Benin: Submission to the UN Committee on the Elimination of Discrimination against Women – Human Rights Watch

We write in advance of the 85th pre-session of the Committee on the Elimination of Discrimination against Women and its adoption of a list of issues prior to reporting regarding Benins compliance with the Convention on the Elimination of All Forms of Discrimination against Women. This submission addresses article 10 of the Convention and includes information on teenage pregnancy and access to education.

Teenage Pregnancy and Access to Education (article 10)

In Benin from 2004 to 2020, the adolescent birth rate was 108 per 1,000 adolescent girls and women aged 15-19,[1] slightly higher than the subregional rate in West and Central Africa of 104, and 2.7 times the world rate of 40. However, also during this period, the adolescent birth rate in Benin has been steadily decreasing: In 2004, the adolescent birth rate was 113 per 1,000 girls, and in 2020, the rate was 80 per 1,000 girls.[2] In 2019, the Guttmacher Institute reported that there were 423,000 births among girls and women aged 15 to 49; 12 percent, or approximately 50,760 births, occurred among girls and women aged 15 to 19.[3]

In many countries in Africa, Covid-19 pandemic-related school closures have resulted in concerning reports of teenage pregnancies.[4] While up-to-date national data on pandemic-specific increases in teenage pregnancies is not yet available, media reports point to regional increases. In the Borgou department of Benin, for example, there were 547 pregnant students in the 2019-2020 school year, an increase from 431 in the previous school year, possibly linked to pandemic-related school closures.[5] Overall, the number of births has been increasing in recent years. UNFPA reported that the number of births in 2021 was higher compared to the same period in 2020.[6]

According to the Guttmacher Institute, 68 percent of the 140,000 girls and women aged 15 to 19 who want to avoid a pregnancy have an unmet need for contraception.[7] Of all pregnancies that occurred in Benin, 39 percent were unintended, higher than the Western African subregional average of 33 percent.[8] Of all unintended pregnancies, 37 percent ended in abortion, lower than the subregional average of 42 percent.[9] While these statistics show that Benin may be lacking behind its subregional neighbors, there are also signs of progress. Since 1990, for example, the unintended pregnancy rate declined by 17 percent, and the number of unintended pregnancies resulting in abortion have increased by 22 percent.[10]

Benins progress in sexual and reproductive health and rights is also reflected in the legalization of abortion. In October 2021, Benins Parliament voted to expand the circumstances under which abortion is legal,up to 12 weeks, and when the pregnancy is likely to aggravate or cause a situation of material, educational, professional or moral distress.[11] This law modified a previous abortion law passed in 2003. According to the nongovernmental organization Ipas, Benin now has one of the most liberal abortion laws in Africa.[12] Still, girls require parental consent to access an abortion.[13]

Benin has measures in place to protect the right to access education for students who are pregnant or are adolescent mothers, as identified in a recent Human Rights Watch analysis of all countries in the African Union.[14] Benins 2015 national Child Code grants pregnant girls the right to carry on going to school or to come back to school after giving birth.[15]

Despite the existence of this law to protect the right to education for pregnant adolescent students and mothers, many Beninese girls still face barriers to return to school once they become parents. Many young mothers drop out of school during pregnancy and do not return.[16] They may face stigma, are left with no support system, or have to prioritize working rather than going back to school.[17]

Human Rights Watch recommends that the Committee ask the government of Benin:

Human Rights Watch recommends that the Committee call on the government of Benin to:

[1] United Nations Population Fund (UNFPA), Seeing the Unseen: The case for action in the neglected crisis of unintended pregnancy, 2022, https://www.unfpa.org/sites/default/files/pub-pdf/EN_SWP22%20report_0.pdf (accessed September 23, 2022).

[2] World Bank, Adolescent fertility rate (births per 1,000 women ages 15-19) Benin, https://data.worldbank.org/indicator/SP.ADO.TFRT?locations=BJ (accessed September 23, 2022).

[3] Guttmacher Institute, Adding It Up: Investing in Sexual and Reproductive Health 2019Methodology Report, July 2020, https://www.guttmacher.org/report/adding-it-up-investing-in-sexual-reproductive-health-2019-methodology (accessed September 23, 2022).

[4] Africa: COVID lockdowns blamed for increase in teenage pregnancies, DW, September 13, 2021, https://www.dw.com/en/africa-covid-lockdowns-teenage-pregnancy-increase/a-59166242 (accessed September 23, 2022); How COVID-19 has increased fertility, adolescent pregnancy and maternal deaths in East and Southern African countries, UNFPA news release, July 11, 2021, https://esaro.unfpa.org/en/news/how-covid-19-has-increased-fertility-adolescent-pregnancy-and-maternal-deaths-east-and-southern (accessed September 23, 2022); LAfrique face au Covid-19: les pics de grossesses prcoces mettent en peril lavenir des jeunes filles, Le Monde Afrique, February 1, 2022, https://www.lemonde.fr/afrique/article/2022/01/31/l-afrique-face-au-covid-19-les-pics-de-grossesses-precoces-mettent-en-peril-l-avenir-des-jeunes-filles_6111747_3212.html (accessed September 29, 2022).

[5] Akpdj Ayosso, 547 cas de grossesses dans les tablissements secondaires du Borgou, 24 Heures au Benin, December 12, 2020, https://24haubenin.info/?547-cas-de-grossesses-dans-les-etablissements-secondaires-du-Borgou (accessed September 23, 2022).

[6] UNFPA, How will the COVID-19 pandemic affect births? Technical Brief, December 21, 2021, https://www.unfpa.org/sites/default/files/pub-pdf/How%20will%20the%20COVID-19%20pandemic%20affect%20births.pdf (accessed September 23, 2022).

[7] Guttmacher Institute, Country Profile: Benin: Unmet needs for essential sexual and reproductive health services, https://www.guttmacher.org/regions/africa/benin (accessed September 23, 2022).

[8] Guttmacher Institute, Country Profile: Benin: Unintended pregnancy and abortion, https://www.guttmacher.org/regions/africa/benin (accessed September 23, 2022).

[11] Encadrement de lavortement au Bnin : Le Parlement a adopt la loi modificative, October 21, 2021, https://www.gouv.bj/actualite/1518/encadrement-avortement-benin-parlement-adopte-modificative/ (accessed September 23, 2022); Republic of Benin, Loi No. 2021 12 du 20 December 2021: modifiont et compltont la loi no. 2003-04 du 03 mars 2003 relative la sant sexuelle et la reproduction, December 2021, https://sgg.gouv.bj/doc/loi-2021-12/ (accessed September 23, 2022); Au Bnin, l'Assemble nationale vote la lgalisation de l'avortement, France 24, October 21, 2021, https://www.france24.com/fr/afrique/20211021-au-b%C3%A9nin-l-assembl%C3%A9e-nationale-vote-la-l%C3%A9galisation-de-l-avortement (accessed September 23, 2022).

[12] A bold step forward: Benins new abortion law, Ipas news release, May 9, 2022, https://www.ipas.org/news/a-bold-step-forward-benins-new-abortion-law/ (accessed September 23, 2022).

[13] World Health Organization and Human Reproduction Programme, Global Abortion Policies Database, Country Profile: Benin, May 2022, https://abortion-policies.srhr.org/country/benin/ (accessed September 29, 2022).

[14] Human Rights Watch, A Brighter Future: Empowering Pregnant Girls and Adolescent Mothers to Stay in School: Education Access across the African Union: A Human Rights Watch Index, August 29, 2022, https://www.hrw.org/video-photos/interactive/2022/08/29/brighter-future-empowering-pregnant-girls-and-adolescent.

[15] Republic of Benin, Loi no. 2015-08 portant code de lenfant en Rpublique du Benin, January 23, 2015, https://features.hrw.org/features/african-union/files/Benin%20-%20Loi%2018%20-%202015%20Code%20de%20l'Enfant.pdf (accessed September 23, 2022).

[16] Akpdj Ayosso, 147 cas de grossesses en milieu scolaire signals dans lAtacora, June 26, 2020, 24 Heures au Benin, https://www.24haubenin.info/?147-cas-de-grossesses-en-milieu-scolaire-signales-dans-l-Atacora (accessed September 26, 2022); Bnin: Dscolarisation des jeunes filles, un phnomne qui prend de lampleur dans le village dAdohoun, December 26, 2018, Agence Socit Civile Mdia, https://www.societecivilemedias.com/2018/12/26/benin-descolarisation-jeunes-filles-phenomene-prend-de-lampleur-village-dadohoun/ (accessed September 26, 2022); Les grossesses en milieu scolaire entravent la scolarisation des filles, 24 Heures au Benin, November 21, 2017, https://24haubenin.info/?Les-grossesses-en-milieu-scolaire-entravent-la-scolarisation-des-filles (accessed September 26, 2022).

[17] Sex Education For Young Girls In Benin: Digital Technology, The Best Way To Maximize Impact, Matin Libre, October 8, 2021, https://matinlibre.com/2021/10/07/education-sexuelle-des-jeunes-filles-au-benin-le-numerique-meilleur-moyen-pour-maximiser-limpact/ (accessed September 26, 2022); Fight against school pregnancies in Benin: need to take new measures, La Nouvelle Tribune, April 18, 2022, https://lanouvelletribune.info/2022/04/lutte-contre-les-grossesses-scolaires-au-benin-necessite-de-prendre-de-nouvelles-mesures/ (accessed September 26, 2022).

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Benin: Submission to the UN Committee on the Elimination of Discrimination against Women - Human Rights Watch

Lauren Lee McCarthy: Exploring the Human Relationship with AI – Stanford HAI

Artist and computer scientist Lauren Lee McCarthy has spent days working virtually as a human Alexa in strangers homes. Shes created a 24-hour machine-driven cocktail party where software controls the actions and conversation of the human host. Shes acted as a real-life follower for people curious about what it would be like to have an actual but hidden observer.

For McCarthy, there are few things more intriguing than examining how human beings are adapting to the prevalence of artificial intelligence and the surveillance, automation, and algorithmic living it brings to their lives.

The systems we build both technical and social shape the way we live together and relate to each other, she says. We tend to think of the apps and tools we use as a neutral presence, but theyre not neutral. There are so many design decisions that go into them based on an assumption of who the user is and what their goals are. These tools are reinforcing and accelerating the world were heading toward, and I feel its important to question all that.

McCarthy will be pursuing those questions as the 2022-23 Visiting Artist at the Stanford Institute for Human-Centered Artificial Intelligence. Currently on sabbatical from her position as an associate professor at UCLA Design Media Arts, McCarthy creates performance-based work using installations, video, software, photography, and sculpture to explore the technological and social systems humans simultaneously build for themselves.

McCarthy first found herself drawn to the intersection of art and technology as an undergraduate at the Massachusetts Institute of Technology (MIT).

Ive always liked art, but had gotten the message early that it was just a hobby, she says. Math was also a good fit for me, so I started out studying computer science. At that time in 2008, it felt like there was a lot of emphasis on technical possibilities without much questioning of the social implications of those possibilities. One day, I wandered into the art department and found people who were asking those questions. I began studying both fields simultaneously and putting them together.

Her award-winning work focuses largely on interactive performances that invite viewers to engage with her and with AI technology. In the series of work titled Lauren, for example, she assumes the duties of a virtual personal assistant for up to a week in homes equipped with custom-designed networked smart devices that allow her to control switches, door locks, faucets, and various electronic devices. Her attempt to be more effective than AI raises questions on the tension between intimacy and privacy, convenience versus agency, and the role of human labor in the future of automation.

Each project asks different questions, McCarthy says. In this series, I was wondering what it means to invite AI into our homes. Where is the boundary between an intimate private space and a public one that can be managed and optimized?

In another performance piece called Follower, McCarthy invites volunteers to download an app and sign up to be physically and surreptitiously followed by the artist for a day. Although participants are notified when the process begins, they never see their follower, receiving only a single photo of themselves at the end of the day. The project explores the desire on the part of some to share their lives without the complexity of forging a new relationship.

I follow all day, but maybe they never even notice me or see me, she says. I have an intense experience with this person for a day, and I think they have an intense experience with me, but we never speak.

McCarthy is also the creator of p5.js, an open-source art and education platform designed to increase access and diversity in learning to code. She developed the platform through The Processing Foundation, which works to expand communities of technology and the arts to include those who have not historically had access to learning to code.

When I started coding in tech spaces, I saw how the dynamics in many of them kept people from feeling welcome, she says. We decided to create p5.js with a different set of values, making it clear that the most important thing is that people feel they have access and are included. The community prioritizes that in every decision. The platform is very collaborative, and communities are springing up around it. It now has a user base of a few million people, has been translated into different languages, and is taught around the world.

At HAI, McCarthy anticipates hosting guest lectures and workshops and incorporating the perspective of students and the Stanford community into an ongoing project concerning human reproduction in the age of AI.

Im interested in the future of reproduction, as AI increasingly provides the ability to predict outcomes in areas such as DNA sequencing and screening in utero, she says. What does that mean in terms of making decisions about the start of life for someone? Im excited to talk with a lot of different people at HAI who might be thinking around these spaces and to see what art might come out of these discussions.

Artificial intelligence, McCarthy says, is changing the dynamics of the art world, as artists consider its implications through their work, use new technological tools to create art, and deal with algorithms that increasingly determine what art is viewed online. Artists, in turn, must be among those providing computer scientists with expanded insight into the design and deployment of AI that benefits all members of society.

If we want a world thats more equitable, then we need to look not only at what technology were building but whos doing the building, she says. Art is a way to bring different people into that conversation and to ask questions that arent always easy to ask within an engineering or science framework. Its a way of pointing out a possible future that we may not yet have imagined. As for myself, Im not saying Heres the future we should have. Im just asking What if?

Stanford HAI's mission is to advance AI research, education, policy, and practice to improve the human condition.Learn more.

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Lauren Lee McCarthy: Exploring the Human Relationship with AI - Stanford HAI

Colonialism and Reproductive Justice in Arctic Canada: The Neglected Historical and Contemporary Analysis of Genocidal Policies on Arctic Indigeneous…

A serpentine man and woman with child, sculpted by Qaunaq Mikkigak of Cape Dorset, Nunavut. Photo: Ansgar Walk

Indigenous peoples have inhabited the Arctic since time immemorial, establishing rich regional cultures and governance systems long before the introduction of modern borders. The Arctic Institutes 2022 Colonialism Series explores the colonial histories of Arctic nations and the still-evolving relationships between settler governments and Arctic Indigenous peoples in a time of renewed Arctic exploration and development.

The intention of this research is to draw connections between historical and contemporary colonialism in so-called canada (canada), and the lack of reproductive justice for Arctic Indigenous communities. This research will demonstrate the ways in which colonialism has historically revoked reproductive justice from Indigenous communities, and in which the contemporary Arctic geopolitical circumstances further emphasize difficulties in accessing reproductive care. Further, this research will seek to identify a lack of Arctic Indigenous reproductive justice within a larger legacy of colonial genocide, by imposing measures intended to prevent the births of Indigenous children, and by forcibly displacing Indigenous children from their communities.

Though the scope of this work is focused on colonial genocide and reproductive justice in Arctic Indigenous communities, it is important to note the ways in which colonial genocide perpetrated through the revocation of reproductive justice impacted Indigenous communities across canada. Violence perpetrated through the separation of children, forced sterilizations, a lack of comprehensive and culturally-informed sexual education, and a lack of basic human needs to food, water, and shelter are not unique to Arctic Indigenous communities. As such, while this research will focus specifically on Arctic Indigenous communities, colonial genocide has impacted reproductive justice in Indigenous communities across canada. Further research should be devoted to the diversity of these impacts on different Indigenous communities.

