From private islands to fancy cars, here are the things Jay-Z has gifted Beyonc – MSN UK

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What could you possibly gift a woman like Beyonce who seems to have everything? Including a killer voice, enviable dance skills and a career with some of the most iconic music in the past two decades?

Well, it seems her husband rapper and business mogul Jay-Z might just have the perfect answer every time.

Whether buying a private tropical island (casual) or getting thousands of (very famous) friends to sing along with him for her birthday, its safe to say that Mr. Carter seems to know what hes doing when it comes to buying gifts for his wife.

Jay Z and Beyonce perform at the London Stadium

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In honour of her 40th birthday, weve had a look back at some of the most lavish and heartfelt gifts that Jay-Z has given Beyonce throughout their relationship.

For Beyonces 32nd birthday, Jay Z decided to gift her a 213-foot luxury Galactica Star yacht valued at over $70 million.

Its without a doubt a superyacht and has tons of outdoor space, as well as a helipad. The couple have been spotted sipping on a glass of champagne while relaxing in the hot tub on the boat (Jealous? Us?). The yacht also apparently has room for 12 guests so the Carters can take their closest pals and family with them for the ride.

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For Beys 25th birthday, Jay-Z pulled up with a vintage, 1959 baby blue Rolls Royce convertible, which is estimated to be worth around $1 million.

Being megastars, privacy for Beyonce and Jay Z can surely be tough. Going on vacation like everyone else without a crowd is pretty much out of the question. So what did Jay do? He bought Bey a private island for her 29th birthday, of course.

Although there isnt much information out there about the island, it's located in the Florida Keys and is confirmed to be around 12.5 acres long with a private mansion for the couple to hang out.

For Beys 35th birthday, Jay ensured that she partied the night away with a star-studded soul train themed birthday party. Guests included Alicia Keys, Kendrick Lamar, Usher, Diddy and many more.

In his headline performance at Made In America Festival, Jay sang happy birthday to Bey for her 36th birthday. Two years later, Jay, Bey, and loved ones serenaded her again backstage at Made in America. She even received a splendid cake that read: Happy Birthday B!

Mother of Dragons, is that you?

Bey is reportedly a huge fan of Game of Thrones. A few years back, Jay was rumoured to have bought her one of the prop dragon eggs for the show.

Actress Emilia Clarke, who played Daenerys Targaryen, toldHarpers Bazaar: Apparently, Jay Z bought one for Beyonce or something... I dont know.

Its not 100 per cent confirmed as to whether or not Bey actually has one of the eggs, but it is described as really, really, really expensive by Clarke.

Jay gifted Bey a $95,000 butterfly ring designed by British jewellery designer Glenn Spiro.

Its made out of titanium and is decorated withtsavorites,which are 1,000 times rarerthan emeralds. Its a precious stone in the garnet group species, but is green instead of cinnamon in color due to the vanadium or chromium.

Its a stunner, but not the most practical. As a result, in 2018, Beydonated the ringto the Victoria & Albert Museum in London.

And they seemed to be over the moon with joy!

Beys ring is displayed alongside other pieces of jewellry once worn by royals such as Queen Elizabeth I.

Wonder whats in store this year?

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From private islands to fancy cars, here are the things Jay-Z has gifted Beyonc - MSN UK

Optimistic Researchers Say There Still Time To Head Off Climate Change Before It Starts Killing Rich People – The Onion

BERKELEY, CAIn a rare silver lining amid increasingly dire assessments of the climate crisis, optimistic researchers at the University of California, Berkeley, released a report Friday suggesting there was still time to head off environmental catastrophe before it started killing rich people. Though rising sea levels and powerful storms are devastating coastal areas, its not too late to stop floods from threatening those who live high above the water in multimillion-dollar penthouses, said climatologist and report author Dennis Gibson, explaining that by 2030, the wealthiest 0.01% of Americans would need to increase investment in charter helicopter services to ensure they would have a way to travel from a metropolitan high-rise to a vacation home without inconvenience. Similarly, rich peoples ski chalets in Wyoming, Vermont, and the Alps are at elevations that provide them with natural protection against flooding rivers. In the case of wildfires, however, they must act now if they wish to save their mountain retreats, mansions in wine country, and various other country estates. The time has come for the wealthy to stop these fires by buying up all the surrounding properties so they can clear-cut every single tree within a mile radius of their palatial homes. Despite its overall conclusion, the report stated that the climate crisis had already worsened to the point at which rich people really ought to start thinking about selling their private islands in the Caribbean.

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Optimistic Researchers Say There Still Time To Head Off Climate Change Before It Starts Killing Rich People - The Onion

Putin Says Private Businesses, Japanese Firms On Disputed Kurile Islands To Receive Tax Breaks – Radio Free Europe / Radio Liberty

VLADIVOSTOK, Russia -- Russian President Vladimir Putin says private businesses, including Japanese firms, operating on the disputed Kurile Islands will receive tax breaks in an effort to boost the local economy.

Speaking at the Eastern Economic Forum in the Far Eastern city of Vladivostok on September 3, Putin said private companies registered and physically present on the Kurile Islands will receive income and property tax breaks for 10 years.

"We have to create competitive conditions for our [Japanese] partners. It means the existing parameters of the tax burden, loan prices, the speed and quality of the state services for businesses here must be globally competitive," Putin said.

The sparsely populated islands have suffered economically since the collapse of the Soviet Union in 1991 as investment dropped and people left for better living standards on mainland Russia.

The Soviet Union seized the Kurile islands in the final days of World War II from Japan, which continues to assert territorial rights to the islands that it calls the Northern Territories. The dispute has kept Russia and Japan from signing a peace treaty formally ending the war.

Decades of diplomatic efforts to negotiate a settlement have failed to produce a solution to the issue.

"We think that the absence of the [peace treaty formally ending the World War II) in our bilateral relations is nonsense.... We have never refused from the dialogue on the peace treaty.... However, we must consider the realities, one of which is the necessity to secure a peaceful future and therefore to guarantee that there will be no U.S. armed forces, especially missile-assault systems near our borders," Putin said at the forum, adding that Moscow is awaiting Tokyo's response on that.

The three-day Eastern Economic Forum started in Vladivostok on September 2.

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Putin Says Private Businesses, Japanese Firms On Disputed Kurile Islands To Receive Tax Breaks - Radio Free Europe / Radio Liberty

An incredible private island for sale in the Summer Isles at the price of a central London parking space – Country Life

Crn Deas is a majestically beautiful private island off the north-west coast of Scotland, with a price tag that will have all of us checking our online balance and doing a few sums. Toby Keel reports.

