8.5m deal to sign Swiss defender Nico Elvedi.

The 29-year-old is travelling to England for a medical on Monday after Borussia Monchengladbach accepted an offer worth an initial £6.8m, with a further £1.7m in add-ons.

The versatile Switzerland international is set to end his 11-year stay with the German top-flight club by moving to Elland Road.

Elvedi is a highly experienced addition, having earned 73 caps for his country and featured as part of Switzerland’s squad at this summer’s World Cup.

Asked about the deal after a 4-0 pre-season win over Augsburg, Leeds manager Daniel Farke said: “I’ve been working in football long enough to know everything is only final once the medical checks are completed and all the paperwork is signed. We’ve seen situations like this before.

“So I only speak about new players once they have been officially announced and everything is settled. But I don’t want to lie, and we expect something to happen in the next 48 hours.”

The move would allow fringe Leeds defender Sebastiaan Bornauw to join Hamburg on an initial loan with an option to buy.

Leeds begin their Premier League campaign away at Nottingham Forest next Saturday.

ROD Stewart has sparked concern for his health as he pulled out of a second concert in a week over a mystery medical issue.

It’s been revealed 81-year-old rocker has pulled out of his August 9 gig at the Riverbend Music Center in Cincinnati.

This comes after he cancelled a string of concerts earlier this year due to health setbacks.

The organisers of the event announced the shocking news yesterday – the day of the gig.

They confirmed Rod was undergoing an “unforeseen but minor medical procedure.”

The venue shared a statement on social media, which said: “Due to an unforeseen but minor medical procedure that required prompt attention, Rod Stewart’s performance tonight in Cincinnati has been postponed.

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“Rescheduling is currently underway, with additional information to follow on Tuesday.

“All previously purchased tickets will be honored for the rescheduled date.”

They claimed Rod is expected to be back tearing up the stage soon.

“Rod is expected to make a quick recovery and looks forward to returning to Cincinnati,” said the Riverbend Music centre.

One fan wrote: “I hope he’s okay,” followed by a praying hands emoji.

“Praying he’s doing well the concert hasn’t been cancelled just postponed,” penned another fan.

This isn’t the first time the Scottish-born star has left his fans feeling concerned.

Back in June the hitmaker was forced to pull out of a gig in California, due to a respiratory infection that later triggered a bout of laryngitis.

Just a week later, Rod stopped midway through his Utah concert and was seen using an oxygen tank onstage after nearly passing out.

Following the sad news, Rod also postponed his concerts at Red Rocks Park and Amphitheatre in Morrison, Colorado in June, citing vocal rest.

He has repeatedly told fans that while he is winding down large-scale global arena touring, he has no intention of fully retiring from music or performing altogether.

Rod Stewart, who is married to TV personality Penny Lancaster, shot to fame in 1971 following the release of his debut album, Every Picture Tells A Story.

His biggest hits include Maggie May, Sailing and Da Ya Think I’m Sexy?

Over his six-decade career, he’s sold over 250 million records worldwide, been inducted into the Rock and Roll Hall of Fame twice, and received a knighthood in 2016.

WASHINGTON  — Fear was growing in hospitals across the country in 2009 as a frightening epidemic that came to be called the H1N1 swine flu swept across the globe.

From Galveston, Texas, where a hospital ran out of test kits, to Loma Linda University Medical Center in San Bernardino, which had to set up tents to handle a crush of patients, to New York, where hospitals scrambled to bring on extra emergency staff, it appeared the nation’s healthcare system would be overwhelmed.

The worst did not materialize. The lesson, though, was clear: The nation needed larger caches of standby medical supplies and hospitals that were better prepared to handle a surge of infected patients.

A decade later, the coronavirus crisis is exposing many of the same gaps. Inadequate supplies of protective masks, ventilators, intensive care beds and other medical resources are forcing mass closures of schools and businesses and restrictions on everyday activities as public officials rush to slow the virus so America’s medical system isn’t overwhelmed.

“So much that was predicted has come to pass,” said Marcia Crosse, former head of the healthcare section of the Government Accountability Office. Since the early 2000s, the GAO, the federal government’s leading internal watchdog, has issued a steady stream of reports about poor pandemic planning.

As the current crisis has widened, President Trump has attempted to deflect responsibility for his administration’s poor planning, suggesting the coronavirus outbreak was inconceivable.

“Nobody knew there would be a pandemic or epidemic of this proportion,” the president said Thursday.

The opposite is true. The GAO, public health experts and others issued a steady drumbeat of warnings that America would sooner or later face a widespread infectious disease outbreak or a major bioterrorism attack and was woefully unprepared.

In both 2018 and 2019, U.S. intelligence agencies issued insistent warnings in their annual Worldwide Threat Assessment.

“We assess that the United States and the world will remain vulnerable to the next flu pandemic or large-scale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support,” the 2019 report noted.

That is only the most recent warning. As early as 2003, the GAO cautioned that many urban hospitals lacked enough ventilators to treat a large number of patients suffering from respiratory problems that would be expected in an anthrax or botulism outbreak.

“Ventilators have long been recognized as a weak link,” said Crosse, who spent 35 years at GAO before retiring in 2018.

Today, a lack of ventilators is emerging as a potentially critical shortfall because patients hit hardest by COVID-19, the illness caused by the coronavirus, often suffer severe respiratory problems.