It is also important to note that this work will specifically address forcible sterilization processes, predominantly tubal ligation; it does not cover canadas history of performing forced vasectomies on Indigenous people. This is due to the disproportionate percentage of tubal litigations forcefully performed on Indigenous people.1)Lombard AR (2018) Without Prejudice: Examination of Canadas State Report, 65th Session. Maurice Law, 15 October, https://tbinternet.ohchr.org/Treaties/CAT/Shared%20Documents/CAN/INT_CAT_CSS_CAN_32800_E.pdf. Accessed on 2 October 2022 Further research would be useful to identify how gender uniquely informed medical procedures forced onto Indigenous communities.

This paper spells canada in lower case to resist the legitimization of the colonial state and as a deliberate act of resistance. Finally, gender neutral language is used throughout this paper, to acknowledge the diversity of identities and Indigenous conceptualizations of the gender spectrum.

This work will begin by acknowledging the limitations of this research followed by a note on language used throughout. The paper focuses on reproductive justice in Arctic Indigenous communities followed by a section that expands the impact of colonialism on Arctic Indigenous reproductive justice. The final section expands on themes of colonialism, reproductive justice and genocide and outlines recommendations for future policy and research.

It is crucial that as researchers we situate our voices within the literature, and identify the limitations that may impact this work. As two settler and one First Nations researchers, we acknowledge the need to amplify Arctic Indigenous voices, and the ways in which our own research lacks this lived experience. This piece is intended to aid in stimulating conversation surrounding Arctic Indigenous reproductive justice, as an underrepresented topic in western academia. All conversations should center the voices of Arctic Indigenous communities.

Additionally, it is important to acknowledge the constraints imposed by western secondary research methods, which often underestimate the value of qualitative research and oral storytelling. This removal of emotion and depersonalization of research has had a negative impact on the way Indigenous communities have come to be represented in western academia.

This paper uses the Reproductive Justice Framework to guide an understanding of colonial impacts on Indigenous peoples autonomy over their health, bodies, and decisions.

In 1994, the Black Womens Caucus of the Illinois Pro-Choice Alliance determined the need to adopt a human rights framework for low-income communities and people of colour that addressed issues of bodily autonomy within reproductive decision-making.2)In Our Own Voice: National Black Womens Reproductive Justice Agenda. Reproductive Justice. https://blackrj.org/our-issues/reproductive-justice/. Accessed on 25 March 2022 As such, the Reproductive Justice Framework defines the human right to control ones sexuality, gender, work, and reproduction.3)In Our Own Voice: National Black Womens Reproductive Justice Agenda. Reproductive Justice. https://blackrj.org/our-issues/reproductive-justice/. Accessed on 25 March 2022 The reproductive justice framework moves beyond simply considering abortion rights, and addresses the social, economic, and political systems that impact an individuals capacity to make healthy decisions about their bodies, families, and communities.4)In Our Own Voice: National Black Womens Reproductive Justice Agenda. Reproductive Justice. https://blackrj.org/our-issues/reproductive-justice/. Accessed on 25 March 2022 The three main tenets of the Reproductive Justice Framework state: a) the right to have children; b) the right not to have children; and c) the right to nurture children in a safe and healthy environment.5)In Our Own Voice: National Black Womens Reproductive Justice Agenda. Reproductive Justice. https://blackrj.org/our-issues/reproductive-justice/. Accessed on 25 March 2022

This research will argue canadas actions impede on all three tenets of the Reproductive Justice Framework.

The Canadian Medical Protection Association specifies that in order for a medical patient to consent to a procedure, they must be properly informed, they must have the capacity to consent, and that consent must be voluntary.6)CMPA (2006) Consent: A guide for Canadian physicians (4th ed.) Canadian Medical Protective Association Any procedure performed when a patient is under the threat of coercion, or unaware of the full consequence of the procedure, is by nature, nonconsensual. As such, the use of the word forced is intentional throughout this paper.

In order to understand the ways in which colonialism revoked Arctic Indigenous reproductive justice, it is important to first establish the ways in which Arctic Indigenous reproductive justice is unique, making it a threat to colonial domination.

In pre-contact societies, Arctic Indigenous peoples held full autonomy of their bodies and sexual abilities. Artic pre-contact societies allowed for full fluidity of relationships; essentially referring to an individuals relationships outside of the western idea of what romantic and sexual relationships look like (i.e. monogamy). Pre-contact societies were often described by their freedom of autonomy.7)Chansonneuve D (2005) Reclaiming connections: Understanding residential school trauma among aboriginal people: A resource manual. Aboriginal Healing Foundation. This was true for adults in regards to their relationships and sexual freedoms; however, it also applied more broadly to relationships that community members created in their own lives and among other members of the community. This explained fluidity in relationships extends to communal relationships. Arctic Indigenous children were very freely accepted into other homes and many children came into the care of other community members, separate from their parents without judgment. These so-called adoptive parents acted as a community support to one another, ensuring that the children were taken care of and held safe. This role of customary adoption in Inuit communities was a clear representation of the interconnectedness of Inuit societies.8)PIWC (2006) The Inuit way: A guide to Inuit culture. Ottawa: Pauktuutit Inuit Women of Canada

These themes of sexual autonomy and community fluidity are exemplary of the strong foundations embedded in Inuit reproductive culture. As such, it is natural that these aspects of Arctic Indigenous culture became the base cause of violent assimilation tactics, used by colonizers to control Arctic Indigenous peoples.

This section will demonstrate the ways in which historical and contemporary colonial policies and practices have negatively impacted Arctic Indigenous communities rights to reproductive justice by infringing on their right to parent, right not to parent, and right to parent in a healthy and sustainable environment.

The government of canada has a vested interest in the removal of Indigenous peoples from their land and communities. Reproductive justice became a primary way of enacting this removal, and infringement on ones right to parent was enacted both by stealing Arctic Indigenous children from their families through the residential schooling and child welfare systems and by forcibly sterilizing Indigenous people.9)Chansonneuve D (2005) Reclaiming connections: Understanding residential school trauma among aboriginal people: A resource manual. Aboriginal Healing Foundation.

The government of canada began legislating residential schools in 1885 in order to legally remove Indigenous children from parental and community care.10)Chansonneuve D (2005) Reclaiming connections: Understanding residential school trauma among aboriginal people: A resource manual. Aboriginal Healing Foundation. The violent removal of Indigenous children from their families also meant the revocation of Indigenous peoples ability to parent. By 1964, 75% of Inuit school-age children were in attendance at residential schools.11)Chansonneuve D (2005) Reclaiming connections: Understanding residential school trauma among aboriginal people: A resource manual. Aboriginal Healing Foundation. These schools demonstrate the violent intentions of severing opportunities for Arctic Indigenous parenthood, as part of a grander colonial project.

The government continues to revoke Arctic Indigenous peoples right to parent through the child welfare system. Intergenerational trauma from colonial legacies such as residential schools has led to Indigenous communities experiencing high levels of poverty, alcohol abuse, and housing instability12)Healey GK (2017) What if our health care systems embodied the values of our communities? A reflection from Nunavut. The Arctic Institute, 20 June, https://www.thearcticinstitute.org/health-care-systems-values-communities-nunavut/. Accessed on 2 October 2022 all which are considered to be reasons for removal of children by the state.13)Badry D & Wight Felske A (2020) An examination of three key factors: Alcohol, trauma and child welfare: Fetal Alcohol Spectrum Disorder and the Northwest Territories of Canada. First Peoples Child & Family Review 8(1): 130142. The states self-appointed power to remove children from their homes and communities allows for the continuous irrevocable traumatization of Arctic Indigenous children, families, and communities.

The other vile and invasive colonial revocation of Arctic Indigenous reproductive justice came in the form of forced sterilizations. The practice of forced sterilization in a canadian context dates back to the early 1900s and has been reported as an ongoing practice as recently as 2012.14)Lombard AR (2018) Without Prejudice: Examination of Canadas State Report, 65th Session. Maurice Law, 15 October, https://tbinternet.ohchr.org/Treaties/CAT/Shared%20Documents/CAN/INT_CAT_CSS_CAN_32800_E.pdf. Accessed on 2 October 2022; Stote K (2012) The coercive sterilization of Aboriginal women in Canada. American Indian Culture and Research Journal 36(3): 117150 Inuit sterilizations were carried out without patients consent both in the North and in provincial institutions throughout the 1900s.15)Stote K (2012) The coercive sterilization of Aboriginal women in Canada. American Indian Culture and Research Journal 36(3): 117150 A submission of data by the Medical Services Branch in 1976 brought about by a parliamentary inquiry found that Indigenous patients were disproportionately targeted by forced sterilization.16)Stote K (2012) The coercive sterilization of Aboriginal women in Canada. American Indian Culture and Research Journal 36(3): 117150 The inquiry found that between the years of 1966-1976, 70 sterilizations were performed on Arctic Indigenous community members.17)Stote K (2012) The coercive sterilization of Aboriginal women in Canada. American Indian Culture and Research Journal 36(3): 117150 The collection of Medical Services files omitted from the parliamentary inquiry, however, show that between the years of 1970-1973, 180 Indigenous people were sterilized across 33 Arctic Indigenous settlements.18)Stote K (2012) The coercive sterilization of Aboriginal women in Canada. American Indian Culture and Research Journal 36(3): 117150 It is important to note that the six Arctic Indigenous settlements selected for the parliamentary inquiry were the communities with the least number of sterilizations.19)Stote K (2012) The coercive sterilization of Aboriginal women in Canada. American Indian Culture and Research Journal 36(3): 117150

In some instances, medical professionals sought consent for tubal ligation using coercion, the leveraging of stressful situations, or misinformation.20)Lombard AR (2018) Without Prejudice: Examination of Canadas State Report, 65th Session. Maurice Law, 15 October, https://tbinternet.ohchr.org/Treaties/CAT/Shared%20Documents/CAN/INT_CAT_CSS_CAN_32800_E.pdf. Accessed on 2 October 2022 In other instances, doctors simply forewent seeking consent and performed these procedures without the patients knowledge.21)Lombard AR (2018) Without Prejudice: Examination of Canadas State Report, 65th Session. Maurice Law, 15 October, https://tbinternet.ohchr.org/Treaties/CAT/Shared%20Documents/CAN/INT_CAT_CSS_CAN_32800_E.pdf. Accessed on 2 October 2022 Morningstar Mercredi describes her traumatic experience of forced sterilization in her book Sacred Bundles Unborn.22)Mercredi M (2021) Sacred bundles unborn. Friesenpress It took place when she was alone and underage. In all cases, the violent and irreversible revocation of an Indigenous persons right to parent through the severance of reproductive organs is an ongoing practice of colonial genocide.

In sum, the right to parent poses obvious threats to any colonial project, as it ensures the opportunity for sustained Indigenous presence in canada. As such, canada used residential schools, child welfare practices, and forced sterilization in order to revoke this right, causing lasting negative impacts within Arctic Indigenous communities.

The second tenet of the Reproductive Justice Framework enshrines ones right not to parent. When considering the right to make a choice about having children, it is integral that one is fully equipped with knowledge and education surrounding their sexual health. The canadian state is responsible for a lack of comprehensive sexual health awareness and education in Arctic Indigenous communities, preventing youth from making informed decisions about reproduction.

A study conducted in 2015 by the National Center for Biotechnology Information (NCBI) confirmed this, finding that sexual health education was inconsistent across the country as well as within provinces and territories.23)Hulme J, Dunn S, Guilbert E, Soon J & Norman W (2015) Barriers and facilitators to family planning access in Canada. Healthcare Policy | Politiques De Sant 10(3): 4863 The majority of family planning education in Arctic Indigenous communities remains culturally irrelevant, focused solely on the prevention of births and, in some cases, includes abstinence teachings24)Government of Yukon (2020) Find information about sex education programs. 5 November, https://yukon.ca/en/health-and-wellness/health-concerns-diseases-and-conditions/find-information-about-sex-education. Accessed on 25 March 2022; Hulme J, Dunn S, Guilbert E, Soon J & Norman W (2015) Barriers and facilitators to family planning access in Canada. Healthcare Policy | Politiques De Sant 10(3): 4863; Lys C & Reading C (2012) Coming of age: How young women in the Northwest Territories understand the barriers and facilitators to positive, empowered, and Safer Sexual Health. International Journal of Circumpolar Health 71(1).

Furthermore, the NCBI study found that Arctic Indigenous communities are particularly vulnerable to physician bias and outdated practices.25)Hulme J, Dunn S, Guilbert E, Soon J & Norman W (2015) Barriers and facilitators to family planning access in Canada. Healthcare Policy | Politiques De Sant 10(3): 4863 In a 2013 study which explored five personal stories of sexual health education and services in Yukon, participants shared that the lack of anonymity and access to health services such as STI testing led them to avoid these services altogether.26)Rudachyk L (2013) Womens stories of Access: Sexual Health Education and services in Yukon. Ottawa: Carleton University In addition, participants shared that when seeking an abortion, they hitchhiked for hours to other communities in order to access anonymous and judgement-free health care.27)Rudachyk L (2013) Womens stories of Access: Sexual Health Education and services in Yukon. Ottawa: Carleton University Access to abortion care is particularly limited in Arctic Indigenous communities, where 64% of the population lives 100km or more from the nearest physician.28)Lys C & Reading C (2012) Coming of age: How young women in the Northwest Territories understand the barriers and facilitators to positive, empowered, and Safer Sexual Health. International Journal of Circumpolar Health 71(1). This is further exacerbated by the fact that amongst Yellowknife, Nunavut and Yukon, there are only four total providers for safe access to abortion.29)Action Canada SHR (2019) Access at a Glance: Abortion Services in Canada. Action Canada for Sexual Health & Rights, https://www.actioncanadashr.org/resources/factsheets-guidelines/2019-09-19-access-glance-abortion-services-canada. Accessed on 2 October 2022

Combined, this data is vital in understanding the scale and scope of what constitutes a clear and comprehensive understanding of sexual health, and the ways in which that understanding has been historically and contemporarily denied to Arctic Indigenous youth. By failing to provide this, the canadian government actively infringes on the reproductive justice rights of Arctic Indigenous communities.

The right to parent healthily and sustainably is dependent on access to basic human needs such as water, food, and shelter. Yet, colonial policies such as relocations, settlement programs, and residential schooling have curtailed Arctic Indigenous mobility and subsequent access to adequate housing and food security since the 1900s.30)INFSS (2021) Inuit Tapiriit Kanatami. Ottawa: Inuit Nunangat Food Security Strategy When discussing the right to parent healthily and sustainably, it is important to note that inadequate Arctic housing infrastructure and food insecurity are two social determinants of health that have been heavily impacted by canadian colonial policies.

