MedCity News | What all this cancer news means for medicine at large MedCity News Founded in 1991 in Salt Lake City, Utah, the molecular diagnostics company has long been a leader in genomics and precision medicine, first with hereditary cancer tests, then with companion diagnostics and tests that could inform prognosis and ... |
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The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated Plato
Attending physicians, the physicians who train interns and residents on hospital wards, have always borne a heavy responsibility. They are accountable for the level of medical care received by each succeeding generation of American patients. But today, these physician-teachers confront unprecedented obstacles. How well they meet the challenge may have long-term consequences for patients and for the medical profession as a whole.
This turning point in medical education was the inspiration for our in-depth study of 12 of the nations outstanding attending physicians. We observed them as they interacted with learners and patients, and interviewed them, as well as some of their past and present learners, to provide a glimpse of what the future of clinical education could look like.
The most important form of clinical training takes place at the patients bedside, yet attending physicians have less time to spend with learners on patient rounds. Due to the mandated reductions in the length of the learners workday and because hospitals are discharging patients sooner than ever before, there are fewer hours for learners to follow the care of any one patient. Meanwhile, learners continue to spend a great deal of their limited time behind a computer screen documenting care rather than administering care.
Attending physicians must also cope with a seismic change in the hospital environment. In days past, they personally provided or oversaw most of their patients hospital care. That is virtually impossible today. Attendings are now part of an interdependent team that encompasses not just learners but nurses, pharmacists, radiologists, and other specialists. Teamwork requires such personal qualities as empathy and communication skills, which were not particularly noticeable among attendings of previous generations. Those same qualities are in demand as hospitals have become more focused on satisfying patients (aka customers) rather than physicians; hospitals expect their physicians to view patients as partners in their care and to treat them with a full measure of respect.
The most important form of clinical training takes place at the patients bedside
Although the 12 attendings exhibited a variety of individual behaviors and techniques, we found that they shared a dedication to the following central propositions: the team environment should be supportive, and the teaching should be team-based and patient-centered.
A supportive environment
The 12 attendings set high standards for their medical team (typically a senior resident, two interns, and several medical students) but they were aware performance anxiety is not conducive to learning. They created an atmosphere that was cooperative and trusting, rather than competitive.
To achieve that goal, the attendings established personal connections with individual team members, exchanging life experiences and jokes. The attendings emphasized that they themselves were students, always learning, and urged team members to challenge their findings when there was a disagreement.
The attendings used their own past mistakes to illustrate their teaching and to demonstrate that mistakes, though obviously to be avoided, will happen and are an essential aspect of learning. Major missteps were corrected in private to keep from publicly embarrassing learners.
Bad outcomes can take a heavy emotional toll on learners. We saw how one of the attendings helped his team cope with the death of a patient. We should reflect on what happened, but not lose our confidence, he told them. The day after he died, I sat in my truck and did a personal pep talk. You have to come in and take care of the next patient and do the best you can.
Team-based learning
The 12 attendings put the team in charge of patient care, while demonstrating that they were available, 24/7, when needed. They positioned themselves as members of the team, rather than the leaders; giving that task to the senior resident. The teams were constantly told to question every diagnosis and every treatment plan, to develop and test multiple hypotheses and alternatives.
The attendings engaged their teams in discussions of a few key points, rather than delivering lectures filled with facts to be memorized. Instead of simply correcting a learners conclusion, the attendings would ask the learner to explain, step by step, how he or she got there. The Socratic method of questioning was used to explore learners understanding of the material and guide them toward the best answers.
The attendings shared with their team their own reasoning process in arriving at a diagnosis or treatment of a patient. In their capacity as role models, they wanted to show how seasoned physicians think about medicine.
Patient-centered teaching
In their behavior with patients, the attendings modelled the kind of safe patient care they expected of their learners. They washed their hands before and after every patient visit; they placed the stethoscope directly on the skin rather than over the patients gown when listening to the lungs or heart.
Before going on rounds with their teams, the 12 attendings reviewed the medical records of their patients allowing them to prepare some key teaching points during rounds.
The 12 attendings sought to create rapport with patients, greeting them in a friendly, upbeat manner; empathizing with their discomfort; explaining medical issues in laymans language. Patients were treated with kindness and humility.
The concern for patients welfare extended to their post-hospital lives. The attendings started their teams thinking about the patients discharge when the patients first arrived on the unit, and included for example, proper transportation home options, patient care at home, and patient insurance coverage.
The 12 attendings recognized their responsibility to model for their learners what it means to be a physician in todays challenging healthcare environment. One of the most impressive qualities about these attendings was that they loved being physicians andteachers. This description from one of the former learners sums up the 12 physicians as a whole: He was a doctor who loved taking care of patients and loved teaching. He was never there to just get through something, but very present and very excited about what he was doing.
If the future of clinical education rests in the hands, minds, and hearts of physicians such as these, learners and patients will be well served.
Featured image credit: Hospital by skeeze. CC BY 2.0 via Pixabay.
