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Tommy Tuberville says he recognizes ‘look’ on Trump’s face in mugshot

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Sen. Tommy Tuberville (R-Ala.) said he recognized the “look” on Donald Trump’s face in the former president’s recently released mugshot during an interview on Newsmax on Thursday, according to NBC.

“I’ve seen President Trump with that look a couple times playing golf with him when he’s missed a putt or I’m beating him in a round of golf,” Tuberville reportedly said.

Trump surrendered to Fulton County, Ga., authorities Thursday, a week after his indictment in District Attorney Fani Willis’ case alongside 18 other co-defendants. His mugshot is the first of a president, in or out of office, known to have been taken.

Trump’s seemingly displeased expression in his mugshot reflects his tone in social media posts made shortly after his booking.

Trump returns to Twitter, under its new moniker X

Trump posted on X, the social media network formerly known as Twitter, sharing a photo of his mugshot with the words “Election Interference” and “Never Surrender!” The post on X was the first Trump has made on the platform in two years.

For the latest news, weather, sports, and streaming video, head to The Hill.

Giannis Antetokounmpo’s Future in Milwaukee Is Uncertain

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Giannis Antetokounmpo carried around a small, black portable fan, which looked minuscule as it whirred in his 12-inch-wide hands. He was trying to counteract the hot sun at a hillside mansion as he watched his youngest brother, Alex Antetokounmpo, pose for photos near a basketball hoop overlooking Los Angeles for an ad campaign.

“Alex, the eyes,” Giannis said. “Eyes of the tiger right there, and then you mix it in with a smile.”

Giannis turned and grinned at a group of about a dozen people watching. He has been coaching Alex for most of his life. When Giannis began his N.B.A. career with the Milwaukee Bucks at 18, he soon brought his family out of poverty in Greece to live with him. Alex was 12 years old.

“Sometimes I think I get annoying to him,” Giannis, 28, said later, though Alex, 21, shows no signs that that might be true. Giannis added: “He could be doing idiotic stuff, stupid stuff, but he’s going through a path that I’m really proud of him.”

As Giannis ascended to N.B.A. superstardom — he’s won the Most Valuable Player Award twice and is the best player on a championship team — he strove to bring his family along for his journey. Three of his four brothers have played professionally in the United States.

But over the past three years, he has brought them along for what he hopes can be a more lasting endeavor: taking ownership of their money and his future. A few months ago, Antetokounmpo launched Ante, Inc. to house the brothers’ projects and investments. It’s about Giannis’s life beyond basketball, though basketball still matters to him — a lot. In a few weeks, he will be eligible for a three-year extension worth about $173 million, but he doesn’t plan to sign one just yet.

“The real question’s not going to be this year — numbers-wise it doesn’t make sense,” Antetokounmpo said. “But next year, next summer it would make more sense for both parties. Even then, I don’t know.”

He added: “I would not be the best version of myself if I don’t know that everybody’s on the same page, everybody’s going for a championship, everybody’s going to sacrifice time away from their family like I do. And if I don’t feel that, I’m not signing.”

This approach and an increased focus on business investments with his brothers are part of Antetokounmpo’s evolution as he has begun to understand his own ambitions and goals more deeply.

“From 2020 to 2023, people think I’ve taken a large jump on the basketball court, but I think I’ve taken 10X jump off the court,” he said.

It started in the spring of 2020 when the world shut down because of the coronavirus pandemic. It wasn’t clear what would happen to players’ salaries or endorsement deals with the season in flux. He began to think of ways to diversify his sources of income.

“We were sitting in the house. OK, now what?” Antetokounmpo said. “Basketball is taken away, what do I have?” He downloaded a stock trading app and started investing on his own for the first time. He began to reach out to successful people from other industries for advice and mentorship.

It was an eventful year for him, which may have contributed to his interest in growing his income. His oldest child, Liam, had been born that February, and he had won his second M.V.P. Award, for the 2019-20 season, which the Bucks finished by losing in the Eastern Conference semifinals at the N.B.A.’s quarantined campus at Disney World.

A few months later, Antetokounmpo signed a five-year, $228 million extension with the Bucks. But something was not right. He felt numb, and did not know why. He told the Bucks that he did not want to play basketball anymore.

He had felt that way before. During his rookie year, he missed his family so much that he had insisted that the Bucks figure out a way to get them to Milwaukee, even threatening to go back to Greece if the team would not do it. He and his brothers had shared beds growing up. When Antetokounmpo left Greece for the N.B.A. draft in 2013, he said his father, Charles, told him: “No matter where you go in this world, doesn’t matter, don’t worry about that, I’ll find you. I love you, my son. Go have a great season.”

“And I remember my mom was crying,” Giannis said. “I left. And then when I came here it wasn’t the same. I was in the hotel. It was the first time I felt lonely in my life.”

Alex said the siblings are “pretty much each other’s best friends.”

When Giannis felt down during the 2020-21 season, he was reassured when he told his older brother Thanasis about his doubts. By then, Thanasis was playing for the Bucks, too, and said that if Giannis was not happy he would leave with him.

“I would have walked away in 2020,” Giannis said. “I care about joy and happiness. I care about my kids.”

The Bucks recommended he speak to a sports psychologist, so Antetokounmpo tried it. Doing so helped him find ways to cope with the stress and pressure he felt. He rediscovered joy in playing basketball, and the Bucks won a championship that season.

“I think it’s the best feeling that I’ve felt so far in basketball,” he said.

He wants it again.

The Bucks lost in the first round of last season’s playoffs, winning only one game against the Miami Heat as Giannis worked through injuries.

Milwaukee fired its coach, Mike Budenholzer, and hired Adrian Griffin, who had been an assistant coach for the Toronto Raptors. That change, Antetokounmpo said, is part of why he is unsure if he’ll sign an extension.

“You’ve got to see the dynamics,” he said. “How the coach is going to be, how we’re going to be together. At the end of the day, I feel like all my teammates know and the organization knows that I want to win a championship. As long as we’re on the same page with that and you show me and we go together to win a championship, I’m all for it. The moment I feel like, oh, yeah, we’re trying to rebuild —”

He paused briefly before continuing.