Federal policymakers concentrated heavily on pandemic preparedness in the aftermath of the 9/11 terrorist attacks and anthrax scare in 2001, which both exposed gaps in the nation’s emergency response system.

In 2005, the administration of President George W. Bush published a landmark “National Strategy for Pandemic Influenza.” The document, among other things, highlighted the need for plans to distribute necessary medical supplies from the nation’s Strategic National Stockpile and to support state and local efforts to “surge” medical personnel and facilities to handle an outbreak.

Medical equipment such as masks and protective clothing in particular were given high priority as planners recognized that doctors, nurses and other medical staff were most vulnerable.

After the swine flu epidemic in 2009, a safety-equipment industry association and a federally sponsored task force both recommended that depleted supplies of N95 respirator masks, which filter out airborne particles, be replenished by the stockpile, which is maintained by the U.S. Department of Health and Human Services.

That didn’t happen, according to Charles Johnson, president of the International Safety Equipment Assn.

The stockpile drew down about 100 million masks during the 2009 epidemic, Johnson said.

“Our association is unaware of any major effort to restore the stockpile to cover that drawdown,” he said.

Last month, Health and Human Services Secretary Alex Azar said that available supplies included just 12 million N95 masks and 30 million surgical masks, a tiny fraction of the 3.5 billion masks one of Azar’s deputies later testified the nation’s healthcare system would need.

Already across the country, there are signs of medical centers running out of protective equipment, compounding the challenges caused by the federal government’s inadequate supply of coronavirus testing kits.

At Sinai Health System, which serves largely low-income patients on Chicago’s South and Southwest sides, hospital officials started signing out masks and other protective equipment as carefully as they handle narcotics.

“We’ve never had to do that before,” said Karen Teitelbaum, the system’s chief executive.

These shortages are particularly appalling, said Jeffrey Levi, a professor at the Milken Institute School of Public Health at George Washington University and former head of the Trust for America’s Health, a nonprofit public health advocacy group.

“Every time we have an emergency, protecting healthcare workers has been the No. 1 policy issue,” Levi said. “To have neglected that is shocking.”

Making the case for investments in material and hospital planning has long been challenging as most people have difficulty envisioning a major disaster, acknowledged Dr. Eric Toner of Johns Hopkins University, an authority on pandemic preparedness.

Hospitals also are under pressure to keep margins thin and eliminate spending on staff and supplies that aren’t used all the time.

The budget crunch represents a particular challenge for so-called safety-net hospitals, institutions that serve many uninsured patients and those covered by Medicaid, and consequently collect less revenue. These same hospitals are now expecting a large surge in coronavirus patients but have limited resources to ramp up staffing and add intensive care beds if needed.

“Cash is very limited,” said Charlie Shields, chief executive of Truman Medical Centers in Kansas City. Shields said the finances are under even more stress since the hospital canceled elective procedures and shut down its dental services to prepare for the pandemic, moves that reduce hospital revenue.

Toner at Johns Hopkins noted these kinds of strains are why the federal government should have provided a stronger backstop.

“The argument we’ve made for 20 years is that if we want to have prepared healthcare institutions, this has to be a societal responsibility, and that means a government responsibility.”

After 9/11, the federal Hospital Preparedness Program was created in 2002 to help hospitals plan for public health emergencies and terrorist attacks.

But as time passed, the program was steadily cut. In 2007, Congress trimmed $44 million from the program’s budget. In 2014, lawmakers cut $120 million.

Overall, money for the program has been slashed by about half since 2003, said John Auerbach, chief executive of the Trust for America’s Health.

Auerbach, who was Boston health commissioner for nine years, said he and other public health officials routinely pleaded with Congress to restore the spending.

He said lawmakers frequently offered the same response: “Do we still need that?”

WASHINGTON — The Department of Homeland Security’s system for paying for detainee medical care has collapsed, records show, leaving a backlog of unpaid claims likely costing millions of dollars.

With a new payment system still not in place, advocates for immigrant detainees fear some are going without necessary treatment as medical providers near a year without compensation.

Newly released federal records reveal what that treatment could be for, detailing more than 233,000 claims for off-site medical and dental care between January and early October of 2025. The claims, for which Homeland Security spent $96 million, show detainees were treated for a wide variety of conditions, including strokes, pregnancy, suicide attempts and frostbite.

For years, Homeland Security relied on a unit of the Department of Veterans Affairs, its financial services center, to process reimbursement claims for detainee medical care. But since that arrangement abruptly ended Oct. 3, the company hired to create a new payment processing system has yet to start reimbursing the medical clinics, dental practices and pharmacies that treat detained patients.

The documents were released by the VA to the nonprofit watchdog group American Oversight through the Freedom of Information Act and shared exclusively with The Times. They paint the clearest picture yet of the off-site medical care received by immigrants in the custody of the federal government before the payment system fractured.

The old system used by Homeland Security was scrapped after critics questioned why the VA was processing paperwork for a different federal department.

During the Biden administration, Republicans claimed that the contract between Homeland Security and the VA took resources from veterans to facilitate healthcare for immigrants and introduced a bill to stop it.

Last year, with President Trump back in office, the VA wrote Immigration and Customs Enforcement on Aug. 19 to say that it would stop processing detainee medical claims by Feb. 28, 2026.

“This termination is necessary to reallocate resources to support mission-facing programs,” the letter states.