Access to adequate housing is necessary in ensuring the health and safety of ones child. The chronic housing shortage faced by Arctic Indigenous communities exacerbated by the lack of social support31)Tranter E (2020) Nunavut MLAs concerned about territorys high birth rate, taboo around accessing reproductive health services. Nunatsiaq News, 25 February, https://nunatsiaq.com/stories/article/nunavut-mlas-concerned-about-territorys-high-birth-rate-taboo-around-accessing-reproductive-health-services/ directly impacts the health of Arctic Indigenous communities, as living situations are often overcrowded, affecting indoor air quality and sanitation.32)Knotsch C & Kinnon D (2011) If Not Now When? Addressing the Ongoing Inuit Housing Crisis in Canada. Ottawa: National Aboriginal Health Organization As of 2016, in Inuit Nunangat, 51.7% of Inuit lived in crowded conditions, and 31% lived in houses requiring major repairs. Housing infrastructure is also a severe hindrance to socio-economic development, which relies on community infrastructure that can provide a good quality of life for community members.33)Mihychuk M (2019) A Path to Growth: Investing in the North. Ottawa: House of Commons Canada

Food insecurity is another social determinant of health that impedes on the right of Arctic Indigenous parents to raise their children in a healthy and sustainable environment. The severity of food insecurity among Arctic Indigenous communities is one of the longest-lasting public health crises in canada, and is attributable to intersecting driving factors, including but not limited to: poverty; climate change; inadequate infrastructure; high cost of living; and systemic racism.34)INFSS (2021) Inuit Tapiriit Kanatami. Ottawa: Inuit Nunangat Food Security Strategy In fact, food security statistics from the years 2011-2012 states that Nunavut had a food insecurity rate over four times that of the national average, and that the highest rates of food insecurity are found across the three Arctic territories.35)Roshanafshar S & Hawkins E (2015) Food insecurity in Canada. Ottawa: Statistics Canada

Beyond physical health, it is important to acknowledge the cultural and spiritual health impacts that canadian colonialism has had on Arctic Indigenous reproductive justice. Territorial policies related to childbirth and delivery systemically hastened cultural erosion, as most community members were required to be removed to a distant hospital or birthing clinic.36)Thibeault R (2002) Fostering Healing through Occupation: The Case of the Canadian Inuit. Journal of Occupational Science 9(3): 153158 This prevented the ability to perform birthing celebrations and rituals which are important to Arctic Indigenous cultural and spiritual health.

As such, the holistic perspective offered by the Reproductive Justice Framework is particularly useful in understanding that social and cultural determinants of health are integral to Arctic Indigenous reproductive rights. Arctic Indigenous communities deserved and continue to deserve to thrive through parenthood, both physically and culturally. However, it is these thriving communities that are considered antithetical to the success of the canadian colonial project.

So far, this paper has aimed to demonstrate the historical and contemporary impacts of the canadian colonial project on Arctic Indigenous communities access to reproductive justice. This colonial project was purposeful and could be interpreted as an intent to destroy in whole or in part, a national, ethnic, racial, or religious group37)UN (1948) Convention on the Prevention and Punishment of the Crime of Genocide. United Nations, p.280 Revoking Indigenous reproductive justice was just one tool that the canadian state used to commit genocide against Indigenous people, by violating Article 2d and 2e of the United Nations Genocide Convention.

The UNGC defines genocide in five categorized acts: a) killing members of the group; b) causing serious bodily or mental harm to members of the group; c) deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part; d) imposing measures intended to prevent births within the group; and e) forcibly transferring children of the group to another group.38)UN (1948) Convention on the Prevention and Punishment of the Crime of Genocide. United Nations, p280, Art. 2

The canadian states infringement on Arctic Indigenous reproductive justice could be considered genocide based on Article 2d and 2e of the UNGC. Specifically, Article 2d on the prevention of births is relevant to canadas history of forced sterilization of Arctic Indigenous women. In fact, the current lawsuit led by Alisa Lombard seeks justice for Indigenous victims of forced sterilization in Saskatchewan, with cases as recent as 2018.39)Lombard AR (2018) Without Prejudice: Examination of Canadas State Report, 65th Session. Maurice Law, 15 October, https://tbinternet.ohchr.org/Treaties/CAT/Shared%20Documents/CAN/INT_CAT_CSS_CAN_32800_E.pdf. Accessed on 2 October 2022; The Standing Senate Committee on Human Rights (2021) Forced and coerced sterilization of persons in Canada. Ottawa: Senate Canada Similarly, canadas responsibility for residential schools and its modern counterpart, the child welfare system could be considered a violation of Article 2e, which highlights forcible transfer of children.

The states 1966 decision to incorporate only UNGC Articles 2a and 2b into the canadian Criminal Code is further evidence of the intentionality behind canadas avoided accountability for their history of genocide.40)MacDonald DB (2019) Understanding Genocide: Raphael Lemkin, the UN Genocide Convention, and International Law in The Sleeping Giant Awakens: Genocide, Indian Residential Schools, and the Challenge of Conciliation. Toronto: University of Toronto Press

This research discusses the impacts of canadian colonialism on Arctic Indigenous reproductive justice, and its potential constitution as genocide under the UNGC Article 2d and e. This research is intended to be a contribution to the discussion on Arctic Indigenous reproductive justice, which should evolve as more research is conducted in new and innovative ways. As such, our recommendations are geared to researchers and academics who are interested in engaging with the topic of Arctic Indigenous reproductive justice:

Maya Crawford (she/her) is an Algonquin and settler woman from the Snimikobi Community in the Ottawa Valley. Currently an undergraduate student at the University of Ottawa, Maya is in her 4th year majoring in Conflict Studies and Human Rights with a minor in Indigenous Studies. As an Indigenous academic, Mayas research has focused on oral storytelling as knowledge, the reality and interconnectivity of Indigenous and Migrant lived experiences on Turtle Island, and providing Indigenous youth with a platform to educate. Jayde Lavoie (she/her) is a queer settler, artist, and academic situated on Tiohti:ke (Montreal), the unceded and unsurrendered territory of the Kanienkeh:ka Nation. A University of Ottawa graduate of Conflict Studies and Human Rights with a minor in Indigenous Studies, Jaydes research interests have predominantly focused on Canadas colonial history, climate justice, and Arctic policy. Reanne Bremner (she/her) is a graduate of Political Science with a focus on woman and gender studies and Indigenous feminisms from the University of Ottawa. As a queer settler currently situated on Tiohti:ke (Montreal), the unceded and unsurrendered territory of the Kanienkeh:ka Nation, Reannes work centers around human rights education, community-based programming, and youth empowerment with an emphasis on an intersectional and human rights based approach.

Link:
Colonialism and Reproductive Justice in Arctic Canada: The Neglected Historical and Contemporary Analysis of Genocidal Policies on Arctic Indigeneous...

Cheetah Cubs Are Born at Front Royal Campus, Smithsonian’s National Zoo and Conservation Biology Institute – Smithsonian Institution

Carnivore keepers at the Smithsonians National Zoo and Conservation Biology Institute (NZCBI) in Front Royal, Virginia, welcomed a litter of two cheetah cubs. First-time mother, 4-year-old female Amani, birthed the cubs Oct. 3 around 9:17 p.m. and 11:05 p.m. ET. This is also the first litter sired by 7-year-old father Asante. As the first offspring of both parents, the cubs are genetically valuable. They appear to be strong, active, vocalizing and nursing well. Animal care staff are closely monitoring Amani and her cubs behaviors via the Cheetah Cub Cam on the Zoos website. Virtual visitors can also observe Amani and her cubs on this temporary platform until the cubs leave the dens.

Keepers will leave Amani to bond with and care for her cubs without interference, so it may be some time before they can determine the cubs sexes. They will perform a health check on the cubs when Amani is comfortable leaving them for an extended period.

Seeing Amani successfully care for this litterher firstwith confidence is very rewarding, said Adrienne Crosier, cheetah biologist at NZCBI and head of the Association of Zoos & Aquariums Cheetah Species Survival Plan (SSP). Being able to watch our cheetah family grow, play and explore their surroundings is incredibly special. We hope this experience brings Cheetah Cub Cam viewers joy and helps them feel a deeper connection to this vulnerable species.

NZCBI is part of the Cheetah Breeding Center Coalitiona group of 10 cheetah breeding centers across the United States that aim to create and maintain a sustainable North American cheetah population under human care. These cubs are a significant addition to the Cheetah SSP, as each individual contributes to this program.

The SSP scientists determine which animals to breed by considering their genetic makeup, health and temperament, among other factors. Amani and Asante were paired and bred naturally July 2 and 3. Keepers trained Amani to voluntarily participate in ultrasounds, and veterinarians confirmed her pregnancy Aug 8. Since 2007, 17 litters of cheetah cubs have been born at NZCBIs Front Royal campus.

Significant scientific studies by NZCBI researchers have demonstrated that maintaining breeding males in group coalitions (as they would live in the wilds of Africa) promotes reproductive performance, specifically improving sperm quality. Other ongoing research focuses on gamete (sperm and egg) biology, health and disease, the influence of age on reproduction, as well as understanding the hormonal complexities of the species. Such data is used by conservationists to modify reproductive strategies for this vulnerable felid, including ensuring that prime-breeding-age cheetahs are maintained in spacious breeding centers, such as at NZCBI, to promote optimal reproduction and cub production.

Cheetahs live in small, isolated populations mostly in sub-Saharan Africa. Many of their strongholds are in eastern and southern African parks. Due to human conflict and poaching, habitat and prey-base loss, there are only an estimated 7,000 to 7,500 cheetahs left in the wild. The International Union for Conservation of Nature considers cheetahs vulnerable to extinction.

The Smithsonians National Zoo and Conservation Biology Institute (NZCBI) leads the Smithsonians global effort to save species, better understand ecosystems and train future generations of conservationists. Its two campuses are home to more than 2,000 animals, including some of the worlds most critically endangered species. Always free of charge, the Zoos 163-acre park in the heart of Washington, D.C., features 1,800 animals representing 360 species and is a popular destination for children and families. At the Conservation Biology Institutes 3,200-acre campus in Virginia, breeding and veterinary research on 200 animals representing 20 species provide critical data for the management of animals in human care and valuable insights for conservation of wild populations. NZCBIs 305 staff and scientists work in Washington, D.C., Virginia and with partners at field sites across the United States and in more than 30 countries to save wildlife, collaborate with communities and conserve native habitats. NZCBI is a long-standing accredited member of the Association of Zoos & Aquariums.

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Cheetah Cubs Are Born at Front Royal Campus, Smithsonian's National Zoo and Conservation Biology Institute - Smithsonian Institution

No guarantee of success for preserving fertility ahead of treatment for benign conditions – ESHRE

A September Campus meeting organised by the SIG Fertility Preservation reviewed approaches to fertility preservation in benign conditions such as endometriosis, POI and haematological diseases.

Indeed, the need for doctors to manage expectations in patients having procedures to retain fertility and recognise when the odds are against them was underlined by several presenters at this Campus meeting on fertility preservation for benign indications. Age, ovarian reserve, gender, disease severity, prior surgery/hormone therapy and treatment method were among the many factors cited which can dictate the chance of success.

An extensive range of benign conditions were considered during the meeting, including endometriosis, Klinefelter syndrome, premature ovarian insufficiency and haematological diseases such as sickle cell; data were also presented on FP approaches and outcomes for transgender men and women.

In his presentation on endometriosis, Professor Grynberg, from Antoine Beclere University hospital in Paris, attempted to answer when, how and if to offer FP. However, many unresolved questions remain, such as the timing and impact of controlled ovarian stimulation and egg retrieval on this disease which can present in many different ways - asymptomatic, as pain and as infertility (or in any combination).

However, Grynberg said there is almost no debate around FP for bilateral endometrioma, voluminous unilateral endometrioma, and expected repeated surgeries with intervention taking place ideally before age 35 in order to preserve gametes before a decrease in ovarian reserve.

What about LBRs from frozen eggs? Data on this are limited, said Grynberg, and vary according to several factors such as age and a history (or not) of surgery. A recent observational study described oocyte vitrification as a valid treatment for women with endometriosis, but found that ovarian response and LBR were higher in young (35 years) non-surgical patients than in those who had had surgey.(2)

In conclusion, he said the possibility of FP should always be kept in mind by all physicians dealing with endometriosis but some indications are debateable and evidence for success rates is as yet lacking.

Semen banking is advised for adult male patients who need aggressive gonadotoxic treatment for diseases such as sickle cell. Testicular tissue banking might be an alternative for teenage boys. Ellen Goossens from Vrije Universiteit Brussel in Belgium presented data from her clinic which has, since 2002, banked samples from over 100 patients of whom over half (57%) have non-malignant disorders.

Evidence on the efficacy of fertility restoration has progressed from births in mice to a macaque monkey, and Goossens now has ethical approval for human trials which will feature cryopreserved testicular tissue grafted to the testes and scrotum.

Should clinics offer PGT to patients with hereditary conditions who need FP? That was the question asked by Anne-Marie Gerdes, a former chairperson of the Danish Council on Ethics, who said demand has been increasing for PGT-M and new techniques are being developed.

In Denmark, the criteria for genetic analysis must be known and recognise a significantly increased risk that the child will develop a serious genetic disease or chromosomal aberration. However, there are grey areas in the law which raise ethical concerns. Gerdes said offering PGT can create a slippery slope from serious diseases to normal traits but not offering patients the procedure may encourage fertility tourism.

Freezing the gametes or tissue of someone about to undergo gender re-assignment surgery is another area of FP in benign conditions that brings challenges for clinicians, especially as the literature is limited. Kenny Rodriguez-Wallberg outlined the situation in Sweden where transgender men and women no longer have to be sterilised before they can legally change their gender following a law change in 2013.

Her clinic has redesigned their information brochure to make it acceptable to trans men leaflets now feature a body with ovaries but without feminine curves and adapted how staff interact with patients. A study of 15 patients found that gender incongruence and dysphoria were triggered by genital examinations and physical changes associated with discontinuation of testosterone or hormonal stimulation.(3)

Fertility outcomes for patients who have undergone gender-affirming hormone therapy (GAHT) are comparable to those whose gender identity corresponds to their sex assigned at birth. For trans women, Rodriguez-Wallberg said sperm banking should be offered prior to GAHT. A study of 212 patients found that previous hormone therapy was associated with significantly lower sperm counts and even patients with no prior GAHT history had a high proportion of sperm abnormalities.(4)

There is also a psychological impact for trans men and women. Many still believe fertility is the price to pay for gender transitioning and may face an uncertain future regarding parenthood, despite having FP options.

1. Grynberg M, Sermondade N. Fertility preservation: should we reconsider the terminology? Hum Reprod 2019; 34: 18551857. doi.org/10.1093/humrep/dez1602. Cobo A, Giles J, Paolelli S, et al. Oocyte vitrification for fertility preservation in women with endometriosis: an observational study. Fertil Steril 2020; 113: 836-844. DOI: doi.org/10.1016/j.fertnstert.2019.11.0173. Armuand G, Dhejne C, Olofsson JI, Rodriguez-Wallberg KA. Transgender men's experiences of fertility preservation: a qualitative study. Hum Reprod 2017; 32: 383390. doi.org/10.1093/humrep/dew3234. Hljestig J, Arver S, Johansson A, Lundberg FE. Sperm quality in transgender women before or after gender affirming hormone therapyA prospective cohort study; Andrology 2021; 9: 1773-1780. doi.org/10.1111/andr.12999

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No guarantee of success for preserving fertility ahead of treatment for benign conditions - ESHRE

Jack London 1: The Call of the Wild – Patheos

Jack London 1: The Call of the WildThe Wolf in Dogs Clothing [1]Jack London, The Call of the Wild, original edition of 1903

Beware of false prophets, who come to you in sheeps clothing but inwardly are ravenous wolves, warns Jesus (Matthew 7:15). According to Jesus, wolf is a metaphor for false prophet. According to American novelist Jack London, wolf is a metaphor for the fallen human race. In one of the most widely read novels of all time, The Call of the Wild, along with sequels White Fang and The Sea Wolf, London undresses the wolf hiding in human clothing.