“There will never be hard feelings with the Milwaukee Bucks,” he said. “I believe that we’ve had 10 unbelievable years, and there’s no doubt I gave everything for the city of Milwaukee. Everything. Every single night, even when I’m hurt. I am a Milwaukee Buck. I bleed green. I know this.

“This is my team, and it’s going to forever be my team. I don’t forget people that were there for me and allowed me to be great and to showcase who I am to the world and gave me the platform. But we have to win another one.”

He is halfway to his goal of playing 20 N.B.A. seasons, and he said he would like to spend them with one team, the way Dirk Nowitzki, Kobe Bryant and Tim Duncan did.

“But at the end of the day, being a winner, it’s over that goal,” he said. “Winning a championship comes first. I don’t want to be 20 years on the same team and don’t win another championship.”

He didn’t mention any motivation for winning another championship outside of his competitive fire. But the cultural relevance that comes with winning can also elevate his growing off-court profile.

Giannis couldn’t help but launch into a sales pitch as he sat in the living room of the home where he and Alex were doing the photo shoot. He was hyping a pain-relieving balm made by a company called Flexpower, which the Antetokounmpo brothers partially own. He has always considered himself to be a great salesman, back to when he was a child trying to help his parents sell sunglasses on the street in Athens.

During the photo shoot, Giannis flitted around like a proud mother hen, beaming at Alex. Working with the company was Alex’s idea.

“I knew you when you were a baby!” Giannis said, holding his hands out as if rocking a baby.

Later, Giannis pondered when it was that he started thinking of Alex as an adult.

“Might be today,” he said.

Four of the brothers are listed as co-founders on the Ante, Inc. website, but Giannis is the chairman. They have different roles, by virtue of their personalities. Alex describes Thanasis, 31, as very driven and bold in his style. Kostas, 25, has a quieter personality, but Alex said he excels at brainstorming.

Giannis involved his brothers in discussions about his new Nike contract, which he said he negotiated himself this summer. One of his earliest investments was in the Milwaukee Brewers, in 2021. The brothers have invested in a candy company, a nutritional company and a golf team co-owned by Venus and Serena Williams and Serena’s husband, Alexis Ohanian. They have a production company in the works, like so many other N.B.A. players do.

This year, Giannis became a co-owner of some funds with Calamos Investments, whose chief executive, John Koudounis, is of Greek descent. The joint venture donates 10 percent of its profits to financial literacy organizations.

“He spent a lot of time talking about how he wishes that he had known about investing earlier,” said Jessica Fernandez, Calamos’s chief marketing officer. Antetokounmpo doesn’t manage the portfolios, but he does pepper those who do with questions about why and how they choose certain stocks.

Earlier this year, the Antetokounmpo brothers joined the ownership group of Major League Soccer’s Nashville SC.

“We came from nothing,” Antetokounmpo said. “And sitting in the owners’ suite with the other owners and enjoy the game, cheering for our team. Our team. Not just a team — our team. It’s insane.”

Soccer was their first love; their father, who died in 2017, briefly played professionally. Their foundation, the Charles Antetokounmpo Family Foundation, seeks to help disadvantaged people in Greece, the United States and Nigeria, where their parents grew up.

The idea that someone with Giannis’s salary would worry about money might strain credulity, but he is thrifty — cheap, he’ll admit.

“I need my kids to spend my money,” he said, smiling.

He said he wants six children, and is almost halfway there. He and his fiancée, Mariah Riddlesprigger, have two sons, Liam and Maverick, and Riddlesprigger is pregnant with their third child, a girl.

Antetokounmpo gets concerned when his children are pulled into the spotlight with him. In the United States, his fame is perhaps not as overwhelming as it would be were he playing in a bigger city. But in Greece things are different.

“The way LeBron James is or Michael Jordan is for the States, the same way I am for Greece,” he said. “Maybe larger.”

He has noticed people filming his children in their stroller and at a birthday party. He wants his children to be able to decide whether they want to live lives in the public. On social media, he typically covers their faces.

When he thinks about growing his wealth, he is thinking about his children’s futures, too.

The brothers try to make business decisions as a group, often on a messaging thread titled “Antetokounbros” (which is also the name of a store they have in Athens; they’re opening one in Milwaukee soon). They save personal texts for a different thread titled “F.O.E.,” which stands for family over everything.

He said he has felt taken advantage of in the past by some of the people hired to handle his life, money or off-court interests, and was confident that will never happen with his family.

“I see it with my teammates, some of my teammates,” Antetokounmpo said. “‘Oh, my cousin did this. My mom did this.’ You see it. It’s public. Moms arguing with their sons, suing one another for property that doesn’t belong to them. You see it every day.”

He added: “The way we were raised in Greece and the things that we went through every single day to provide for our family, all those moments brought us close. They knew that at all costs I would protect the family, take care of my brothers. And I did.”

C.D.C. Sets New Standards for Hospitals to Combat Sepsis

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On a Wednesday afternoon in 2012, 12-year-old Rory Staunton got a scrape during a middle-school basketball game. His gym teacher applied two Band-Aids to the cuts on his arm.

By Thursday, Rory had a 104-degree fever, vomiting and leg pain, but the emergency room staff at NYU Langone Health suspected dehydration and gave him fluids and anti-nausea medicine.

By Friday, the boy was critically ill. By Sunday, he was dead. Hospital records show the cause was severe septic shock.

More than a decade later, Rory’s mother, Orlaith Staunton, believes that change may finally be coming, that there may fewer tragedies like this one in the future. The Centers for Disease Control and Prevention on Thursday released new guidelines to help hospitals quickly detect and treat cases of sepsis.

The road map, a 35-page document outlining the “core elements” of a hospital sepsis program, is meant to help administrators bring together experts from various medical disciplines to detect and treat sepsis faster.

Dr. Raymund Dantes, a C.D.C. medical adviser and one of the experts who designed the new guidelines, said they were intended to “complement clinical guidelines” by detailing the infrastructure needed to equip health care workers on the front lines.

An interdepartmental sepsis group should “look something like hospitals’ other code teams,” said Dr. Chris DeRienzo, the chief physician at the American Hospital Association, at a news briefing on Thursday.

