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Abstract

Background
The relationship between pain and falls remains controversial. Therefore, this study explored the associations between pain and fall-related outcomes in 5 340 middle-aged (45–65 years) adults residing in the communities in Korea.


Methods
Pain was defined as pain at any location, pain-related activity restriction, and persistent pain. The outcome measures included fall injuries, recurrent falls, injurious falls, and fall-related hip fractures. A multivariate logistic regression model was used to examine the relationship between pain and fall outcome.


Results
Among the study participants, 54.0% reported having experienced pain. During a follow-up period of up to 14 years, those who reported pain and pain-related activity restriction at baseline exhibited a positive association with the occurrence of fall injury (odds ratio [OR] 1.79, 95% confidence interval [CI]: 1.27–2.53) and injurious falls (OR 1.72, 95% CI: 1.20–2.48) but not with recurrent falls (OR 1.90, 95% CI: 0.80–4.54). We also observed a positive association between persistent pain and the risk of fall injury (OR 1.41, 95% CI: 1.13–1.91), whereas no consistent conclusions were drawn regarding the risk of recurrent falls and injurious falls. We also did not identify any correlation between pain and hip fractures resulting from falls.


Conclusions
In conclusion, our findings of the positive correlations of pain and pain-related activity restriction at baseline with fall injuries and injurious falls but not recurrent falls during follow-up suggest that public health initiatives should prioritize pain screening, especially for participants reporting ankle and toe pain, and implement suitable interventions to mitigate the risk of falls and the associated adverse outcomes among middle-aged adults.

Background Falls are common in the older UK population and associated costs to the NHS are high. Systematic reviews suggest that home exercise and group-based exercise interventions, which focus on progressively challenging balance and increasing strength, can reduce up to 42% of falls in those with a history of falls. The evidence is less clear for those older adults who are currently at low risk of falls. Aim ProAct65+, a large, cluster-randomised, controlled trial, investigated the effectiveness of a home exercise programme (Otago Exercise Programme (OEP)) and a group-based exercise programme (Falls Management Exercise (FaME)) compared to usual care (UC) at increasing moderate to vigorous physical activity (MVPA). This paper examines the trial's secondary outcomes; the effectiveness of the interventions at reducing falls and falls-related injuries. Setting & participants 1256 community-dwelling older adults (aged 65 + ) were recruited through GP practices in two sites (London and Nottingham). Frequent fallers (≥3 falls in last year) and those with unstable medical conditions were excluded, as were those already reaching the UK Government recommended levels of physical activity (PA) for health. Methods Baseline assessment (including assessment of health, function and previous falls) occurred before randomisation; the intervention period lasted 24 weeks and there was an immediate post-intervention assessment; participants were followed up every six months for 24 months. Falls data were analysed using negative binomial modelling. Outcome measures Falls data were collected prospectively during the intervention period by 4-weekly diaries (6 in total). Falls recall was recorded at the 3-monthly follow-ups for a total of 24 months. Balance was measured at baseline and at the end of the intervention period using the Timed Up & Go and Functional Reach tests. Balance confidence (CONFbal), falls risk (FRAT) and falls self-efficacy (FES-I) were measured by questionnaire at baseline and at all subsequent assessment points. Results 294 participants (24%) reported one or two falls in the previous year. There was no increase in falls in either exercise group compared to UC during the intervention period (resulting from increased exposure to risk). The FaME arm experienced a significant reduction in injurious falls compared to UC (incidence rate ratio (IRR) 0.55, 95% CI 0.31, 0.96; p = 0.04) and this continued during the 12 months after the end of the intervention (IRR 0.73, 95% CI 0.54, 0.99; p = 0.05). There was also a significant reduction in the incidence of all falls (injurious and non-injurious) in the FaME arm compared with UC (IRR 0.74, 95% CI 0.55, 0.99; p = 0.04) in the 12 month period following the cessation of the intervention. There was a non-significant reduction in the incidence of all falls in the OEP arm compared with UC (IRR 0.76, 95% CI 0.53, 1.09; p = 0.14) in the 12 months following the cessation of the intervention. The effects on falls did not persist at the 24 months assessment in either exercise arm. However, when those in the FaME group who continued to achieve 150 min of MVPA per week into the second post-intervention year were compared to those in the FaME group who did not maintain their physical activity, there was a significant reduction in falls incidence (IRR = 0.49, 95% CI 0.30, 0.79; p = 0.004). CONFbal was significantly improved at 12 months post intervention in both intervention arms compared with UC. There were no significant changes in any of the functional balance measures, FES-I or FRAT, between baseline and the end of the intervention period. Conclusion Community-dwelling older adults who joined an exercise intervention (FaME) aimed at increasing MVPA did not fall more during the intervention period, fell less and had fewer injurious falls in the 12 months after cessation of the intervention. However, 24 months after cessation of exercise, the beneficial effects of FaME on falls reduction ceased, except in those who maintained higher levels of MVPA. OEP exercise appears less effective at reducing falls in this functionally more able population of older adults.