Just a quick reminder of the plot. Buck, a pet dog from Santa Clara Valley in California, was dognapped and taken to Alaska to pull sleds. In the Klondike, away from civilization, Buck began to revert to an earlier stage of evolution. The dominant primordial beast was strong in Buck, writes London. After a fight with another dog, Spitz, Buck emerges triumphant over Spitz just as the wolf becomes triumphant over the dog. Buck stood and looked on, the successful champion, the dominant primordial beast who had made his kill and found it good (London, Call of the Wild).

What is true for the wolf within Buck is as true for the wolf within the human. The dog slaver gained dominance over Buck by hitting him with a club.

After a particularly fierce blow he [Buck] crawled to his feet, too dazed to rush. He staggered limply about, the blood flowing from nose and mouth and ears, his beautiful coat sprayed and flecked with bloody slaver. The man advanced and deliberately dealt him a frightful blow on the nose. All the pain he had endured was as nothing compared with the exquisite agony of this (London, Call of the Wild).

What Jack London himself witnessed in the Klondike that became background for his wolf books was human nature in the raw. When gold prospectors from California and the rest of the world converged on Alaska in the 1890s, they left their modern humanity behind. The civil became uncivil. The humane became inhuman. Law and order were discarded and replaced by the Law of Club and Fang. The primordial wolf, once suppressed, emerged again in both dog and human with ferocity and bloodshed. At any moment, London implied, what we know as orderly civilization could suddenly revert to an earlier stage of evolution where nature is blood red in tooth and claw (Tennyson, In Memoriam).

Might there be a dovetail between Jack Londons evolutionary anthropology and the public theologians understanding of original sin? Was the masterful teller of dog stories actually a literary philosopher exploring human nature? Was London even conscious that he was synthesizing science with religion?

Here are our existential questions: are we Homo sapiens more civilized than a wolf pack? If not, can we hope for redemption descending from heaven in the form a UFO coming to Earth to advance our civilization beyond the wolf stage of evolution? Will extraterrestrial aliens provide the grace we need to transcend our inherited wolf traits?

What!? UFOs!? How do these things fit together?

In this Patheos Public Theology series analyzing a portion of the corpus of prodigious California novelist and short story author, Jack London, we will apply the analytic tools developed in the field of Theology and Literature. Specifically, we will follow the path blazed by one of my favorite University of Chicago professors, Nathan A. Scott (1925-2006).

We have only one topical question: will we Homo sapiens evolve into civilized creatures that outgrow our wolflike tendencies toward violence? We will ask this one question multiple times as we review Jack Londons different writings. Heres whats coming.

Jack London 1: The Call of the Wild

Jack London 2: White Fang

Jack London 3: The Sea Wolf

Jack London 4: Lone Wolf Ethics

Jack London 5: Wolf Pack Ethics

Jack London 6: Wolf & Lamb Ethics

Jack London 7: The Red One

Oh, yes, multiple movies have been made ofThe Call of the Wildover the decades. Most recently in 2020 (Hulu online), The Call of the Wildfilm starred Harrison Ford. Ford played a man named John Thornton, not Buck. In the 1935 film, it was Clark Gable (full movie online). And, in the 1997 version, it was Rutger Hauer as John Thornton and Richard Dreyfuss as narrator. You can watch a 2009 childrens variant with Christopher Lloyd here.

The field of Theology and Literature has fallen on rough times. More frequently today, universities offer courses on Theology and Film.

I was privileged to study under Nathan A. Scott at the University of Chicago. Dr. Scott was a pioneer in the field of Theology and Literature (Scott 1994). He borrowed from Paul Tillich the notion that religion is the depth of culture and culture the form of religion, a notion amplified by Reinhold Niebuhr and Langdon Gilkey (Tillich 1951-1963, 3: 158). Scott applied this notionthe depth of cultureeffectively to his literary criticism. Not only did this provide a new set of insights regarding literature, it also enriched theology.

Christian theology, as a result of its dialogue with great literature of the modern period, will find itself more richly repaid (in terms of deepened awareness of both of itself and of the age) than any other similar transaction it may undertake.(Scott 1994) [2]

What I so appreciated as a student was the way Scott could make transparent the religious depth hidden beneath secular surfaces. Scott asked Tillichs question: what is ultimate? Scott did not ask any questions about science. But I certainly do.

May we expand Theology & Literature into Theology, Science & Literature? A Scott student now a professor at Baylor University, Ralph C. Wood, gives us permission. Both scientific and religious knowledge flourish when they engage present concerns by way of antecedent experience, and thus as they formulate judgments and principles via constant modification and enlargement. (Wood 2012, 31). London the fictional author provides the low hanging fruit of antecedent experience which the public theologian will find easy picking.

As you will soon see, I plan to ask questions about science. When we turn to Americas most widely read author of the first quarter of the twentieth century, Jack London, Charles Darwins theory of evolution explodes like fire works on the 4th of July. Without attending to the science, the reader could not grasp Londons anthropology. It is in the evolutionary anthropology where we find religious depth.

In 1915, the father of depth psychology, Sigmund Freud drew a conclusion Jack London had arrived at two decades earlier. The primitive, savage and evil impulses of mankind have not vanished in any individual, but are simply waiting for the opportunity to show themselves again.

Now to our topical question: does a ravenous wolf lurk within each of us? Only some of us? Must we remain ever alert to the danger that our repressed evolutionary past will surge forth in viciousness, chaos, destruction? Is our civilized order threatened at every moment with dissolving into a cauldron of primeval violence?

Jack London thought so while in Alaska during the Klondike God Rush, 1896-1899. Today, we ask with London: do both dogs and humans bear the genes of a common ancestor, the wolf? If so, must our future be determined by our evolutionary past?

There is more. Much more. The prescient Jack London a century ago asked a very contemporary question: did interstellar travelers intervene in Earths evolution in order to accelerate human development? Are we Homo sapiens a hybrid progeny of terrestrial apes and extraterrestrial geneticists? If so, why does the ravaging world still growl within the terrestrial soul?

Or, to put it another way, should we spend more time in front of our TVs watching Ancient Aliens?

On the one hand, according to London, todays Homo sapiens could without notice suddenly revert to our ravenous wolf past. On the other hand, according to London, Jesus points us to an egalitarian, humane, and socialist future. London had considered writing a short story about Jesus. Then, he thought better of it and abandoned the idea(Williams, Author Under Sail: The Imagination of Jack London 1902-1907. 2021, 37).

Lets say this again. On the one hand, Charles Darwins law of natural selection or Herbert Spencers survival of the fittest incarcerates Homo sapiens in a primeval past from which we can never on our own escape.

On the other hand, the science of Marxist socialismwhich enamored London the labor organizerpromises human transformation. It promises temporal transcendence. It promises an egalitarian, prosperous, and humane future. Redemption will come through revolution.

London was an supporter of the Bolshevik momentum leading to the revolution of 1917 in Russia. He endorsed Marxist socialism. The Call of the Wildbecame required reading for school children for many years in both the Soviet Union and Maoist China. Jack Londons name is engraved on a wall in the Kremlin. Just how, we ask, can we reconcile Londons atavism via evolution with his anticipation of a post-revolutionary utopia?

So, which is it? Are we imprisoned in our past or liberated for our future? That is the human struggle that points us to religious depth. At least as deep as London can dig.

Here, in this small bite, is the fare garnished and served up in thirty-nine books and countless short stories by Californias notorious author, Jack London (1876-1916). Just a little more than a century ago, this adventurer and novelist literally penned three fictional accounts of what I dub, The Wolves of Jack London.[3] The troika includes The Call of the Wild (1903), White Fang (1904), and The Sea-Wolf (1906). Whether in dogs or in their human masters, the convulsive combination of love for life and vicious cruelty surges up from the primordial Wild still lurking within us.

For London there are connections among evolutionary theory, criminality, and primitivism, observes Jay Williams. The impulse to commit crime is something that comes out of the mysterious unknown, or the unconscious(Williams, Author Under Sail: The Imagination of Jack London 1902-1907. 2021, 270). Theologians will think about original sin or even inherited sin here. Theologians will also think about the relationship between natural evil and moral evil.[4] But this is not Londons vocabulary.

Reversion is perennially a threat. At any moment we humans or our dogs may revert to an atavistic heritage that has been apparently lost for a hundred generations. Primeval ferocity is ever ready to pounce. In the 1901 short story, A Relic of the Pliocene, a prehistoric mammoth appears and engages a Klondike hunter in a life-and-death struggle. At any moment, the dead past can live again. Still we ask: can we look forward to a future where that threat will be no more?

White Fang would comprehend a most striking line that appears in David Brooks new book, The Second Mountain. Speaking of her daughter, a young mother says to Brooks, I found I loved her more than evolution required(Brooks 2019, 42). Can the love we share as civilized beings rocket us up and off from our evolutionary launch pad? Or, is the gravity of our ancestral instinct for survival so strong that well inevitably crash back to earth strewn with tooth gnawed bones?

Nature is blood red in tooth and claw, averred Alfred Lord Tennyson in the dinosaur canto of his In Memoriam in the middle of the nineteenth century. According to Michael Lundblad, the law of the jungle later in the nineteenth and early in the twentieth century meant the behavior of wild animals can be equated with natural human instincts not only for competition and reproduction but also for violence and exploitation(Lundblad 2013, 1). Is todays civilization condemned to remain in the past, governed solely by natural selection or the survival-of-the-fittest?

To repeat the theme: the dog becomes a wolf in The Call of the Wild. Buck, a dog from San Francisco goes to Alaska during the gold rush of the 1890s. Instincts hitherto repressed by domestication rush into Bucks consciousness, instincts borne through millions of evolutionary years. He must master or be mastered; while to show mercy was a weakness. Mercy did not exist in the primordial life. It was misunderstood for fear, and such misunderstandings made for death. Kill or be killed, eat or be eaten, was the law; and this mandate, down out of the depths of Time, he obeyed. Like Platos Meno, Buck the dog was learning what he already knew from a previous incarnation as a wolf.

After his reversion to the wolf, Buck was chasing a rabbit.

All that stirring of old instincts, which at stated periods drives men out from the sounding cities to forest and plain to kill things by chemically propelled leaden pellets, the blood lust, the joy to killall this was Bucks, only it was infinitely more intimate. He was ranging at the head of the pack, running the wild thing down, the living meat, to kill with his own teeth and wash his muzzle to the eyes in warm blood. (London, The Call of the Wild 1903)

Note that it is not only Buck the dog who washes his muzzle in warm blood. So does the human race.[5]

Philosophically, Jack London was a naturalist. Any naturalistic perspective in our post-Darwinian era must recognize that nature is blood red in tooth and claw, that survival-of-the-fittest determines the winners in the struggle for existence, that killer animals are our ancestors, and that their propensity for violence lives on in Homo sapiens.

Can we ground our ethics in nature understood this way? If nature alone is to provide a foundation for human ethical deliberation, must we construct our ethical superstructure on this evolutionary inheritance? The result would be wolf ethics. In short, a Darwinian naturalist would have no inclination to be nice. How might a public theologian assess this?

Whats next in our Patheos Public Theology series on Jack London? White Fang.Whereas Buck inThe Call of the Wildis a dog who goes to Alaska and becomes a wolf, White Fang is a wolf in Alaska who moves to California and becomes a dog. Look for the next post in this Patheos series on the wolves of Jack London.

Ted Peters is a Lutheran pastor and emeritus seminary professor, teaching theology and ethics. He specializes in the creative mutual interaction between science and theology. He co-edits the journal, Theology and Science. His one volume systematic theology is now in its 3rd edition, GodThe Worlds Future (Fortress 2015). His book, God in Cosmic History, traces the rise of the Axial religions 2500 years ago. He has undertaken a thorough examination of the sin-and-grace dialectic in two works, Sin: Radical Evil in Soul and Society (Eerdmans 1994) and Sin Boldly! (Fortress 2015). Watch for his forthcoming, The Voice of Christian Public Theology (ATF 2022). See his website: TedsTimelyTake.com and Patheos column on Public Theology, https://www.patheos.com/blogs/publictheology/.Ted Peters fictional series of espionage thrillers features Leona Foxx, a hybrid woman who is both a spy and a parish pastor.

I. Incontestably, animals and humans inhabit the same world, the same objective world even if they do not have the same experience of the objectivity of the object 2. Incontestably, animals and humans do not inhabit the same world, for the human world will never be purely and simply identical to the world of animals 3. In spite of this identity and this difference, neither animals of different species, nor humans of different cultures, nor any animal or human individual inhabit the same world as another the difference between one world and another will remain always unbridgeable, because the community of the world is always constructed, simulated by a set of stabilizing apparatuses nowhere and never given in nature. (Derrida, 2009, 8-9)

When applying Derridas view of worldview, Hannah Strmmen tries to reestablish human-animal continuity minus human sovereignty over the animals.

If part of animal studies is attempting to think the animal outside a logic of human sovereignty, and to attempt to rethink humananimal relationships outside, or other to, such a discourse of power, then a different kind of discourse is needed that can do precisely that (Strmmen, 2017, 408).

The power that humans exert over their dogs and other animals in Jack Londons stories stresses both human cruelty and human kindness. Both exemplify sovereignty. Yet, both are intended to convey the wolflike traits still operative at the human level.

Basket, Sam. 1996. Sea Change in The Sea Wolf. In Rereading Jack London, by eds Leonard Cassato and Jeanne Campbell Reesman, 92-109. Stanford CA: Stanford University Press.

Berkove, Lawrence. 2004. Jack London and Evolution: From Spencer to Huxley. American Literary Realism 36:3 243-255.

Berkove, Lawrence. 1996. The Myth of Hope in Jack Londons The Red One. In Rereading Jack London, by eds Leonard Cassuto and Jeanne Campbell Reesman, 204-216. Stanford CA: Stanford University Press.

Brandt, Kenneth. 2018. Jack London: An Adventurous Mind. In Jack London, by Kenneth K. Brandt. Liverpool: Liverpool University Press (Northcote).

Brooks, David. 2019. The Second Mountain. New York: Random House.

Derrida, Jacques. 2009. The Beast and the Sovereign. Vol. I, trans. Geoffrey Bennington. Chicago, IL and London: University of Chicago Press.

Deudney, Daniel. 2020. Dark Skies: Space Expansionism, Planetary Geopolitics, and the Ends of Humanity. Oxford: Oxford University Press.

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The Pentagon’s Abortion Policy Is an Empty Gesture – The Nation

US soldiers lined up at Albrecht Drer Airport. (Karl-Josef Hildenbrand / Getty Images)

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In significant parts of this country, the Supreme Courts June 2022 decision to overturn Roe v. Wade returned Americans to a half-century-old situation in which hundreds of thousands of women, faced with unwanted pregnancies, were once forced to resort to costly, potentially deadly underground abortions. My spouses employer, the Pentagon, recently announced that its own abortion policy, which allows military insurance to cover the procedure when a pregnancy results from rape or incest, or poses a threat to the mothers life, still holds.

Sadly enough, this seems an all-too-hollow reassurance, given the reality that pregnant women in the military are, in many places, likely to face an uphill battle finding providers trained andheres the key, of coursewilling to perform the procedure. The Supreme Court abortion ruling in Dobbs v. Jackson Womens Health leaves it up to the states to determine whether to allow abortions. In doing so, it ensures that the access of military populations to that procedure will be so much more complicated, especially for spouses who need to seek off-base care, including ones like me who have chosen the military insurance option TRICARE Select that allows us to access almost exclusively civilian providers. Americas 2.6 million military dependents now live in a country where an ever-changing patchwork of state laws can make seeking an abortion costly, risky, and stressful in the extreme.