He likened the teams to a “well-oiled NASCAR pit crew,” coordinated to act quickly at the first signs of sepsis.

Sepsis is an extreme immune response to an infection, which sends a chain reaction through the body that can result in tissue damage, organ failure and death. About one in three people who die in a hospital had sepsis during their time there, according to the C.D.C. About 1.7 million adults in the United State develop sepsis each year, and about 350,000 of them die or are moved to hospice.

Despite its prevalence, hospitals often misdiagnose the illness because it is masked by common symptoms, such as fevers and shivering, clamminess and shortness of breath, according to Dr. Hallie Prescott, a sepsis expert at the University of Michigan who helped develop the C.D.C. guidelines.

Sepsis detection and care also require coordination across departments and disciplines, a weak point in many health care settings.

A new survey of over 5,000 hospitals found that about 73 percent had sepsis teams, but only 55 percent had a leader with time allocated to manage the program. Only about half of hospitals integrate their sepsis programs with antibiotic stewardship initiatives, despite the fact that these drugs are the key to recovery.

The C.D.C.’s guidance explores the best practices for sepsis programs in both large hospital systems and small rural facilities, including how to allocate personnel and financial resources, institute processes to improve case identification, and train staff members to look for symptoms.

The agency now says that sepsis programs should include experts from the hospital’s antimicrobial stewardship, the emergency room, infectious disease department and even the pharmacy — and should be led by both a doctor and a nurse.

Every hospital should have a well-rehearsed “code sepsis” protocol and a live dashboard for tracking various metrics in case management and outcomes.

Dr. DeRienzo said hospital administrators should think of the C.D.C.’s road map not as a prescriptive plan but as “scaffolding” upon which to build a program that fits the local context.

The C.D.C. also offered a detailed assessment tool to help apply the guidance to the local setting, as well as a list of first steps for the 1,400 hospitals in the United States that, according to the survey, must begin from scratch.

Rory’s mother, Ms. Staunton, who started a foundation to combat sepsis with her husband, Ciaran Staunton, acknowledged the federal guidance didn’t go as far as the state regulations they championed the year after Rory died. (In 2013, New York became the first state to mandate that all hospitals adopt sepsis protocols, known as “Rory’s regulations.”)

Still, after years of pleading with C.D.C. officials to take action, she is hopeful that the new guidance won’t slide to the bottom of the pile among hospital administrators’ tasks.

“It’s too late for Rory,” but not for the three million others who are predicted to die of sepsis in the next decade, Ms. Staunton said in an interview. “He never got to graduate high school, or college, or have a girlfriend,” she said. “If the C.D.C. guidelines had been in place 11 years ago, when our son died at a major New York City hospital, maybe he would have.”

In Portugal, a Former Royal Home Opens as a Hotel

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A decade ago, the Spanish landscape designer Fernando Caruncho began working on a project that would link the private walled gardens of several aristocratic estates in the Portuguese village of Santar, in the Dão wine region. Now, visitors will have a new way to access the 50-acre parkland: One of the ancestral manor homes within Caruncho’s greenscape has been converted into a small hotel. Formerly known as Casa das Fidalgas and owned by the House of Bragança, who ruled Portugal from 1640 to 1910, when the monarchy was overthrown, Valverde Santar Hotel & Spa served as a residence for the Bragança family until 2019. The Porto-based design firm Atelier Bastir carried out a restoration of the residence, preserving original details — including pitched, wood-paneled ceilings, 18th-century French and Portuguese furniture and bookshelves lined with hundreds of timeworn tomes — while carving out 21 rooms, some with hand-painted ceilings. At the Memórias restaurant, the chef Luís Almeida serves regional specialties such as roasted goat with smoked rice and a buttery cheese-and-citrus pudding, made with ingredients sourced from Santar Vila Jardim’s gardens. Guests can wander through the property’s vast acreage to pick aromatic herbs including lemongrass and chamomile to be used for massages and facials at the hotel’s spa, housed in what was once the estate’s wine cellar. From $490 a night, valverdesantar.com.

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The concept of a charm necklace or bracelet can be traced back to ancient times, when early civilizations imbued talismans with spiritual significance. For her latest collection, the Los Angeles-based designer Darya Khonsary — who often references her Persian ancestry in her jewelry line, Darius — looked to the shapes of idols that were uncovered at the site of the Mesopotamian Eye Temple at Tell Brak and dated to the third millennium B.C. Khonsary created pieces including earrings, a ring and a charm that could be strung on a necklace, all made of 18-karat Fairmined gold. The Paris-based designer Fanny Boucher takes a lighthearted approach to charms with her brand Bangla Begum, offering a selection of trinkets with suggested meanings. Among the available trinkets are a frog, symbolizing a French lover, and a chess piece, which plays on the French word “échec” (failure) to celebrate a failed relationship. Timeless Pearly’s Leslie Chetrit launched her brand in 2017 with an array of eclectic pieces, the latest being pendant necklaces variously featuring whimsical mushrooms and a gold-plated Pinocchio, all handmade in her Paris studio. With her three daughters in mind, the former magazine editor Maria Dueñas Jacobs created Super Smalls, a line for children. Her pieces, like a four-leaf-clover necklace featuring a real clover pressed in resin, are meant to be shared among family members.

Atacama, Chile, is known for its dramatic landscapes ranging from arid desert and salt flats to volcanoes and geysers. Our Habitas Atacama, a 51-room hotel slated to open in the northeastern town of San Pedro de Atacama on Sept. 15, hopes to give visitors a thoughtfully designed access point to such surroundings, while also doing its part to preserve them. The owners plan for the entire property to be free of single-use plastic, and food waste will be collected by a local company for composting. The rooms, some with roof terraces or patios, feature tapestries and ceramics created by artisans in the area. Guests can opt to try a sound bath or a temazcal ceremony in a traditional sweat lodge, or can arrange to take part in one of the many guided outdoor excursions, including hiking, biking, paragliding and stargazing. The hotel’s on-site restaurant, Almas, focuses on seasonal produce and wood-fired cooking, with dishes inspired by regional cuisine such as Machas y Rica Rica, which incorporates a type of razor clam native to Chile, and a lamb dish that exhibits clay cooking typical of the region. From $350, ourhabitas.com.