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Teaching medicine: how the great ones do it - OUPblog (blog)
The Hindu | Thousands administered fish medicine in Hyderabad The Hindu With great belief: (Left) Asthma patients being administered fish medicine by a member of Bathini Goud family at Exhibition Grounds at Nampally on Thursday. Hundreds of people waiting for their turn to receive the medicine. | Photo Credit: G_RAMAKRISHNA. |
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Thousands administered fish medicine in Hyderabad - The Hindu
Science Translational Medicine has retracted a paper by researchers based in Switzerland, after an investigation concluded two figures had been manipulated.
The investigation occurred at theUniversity of Basel. Its not clearwhat prompted it, but the paper has been discussed at length on PubPeer. After the investigation concluded two figure panels included manipulated data, the last author asked to retract the paper.
Heres the notice:
Following concerns raised about potential data manipulation, the University of Basel conducted an internal investigation. This evaluation established that data had been manipulated in Figure 2A and Figure 3. Given that the integrity of the manuscript is compromised, the corresponding author Michael Sinnreich has requested that the Research Article be retracted. Thus, Science Translational Medicine is retracting the paper in full.
Proteasome inhibitors increase missense mutated dysferlin in patients with muscular dystrophy has been cited eight times since it was published in 2014,according to Clarivate Analytics Web of Science.
One month after the paper appeared online in August 2014, a user on PubPeer raised a question about another figure panel, 2B. Another commenter tagged as author (and signing the note as last author Michael Sinnreich) uploaded an image of the entire blot used in figure 2B. However, that prompted additional comments from readers, who allege the published image has a much higher resolution than what the author shared, and some bands still appeared identical.
We contacted Sinnreich, who referred us to a university spokesperson.
First author Bilal Azakir is now an assistant professor at Beirut Arab University; he declined to comment further, and referred us to the retraction notice.
Update, 00:44UTC time, June 9, 2017: We received a statement fromEdwin Constable, Vice President for research of the University of Basel, earlier today:
The University of Basel was alerted to a possible problem with this publication by the lead scientist. The initial alert stemmed from the discussion on PubPeer. The University of Basel implemented its established procedures for cases of potential scientific misconduct. As a result of these procedures, we recommended the retraction of this paper.
We cannot make statements regarding either the nature of and responsibility for potential misconduct or any additional retractions.
Like Retraction Watch? Consider making atax-deductible contribution to support our growth. You can also follow uson Twitter, like uson Facebook, add us to yourRSS reader, sign up on ourhomepagefor an email every time theres a new post, or subscribe to ourdaily digest. Clickhere to review our Comments Policy. For a sneak peek at what were working on,click here.
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Data had been manipulated: Science Translational Medicine retracts paper - Retraction Watch (blog)
According to Columbia University, narrative medicine fortifies clinical practice with the narrative competence to recognize, absorb, metabolize, interpret, and be moved by the stories of illness.
Although it seems like medicine and creative writing may have no similarities, the Narrative Medicine program at Baylor College of Medicine is proving otherwise. One of the ways the program is forging this connection is through an event called Off Script: Stories from the Heart of Medicine.
In the Q&A below, Dr. Ricardo Nuila, assistant professor of medicine at Baylor and a founding member of the Narrative Medicine program, discusses his interest in narrative medicine, how it can be used to help strengthen the link between healthcare providers and patients, and the Off Script event.
Q: How did you first learn about narrative medicine? A: Ive been interested in creative writing and literature since college. As a resident in internal medicine at Baylor, I began writing short stories. Then someone told me there was a field that combines creative writing with medicine. I did some research and found that Columbia University offered a Narrative Medicine program. I ended up going to one of their workshops and after that it seemed to be a good idea to build upon at Baylor.
Q: How has the Narrative Medicine program at Baylor evolved? A: We are still growing but now we are part of the Center for Medical Ethics and Health Policy. A lot of the programs growth at the beginning came from word-of-mouth. It began as a group of like-minded colleagues, and then it became something that interested other people.
Q: How do you educate health professionals through the Narrative Medicine program?A: We put on skill-building workshops at different levels. A typical workshop would be a noontime lecture where we hand out a short piece of literature such as Indian Camp by Ernest Hemingway. After participants read the story, they write something according to a prompt we give them. We then have a discussion tailored around a medical topic. Discussing stories is not just for fun, it helps increase analysis and communication, skills that everybody can benefit from.
Q: How does narrative medicine help promote a more holistic understanding of patients?A: Narrative medicine is about storytelling and respecting complex stories. For instance, when I talk to a patient, Im looking at a lot of details about that patient separate from what he or she might say. A hat, or how he or she is dressed, word use, an accent all of these things are data points in your head that help you shape this persons story. This process can also help with planning for possible hindrances the patient might face once they leave the hospital so you may be able to bypass them.
Q: How can storytelling help physicians be more thorough and empathetic?A: When I think of someone in story terms, I become more interested in his or her life and I find myself learning from the patient. Its not uncommon for me to ask patients questions like, What part of Texas or Mexico are you from? or How did you get here? When I take in all of those data points and I can see more of the patients story, I understand them better.