There was a time when 50,000 could buy you a street full of houses. Even as recently as 1992, it was roughly the average cost of a house in the UK something thats almost unimaginable three decades later, especially for first-time buyers.

Of course, you can still buy properties, just about, for under 50k, if youre prepared to do a lot of work. But when you hear that number in relation to property in 2021 its generally for a parking space, or the outlandish weekly rental cost of the Mayfair mansion occupied by Adar Poonawalla, which set a record earlier this year.

So to find a 50,000 property which makes you rub your eyes in disbelief but in a good way is rare indeed. Yet thats what we have today in the form of Crn Deas, an uninhabited private island off the coast of north-west Scotland, which has just been launched to the market for offers over 50,000.

Carn Deas from the air, showing the stunning clear waters.

Its not rare to find estate agents waxing poetical, but even still the words of Goldcrest Land and Forestrys Fenning Welstead are striking: its stunningly rugged and romantic, they write. A remote sanctuary to the buyer seeking an escape to one of the countrys most wonderful natural wildernesses. Here, you can truly escape from reality, take a deep breath and enjoy what nature can offer.

That is a beautiful description for this dot on the map in the Summer Isles archipelago, which sit in the bay beyond Loch Broom, a little to the north-west of Ullapool. Sadly, the archipelago isnt named due to some devastatingly wonderful microclimate: instead, the island took their collective name thanks to the shepherds who used to bring their flocks here to graze in summer.

Crn Deas island itself is a 22-acre piece of land with beautiful views across to neighbouring Crn Iar to which it is connected by a shingle spit as well as to the mainland, with the mountains of Coigach and Assynt to the north and east, and the Fannich and Torridon hills to the south.

Accessing the island is a matter of a 25-minute boat ride from Badentarbat Pier near Achiltibuie, almost due east; or from Old Dornie Harbour to the north. You could bring your own boat and anchor off the island, and access it by dinghy. Crn Deas is sheltered both sides by neighbouring islands, which should make doing so relatively straightforward.

The sheltered, shingle beach at Carn Deas looks relatively straightforward for access via dinghy.

All that leaves is the question of what you could do with your island once it was yours. The island and all the neighbouring islands are havens for wildlife, birds and sealife. Porpoises and basking sharks are a common sight, and the waters are full of everything from mackerel and cod to lobsters and crabs. You can camp on the island and live off what you catch, enjoy swimming, snorkelling and the clearest night skies imaginable, and truly escape from modern life for a while.

Or you could spend that 50,000 on a central London parking space. Up to you really.

Carn Deas is for sale via Goldcrest for offers over 50,000 see more details and pictures.

On the banks of Loch Tay, the Old Village of Lawers has come up for sale with an eye-catching price

We take a look at the finest country houses, castles and estates for sale in Scotland, from an amazing renovation

Catch up on the best country houses for sale this week that have come to the market via Country Life.

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An incredible private island for sale in the Summer Isles at the price of a central London parking space - Country Life

Punta Mita, Mexico, Is Having Its Day in the Sun – Mansion Global

On the Pacific coastline of Mexicos Nayarit state lies a small, upscale resort community with a fast-growing population. Punta Mitas dreamy beach-and-jungle setting with plenty to see and do has drawn increasing numbers of remote workers, including many entrepreneurs, in recent years.

Punta Mita is a 1,500-acre private peninsula and a gated, high-end retreat with relatively accessible luxury property prices and an emphasis on rest and relaxation and outdoor pursuits. It offers ideal conditions for remote workers seeking more picturesque surroundings in which to work. Its safe, modern and immersed in nature, plus its a short flight from the West Coast of the U.S..

The sanctuary-inspired, luxury residential resort in west Mexico, just outside Puerto Vallarta has an expanding luxury real estate market and many luxury brands, including two Jack Nicklaus signature golf courses, and top-of-the-range hotels by the Four Seasons, W, St. Regis Punta and the five-star private resort estate of Casa Aramara. All of this is set along a pristine coastline and within its lush interior, which teams with plants, birds and other wildlife.

More: Haddington Offers Historic Homes, From Country Estates to Victorian Townhouses, Just 20 Miles From Edinburgh

Local agents report soaring demand for homes in Punta Mita over the past year or so, dropping inventory levels to a record low. The pandemic has made this destination grow even more popular with the elite for being private and secluded, said Brbara Livas, of Monterrey Sothebys International Realty.

You can enjoy a home with deluxe accommodation and many outdoor activities, she said.

Boundaries

Punta Mita sits at the top tip of the Bay of Banderas, in the Mexican state of Nayarit. It lies just off the Tepic-Puerto Vallarta highway, also known as the Riviera Nayarit Boulevard, which goes north to Sayulita, San Blas and Tepic. Its west, south and east borders are surrounded by the Pacific Ocean, and it is entered at the northern end via the roads Vialidad La Punta and the Federal la Cruz de Huanacaxtle Punta de Mita.

The resort is about 24 miles from the Licenciado Gustavo Daz Ordaz International airport in Puerto Vallarta, which serves multiple destinations in the U.S., including Los Angeles where flights take about three hours.

More: From Portugals Western Algarve to Salt Lake: Six Cities, Six Continents

Price Range

A nice but simple three-bedroom oceanfront home can start from US$350,000 while a luxury, ten-bedroom residence can cost as much as $12 million and sometimes more in some cases, Ms. Livas said, who added that properties can be sold in either US dollars or Mexican pesos.

Housing Stock

Punta Mita has a few standalone houses and mostly apartments and private villas that are part of private developments and resorts, which face the coastline and have serene and secluded ocean views, Ms. Livas said. There are about 20 communities in the resort, including branded private residences, estate lots, golf and waterfront condos, and hillside villas built in a modern and contemporary style with Mexican and Mediterranean influences, according to LPR Luxury Punta de Mita.

Many homes feature high-end amenities and stylish interiors. For example, the Four Seasons private villas have private infinity-edge plunge pools, gourmet kitchens and antique Mexican wooden doors, among other features.

Naya is a new beachfront apartment scheme created by the Mexican-owned One Development Group, housing 60 homes set across eight buildings spread over 11 acres. The complex is built in a minimalist style with concrete and wooden accents and has a 102-meter private beach and large balconies featuring plunge pools. Only one-third of the natural environment has been built on and the residences have ocean views and access to a team of staff, chefs, spa facilities, gym, pools and private beach, among other amenities, Ms. Livas said.

