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When a draft of the Supreme Court’s Dobbs v Jackson opinion that would overturn Roe v Wade leaked in May of last year, US Senator Tina Smith had only three words. “This is bulls***,” the Minnesota Democrat tweeted. She had similar words when Walgreens announced in March of this year it would not dispense abortion pills in states where abortion remained legal. Ms Smith told The Independent in a phone interview that she knew the consequences of overturning the enshrined constitutional right to seek an abortion from her time working at Planned Parenthood as the Minnesota branch’s executive vice president for external affairs. She said her time working there taught her about the effects restrictions have on women’s lives. “The first thing I realized is that for women facing a decision about what to do about an unplanned pregnancy, a pregnancy that they don't want, this is a purely personal decision for them,” she said. “As a policymaker, why do Republicans in the Senate and in state legislators around the country think that they know better than those women whose stories they'll never know? Why do they think that they should be the ones who decide? It’s those women's decisions.” Ms Smith said that the Dobbs decision has led to rooting the question of abortion rights in terms of personal freedom. “You know, they can see this, these stories of individuals and doctors that are trying to provide the best health care, get the best health care for people, and you know, they unable to do that and they can see that that's just wrong,” she said. Sen Smith arrived under peculiar circumstances after then-Governor Mark Dayton nominated her, while she was serving as lieutenant governor of Minnesota, to replace Sen Al Franken amid multiple allegations of inappropriate sexual behaviour. Similarly, she has often been overshadowed by Minnesota’s senior Democratic Sen Amy Klobuchar, who ran for president. She and fellow midwestern Democratic Sen Tammy Baldwin, of Wisconsin, have a running joke that reporters and Capitol Hill staff often confuse them. In the past year, Sen Smith has emerged as a stronger presence. She wrote some of the climate provisions in what would become the Inflation Reduction Act. When Sen John Fetterman (D-PA) left the Senate for a few weeks to undergo treatment for depression, she spoke about her own difficulties with the condition. In addition, she’s emerged as one of the strongest voices defending abortion rights. Ms Smith said the Dobbs decision has made the contrast between Democrats and Republicans clearer. In recent months, Sen Tommy Tuberville (R-AL) has blocked military nominations because of the Pentagon’s policy that reimburses people who travel out of state to receive abortions. “What Senator Tuberville is doing is so outside the norms of what we should be doing in the Senate, it's outrageous,” she said. “I just need to point out that what Senator Tuberville is trying to do is to overturn a policy which basically provides women serving in the military with the same access to health care that people that are incarcerated in our federal prisons have.” Few Republicans seem deterred from their opposition to abortion despite the role it played in dulling their efforts to flip the Senate last year. Ms Smith’s colleague Sen Tim Scott (R-SC), now a candidate for president, told the Faith & Freedom Coalition’s Road to Majority Conference last month “thank God almighty for the Dobbs decision.” Former vice president Mike Pence has called for a 15-week national abortion ban. Meanwhile, former president Donald Trump has campaigned as the president who nominated the three Supreme Court justices who made the decision possible. Florida Gov Ron DeSantis, who often places a second distant behind Mr Trump in polls, signed legislation banning abortion after six weeks. As vice chairwoman of the Democratic Senatorial Campaign Committee, Ms Smith faces a tough challenge because not only does she have to defend Senate seats in Wisconsin, Michigan, Pennsylvania, Arizona and Nevada – all of which President Joe Biden won in 2020 – she also has to defend Senate seats in three states Mr Trump won twice: Ohio, Montana and West Virginia. “And make no mistake, if Republicans win the Senate or if Republicans win the White House, we can see from their statements, they're going to move to pass a national ban on abortion,” she said, noting how many GOP candidates for Senate oppose abortion. “So, this is the contrast, this is what voters will be confronted with when they cast their votes in 2024,” she said. “Do you want to elect individuals who think they know better, that they should be the ones making decisions, individuals that want to ban abortion rights? Or do you want to elect Democrats who believe that women and not politicians should be making their own health care decisions?” At the same time, Democrats face huge challenges to codify abortion rights. Last week, Mr Biden told donors he was personally uncomfortable with abortion. “I'm a practising Catholic,” he said on Tuesday. “I'm not big on abortion, but guess what? Roe v Wade got it right.” Sen Smith defended Mr Biden’s actions defending abortion rights. “I believe that the President and the administration have moved decisively in all the ways that they can as they look for other ways to the practical reproductive freedom, that's a good thing,” she said. “I'm proud of the work that they've done. I think ultimately, the action that we need to take is legislative action, and that is why we need to win these elections.” Last year, shortly after the Dobbs leak, Senate Majority Leader Chuck Schumer tried to put the Women’s Health Protection Act, which would have codified the protections in Roe, to a vote. But Sen Joe Manchin (D-WV) opposed the measure. Even then, Sen Kyrsten Sinema of Arizona, who later left the Democratic Party to become an independent, opposes removing the filibuster, which demands a two-thirds majority to pass legislation. Sen Smith said if Democrats with the House, the Senate and the White House again, they should get rid of the filibuster. “And you know, we need to work towards a Senate majority that will not only support reproductive freedom but will also change Senate rules so that we can act on that belief,” she said. “And that I think is going to as I said before, that I believe will be a decisive issue in the in the elections in 2024.” Read More Congresswoman who authored abortion rights bill calls Senate’s inaction to codify Roe v Wade ‘such a crime’ Ritchie Torres, the only openly gay Black man in Congress, on how he fights GOP ‘bullying’ of LGBT+ people Republicans try to thread the needle on abortion on anniversary of the death of Roe 'Rage giving' prompted by the end of Roe has dropped off, abortion access groups say Arizona executive order safeguards abortion seekers and providers from prosecution Why some doctors stay in US states with restrictive abortion laws and others leave