Storytelling also helps me develop a better ear for how a patient speaks, which can tell me what kinds of words to utilize to convey the message. I want patients to be engaged with me so I am aware of how Im using my words.
Q: Can you tell me more about Off Script: Stories from the Heart of Medicine?A: Off Script is one of our community outreach programs. I would describe it as a medical storytelling event. As a medical student and resident here at Baylor, I would see doctors, nurses and physicians assistants all huddled up telling stories about their experiences. The Off Script event is a chance for us to cultivate these stories.
For this Off Script event, the topic is Scrubbed. Stories are accepted through submissions so that we can help develop them. We work alongside writers to improve storytelling, writing technique, and delivery. We want each story to resonate with the audience.
Off Script takes place from 5:30 to 6:30 p.m. on Wednesday, June 14 at the UT McGovern Medical School, room MSB 2.135. The event is free and open to the public.
-By Julia Bernstein
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The UW School of Medicine and Public Health is joining the Medical College of Wisconsin and five other medical schools in a new effort to transform medical education, as health care focuses more on population groups as well as individual patients.
In addition to teaching students biomedical knowledge and clinical skills, they need to have the skills of professionalism, a societal perspective and be able to address the science of heath care delivery and public health issues, said Dr. Elizabeth Petty, senior associate dean of academic affairs at the UW medical school.
The newly formed National Transformation Network, announced Thursday, is part of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, based at the Medical College in Milwaukee.
The network also includes: the Geisel School of Medicine at Dartmouth College in Hanover, New Hampshire; Mayo Clinic School of Medicine in Rochester, Minnesota; University of California-San Francisco School of Medicine; University of Texas-Austin Dell Medical School; and Vanderbilt University School of Medicine in Nashville, Tennessee.
The UW medical school has made changes in recent years to focus more on public health, which includes social determinants of health, such as poverty, nutrition and employment.
In 2005, the school added public health to its name, integrating community approaches to health with clinical and research efforts.
The Wisconsin Academy for Rural Medicine, or WARM, started in 2007, bringing in students from rural areas or with an interest in rural practice and training them in rural settings, with the hope that theyll work in similar locales after medical school.
Training in Urban Medicine and Public Health, or TRIUMPH, based in Milwaukee, began the next year.
Other programs have worked on increasing diversity among students and serving diverse populations of patients, including the Native American Center for Health Professions, created in 2012.
Despite those efforts, the school could do better at preparing doctors for todays health care challenges, Petty said. We need to improve health outcomes and better address health disparities and inequities, she said.
The network will promote a Triple Aim for Medical Education: character, competence and caring. The idea springs from a well-known Triple Aim for Health Care, which focuses on enhancing the patient experience, improving the health of populations and reducing the cost of care.
Through the network, UW could exchange curriculum with other schools or set up faculty workshops or student exchanges with them, Petty said.
The collaboration will also teach medical students to work alongside nurses, pharmacists and other health professionals, as doctors are increasingly doing, she said.
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Pharr is scheduled to pay the University of Texas Rio Grande Valley its agreed-upon annual payment of $500,000 on Tuesday, City Manager Juan Guerra confirmed. This leaves McAllen and Mission as the only cities that have not yet paid.
Edinburg and Hidalgo County have come through with their pledged $1 million payments while McAllen has $1 million budgeted for the medical school this fiscal year, which ends at the end of September. City Manager Roel Roy Rodriguez has confirmed that money is still budgeted, but he has not yet been directed by the city commission to put that payment on the agenda.
UTRGV has a memorandum of understanding with McAllen, Edinburg, Mission, Pharr and Hidalgo County. The line in the MOU between McAllen and UTRGV states, On or about Oct. 15, each year from 2014 to 2023, the city shall pay/transfer/provide to The University of Texas System up to $2,000,000. That money is for the medical school. Edinburg agreed to exactly $1 million, Mission pledged exactly $250,000 and Pharr committed to exactly $500,000.
McAllen has made one payment of $2 million, in fall 2014. The item was on three consecutive commission meeting agendas in November and December but it was tabled each time. Mayor Jim Darling said Thursday there is not an item on Mondays regularly scheduled commission meeting agenda regarding a UTRGV medical school payment.
Before the Texas Legislature adjourned last month, it agreed to fund the medical school with $54.1 million for the next two years, which is $7.2 million short of what lawmakers approved in 2015. Overall, the entire university received $313.1 million, down 4 percent from $326.3 million given the last biennium. mferman@themonitor.com
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Pharr to make pledged UTRGV medical school payment | Local ... - Monitor
Joplin city leaders and school officials held a ribbon cutting ceremony for the new Kansas City University of Medicine and Bioscience campus on Tuesday.
Built near the site of what was the parking lot of the old Saint Johns Regional Medical Center, which was destroyed in a 2011 tornado that killed 161 people, the new medical school was described as a phoenix rising from the ashes.
Like the KCUMB medical school in Kansas City, the Joplin school will teach osteopathic medicine, which supporters describe as a more holistic approach to health than that practiced by the majority of doctors and nurses. The school is the first medical school to open in Missouri in nearly half a century.