More: Open Spaces, Historic Homes and Rising Prices Define Australias Capital, Canberra

What Makes It Unique

Punta Mita is a gated, low-density, master-planned resort created 15 years ago by Mexican development company Dine who bought the 1,500-acre plot to create a luxury resort with high-end hotels and world-ranking golf courses. It appeals to an exclusive group of people for many reasons, but primarily because of the excellent value it offers in terms of luxury, accessibility, privacy, and a beautiful setting in a secure gated, oceanfront community, Ms. Livas said.

Punta Mita comes from the Aztec word mictlan meaning gateway to paradise and it lives up to its name. The peninsula boasts a lush, jungle setting with a hill overlooking the ocean and has idyllic sandy beaches and coves all along its three sides. It has waters with a kaleidoscope of bright blues and the volcanic Marietas Islands (15 minutes offshore).

Many people come to Punta Mita to unplug and unwind. Its a trend recognized by the hotels on the island with St. Regis Punta Mita Resort encouraging guests to detox from the digital world and reconnect with nature with its new Disconnect to Reconnect package.

From Penta: Future Returns: Investing in Post-Pandemic Fitness and Wellness

Luxury Amenities

Punta Mita is a great place to relax on the beach and not do much else, but there is plenty to keep residents who want more occupied.

At Club Punta Mita, there is the 72-hole, Jack Nicklaus Signature Punta Mita Pacifico Golf Course set on the northernmost point of Banderas Bay, a tennis center, and residents beach club. Punta Mitas other Jack Nicklaus Signature championship par-72 course is called Bahia and offers pars with fairways meandering through the St. Regis Resort, El Encanto, Porta Fortuna and La Punta Estates communities. Nicklauss Pacifico course features the famous Tail of the Whale holean optional part of the course that requires golfers to play their first shot from an onshore tee box to an island green located on a natural rock formation.

The Kupuri Beach Clubs dedicated concierge person guides members through state-of-the-art spa services and recreational activities at Punta Mita Ocean Sports program, which has top-line equipment. Meanwhile, Sufi Ocean Club in the Porta Fortuna community is a new addition and features a curving, beachfront saltwater pool, a stately reception hall, wooden poolside cabanas and seaside dining at the Sufito Cevicheria Bar.

More: Sustainable and Smart: South Koreas Songdo Offers Green Spaces and Good Schools

Across the peninsula, there are walking trails amid nature, while the top local surfing spot at the Cove is a short water taxi ride away. Head to the summit of the nearby 1,150-foot Monkey Mountain in the Higuera Blanca community for impressive coastline views. Meanwhile, the wildlife-filled Marietas Islands have great snorkeling opportunities and the Instagram-worthy Hidden Beach set within a man-made crater.

The W Punta Mita offers a range of dining experiences, including its signature restaurant, Spice Market, which is a must and features a Southeast Asian-inspired menu, as well as Cevicheria, which serves ceviche and craft beers by the ocean. The Four Seasons Punta Mita restaurants include Dos Catrinas, which has authentic Mexican fare with a contemporary twist, and the Asian-inspired Aramara, while Carolina at the St. Regis Punta Mita Resort offers a AAA Diamond Award dining experience and modern Mexican cuisine.

Both the St. Regis and Four Seasons resorts host rotating art exhibitions by contemporary and traditional Mexican and Latin American artists throughout the year and as well as casual clothing stores. Outside of Punta Mita, explore the numerous art galleries and artisan shops in the beach resort city of Puerto Vallarta, an hour away, and in the coastal town of Sayulita, 30 minutes north of Punta Mita.

Puerto Vallartas well-regarded schools include the Instituto SPAC or ISPAC, a private co-ed school for pre-school, primary and secondary students; the British American School, which offers education to students from kindergarten to the 12th grade; the American School of Puerto Vallarta, a private, bilingual and bicultural school for pupils ages 3 to 18.

More: Sandton, Africas Richest Square Mile, Offers a Wide Range of Luxury Homes and a Bustling Economy

Who Lives There

Its mostly wealthy Mexicans and Americans and many have chosen the resort as a refuge from the pandemic, Ms. Livas said. For some its a vacation home, for others its a second home. The people who live here are part of a community of individuals who share tastes for the finer things in life, she said. They love to have a fun and relaxing time just as much as they like to work hard. Within the last ten years, the entrepreneurial community has begun to make a strong move here and has become one of the leading buyers of Punta Mita real estate.

Famous Residents

Bill Gates and Tim Ferris own property on thebeachfront in Punta Mita, according to Ms. Livas. Jack Nicklaus designed the Pacifico golf course a few years after he started to regularly holiday at the resort in the late 1990s.

More: Buyers Are Flocking the Golden Triangle of Portugals Algarve Region

Outlook

Theres a positive outlook for the Punta Mita market over the coming year, Ms. Livas. Punta Mita real estate trends have been very favorable, even in a post-pandemic world. It has become a highly desirable location, especially with the growing acceptance of remote work.

Alejandro Aldrete of The Agency says that sales have been out of control since last summer. He added that inventory levels are very low because everything is being bought and that the market is as hot as its ever been.

Click for more profiles of high-end neighborhoods around the world

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Punta Mita, Mexico, Is Having Its Day in the Sun - Mansion Global

The Return of the Dream Honeymoon – The New York Times

When Kalyn and Collin Pounders finally went on their honeymoon to Greece in July after delaying it for more than a year because of the pandemic, they were ready to splurge. The couple, who live in Atlanta and married in June 2020, extended their trip so that they were able to visit Mykonos and Santorini islands, got a nicer room at the hotel they had booked and even went on a private cruise.

At first, Ms. Pounders, 25, wasnt planning on taking the advice of her friends, who told her that this was a once-in-a-lifetime trip and that she shouldnt hold back on luxuries. But thats exactly how she and Mr. Pounders, 27, ended up approaching the vacation after the months of waiting and pandemic hardship. Were really glad we took that advice, said Ms. Pounders, who works as a clinical pharmacist. Her husband is an investment analyst. Weve waited for this, we worked really hard in between, she said, and when the time finally came, we were like Why not? We deserve it.

After the pandemic forced a halt for many honeymoons, this summer has shown indications that theyre back and bigger and splashier than ever before. The Travel Siblings, a New York-based travel consultancy that focuses on romantic trips, saw its honeymoon bookings, as of July, quadruple since last year. More than 70 percent of couples who married last year went on or are planning to go on a post-wedding getaway, a figure that is up almost 20 percent from 2020 and back to prepandemic levels, according to a recent report from WeddingWire.