On Sept. 30, the right-wing Center to Advance Security in America filed a lawsuit against the VA seeking answers to a year-old request for records related to the alleged diversion of resources. The VA didn’t respond to requests for comment. But then-VA press secretary Pete Kasperowicz told the Daily Signal that the department had, under President Biden, focused on unnecessary activities such as processing healthcare claims for immigrants.

“Under President Trump, the department has abandoned these radical liberal priorities and rededicated itself to providing the best possible care and benefits to the Veterans, families, caregivers and survivors we serve,” he said.

Three days after the lawsuit was filed, the VA stopped processing Homeland Security claims. Later that month, ICE awarded multimillion dollar no-bid contracts to two companies tasked with taking over claims processing: Acentra Health for healthcare services and Ardent Group for pharmacy services.

Federal law requires Homeland Security to provide medical care to the people in its custody. Those held by Customs and Border Protection near the border, or by ICE in the country’s interior, are civilly detained for the purpose of removal proceedings. ICE is holding more than 65,000 detainees as the agency touts record-high arrests this summer.

ICE and Customs and Border Protection rely on about 3,000 community-based providers and local hospitals, which submit about 300,000 claims annually for detainee care, according to ICE.

The claims outlined in the VA documents show ICE paid $77.3 million, 80% of the total, and CBP paid $19 million. Together, the agencies paid on average about $260 for off-site care per detainee from January to October 2025, a Times analysis found. By comparison, federal prisons in fiscal year 2025 spent about $2,700 per inmate on external medical care.

For ICE, medical conditions that had the highest number of claims included screenings for tuberculosis and other diseases and treatment for hypertension, chest pain and type 2 diabetes. Some of the highest-paid amounts related to treatment of psychosis, schizophrenia and sepsis.

More than a third of the claims for CBP — and more than half of the total paid amount — went to a category of claims called “injury, poisoning and certain consequences of external causes.” That includes traumatic injuries such as fractures, concussions and hemorrhages.

Among other notable claims are 2,267 for pregnancy, birth and maternal care, 1,793 for seizures and 419 for suicide or self-harm. The most expensive claim was $292,199 for treatment of leukemia.

Homeland Security did not return requests for comment but frequently says it provides comprehensive medical, dental and mental health care, which officials tout as the best healthcare many detainees ever received.

Dr. Amy Zeidan, an emergency medicine doctor and associate professor at Emory University who studies immigrant detainee health outcomes, said the VA data show detained immigrants require significant medical care. She said some of those entering detention facilities likely have chronic conditions and don’t get proper care, while others likely develop serious conditions while detained.

“There is a high burden of disease in detention facilities that we have always suspected but really had no evidence to support,” she said. “It’s not like these are people getting routine visits for mildly high blood pressure — these are people who require hospitalizations.”

“If claims are no longer being paid, this is a big problem because outside care is certainly needed,” she added.

The decision to end the processing agreement with the VA “created an emergency,” according to ICE officials. That phrase appears in a contracting document for Acentra Health that was first reported on by independent journalists through the newsletter Popular Information.

Several vendors expressed interest in the job, but ICE said a formal competition would take months and the lack of a way to process claims could delay necessary medical care, such as dialysis, prenatal care and chemotherapy.

ICE needed to come up with a new way to process medical claims “instantly” in order to “prevent any further medical complications or loss of life,” the contracting document states. “Off-site providers who are not paid timely may not accept new patients or continue to provide vital care and services.”

The ICE officials wrote that Acentra Health provides the same claims processing system used by the VA and would be able to restore claims processing services quickly.

Claims processing was slated to resume April 30, but providers still haven’t been paid.

The ICE Health Service Corps website says providers should “hold all claim submissions while we work to bring the new system online.”

Lindsey Rodarmer, public relations manager for Acentra Health, said the company’s role under its contract is solely to build out the claims processing system — not to start processing claims.

“The timeline for the completion of this project depends on factors beyond any single party, including two government shutdowns, funding lapses, and the timing of federal authorizations, all of which have impacted the project schedule,” Rodarmer said.

According to a federal contracting website, Acentra has been paid $44.6 million of its $67.5-million contract, which Rodarmer said was extended until Sept. 24. Ardent Group has been paid $26.7 million of its $42.6-million contract, which is slated to end Oct. 24.

In June, Homeland Security posted a request for information to identify other potential vendors. The agency wants companies to answer 29 questions. The first asks for a “realistic timeline” on when the processing of claims can begin.

Rodarmer said Acentra responded to the request for information and, if chosen, would begin paying out claims under the system it built.

Last month, Reps. Mark Takano (D-Riverside) and Delia Ramirez (D-Ill.) wrote to the leaders of the VA and Homeland Security seeking answers about when Acentra will begin processing reimbursements, whether any claims have been paid since Oct. 3, and how many detainees have had health complications or died because they were unable to access off-site healthcare. The lawmakers said the agencies haven’t responded.

In an interview, Ramirez said she believes the lack of payment for medical claims is directly tied to an increase in detainee deaths. At least 23 people have died in immigration custody this year. Last year the agency reported 33 in-custody deaths.

She said that without answers to the questions she raised with Takano, there’s no way to know what Homeland Security has been billing for and how much care has been put on hold.

