Summer Sweets – White Peach Cakes of Ginza Cozy Corner in Tokyo, Japan

The prices are from 464 yen to 626 yen (tax included) each.

Is It Hoarding, Collecting, or Archiving? Keep? Toss?

Gina Barreca wrote . . . . . . . . .

“Let me know when you write a column about people who keep EVERYTHING just in case they ever need it…but never do,” asked James Lattin, a friend from college. “Baseball cards? Still got ‘em. Old letters from friends and family? Check. Treasured albums on vinyl? But of course! Papers written in elementary school? The only one I remember is still in my possession. And yes, the extra screw that came in the furniture assembly kit that looked like it might come in handy one day–I’ve still got that, too.”

“Just in case” might be the most tempting phrase when it comes to keeping things we don’t need; it’s the equivalent of an alcoholic’s “just one more” or an unfaithful partner’s “just this once.” It’s the enabling mantra, a version of a permission slip, or an emotional hall-pass.

Other mantras are effective, if not quite as seductive. These include but are not limited to: “There’s nothing wrong with that”; “That’s practically new”; “But look what it can do!”; “They don’t make these anymore.”

Creative, smart, and curious readers and friends wrote to me after my previous post on what items we decide to keep, what we decide to give or throw away, and what our emotional responses are to those choices.

Writer, speaker, and scholar Nancy Bocksor wrote to me directly, telling me that “Cleaning out my mom’s house was emotionally complex because she and I are ‘historians, not hoarders.’ She had been collecting newspapers and clippings since Hitler took over Germany –page one of VE Day in the ‘Dayton Daily News,’–that kind of thing. No one wanted them. I tried. It about killed me to throw them away. She lived through a Depression and WWII and I threw it away.”

I wrote Nancy back and said, from the heart, that she honored her mother by releasing them both from the “stuff” of even the carefully curated materials. “You dealt with them with tenderness even as you put them away into history,” I explained, and said these hard words that I know are tough truths to admit: No one needs these papers and books now. They are digitally archived. Unless they are in perfect condition or rare editions, no library will take them.

It’s hard to accept that stuff we treasured is not a treasure for others.

Other have their have their own stories to tell. The future doesn’t always leave much room for the past.

It’s what old people think, and I say this as a woman in her sixties. While I think it’s simply fascinating to sit down and thumb through pages of LIFE magazines from the year I was born, for example, I no longer expect anybody younger than I am even to pretend they think it’s fun.

It’s easy to say “She’s a hoarder” about somebody we don’t like.

And it’s easy to say “He’s a collector” about somebody we do like.

About ourselves, however, we’ll say something like, “it’s true, I am an archivist.”

(That “what I happen to ‘archive’ are tablecloths, napkins, tea towels and table runners, all of which are rarely, meaning never, ironed and pretty much remain randomly stuffed into a dark cabinet” is the part we leave out.)

I have made literal the idea of “material” and materiality by clinging to my cache of fabric.

But getting rid of our stuff makes us feel immaterial, and that’s one reason we don’t like to do it.

James Lattin, the friend I mentioned earlier who will never have a screw loose-—and who also happens to be Robert A. Magowan Professor of Marketing at Stanford Graduate School of Business-—assigns almost talismanic power to certain pieces of property: “You know the portkeys in the Harry Potter series? A magical object that instantly transports the person who touches it to a specific location? Well, old baby clothes are like a portkey to the past. The touch and the feel make those old memories more immediate and more tangible. It’s like a tool for augmenting and intensifying those old memories.”

But do we want to be the gatekeepers and key-holders of the past, especially when the past is shared with others who are no longer with us? Those keys, and the rings that hold them, can turn into heavy chains, however, and no longer represent merely healthy ties that bind.

Judith Wenger cleaned out her late sister’s condo after she died and told me, “I cried ugly. What should I do with my late sister’s three diplomas? She had no children and neither did I. What else could I do but let them go?”

This wasn’t Judith’s first encounter with the process of clearing out after loved ones died. She explained, “When I cleaned out my parents’ places (first a senior apartment, then assisted living), we sibs took things that had meaning. It made me sad, but it also taught me to downsize my own life.”

My brother and I had a similar experience when going through my father’s stuff after he passed away. Although my brother has kids who loved their grandpa, my brother and I made the choice to be the last ones to touch anything we knew that nobody else would respect, understand, or care about. I never regretted those decisions. Better, we thought, that two people who loved him should have been the last one to touch these items; I didn’t like the idea of having strangers judging his old ties or pajamas at thrift shops.

I kept an old frame, a couple of pots (now resting in peace with their iron brethren, because nothing lasts forever), a few books, and a few of his ties (I judged them as best).

The idea that somebody will have to go through my stuff now makes me think twice, Judith-like. Any purchase must offer immediate satisfaction because the last thing I want is to do at the end of my life is leave behind me a legacy of tchotchkes.