The Pounders are far from alone in forgetting frugality on their postponed honeymoon. We absolutely can say that honeymoons are back with both a passion and a vengeance, said Harlan deBell, an owner of the Travel Siblings. Kara Bebell, also an owner, added: Since many couples have had to postpone their wedding dates several times, they are splurging more on hotel upgrades and private romantic experiences. Before the pandemic, the companys clients typically spent around $16,000 on a honeymoon trip. Now they are seeing that couples who had to postpone their original honeymoons are spending more than $20,000.

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The Return of the Dream Honeymoon - The New York Times

Hilton to Debut in Spectacular Santorini with Stunning Beachfront Property – Hospitality Net

Opening in 2022, all rooms at the Sea Breeze Santorini Beach Resort, Curio Collection by Hilton, will boast private terraces and a hot tub or pool.

Hilton (NYSE: HLT) announced the signing of a franchise agreement with Alexandros Ltd to open Sea Breeze Santorini Beach Resort, Curio Collection by Hilton. Due to launch in Spring 2022, the new 37-room hotel will be Hilton's first on the glamorous Greek island, complete with private beach.

Each room in the new premier development, which is built on the south coast of the island with a private beach, will benefit from its own private terrace and guests will be able to take a dip in their own personal hot tub or swimming pool. The hotel's exceptionally designed rooms take inspiration from Santorini's iconic blue and whitewashed architecture, as well as incorporating the island's rugged natural beauty with stone walls and organic wooden textures. Guests will be able to choose between the hotel's two restaurants and two bars for a relaxed bite to eat or cocktail, with two of the outlets being located on the resort's private beach. With two pools, a spa, fitness facilities and loungers by the beach, guests can alternate between working up a sweat, being pampered relaxing and cooling off with a dip in the water.

On the southern tip of one of Greece's most popular islands, the Sea Breeze Santorini Beach Resort, Curio Collection, is a short drive from Santorini's most popular sights. From the architecture of the island's cosmopolitan capital Fira to the prehistoric city of Akrotiri, visitors can explore the volcanic island's many must-sees without straying too far from the hotel. Less than two kilometres from Vlichada, a bustling marina full of seafood tavernas, attractions like the Santorini Arts Factory and neighbouring black-pebble beach, guests can explore Santorini against a backdrop of volcanic cliffs and visit colourful beaches like the famed Red Beach and iconic Perissa Black Sand Beach.

Curio Collection by Hilton is a global portfolio of more than 100 one-of-a-kind hotels and resorts, all offering a unique way to experience incredible destinations. In recent years, Hilton has signed an ever-increasing number of Curio Collection by Hilton hotels, with 66 hotels currently in development. The Sea Breeze Santorini Beach Resort will be the latest Grecian Curio hotel, following the recent opening of The Royal Senses Resort & Spa Crete, Curio Collection by Hilton in June.

The Sea Breeze Santorini Beach Resort, Curio Collection by Hilton will join the award-winning Hilton Honors guest loyalty programme, allowing more than 118 million members who book directly with Hilton to earn Points for hotel stays and experiences, plus instant benefits including contactless check-in with room selection, Digital Key and Connected Room.

Sea Breeze Santorini Beach Resort, Curio Collection by Hilton will be located in Exomitis. Hilton currently has two trading hotels in Greece under the brands Curio Collection by Hilton and Hilton Hotels and Resorts.

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Hilton to Debut in Spectacular Santorini with Stunning Beachfront Property - Hospitality Net

Saint Lucia Island Innovation Ambassador to Participate at Virtual Island Summit 2021 – St. Lucia News From The Voice – The Voice St. Lucia

MICHELLE N. Samuel, Island Innovation Ambassador from St. Lucia will be involved in this years Virtual Island Summit (VIS). The Summit, to be held entirely online over the course of September 6th-12th, 2021, will feature heads of state, academics, and entrepreneurs from global islands, including St. Lucia, to discuss a range of complex issues including but not limited to: the COVID-19 pandemic, the climate crisis, sustainable development, renewable energies, responsible tourism, and many others.

In the run-up to the VIS, the Island Innovation Ambassadors from +350 islands worldwide have had the opportunity to communicate and liaise with each other, serving as bridges between their communities. This has provided an opportunity to connect distant islands and to amplify the voices of politicians, entrepreneurs, innovators, activists, and community leaders on the challenges faced and solutions being developed on islands worldwide.

The ambassadors will be representing the interests of their islands and able to discuss with other attendees, speakers, and decision-makers throughout the VIS. Anticipated to have over 10,000 island stakeholders in attendance, the VIS is the only global summit bringing together stakeholders from around the world and enabling the public to listen in.

This will be my second time representing St. Lucia in the capacity of Ambassador at VIS. Last years summit featured local artiste Mr. Ronald Boo Hinkson and Speaker Mr. Didacus Jules. This year is especially welcoming, that the Prime Minister of St. Lucia Hon. Phillip J. Pierre will be participating as a key speaker from the Western Hemisphere. The main theme for the Summit this year is Sharing Knowledge for Resilient, Sustainable and Prosperous Islands Worldwide, so it would be very interesting to hear what he and other key leaders have to say, Samuel said.

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James Ellsmoor, Island Innovation founder, commented: The Island Innovation ambassadors play an incredibly important role in transmitting sustainable innovations between island communities and sharing best practices. This years ambassador cohort is incredibly passionate about economic and environmental issues facing islands, international cooperation, and sustainable development.

Island Innovation brings together the private sector, government, utilities, NGOs and universities to advance innovation for sustainability and prosperity in islands worldwide. For more information, visit the Island Innovation Website.

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Saint Lucia Island Innovation Ambassador to Participate at Virtual Island Summit 2021 - St. Lucia News From The Voice - The Voice St. Lucia

Big 12 vs. The World: Conference eyes expansion as commissioner stands by collusion accusations – CBS Sports

Bob Bowlsby's flight touched down the afternoon of July 21. The Big 12 commissioner was on a routine campus visit to Kansas.

"My phone went off," Bowlsby recalled. "It was about 3 o'clock."

It truly was one of those where-were-you-when moments. Major news broke that day: Texas and Oklahoma are in talks to join the SEC.

It was true, and it was awful for the Power Five's most experienced commissioner and his eight remaining schools. The shock hasn't worn off for the 69-year-old administrator.

