CNBC: Biden Says Medicare Should Negotiate Prices For At Least 50 Drugs Each Year, Up From A Target Of 20
President Joe Biden on Wednesday said the federal Medicare program should negotiate prices for at least 50 prescription drugs each year, up from the current target of 20 medicines. That’s one of several new health-care policy proposals that Biden will outline during his State of the Union address Thursday, according to a fact sheet released by the White House on Wednesday. (Constantino, 3/6)

Axios: Biden Speech Again Seeks Credit On Drug Prices
President Biden will use Thursday night's State of the Union address to again claim credit for lowering Americans' drug costs — something the public just isn't willing to concede. (Reed and Goldman, 3/7)

CBS News: In State Of The Union Address, Biden To Urge Congress To Pass Measures To Lower Health Care Costs
In his speech, the president is expected to call on Congress to extend the $2,000 cap on out-of-pocket prescription drug costs — which is currently scheduled to go into effect for senior citizens in 2025 — to all Americans with private insurance. (Erickson, 3/6)

NPR: What To Expect In Biden's State Of The Union Speech, According To His Chief Of Staff
White House Chief of Staff Jeff Zients told Morning Edition's Steve Inskeep on Wednesday that Biden's speech will also highlight his agenda for a potential second term. "Lowering costs, continuing to make people's lives better by investing in childcare, eldercare, paid family and medical leave, continued progress on student debt," Zients said, listing a few. "But I think importantly, the president is also going to call for restoring Roe v. Wade and giving women freedom over their healthcare. And he'll talk about protecting, not taking away, freedoms in other areas, as well as voting rights." But Zients also acknowledged that restoring Roe is one of many objectives that the president can't accomplish without Congress. (Treisman, 3/7)

CNN: The State Of The Union, In 9 Charts
Ahead of Biden’s election-year State of the Union address to Congress, here’s a look at the data behind some of the topics and policies he could bring up. (Matthews and Choi, 3/7)

Modern Healthcare: Spending Bill With DSH Cut Delay, Doctor Pay Fix Passes House
Legislation crucial to hospitals, physicians and community health centers took a major step forward Wednesday when the House passed a measure to prevent parts of the federal government from shutting down. The bill would delay an $8 billion reduction in Medicaid disproportionate share hospital payments for a year, mitigate a Medicare physician pay cut that took effect Jan. 1 and extend funding for federally qualified health centers for four years. (McAuliff, 3/6)

Modern Healthcare: CMS Nursing Home Staffing Mandate Could Be Blocked By House Bill
A controversial effort to mandate minimum staffing levels for nursing homes would be halted under legislation a congressional committee approved Wednesday. President Joe Biden announced the initiative during the State of the Union address in 2022 and the Centers for Medicare and Medicaid Services issued a proposed rule to carry it out last September. The nursing home industry strongly opposes the policy, which has generated less than vigorous public support. (McAuliff and Eastabrook, 3/6)

The Hill: These Two Democrats Voted Against Spending Bill, Citing Firearms, Veterans
House Reps. Maxwell Frost (Fla.) and Mark Takano (Calif.) voted against the “minibus” legislation Wednesday that funds a slew of agencies and departments through the end of fiscal 2024. Frost, a first-term lawmaker who rose to prominence as a gun control advocate, said the measure features “the greatest rollback of the background check system since it was created.” A provision in the bill would allow veterans determined unable to manage their benefits to be able to purchase guns. Takano, the ranking member on the Veterans’ Affairs Committee, said it comes at the expense of the most “vulnerable” U.S. veterans.” (Timotija, 3/6)

The Washington Post: GOP Leaders Demand Answers From Medicare On Alleged $2B Catheter Fraud 
House Republicans on Wednesday demanded that federal health officials address an alleged Medicare fraud ring estimated at more than $2 billion. Health-care groups warn that the scheme has ensnared hundreds of thousands of patients and continues to expand. At least 10 companies are linked to an unexplained surge in bills for intermittent urinary catheters, low-cost devices used to relieve urinary incontinence, according to interviews with health-care officials, physicians and patients and documents obtained by The Washington Post. (Dan Diamond, 3/6)