“In our current system, if no one is paying for services, no one gets healthcare,” Ramirez said. “Since DHS and VA stopped processing medical claims nine months ago, it is clear that our neighbors are being deprived of necessary medical care in violation of the law.”

Meanwhile, detained immigrants and their supporters have raised increasing alarms over medical care provided by ICE.

ICE said Edwin Jovanny Lopez Cornejo, 41, of El Salvador suffered a medical emergency on Saturday and was pronounced dead after being taken to a New Jersey hospital.

The agency said Lopez Cornejo had received proper medical care and was seen by medical professionals. His mother, however, told a local immigrant rights group that she believed he hadn’t received his medication for diabetes, high blood pressure and seizures.

In California, a court-appointed medical monitor issued a report last month finding that the state’s largest immigrant detention center repeatedly has delayed assessments, treatment and administration of medication for detainees. The center’s operator told The Times it was reviewing the report and that nothing matters more than the health, safety and well-being of people under its care.

At the California City Detention Facility, one man waited months for a surgery he never received. The 34-year-old man asked to be identified by his initials, A.S., over concerns about his immigration case.

A.S. said he tripped and broke an ankle while detained in late February. He was transported to a local hospital and placed in a cast.

Medical records show A.S. didn’t see a specialist until April 10, when it was determined he needed surgery. At an appointment June 1, A.S. said a doctor told him he had missed a scheduled operation, which medical records appear to confirm.

He said the doctor told him too much time had passed and the surgery no longer was possible because of risk of complications. The doctor ordered physical therapy, A.S. said, but medical records show he didn’t receive any.

A.S. was released from the detention center last month still limping and in pain. Unable to find work or pay to see a doctor, he has resorted to recycling cans and bottles to support himself.

“They knew about my situation — there were requests asking to be seen, there were complaints I had filed, so it’s not like they didn’t know,” A.S. said. “Instead, it’s as if they didn’t want to give me the medical attention.”

Chelsea have agreed a deal to sign Danny Welbeck while Jordan Henderson is set to cancel his Brentford contract to enable a move to Stamford Bridge.

Henderson, 36, is under contract until 2027. Welbeck, 35, has agreed a two-year deal and been given permission by Brighton to conduct a medical at Stamford Bridge.

A fee for the striker has also been agreed but remains undisclosed as Chelsea tie up the deal for him to join pre-season in Hong Kong after Chelsea‘s final match in Australia against Tottenham on Saturday evening.

Welbeck will become the oldest signing under the Todd Boehly and Clearlake Capital ownership, until Henderson’s likely arrival with the west Londoners.

It is part of new manager Xabi Alonso’s drive to add experience to Chelsea‘s squad, which has been the youngest in the Premier League for the past two seasons.

Their focus on youth has been viewed as a factor in their inability to challenge consistently for major honours.

Towards the end of last season’s disappointing campaign, when they finished 10th and won nothing, Chelsea co-owner Behdad Eghbali said their recruitment model needed a “tweak”.

Since then, Chelsea have made an offer to reunite Sunderland midfielder Granit Xhaka, 34, with Alonso – they won the Bundesliga title together at Bayer Leverkusen in 2024.

They have also signed 26-year-old centre-back Maxence Lacroix from Crystal Palace on a six-year contract, pending an official announcement, while talks continue over Henderson.

Morgan Rogers, who signed for a club-record £117m from Aston Villa earlier this month, is relatively experienced, despite having just turned 24.

The club have also signed 21-year-old full-back Marco Palestra from Atalanta.

Welbeck, formerly of Manchester United and Arsenal, has hit 90 goals in 400 top-flight appearances – and is the leading Premier League scorer at Brighton, who he joined on a free transfer from Watford in 2021.

His arrival would leave Chelsea with six senior strikers on their books, with others available for loan or sale.

Among those who could leave on either a permanent deal or loan are Nicolas Jackson, Liam Delap and Marc Guiu.

The Blues have also brought in Dutch striker Emmanuel Emegha from sister club Strasbourg this summer and he could remain part of the squad.

Henderson, meanwhile, would add further experience and seniority to the squad, having been selected by Thomas Tuchel as part of England’s leadership group at this summer’s World Cup.

It was during the celebrations following England’s last-16 victory over Mexico that Henderson fractured his arm and wrist after landing awkwardly while jumping over an advertising hoarding.

Henderson joined Brentford last summer after spells abroad with Dutch side Ajax and Saudi club Al Ettifaq. That followed a hugely successful spell at Liverpool, where he won six major honours, including the Champions League and Premier League.

He joins a midfield that includes Moises Caicedo, Enzo Fernandez, Dario Essugo, Romeo Lavia and Valentin Barco – who is expected to join from Strasbourg – pending an official announcement.

Wilfredo Engalla, a 51-year-old Filipino immigrant, alleged in a medical malpractice case that Kaiser doctors misdiagnosed him with colds and allergies for years before eventually informing him he had terminal lung cancer.

He died before his complaint could be heard by an arbitrator, which his Kaiser policy required. His case prompted a withering rebuke from the California Supreme Court, which said Kaiser’s system of arbitrating legal disputes was subject to long delays and unfair to its members. The year was 1997.

Nearly three decades after the landmark decision, the HMO giant — which made a series of sweeping reforms after the ruling — is once again facing questions over whether its arbitration system is stacked against the interests of its members.