At the ceremony, which was attended by hundreds of Joplin residents, city leaders and medical professionals, Joplin mayor Mike Seibert said he hoped the schools students would help fix the shortage of health care providers in rural parts of the region.
We stand a real good chance that upon their graduation, when theyre ready to set up practice, that choosing an area like Joplin or in the surrounding areas to set up practice is huge, because recruitment is always a challenge in the rural areas, Seibert said.
The schools first class of 150 students begins studies at the end of July.
Alex Smith is a health reporter for KCUR. You can reach him on Twitter @AlexSmithKCUR
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First New Missouri Medical School In Nearly Half A Century Opens ... - KCUR
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GEORGETOWN, Texas (KXAN) Even though shes been missing for 15 years, a recent tip could lead authorities to answers aboutwhat happened to Rachel Cooke.
The Williamson County Sheriffs Office confirms a deputy received a tip approximately three weeks ago about possible human remains buried on the property at 221 Chaparral Dr. in Liberty Hill. Rachels mother, Janet Cooke, tells KXAN she has received a phone call from local authorities but says she cant elaborate on the conversation in fear of jeopardizing the investigation.
The tip was not only specific to the fact that there were possible remains of a human in that area and the name Rachel Cooke was brought up one time, explained Williamson County Sheriff Robert Chody in a briefing Friday morning. We had no other evidence related to that one tip that Rachel Cooke was involved.
Chody said they are currently excavating a 15-by-20-foot area, about 18 inches deep, but nothing has been found as of noon. However, prior to digging, cadaver dogs did detect the scene of human remains in the area.
While the tip may or may not lead to anything, Chody said the department owes it to the family to not leave any stones unturned. I felt we had a duty to go and use all our resources to make sure, said Chody, and whether its RachelCooke or any other person that we are trying to locate, that we can check this one off the box and move on.
Rachel,who was 19 years old at the time, vanished during her morning run in Georgetown on Jan. 10, 2002. Janet says a neighbor saw Rachel walk past their driveway around that time, during her cool down. She had earbuds in at the time.
Ever since Rachels disappearance, her family became very active in missing persons causes. Rachels father, Robert, passed away in November 2014. According to his obituary, Robert made a promise on the day his daughter disappeared that he would never stop looking for her.
During a recent memorial run, organizers were hoping the community would call in any and all tips regarding Rachels disappearance.
One day Im going to have closure, whether it be on earth or in heaven, said Janet.
The Federal Bureau of Investigations confirms they are assisting WCSO with the case.
According to chargleyproject.org, witnesses told authorities that an unidentified man was driving a late-model white or blue Chevrolet Camaro or Pontiac Trans Am in the area where Cooke was last seen. Some witnesses also said there were two men inside the vehicle. Sketches were originally released of three unidentified men.
In 2006, convicted murderer Michael Keith Moore admitted to investigators that he killed Rachel with a hammer blow to the head.Moore also detailed dropping her body in the Gulf of Mexico, confessing on videotape from prison, the source said. In the end, Moore said he had nothing to do with her disappearance.
This is a developing story and KXAN News will have an update on KXAN News at 5 and 6 p.m.
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File photo of Rachel Cooke. (KXAN File Photo)
Rachel Cooke's mother has been active in the search for her daughter ever since she went missing. (KXAN File Photo)
Equusearch teams searching for Rachel Cooke during the first year she went missing. (KXAN File Photo)
High school photo of Rachel Cooke. (KXAN File Photo)
Vigil for Rachel Cooke. (KXAN File Photo)
File photo of Rachel Cooke. (KXAN File Photo)
Rachel Cooke's mother has been active in the search for her daughter ever since she went missing. (KXAN File Photo)
Equusearch teams searching for Rachel Cooke during the first year she went missing. (KXAN File Photo)
High school photo of Rachel Cooke. (KXAN File Photo)
Vigil for Rachel Cooke. (KXAN File Photo)
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Tip regarding human remains in Liberty Hill could be tied to Rachel Cooke case - KXAN.com
Falwell Higher Ed Task Force Won't Happen Inside Higher Ed In the months since Liberty University President Jerry Falwell Jr. said in January that he would be leading a presidential task force on higher education, the announcement went unacknowledged by the White House and the Department of Education, and few ... |
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Falwell Higher Ed Task Force Won't Happen - Inside Higher Ed
The Liberty baseball team turned to some well executed small ball to pad their lead over Frankford in the bottom of the fourth inning Thursday.
The Hurricanes then used some power ball to finish off the Pioneers and emphatically punch their ticket to the state semifinals.
A pair of two-run doubles from Jared Burcin and Gabe Albino helped break open the game and senior pitcher Alex Laudenslager took care of the rest as Liberty pummeled District 12 champ Frankford in the PIAA Class 6A quarterfinals at Spring-Ford High School.
This is what weve worked for. This is what weve been trying to do all season, Burcin said. We finally got our bats back. Everyone started hitting the ball a little bit more. We started taking more pitches and doing our thing.