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Being lonely may the increase risk of heart disease in diabetes patients, research suggests. Scientists have found loneliness to be a bigger risk factor for coronary heart disease – a condition where the blood vessels supplying the heart are narrowed or blocked – than diet, exercise, smoking and depression. The researchers said their findings, published in the European Heart Journal, highlight the importance of meaningful social relationships to stay healthy. Study author Professor Lu Qi, of Tulane University School of Public Health and Tropical Medicine in New Orleans, said: “The quality of social contact appears to be more important for heart health in people with diabetes than the number of engagements “We should not downplay the important of loneliness on physical and emotional health. “I would encourage patients with diabetes who feel lonely to join a group or class and try to make friends with people who have shared interests.” For the study, the researchers looked at data from the UK Biobank – an online database of medical and lifestyle records from more than half a million Britons – involving more than 18,000 adults aged between 37 to 73. These people had diabetes but no heart disease at the start of the decade-long study. The researchers used questionnaires to assess loneliness and other factors that may affect relationships such as body mass index (BMI), physical activity, diet, alcohol, smoking, and medications, blood pressure, cholesterol and control of blood sugar. The findings suggest that asking patients with diabetes about loneliness should become part of standard assessment, with referral of those affected to mental health services Prof Lu Qi Over the course of more than 10 years, more than 3,000 people developed heart disease, which included coronary heart disease or stroke. The researchers found those who scored the highest in loneliness had a 26% greater risk of heart disease, compared to people with lower scores. The team also found loneliness to be a bigger risk factor for heart disease than diet, exercise, smoking and depression – but showed a weaker influence when compared to kidney function, cholesterol and BMI. Professor Qi said: “Loneliness ranked higher as a predisposing factor for cardiovascular disease than several lifestyle habits. “We also found that for patients with diabetes, the consequence of physical risk factors (ie poorly controlled blood sugar, high blood pressure, high cholesterol, smoking and poor kidney function) was greater in those who were lonely compared to those who were not.” “The findings suggest that asking patients with diabetes about loneliness should become part of standard assessment, with referral of those affected to mental health services.” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live 7 ways to save money on your hair Sarcoma Awareness Month: What you need to know about these cancers Bjork’s controversial swan dress to go on display in new exhibition

Although most people have heard of sarcomas, research suggests the majority don’t really know what they are. A study by Sarcoma UK found 75% of people didn’t know what a sarcoma was – but there’s no better time than July’s Sarcoma Awareness Month to learn. Sarcomas are rare cancers that can either form in the bones or soft tissues that connect, support and surround other body structures and organs, explains Sarcoma UK. “If you’ve never heard of sarcoma before, you’re not alone,” says Dr Sorrel Bickley, director of research, policy and support at Sarcoma UK. “Sarcoma can affect any part of the body, on the inside or outside, including the muscle, bone, tendons, blood vessels and fatty tissues.” She says around 15 people are diagnosed with sarcoma cancer every day in the UK, and stresses: “It can affect anyone, at any age, and it’s vital that healthcare professionals can recognise its signs and symptoms.” During Sarcoma Awareness Month the charity is running a campaign called Does Size Matter?, in a bid to draw attention to the fact that a lump getting bigger is a key sign of sarcoma. “Most lumps and pains won’t be sarcomas, but it’s important to keep an eye on symptoms and to seek medical help if you’re worried,” stresses Bickley, who explains that many patients tell the charity it’s taken a long time for them to get a correct diagnosis. She adds: “Many people don’t consider their symptoms might be serious. Delays cost lives, and people have a better chance of surviving sarcoma if their cancer is diagnosed early. ” There are around 100 different subtypes of sarcoma, grouped into soft tissue sarcomas and bone sarcomas, and Bickley explains: “Soft tissue sarcomas may not have obvious symptoms in the early stages when the tumour is very small. The symptoms can become more obvious as the sarcoma grows, but this can depend on where in the body it’s found. ” She says there are several main sarcoma symptoms to be aware of… A lump that grows or changes Bickley says sarcoma is a “complicated cancer”, but the most common symptom is a lump, which could be anywhere on the body – including the arm or leg. “Most lumps aren’t harmful and a lump that isn’t getting bigger, isn’t causing any pain, or that has been there for a long time isn’t likely to be anything to worry about,” she says. “But if it’s growing quicky or measures more than five centimetres – about the size of a golf ball – then you should get it checked by your GP.” Swelling or pain in or around a bone Sarcoma cancer can also start in a bone – the most common symptoms are unexplained pain or tenderness around a bone, which may come and go and may be worse at night, explains Bickley. “If the pain is getting worse and doesn’t go away with rest or at night, you should go and see your GP to get it checked,” she advises. Stomach pain, feeling sick and loss of appetite Some forms of sarcoma – known as a gastrointestinal stromal tumours, or GISTs – can start in the gastrointestinal tract. “With this type of sarcoma, people most often experience symptoms like fatigue, anaemia, weight loss, feeling sick or discomfort around their stomach,” Bickley says. Blood in poo or vomit Noticing blood in your poo or vomit can also be a sign of a gastrointestinal stromal tumour, says Bickley, who adds: “There are lots of causes for blood in poo or vomit, but it needs to be checked by a medical professional.” For more information or advice about sarcoma, call the Sarcoma UK support line on 0808 801 0401, email supportline@sarcoma.org.uk, or text 07860 058830 to contact a specialist adviser. Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live Bjork’s controversial swan dress to go on display in new exhibition Chrissy Teigen welcomes fourth child – how does surrogacy actually work? 11 ways to work the colour clash trend at home

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