Plaintiffs attorneys, legislators and patients say Kaiser’s private and confidential process for arbitrating legal disputes over medical care still has key flaws that favor Kaiser over patients bringing malpractice cases. The company insures about 25% of Californians, including some employees of the Los Angeles Times.

“Kaiser has really lost its way,” said Assemblyman Robert Garcia (D-Rancho Cucamonga). Garcia, who is a longtime Kaiser member, recently introduced a bill to require the California attorney general to oversee arbitrations mandated by any health plan.

Kaiser defended its arbitration system, saying in a statement that it was fair for both patients and the nonprofit.

Many companies and other organizations, including some hospitals, HMOs and physician groups, require their customers or patients to take their complaints to private arbitration rather than to court.

But unlike most other companies, which send claims to large arbitration firms, Kaiser created its own system back in 1971.

Under Kaiser’s system, once a neutral arbitrator is selected, either party can opt to disqualify that person without cause. There is no limit on the number of disqualifications.

Although the health plan designed the system to be fair, patients and their lawyers have alleged that in reality Kaiser’s greater knowledge of arbitrators’ past rulings and its ability to veto arbitrators give it an advantage to pick favorable judges.

Critics such as Arlan Cohen, a physician and attorney who has brought more than two dozen cases against the health plan, say the system also provides a financial incentive to arbitrators to rule in Kaiser’s favor in order to be selected for future cases.

While Kaiser has access to all the decisions made by arbitrators in its system, the patient’s family gets a more limited disclosure of an arbitrator’s history of cases, lawyers say, adding that it’s not easy to see which arbitrators have ruled frequently for Kaiser.

Kaiser said it disagreed that the system allowed it to select favored arbitrators.

“The appointment process is not influenced by whether the arbitrator has ruled for or against KP or has a record of ruling against Kaiser Permanente,” its statement said.

“As required by law, both parties receive information about potential arbitrators and can decline to move forward with any they are not comfortable,” the statement said.

One problem is what experts call the “repeat player effect,” in which a large company appearing repeatedly before the same panel of arbitrators allegedly gains an advantage over the individual bringing a single complaint.

David Allen Larson, past chair of the American Bar Assn.’s dispute resolution section, said the repeat player effect happens because the patient will likely be choosing an arbitrator on the health plan’s system just once, while “Kaiser is selecting them every single day.”

“They know the system. They know the rules,” Larson said of Kaiser. “The entire process gives them an advantage.”

Alan Kang, a lawyer, in a recent petition filed in L.A. County Superior Court, contends that the fees the arbitrators earn from hearing cases — as much as $2,000 an hour — give them an incentive to rule in Kaiser’s favor so they are chosen to hear more cases.

“When a judge’s future income is at stake, it is impossible to be impartial,” Kang wrote in the petition.

The petition seeks to void the December decision of an arbitrator who ruled against the family of Evangelina Aquino, a Kaiser employee who died of cancer at age 40.

Kang, the Aquino family and the medical experts they hired for the case say her cancer would have been treatable if Kaiser doctors had found it with a test they said her symptoms called for. Kaiser argued it was a different kind of cancer that was aggressive and untreatable. The arbitrator agreed with Kaiser in the December decision.

After the ruling, Kang began analyzing data from Kaiser’s system.

His review of dozens of cases in the last six years found that judges overseeing the most cases nearly always ruled for Kaiser.

“The message is clear: deliver wins for Kaiser and you will get additional business,” Kang wrote in his court petition.

The Oakland-based health plan declined to answer questions about its arbitration system and Kang’s claims, but said in a statement that its “arbitration process is designed to be fair, impartial, and accessible to all members. While some arbitrators may handle multiple Kaiser Permanente-related cases, they are not employed by Kaiser Permanente, and they are selected by both parties, in accordance with the law.”

“We recognize that arbitration cases often involve difficult and deeply personal experiences for patients and families,” the statement said, “and we take all concerns raised through these processes seriously.”

Kaiser’s unique arbitration system

Arbitration can have advantages over the court system, including allowing Kaiser to save on legal costs, which otherwise would raise the price of premiums it charges to families, employers and governments.

Kaiser offers to pay the arbitrators’ fees, which can save families tens of thousands of dollars.

Arbitration may also lead to faster outcomes, possibly avoiding years of litigation. Unlike civil litigation, arbitration decisions are especially difficult to appeal.

After the criticism by the state Supreme Court in 1997, Kaiser reformed the system by creating the Office of the Independent Administrator. The office is funded by a Kaiser trust and the $150 fee each patient filing a claim must pay, said Marcella Bell, who serves as the independent administrator.

Bell said the office works independently from Kaiser.

The office selected 195 retired judges and lawyers to serve on a panel that patients and Kaiser can choose from when selecting a neutral arbitrator to oversee and decide a malpractice case.

Rules written by the independent administrator, in consultation with the health plan and an advisory board, allow Kaiser and the family to cut an arbitrator they don’t like, at multiple steps in the process.

The administrator’s office randomly selects 12 members from its panel. Both sides can each remove any four of those arbitrators. The two sides then rank the remaining arbitrators in order of preference. The administrator selects the top-ranked arbitrator to hear the case.

The two parties then still have the ability to disqualify that selection without cause.

Members of the United Nurses Assns. of California and Union of Healthcare Professionals strike outside Kaiser Permanente in Oakland on Jan. 28.

(Jessica Christian / San Francisco Chronicle)

Last year, Kaiser’s arbitration system closed 529 arbitration cases.