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After a retrospective featuring work that spanned nearly eight decades at the Guggenheim last year, the artist Alex Katz, 96, would have every reason to sit back and enjoy the accolades. But as a new show that opens at Gray Chicago next month proves, Katz is still driven by a need to create. “What gets me going every morning is knowing I’m going into the studio to paint,” he says. While many of his landscapes have been inspired by Lincolnville, Me., where Katz has spent several months of the year since the 1950s, the 11 new compositions on view (which will be presented alongside a series of 16 new ink portraits on paper) started taking shape on crisp morning walks that Katz took in New York last fall. “I looked up and saw all these colored leaves against a blue sky. They were relatively small trees, and the leaves stood out distinctly,” he recalls. “I felt a sensation of brightness and tried to paint this sensation.” Across enormous canvases (some measuring as wide as 14 feet), he depicts the windblown trees and delicate foliage of the changing season in vibrant golds, greens and reds. Painted in a kinetic, impressionistic style, these panoramic works create an almost immersive experience. “Alex Katz: Autumn” is on view at Gray Chicago from Sept. 8 through Oct. 28, richardgraygallery.com.

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In St. Moritz, Switzerland, the fabled winter sports enclave of the Alps, the landmark La Margna hotel has reopened as the 74-room Grace La Margna after a multiyear restoration. Built in 1906 just above the town’s railway station, the original property referenced Art Nouveau style as well as regional design elements found in the surrounding Engadin Valley, like massive walls and playfully decorated facades. Those exterior details have been maintained along with a number of interior aspects: In the ground-floor living room, the handmade metal chandeliers remain (though they’ve been retrofitted to accommodate LED lights), as does the marble fireplace and wood-paneled walls. At the bar, with its new curved Carrara marble counter and velvet bar stools, the menu features Orma whisky, distilled nearly 11,000 feet above sea level on the nearby Corvatsch mountain. The hotel restaurant, facing Lake St. Moritz, has reopened as the View, with a Mediterranean menu. A bistro, Max Moritz, is expected to open later in the fall; a brasserie is slated for the winter season. And in an entirely new wing, 27 guest rooms feature floor-to-ceiling windows that frame views of the village and the lake. From about $466 a night, gracehotels.com.

‘Bachelorette’ Finale is Cut by ABC Affiliate for Football Game

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Fans of “The Bachelorette” reality television show who live in the Washington, D.C., area were unable to watch the finale of the show’s 20th season on Monday night. It turns out their ABC affiliate showed an N.F.L. game instead — and a preseason one at that.

If you know any “Bachelorette” fans, you can probably guess how the Washington-area ones felt about this particular programming call.

“I was pretty frustrated,” Pegah Moradi, 25, who lives in Arlington, Va., said by phone early Tuesday.

“It’s more important for sports to be live, obviously, than it is for a prerecorded reality show finale,” said Ms. Moradi, a graduate student. “But at the same time, it’s difficult when something that you’re accustomed to viewing at a certain time is just not there.”

The practice of cutting one must-watch TV broadcast for another, more common in the past, has become rare in the streaming era. If something is important enough to broadcast live these days, networks and streaming platforms can usually find a way to do that.

But on Monday, the “Bachelorette” finale was shelved in the D.C. area by ABC’s local affiliate in favor of a football game between the Washington Commanders and the Baltimore Ravens. (The Commanders won, 29-28, after kicking a field goal in the game’s waning seconds.)

“It might be because the two football teams are regional favorites that people are obsessed with,” said Julia Swift, a professor in the Division of Communication and Creative Media at Champlain College in Burlington, Vt. “But people are also obsessed with ‘The Bachelorette.’”

N.F.L. policy mandates that games that air nationally — on cable networks like ESPN or on streaming services such as Amazon Prime — are broadcast on free, over-the-air television in the local markets of the participating teams. This is so fans can see their hometown teams play, even if they don’t have cable or a subscription to a streaming service, Brian McCarthy, an N.F.L. spokesman said in a statement.

The network, in this case ESPN, arranges with a local affiliate of its choice to broadcast the game in the teams’ markets. Neither ESPN nor the local ABC affiliate, WJLA, provided comment on the matter.

ABC, the majority owner of ESPN, did not respond to questions about why the game was aired in lieu of the “Bachelorette” finale, but a spokesman said that the episode would be available Tuesday on streaming platforms such as Hulu and that fans could sign in with their cable provider to stream it online.

The “Bachelorette” finale was available on Charge!, an over-the-air broadcasting network owned by the Sinclair Broadcast Group. Charge! is free and does not require a paid subscription. But some fans, including Ms. Moradi, had never heard of it and could not figure out how to watch.

Professor Swift said that it would have made more sense to air the episode on a streaming platform that belongs to ABC or Disney, the network’s corporate parent. (WJLA, the ABC affiliate that showed the game instead of the finale, is owned by Sinclair.)

The latest season of “The Bachelorette,” a spinoff of “The Bachelor” and “Bachelor in Paradise,” stars Charity Lawson, a real-life child-and-family therapist from Georgia who is looking for a life partner. Ms. Lawson, 27, began the season with 25 suitors; by the finale, she was down to three.

The ABC affiliate that cut the finale likely did so after calculating that more people would watch the football game, said Amanda Lotz, a professor of media studies at Queensland University of Technology in Australia who has studied the U.S. television industry.

Whatever the reason, the decision illustrates how the federal policies governing American television today were designed decades ago to promote “local sovereignty” by giving local affiliates discretion over what to air, said Professor Lotz, the author of “We Now Disrupt This Broadcast: How Cable Transformed Television and the Internet Revolutionized It All.”

The concept of “local sovereignty” may sound anachronistic in the streaming era, she added, “but these were policies that were designed to protect local community differences so that they wouldn’t be overrun by the creation of a national culture.”

One way to read Monday’s scheduling call would be as a kind of karmic victory for football fans, who were famously denied the ending of a nail biter of a game between the Jets and the Oakland Raiders on Nov. 17, 1968. With 50 seconds left, the television broadcast cut out abruptly to make way for “Heidi,” a made-for-TV children’s movie about a Swiss orphan.