For the first time since 2002, the Hurricanes (25-3) advanced to the PIAA semifinals set for Monday against District 1 champ Pennsbury at a site and time to be determined. The Falcons beat Perkiomen Valley 3-0 in another quarterfinal after outlasting Parkland 2-1 (11 innings) in the first round.
Laudenslager cruised through Frankfords lineup, allowing just two singles (only one of which left the infield) while striking out six and walking none. He retired the final 10 batters he faced in order.
My command was working well and I was hitting my spots, Laudenslager said. The first inning felt really good. I knew I was on.
Leaning on a solid curveball to complement his fastball command, Laudenslager faced just two batters over the minimum.
A two-hit shutout in the state quarterfinal is amazing, Liberty coach Andy Pitsilos said.
From the first pitch to the final out, the Hurricanes outplayed the Pioneers with heads-up base running, timely hitting, smart pitching and slick defense including a diving grab by first baseman Mike Perreault in foul territory for the second out of the seventh inning, which was just a cherry on top of the sundae at that point.
While Liberty had developed a flair for the dramatic of late, winning its last three games before the quarterfinal in its final at-bat, it spared the crowd any nail-biting on Thursday.
After an RBI double from Jake Morgan in the second inning and an RBI single from Burcin in the third inning, the Hurricanes entered the fourth holding a 2-0 lead that soon exploded into 8-0.
Senior designated hitter Jake Wagner, who had scored in the second inning when he jump-started a two-out rally, provided another spark as he led off the fourth with an infield single. Morgan then dropped down a sacrifice bunt and with the third baseman making the play, Wagner kept his head up and took third base with nobody covering.
I dont think they were aware of what were capable of, Wagner said. We just took advantage of their mistakes and went from there.
After sophomore Antonio Zabala, a newcomer to the starting lineup in place of an injured Elias Gross (back), made it runners on the corners with a bunt single, senior Kyle Hlavaty cashed in with an RBI single to left field for the 3-0 lead.
One out later, Burcin returned to the dish with runners on second and third and ripped a two-run double to right field.
Sammy Kraihanzel then drew a walk, knocking out Frankford starter Nick Herrera and Perreault greeted the new pitcher by drawing another base on balls to load the bases.
Albino made the walks hurt as he came up next and roped a two-run double down the left field line to make it 7-0.
Its fundamental baseball with a little hitting added in there, Pitsilos said. Its all the kids. Theyre extremely disciplined kids and theyve been like that all year. Although we preach that, its very, very hard to find players that are that good at the plate. Its a testament to them. A lot of them are seniors and they have a lot of experience. Great kids.
Perreault later scored on a wild pitch for the eighth and final run.
The Hurricanes are now headed where no other Liberty team has gone since 2002: the states final four. The 2002 squad made it all the way to the PIAA Class 3A final before falling to Moon 3-2.
This years group isnt ready to be done just yet.
Its just something coach Pit, everyone and the Liberty community is proud of, Burcin said.
Weve been together for a while and we knew it was coming, Laudenslager added.
Said Wagner: Its amazing. I (wouldnt) change it for the world. I dont even know how to describe it, its breathtaking.
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No drama this time as Liberty baseball flies into PIAA semifinals - lehighvalleylive.com
LIBERTY TWP.
Liberty Twp. Fire Chief Paul Stumpf and others on the fire department are pooling some of their unused sick and vacation time to help out a fellow firefighter/medic who has run out of sick days.
Stumpf and Captain Jim Limerick have each turned over a total of 160 hours of sick and vacation time so one of their own wont be out any money while he is on sick leave.
Stumpf told the Journal-News this person to protect his privacy the Journal-News is not revealing his name has had family illnesses to contend with and now he himself is out of commission for six to eight weeks. Stumpf said since the injury occurred on his own time, workers compensation cant be drawn so his brothers and sisters on the department want to help.
Limerick said they have done this before when other people have been injured or ill and he is glad to help.
I feel obligated to do it, he said. I like helping staff and were in the business of helping people so why not help our own when we can.
Limerick has been with Liberty Twp. more than 20 years and Stumpf, who is retiring in September, has been there 45 years.
Stumpf said other firefighters also plan to work shifts for the man while he is out. He said they dont want to stack up too many days, especially since they dont know exactly when the firefighter will be returning. He said there were three people who needed sick time last year.
This was kind of the quickest, easiest way to get him through a couple weeks, Stumpf said. Last year everybody wanted to donate.
Between the two men they have accumulated 328 hours of vacation time and 2,570 hours worth of sick time. The townships policy allows employees to accrue a maximum of 1,600 hours of sick time, anything over that they get credit for one hour of pay for every four hours. Employees with 10-plus years of service get four weeks of vacation and one week can be carried into the next year.
Trustee Tom Farrell said the department should be commended for giving so much to their co-worker.
I think it is very admirable and I support it, Farrell said. It is our policy that they are allowed to do that, thats their choice, thats their money. For them to take money out of their own pocket and give it to their family like that is very respectful, its amazing.