Bloomberg: Weight Loss Drugs Threatened By US Effort To Contain China
Popular weight loss and diabetes drugs are getting caught up in a bid by US lawmakers to reduce the country’s reliance on Chinese biotech companies. Much of the active base ingredient used in Eli Lilly & Co.’s Zepbound and Mounjaro medicines is produced by WuXi AppTec Co., one of the main companies in the crosshairs of the Biosecure Act currently under discussion in the US Congress, according to people familiar with the company’s operations. (Cha, Muller, and Fay Cortez, 3/6)

USA Today: Alabama Lawmakers Pass Bill To Protect IVF Treatments
Alabama lawmakers gave final approval Wednesday to legislation protecting in vitro fertilization providers and patients, less than a month after the state Supreme Court upended fertility practices with a ruling that frozen embryos are legally protected as children. Members of the House passed the bill 81-12, and the Senate voted to concur, 29-1. The bipartisan legislation provides civil and criminal immunity to fertility clinics and doctors for the "death or damage to an embryo" during the IVF process. (Hitson and Hagan, 3/6)

NBC News: Two Alabama Fertility Clinics Say They Will Resume IVF Services After Bill To Protect Doctors Passes
Two Alabama fertility clinics that paused in vitro fertilization services last month expect to resume them now that state lawmakers have passed a bill to protect doctors and clinics that discard embryos as part of routine IVF services. The bill "provides the protections that we need to start care — or resume care, really," said Dr. Janet Bouknight, an IVF provider at Alabama Fertility, which suspended IVF services Feb. 22 after the state Supreme Court ruled that frozen embryos are considered unborn children. (Harris and Bendix, 3/7)

The Washington Post: America’s First IVF Baby To Attend State Of The Union As Tim Kaine Guest 
Elizabeth Carr entered the world as a 5-pound, 12-ounce earthquake, making medical history and unleashing furious controversy in 1981 as the first American conceived in a lab. Born in Norfolk with a “Nova” documentary crew in the delivery room and armed guards in the hall, America’s first IVF baby is 42 today and no longer a novelty. But Carr still stands as potent symbol of that now-commonplace — but newly threatened — way to make a baby. And that’s why Sen. Tim Kaine (D-Va.) has invited Carr to be his guest at Thursday’s State of the Union address. (Vozzella, 3/6)

Politico: How Biden’s SOTU Guest Upended The Abortion Debate 
President Joe Biden wants abortion rights to be a centerpiece of his rematch with Donald Trump this fall. Biden’s State of the Union speech on Thursday could reveal how he hopes to frame the debate. The Bidens have invited Kate Cox, the Texas woman at the center of a high-profile abortion case, as a guest — and the president is expected to highlight her story as he touts his executive actions to protect and expand access to abortion after the fall of Roe and slams Republicans for pushing restrictions at the state and federal levels. (Ollstein and Messerly, 3/7)

The New York Times: Profound Damage Found In Maine Gunman’s Brain, Possibly From Blasts
A specialized laboratory examining the brain of the gunman who committed Maine’s deadliest mass shooting found profound brain damage of the kind that has been seen in veterans exposed to repeated blasts from weapons use. The lab’s findings were included in an autopsy report that was compiled by the Maine chief medical examiner’s office and released by the gunman’s family. The gunman, Robert Card, was a grenade instructor in the Army Reserve. (Philipps, 3/6)

CBS News: Veterans Breathe Sigh Of Relief After VA Expands Access To Health Care
The early expansion of VA health care benefits is a major win for Pennsylvania veterans who often have to deal with life-altering conditions following deployment. "I didn't really think about it at the time, but everything kind of hit me when I came back that I kind of had to take it seriously," Jack Stonesifer. ... All veterans who were exposed to toxins and other hazards while serving in the military are now eligible to enroll in VA health care. This went into effect under the PACT Act on Tuesday, nearly eight years earlier than originally planned. (Guay, 3/6)

Military.Com: They Stood Sentry Over America's Nuclear Missile Arsenal. Many Worry It Gave Them Cancer. 
Danny Sebeck was shaving on an August day in 2022, when he spotted a lump on his neck he hadn't noticed before. It was probably nothing, he thought. Later that month, he was talking with a close friend who said he had noticed a similar bump, too. The two had served together at Malmstrom Air Force Base, Montana, as missileers -- a high-stress job in which young officers are stationed below ground in launch control centers to keep careful watch over and, if called upon, fire America's nuclear intercontinental ballistic missiles. (Novelly, 3/7)