Any military spouse with young children in tow whos had to relocate somewhere in this nations vast network of military bases can tell you that just caring for another person is challenging in itself. Upon learning youre pregnant, you practically need a PhD to locate a competent obstetrician who also accepts military insurance.

And even when you do, dont discount the problems to come. After an ultrasound, my first provider in the militarys TRICARE Select healthcare program told me that my child was missing a foot. (In fact, he was just positioned with his back to the camera.) My second provider almost injured that same child by attempting to apply force during labor when his head was stuck against my hip bone.

And once youve actually had the child, youre likely to find yourself bickering for hours with uninformed military insurance providers simply to get coverage for a breast pump so you can feed your baby and go to work. Your military-approved pediatrician mayor may not!know anything about local TRICARE Select specialists who can help you address common family problems like deployment-related anxiety in kids. And child care? This countrys child care facilities are already stuffed to the gills and thats even more true of military child care centers. Typically enough, I fear, I was on wait lists for them for years without the faintest success.

Now, add the devastating Dobbs decision to that military reproductive healthcare landscape. Imagine that you want and need an abortion and rely on TRICARE Select, especially if you and your family are stationed in one of the 13 states that have near or total bans on the procedure. If youre lucky enough to have the funds and social connections, you may be able to call in your babysitter to watch your older children and let your employer know that youve got to travel out of state for a medical procedureas if they wouldnt know what kind! Then youll spend what disposable income you have, if anypoverty and food insecurity being rampant in todays militaryto head out of state alone in hopes of getting access to an abortion. Current Issue

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You may want your partner to come with you. If hes not deployed and assuming he supports your choice to seek an abortion, the two of you will face a barrier peculiar to military life: Any service member who needs medical leave must request it through a commanding officer. To be sure, the Army and Air Force have issued directives to commanders not requiring soldiers to state why theyre requesting it. Still, its hard to imagine how a pro-life commanding officer wouldnt see right through such a sudden request and deny it. This is one of the many reasons you may find yourself alone on your journey.

And oh, the places youll go! The nearest abortion clinic likely wont be off base over on Main Street. The states with the most restrictive laws governing abortion also have among the highest concentrations of military bases. So military dependents and soldiers whose insurance or health conditions require them to go off base will likely have to travel across state lines (possibly many state lines) to get the services they need and, of course, do so on their own dime. And by the way, the anti-abortion states are also among those with the largest number of per capita troop hometowns, meaning that military personnel from them are unlikely to get access to care if they go home to be with family during a time when they undoubtedly need extra support.

In other words, in the military world, Dobbs is a recipe for disaster.

For those unfamiliar with the militarys insurance system, let me make a key distinction. Military family members like myself get to choose between two main types of health insurance. The first, called TRICARE Prime, lets you access care in Department of Defense healthcare facilities military bases or posts. This is how active-duty troops typically get care as well. A case manager refers you to various primary and specialty-care providers as needed. With TRICARE Prime, youd be using federal facilities, so you might, at least theoretically, have an easier time getting access to an abortion when, under a narrow set of conditions, the federal government is willing to cover such a procedure.

In my experience as a therapist listening to military spouses over the years, to seek healthcare at military facilities almost invariably involves conflicts of interest. Doctors there tend to treat you as though your concerns about your health or that of your children are remarkably insignificant compared to the needs of the troops. They tend to speak to spouses like me as if we were the only ones responsible for the health of our families, in the process essentially dumping such issues (and the services that go with them) onto the unpaid shoulders of us and us alone.

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To offer an example, a mother I knew in Washington State was increasingly worried about her toddlers rapidly declining weight, only to have that phenomenon dismissed by physicians at a military hospital as the result of poor parenting. In the end, her suspicion that her child was gravely ill turned out to be all-too-sadly correct. Another military wife I interviewed went to couples therapy on a military base to discuss how an upcoming move might impact their marriage. The counselor they saw, she told me, emphasized her spouses service to the country, suggesting that she prioritize his career over hers and complete the move.

Perhaps because of such conflicts of interest and the greater choice offered by civilian-based health plans, most military dependents (72 percent in 2020) choose the second military-authorized insurance program, TRICARE Select. There, you manage your own care by finding civilian doctors willing to accept the Select plan or you simply pay out of pocket for civilian providers, hoping for some reimbursement sooner or later. With this option, if you were faced with an unwanted pregnancy, you would be subject to any abortion restrictions in your surrounding area.

Keep in mind that specialty care like obstetric services is not likely to be easy to find when youre looking for military providers in your community. A recent Pentagon evaluation of access to healthcare found that 49 percent of the people with TRICARE Select could not find a specialist in their community who accepted TRICARE patients, nor could 34 percent travel the necessary distance to reach an appropriate specialist. Meanwhile, 46 percent couldnt access a specialist in a timely manner due to long wait lists. Worse yet, overall access to specialist care within 24 to 48 hours for TRICARE Select beneficiaries decreased significantly between 2016 and 2019 and continued to do so through the first half of 2021.

Lack of access is not an accident. Despite the monstrous size of the Pentagon budget in these years, the Department of Defense actually decreased its health expenditures for all medical programs relative to its overall spending between 2017 and 2020.

In such an environment, its hardly surprising that state abortion bans containing exceptions in cases when pregnancy threatens the parents life will not easily result in access to the procedure. For example, Tennessee, home to five military bases and with a per capita troop concentration about 10 percent greater than the national average, provides exceptions to its ban when a parents life is at risk. Heres the catch: doctors need to be prepared to show evidence that the procedure is necessary to prevent the impairment of a parents major bodily functions were the pregnancy to continueenough evidence that a team of prosecutors with its own expert medical witnesses could not convincingly argue otherwise in court. If not, a doctor could face felony charges and up to 15 years in prison.

Under such circumstances, if you were a doctor considering whether to terminate a life-threatening pregnancy for a patient, would you choose the patient or protect your ability to stay with your own family, avoiding the risk of prison? Im not sure what I would do in such a situation.

Theres reason to believe that even military dependents not seeking abortions could end up struggling to get the pregnancy care they need because of the restrictions doctors will face when it comes to treating complicated pregnancies. For example, the drugs used to induce abortion by medication, misoprostol and mifepristone, are also the most effective ones for treating patients experiencing miscarriages. At the Cleveland Clinic Emergency Department, under Ohios new heartbeat ban, which makes it a felony to end a pregnancy after a fetal heartbeat has been detected, women could soon enough have to wait 24 hours before receiving treatment for miscarriages, since anything earlier might qualify as an illegal abortion. Thankfully, for the time being two judges have placed a pause on the ban.

Another troubling fallout from new state abortion bans is the way providers and their patients are now being left to handle exceptions when a pregnancy results from rape. Many abortion bans contain sexual assault reporting requirements that make it all but impossible for doctors to avoid serious liability. For example, Utahs new abortion law permits the procedure in cases of rape, but for a doctor to perform it without risking criminal charges, he or she would need to report the rape to law enforcement. Similarly, in Wyoming (a state with just one abortion clinic that has two providers), the new exception in cases of rape does not specify how a client should prove that rape occurred, again leaving it up to doctors to decide how to treat patients and protect their own lives from devastating consequences.

The assaulting of civilian women by soldiers is not a widely studied subject, but accounts by activists and journalists suggest that it is a significant problem. Whats more, about 80 percent of rapes committed by soldiers are never officially reported because victims fear retaliation either from their rapist or others in their communities, including their own or their spouses commands. If the rapist happens to be their spouse, reporting the rape in order to obtain an abortion could mean that the family loses its sole source of income, since a convicted rapist would assumedly be discharged from duty. In addition, its widely known that people who report sexual assaults often face uninformed responses from law enforcement officers who doubt their stories or blame them for being attacked, only increasing the trauma of the situation.

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The pro-life activists and policies behind those cowardly laws belie the fact that much of what far-right Americans and their elected representatives support undermines human life. Look at the violence and poverty some of the same leaders who advocate abortion bans allow in a country whose politicians generally choose to sanction war and investments in weapons development over better social services. Look at the way a significant minority of the citizenry support elected officials who encourage violence against other Americans of differing political beliefs. Look at the way some of us would support the separating of parents and children at the end of life-saving journeys away from drug wars and poverty in their home countries.

Given such political headwinds, its worth remembering that a pregnant person is not a passive receptacle but a worker, whether for nine months or the rest of her life. If anyone should have the power to choose death, she should, because there is always a damn good, heart-wrenching reason for doing so.

I dont know how many people realize this, but if Roe had not become the law of the land in 1973 to protect abortion rights, a different case might have taken its place. In the early 1970s, the late Supreme Court Justice Ruth Bader Ginsburg, then a lawyer for the American Civil Liberties Union, took up the case of an Air Force nurse in Vietnam named Susan Struck who was told (as was the militarys policy at that time) that she would be discharged if she were to carry her pregnancy to term.

Captain Struck was a devout Catholic who wanted to keep her job and have that baby. Ginsburg argued that all government attempts to regulate reproduction constituted sex discrimination, whether it involved restricting pregnancies or abortions. The Supreme Court agreed to hear the case in 1972, but before that could happen, the military changed its policy, rendering the case moot. Had Ginsburg won that case before the Supreme Court, our legal system might have prioritized parents, not the state, as the ultimate decision-makersheroes no longer navigating a landscape of red tape and indignities.

Last June, right after Roe was overturned, I contacted a fellow military spouse visibly pregnant with her first child. She told me how complicated her feelings were about showing up in Washington, D.C., to advocate for abortion rights just after the draft decision to overturn Roe was leaked this past May. Would people misunderstand her presence at that demonstration? About a year ago, shed sought emergency care for a miscarriage, which she might not have been able to get had abortion rights already been taken away. Perhaps, in the absence of adequate care, she might have suffered complications that prevented her from becoming pregnant this time around. She did, however, attend that demonstration, convinced that advocacy was as important to self-care as any other act in this country.

Hers is a true pro-life position. Its the position of someone who has for years moved from one military base to another. Loving both yourself and your baby is a struggle, not a campaign slogan. As a parent myself, I think that parenting is a journey many more pregnant people would happily embrace if the conditions in this country were significantly more humane. Right now, if you truly care about the lives of us all, its up to you (and me) to join women like my friend in her post-Roe advocacy.

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Jake Foster Likely Not Taking Fifth Year, Will Retire If He Gets Into Med School – SwimSwam

University of Texas senior and U.S. National team member Jake Foster will likely not be using his fifth year of eligibility, which was awarded to all NCAA athletes that competed during the COVID-afflicted 2020-21 season.

At the moment, I will be finishing my degree in the spring, and with some degree of certainty, I can say that I will not be using my 5th year of eligibility, Foster told SwimSwam. I may still be swimming next year as a pro, but that situation is still in flux with whether I will be enrolling in med school next fall.

Foster also confirmed that he would be retiring from competitive swimming if he enrolled in medical school, because it wont be possible for [him] to balance the demand of med school and competitive swimming while doing them at the level that [he] wants to.

Additionally, Fosters retirement was hinted at in his younger brother Carson Fosters recent Instagram post, where he says his 16th and final season swimming on the same team as [Jake] starts today.

In February 2022, Fosters teammates from Texas posted on social media about how he got a score of 519 on his MCAT test, which is an exam required for admission to the majority of medical schools in the United States. The highest possible MCAT score is a 528, so a 519 would put Foster in the 96th percentile of all medical school applicants, according to Association of American Medical Colleges.

Fosters potential retirement comes despite the fact that he has a chance of making long course international teams in the future, including the 2023 U.S. World Championships team and the 2024 U.S. Olympic team. At the 2022 U.S. National Championships, he finished second in the 200 breast with a time of 2:09.00, which is ranked third in the United States and just 0.16 seconds off the 2:08.84 it took to make the 2022 World Championships team.

At the 2022 U.S. International Team Trials, Foster narrowly missed the World Championship team in the 200 breast by placing third to Nic Fink and Charlie Swanson in a time of 2:09.73. He was also fifth in the 400 IM in 4:13.76 and sixth in the 200 IM in 1:58.64.

Collegiately, Foster is a high-impact swimmer, having scored 30 individual points for Texas at the 2022 NCAA Championships. He set personal best times in all three of his primary events, finishing twelfth in the 200 breast (1:51.82), eighth in the 200 IM (1:40.63), and fifth in the 400 IM (3:38.24). His PBs of 1:51.40 and 3:37.33 in the 200 breast and 400 IM respectively both came in prelims.

Foster isnt the only Texas swimmer to retire from competitive swimming due to med school, as 2017 World Championship medalist Madisyn Cox also recently hung up her goggles after not making the 2020 Olympic team to enroll in med school.

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Competition heats up between OUWB, other med schools in bone marrow drive – News at OU

Oakland University William Beaumont School of Medicine is going head-to-head with three other medical schools as part of a friendly competition being held in the name of saving lives.

The 2022 Bone Marrow Donor Registration Drive is now underway.

OUWB has partnered with Be The Match the National Marrow Donor Programs annual bone marrow registration drive thats aimed at educating and signing up as many potential donors as possible.

Led by medical students from the Student National Medical Association (SNMA), OUWB will compete with other medical schools in Michigan and Indiana to try and be the one that signs up the most people for the national bone marrow registry.

The drive will consist of in-person events this week as well as an option to participate online through Nov. 15.

Tiffany Williams, director, Diversity & Inclusion, credits students from SNMA for leading the effort.

Theyve been very diligent in making this drive a priority every year, she says. Its a testament that theyve been able to continue the drive, especially since it had to be completely virtual for the last two years.

OUWB is big on compassion

The importance of the bone marrow registry cannot be overstated.

Bone marrow donations have the ability to help with more than 70 diseases that can be treated by a blood stem cell transplant, including leukemia and lymphoma, sickle cell disease, inherited immune disorders, and more.

According to the National Marrow Donor Program (NMDP), Be The Match helped facilitate nearly 6,7000 blood stem cell transplants or other cell therapies in 2021.

OUWB has been participating in the bone marrow donor registration drive since 2014, after OUWBs Student National Medical Association (SNMA) proposed the idea.

Williams says it makes sense for the OUWB community to be involved in the drive because it reflects a commitment to giving back and getting involved in the community.

OUWB is big on compassion and serving the community, says Williams. (The bone marrow donor registration drive) falls right in live with that.

How does it work?

The drive is open to those who are 18 to 40 years of age, in general good health, and willing to donate to any searching patient.

The way it works is relatively simple: An individual swabs the inside of the cheek to generate a sample that is used to compare, and ideally match up, specific protein markers with patients who need a bone marrow transplant.

In-person swabs can be done Tuesday, Oct. 11, from 10 a.m. to noon; Thursday, Oct. 13, from 10 a.m. to noon; and Friday, Oct. 14, from 11 a.m. to 1 p.m. On those dates and times, medical students from SNMA will be at a registration table in the Oakland Center.

Williams says one of the most exciting aspects of this years drive is that it will have an in-person element for the first time since 2019.

Being in-person gives the drive that personal touch, she says. Were able to explain face-to-face the importance of registering to potentially be a donor, as well as provide access to swab kits.

There are two other ways for people to participate.

One is to text MSOUWB22to61474for a swab kit to be sent in the mail the return the swabs to Be The Match by Nov. 15.

Another is to use this link to register online and request a swab kit.

Williams says the goal is to register as many people as possible. As an extra incentive, OUWB is competing with medical schools from Central Michigan University, Indiana University, and Wayne State University.

The school that secures the most registrations by Nov. 15 will win bragging rights, according to Williams.

OUWB won the competition in 2020, and Williams says she is looking forward to the results from this year.