As for “The Bachelorette,” Ms. Moradi said she understood that the Commanders and the Ravens are both in her television market and have local fan bases. “But a preseason N.F.L. game versus the finale of a major franchise TV show is not a very difficult decision to make in terms of what to broadcast,” she said.

After her viewing plans were scrambled on Monday, Ms. Moradi inadvertently saw a spoiler for the show as she searched for how to watch. At this point, she said, she wonders if watching the finale will even be worth her time.

“Everyone I know who was watching it will have already seen it, for the most part, so I’ll just kind of be in the dark for 24 hours,” she said. “I won’t get to join in on this rare experience: watching live TV at the same time as everyone else.”

Rebecca Carballo contributed to this report.

Writing Therapy Shows Promise for PTSD

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The two therapies were found to be equally effective, and only 12.5 percent of subjects dropped out of the written exposure group before completing a course of treatment, compared with 35.6 percent in the prolonged exposure group. In 2018, a study by the same team found that written exposure therapy was as effective as cognitive processing therapy, another first-line, or most highly recommended, PTSD treatment.

Writing down traumatic memories may be easier for some people, if they feel shame or embarrassment about what happened to them, said Denise Sloan, a psychologist who helped develop the treatment and is an author of the study. She said patients were asked to write by hand, which takes longer and allows them to engage with the memory.

“It’s a slower process, that allows them to better think through ‘what happened next, and who was there, and what did they say,’ because they’re writing about it,” said Dr. Sloan, associate director of the Behavioral Science Division of the National Center for PTSD. “It slows everything down, versus just saying it out loud.”

The therapy was inspired by the work of James Pennebaker, a Texas psychologist who, in the 1980s, began experimenting with what he called “expressive writing,” and found that people who regularly wrote about negative life experiences had stronger immune systems and paid fewer visits to the doctor.

The first study of written exposure therapy as a treatment for PTSD appeared in 2012. It works, Dr. Sloan said, much the way other trauma-focused treatments do: by allowing the client to confront the traumatic memory, lessening their fear and avoidance, and allowing them to identify misconceptions like self-blame.

Cognitive processing therapy and prolonged exposure therapy, the two treatments most highly recommended by the Departments of Veterans Affairs and Defense, have been in widespread use since the 1980s and are backed up by abundant research. A newer method, eye movement desensitization and reprocessing, is rapidly growing in popularity.

But all three are time-intensive, requiring sessions of 60 to 90 minutes for three months or more. A large number of patients — an average of 20 percent, and sometimes as high as 50 percent, studies have shown — drop out before completing a course of treatment.

Written exposure therapy, Dr. Sloan said, seems to achieve similar effects in fewer sessions.

“We have a lot of people that need mental health treatment, and we can’t accommodate the demand,” she said. “We need to revisit what we’re doing and how much is necessary for a good outcome. Because most people can’t go to treatment for 12 to 16 sessions.”

Data on the effectiveness of written exposure therapy is still emerging.

The studies comparing it to cognitive processing therapy and prolonged exposure therapy are non-inferiority trials — devised to demonstrate that a newer treatment is not worse than an established one — and “not as scientifically stringent” as trials devised to determine superiority, said Dr. Barbara Rothbaum, one of the developers of prolonged exposure therapy. She added that dropout rates at her clinic, at Emory University, were around 10 percent.

There is a reason, she said, that talk therapy has such a strong record of success in treating PTSD.

“There is something inherently healing about saying out loud the worse, most scary, most embarrassing, most shameful moment of your life to another human who is trying to be helpful,” she said. “Does it have to be that? No.”

Written exposure therapy was not endorsed as a first-line intervention by the Departments of Veterans Affairs and Defense in its most recent clinical practice guidelines, largely, Dr. Sloan said, because of the small number of published studies examining it.

That is likely to change over the next two years, she said, as a number of larger trials are completed. Clinicians, too, are going to have to get used to the idea of using writing, in addition to speech, to engage with patients on painful topics.

“Some people, they feel threatened by this, because it kind of challenges the crux of what they generally do,” she said. “It flies in the face of what they think is important in treatment.”

3 takeaways from Tucker Carlson’s softball interview with Donald Trump

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In a pretaped interview designed to undercut the first Republican presidential primary debate, fired former Fox News host Tucker Carlson gave former President Donald Trump a platform to express himself without being challenged. Trump opted to skip the debate, where the GOP frontrunner would have taken blows from his rivals.

Before the 46-minute interview began, Trump wrote on his social media site that “SPARKS WILL FLY.” Instead, Carlson marched in lock-step with Trump throughout the bulk of the interview.

Softball questions

Tucker Carlson interviews Donald Trump
Tucker Carlson one-on-one interview with Donald Trump on Wednesday night. (via X)

Carlson did not touch on the substance of the 91 felonies Trump is accused of having committed in the four criminal trials that could take place during the presidential election. But he did offer: “How do you get indicted every week and stay cheerful?”

On the subject of who Trump might run against if Biden were to drop out of the race, Carlson ventured, “I’m interested. So you think he’s failing. It’s obvious he is failing. I think it’s clear to everybody. But that would make Kamala Harris the candidate?”

“Well, not really,” Trump responded before speculating at length and reflecting that Harris “has some bad moments.”

An eye on revenge

Republican presidential candidate and former Vice President Mike Pence
Republican presidential candidate and former Vice President Mike Pence speaking on Saturday. (Rogelio V. Solis/AP)

While Carlson boasted that his interview with Trump would likely have more viewers than the GOP debate on the network fired in April, he also made sure to encourage some score settling with those who have criticized the former president. That list included Republican presidential candidates Asa Hutchinson, Chris Christie and Mike Pence, who Trump singled out for not going along with his efforts to overturn the 2020 election.

“I was very disappointed in him,” Trump said of his former running mate.

Also singled out for scorn were Trump’s former Attorney General William Barr, Senate Minority Leader Mitch McConnell and former Fox News anchor Chris Wallace.