WMFE: VA Says 9,000 Vets Were Notified After A Former Orlando Employee Emailed Patient Info
The Department of Veterans Affairs is notifying thousands of veterans about a disclosure of personal information in the service network that includes most of Florida. The department said the disclosure was caused by a former Orlando VA health care system employee. The VA said the person emailed documents to a personal account on the last day of employment, but there’s no evidence the information went farther than that. (Byrnes, 3/6)

Stat: Study: Nursing Homes Use Related Party Transactions To Hide Profits
A new study shows that some nursing homes are shunting the majority of their profits off of their own books and into less-visible corners of their owners’ pockets. (Trang, 3/7)

Axios: Hospital Debacle Puts Focus On Private Equity
When Cerberus Capital Management bought an unprofitable Massachusetts hospital chain in 2010, many viewed the deal as a financial lifeline. Now some believe it was actually a noose. The company, which Cerberus sold four years ago, is in severe distress and may close facilities, threatening care for thousands of patients, most of whom live in lower-income areas. (Primack, 3/6)

KFF Health News: Operating In The Red: Half Of Rural Hospitals Lose Money, As Many Cut Services
In a little more than two years as CEO of a small hospital in Wyoming, Dave Ryerse has witnessed firsthand the worsening financial problems eroding rural hospitals nationwide. In 2022, Ryerse’s South Lincoln Medical Center was forced to shutter its operating room because it didn’t have the staff to run it 24 hours a day. Soon after, the obstetrics unit closed. (Orozco Rodriguez, 3/7)

Reuters: Patients Or Payroll? US Healthcare Hack Creates Hard Choices 
Nearly two weeks after the ransomware attack on UnitedHealth's Change Healthcare unit that has disrupted claims processing across the U.S., doctors are beginning to face a no win choice - stop treating patients or stop paying staff. The attack, which was disclosed on Feb. 21, shut down the system that many doctors depend on to verify insurance coverage, file claims and get paid, sparking a campaign by hospitals and doctors for the U.S. government to provide financial relief as it did during the COVID-19 pandemic. (Steenhuysen, 3/7)

Modern Healthcare: Nursing Homes Limiting Admissions Amid Staffing Shortage: AHCA 
As the Centers for Medicare and Medicaid Services' staffing mandate looms, nearly half of nursing homes polled by the American Health Care Association are already limiting admissions due to severe staffing shortages, according to a report the industry trade group released Tuesday. In a survey conducted last month of 441 nursing homes across the country, seven out of 10 operators reported lower staffing levels than before the COVID-19 pandemic. (Eastabrook, 3/6)

CBS News: ER Workers At Detroit Hospital Contemplate Strike, Citing Long Hours And Lack Of Staff
It's not every day that our health care providers walk off the job and onto the picket line. Now, over 40 workers at Ascension St. John Hospital are contemplating taking bold measures. For them, it's to make sure things are running smoothly inside. "We're a huge stroke center, cardiovascular center, trauma center, but we are worried that we are about to be unable to meet some of those national standards if current practices continue," said Dr. John Bahling. (Bailey, 3/7)

Bloomberg: NYC’s Mount Sinai To Shut Beth Israel Hospital's Cardiac, Stroke Units 
New York’s Mount Sinai Medical Center said it’s closing two units at its Beth Israel Hospital in downtown Manhattan this month. Certifications for stroke and cardiac units expire in early March, according to court documents filed Tuesday. “Due to the lack of staffing and increasing patient safety concerns, these designations will not be renewed,” Mount Sinai said in an emailed statement Wednesday.(Coleman-Lochner, 3/6)

The Baltimore Sun: Johns Hopkins Medicine Chief Diversity Officer Steps Down After Viral Backlash Over ‘Privilege’ Definition 
Johns Hopkins Medicine’s chief diversity officer is no longer in the role two months after she wrote a newsletter identifying people with “privilege” and sparking backlash. In the January newsletter from the Baltimore hospital and research center’s diversity office, Dr. Sherita Golden wrote that “privilege” was the “word of the month,” defining it as “a set of unearned benefits given to people who are in a specific social group.” Those social groups were categorized as white people, heterosexuals, cisgender people, men and Christians, among others. (Price, 3/6)