We should all get those colored-paper circle stickers and put them on the backs of stuff (paintings, photos, knick-knacks) indicating “This goes to the Whitney Museum,” “This goes to Goodwill,” and “This can be the first thing on the dumpster and I’m sorry you even have to look it.”

Source: Psychology Today

U.S. Provincetown Outbreak Shows Delta Can Spread Among Vaccinated, But Cases Are Mild

Ernie Mundell and Robin Foster wrote . . . . . . . . .

The Cape Cod resort town of Provincetown draws big crowds every summer. In July, those largely vaccinated crowds — packed into bars, restaurants and private homes — were the genesis of an outbreak of the Delta variant that could be a sobering model for the nation.

New data on the outbreak, released Friday, shows there were a known total of 469 COVID-19 cases “associated with multiple summer events” among Provincetown revelers. Three-quarters (74%) of those cases occurred among people who’d gotten their COVID vaccinations an average of almost three months before.

In 89% of those cases, the highly contagious Delta variant was implicated, concluded a team led by Dr. Catherine Brown of the Massachusetts Department of Public Health.

There was some good news, however: While many of the 346 cases among vaccinated individuals might have made them feel miserable for a time — coughs, headache, sore throat, aches and fever being the major symptoms — there were only four cases (1.2%) in this group that required hospital care.

In all four of those hospitalized cases, patients had underlying medical conditions that upped their odds for severe COVID-19, the researchers found.

A fifth case requiring hospitalization occurred in an unvaccinated patient, Brown’s team noted, and that case also involved an underlying medical condition.

There were no deaths linked to the outbreak.

The researchers noted that it’s not surprising that three-quarters of cases in the Provincetown outbreak occurred among the vaccinated, because a full 69% of the town’s vaccine-eligible residents have gotten their shots — a number that’s much higher than the national average.

Equal viral loads

However, given the increased transmissibility of the Delta variant, Brown’s team believe their findings “suggest that even jurisdictions with substantial or high COVID-19 transmission might consider expanding prevention strategies.”

Those strategies should include “masking in indoor settings regardless of vaccination status, given the potential risk of infection during attendance at large public gatherings,” they said.

The Provincetown findings also confirm that, unlike its predecessor, the Delta variant appears to produce high viral loads in people’s systems, upping transmission risks.

“Specimens from 127 vaccinated persons with breakthrough cases were similar to those from 84 persons who were unvaccinated,” the research team noted.

That finding helped drive the CDC’s decision this week to reverse course on its masking advisory. The agency now recommends that even the vaccinated once again don masks in many indoor settings, to lessen the odds they might transmit SARS-CoV-2 to others.

It also adds new energy to federal, state and local efforts to get more Americans vaccinated.

However, one leading infectious disease expert stressed that the one thing the Provincetown report should not do is lessen the average American’s faith in the power of vaccines to protect against what’s most important: Severe illness.

“The new data should not alarm anyone, but reinforce that vaccinations are the solution to the pandemic,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security in Baltimore.

A return to masking indoors

“That severe breakthrough infections were rare is testament to the vaccines, which limit the harm an infection can do in a fully vaccinated person,” he said. “It’s also important to remember the breakthroughs that occurred in this situation are likely not completely applicable to the everyday life of the vaccinated, as the intensity and nature of exposure was in the context of a large public gathering.”

Another expert said the implications of the findings are clear.

“At this time, even fully vaccinated people need to consider large gatherings as a potential place to contract the virus,” said Dr. Teresa Murray Amato, chair of emergency medicine at Long Island Jewish Forest Hills, in Queens, N.Y. “This also means that for Americans that are not yet vaccinated,” they should strongly consider doing so.

Adding to the Provincetown findings, a new internal federal government document also finds the Delta variant can cause more severe illness than earlier coronavirus variants, especially among the unvaccinated, and spreads as easily as chickenpox.

In laying out the evidence that this variant looks like the most dangerous one yet, the document urges health officials to “acknowledge the war has changed,” the Washington Post reported.

The document mirrors the data in the Provincetown study, finding that vaccinated people infected with Delta have viral loads similar to those who are unvaccinated and infected with the variant, the Post reported.

CDC scientists were so alarmed that the agency changed masking guidance for vaccinated people earlier this week, even before making the new data public, the newspaper said.

CDC Director Dr. Rochelle Walensky said in a statement on Friday that the Provincetown investigation “is one of many CDC has been involved in across the country and data from those investigations will be rapidly shared with the public when available.”

The Provincetown study was published in the CDC journal Morbidity and Mortality Weekly Report.

Source: HealthDay

Two Types of Blood Pressure Meds Prevent Heart Events Equally, But Side Effects Differ

People who are just beginning treatment for high blood pressure can benefit equally from two different classes of medicine – angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) – yet ARBs may be less likely to cause medication side effects, according to an analysis of real-world data published today in Hypertension, an American Heart Association journal.