Background Falls are common in the older UK population and associated costs to the NHS are high. Systematic reviews suggest that home exercise and group-based exercise interventions, which focus on progressively challenging balance and increasing strength, can reduce up to 42% of falls in those with a history of falls. The evidence is less clear for those older adults who are currently at low risk of falls. Aim ProAct65+, a large, cluster-randomised, controlled trial, investigated the effectiveness of a home exercise programme (Otago Exercise Programme (OEP)) and a group-based exercise programme (Falls Management Exercise (FaME)) compared to usual care (UC) at increasing moderate to vigorous physical activity (MVPA). This paper examines the trial's secondary outcomes; the effectiveness of the interventions at reducing falls and falls-related injuries. Setting & participants 1256 community-dwelling older adults (aged 65 + ) were recruited through GP practices in two sites (London and Nottingham). Frequent fallers (≥3 falls in last year) and those with unstable medical conditions were excluded, as were those already reaching the UK Government recommended levels of physical activity (PA) for health. Methods Baseline assessment (including assessment of health, function and previous falls) occurred before randomisation; the intervention period lasted 24 weeks and there was an immediate post-intervention assessment; participants were followed up every six months for 24 months. Falls data were analysed using negative binomial modelling. Outcome measures Falls data were collected prospectively during the intervention period by 4-weekly diaries (6 in total). Falls recall was recorded at the 3-monthly follow-ups for a total of 24 months. Balance was measured at baseline and at the end of the intervention period using the Timed Up & Go and Functional Reach tests. Balance confidence (CONFbal), falls risk (FRAT) and falls self-efficacy (FES-I) were measured by questionnaire at baseline and at all subsequent assessment points. Results 294 participants (24%) reported one or two falls in the previous year. There was no increase in falls in either exercise group compared to UC during the intervention period (resulting from increased exposure to risk). The FaME arm experienced a significant reduction in injurious falls compared to UC (incidence rate ratio (IRR) 0.55, 95% CI 0.31, 0.96; p = 0.04) and this continued during the 12 months after the end of the intervention (IRR 0.73, 95% CI 0.54, 0.99; p = 0.05). There was also a significant reduction in the incidence of all falls (injurious and non-injurious) in the FaME arm compared with UC (IRR 0.74, 95% CI 0.55, 0.99; p = 0.04) in the 12 month period following the cessation of the intervention. There was a non-significant reduction in the incidence of all falls in the OEP arm compared with UC (IRR 0.76, 95% CI 0.53, 1.09; p = 0.14) in the 12 months following the cessation of the intervention. The effects on falls did not persist at the 24 months assessment in either exercise arm. However, when those in the FaME group who continued to achieve 150 min of MVPA per week into the second post-intervention year were compared to those in the FaME group who did not maintain their physical activity, there was a significant reduction in falls incidence (IRR = 0.49, 95% CI 0.30, 0.79; p = 0.004). CONFbal was significantly improved at 12 months post intervention in both intervention arms compared with UC. There were no significant changes in any of the functional balance measures, FES-I or FRAT, between baseline and the end of the intervention period. Conclusion Community-dwelling older adults who joined an exercise intervention (FaME) aimed at increasing MVPA did not fall more during the intervention period, fell less and had fewer injurious falls in the 12 months after cessation of the intervention. However, 24 months after cessation of exercise, the beneficial effects of FaME on falls reduction ceased, except in those who maintained higher levels of MVPA. OEP exercise appears less effective at reducing falls in this functionally more able population of older adults.