Were going to bring it home, she says.

For more information, contact Andrew Dietderich, marketing writer, OUWB, at adietderich@oakland.edu.

To request an interview, visit the OUWB Communications & Marketingwebpage.

NOTICE: Except where otherwise noted, all articles are published under aCreative Commons Attribution 3.0 license. You are free to copy, distribute, adapt, transmit, or make commercial use of this work as long as you attribute Oakland University William Beaumont School of Medicine as the original creator and include a link to this article.

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Competition heats up between OUWB, other med schools in bone marrow drive - News at OU

Talking cardiac awareness with U of M – UMN News

Sudden cardiac arrest is the leading cause of death in the United States. According to theSudden Cardiac Arrest Foundation, there are more than 356,000 out-of-hospital cardiac arrests annually in the U.S. and nearly 90% of them are fatal.

For National Sudden Cardiac Arrest Awareness Month in October,Demetri Yannopoulos, MD, with the University of Minnesota Medical School and M Health Fairview, talks about cardiac arrest symptoms and care innovation in Minnesota.

Q: What is sudden cardiac arrest?Dr. Yannopoulos:Sudden cardiac arrest is a mechanical malfunction of the heart that is immediate and unexpected. The result is that blood stops pumping throughout your body and the ability to bring oxygen to vital organs such as your brain is compromised. This results in someone becoming suddenly unresponsive and requires immediate action, such as calling 911 and providing CPR. According to the American Heart Association, survival from sudden cardiac arrest is approximately 10% nationwide. In areas such as Minnesota, where the Center for Resuscitation Medicine has focused efforts to improve outcomes through a systemwide approach, survival can be as high as 40% in cases where early recognition and bystander CPR are present.

Q: What are the symptoms of sudden cardiac arrest? Are they different from a heart attack?Dr. Yannopoulos: The primary symptom of a sudden cardiac arrest is the sudden loss of consciousness with an absence of breathing or pulse. Some patients have heart attacks before or during their sudden cardiac arrest. As such, heart attacks blocked arteries of the heart are a common cause for sudden death. A person suffering from a heart attack can have chest pain; weakness; discomfort in the jaw, neck or back; and shortness of breath. A heart attack can trigger an electrical malfunction that leads to cardiac arrest.

Q: Are the symptoms of cardiac arrest different for men and women?Dr. Yannopoulos: The symptoms of cardiac arrest are the same for both men and women, however, heart attack symptoms can vary. Most heart attack symptoms are the same and include chest pain and weakness or lightheadedness. Women may be more likely to have back pain, nausea and shortness of breath. With any symptoms, you should be examined, or if symptoms are obvious, call 911. In the event of a cardiac arrest, recent studies have shown that women are less likely to receive bystander CPR and have lower overall survival rates. Currently, there are several campaigns to improve CPR response for women.

Q: How is the University advancing care for cardiac arrest in Minnesota?Dr. Yannopoulos:The University of Minnesota has been at the forefront of major scientific developments in the constant battle against sudden cardiac death. We have invented new ways to improve blood flow during CPR, better ways to ventilate and new drugs to treat cardiac arrest. We have collaborated with all EMS agencies in the state and organized together a best-in-the-world advanced resuscitation program that treats all victims of sudden cardiac arrest with the most advanced and skilled team that is currently available. We use a machine called ECMO (extracorporeal membrane oxygenation) that acts like the heart and lungs through the major blood vessels to allow time to find the underlying cause, treat it and then continue to support the patients in an intensive care unit.

With this novel strategy that is now the standard of care in our community, patients that have primary electrical storm related sudden death have a six to seven times higher survival rate compared to the national standard of care. We are in the process of spreading the knowledge and process to be applied nationwide, and we are working tirelessly to even further improve the outcomes for patients surviving neurologically intact.

Q: How have the collaborations with The Leona M. and Harry B. Helmsley Charitable Trust forwarded our care to patients in rural areas?Dr. Yannopoulos:The Helmsley Charitable Trust has been a strong supporter of cardiac care improvement in Minnesota. They have supported the mobile ECMO project in the metropolitan area that continues to expand further into rural Minnesota. Recently, the Helmsley Charitable Trust supported an AED project through the Center for Resuscitation Medicine to place new AEDs in all law enforcement vehicles throughout Minnesota. Law enforcement officers are often the first responders on scene, especially in rural communities, and these devices will help them provide critical lifesaving care.

Demetri Yannopoulos, MD, is a professor in the Center for Resuscitation Medicine in the Medical School on the Twin Cities campus and a cardiologist at M Health Fairview. His clinical interests include emergent cardiac care, coronary-artery disease and congenital and peripheral intervention.

In collaboration with The Leona M. and Harry B. Helmsley Charitable Trust, Dr. Yannopoulos is the University lead in increasing access to cardiac care in Minnesota through the Minnesota Mobile Resuscitation Consortium by launching the ECMO truck, three ECMO SUVs and outfitting law enforcement agencies and first responders statewide with state-of-the-art automated external defibrillators. Law enforcement agencies interested in participating in the AED program can enroll at [emailprotected]

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About Talking...with U of MTalking...with U of M is a resource whereby University of Minnesota faculty answer questions on current and other topics of general interest. Feel free to republish this content. If you would like to schedule an interview with the faculty member or have topics youd like the University of Minnesota to explore for future Talking...with U of M, please contact University Public Relations at [emailprotected].

About the University of Minnesota Medical SchoolThe University of Minnesota Medical School is at the forefront of learning and discovery, transforming medical care and educating the next generation of physicians. Our graduates and faculty produce high-impact biomedical research and advance the practice of medicine. We acknowledge that the U of M Medical School, both the Twin Cities campus and Duluth campus, is located on traditional, ancestral and contemporary lands of the Dakota and the Ojibwe, and scores of other Indigenous people, and we affirm our commitment to tribal communities and their sovereignty as we seek to improve and strengthen our relations with tribal nations. For more information about the U of M Medical School, please visitmed.umn.edu.

Minnesota Mobile Resuscitation ConsortiumUnder the Office of Academic Clinical Affairs, the Minnesota Mobile Resuscitation Consortium (MMRC) is a non-profit community resource that is an extension of the Universitys ECMO resuscitation program that started in 2015. The U of M has more ECMO experience than any other organization in the U.S., having treated more than 300 cardiac arrest ECMO cases since its inception, with a 40% survival rate comparatively higher than the average survival rate of less than 10% at other locations that treat similar patient populations.

This is a collaborative initiative funded by an $18.6 million grant from The Leona M. and Harry B. Helmsley Charitable Trust and in-kind donations from industry and private donors. Other recognized donors are Zoll Medical, Stryker Emergency Care, Getinge Incorporated and General Electric. Health care system partners include Fairview Health Services, Regions Hospital (HealthPartners) and North Memorial Health Care System, with contractual partnership for physician services with M Health Fairview, Health Partners, U of M Physicians, Hennepin Healthcare and Lifelink III for clinicians

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Talking cardiac awareness with U of M - UMN News

Join OHEI and OMSE for community conversations Michigan Medicine Headlines – Michigan Medicine Headlines

Recent Supreme Court decisions are weighing heavily on many caregivers, and our nations political polarization makes it more complicated to navigate different belief systems and our roles as patient advocates.

Join the Office for Health Equity & Inclusion and the Office for Medical School Education as we partner with various leaders and subject matter experts to host the second in a series of four Community Conversations where faculty, staff and students have the opportunity to share information, experiences and thoughtfully consider how we demonstrate and practice our institutional values.

This second session will provide tools and ideas for consideration when we are navigating a space with those we disagree with.Speakers will lead us in dialogue about navigating polarizing topics and finding the balance between tolerating difference and potentially providing implicit support to ideas that may be dangerous or leave community members feeling isolated or marginalized.

Thoughtfully and carefully navigating challenging topics like climate change, war, poverty, gun violence, an ongoing pandemic, intractable racism, provider shortages and healthcare disparities can make our lives and our work more difficult but also make our work more important, meaningful and impactful.

Navigating Polarity

When: Oct 17, 6:00 p.m. 7:30 p.m.

Where: Med Sci I M3330

Event will be livestreamed

RSVP here

Speakers include:

Julia Minson, PhD, Associate Professor of Public Policy, Harvard Kennedy School

Kevin Hawkins, Commissioner, Federal Mediation and Conciliation Service

Moderator: Whitney Peoples, PhD, UM School of Public Health, Director of Diversity, Equity, and Inclusion

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Join OHEI and OMSE for community conversations Michigan Medicine Headlines - Michigan Medicine Headlines

Mayor Bowser and Universal Health Services Cut Ribbon on Cedar Hill Urgent Care, GW Health in Ward 8 | mayormb – Executive Office of the Mayor

(Washington, DC) Today, Mayor Muriel Bowser and Universal Health Services(UHS)cut the ribbon on the new Cedar Hill Urgent Care, GW Health. Owned and operated by UHS and inpartnership with the GW School of Medicine and Health Sciences and the GW Medical Faculty Associates,the $1.8 million full-service urgent care will provide comprehensive services for a wide range of illnesses. Cedar Hill Urgent Care, GW Health is the first location to open as part ofa partnership between theDistrict and UHSto createa comprehensive system of healthcare serving communities east of the Anacostia River.

We were very proud, earlier this year, to break ground on the new Cedar Hill Regional Medical Center, but we also know that it is not just about building one hospital it is about the entire health care system. This new urgent care is a critical piece of that system,said Mayor Bowser.The new urgent care facility will help ensure more Washingtonians are getting the right care at the right place at the right time.

When complete, the system will include two urgent care facilities, an ambulatory center,and the new Cedar Hill Regional Medical Center, GW Health. Thenewfacility, located on the ground floor of the Mapleview Flats building at 2228 MartinLuther King Jr Avenue SE, will open its doors to patients on Monday, October 10. The urgent carecenterwill be opensevendays a week, 8 am to 8 pm,and serve all District residents.

Cedar Hill Urgent Care, GW Health will offer comprehensive services for a broad range of illnesses including:

In addition, x-rays and basic lab work will be offered.

We are thrilled to be embarking on the development of these vital health services East of the Anacostia River so that we can better serve all residents across the District of Columbia, said Kimberly Russo, MBA, MS, Group Vice President of the Washington, DC Region for UHS and Chief Executive Officer of GW Hospital. Opening Cedar Hill Urgent Care is the next step in creating a comprehensive, academic medical network which will enhance health access, equity and outcomes and elevate healthcare in our nations capital.

Cedar Hill Urgent Care, GW Health will be fully integrated with the new Cedar Hill Regional Medical Center opening in early 2025 as well as a second urgent care facility opening in 2024 in Ward 7.

Providing access to high-quality health care to all citizens of the District is a 200-year tradition for GW, said Barbara L. Bass, MD, Vice President for Health Affairs, Dean of the GW School of Medicine and Health Sciences, and CEO of the GW Medical Faculty Associates. In this new urgent care facility, we will have the ability to provide convenient, on-the-spot care to our patients and partner with our neighbors to improve the health and wellness of our great city.

In February, Mayor Bowser, UHS, George Washington University and Childrens National Hospital broke ground on the new Cedar Hill Regional Medical Center, GW Health in Ward 8 at the St. Elizabeths East Campus. Last month, the Mayor and UHS announced a plan to expand the size of the new hospital to include a fourth floor. The expansion is made possible through a $17 million investment from UHS.

Social Media:Mayor Bowser Twitter:@MayorBowserMayor Bowser Instagram:@Mayor_BowserMayor Bowser Facebook:facebook.com/MayorMurielBowserMayor Bowser YouTube:https://www.bit.ly/eomvideos

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Mayor Bowser and Universal Health Services Cut Ribbon on Cedar Hill Urgent Care, GW Health in Ward 8 | mayormb - Executive Office of the Mayor

What’s happening at Augusta University? Week of Oct. 10-16 – Jagwire Augusta

This week: A chance to network with health care marketing professionals, bike riders hit the streets to benefit cancer research and a medical student turned author pens a book for young adults.

Hull College of Business will host a business showcase and lecture featuring Dentsu Health from 4-6:30 p.m. Tuesday, Oct. 11 in the Dr. Roscoe Williams Ballroom in the Jaguar Student Activities Center. Dentsu Health specializes in health, wellness and pharmaceutical marketing and will network with students during the event.

Weve lost sight of care: care of ourselves, care of our loved ones and friends, the care that we received and the real care that we need, said Ken Groves, the firms global head of strategy. Two years since the pandemic outbreak, we keep hearing about the acceleration of tech adoption in health care. However, our new outlook on care cannot be limited to a broader set of services and devices.

The opening ceremonies for PaceDay 2022 will be from 4-9 p.m. Saturday, Oct. 15 to benefit the Georgia Cancer Center. The event will take place at SRP Park in North Augusta with food, fun, live music and cancer stories being told. Those participating in Sundays ride can also drop off their bikes. The 25-, 50- and 70-mile rides will start at 8 a.m. Sunday, Oct. 16 with the finish line at the Augusta Common. Since 2019, over $700,000 has been raised and invested in cancer research thanks to Paceline.

Cancer research is very competitive. Less than 10 percent of grants submitted get funded. A lot of people will be eventually impacted by cancer during their lifetime or have family members suffer from the disease, so its a fight that needs everyones involvement, said Huidong Shi, PhD, a cancer researcher at the Georgia Cancer Center.

Tyler Beauchamp, a fourth-year medical student at the Medical College of Georgia, has published his first book, Freeze Frame. Beauchamp has been working on the book since the beginning of the pandemic and would unwind from his studies by writing.

The story follows high school junior Will Horner, an introverted, avid filmmaker trying to move on from the horrors of his past.

I dont think I could do medicine without letting my creative side out every now and then. It just makes me feel human, Beauchamp said. There is something about creativity I really find beautiful, thats exciting.

Interview opportunities are available for these story ideas. Call 706-522-3023 to schedule an interview. Check out the Augusta University Expert Center to view our list of experts who can help with story ideas.

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What's happening at Augusta University? Week of Oct. 10-16 - Jagwire Augusta

Researchers find tumor microbiome interactions may identify new approaches for pancreatic cancer treatment – EurekAlert

Investigators from Rutgers Cancer Institute of New Jersey, the states leading cancer center and only National Cancer Institute-Designated Comprehensive Cancer Center, together with RWJBarnabas Health, examined the microbiome of pancreatic tumors and identified particular microorganisms at single cell resolution that are associated with inflammation and with poor survival. According to the researchers, these microorganisms may be new targets for earlier diagnosis or treatment of pancreatic cancer, which is the fourth leading cause of cancer death for both men and women in the United States. The findings are published in the online version of Cancer Cell (10.1016/j.ccell.2022.09.009).

Microbes are living things that are too small to be seen with the naked eye. We have more microbes living in our body than the total number of human cells, and can be found in organs like the pancreas, which at one time was considered microbe-free. Subhajyoti De, PhD, principal investigator at Rutgers Cancer Institute and senior author of the study along with graduate student Bassel Ghaddar, a student in the MD/PhD program at Rutgers Robert Wood Johnson Medical School, began exploring if there are microbes residing in pancreatic tumors, and if they have consequences for cancer progression or treatment. However, studying microbes in tumors is difficult, in part since every patient is different, and because microbial footprints are too subtle to detect reliably.