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Louisville Business First | ReSurfaced returns with new summer schedule Louisville Business First ReSurfaced The Liberty Build will open on Thursday, June 15, from 6 to 10 p.m. with a soccer tournament between the front-office staff of Louisville FC, including head coach James O'Connor, and the Louisville Coopers, a supporter group for the team. |
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ReSurfaced returns with new summer schedule - Louisville Business First
June 9, 2017
By: Sierra Emilaire, North American Division News
More than 150 diplomats, religious liberty advocates, and guests gathered on June 1 for the 15thannual Religious Liberty Dinner held in the Religious Freedom Center of the Newseum Institute in Washington, D.C. The annual event is held to celebrate and bring attention to a central human right: the freedom of religion or belief.
U.S. Secretary of Housing and Urban Development Ben Carson delivered the keynote address. In his message, Carson made the clear distinction between simply being free to worship and being free to exercise religion not only in the public sphere, but in private businesses and institutions. Carson praised the United States stance on religious liberty.
The Founding Fathers were very aware of the sectarian strife that affected Europe, Carson said. They thought of a better way, they instituted a better way. A government that would not establish a single religion. They left the choice of religion up to each individual person. This was more than tolerance, it was religious liberty.
Carson further encouraged attendees to promote mercy and compassion, rejecting hateful speech and actions in response to the recent murders of two heroic Portland, Oregon, men who were killed by a white supremacist for intervening when the supremacist attacked two Muslim women with hate speech and biased language.
While he represented the worst in humanity, his victims represented the best, Carson said.
Two awards and a special recognition of service were presented during the dinner to honor national and international religious liberty pioneers and advocates.
Secretary Ben Carson addresses attendees at the annual Religious Liberty Dinner organized by the Seventh-day Adventist Church. [Photo: Maria Bryk]
Kimberlee Colby, director of the Christian Legal Society's Center for Law and Religious Freedom, accepting the national award for dedicating more than 35 years to domestic religious liberty cases. [Photo: Maria Bryk]
Thomas Farr, president of the Religious Freedom Institute, accepting the international award for more than 20 years of advancing the cause of religious liberty, with Melissa Reid, executive director of the North American Religious Liberty Association, an entity of the Seventh-day Adventist Church. [Photo: Maria Bryk]
Attendees at the Religious Liberty Dinner listen as Dwayne Leslie, associate Director in the Department of Public Affairs and Religious Liberty and Director of Legislative Affairs for the General Conference of Seventh-day Adventists introduces an honoree. [Photo: Maria Bryk]
Secretary Ben Carson together with his wife Candy and honoree Thomas Farr at the annual Religious Liberty Dinner. [Photo: Maria Bryk]
Bert Beach, long-time religious liberty leader for the Seventh-day Adventist Church, displaying the award he received at the Religious Liberty Dinner. [Photo: Maria Bryk]
Kimberlee Colby, director of the Christian Legal Society's Center for Law and Religious Freedom, was awarded the national award for dedicating more than 35 years to domestic religious liberty cases.
I think if you are wanting religious freedom for everyone, the golden rule is the religious freedom you wish for yourself, you must extend to others.
Colby commented on the importance of religious freedom and the recent cultural lack of respect for religious freedom, voicing concerns regarding the repercussions this shift in mindset may have on the capacity at which people may be free to live according to their religious conscience.
I think if you are wanting religious freedom for everyone, the golden rule is the religious freedom you wish for yourself, you must extend to others, Colby said. [Religious freedom] is really the basis for tolerance.
Thomas Farr, president of the Religious Freedom Institute, was awarded the international award for more than 20 years of advancing the cause of religious liberty.
Farr believes religious liberty is the first freedom of not only the Constitution, but of the human soul. He shared concerns about the currently skewed perception of religious liberty both domestically and internationally. Farr then proposed ways to become involved in the fight for religious liberty.
Individuals can live their lives and do what they do as citizens by protecting religious liberty, said Farr. If they happen to be religious people, exercise religious liberty publicly not just in your church, synagogue, or house of worship. If you are an entrepreneurial type or working in an allied field, get involved either with your church or religious organization or with a separate NGO that advocates religious freedom. Finally, if you're an American, push your own government to do what its required by law to do, but is not doing very well; and that is advance religious freedom in our foreign policy.
The third person honored is long-time religious liberty leader for the Seventh-day Adventist Church Bert Beach. Nearly 90, the man who is known to have defined his churchs interdenominational relations, responded with self-effacing humor to the well-deserved honor.
The annual religious liberty dinner is sponsored byLibertyMagazine, the International Religious Liberty Association, North American Religious Liberty Association, the Seventh-day Adventist Church and the Religious Freedom Center at the Newseum Institute.
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Ben Carson, Keynote Speaker at Annual Religious Liberty Dinner - Adventist Review
In a previous article we wrote about how we found Formula One Group (NASDAQ:FWONK) an attractive investment opportunity now that the company had new management. However, we did not present a valuation of the company. Given the complex nature of what assets and liabilities are attributed to the Formula One Group tracking stock we thought it would be helpful to share our valuation and also our reasons for viewing the stock as undervalued.
What Does Formula One Group Own?