Purpose: We investigated the association between food insecurity and fall-related injury among older adults from six low- and middle-income countries (LMICs), and the extent to which this association is mediated by mental health. Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Fall-related injury referred to those that occurred in the past 12 months. Multivariable logistic regression analysis and mediation analysis were conducted to assess associations. Results: Data on 14,585 adults aged ≥65 years [mean (SD) age 72.5 (11.5) years; 54.9% females] were analyzed. After adjustment for potential confounders, severe food insecurity (versus no food insecurity) was associated with 1.95 (95%CI = 1.11-3.41) times higher odds for fall-related injury. Moderate food insecurity was not significantly associated with fall-related injury (OR = 1.34; 95%CI = 0.81-2.25). The mediation analysis showed that 37.3%, 21.8%, 17.7%, and 14.0% of the association between severe food insecurity and fall-related injury was explained by anxiety, sleep problems, depression, and cognition, respectively. Conclusion: Severe food insecurity was associated with higher odds for injurious falls among older adults in LMICs, and a large proportion of this association may be explained by mental health complications. Interventions to improve mental health among those who are food insecure and a strong focus on societal and government efforts to reduce food insecurity may contribute to a decrease in injurious falls. ; restriction

Purpose: We investigated the association between food insecurity and fall-related injury among older adults from six low- and middle-income countries (LMICs), and the extent to which this association is mediated by mental health. Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Fall-related injury referred to those that occurred in the past 12 months. Multivariable logistic regression analysis and mediation analysis were conducted to assess associations. Results: Data on 14,585 adults aged ≥65 years [mean (SD) age 72.5 (11.5) years; 54.9% females] were analyzed. After adjustment for potential confounders, severe food insecurity (versus no food insecurity) was associated with 1.95 (95%CI = 1.11–3.41) times higher odds for fall-related injury. Moderate food insecurity was not significantly associated with fall-related injury (OR = 1.34; 95%CI = 0.81–2.25). The mediation analysis showed that 37.3%, 21.8%, 17.7%, and 14.0% of the association between severe food insecurity and fall-related injury was explained by anxiety, sleep problems, depression, and cognition, respectively. Conclusion: Severe food insecurity was associated with higher odds for injurious falls among older adults in LMICs, and a large proportion of this association may be explained by mental health complications. Interventions to improve mental health among those who are food insecure and a strong focus on societal and government efforts to reduce food insecurity may contribute to a decrease in injurious falls.

Objective This study evaluated the hazard (risk of unrecovered balance loss and hazardous fall) and strategies associated with grab bar use, compared to no grab bar use, during unexpected balance loss initiated whilst exiting a bathtub. Background While independent bathing is critical for maintaining self-sufficiency, injurious falls during bathing transfer tasks are common. Grab bars are recommended to support bathing tasks, but no evidence exists regarding fall prevention efficacy. Method Sixty-three adults completed a hazardous bathtub transfer task, experiencing an unpredictable external balance perturbation while stepping from a slippery bathtub to a dry surface. Thirty-two were provided a grab bar, while 31 had no grab bar available. Slips and grab bar use were recorded via four video cameras. Slip occurrence and strategy were identified by two independent video coders. Results Participants who had a grab bar were 75.8% more likely to recover their balance during the task than those who did not have a grab bar. Successful grab bar grasp was associated with balance recovery in all cases. Attempts to stabilize using other environmental elements, or using internal strategies only, were less successful balance recovery strategies. Grab bar presence appeared to cue use of the environment for stability. Proactive grasp and other strategies modified grasping success. Conclusion Grab bars appear to provide effective support for recovery from unexpected balance loss. Grab bar presence may instigate development of fall prevention strategies prior to loss of balance. Application Bathroom designs with grab bars may reduce frequency of fall-related injuries during bathing transfer tasks.