While the class of blood pressure-lowering medicines called angiotensin-converting enzyme (ACE) inhibitors may be prescribed more commonly, angiotensin receptor blockers (ARBs) work just as well and may cause fewer side effects. Currently, ACE inhibitors are prescribed more commonly than ARBs as a first-time blood pressure control medicine.

The findings are based on an analysis of eight electronic health record and insurance claim databases in the United States, Germany and South Korea that include almost 3 million patients taking a high blood pressure medication for the first time with no history of heart disease or stroke.

Both types of medicines work on the renin-angiotensin-aldosterone system, a group of related hormones that act together to regulate blood pressure. ACE inhibitors lower blood pressure by blocking an enzyme early in the system so that less angiotensin, a chemical that narrows blood vessels, is produced, and blood vessels can remain wider and more relaxed. ARBs block receptors in the blood vessels that angiotensin attaches to, diminishing its vessel-constricting effect.

“In professional guidelines, several classes of medications are equally recommended as first-line therapies. With so many medicines to choose from, we felt we could help provide some clarity and guidance to patients and health care professionals,” said RuiJun Chen, M.D., M.A., lead author of the study, assistant professor in translational data science and informatics at Geisinger Medical Center in Danville, Pennsylvania, and NLM postdoctoral fellow at Columbia University at the time of the study.

The AHA/ACC 2017 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults says the primary medications for treating high blood pressure are thiazide diuretics, ACE inhibitors, ARBs, and calcium channel blockers as they have been shown to reduce cardiovascular events. Physical activity and other lifestyle changes are recommended for managing all levels of high blood pressure, even if medication is required.

Health records for patients who began first-time blood pressure-lowering treatment with a single medicine between 1996-2018 were reviewed for this study. Researchers compared the occurrence of heart-related events and stroke among 2,297,881 patients treated with ACE inhibitors to those of 673,938 patients treated with ARBs. Heart-related events include heart attack, heart failure or stroke, or a combination of any of these events or sudden cardiac death recorded in the database. The researchers also compared the occurrence of 51 different side effects between the two groups. Follow-up times varied in the database records, but they ranged from about 4 months to more than 18 months.

They found no significant differences in the occurrence of heart attack, stroke, hospitalization for heart failure, or any cardiac event. However, they found significant differences in the occurrence of four medication side effects. Compared with those taking ARBs, people taking ACE inhibitors were:

  • 3.3 times more likely to develop fluid accumulation and swelling of the deeper layers of the skin and mucous membranes (angioedema);
  • 32% more likely to develop a cough (which may be dry, persistent, and bothersome);
  • 32% more likely to develop sudden inflammation of the pancreas (pancreatitis); and
  • 18% more likely to develop bleeding in the gastrointestinal tract;

“We did not detect a difference in how the two types of medicine reduced the complications of hypertension, but we did see a difference in side effects,” said George Hripcsak, M.D., senior author of the study and professor and chair of biomedical informatics at Columbia University Vagelos College of Physicians and Surgeons and medical informatics services director at New York-Presbyterian/Columbia University Irving Medical Center. “If a patient is starting hypertension therapy for the first time, our results point to starting with the ARB over the ACE inhibitor.”

“ARBs do not differ in effectiveness and may have fewer side effects than ACE inhibitors among those just beginning treatment,” said Chen. “We unfortunately cannot extend these conclusions to people who are already taking ACE inhibitors or those who are taking multiple medications. We would reiterate that if you experience any side effects from your medicine, you should discuss with your doctor whether your antihypertensive regimen may need to be adjusted.”

The study is limited by wide variation in the length of time patients were included in the different databases. Although many people were followed for a long period of time, those who had shorter follow-up periods may not have taken the medications long enough to experience their full benefits in preventing cardiovascular disease events. Most of the participants taking ACE inhibitors (80%) were taking lisinopril, and the most used ARB (45% of those taking this class of medication) was losartan, so the results may not be fully generalizable to other medicines in these classes. It is also important to note that results from this analysis of first-line therapy may not be generalizable to people with hypertension who have been prescribed combination treatment or who switch from one type of medication to another.

“In addition to encouraging patients to live a healthy lifestyle and taking medication as prescribed to control blood pressure, the American Heart Association recommends regular self-blood pressure monitoring with a validated device and working with a health care professional on a plan to reduce blood pressure,” said Willie Lawrence, M.D., interventional cardiologist and medical director for Health Equity, Spectrum Health, Benton Harbor, Michigan and head of the American Heart Association’s National Hypertension Control Initiative Oversight Committee.

Source: American Heart Association

What’s for Dinner?

Luxurious Seafood Set Meal at Kaneshichi Fisheries in Kamogawa City, Japan

The price is 2,750 yen plus tax.