To explore further, the researchers teamed up with Martin Blaser, MD, Henry Rutgers Chair of the Human Microbiome at Rutgers University and world-renowned microbiome expert. The investigators developed a genomic approach called SAHMI (Single-cell analysis of Host-Microbiome Interactions) to identify microorganisms associated with individual human cells. Sifting through millions of RNA sequences using sophisticated software, they identified which ones likely represent human genes, and which ones are microbial in origin. This new technique allowed us to identify tumor-associated microbes and measure the activity of the host cells at the same time, which is a significant technical advance, and the results were stunning, notes Dr. De, who is also an associate professor of cancer systems biology at Rutgers Robert Wood Johnson Medical School.

Studying two independent groups of pancreatic tumors, the team found that some had bacteria that associated with specific cell-types within the tumor, which were essentially absent in normal pancreatic tissues. These bacteria were predominantly located within tumor cells, and their abundance correlated with cancer-related cell activities. The specific signatures of the microbes that were found predicted particularly aggressive cancer progression and poor prognosis.

The microbial footprints within the pancreatic tumors raised the question of whether the immune cells that were present were responding to the cancer or to the microbes. The study findings suggested that the immune responses were mostly responding to the microbes in the tumor and not to the cancer cells. Our observations provide a new view about why pancreatic cancers are so difficult to treat, notes Dr. Blaser, who is also a research member at Rutgers Cancer Institute and professor of epidemiology and biostatistics at Rutgers School of Public Health. But better understanding these interactions may identify new approaches for therapies.

Along with Drs. De, Ghaddar, and Blaser, other investigators include: Antara Biswas, PhD, Center for Systems and Computational Biology, Rutgers Cancer Institute; Chris Harris, PhD, Department of Surgery, University of Rochester Medical Center; M. Bishr Omary, PhD, Center for Advanced Biotechnology and Medicine, Rutgers University and Darren R. Carpizo, MD, PhD, Department of Surgery, University of Rochester Medical Center.

About Rutgers Cancer Institute of New Jersey

As New Jerseys only National Cancer Institute-designated Comprehensive Cancer Center, Rutgers Cancer Institute, together with RWJBarnabas Health, offers the most advanced cancer treatment options including bone marrow transplantation, proton therapy, CAR T-cell therapy and complex surgical procedures. Along with clinical trials and novel therapeutics such as precision medicine and immunotherapy many of which are not widely available patients have access to these cutting-edge therapies at Rutgers Cancer Institute of New Jersey in New Brunswick, Rutgers Cancer Institute of New Jersey at University Hospital in Newark, as well as through RWJBarnabas Health facilities. To make a tax-deductible gift to support the Cancer Institute of New Jersey, call 848-932-8013 or visitwww.cinj.org/giving.

Observational study

Cells

Tumor microbiome links cellular programs and immunity in pancreatic cancer

10-Oct-2022

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Researchers find tumor microbiome interactions may identify new approaches for pancreatic cancer treatment - EurekAlert

UMass Chan and Wellinks study mobile tools to keep COPD patients healthy – UMass Medical School

Apurv Soni, MD, PhD21

Researchers from UMass Chan Medical Schools Program in Digital Medicine are leading an innovative study with virtual health care company Wellinks to improve management of chronic obstructive pulmonary disease (COPD) at home.

The study, Healthy at Home, aims to assess the feasibility of app-based consumer technology and comprehensive virtual disease management to improve quality of life and achieve better health outcomes among people with COPD. According to the Centers for Disease Control and Prevention (CDC), COPD is the third leading cause of death by chronic disease in the United States and the fifth most costly chronic disease.

The study plan fits into a broader vision of innovation for health care at home. It will enhance our ability to understand what patients are going through in their home environment surrounding social determinants of health and use that information to predict and try to avert urgent care needs such as emergency room visits or hospitalization, said principal investigator Apurv Soni, MD, PhD21, assistant professor of medicine and co-director of the Program in Digital Medicine. Partnership with UMass Memorial Health and newly formed Center for Digital Health Solutions is critical for growth of innovative programs like this.

John P. Broach, MD, MPH, MBA, FACEP, associate professor of emergency medicine, and Laurel Caren O'Connor, MD, assistant professor of emergency medicine, are co-principal investigators on the study. Healthy at Home will plug in via the Wellinks study app to the mobile integrated health service paramedic response team set up by Drs. Broach and OConnor.

OConnor said COPD patients tend to be very complex with multiple factors affecting their disease progression. When a patient gets admitted to the hospital, the chance of readmission for that person is one in three. COPD patients utilize much more health care services and have nearly double the mortality odds at a given time than a similar person without COPD.

Pulmonary rehabilitation exercise along with care management is among the most effective treatments, but Broach said there is a shortage of respiratory therapists, and the service is underprescribed and underutilized.

Working with the Wellinks disease management model and CareEvolution health data platform, the Healthy at Home program will enroll in the pilot study 100 adults diagnosed with COPD who are part of the UMass Memorial Medicare Accountable Care Organization and at risk of requiring acute care within the next six months.

The study will follow patients over six months, evaluating the impact of components of the program including: mobile integrated health service, a physician-supervised team of paramedics available 24/7 to perform in-home medical care; mobile integrated health dashboard that displays biometric data from wearable sensors, results of patient-reported outcomes and relevant clinical data from the electronic health record; and Wellinks virtual-first COPD management solution, which combines virtual pulmonary rehabilitation, personalized health coaching, monitoring through connected devices to measure spirometry and pulse oximetry, and an easy-to-use patient app.

The UMass Memorial ACO will work with its partners to scale the intervention model with a larger patient population to increase clinical impact, if the study results demonstrate its effectiveness, according to Thomas Scornavacca, DO, chief medical officer for UMass Memorial Healths Office of Clinical Integration, the program that operates the ACO.

Soni said Healthy at Home differs from other COPD research in a few ways. One, were focused on maintenance of health at home prior to ER visits and hospitalizations, he said. And second, were increasing our ability to capture and understand data of patients from their home environment to improve our ability to predict what their medical needs are going to be.

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UMass Chan and Wellinks study mobile tools to keep COPD patients healthy - UMass Medical School

‘Long Covid is going to push us to get outside of our comfort zone’ – STAT – STAT

I first met Wes Ely in 2016, when I wrote about ICU delirium and Elys attempts, as a critical-care physician at Vanderbilt University Medical Center, to urge fellow health care workers to rethink the use of heavy sedation in ICUs. His research was an attempt to limit the crippling cognitive and physical impairments he saw develop in many critical-care patients long after they left the hospital, something he came to call post intensive care syndrome, or PICS.

Well, a lots happened since 2016. I thought of Elys work often as ICU care became a mainstay of the Covid-19 pandemic and wondered about the long-term prognosis of people who were so sickened by the virus theyd been heavily sedated and placed on ventilators to survive. Then long Covid showed up, and became something Ely grappled with as well.

Through a new book, op-eds, and a steady stream of TikToks, Ely has become a leading voice on the recovery that can take place after trauma or grueling illness and on the importance of preventing new Covid infections. As the pandemic marches on, hes increasingly concerned about the resulting epidemic of chronic disease society may face. I spoke with Ely about his concerns, what he initially got wrong about long Covid, what he finds humbling about medicine, and, why, despite all the suffering he sees and treats, he still holds hope. The conversation has been lightly edited for length and clarity.

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In your book Every Deep-Drawn Breath, you describe how you came to understand that ICU treatment may harm patients even as it allows them to survive. Can you describe this awakening you had and how it started you on your research trajectory?

I had the opportunity to care for a woman in her 20s named Tracy Martin. She had made a mistake and found herself, after an overdose, in the ICU. I was the primary doctor helping to take care of her. We worked so hard, with all the technology that we had, to try to get her through. At the end of the day, I thought, What a great doctor I am, I helped you survive this. When she came back to clinic weeks later, I was expecting a high-five, but I saw a woman who couldnt walk, who couldnt go to the bathroom, who couldnt shower. Her mother said, Wheres my daughter? What happened to her? She looks like an old woman now.

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As a physician, I had to face the fact that none of that stuff she was suffering was what she came into the ICU with and that I was complicit. I felt guilty about it. I knew that something that Id done had injured her but I didnt even know what. I started grappling with that and became kind of obsessed with figuring out how to get people off the ventilator sooner so they didnt get so much injury in the ICU. And thats what started me on a 25-year journey in this area.

Can you describe these issues you work on: post-intensive care syndrome and ICU delirium?

What happens with people who get critically ill and live in an ICU is they come in with one problem and under our noses, in the ICU, under our care [and due to sedation, ventilation and immobilization], they accrue problems in their brain, such as acquired dementia, PTSD, and depression. And then they accrue profound problems neck down in their muscles and nerves which leave them unable to walk, climb stairs, and live a normal life physically. So they become very disabled, cognitively, mentally, and physically. Thats what PICS is. ICU delirium is one of the strongest predictors of the development of post-ICU syndrome.

Like so many ICU physicians and other staff, you were on the front lines of the first Covid waves. What were your first impressions, and how did those evolve during the pandemic?

Taking care of the most critically ill patients who were on ventilators, dialysis, and other forms of life support was just an immensely profound experience. And I knew that those patients were going to leave the hospital, those who survived, with an immense amount of acquired disease, that this was going to be PICS to the extreme. So when people started talking about being long haulers and having long Covid, I just thought, those are the ICU survivors who have PICS. Through our CIBS (Critical Illness, Brain Dysfunction, and Survivorship) center, we started offering Covid survivor support groups we didnt even call it long Covid in the beginning. We started finding people who got out of the ICU and had PICS. And we had patients, and this was shocking to me, who got out of the ICU, their PICS was in a strong state of recovery, then 100 days later they would fall off a cliff. And I thought, What is that? That is not PICS.

Then there was a third group that never came to the ICU at all, went through a mild case of Covid but then came to our support group and said, I didnt have a problem until three months after Covid and now my life is ruined. I cant think well anymore, and I cant work. I have all these heart-racing problems and GI disturbances. I had originally thought, this is PICS and all these people dont know about PICS yet, but then I realized that long Covid was something completely different.

That must have been startling because your research focuses on people post-ICU?

Yes, I had to admit I was wrong. And I was so sure I was right. It was super humbling. But thats what I love about medicine: The second we think we know what we are doing, we fall flat on our face.

Youve spent two decades trying to get people to realize that being released from the ICU may not necessarily be the end of their medical or mental health issues. Do you see an analogy with Covid that just because you test negative after an infection, your problems are not necessarily over?

Absolutely. The rapid antigen test tells you when you have that virus active in your body, and when it starts going negative, you think, this has passed. But now we know that the virus can persist as a viral ghost in your GI tract, brain, and cardiovascular system, and that it can also alter your immune reactions. What happens is that over ensuing weeks and months, your body takes on a new set of diseases that you did not have at the end of acute Covid. Thats what we call long Covid.

Unfortunately way too many people with this are not being believed about their illness. And this has happened before, with long Lyme, and CFS, and fibromyalgia. And I will tell you, as a medical insider, that I used to think that those werent real. I was taught in medical school that they werent real. I was just with some medical students last week, and I talked to them about a patient of mine who had long Lyme. And they said we were taught that thats not real and these are current med students. This is something the ivory tower medical profession needs to realize long Covid is going to push us to get outside of our comfort zone with illnesses that we cant define. Because we dont like it when we cant understand something, but we have to get over that.

In your book, you describe saying to patients, I will not leave you. Its not something you typically hear doctors saying to patients, even in movies. Can you talk about how you communicate with patients, especially those with PICS and long Covid?

If a person is suffering pain, fear, illness with uncertainty about where theyre going to be going with this illness and they are seeking somebody who can help, they want to be cuddled and lifted up and have things explained on their level. And by cuddled, I dont mean physically holding because some people wouldnt want that. What I mean is paid attention to at an intimate level. You know, if somebody was in the streets and they were broken, Im not going to stand 20 feet away from that person and minister to them at a distance. And yet, when patients come into the ICU and theyre super, super sick, that distance caring is exactly what our culture evolved into, where instead of being at the bedside and holding their hands, looking in their eyes, oftentimes were caring for them from the door. Were looking at their monitors. Were adjusting their life support machines at a distance. And throughout Covid, we literally were outside their room with the glass door shut, a worst-case scenario. Thats why Ill whisper in their ear and say, Im present. Im your doctor. Im not leaving you.

Whats your message to doctors, not just in critical care but in any speciality, who are seeing patients with these complicated symptoms that are difficult to understand, let alone treat?

The first thing I say to my fellow physicians and nurses and health care providers is were busy. We dont have a lot of extra time, I get that. But it does not take that much time to be at eye level with a patient, look them in the eyes, hold their hands, and give them this compassionate message of your presence and the fact that you will not abandon them during this illness. And also to say, I dont have all the answers for you. For example, for long Covid, theres no treatment yet, but you can say to them, Ill stick with you as we learn more in the months and years ahead and well figure this out together.

Why did you decide to write your book?

As a physician who is also a scientist, I have an intense amount of discomfort at the bedside when I see that we do things that dont have evidence to back them up. As a scientist, Ive conducted 25, 30 years of research and I realized there was a story evolving that no matter how many papers I published was never going to reach the lay public or other health care professionals who dont really keep up with the literature. Growing up in Louisiana with my mom, we read poetry, she edited my essays, she taught me to love words. So I love writing and reading and literature and thats why I thought, Why dont I use the stories of my patients, with their permission, to leverage the power of literature to show people how we can be caring for people in the most humanistic way.

I asked each patient for permission to use their story. And one patient said, OK, but I dont want you to make any money off my story. After she said that to me, we decided that every penny in proceeds from Each Deep-Drawn Breath would go into an endowment to help people with long Covid. Weve hired social workers and are helping people find disability services all over the country and the world.

On a very different end of the communication spectrum, theres your TikTok account. Why did you start that?

So, Im 58 years old. You know, an old doctor. And if you had told me two years ago that I was going on social media and Twitter, I would have said, Youre crazy. Theres no way. But two things happened. One was that at the beginning of the pandemic, a lot of doctors around the world were writing me and saying, theres so much ICU delirium, weve got to study this. And they said if you get on Twitter, we can find the patients faster. I said fine. Ill open a Twitter account and we will advertise for the study on Covid delirium. We enrolled 2,100 patients in two weeks. And so I decided to stay on Twitter to share and validate peoples stories and spread good science about long Covid and brain dysfunction and PICS and such.

And then about six months ago, people in the office said you need to get on TikTok and I said, No, Im drawing the line. But theres this crazy set of misinformation being spread on TikTok, misinformation so egregious that I thought, You know what, Im just going to try five videos and see what happens. So all I do is I sit in my office, flip my phone around, and give a two to three minute message on some topic, and I post it. I dont spend any time on it, theres no production. Its super old school. But if its helping people, then Ill keep doing it.

Entering the third year of the pandemic, there is so much anguish and strife right now, and possibly a wave of chronic disease that patients, health workers, and society at large will be facing. Yet you remain hopeful. Can you explain why people with long Covid should hold similar hope?

They can absolutely heal. The brains capacity to heal is so much greater than what people give it credit for. We have trillions and trillions of neurons and connections, and these things can regrow. So, if a patient gets this brain fog and they think, Oh, my gosh, Im never going to get back again, I always tell them, do not lose hope because you will find recovery. And whether its mitochondrial disease or glial cells that have died, or vascular clotting that develops into long Covid, your body has this capacity to recover, and you must remain hopeful that you can get through this. And we are working hard as scientists to do the right trials to find answers. I just want people to hang on and know were going to stick with them and not abandon them during the process.