Bowlsby still believes ESPN conspired with SEC and American to (perhaps mortally) wound his league. Bowlsby has not shared evidence to this end; both ESPN and AAC commissioner Mike Aresco denied the accusation.

"You know me well enough," Bowlsby told CBS Sports this week. "I wouldn't have said it unless it was absolutely true."

Bowlsby hasn't lost any part of his bravado since that day. Asked if it's possible to mend fences with a powerful rights holder in future negotiations, Bowlsby did not relent.

"Any time you speak truth to power, you run risks," he said.

That's a glimpse of the Big 12 five weeks removed from the Texas-Oklahoma news and one week away from its 27th season. Things were never supposed to be this uncertain. At the Big 12 Media Days last month, Bowlsby kiddingly thanked reporters for not "asking the expansion question. I think I won five bucks on that."

Now, you can't think of the Big 12 without thinking of expansion for an entirely different reason than the league's ultimately fruitless look at adding members five years ago.

Asked how he's doing lately, Bowlsby sarcastically replied, "Oh, I'm having a wonderful time."

"It's been a long month," he added. "There's not any way to put a good face on it. We were shocked at the announcements. We were given no indication of displeasures on [Texas and Oklahoma's] part. I share those feelings, and everybody associated with us shares those feelings."

CBS Sports spoke to Bowlsby on a variety of subjects regarding his conference during an unprecedented time of upheaval. Safe to say it has suddenly become the Big 12 against the world.

Industry sources say the league's media rights value has decreased at least 50% with the losses of Texas and Oklahoma.

The Pac-12 has decided it will not expand for the moment, eliminating safe haven for any Big 12 schools that were looking West. The Big Ten, ACC and Pac-12 went off on their own to form an alliance largely to fight perception of the SEC's growing power.

"Hopefully this will bring some much-needed stability to college athletics," Big Ten commissioner Kevin Warren said. " Some of the events over the last couple of months have shaken the foundation of the beliefs of college athletics."

None of the alliance conferences called Big 12 to participate.

"We want and need the Big 12 to do well," ACC commissioner Jim Phillips said. "The Big 12 matters in Power Five athletics."

Actually, what was once a Power Five now looks more and more like it will be a Power Four unless the Big 12 expands. You can understand the angst at the conference headquarters in Las Colinas, a planned development in the Dallas-Fort Worth metroplex.

"Not surprisingly, everybody is watching their backside," Bowlsby said. " Trust in the athletics ecosystem is not very high right now."

It is a tenuous existence for the Big 12. Publicly, it plans to hold Texas and Oklahoma to the terms of the current ESPN/Fox contract, which runs four more years. But inside the conference, there's a feeling the two giants will use any available excuse or legal maneuver to bolt early.

As such, the Big 12 in late July formed an expansion subcommittee made up of officials from Baylor, Iowa State, Kansas and Texas Tech.

"As you would expect, [it is] a smaller group that can facilitate thought and conversation that we can bring back to the presidents and athletic directors," said Texas Tech athletic director Kirby Hocutt, one of the subcommittee members.

The Big 12 is in the ironic position of needing expansion candidates it rejected five years ago. Those would include UCF, Memphis, Cincinnati, Houston and BYU, among others. Back then, the Big 12 chose not to exercise a clause in its ESPN/Fox contract that would pay $1 billion if it added any four schools.

The league stayed at 10, in part, so as not to antagonize its rightsholders. Now the commissioner who helped make that decision is at odds with ESPN.

There is the uncertain possibility of Kansas basketball -- a top-five program -- playing in the AAC or Mountain West. That is possible because, even in its depressed state, Kansas football would bring 80% of the value to any conference contract. In other words, it's unlikely that basketball alone will carry Kansas through to another Power Five conference.

Even if the Big 12 continues at eight teams, its budgets will most likely be slashed because the league's worth has taken a hit. Will Iowa State be able to keep Matt Campbell? Will top-flight coaches in any sport be attracted to the Big 12? What will happen to the massive athletic debt services on some of these campuses?

Without the $37 million per school it gets from its media rights deal, will the Big 12 remain a Power Five conference? It may be four potentially agonizing years until the league knows as it waits for its current deal to run out.

"That isn't going to happen for a while," Bowlsby said. "I don't have any particular reason to be concerned about it."

He would like to be around for all of it. Bowlsby's contract runs through June 2025, the month that media rights deal expires.

With the news of the week -- alliance formation, Pac-12 standing pat -- there may some certainty. With no additional movement coming at the top, the Big 12 suddenly has expansion leverage over Group of Five conferences. That means the eight remaining schools, nicknamed "The Hateful Eight", just might stay together after all.

The best news: There is "significant interest" in the Big 12 from other schools, according to Hocutt. The Lubbock Avalanche-Journal reported Friday "at least 15 schools" are interested in joining the Big 12.

Oliver Luck -- the former West Virginia AD, NCAA executive and XFL commissioner -- is consulting with the Big 12 on expansion.

The league must proceed cautiously. If it expands too soon, that could give Texas and Oklahoma the legal leverage they need to leave the Big 12 before the end of the current contract in 2025. The schools would have to pay up to $80 million in penalties each to leave early. However, the Big 12 would still control the schools' TV rights.

The animosity towards Texas and Oklahoma will likely reveal itself on the field and courts as long as the two schools are in the Big 12. The blowback this time could be different than when Colorado, Missouri, Nebraska and Texas A&M left the league. The Longhorns and Sooners are two of the biggest sports brands in the country.

Mark your calendars for Oct. 2. That's the date both Texas (at TCU) and Oklahoma (at Kansas State) play their first conference road games since the announcement.

"We'll do every last thing we can to make sure their student-athletes have a great experience and fair experience and have the best circumstances they possibly can," Bowlsby said. "That's what we're professionally obligated to do."

There are already examples of untidy exits. In November 2010, Nebraska played its last Big 12 road game at Texas A&M on its way to the Big Ten. By the end of the 9-6 loss, the Cornhuskers were called for 16 penalties to the Aggies' two. There are accusations of conspiracy. At the time, the Big 12 commissioned an independent review of the officiating. It found no wrongdoing.

"I can't see Texas and OU waiting," said former Texas A&M president R. Bowen Loftin. "It's going to be next year. One more year. As an experienced person, it was no fun being at A&M going through a conference schedule in the Big 12. I was heckled everywhere I went."

Texas A&M left the Big 12 for the SEC in 2012.