Background: Parkinson's disease (PD) is a common, progressive neurodegenerative disorder, recognized by the motor symptoms of bradykinesia, tremor, rigidity, and postural impairment. At clinical onset, extensive amounts of dopaminergic neurons have already been lost. The duration of this prodromal phase is uncertain, and it is thought to include predominantly non-motor symptoms. The progressive nature and the symptoms of PD are disabling and reduces the quality of life. Among patients affected in working age, early cessation of employment is common, and such socioeconomic consequences of PD may contribute to an impaired quality of life. The aims of this thesis were to investigate the life situation for people affected by PD in working age, with attention to factors of importance for quality of life and working situation, and to evaluate long-term associations between potential prodromal signs and the later development of PD.Methods: We used a postal survey to investigate the self-perceived life situation among working-aged individuals with PD compared to matched controls, with a specific attention to socioeconomic consequences of disease (paper I). To investigate risk markers preceding the diagnosis of PD (paper II-IV), we used data from nationwide registers. Study II was performed as a cohort study, based on the Swedish Military Service Conscription Register, and study III-IV were performed as nested case-control studies based on a cohort comprising all Swedish citizens aged ≥50 years in 2005.Results: In the survey study (paper I), 38% of the PD participants and 9% of the controls were dissatisfied with life as a whole, and the working situation was an independent risk factor for dissatisfaction with life. In total, 59% of the PD participants had reduced working hours or stopped working due to PD, and many PD participants struggled to cope with their work demands. Support from employer was associated with a higher likelihood to remain employed.We found that low muscle strength in young adulthood, (paper II) and depression (paper III) were associated with an increased risk of PD over follow-up times of more than 2 decades, and that patients with PD were at increased risk of fall-related injuries, hip fractures in particular, a decade or more before the PD diagnosis (paper IV). For depression and fall-related injuries, the association with PD was clearly time-dependent, strongest in the last years before the diagnosis of PD.Conclusions: The results suggest that the prodromal phase of PD may last for more than 2 decades and include also motor symptoms. The consequences of PD include a reduced quality of life associated with the working situation. Employer's support appear to be particularly important for a successful vocational rehabilitation.

Interdisciplinary teams play an important role implementing innovations that facilitate the quality and safety of patient care. This article examined the role of reflexivity in team innovation implementation and its association with an objective patient safety outcome, inpatient fall rates (a fall is an unintended downward displacement of a patient's body to the ground or other object). In this study, we implemented, supported, and evaluated interdisciplinary teams intended to decrease fall risk in 16 small rural hospitals. These hospitals were part of a collaborative that sought to increase knowledge and facilitate reflexivity about fall event reporting and fall risk reduction structures and processes. We assessed team reflexivity at the start and at the end of the 2-year intervention and innovation implementation at the end of the intervention. The 16 hospitals reported objective fall event data and patient days throughout the project, which we used to calculate comparative rates for assisted, unassisted, and injurious falls. The results suggest that teams benefited from the intervention, increasing reflexivity from the start of the project to the end, which was related to innovation implementation and decreases in fall rates. Theoretical and practical applications of the results are discussed.

When family members admit a loved one to a nursing home, they expect that the facility will assure the physical safety of the residents. However, this does not always occur. Safety concerns persisting in at least some modern American nursing homes involve adverse drug events, injurious falls, pressure ulcers, problems with tube feeding, faulty communications or other breakdowns during transfer to or from hospital, and equipment breakdowns or mix-ups. The adversarial legal, economic, political, and media environment surrounding the US nursing home industry poses serious practical impediments to alleviating these safety concerns more effectively. However, resident safety comprises only one part of the larger quality improvement picture in the nursing home context. While the threat of negative legal repercussions may be necessary to address safety issues, a fuller concern about improving the quality of care and quality of life for nursing home residents will also involve the development and implementation of a combination of positive incentives for facilities to do better.