CIDRAP: Even Healthcare Workers Face Difficulty Accessing Long-COVID Care, Review Suggests 
Healthcare workers with long-COVID symptoms reported that their physicians shrugged off their concerns and that they struggled to get the care they needed, a new systematic review suggests. (Van Beusekom, 3/6)

USA Today: Long COVID May Increase Alcohol Sensitivity, Stanford Research Finds
Long COVID may be to blame for the worsening headaches, nausea, fatigue and sweats that accompany hangovers, a recent study shows. The peer-reviewed study done by researchers at Stanford University concluded that SARS-CoV-2 infection could be related to increased alcohol sensitivity. The group at Stanford’s Post-Acute COVID-19 Syndrome Clinic studied four patients to determine if their long-term COVID had any effect on them after alcohol consumption. (Limehouse, 3/6)

CIDRAP: COVID-19 Pandemic Changed All-Cause Mortality Among US Latinos 
A new analysis of all-cause mortality of Hispanic and Latino adults published in Annals of Internal Medicine shows Mexicans and Central Americans were most affected by the pandemic. Participants were recruited from the Bronx, New York City; Chicago; Miami; and San Diego and were of Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American backgrounds. (Soucheray, 3/6)

Los Angeles Times: Friday Is Your Last Day To Order Free Mail-Order COVID Tests
Free COVID-19 tests are still available by mail, but the U.S. Postal Service says orders will be suspended after Friday. Since Nov. 20, residents have been eligible to receive up to two orders of four at-home COVID-19 tests via the USPS, meaning each home could receive up to eight tests. The offer is ending just as COVID-19 restrictions and recommendations from health officials have been significantly relaxed, but testing continues to be a central part of the recommendations made by state and federal officials. (Hernandez, 3/6)

Stat: The Public Health Thinking Behind The CDC’s New Covid Guidance 
What makes for good public health guidance? That’s the conversation I was having with a colleague in her 40s railing against the Centers for Disease Control and Prevention’s erstwhile guidance about alcohol consumption for women of “childbearing” years. The guidance, if followed closely, would mean that all women ages 15 to 49 should fully abstain from alcohol consumption unless they’re using birth control. That’s more than 77 million women in the U.S. alone. The CDC guidance was finally archived last year, along with a similar proposal from the World Health Organization. For good reason: It’s absurd. (Ashish K. Jha, 3/6)

AP: Ground Cinnamon Sold At Discount Stores Is Tainted With Lead, FDA Warns
Ground cinnamon sold by U.S. discount retailers is contaminated with high levels of lead and should be discarded, federal health officials said Wednesday. The U.S. Food and Drug Administration said cinnamon sold by stores including the Dollar Tree and Family Dollar contains lead at levels that could be unsafe for people, particularly children, with prolonged exposure to the spice. The agency urged suppliers to recall the products voluntarily. Cinnamon products included in the agency’s safety alert include the La Fiesta brand sold by La Superior and SuperMercados; Marcum brand sold by Save A Lot stores; MK brands sold by SF Supermarket; Swad brand sold by Patel Brothers; El Chilar brand sold by La Joya Morelense; and Supreme Tradition brand sold by Dollar Tree and Family Dollar stores. (Aleccia, 3/6)

Reuters: Cancer-Causing Chemical Found In Clinique, Clearasil Acne Treatments, U.S. Lab Reports
High levels of cancer-causing chemical benzene were detected in some acne treatments from brands including Estee Lauder's Clinique, Target's Up & Up and Reckitt Benckiser-owned Clearasil, said independent U.S. laboratory Valisure. Benzene was also detected in Proactiv, PanOxyl, Walgreens' (WBA.O), opens new tab acne soap bar and Walmart's (WMT.N), opens new tab Equate Beauty acne cream among others, according to Valisure. (3/6)

North Carolina Health News: A Study Shows Increased PFAS Risks To Firefighters As Gear Ages
Firefighters are regarded as heroes because they often put themselves in harm’s way when responding to emergency calls. They are able to carry out heroic deeds, in large part, because of the safety shield provided by their protective equipment or “turnout” gear. However, a growing body of research suggests that the gear that protects firefighters could also be risking their health. (Atwater, 3/7)