The arbitrators threw out 14% of the cases, ruling in favor of Kaiser’s motion for summary judgment, and dismissed an additional 5% of cases on technical or procedural grounds.

Only 23 cases, or 4% of the total, went to a hearing. Among those, the arbitrator decided for Kaiser in 17, with the patient winning the remaining six.

Patients and their families withdrew their claim in 20% of the cases. About half of those patients did not have a lawyer and had tried to represent themselves.

The parties settled for an undisclosed sum in 57% of the cases. The settlements are confidential.

Patient safety questions

Those who have studied the use of arbitration by Kaiser and other HMOs for medical malpractice claims say the secrecy of the settlements and the closed hearings could keep safety problems from coming to light.

“The secrecy of arbitration proceedings may prevent publicity that could reveal poor doctors,” the California Research Bureau warned in a report in 2000 that analyzed Kaiser’s system. That compares with public court cases that could deter “bad behavior” in the future, the researchers wrote.

In December 2023, 53-year-old Francisco Delgadillo arrived at the Kaiser ER in Vallejo with severe chest pain. After an initial assessment, he waited eight hours for care, according to state regulators.

He died in the lobby. A state and federal investigation found multiple violations, including that Kaiser failed to have a licensed nurse monitoring the dozens of patients in the ER’s waiting room.

The Delgadillo family filed an arbitration claim. Their lawyer Jeff Mitchell said the case settled for a confidential sum and he could not discuss it.

Mitchell agreed that the secrecy raised patient safety concerns.

“They love the system, otherwise they would not be so hellbent to keep it,” Mitchell said of Kaiser’s repeated efforts to dispel criticism. “They don’t want these cases to get in front of juries.”

A licensed practical nurse attends to a patient at a Kaiser Permanente in Culver City in September.

(Allen J. Schaben / Los Angeles Times)

Calls for reform

Despite the changes Kaiser made after the 1997 court decision, patients and their families have continued to complain.

According to the administrator’s 2025 annual report, the “most common” complaint the office heard last year was about the neutral arbitrator.

“Most complained that the arbitrator was biased, partisan, unjust, and in Kaiser’s favor,” the report said.

Stephen Martinez, a retired aerospace engineer from Bellflower, is leading the effort to pass the state bill introduced by Garcia.

At an April hearing in the state Assembly, Martinez spoke about how his wife had found a lump in her breast and asked for an appointment with her longtime caregiver at Kaiser to examine it. Instead she was sent to a physician assistant, who dismissed it, he said.

“The PA prescribed warm compresses, a sports bra, and limited chocolate,” Martinez testified. “We would later find that Lindalee did have breast cancer that had already spread.”

Martinez and his wife said they spent $175,000 on lawyers and medical experts to bring that arbitration case. A chief breast surgeon at Kaiser and another surgeon who had retired from that job both testified that the Kaiser physician assistant failed to follow the health system’s guidelines.

Kaiser’s expert argued that the physician assistant did an appropriate exam and that his low suspicion of breast cancer was reasonable. The neutral arbitrator concurred and ruled against the couple.

After passing the Assembly, Assembly Bill 1770 is now in the state Senate for consideration. The bill lets the attorney general decide what actions they will take to ensure health plan arbitrations are handled fairly and transparently. If the bill passes, the state would add four deputy attorneys general, a legal analyst and three legal secretaries to do that work, according to a legislative analyst’s report.

Kaiser says it has concerns about the bill, including that it would “create overlapping state oversight and duplicative reporting requirements.”

Kaiser Permanente’s corporate offices in downtown Oakland in January 2025.

(Jane Tyska / East Bay Times via Getty Images)

Questions of a missed diagnosis

When Janene Fowler was 22, her body seemed to turn against her. She grew weak, pain shot through her hands and feet, her heart raced. She soon required a wheelchair.

Fowler’s medical chart detailed what could have caused her disabling problems. A test eight years before had found a deficiency of vitamin B12, according to the chart. Over the years, Kaiser doctors noted problems such as depression, unexplained pain, shortness of breath, a sore tongue and an abnormal gait — all possible symptoms of vitamin B12 deficiency.

In February 2022, after her family complained about her not being able to see a neurologist, she got an appointment. The specialist noted her vitamin deficiency, telling the nurse to start her on a supplement at once. But the treatment did not begin because the paperwork was lost, her medical records show.

Two weeks later, Fowler left Kaiser to see a doctor at UCLA. A doctor there quickly started injections of B12.

Her symptoms gradually got better, but her new doctors say the years-long deficiency left permanent damage. She still can’t walk without help.

The arbitrator, a retired judge, sided with Kaiser’s doctors and experts, who questioned whether Fowler’s problems were caused by a deficiency of vitamin B12. While one test showed a deficiency, he noted that a second test failed to confirm it. He wrote that Fowler and her lawyers had failed to prove that Kaiser “breached its duty of care.”

Cohen, Fowler’s lawyer, asserted that the retired judge’s decision was contrary to UCLA medical records, which detail her deficiency and treatment.

Fowler now spends most of her time at home. She can’t drive. She often falls when she tries to get around with a cane. She loves to cook, but said she burns herself when she tries.

“My hands don’t really do what I tell them,” she said.

Kaiser declined to answer questions about her case, citing patients’ privacy rights.