AbstractThe characteristics of Australian retirement village residents, an under-researched population, are not well understood. Knowledge of their wellbeing and modifiable factors associated with low wellbeing would aid in the introduction of health promotion measures and supports to facilitate healthy ageing-in-place. A novel approach utilising latent class analysis (LCA), a statistical method not previously employed to study this population, was undertaken to analyse cross-sectional survey data from 871 participants aged ≥65 years from retirement villages in Queensland, Australia. LCA identified latent, i.e. unobserved, underlying and often difficult to measure, groups within this population based on the responses of individuals to multiple observed variables. Survey participants were divided into groups, each with a distinct profile associated with a wellbeing state, as determined by responses to questions about physical health, unplanned hospitalisations, cognitive health and social connectedness. Multinomial logistic regression explored the relationship between modifiable health and lifestyle characteristics and membership of a particular wellbeing group. The median age of participants was 82 years (interquartile range = 76–88). While 69.0 per cent reported good to excellent health, polypharmacy was evident with 45.6 per cent of participants taking five or more prescription medications. In the previous 12 months, 33.3 per cent had experienced one or more falls and 30.6 per cent an unplanned hospitalisation. Distinct profiles were identified for three wellbeing groups: high (57.7% of participants), moderate (20.6%) and low wellbeing (21.7%). Injurious falls, limited ability to prepare meals and debilitating pain were associated with the moderate and low wellbeing groups. Physical activity significantly lowered the probability of a retirement village resident being in the low wellbeing group. Our findings highlight falls prevention, maintaining adequate nutrition, pain management and regular physical activity as actions that may optimise wellbeing, mitigate functional decline and support the independence of retirement village residents into later years of life.

Purpose Various forms of exercise have proven health benefits for people with Parkinson's (pwPD) yet high intensity functional training (HIFT) has yet to be studied. The purpose of this study was to examine the feasibility, physical and psychosocial impacts of a HIFT program for pwPD and their care partners (CPs). Design A single group, pre-post design with assessments before, in the middle (13 weeks), and after the 25-week intervention. Setting Community fitness facility Participants Fourteen pwPD (10 at Hoehn Yahr Stage ≤2, 4 females) and 10 CPs (5 females) were included (mean age = 71.5 (6.1)). Intervention A 25-week HIFT program (≤49 exercise sessions, ≤75 min long) Measures Recruitment, retention, attendance, safety and exercise intensity (measured via session-Rating of Perceived Exertion (RPE)) was assessed in addition to cardiovascular endurance, lower extremity strength, walking speed, balance, exercise self-efficacy, balance confidence, social support for exercise and health-related quality of life. Analysis Descriptive data was used to describe feasibility measures. Wilcoxon signed-rank test was used to compare pre- and post-program data. Effect size, r, was calculated. Results Recruitment rates were ≥40% for pwPD and CPs and retention rates were 80% for pwPD and 62.5% for CPs. Average session attendance was 71.2% with 15 adverse events reported, including 7 non-injurious falls. Median session-RPE was 5 (IQR = 1) out of 10. PwPD demonstrated significant improvements in cardiovascular endurance, self-selected and fast walking speeds, balance and social support for exercise. CPs demonstrated significant improvements in cardiovascular endurance and lower extremity strength. Exercise self-efficacy, balance confidence and health-related quality of life did not significantly change for pwPD or CPs. Conclusion High intensity functional training appears feasible for pwPD and their CPs and may lead to health benefits. Healthcare providers should consider HIFT as another option to engage pwPD in community-based exercise.

This article focuses on the historical experience with U.S. external adjustment, that is, narrowings of the trade deficit. Using data from the past 35 years, we compare economic performance in episodes during which the U.S. trade balance declined against episodes during which it rose. We find that trade balance adjustment has been generally benign: U.S. real gross domestic product growth tended to fall but not to a statistically significant extent; housing construction slumped; inflation generally rose modestly; and although nominal interest rates tended to rise, real interest rates fell. The article then compares these outcomes to those in foreign industrial economies. We find that the economic performance of the United States during periods of external adjustment is remarkably similar to the foreign experience. Finally, we also examine the performance of the foreign industrial economies during the periods when the U.S. trade deficit widened and narrowed. Contrary to concerns that U.S. adjustment will prove injurious to foreign economies, our analysis suggests that the foreign economies fared reasonably well during past periods when the U.S. trade deficit narrowed. (JEL F32, F41)

