I am a clinical epidemiologist whose research focuses on assessing interventions for the treatment and prevention of dementia. The recent study on coffee and dementia that was discussed in Leana S. Wen’s Feb. 18 op-ed, “Drinking coffee to prevent dementia? Not so far-fetched.,” was well conducted. However, I believe it is premature to promote coffee for the prevention of dementia.
Over decades of research, dementia has proved difficult to prevent or treat. Interventions with far stronger biological rationale than coffee have looked promising in observational studies, only to fail in randomized trials. Dementia research is especially challenging because the disease develops over decades and is difficult to measure. Changes in cognition and functioning well prior to diagnosis can affect behavior. Psychoactive substances, including coffee, may transiently improve cognitive test performance without altering the course of the disease. In addition, unmeasured differences between individuals who do and don’t receive an intervention can make an ineffective intervention appear effective. Food and beverage intake is notoriously challenging to measure accurately, further increasing potential for spurious findings.
It’s worth considering whether an intervention is truly effective or whether we’re drawn to findings that validate behaviors we already enjoy in the context of a devastating disease we fear.
Sarah F. Ackley, Providence, Rhode Island
The writer is an assistant professor of epidemiology at the Brown University School of Public Health.
Respect the title, respect the training
The Feb. 16 news article “Health care hiring keeps labor market off sick bed” referred to nurse practitioners and physician assistants as “mid-level” providers. NPs and PAs, also known as advanced practice providers, hold master’s or doctoral degrees and have extensive training.
The term “mid-level” is inaccurate and implies that the provider holds a lower-quality or inferior status, despite holding advanced degrees, national certification and the ability to diagnose and treat patients independently or in collaboration with other members of the health care team. APPs are fully licensed and not mere extenders of care by physicians.
Studies show that NPs deliver high-quality, safe and effective care; receive high patient satisfaction scores; and fill health care provider shortage gaps across the country.
Let’s stick to using our titles and not diminish our role by calling us “mid-level.”
Lois Wessel, Takoma Park
The writer is a family nurse practitioner and an associate professor of nursing and medicine at Georgetown University.
Public universities are evolving
James B. Murray Jr. and Meredith Woo argue in their Feb. 19 Friday Opinion essay, “U.S. universities have lost sight of their core task,” that universities must recommit to practical curriculums, business collaboration and workforce preparation.
At the California State University — the nation’s largest four-year public university system — that work is already central to our mission.
Public universities must evolve alongside the economies they serve. At the CSU, meeting workforce demand, expanding opportunity and embracing emerging technologies are not future ambitions — they are present commitments delivering measurable results for California’s communities and industries. As artificial intelligence promises to reshape nearly every sector, we launched a landmark initiative to provide students, faculty and staff with access to advanced AI tools integrated across disciplines. Through public-private partnerships, micro-internships and experiential learning, students are applying these tools in real-world settings — ensuring that AI literacy becomes a workforce skill, not a buzzword. And, through CSU Forward and our Student Success Framework, we are embedding career-connected learning, employer partnerships and expanded student support into every campus, ensuring every student graduates with a pathway to a first career job or further study.
University systems like CSU are not behind the moment. We are helping power it.
Dilcie D. Perez, Long Beach, California
The writer is deputy vice chancellor of strategic enrollment management and student success at the California State University.
Why Washington’s uniform endures
I’m in my 70s, and I have recently found myself remarking to friends and family that I’ve been wearing essentially the same semiformal outfit my entire life.
So I was fascinated by Chloe Chapin’s Feb. 19 online op-ed, “Incredibly, men are still wearing ‘the George Washington,’” which linked the blue blazer and tan pants to our first president. However, I laughed out loud at her conclusion that this combo evokes the politics of “a simpler time.” As she herself noted, the outfit has persisted for decades, through actual simpler times.
I believe she overlooked the real reason this outfit persists. When I grab my blazer and tan pants (or, yes, gray pants in the winter months), I know that the outfit doesn’t clash, especially if I choose a plain blue shirt.
For generations of men of all political persuasions, that fashion simplicity is what we, who know ourselves to be otherwise fashion-clueless, enthusiastically embrace.
Michael L. Millenson, Highland Park, Illinois
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