For starts, the Formula One Group tracking stock contains more than just Formula 1. From Liberty Media's 10-K "including Liberty's interests in Live Nation, minority equity investments in Formula 1, Time Warner, Inc. ("Time Warner") and Viacom, Inc. ("Viacom"), the recovery received in connection with the Vivendi lawsuit and cash, as well as Liberty's 1.375% Cash Convertible Notes due 2023 and related financial instruments and Liberty's 2.25% Exchangeable Senior Debentures due 2046." And "representing a 15.5% intergroup interest in the Braves Group at December 31, 2016."
So let's start with the easiest parts first. Both Live Nation Entertainment (NYSE:LYV) and Liberty Braves Group (NASDAQ:BATRK) are publicly traded. Formula One Group's stock contains the groups 34% interest in Live Nation worth $2.45B at current market prices and Group's 15.5% interest in Liberty Braves Group worth $185M at current market prices. The group also has approximately $416M in Time Warner (NYSE:TWX) stock and $86M in Viacom (NASDAQ:VIAB) stock.
The Vivendi settlement mentioned in the 10-K appears to have already been paid to the group and so would appear in the cash balance on the latest 10-Q. Below is the language showing the suit has been settled and the payout received.
Vivendi Settlement. In connection with a commercial transaction that closed during 2002 among Liberty, Vivendi Universal S.A. ("Vivendi") and the former USA Holdings, Inc., Liberty brought suit against Vivendi and Universal Studios, Inc. in the United States District Court for the Southern District of New York, alleging, among other things, breach of contract and fraud by Vivendi. On June 25, 2012, a jury awarded Liberty damages in the amount of 765 million, plus prejudgment interest, in connection with a finding of breach of contract and fraud by the defendants. On January 17, 2013, the court entered judgment in favor of Liberty in the amount of approximately 945 million, including prejudgment interest. The parties negotiated a stay of the execution of the judgment during the pendency of the appeal. Vivendi has filed notice of its appeal of the judgment to the United States Court of Appeals for the Second Circuit. During the first quarter of 2016, Liberty entered into a settlement with Vivendi which resulted in a $775 million payment to settle all claims related to the dispute described above. Following the payment of a contingency fee to our legal counsel, as well as amounts payable to Liberty Global plc, an additional plaintiff in the action, Liberty recognized a net pre-tax gain on the legal settlement of approximately $511 million. This settlement resulted in a dismissal of all appeals and mutual releases of the parties.
The group also has a total of $1.07B in cash and approximately $5.8B in long term debt attributed to it.
So, with the easy pieces of the valuation out of the way let's look at what the implied valuation for just the Formula 1 part of the group is.
The tracking stock has a total market cap of $6.71B. So, plugging in our numbers we get an implied valuation of $8.3B for Formula 1. The table below shows the math for the calculation.
Implied Formula 1 Group Value
$8284.0M
Liberty Braves Group (15%)
$184.6M
Live Nation Entertainment (34%)
$2448.0M
Viacom & Time Warner stock
$502.0M
Add: Cash
$1071.0M
Less: Debt
-$5780.0M
Current Equity Value of FWONK
$6710M
What is a Fair Value for Formula 1?
Last year Formula 1 generated $1,829M in revenue and earned $479M in adjusted EBITDA. That means that Formula 1 is trading at 4.5 times revenue. There is approximately $3.4B in net debt attributed to Formula 1 which would mean the EBITDA multiple is approximately 26 ($8,284M equity value plus $3400M net debt divided by $479M in adjusted EBITDA).
Formula 1 is a unique business and probably the best way of valuing it is looking at other comparables in the sports world, especially recent transactions. We looked at valuations for the recent sale of the UFC, publicly traded World Wrestling Entertainment (NYSE:WWE) and Manchester United plc (NYSE:MANU). We also looked at premier North American sports franchises like the New York Yankees, and the Dallas Cowboys.
UFC was recently sold for $4B, which valued the company at approximately 6.6 times revenue and 22 times EBITDA. However, the buyers believe that the UFC's current media deal, which is up in 2018, can be renegotiated for a substantially higher amount. If that does happen, people peg the valuation closer to 13 to 14 times EBITDA.
WWE and Manchester United are publicly traded so it's easy to get valuation figures for them. WWE trades at 2.1 times sales and 20.5 times EBITDA. MANU trades for 3.9 times sales and 14.5 times EBITDA. For the Dallas Cowboys and New York Yankees we used Forbes valuation figures. The franchises trade at 6 times revenue and 7 times revenue respectively.
The table below shows the average valuation multiples.
Business/Team
Price/Sales Multiple
EBITDA Multiple
UFC
6.6
13/14 to 22
WWE
2.1
20.5
Manchester United
3.9
14.5
Dallas Cowboys
6.0
NY Yankees
7.0
Average
5.1
17.6
We are included to exclude the WWE from our comparables because of the "sports" demographic problem. During the past 16 years the median age for a WWE viewer has risen 26 years compared to other sports like the NBA and MLB which have seen age increases of just 2 years and 5 years respectively! An aging demographic is obviously less attractive for advertisers and thus lowers the value of the franchise.