Having reached the tenth anniversary of the Convention on Prohibitions or Restrictions on the Use of Certain Conventional Weapons Which May be Deemed to be Excessively Injurious or to have Indiscriminate Effects, adopted on 10 October 1980 (hereinafter referred to as the 1980 Convention), we can measure the progress brought about by the treaty within the limits which the law sets for the suffering caused by war. Paradoxically, however, we are witnessing an increasing number of situations which, in form at least, fall outside the scope of application of the 1980 Convention, namely non-international armed conflicts.Yet international humanitarian law on methods and means of combat includes general rules applicable to all armed conflict, and hence to non-international armed conflicts too. The provisions of the 1980 Convention are an application of those general rules to the means of combat which the treaty is intended to regulate. The question thus arises whether some of the rules of conduct laid down in the 1980 Convention are applicable to all armed conflicts, whether international or non-international. In the present study, we shall attempt to reply at least to some extent to that question.

There are those days when the entire idea of government is called into question - given how hard it seems to gain good government: Half of young people using disposable vapes were not smokers, research has shown, as ministers consider a ban.The UK study of almost 70,000 people shows a steep rise in the number of adults using the products.Overall, the study found that from January 2021 to August 2023, the prevalence of disposable e-cigarette use grew from 0.1 per cent to 4.9 per cent of the adult population.The figures show that among those aged 18 to 24, the proportion using disposable vapes is significantly higher. In total, 14.4 per cent of this age group used the devices, including 7.1 per cent who used them despite not having a history of smoking tobacco.That all sounds to us like excellent news. We know that tobacco smoking is injurious to health, vaping is a vastly less damaging substitute, more vaping and less smoking seems like a damn good idea. This is not, however, how government seems to see it: The Government is considering banning disposable vapes, as part of efforts to prevent youth vaping.Given the difference in health effects the correct reaction to the evidence so far would be to subsidise vaping, not ban it. The charity said ministers faced a "complex balancing act" to keep vapes out of the hands of children and those who have never smoked, while ensuring help was available for those trying to quit smoking.Why try to stop people who don't smoke from vaping? This is the very thing desired, that people don't smoke, yes? So, if people vape instead of smoke then they're not smoking - job done.And the thing is, alongside the rise in vaping over the years there's been a collapse in the number of young and teen smokers. "Smoking rates among 16-24 year olds have only fallen by a half since 2000, from 32.9% in 2000 to 15.7% in 2020." and "Regular smoking among males and females aged 15 in England has fallen steadily since 2011, from 11.0% for both sexes to 4.9% and 5.3% in 2018 respectively" and "The proportion of children who have ever smoked continues to decline. In 2018, 16% of 11-15 year olds (23% in 2012) had smoked at least once; the lowest proportion since the survey began in 1982, when 53% had tried smoking." Different measures in different years provide different numbers of course.We can even test this against the experience of other places: The proportion of teenagers smoking has increased for the first time in 25 years in a situation health experts have labelled "alarming".Data analysed by Cancer Council Victoria's Centre for Behavioural Research in Cancer (CBRC) has revealed a threefold increase in the proportion of 14 to 17-year-olds smoking tobacco in the past four years, from 2.1% in 2018 to 6.7% in 2022.So, why might that be?It is illegal to purchase any e-liquids or vaping products containing nicotine for personal use from any Australian retailer as it is classified as a schedule 7 – dangerous poision under the National Poisons Standard. The use of Nicotine is regulated by the Federal Government under the Theraputic Goods Act 1989. However, if the e-cigarette is for therapeutic purposes such as smoking cessation or alleviation of nicotine withdrawal, the e-cigarette must be registered by the TGA in order to be lawfully sold. This is only available by a doctor as a schedule 4 prescription only medicine under the National Poisons Standard.Putting vapes - containing nicotine at least - on prescription only increases the teen smoking rate. Or, at least, is strongly correlated with it rising.Britain has nicotine vapes widely available and a low and falling teen smoking rate. Australia has nicotine vapes on prescription only and a high and rising teen smoking rate. Therefore the British government is to control teen access to nicotine vapes in order to reduce the teen smoking rate. Currently the UK government takes 37% of all economic effort by everyone in the country. Clearly too much of that is spent upon fools. The correct solution to government losing its mind is to have less government, obviously.