Bowlsby remains a member of the College Football Playoff subcommittee that proposed a 12-team bracket expansion still under consideration.

One of his league presidents, West Virginia's E. Gordon Gee, told WVU's school newspaper the proposal is "on life support" and would not receive his vote due to the uncertainty created by Texas and Oklahoma moving to the SEC. Earlier this year, Gee was enthusiastically in favor of expansion.

Another example of things changing rapidly in the Big 12.

Elsewhere for Bowlsby, life is good. God is good. His granddaughter's recent successful heart surgery allows him to see past any league matters. The commissioner praised pediatric surgeon Charles Fraser, who is in residence at the Dell Medical School in Austin, Texas.

Fraser just so happened to attend Texas for medical school. Some things are more important.

"Chuck Fraser is an unbelievable, unbelievable guy," Bowlsby said. "Humble as the day is long, spends eight hours a day in little children's chests. He is an amazing healer. You're just a nicer person when you've been around your grandchildren."

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Big 12 vs. The World: Conference eyes expansion as commissioner stands by collusion accusations - CBS Sports

Virtual Objective Structured Clinical Examination | AMEP – Dove Medical Press

Introduction

Examinations are ubiquitous in the lives of medical students. The Objective Structured Clinical Examination (OSCE) is a high-stake clinical assessment that evaluates a broad range of competencies, including history taking, physical examination, communication/interpersonal skills, professionalism, clinical reasoning, and telemedicinewhich has gained importance since the COVID-19 outbreakand the ability to integrate these skills. Effective summative assessment using OSCE (sOSCE) is a time consuming, demanding, and costly operation. OSCEs are exceptional and distinctive in assessing competencies that are difficult to evaluate using other methods. OSCEs have superior psychometric properties. The psychometric attraction of the OSCE is that it assesses the shows how level of the Millers Pyramid with reliability and validity.1 The tips provided are based on available literature and authors expertise in managing formative, summative, and virtual OSCE experiences. Formative OSCEs are assessments FOR learning; they do not count toward a final grade and are for self-assessment purposes only. Summative OSCEs are assessments OF learning that count toward a grade. It has been said that When the cook tastes the soup, thats formative; when the guests taste the food, thats summative.

In view of the current times, the severity of the COVID-19 pandemic, and its effect of the administration of all types of OSCE experiences, face-to-face OSCEs have been converted to an online or hybrid format; as a result, tips on virtual OSCEs (vOSCE) have been provided as well. The pandemic has presented educators and learners with several challenges in conducting realistic OSCE experiences. Medical schools have become very adept in using technologies for the continuation of this educational experience. vOSCE is an emerging model for administration of OSCEs. The majority of medical schools in North America have avoided face-to-face learner/Standardized Patient (SP) contact. Very few medical schools provide telemedicine/TeleOSCE instruction to medical students.2 Despite the impediments posed by COVID-19, telemedicine has flourished, and it has been a glimmering highlight that advances medical students knowledge of this new technology through virtual OSCEs. Transitioning to a virtual videoconferencing mode, will necessitate dramatic changes to the administration of vOSCEs. Assessment endpoints needs to be consistent, thus educational objectives need adaption to the virtual milieu. Attributes of digital communication and webside manners need to be introduced. Furthermore, standardized patient training methodologies will require translation from in-person to the new environment as well. In the virtual environment, the medical history is obtained from the standardized patient, and the intended physical examination maneuver is verbalized by the learner. Virtual OSCEs necessitate the use of reliable digital videoconferencing technologies. Numerous commercial platforms are available. Training needs to be provided to learners, SPs, staff, and faculty for a seamless experience. Pre-brief session instructions are delivered in a virtual waiting room. Subsequently, each dyad (learner and SP) enters a timed virtual breakout room. A major challenge to overcome for the learner is optimization of engagement and non-verbal communication. This can be mitigated by explaining the encounter steps to the SP as the session evolves. Optimal camera positioning for appropriate framing will enhance the experience.

SPs are actors/laypersons who are highly trained to portray patients in OSCE stations for the purpose of teaching and assessment. Their performance is routinely monitored, evaluated, and reviewed by SP trainers and faculty. This is different from peer role play, in which the participants have no prior training. SPs do not replace real patients, are faithful to the standardization of the scenario case portrayal and are not supposed to express personal originality or inventiveness.

Most formative OSCEs and some sOSCEs utilize non-binary checklists3 as well as various global rating instruments. Notwithstanding the use of checklists by SPs for grading, it should be noted that an OSCE assessment is not a prescriptive checklist performance, as every encounter is distinctive, has its own climate, and needs to be customized to the door note/SP presentation. A successful OSCE depends on having a growth mindset and adjusting the process to the content.

Over the years, the evaluation of medical students clinical skills and performance has evolved from direct observation to OSCEs.1 With the exception of cost, this assessment format optimizes a number of variables such as objectivity, reliability, validity, and feasibility. The reliability of the summative OSCE, covering a wide curriculum, is increased by a large number of stations. The number of OSCE stations that are sampled vary from one medical school to another, from 5 to more than 15.4 However, 12 to 16 stations will cover a good range of content and provide an acceptable level of reliability (0.6 to 0.7).5 Rigorous training and assessment of SPs and the use of checklists ascertain the objectivity of an OSCE station. OSCEs have modest validity.6 In order to be valid, OSCE stations must assess a wide array of knowledge, skills, and attitudes that reflect the scope of the curriculum. Faculty will not conduct OSCE experiences on aspects that are not clearly defined in the medical schools course objectives or suited to the learners level of experience. The complexity of the scenarios can vary reasonably by faculty to accommodate the training level of the learners. To be feasible, an OSCE station, to some extent, needs to be straightforward and easy to manage. OSCEs are very resource intensive and take an astonishingly long time develop; it has been said that instructional systems designs traditionally follow a multistage, iterative model.7 This four-step process includes: Needs Assessment, Program Development, Design and Implementation, and Evaluation.7 Consideration should also be given to time, complexities of case development, number of available SPs, and faculty training.

The following compilation of 20 tips and pointers can help guide medical students preparing for OSCEs:

Most medical students and residents are successful in OSCEs. Although some face challenges and a few even fail OSCEs, the best solution is preparation and deliberate practice. Based on the experience of the authors, they can conclude that the most participants who have challenges in OSCEs need additional deliberate practice.

Know the environment of the clinical center and the OSCE venue. Take a tour before the OSCE experience. Most centers will be happy to give you a tour.