Fowler said she’s angry about how the health plan’s doctors and its arbitration system treated her.

“I thought I was going to die, and no one at Kaiser seemed to care,” she said. “What justice can you have in a system that is run by those you are trying to sue?”

Research shows language barriers on holiday are among the biggest obstacles when falling ill abroad — but a new service aims to help Brits in need.

Just one in three holidaymakers feel confident they could adequately describe a medical problem to a doctor while overseas. A survey of 2,000 adults revealed that language remains one of the most significant obstacles when falling ill on holiday.

A mere 28% are confident they could comprehend medical advice given to them, and 13% have delayed seeking help for a medical issue while abroad because of issues with the language, or a lack of knowledge on how to get help in a different country.

Two thirds of travellers couldn’t request a new prescription if they urgently needed one, and wouldn’t know how to communicate that they were suffering an allergic reaction or had been bitten or stung.

Despite most holidaymakers being perfectly capable of ordering a drink or locating the nearest loo, a mere 5% bother to learn essential medical phrases before jetting off.

The research was commissioned by the Staysure, to launch its free 24/7 Travel Doctor service.

The service will enable travellers to speak to an English-speaking doctor or dentist in many worldwide locations via video call, arrange prescriptions, or make an in-person appointment at a clinic or at their hotel when they need medical assistance abroad.

Spokesperson Simon McCulloch said: “I’m not surprised to see, in true British style, most of us would be able to order a beer in another language when we’re on holiday.

“But while we hope we never need to deal with a health issue while we’re away, the research shows a third of people have had to seek medical advice and come up against language barriers.

“While it’s good to be able to order a drink or ask for the bill in other languages, it’s arguably more important that travellers feel confident they can get the right medical assistance quickly if they’re ill or injured.

“We can’t be prepared for every single eventuality but knowing a few key phrases can help especially if you require fast care, have a medical condition or take medication.

“But the thought of speaking with a pharmacist or doctor abroad can be a worrying and daunting experience especially with language barriers.

“In fact, we’ve already seen 50% of those who use the service opt for a video consultation with an English-speaking doctor taking that stress away.”

Can you tell the difference between ordering a coffee and a cry for medical help? Take the quiz now to find out.

The study found when it comes to communicating abroad, 59% assume they’ll be able to get by in English when travelling to a non-English speaking country. While 37% simply rely on translation tools, and 12% would ask AI to understand.

Others admit they would turn to alternative ways to communicate, including using hand signals or gestures (70%), speaking English slowly (10%) or asking someone else to translate (nine%). With 39% even admitting to putting on a foreign accent to try and communicate better.

But these tactics don’t always pay off, with 39% ending up in an embarrassing or difficult situation due to language mix-ups.

Simon McCulloch, from Staysure, added: “When we travel, we don’t ever imagine we are going to end up needing medical help, but there are many occasions where we do.

“That’s why we launched the free 24/7 service, providing travellers with that extra layer of confidence. Our research also found that 79% of respondents said they would be inclined to use the service”.

JOSH Duggar has been moved to a new federal prison more than 100 miles closer to his wife and family after leaving a medical facility, The U.S. Sun can exclusively reveal.

The disgraced TLC reality star, 38, is currently serving more than 12 years after being convicted of receiving and possessing child sexual abuse material following his arrest in April 2021.

Official records show he has been transferred to the Federal Transfer Center in Oklahoma City after a short stay at the Federal Medical Center in Fort Worth, Texas.

A Bureau of Prisons spokesperson previously said inmates may be transferred for a variety of reasons, including medical concerns, or other measures designed to maintain institutional safety and inmate protection.

Duggar is now about 218 miles from the family’s home in Tontitown, Arkansas — compared to the roughly 350-mile journey to FCI Seagoville in Texas, where he had been incarcerated since 2022.

The new facility serves as a temporary processing hub for federal inmates being moved between prisons, which means Duggar could be transferred again before serving out the remainder of his sentence.

The U.S. Sun has reached out to the bureau and Duggar’s lawyers comment.

He has been incarcerated since his conviction on federal child pornography charges stemming from downloads made at the used car dealership he operated in Springdale, Arkansas.

In December 2021, a federal jury found him guilty of receiving and possessing child sexual abuse material after investigators traced illegal downloads to a password-protected computer at his business.

Prosecutors argued Duggar was the only person with the knowledge and access needed to download the files.

In May 2022, he was sentenced to 151 months — more than 12 years — in federal prison, followed by 20 years of supervised release.

He was also ordered to pay a $10,000 fine.

Ever since, Duggar has unsuccessfully fought to overturn his conviction, arguing that errors were made during his trial and that evidence should not have been admitted.

Federal appeals courts have rejected the arguments, leaving his conviction and sentence intact.

His wife Anna has remained publicly loyal to her husband throughout his imprisonment despite the scandal that ended the Duggar family’s reality TV empire.

She has regularly visited him in prison and attended court hearings during his legal battle, while continuing to raise the couple’s seven children in Arkansas.

They have been married since September 2008 and have seven children together.

The Bureau of Prisons has not disclosed why Duggar was transferred or where he will ultimately be sent next.

Federal inmates are commonly moved because of security classifications, institutional needs, programming opportunities, medical reasons or other administrative decisions.

For now, Duggar remains in Oklahoma City as officials determine his permanent placement.