‘Not a conspiracy person at all’

Jeffrey Epstein
Financier and sex offender Jeffrey Epstein, who died in prison in 2019. (New York State Sex Offender Registry via AP)

Though Carlson asserted that he was “not a conspiracy person at all,” he asked Trump whether he believed his former friend Jeffrey Epstein had been killed in prison and whether Barr might have had something to do with it or helped cover up the murder. In perhaps the most newsworthy moment of the interview, Trump responded that he believed Epstein had “probably committed suicide.”

At two different points in the interview, Carlson asked Trump whether he was worried that his political opponents were “going to try to kill you?”

“They’re savage animals,” Trump responded. “They’re people that are sick.”

Judge Orders New Trials for 2 Men Convicted in Grisly ’93 Murder

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An Erie County, N.Y., judge on Wednesday set aside the convictions of two men who, despite their protests of innocence, were found guilty in the grisly 1993 murder of a young mother outside Buffalo.

The ruling, by Justice Paul B. Wojtaszek of State Supreme Court, came after a lengthy re-examination of the case prompted by inconsistencies in the original prosecution, cited by lawyers for the two men, and by an explosive claim about another possible suspect: Richard Matt, one of two escapees in a famous New York jailbreak.

Justice Wojtaszek ordered that the two men, Brian Scott Lorenz and James Pugh, be granted new trials in the slaying of the young mother, Deborah Meindl, who was killed in her home in Tonawanda, N.Y.

The judge rejected the men’s assertions of innocence. But he ruled that new trials were warranted because of new evidence, and because the original prosecutors had violated rules governing the sharing of evidence. The Erie County District Attorney’s Office said it would be appealing the judge’s decision.

Zachary Margulis-Ohnuma, a lawyer for Mr. Pugh, said that it was “a wonderful day” for his client.

“Jimmy can finally get on with his life without the weight of a false conviction hanging over his head,” he said of Mr. Pugh, adding, “His story should inspire others to keep fighting for justice and strike fear in the hearts of corrupt police and prosecutors who think they can get away with framing innocent people.”

For years, Mr. Lorenz, 52, and Mr. Pugh, 61, had sought to overturn their convictions, noting a lack of forensic evidence linking them to the crime. Their lawyers and a pair of veteran Erie County prosecutors had also suggested that the actual killer was Mr. Matt, whose 2015 escape from a maximum-security prison in Dannemora, N.Y., set off a nationwide manhunt that ended when he was fatally shot.

That claim was advanced by David Sweat, who escaped with Mr. Matt and was recaptured alive.

In letter to The New York Times, Mr. Sweat also made an even more sensational claim: that Mr. Matt, who was living near the house where the murder occurred, had killed Ms. Meindl on orders of a local police officer, David Bentley, who later helped lead the investigation into her murder.

Mr. Sweat said Mr. Bentley had been worried about Ms. Meindl telling the authorities about illegal activities in which he and Mr. Matt were involved.

“The cop said she had to go,” Mr. Sweat wrote to The Times, “because she was going to rat them out.”

The former detective has vehemently denied any involvement in the Meindl killing. “It’s totally, absolutely, unequivocally insane,” he said. He has also denied that he had an affair with Ms. Meindl, which has been suggested by the victim’s husband, Donald, and others.

In his decision, Judge Wojtaszek also cast doubt on Mr. Sweat’s claims, calling them “patently incredible” and “totally unworthy of belief.” But he said that advances in DNA testing, which had excluded both men from various items found at the crime scene, warranted setting aside the convictions.

The decision marks the end of another chapter in the long and lurid saga surrounding Ms. Meindl’s murder.

In a savage attack, Ms. Meindl, a nursing student with two young daughters, was repeatedly stabbed and strangled to death with a man’s necktie on a snowy afternoon in February 1993.

Initially, suspicion fell on Donald Meindl who had a $50,000 life insurance policy on his wife and was having an affair with a 17-year-old girl at the time. He had also spoken with an associate about murdering his wife, though he insisted such conversations were in jest. (Mr. Meindl, who attended the hearing in Buffalo in late 2021 and early 2022, died in May.)

Soon after the murder, however, the investigation — spearheaded by Mr. Bentley — pivoted to Mr. Lorenz and Mr. Pugh, two low-level thieves with drug habits who authorities posited had aimed to rob the Meindl house and who killed Ms. Meindl when they were discovered.

Under arrest for another crime in Iowa, Mr. Lorenz confessed to the murder and implicated Mr. Pugh, which he later said was a false confession he made because he believed it would be easy to prove his innocence.

Mr. Pugh had always maintained that he had not known Ms. Meindl and had nothing to do with the crime.

Despite a dearth of physical evidence, prosecutors used a series of statements from acquaintances of the two men to secure a quick conviction. Both were sentenced to life in prison.

The case likely would have been forgotten if not for Mr. Pugh and Mr. Lorenz’s repeated attempts to reopen the investigation amid recantations by some of the prosecution’s witnesses, including some who said Mr. Bentley had coerced statements or threatened them.

In 2018, the two men’s efforts at exoneration gained strength after New York City defense lawyers representing Mr. Lorenz and Mr. Pugh convinced a state judge to grant a review of forensic evidence, which found that neither man’s DNA was at the crime scene. DNA testing also did not turn up Mr. Matt’s DNA, but did find evidence of another unknown individual on a variety of items, including a knife used in the attack, the necktie, and on Ms. Meindl’s bloodied clothes.

Pressed to vacate the convictions, the Erie County district attorney, John J. Flynn, agreed to a review by two prosecutors from his office in 2021.

Those prosecutors came to a staggering conclusion: Mr. Matt was the likely killer.

The allegation was made even more intriguing by the close relationship between Mr. Bentley and Mr. Matt, which had been likened to that of a father and son.

“I felt bad for him,” Mr. Bentley said in an interview in 2021. “You could almost say I loved the kid.”

But Mr. Flynn rejected his own prosecutors’ findings, demoting one of them and reassigning the other. He also vigorously opposed the motion to vacate the convictions of Mr. Pugh and Mr. Lorenz.