The door note used to be a clipboard; however, these days, it is a screen document. In some centers it may still be written on a clipboard. This is one of the most common causes of applicants not performing well in OSCEs. Because the door note is the road map of the station, time should be taken to read it carefully and follow its instructions. Do not do more than is asked or less than is directed. You must follow it exactly as you are told. If the instructions ask you to verbalize your physical examination in virtual OSCEs, you may use clinical terminology. If the instructions ask you to perform a toe examination, do not waste your time reviewing the history or the management. The SPs are provided with a pre-determined checklist and grade your performance accordingly. No extra grade is given. More is not always better.

It is imperative to avoid the use of medical jargon. Learners need to use simple laypersons language that will be understandable to someone with a fifth-grade education. Do not ask: Why were you admitted to the sickyou (SICU) after surgery? Instead, ask: Where were you admitted after surgery? If you use medical jargon, the SPs will act confused and may seek further explanation.

Avoid asking multiple rapid-fire questions strung together. In such situations, SPs are advised to answer only the last question put forth to them. An example of such a multiple, rapid-fire question would be: You seemed to be concerned about lung cancer. Do you smoke, drink, or cough up blood? Incidentally, what kind of work do you do and for how long have you been doing it?. This line of questioning is confusing to the patient and does not give the SP adequate time to mentally process what is being asked.

The mnemonic device WIPERS can be used after you enter the room and close the door. Establish rapport early, at the beginning of the encounter. Let the patient talk and do not interrupt; where appropriate, express empathy.

Patients are clued to the nonverbal behavior of the providers; thus, this mnemonic will be very helpful when dealing with SPs. Moreover, these are easy points in the checklist.

The SOFTEN mnemonic is used to enhance nonverbal behavior during the SP encounter.

SOFTEN nonverbal communication skills.

As the HPI: Timeline, not a Time Machine reveals,10 time is the main organizational element. Always begin with a starting point in mind: When were you well before all this started? The chronology of the story should begin at the baseline state of health and the narrative should develop and flow smoothly, in an insightful and judicious fashion, while managing the psychological safety of the patient. A diagnosis cannot be made without taking an all-inclusive and appropriate HPI. That being said, you cannot take the HPI without knowing how to do it. Do not forget to enquire about the setting and its effect on the patients day to day activities. Taking the HPI is probably the most important and difficult requirement of the OSCE. Always use a structured, fluent, and laser-focused approach.

An SP is an actor who has been faithfully trained to simulate a patient in the domains of history and physical, communication, and other necessary clinical skills with an authenticity that often cannot be distinguished by expert clinicians. In reality, the OSCE is a staged play11 that requires certain predetermined skills to be learned. Remember that SPs are actors, most of whom have been recruited from local theaters. That being said, this is not a mindset that medical students want to have. The key to success is think of SPs as real patients. SPs take their tasks very seriously, have to pass competency tests for each case, and are even re-assessed after performances if learners fail or if there are complaints.

An OSCE is an immersive experience and it is imperative to treat the SPs as real patients. Additionally, it is crucial to accept the SPs chief complaint as real and immerse oneself into the medical context of the simulation. In reality, the SP should be treated as the question in an examination. It is important to note that SPs rarely go off-script and will not provide all answers unless they are asked.

ICEing the patient at the end of the HPIusing the mnemonic ICE for Ideas/Impact, Concerns, and Expectationsinvolves asking the patient what s/he thinks is happening and how it has impacted his/her daily life as well as identifying what is worrying him/her and determining his/her expectations from treatment.

Signposting imparts structure and organization to the OSCE experience. It engages the SP and lets him/her share your thoughts. Acknowledge what you have discussed and use it to link the topic you will be asking subsequently (eg: So you have talked to me about your chest pain; next, I would like to discuss your risk factors for coronary artery disease).

Before you start the physical examination, it is useful to consider the mnemonic device SET UP:

At the end of the OSCE experience, a summary statement is expected and should be discussed with the SP. The summary statement heralds the end of the session, with the aim of restating the important salient information that you have obtained and is needed for continuity of care. It should always explain the next steps that will be taken. This will give the SP a chance to clarify the information if necessary. An example would be:

I know that, until now, I have given you a lot of information; at this time, I will summarize and discuss my findings, which will give you a chance to clarify the information and ask questions as well.

A concise summary statement will bring the session to a smooth close.

Interviewing real psychiatric patients is time consuming; instead of 60 minutes, your interview will have to be completed in 8 minutes in OSCEs! Remember that OSCEs are mock situations, with SPs, simplified scenarios, and impractical time constraints. The core framework of the psychiatric interview makes undergoing an OSCE station a challenging experience. The key to success is reading the door note carefully, watching the clock, and ensuring not to waste time. Do not perform a mental status examination unless the door note instructs you to do so.

Efficiency is the key to psychiatric interview stations; always enquire about the following:

Interactions with patients via videoconferencing are referred to as ones webside manner. This is a new competency domain for vOSCE sessions and a modern twist on bedside manner. Appropriate webside manner12 will add to patient satisfaction and better outcomes.12 The key elements of webside manner are: proper set up, acquainting the participant, maintaining conversation rhythm, responding to emotion, and closing the visit.13 Enquiries should be made as to whether the SP can hear or see with technology. You should be patient-centered and focused at all times, and all distractions with the computer interface should be explained in real time. When reviewing the electronic health record (EHR), verbalize what you are doing. Similar to bedside manner: possessing nuanced verbal and nonverbal webside manner skills is essential to conducting serious illness conversations during virtual visits.7 After your summary, ask the SP to echo back your recommendations.

It is important to understand the difference between an OSCE and a Clinical Skill Assessment (CSA), also known as an integrated OSCE (iOSCE). The CSA assesses the medical learners ability to integrate and apply multiple skills in each station, e.g., communication, physical exam, diagnostic, and professionalism.14 This why it is of utmost importance to read the door note carefully.

OSCEs are performance-based assessments that present all candidates with the same challenge. Scoring, when performed by SPs, is accomplished using checklists. The SPs ratings are improved using non-binary ratings. SPs rate whether an action/question was not done, attempted, or done. It is important for learners to verbalize what they are performing during the physical examination to get the point in the checklist and, thus, improve the overall score. As noted earlier, global rating scores may be used when grading is done by trained examiners.