His projected release date remains October 2, 2032, according to Bureau of Prisons records.

Meanwhile, his racy messages to his wife Anna while he was in custody in Arkansas were revealed in a report by PEOPLE.

“[I] miss you my lover. i miss being in the shower with you scrubbing, i miss watching you try on clothes, I miss watching you being sexy,” Josh wrote.

He also congratulated his wife for “making the scale numbers lower than expected” and suggested she buy herself “something low cut” to wear in the shocking text.

He continued, “[O]r you can try on clothes and send me a pic of you in your bra and panties 😉 or try on ‘go to the private pool for sun’ swimsuit? btw you should order you a 2-piece swimsuit since summer is coming on soon, get something hot and fun.”

Josh then signed off, telling her he would love her forever and calling her “sexy.”

He wrote a similar sign-off in a message sent to Anna, 38, days later, and added, “p.s. – send pics asap as requested, imlied (sic), inferred or otherwise stated lol. nice one(s) with your twos in it! (OvO).”

Justin Gaethje waited a long time to become an undisputed UFC champion.

Now the 37-year-old MMA star might have to wait another six months or so before fighting again.

Gaethje upset former two-weight champion Ilia Topuria with a technical knockout in a lightweight unification championship bout at the UFC Freedom 250 event Sunday on the White House South Lawn.

Topuria was a bloody and swollen mess by the time his corner stopped the fight between the fourth and fifth rounds. Gaethje executed a soaring back flip off the cage to celebrate his first undisputed belt, but it turns out that the former two-time interim champion also suffered significant injuries during the bout.

Both Gaethje and Topuria were among the five UFC Freedom 250 fighters who received 180-day medical suspensions from the Association of Boxing and Combative Sports Commissions, according to a list issued by the commissions and viewed by The Times.

Ilia Topuria suffered two broken orbital bones during his loss to Justin Gaethje at UFC Freedom 250 on June 14 in Washington.

(Chris Graythen / Getty Images)

Gaethje’s suspension can be shortened if he is cleared with negative MRIs for his right wrist and left knee. Topuria, who suffered two broken orbital bones, can return early if cleared by a an Oral and Maxillofacial Foundation specialist.

Both men also are required to serve mandatory rest days (45 for Gaethje, 60 for Topuria).

Alex Pereira, who lost his interim heavyweight title bout to Ciryl Gane by TKO, was medically suspended for 180 days or until he’s cleared with a negative maxillofacial CT scan. Undercard fighters Aiemann Zahabi and Steve Garcia also received 180-day medical suspensions.

Topuria won the UFC featherweight championship by knocking out Alexander Volkanovski in February 2024. He vacated that title a year later and in June 2025 defeated Charles Oliveira by knockout to claim lightweight belt.

In November, Topuria announced he was temporarily stepping away from fighting. Gaethje earned the interim lightweight title in January by defeating Paddy Pimblett by unanimous decision.

That set up the unification bout between Gaethje and Topuria, which was the final fight of an elaborate event at the White House held on President Trump’s 80th birthday and billed as part of a summer-long celebration of the country’s 250th anniversary.

The “Love Island USA” production team is mourning the loss of executive producer James Barker, who died last week while on set in Fiji.

“Love Island USA” producers ITV America and Peacock confirmed Barker’s death in a media release shared with The Times on Monday. The announcement said that Barker died after “an unexpected medical emergency” but did not provide additional details, including the day of his death and a cause of death. Barker was 40.

“James’ unimaginable loss has been deeply felt across not just the entire Love Island USA production, but throughout all of ITV and Peacock,” the television companies said in a joint statement. “He was a beloved and greatly valued member of our collective family whose kindness, talent and dedication left an indelible mark on all of us and everyone who had the privilege of knowing and working with him. We extend our heartfelt condolences to James’ family, friends and colleagues.”

Barker began his tenure on “Love Island USA” in 2020, first working as a story producer. He has worked as an executive producer on the series for the last three seasons and was also a member of the producing team on “Love Island” companion series “Love Island Games” and “Love Island: Beyond the Villa.”

Barker, according to Monday’s statement, also oversaw the hit series’ pop soundtrack. For an interview with Rolling Stone in 2025, Barker recalled watching the original British “Love Island” series and how pop music supplemented the on-screen romances and heartbreak: “I think that is where my brain immediately said, ‘One, this is amazing, and more shows should be like this.’ And two, ‘How do I work on “Love Island”?’”

Barker also noted in the interview that he drew inspiration for the “Love Island USA” villa sound from his pre-TV career as a nightlife DJ and spoke about the process of hand-selecting music from established pop acts and up-and-coming artists.

“In the past, there was such a stigma about reality shows that a lot of artists didn’t want their music associated with reality shows. And that’s starting to turn around now,” Barker told the outlet. “[Artists are] more and more seeing, well, one, the financial aspect of having your music synced in these kind of shows, and also just the wide reach of viewers.”

Before “Love Island USA,” Barker was a producer on reality series “Pawn Stars,” “Counting Cars” and “Forged in Fire.” He later served as a story producer on “Queer Eye,” “Cosmic Love” and “Are You My First?” Outside of his TV work, Barker often performed as DJ Chaotic at gay bar C’mon Everybody in Brooklyn.

“Love Island USA,” which began its eighth season earlier this month, will pay tribute to Barker in Tuesday’s episode.

He is survived by his mother Malinda.