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'Long Covid is going to push us to get outside of our comfort zone' - STAT - STAT

Decolonizing Healthcare Education and Practice – Non Profit News – Nonprofit Quarterly

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This is the fourth installment of a five-part series,Reclaiming Control: The History and Future of Choice in Our Health, examining how healthcare in the US has been built on the principle of imposing control over body, mind, and expression. However, that legacy stands alongside another: that of organizers, healers,and care workers reclaiming control over health at both the individual and systems levels.Published in five monthly installments from July to November 2022, this series aims to spark imagination amongstNPQs readers and healthcare practitioners by speaking to both histories, combining research with examples of health liberation efforts.

In their new book, Inflamed, doctors Rupa Marya and Raj Patel explore how colonialism makes us sick while also shaping our core beliefs about how healthcare providers should make us better. For example, Lakota elders in the book describe the forces that led to widespread prevalence of diabetes in their communities: colonizers arrived and dammed a river that traditionally fertilized a rich river valley where nutritious food and medicinal plants utilized by local peoples grew. As this ecosystem was erased, and as the impacts of erasure and assimilation took hold, the Lakota became less active and were forced to rely on the food and medicine of their oppressors, rather than their ancestors. Marya and Patel point out that skeletal evidence backs up these claims, showing a marked difference in Indigenous remains excavated before and after European invasion. However, they also point out a paradox that comes with this data, writing:

If you find yourself more convinced by studying skeletal remains than by listening to the oral histories of Indigenous people, youre a participant in a colonial system of organizing truth. Reconstructing history through bones misses much that oral histories capture. Yet, in a colonial world, stories passed down by Indigenous elders cannot be considered true until they are validated by the empires that colonized them.

This tenet applies not only to our society writ large, but also to healthcare professionals. As physicians, the authors grapple with their own training, pointing out that modern clinical professionals are taught to be biomedical technicians rather than healers. Inevitably, they fall short when root causes of poor health, from structural racism to food insecurity, present themselves.

The COVID-19 pandemic and the national uprisings on race that took place in summer 2020 further exposed the shortcomings of our current paradigm for training, recruiting, and deploying healthcare workers. Coverage of the harrowing experiences that healthcare workers endured over the past two and a half years highlights not only the trauma that the pandemic inflicted on such workers as they cared for surges of critically ill patients with limited supplies and equipment; it also shows the stress caused by underpayment and overwork, divisive, politically driven policy shifts, and the disproportionate morbidity and mortality burden that low-income and BIPOC communities face. BIPOC healthcare workers, as well as frontline support staff, home care workers, and service staff, all of whom are deprioritized within the medical hierarchy, experienced additional layers of threat: racism and xenophobia inside and outside of their institutions and a compounded mental health toll. Since the pandemic began, 20 percent of healthcare workers in the US have quit their jobs, and healthcare labor shortages are now a major challenge for the sector.

Healthcare staffs feelings of powerless in the face of broader societal forces, however, are not unique to the pandemic. Almost two decades ago, as an undergraduate patient advocate, I experienced this dynamic up close. At clinics in East and West Baltimore, I had the opportunity to partner with individuals and families who presented not just with individual health issues like asthma and lead poisoning, but also with social issues: a crumbling rowhome with asbestos dust; limited fresh food options in the neighborhood; a bureaucratic social services system quick to judge Black and Brown families. Many of the clinics I worked in had one social worker for every 5,000 patients, presenting an impossible capacity challengeeven when medical staff asked about patients life situations and referred patients to social work or our advocacy program to identify helpful resources. While not all the clinics physicians, nurses, or medical staff felt obliged to address the impacts of social forces on their patients lives, most didbut they had limited training, resources, and time to do so.

In the first few articles of this series, we covered the political history of our healthcare system and the role that organizers and healers play in imagining what the future could hold. But what role will healthcare workers have in that future? As actors who benefit from the existing healthcare system while facing harsh challenges within it, healthcare professionals hold a specific positional power and can play a unique role. Even for those of us that have faced trauma inside healthcare institutions, or who have reason to distrust the system as a whole, healthcare workers can still act as trusted messengers and crucial lifelines during the uncertainty of seeking care for ourselves or loved ones.

Much of medical educations current pillarsthe separation of public health and medicine, a focus on treatment rather than preventioncan be traced to a 1910 report prepared by Abraham Flexner. In an effort to standardize curricula across medical schools, the report prioritized a biomedical care model that excludes social and environmental factors. It reinforced a healthcare model, including a paternalistic doctor-patient complex, adopted by institutions that only white males could access. That prioritization also led to the closure of many historically Black medical colleges.

What would it look like to reimagine the tenets of healthcare education through a host of lenses, voices, and teachers who take a more holistic, healer-rooted approach? Many training programs are now adding anti-racism frameworks and a focus on health equity to their classrooms. The Institute for Healing Medicine and Justice, launched in 2020 by a community of medical and graduate students at the Joint Medical Program of UCSF School of Medicine and UC Berkeley School of Public Health, envisions a new medicine that centers healing, community, and justice. They seek to bridge their own educational experiences with multidimensional healing paradigms that have long been promoted by women, people of color, disability activists, queer organizers, and healers across cultures.

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With a community of more than 3,000 people representing 300 institutions, the institute focuses on establishing a new, ground-up praxis for medicine, consisting of interdisciplinary research working groups, community healing gatherings, a justice hub, and a peer-reviewed publication. Along with the Othering and Belonging Institute and the Center for Race and Gender at UC Berkeley, the group published Toward the Abolition of Biological Race in Medicine: Transforming Clinical Education, Research, and Practice, which traces the history of white supremacy and racism in healthcare training. The publication also points out that epigenetics, the study of how the environment can alter gene expression, promises to deepen understanding of how racismand not raceimpacts health outcomes. The also launched the Freedom School for Intersectional Medicine and Health Justice, a community organizing effort led by Bernie Lim and Nicole Carvajal, both women of color in the Joint Program. The Freedom School re-imagines medical praxis and creates community for women of color in medicine, offering a community organizing model, an alternative syllabus populated by critical studies frameworks, and a fellowship for people interested in intersectional healing, medicine, and/or public health initiatives.

One additional effect of the Flexner recommendations was that advocacy training is largely absent from clinical curricula. While this has started to shift in the past 20 years, such training is still rarely seen in clinical classrooms, and when included, it varies from program to program: some programs focus on social determinants of health policy, while others focus more on advocacy to ensure the healthcare professions viability as a whole. This lack of training contributes to missed opportunities for the sizable healthcare workforce trusted experts with a front row view of the challenges involved in improving patients healthto leverage their collective power to enact change.

People Power Health, which trains health professionals in community organizing skills in order to set them up to redress power and resource inequities, aims to agitate healthcare workers to co-create just systems for communities, caregivers, and clinicians alike via trainings and fellowships targeted at different sections of the healthcare worker ecosystem, including clinicians interested in health justice, immunization professionals, climate health organizers, healthcare professionals focused on civic engagement and voting, and more.

Pedja Stojicic, executive lead of People Power Health and a physician by training, shares the role that a power-building community for healthcare professionals can play in moving physicians from an individualistic, passive mindset to one of collective action:

Right now, many [medical residency programs] are thinking about health equity tracks. But what is still problematic is its [just] awareness generation. Medical education itself is organized in such a way that is focused on individuals. The fact that [participants in People Power Health programs] often need us to see their colleagues as a sense of solidarity in pursuit of change is mind blowing. These are the facts of the system: a session outside of it can bring solidarity, hope, etc.

A collectivist approach may also enable healthcare professionals to move beyond defensiveness about their role in a system that often causes harm and to leverage their power beyond the context of an individual patient. Sam Gonzales, a member of the People Power Health core team, points out the value of the relational organizing on which the organization is focusing. Such organizing can be built upon to identify institutional or policy-level campaigns that members want to engage inan antidote to project proliferation, in which healthcare trainees identify an initiative they want to engage patients or community members in, but without first building rooted relationships. When I was in high school, I had a cancer diagnosis, and that helped me to see some of the health inequities that were in the Mexican health system. and when I went into medical school, I saw that it was more than just a drug or a treatment that was involved, shares Gonzales. Racism, classism, poverty. That is how I came to politics, policy to organizing. And then wow, to meet other professionals who are working on these topics was incredible.

Significant work remains to be done if we are to shift the healthcare systems core pedagogy. These efforts, however, point to a small but growing movement that is underway, spearheaded by a growing number of healthcare professionals who refuse to accept the status quo. Often lifted up as heroes, healthcare staff are in reality humans frequently tasked with doing challenging jobs in a system with a long history of harmand are increasingly also challenged to examine their own agency within that system. These models provide an emerging vision of how these individualscharged with caring for the rest of uscan move from healthcare to healing.

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Decolonizing Healthcare Education and Practice - Non Profit News - Nonprofit Quarterly

Where Iowa House District 30 candidates stand on the issues – Des Moines Register

Des Moines Register staff| Des Moines Register

From 2022 races to caucus action, what to watch for in Iowa politics

It's an election year: Look for no shortage of news from Gov. Kim Reynolds' and Sen. Chuck Grassley's reelection races to early Iowa caucus action.

Megan Bridgeman, Wochit

Republican Jerry Cheevers is running against Democrat Megan Srinivas to represent Des Moines' south side in the Iowa Legislature.

The two are seeking to succeed Democratic state Rep. Bruce Hunter, who is retiring at the end of his term, for the seat in the redrawn Iowa House District 30. Cheevers has run unsuccessfully against Hunter in two previous campaigns. Srinivas won June's Democratic primary, defeating Democrat Eddie Mauro.

To help voters, the Des Moines Register sent questions to all federal, statewide and Des Moines area legislative candidates running for political office this year. Their answers have been lightly edited for length and clarity.

Cheevers did not respond to the Register's request to fill out a questionnaire.

Early voting begins Oct. 19 for the Nov. 8 election.

More:A guide to voter rights in Iowa. What you need to know before you cast a ballot

Age:No response

Party: Republican

Where did you grow up? No response

Current town of residence: Des Moines

Education: No response

Occupation: No response

Political experience and civic activities: No response. Cheevers previously ran for the Iowa House in 2018 and 2020.

Age:35

Party:Democrat

Where did you grow up?Fort Dodge

Current town of residence:Des Moines

Education:

Occupation:Physician

Political experience and civic activities:

Cheevers: Did not respond.

Srinivas:I became a doctor to help my community, but so many of the challenges that my patients and neighbors face are systemic problems that I cannot solve with my prescription pad. The reason Im running is to address those issues, the social determinants of health that keep people from living the quality of life they deserve. This includes making sure people have access to the things that they need to succeed, such as food, housing, transportation, good jobs, and education. All of these factors are critical to ones health, and I will advocate for my community using this holistic approach.

More:Where Sonya Heitshusen & David Young stand on key issues in the House District 28 race

Cheevers: Did not respond.

Srinivas:We need to bolster our small businesses, especially after the economic hardship of the last few years. Ill also work for all Iowans to have access to a living wage protect pensions, including IPERS and 411, so workers enrolled in these plans remain secure in their retirement. Additionally, affordable childcare is a hurdle for many in the workforce. We must support childcare businesses in the face of rising operational costs that caused many to close over the pandemic. We can also adopt an income-based tax credit to create affordable childcare options. These upfront investments to create viable childcare options will spur economic growth for the state.

Cheevers: Did not respond.

Srinivas:As a physician, I strongly believe that an individuals healthcare decisions are their own and should only be discussed with their medical team. Ill advocate for an individuals right to abortion care. Ill also fight against efforts to remove insurance coverage for contraception and family planning. In 2017, our state stripped family planning health centers of public funding if they are affiliated with an abortion provider or even discuss abortion as a healthcare option. One of my goals is to reverse this policy and improve delivery of reproductive health services in every part of our state.

More:Where Iowa House District 27 candidates Kenan Judge & Kristen Stiffler stand on key issues

Cheevers: Did not respond.

Srinivas:We need to increase our supplemental state aid (SSA funding) to public schools to not just meet inflation, but to make up for the underfunding of the last decade. We need to change the narrative from our legislative leaders about our teachers and school staff, recognizing the critical and hard work they do rather than attacking them. We can improve teacher recruitment and retention by increasing teacher pay and creating programs to help with education loans for individuals teaching in high-need areas. We also must properly fund our public universities and community colleges. Additionally, I'll advocate to reinstate vocational curricula into schools.

More:Meet Todd Halbur & Rob Sand, running for Iowa state auditor in the 2022 election midterms

Cheevers: Did not respond.

Srinivas:

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Where Iowa House District 30 candidates stand on the issues - Des Moines Register

What is relational health, and why is it so important? – Contemporary Pediatrics

Rebecca Baum, chief, section of Development, Behavior, and Learning at the University of North Carolina, Hillsborough, North Carolina; and Katherine Wu, MD, FAAP, Pediatric Health Care Associates in Cambridge, Massachusetts began their presentation, Promoting relational health during health supervision visits with an anecdote of a mother sitting in a pediatricians office with 2 of her children, one rather unruly. If you dont stop misbehaving, Im going to get the doctor to give you a shot, the very stressed mother warned her child.

Comical or concerning? Using the Bright Futures Guidelines, 4th edition, a book that offers principles, strategies, and tools to improve the health and well-being of children through culturally appropriate interventions, the 2 practitioners went on to explain relational health, how the pediatric HCP can promote relational health during office visits, and offered both strategies and resources for attendees.

Baum and Wu explored 4 concepts during their session: adverse childhood experiences (ACEs); toxic stress; relational health; and strength-based approach. ACEs were categorized into 3 different types; neglect, abuse and household challenges, such as substance misuse, divorce, etc) along with other adversity (bullying, community violence, etc). ACEs can increase the risk for disease, early death, and poor social outcomes, Baum stated.

Toxic stress was explained as biological processes that occur after the extreme or prolonged activation of the bodys stress response in the absence of safe, stable, and nurturing relationships (SSNRs), the crux of this conversation. With SSNRs, children, even in the face of ACEs, can still grow up to be mentally and emotionally stable adults.Relational health, in essence is what creates these SSNRs, and the focus is on finding patient, family, and community capacities that can promote these SSNRs. How to create, though? As the presenters explained, the strength-based approach shifts the focus from a deficient model (emphasizing problems and disease detection) to health promotion and disease prevention, acknowledging the patient and familys particular skills that can promote family (and particularly patient) overall well-being.

Baum and Wu then shared examples through videos of doctors and parents discussing challenges in the family that could be impacting the patient. The key takeaways here:--the clinician should echo the mothers concerns (I am sorry to hear that you are going through the challenge of a divorce right now)-- then through positive reinforcement, help the parent to strategize additional solutions to the problem (It is great that you can work with your ex-husband in that way; would it be OK if I help you explore some additional options to come up with a solution to your childs misbehaving?).

If a family is successfully executing SSNRs, it will reap positive benefits; the child will demonstrate interest and curiosity to learn new things; complete tasks; and (one of the most important), stay calm and in control when faced with a new challenge (ie, moving to a new school).

Additionally, Baum and WU shared both screening tools and resources, and offered these final suggestions:--Assess a childs level of relational health as part of pediatric health supervision visits--Support families by utilizing the common factors approach (using hope, empathy, lay language, support; ask the family for permission to delve further with questions; and partner with family for solutions)--Provide prevention and treatment counseling and guidance to children and adolescents and their parents/families--Refer to local parent/child services when relationships are strained--Advocate for effective opportunities for focusing on relational health in schools, communities, and hospitals--Incorporate relational health in medical school curricula

ReferenceBaum R, Wu K. Promoting relational health during health supervision visits. 2022 AAP National Conference & Exhibition. October 9, 2022. Anaheim, California.

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What is relational health, and why is it so important? - Contemporary Pediatrics