Judge Wojtaszek also seemed skeptical of the two prosecutors’ findings, calling it “nothing more than speculation, conjecture and surmise without any substantiation or corroboration.” But he did chide the initial prosecution for not turning over critical evidence, including a statement from a prosecution witness that he could not identify a commemorative coin that was found in Mr. Lorenz’s possession, seemingly linking him to the murder.

Mr. Flynn, a Democrat who currently serves as president of the state district attorney association, did not immediately return a request for comment.

But Mr. Lorenz’s attorney, Ilann M. Maazel, said that he hoped his client would be released from state prison as soon as possible.

“Scott is a broken man,” Mr. Maazel said. “More than anything, he just wants to go home to his wife and live in peace.”

Prigozhin Listed as Passenger on Plane That Crashed, Killing All Aboard: Latest Updates and Video

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Gen. Sergei Surovikin, a former commander of Russia’s forces in Ukraine was removed from his post as the chief of Russia’s Air Force, in what appears to be Kremlin’s most public action against those connected to the armed rebellion of the mercenary warlord Yevgeny V. Prigozhin in June.

The low-key crackdown in response to the mutiny, the most drastic threat to President Vladimir V. Putin in his 23-year rule, highlights the Russian leader’s cautious crisis-management style. So far, General Surovikin is the only senior official with ties to Mr. Prigozhin confirmed by Russian state media to have been demoted or otherwise punished in its aftermath.

Some Wagner fighters have relocated to Belarus, where officials have said the mercenaries are training Belarusian troops; others remain active in the Central African Republic, Mali and elsewhere in Africa, where they have helped prop up authoritarian leaders loyal to Moscow.

Mr. Prigozhin on Monday released a brief video message online for the first time in the mutiny’s aftermath, hinting that he was in Africa, even though the video recording’s timing and location were unclear. Dressed in fatigues and holding an assault rifle, he said that Wagner was “making Russia even greater, on all continents, and Africa even more free.”

General Surovikin has not been seen in public since the rebellion and his whereabouts has remained a mystery. In July, Andrei Kartapolov, the head of the defense committee of Russia’s lower house of Parliament, said that General Surovikin was “taking a rest” in response to questions from a reporter.

On Wednesday, RIA Novosti, a Russian state news agency, said that “the ex-commander in chief of the Aerospace Forces of Russia, Sergei Surovikin has now been relieved of his post.” It said that Col. Gen. Viktor Afzalov, chief of the air force’s general staff, had been named as the acting commander.

“Surovikin was relieved of his post in connection with the transfer to another job. He is now on a short vacation,” the RIA report added, citing a report from the Russian news outlet RBC.

Analysts have described General Surovikin, called “General Armageddon” for his ruthless tactics, as a brutally effective leader in a Russian military that even many Russian cheerleaders of the war have described as troubled by incompetence in its command structure. But his links to Mr. Prigozhin’s Wagner mercenary group, which took over a Russian city and began a march on Moscow in its brief mutiny, appeared to precipitate his fall from grace.

U.S. officials believe that General Surovikin had advance knowledge of Mr. Prigozhin’s rebellion. In the hours after the mutiny began, the Russian authorities quickly released a video of the general calling on the Wagner fighters to stand down.

Rumors have been circulating among Russia’s military bloggers, some of whom have close ties to Russian officials and the military, that General Surovikin had been under house arrest since the failed mutiny.

The reports about General Surovikin’s firing are “far from news for people in the know,” wrote Mikhail Zvinchuk, a popular pro-war Russian blogger who posts under the moniker Rybar on the messaging app Telegram. He added that General Surovikin lost his job immediately after Mr. Prigozhin’s rebellion.

General Surovikin was appointed to lead what Russian officials describe as its “special military operation” in Ukraine in October 2022 before being relieved of that job in January. In 2015, he commanded Russia’s forces during the country’s intervention in Syria, and he was the head of the Russian air force from 2017 onward.

In his three-month stint as the commander of Russian forces in Ukraine, General Surovikin helped stabilize Russia’s flailing war effort. In the fall, he oversaw what analysts described as a professionally managed withdrawal of Russian troops from the southern Ukrainian city of Kherson, where they were nearly encircled last fall and cut off from supplies.

He is also believed to have spearheaded the construction of Russia’s daunting network of defensive lines in the territory it occupies in Ukraine, which have challenged Kyiv’s counteroffensive.

General Surovikin’s replacement, General Afzalov, has been chief of the Air Force’s general staff since 2018, according to Russian state media, having risen through the ranks. He was “directly involved in planning and organizing” the full-scale invasion of Ukraine, according to Anton Gerashchenko, an adviser to Ukraine’s Interior Ministry, in a post on the social media platform X, formerly known as Twitter.

General Afzalov had previously served as the interim commander of Russia’s air force while General Surovikin led Russia’s armed forces in Ukraine. Suspicions that General Afzalov had replaced General Surovikin were raised in July, when the former was shown in official video footage delivering an air force report to General Valery V. Gerasimov, Russia’s top military officer.

Childcare, the Workforce, and the Economy: Connecting the Dots

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We hear it often—the weight of expensive and inaccessible childcare on working families with young children. What we haven’t discussed enough is the overall impact this challenge has on the U.S. economy… until now.

Without a doubt, affordable and available childcare is a critical component of a vibrant economy and researchers, economists, and policy leaders are currently working hard daily to unlock its potential.

Business and industry rely on employees and employees rely on childcare. “Work-Willing” parents of young children can only participate in the workforce and advance their careers when they have affordable, accessible, and high-quality childcare options for their young children. Unfortunately, those options are more limited than ever for parents eager to rejoin the workforce on a full-time basis. 

This dilemma keeps a significant number of parents and caretakers out of the workforce altogether and creates a wide-reaching ripple effect—driving down household earnings, employer sales, regional GRP and ultimately the overall prosperity of cities, regions, states, and the American economy.

Childcare: A Broken System for Everyone Involved

The escalation of childcare costs has been felt most acutely by the working class, with swift and unrelenting increases driving down take-home pay and purchasing power.  A 2022 study presented by the First Five Years Fund revealed that the average annual cost of childcare in America has increased 220% over the past three decades and considerably faster than any other essential family expense.