The Washington Post: East Palestine ‘Controlled Burn’ Could Have Been Avoided, NTSB Chair Says 
The decision to conduct a controlled burn of five derailed tank cars that unleashed a plume of toxic chemicals last year in East Palestine, Ohio, was based on flawed and incomplete information, the chair of the National Transportation Safety Board testified Wednesday at a Senate hearing. Jennifer Homendy, facing questioning from Sen. J.D. Vance (R-Ohio), testified that contractors employed by the Norfolk Southern railway company “lacked the scientific background” to decide that a vent-and-burn was necessary. (Goodwin, 3/6)

Reuters: Plastic Lodged In Arteries May Be Linked To Higher Risk Of Heart Disease And Death
Minuscule pieces of plastic lodged in the fatty deposits that line human arteries may be linked with higher risks for heart disease, strokes, and death, Italian researchers reported on Wednesday. Among 304 patients who underwent procedures to clear a major artery in the neck, 58% were found to have microscopic and nanoscopic “jagged-edged” pieces of plastic in the plaque lining the blood vessel, including polyethylene and polyvinyl chloride containing chlorine, Dr. Raffaele Marfella at the University of Campania in Naples and colleagues reported. (Lapid, 3/6)

ABC News: 4 Children Surpass A Year Of HIV Remission After Treatment Pause: Study 
Four children born with HIV were able to live virus-free for more than a year after their HIV medication was paused, according to results of a study funded by the National Institutes of Health. The results of the P1115 study were announced on Wednesday at the 2024 Conference on Retroviruses and Opportunistic Infections (CROI), in Denver, Colorado. The study explored the effects of early intensive antiretroviral therapy on achieving HIV remission in babies who acquired the virus before birth. (Salzman, 3/6)

NBC News: After Decades Of Failures, Researchers Have Renewed Hopes For An Effective HIV Vaccine
The world needs an HIV vaccine if it ever hopes to beat a virus that still infects over 1 million people a year and contributes to hundreds of thousands of deaths. Despite 20 years of failures in major HIV vaccine trials — four this decade alone — researchers say recent scientific advances have likely, hopefully, put them on the right track to develop a highly effective vaccine against the insidious virus. But probably not until the 2030s. (Ryan, 3/6)

The Washington Post: For Longevity, Women Need Only Half As Much Exercise As Men, Study Finds
It’s well-established that exercise can help you live a longer and healthier life. Now, a new study suggests that women may require less exercise to get similar longevity benefits as men. The finding is striking because physical activity guidelines for American adults are the same for men and women. But partially because of differences in size, muscle mass and lean body mass, it appears that women can make big gains in longevity while doing about half the exercise men need to do to get the same benefit. (Soong, 3/6)

KFF Health News: When It Comes To Ketamine, Meta’s Posting Policy Is No Party To Decipher
People keep talking about ketamine. The drug has become a favorite of celebrities, billionaires, and ordinary patients, many of whom view it as a potential miracle drug for depression and other mental health conditions. Whether on Facebook or Instagram, patients and clinics alike are giddy about the possibilities. But it is a drug that can be abused and can be deadly. Thus, ketamine is the latest challenge for Meta, the social media platforms’ parent company, which for years has struggled to moderate posts and ads touting health-related products like weight loss supplements and dodgy covid-19 cures. (Tahir, 3/7)

The 19th: If Your Boss Is The State Of Texas, Some Pregnancy Protections Just Ended For You
Last June, a new federal law granted pregnant people across the country additional protections in their workplaces. But as of Wednesday, those protections have now ended for government workers in the state of Texas. (Carrazana, 3/6)

The Texas Tribune: Lifesaving Narcan Tough To Find In Texas Pharmacies
When the U.S. Food and Drug Administration made the opioid overdose reversal drug naloxone an over-the-counter medication last summer, health care advocates praised the removal of the prescription barrier as an effective tool to prevent fentanyl deaths. That is, if you can find it. A February report from Rice University’s Baker Institute for Public Policy found that of the 156 pharmacies they contacted, 71 percent of the Houston pharmacies kept it behind the pharmacists’ counters or were entirely out of the product. (Simpson, 3/7)

Iowa Public Radio: Report Finds More Than Two Dozen Iowa Hospitals Not In Compliance With Federal Price Transparency Rules
A new report has found more than two dozen Iowa hospitals are not fully compliant with federal price transparency requirements. The non-profit Patient Rights Advocate released the report last month reviewing 43 Iowa hospitals and found 26 hospitals, or 60% percent, are non-compliant with the Hospital Price Transparency Rule. (Krebs, 3/6)