Manchester United, while close to a global franchise like Formula 1, has much higher labor costs. As we've shown in a previous article European soccer (football) clubs pay out almost half their revenue in player salaries. In terms of economics Formula 1 is much closer to American major league sports franchises that have much lower labor costs.
If the new ownership group at Formula 1 can broaden the sports appeal, and we believe they can, a valuation multiple more in line with North American sports franchises would be more appropriate. That could mean up to a 50% increase in value over the next few years.
Disclosure: I/we have no positions in any stocks mentioned, but may initiate a long position in FWONK over the next 72 hours.
I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article.
Excerpt from:
Formula One Group Could Be Undervalued By 50% - Seeking Alpha
The citys only Girl Scout troop made up solely of homeless girls got treated to a surprise Girls Night Out with NYCs womens basketball team Thursday night.
Troop 6000 started its night with a dinner at Planet Hollywood in Times Square, but the girls didnt know players from the New York Liberty team would be joining them.
The players showed up to tell them they were taking them to see Wonder Woman and that theyd get to go to the NY Liberty game at Madison Square Garden on Sunday, June 11, where they will be recognized on the court.
Ta'Shauna "Sugar" Rodgers, a guard for NY Liberty, said she was moved by the girls because she had also been homeless when she was a teenager.
"It's just motivating to see that they started something thatI never had, even though I was in the same situation as them," she said in a statement. "Just giving back and justseeing the smiles on their faces. It means a lot to me."
Karina, an 11-year-old in Troop 6000, said she looks up to the players.
"I love basketball, and they just make me keep moving forward and keep on doing what I do best, which is basketball. They inspire me so much," she said in a statement.
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NY Liberty players surprise homeless girls in Girl Scout Troop 6000 with night out - amNY
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China is no long making more artificial islands to bolster its territorial claims in the South China Seait has moved on to developing them, adding aircraft hangars, communications equipment, and weapons positions. That's one conclusion of the Pentagon's annual report on the Chinese military, and it's a finding that contradicts Chinese leader Xi Jinping's pledge to not militarize the contested region, which is also claimed by many of China's neighbors.
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In 2009, Beijing set off alarm bells by circulating a map in which it appeared to claim up to 90 percent of the South China Sea. The territorial claim intruded on competing claims by neighbors including Taiwan, the Philippines, Indonesia, Vietnam, Brunei, and Malaysia. Starting in 2014, China began using dredging equipment to expand existing reefs and shoals in the region into full-fledged "islands," adding 2,300 acres of new "land" to the Spratly Islands.
Satellite photo of Chinese occupied Subi Reef showing new runaway. Subi Reef has added 976 acres of new dry land.
Getty NASA/USGS photo.
In early 2015, Chinese leader Xi Jinping vowed not to militarize the islands, saying, "Relevant construction activities that China are undertaking in the island of South Nansha [Spratly] Islands do not target or impact any country, and China does not intend to pursue militarization." China has claimed its activities in the South China Sea are strictly limited to safety, tourism, and scientific research.
Despite this pledge, outside observers have noted several military facilities, including anti-ship missile systems, surface to air missiles, and communications facilities. The new Department of Defense report (available here) states China has built advanced runways and 24 fighter-sized hangars on three of the "islands." That's enough for a regiment of People's Liberation Army Air Force fighters, an organization broadly comparable to a U.S. Air Force wing of 48 to 72 aircraft. China has said the aircraft runaways are in part necessary for tourism flightsbut it is unclear why a single island would need 24 hangars too small for civilian airline aircraft.
Woody Island -- known as Yongxing Island to China. China has deployed advanced surface to air missiles and J-11BH fighters to the island.
Getty Visual China Group
China claims that while it has pledged not to militarize the South China Sea, it does reserve the right to maintain enough military facilities to guard the territory. Whether or not China has any right to this territory to begin aside, China's statement begs the question as to what exactly constitutes "defensive military facilities." The United States, Australia, and Japan have all conducted so-called "freedom of navigation" operations in the South China Sea in defiance of China's claims, sailing warships there in a gesture of defiance. Beijing promptly uses those incidents as justification to increase the level of military forces it maintains in the islands.
Source: DefenseOne
Read more from the original source:
China Breaks Promise, Starts Arming Its Fake "Islands" - Popular Mechanics
There is a reason that families choose islands over the mainland when they seek their summer sun.
Of course, the beaches running from the Costa del Sol to the Cte d'Azur, curving around Puglia and along the miles of Croatian and Greek coastline, have their charms. But a family escape to an island offers something different.
First, theres the sense of physical separation from the mundanities of work and school life. Then theres the fact that the island is finite: you can cross its main attractions and activities off your list at a leisurely pace - travel time to and from these events will be minimal.
Then, just gaze out at the sea, happily marooned and safe in the knowledge that nothing else is visible on the horizon. But which is the right island for your family?
Let our experts be your guides through the five stages of family travel to find the perfect island for you...
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The 25 greatest Mediterranean islands for a family holiday - Telegraph.co.uk