Annual costs of center-based childcare are in excess of $10,000 – a number that most families simply can’t afford, and multiplies for each additional child in a family unit.   At the same time, the rate of pay for childcare workers remains low and the profit margins for childcare center operators slim, or in many cases, become negative.  There is good reason why an overwhelming majority of centers are operated by non-profits or school districts: they can offset annual losses with grants, write-offs, or increased taxes levied at the district level. 

In short, the childcare model in the United States is broken for everyone involved: staff can’t earn a living wage, operators can’t turn a profit, and parents can’t afford the fees associated with enrolling their children. 

Childcare is Essential to the Success of Families

Although childcare costs have spiraled out of control, the need for it has remained constant. There are an estimated 15 million children in the U.S. under the age of six who have both parents in the household actively engaged in the workforce.  Indeed, that means there are between 20 and 30 million workers in the United States whose ability to earn and contribute to our national economy is entirely dependent on a childcare model that is not functioning as it should. 

For many parents, trying to juggle the steep cost of childcare, stay afloat with additional household expenses, all while advancing their careers is a difficult balancing act—that sadly never quite balances out.

Women Are Being Held Back from Career Goals

This problem is particularly acute among working mothers, or mothers attempting to rejoin the workforce.  It’s no secret that women disproportionately take on unpaid caregiving responsibilities when their family cannot find or afford childcare. Too often, mothers find themselves making career decisions based on childcare considerations rather than their personal financial and career goals.

A recent survey conducted by the Center for American Progress revealed mothers were 40 percent more likely than fathers to report they personally felt the negative impact of childcare issues on their careers.  Added to these challenges are the non-standard shifts, particularly in areas dependent on manufacturing or the service industry.  Most childcare centers operate during normal (dayshift) business hours, Monday through Friday. 

For families or individuals that work 2nd shift, or non-traditional split shifts, even if childcare was affordable for them, there is virtually no availability during the hours they need.

Billions in Economic Damage Will Continue Without Action

Studies have shown that the annual economic damage of the childcare crisis in the United States is more than $120 billion, when accounting for lost earnings, productivity, and revenue. That’s an incredible number and one that has risen from an estimated $57 billion just a few years ago.

Add to this the series of well-publicized labor shortages facing almost every industry in the United States and the general population decline that will further exacerbate these shortages the years to come, and it becomes alarmingly apparent that we are staring off the edge of a cliff.  This problem is only going to become worse unless immediate action is taken.

Lessons from Northeast Indiana

At TPMA, we use our 35 years of expertise to empower organizations and communities through strategic partnerships and informed solutions that create positive, sustainable change. Our team provides professional consulting services and delivers transparent insights to the complete workforce, education, and economic development ecosystem that allow them to move forward, together.

Recently, our Senior Strategic Advisor of Research and Impact, Brian Nottingham, created a methodology that allows us to estimate the financial benefits of communities when “work-willing” parents are able to return to the workforce thanks to accessible and affordable childcare.  Applying this framework to the region of Northeast Indiana:

  • We estimated that 8,987 parents in the region could be counted as “work-willing”: ready and able to go back to work full-time, but cannot because they do not have access to reliable, affordable childcare.
  • Using conservative estimates and distributing these parents proportionally across existing industries in the region, returning ALL of these 8,987 “work willing” parents in Northeast Indiana back to the labor force will increase payroll taxes by just over $21 million ($9.8 million to the state, $10.3 million to local governments in the region), and sales/import taxes collected from the industries employing these workers by approximately $20.2 million.
  • Driving this bump in tax revenue would be an additional $571 million in earnings for these parents and an estimated increase of just under $1 billion in Gross Regional Product for their employers.

A Search for Solutions

So where do we go from here? Our work in northeast Indiana shows that should the state choose to invest in childcare- covering 1/3 of the annual cost for these “work willing” parents- they would turn a net profit on the investment by reaping the rewards of additional sales and income tax revenue. 

Employers in the region as well are taking important, meaningful steps to also help share the burden with their employees because they too understand that at the end of the day, it is a profitable investment to fully staff their operations with work-willing parents.  But the solutions to this challenge are myriad and there is no one-size fits all approach to any given community.  As a starting point, we recommend:

  • Understand the economic impact. Whether it’s your city, state, or region—understanding the economic impact and the childcare landscape is critical to approaching the problem. Armed with knowledge and verifiable, independent estimates of impact based on a tested and respected, methodology, communities can start the conversation with elected officials, employers, and community organizations about how and why it is important to rally around solutions.  Contact us to learn how we can support these efforts.
  • Federal funding and/or state investment. As our work has shown, there is a strong economic case to be made for more federal or state dollars to be driven into the childcare system across the country.   As the principal beneficiaries of the tax dollars collected out of the paychecks of working parents, investing to ensure childcare workers can make a living wage and parents have money left over AFTER paying for childcare is a common-sense, cost/benefit approach.  Governments should treat the childcare industry like they do infrastructure: it is a vital driver of business in the United States.
  • Develop childcare networks. The nature of the childcare industry is such that small businesses operating either independently or as part of a small group teeter on the edge of-but seldom reach- profitability. Developing economies of scale can reduce financial burdens on the businesses and allow them to adjust down prices AND turn a profit.
  • Incentivize workers.  This crisis is not only about the cost of childcare, but also the availability. A lack of workers in this space makes it hard to find care even at higher prices, so creating programs and incentives for individuals to enter into the industry are essential. This might take the form of state-funded bonuses that boost overall income for childcare workers, or it could be that businesses themselves are able to offer a more competitive salary because they are receiving more support. 
  • Mindful considerations about what these employees are earning and actively working to increase the salaries of the people we charge with the care of our children should be forefront in any conversation about expanding training opportunities/educational programming.

Overall, everyone wins when childcare is affordable and accessible. If parents can get the care they need for young children while they work, businesses can flourish, and families can re-invest their savings into every other purchase that drives the American economy.

These efforts will require a collaborative approach where employers, employees, parents, governments, and community organizations work together to address what may be one of the biggest challenges facing the American workforce today.

For more information, contact Steven Gause, Director of Strategy and Growth Initiatives, at sgause@tpma-inc.com

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