CBS News: Colorado Bill Would Require Insurers And Medicaid To Cover Weight Loss Drugs Like Wegovy
"We know that if this was a cure for cancer that it would absolutely be paid for," says State Sen. Dafna Michaelson Jenet who has introduced a bill that would require insurers and Medicaid to cover the drugs. (Boyd, 3/6)

CBS News: Sacramento Youth Development Program Allows Kids To Play Independently. Some Say Its A Game Changer
Steve Caudle is a play manager at the Sacramento Adventure Playground, where kids can do anything from catching frogs in the mud to building a fort out of real wood with real hammers and nails, all while parents aren't allowed to hover. "We openly promote this as risky play," Caudle said. "There's a physical risk but also social risk associated with it." (Garcia, 3/6)

CIDRAP: Low Iron May Play Key Role In Long COVID 
Patients who went on to develop long COVID showed more problems with regulation of blood iron levels, including anemia, as soon as 2 weeks after acute infection, suggesting low iron levels may play a role in the chronic condition, according to a new study in Nature Immunology. (Souchery, 3/4)

Stat: Covid-19 Increases Risk Of Autoimmune Disease
Having Covid-19 increases a person’s risk of developing an autoimmune disease in the year after infection, a large study out of South Korea and Japan reports, but vaccination helps decrease that risk. (Cueto, 3/4)

CIDRAP: COVID Vaccination In First Half Of Menstrual Cycle Tied To Temporarily Longer Cycles
Women vaccinated against COVID-19 in the first half of their menstrual cycle (follicular phase) are more likely to see slight, short-term changes in cycle length than those vaccinated in the second half (luteal phase), concludes a large study published in Obstetrics & Gynecology. (Van Beusekom, 3/4)

The Washington Post: Menopause Is Often Wrongly Linked With Depression, Study Finds
For years, menopause and depression have been closely linked. But now a new paper in The Lancet disputes the commonly held notion that menopause consistently raises risk for mental health problems. (Chesler, 3/5)

ScienceDaily: This Injectable Hydrogel Mitigates Damage To The Right Ventricle Of The Heart 
As a result of the new preclinical study, the FDA approved an investigational new drug application to start a clinical trial with the hydrogel in pediatric patients in the coming months, once institutional approvals are received. (University of California - San Diego, 3/6)

The Atlantic: The U.S. Health System’s Single Point Of Failure 
When the coronavirus began straining American health care four years ago, hospitals and public officials at least saw the problem coming. Now a different kind of invader—purposeful and malign—has caught the system off guard. Late last month, hackers conducted a massive ransomware attack on Change Healthcare, a division of UnitedHealth Group that transmits health providers’ claims to patients’ insurers, and the consequences are rippling outward. (Juliette Kayyem, 3/6)

Stat: Tuition-Free Medical Schools Alone Won't Fix Diversity Problems 
Medical students at Albert Einstein School of Medicine in New York City gathered last week to hear a life-changing announcement: Ruth Gottesman revealed she would be donating $1 billion, ensuring no student at Einstein will pay tuition ever again. (Tricia Pendergrast and Jared E. Boyce, 3/7)

Newsweek: Transgender Vets Deserve Access To Care 
The United States military is a fighting force for which this nation owes its freedoms. It is made up of millions of our fellow Americans, who are all volunteers, and whose sacrifices are great. They travel the globe, pick up their families when duty calls, and relocate to wherever their nation needs them. They are deployed at this very moment in combat zones in defense of our country and all that we stand for. And, these brave service members risk their lives day in and day out, and no matter their race, sex, sexual orientation, or gender identity. It is our responsibility to care for those who've served our nation just as they have served us. (Kelley Robinson and Allison Jaslow, 3/6)

Miami Herald: Florida Lawmakers Must Stem Healthcare Worker Shortage
March 2024 marks four years since COVID-19 was declared a global pandemic. Thankfully, we’re long past lockdowns, overrun emergency rooms and makeshift morgues. But for the millions who lost loved ones — in Florida about 93,000 people died related to the virus — and many millions more who suffered serious illness and effects, the trauma remains fresh. (Shirley Vyent, 3/6)