As a parting gift to Louisianans, Democrat Gov. John Bel Edwards
gave them the middle-fingered salute that forever cements his reputation as
Gov. Nyet.

It's not so much the volume of vetoes, contrasted
to his predecessor Republican Gov. Bobby
Jindal who in his first term vetoed 74 regular session non-appropriations
bills and 50 in his second term, while Edwards vetoed just 29 in his first term
and wrapped up with 78 in his second. In part, it's because Edwards cast nearly
half his vetoes in just the past two years while Jindal cast only a few in his
last quarter of service.

But mostly it's because Jindal's vetoes only
rarely struck anything but low-profile measures while Edwards' have gone
against some subjects of considerable popular and newsworthy concern. So much
so that Edwards looks to have triggered a third veto session in an annual row, where
these meetings to overturn vetoes had been unprecedented prior to his time in
office, and where one override became the first to succeed.

Expect more. Prior to Edwards, past governors shied
away from vetoing big items, in part because they didn't have to face them. High-profile
measures usually carried popular support and legislative supermajorities, so if
a governor couldn't cut these off at the pass, he would have to let them go.

But Edwards, if not the most liberal governor in
the state's history in the aggregate certainly the most committed leftist on
social issues, just won't lay down on some of these. And he does so for the
most relentless partisan and ideological reasons, even as he invokes tiresome
preachiness about how anybody disagreeing with him is sowing division when, in
reality, he disingenuously goes out of his way to provoke conflict as a necessity
of ideological fealty and to pay off allies.

Some of his veto messages provide prime examples
of this sanctimony. HB 399 would
have had schools when communicating information about the state schedule of
vaccinations also reminding parents and students that under statute they can
opt out themselves or their children from this. He vetoed this,
calling it "a covert attempt to undermine the faith of the public in vaccines"
as his way of covertly attacking state law he dislikes because it disempowers
government – even as the evidence
continues to grow about intentional media and government downplaying of the
volume and magnitude of adverse impacts of Wuhan coronavirus vaccination.

Or with SB 1 that over
the next few years would have reduced substantially, perhaps even entirely, the
corporate franchise tax considered economically injurious. Edwards admits this
but says he vetoed
it because it might cut government revenues too much in light of previous
reformation efforts and the coming expiration of the 0.45 percent sales tax
hike he had backed to the hilt. Of course, in his zeal to overinflate
government to this year's budget Edwards led the charge to add hundreds of
millions of dollars in unneeded new commitments, which without that happening would
have mooted any future concerns about tax cuts that would have reached consumers.

And there's SB 196, which attempted to bring
transparency to the Wild West of third
party litigation funding – critically appraised by the television news
program 60
Minutes, many state attorneys general, and GOP Sen. John Kennedy for resulting
in an unnecessary amount of litigation and potential noncitizen interference in
legal processes – not by prohibiting this but merely asking for revelation of
lawsuit funders. But as this could have the slightest possibility of reducing
trial lawyer business – the single largest group of funders of Edwards'
political career – he vetoed it,
ignoring consequences from the zero oversight and rules about it and instead calling
it "a pretense designed to gain a litigation advantage" for trial lawyer opponents.

His pièce de résistance was the last-minute
vetoes of HB 81,
HB 466,
and HB 648.
HB 466 would prevent school employees from psychological coaching of students
about their gender identity inconsistent with state instructional standards and
protect school employees and students from confusion over pronoun use of
students. HB 81 would cover pronoun usage like HB 466. HB 648 would prohibit
medical interventions to alter the sex of children, where research
shows such interventions regretted by almost a third of all children guided into
these and a significant portion of others years later feeling no more
positively about themselves.

These disapprovals guaranteed another veto
session, with each having passed by healthy supermajorities. Not only will all
but a couple of Republicans vote for overrides but also several Democrats threatened
to lose reelection this fall will jump at the chance to override as nationally
opinion polls show the sentiments behind the bills favored by the public.

Edwards' actions are so predictable. This pathetic
political hack never has had the best interests of Louisianans in mind other
than as an appendage to ruthless promotion of an ideological template alien to
the state and/or empowering special interest political allies. But he'll go
down swinging, railing against whatever contravenes his warped agenda for the
polity.