OSCE stations are either dynamic or static. Dynamic stations assess clinical competency skills, are manned with an SP, and are interactive. Static/ question stations are called pseudo-OSCEs and assess knowledge. Although learners interpret electrocardiograms (EKGs), chest X-rays (CXRs), arterial blood gases (ABGs), and other tests, no actual clinical tasks are involved. The approach to pseudo OSCEs should be the same as answering a multiple-choice question. These types of OSCE pretender stations are not being used frequently and, in reality, contravene the sound educational underpinnings of a solid clinical skill assessment program. Studies on the reliability and validity of OSCEs are based on learners performing clinical tasks.

OSCEs are reliable and valid instruments of assessment for medical students and residents. They can be formative or summative. Success in OSCEs (in-person and virtual) is process and content dependent. We have encapsulated a series of practical and actionable approaches for medical students and residents. Understating theses specific tips and strategies will improve and optimize the OSCE experience.

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

The authors have received no funding.

The authors declare that there is no conflict of interest.

1. Khan KZ, Ramachandran S, Gaunt K, Pushkar P. The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part I: an historical and theoretical perspective. Med Teach. 2013;35(9):e1437e1446. doi:10.3109/0142159X.2013.818634

2. Nesbitt TS, Dharmar M, Katz-Bell J, Hartvigsen G, Marcin JP. Telehealth at UC Davisa 20-year experience. Telemed J EHealth. 2013;19(5):357362. doi:10.1089/tmj.2012.0284

3. Pugh D, Halman S, Desjardins I, Humphrey-Murto S, Wood TJ. Done or almost done? Improving OSCE checklists to better capture performance in progress tests. Teach Learn Med. 2016;28(4):406414. doi:10.1080/10401334.2016.1218337

4. Barzansky B, Etzel SI. Educational programs in US medical schools, 20032004. JAMA. 2004;292(9):10251031.

5. Gruppen LD, Davis WK, Fitzgerald JT, McQuillan MA. Reliability, number of stations, and examination length in an objective structured clinical examination. In: Scherpbier AJJA, van der Vleuten CPM, Rethans JJ, van der Steeg AFW, editors. Advances in Medical Education. Dordrecht: Springer; 1997;441442. doi:10.1007/978-94-011-4886-3_133.

6. Carraccio C, Englander R. The objective structured clinical examination: a step in the direction of competency-based evaluation. Arch Pediatr Adolesc Med. 2000;154(7):736741. doi:10.1001/archpedi.154.7.736

7. Hastie MJ, Spellman JL, Pagano PP, Hastie J, Egan BJ. Designing and implementing the objective structured clinical examination in anesthesiology. Anesthesiol. 2014;120:196203. doi:10.1097/ALN.0000000000000068

8. Roper TA. Time for a sinister practice. BMJ. 1999;319(7223):1509. doi:10.1136/bmj.319.7223.1509

9. Qayyum MA, Sabri AA, Aslam F. Medical aspects taken for granted. McGill J Med. 2007;10(1):4730.

10. Packer CD. Presenting Your Case: A Concise Guide for Medical Students. Springer; 2018.

11. Michaels J. History Taking for Medical Finals. Banbury, UK: Scion Publishing; 2018.

12. McConnochie KM. Webside manner: a key to high-quality primary care telemedicine for all. Telemed J EHealth. 2019;25(11):10071011. doi:10.1089/tmj.2018.0274

13. Chua IS, Jackson V, Kamdar M. Webside manner during the COVID-19 pandemic: maintaining human connection during virtual visits. J Palliat Med. 2020;23(11):15071509. doi:10.1089/jpm.2020.0298

14. Gerzina HA, Stovsky E. Standardized patient assessment of learners in medical simulation. In StatPearls. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546672/. Accessed August 20, 2021.

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Virtual Objective Structured Clinical Examination | AMEP - Dove Medical Press

CCNY appoints Carmen Renee’ Green, MD and health policy expert, new Dean of CUNY School of Medicine – PRNewswire

The CUNY School of Medicine is an expansion of City College's Sophie Davis School of Biomedical Education, which was founded in 1973.The medical school houses a novel 7-year BS/MD program and one of the oldest physician assistant programs in the US. It is the only school in the US that has eliminated the MCAT as a barrier to access to medical careers and integrates medical education within the undergraduate curriculum. It is the only public medical school in Manhattan and is known for producing excellent and diverse health professionals who are leaders in providing primary care and serving in health professional shortage areas.

"The CUNY School of Medicine at City College is one of our great contributions to New York society and I am thrilled that it is poised to benefit from the visionary leadership of Carmen Green," said Dr. Vincent Boudreau, president of The City College. "Dr. Green comes at a pivotal time in our national deliberations about public health and the need to serve the whole people. Her background positions the School of Medicine to be a critical voice in that conversation."

Green joins CSOM from Michigan Medicine, the academic medical center of the University of Michigan, one of the world's premier research universities with 19 schools and colleges nationally ranked for excellence in education, research, and clinical care. Green, tenured at U-Michigan, is a pain medicine physician and anesthesiologist.

While at U-Michigan she held several senior faculty positions including:

At U-Michigan, Green completed an anesthesiology residency and pain medicine fellowship. She is considered one of the top pain doctors in the country by US News and World Reports and a top doctor and anesthesiologist. She provided care for patients at Michigan Medicine's Back and Pain Center.

Green's health policy and research interests focus on pain, disparities, and the social determinants of health. She is also an expert in minority and women's health, aging, and diversity in academic medicine.Dr. Green was also the Director of the Healthier Black Elders Center at the NIH-funded Michigan Center for Urban African American Aging Research. Her published articles focused on the "unequal burden of pain" shouldered by minorities and race-based disparities in hospital security calls, and are considered foundational.

A graduate of U-M Flint (BS) and Michigan State University College of Human Medicine (MD), Green is a member of Alpha Omega Alpha National Medical Honor Society. As a Robert Wood Johnson Foundation Health Policy fellow at the National Academies, she worked in the US Senate on the Health Education Labor & Pensions Committee and the Children & Families Subcommittee where she was instrumental in developing the National Pain Care Policy Act, included in the Affordable Care Act and passed by the US Congress (2010).

Among Green's numerous honors for community and scientific service are the John Liebeskind Pain Management Research Award and the Elizabeth Narcessian Award for Outstanding Educational Achievements. She was the inaugural Mayday Pain and Society fellow, a Hedwig van Ameringen Executive Leadership in Academic Medicine fellow, and a fellow of the Gerontological Society of America. She serves on advisory boards for the NIH, US Secretary for Health and Human Service, and American Cancer Society and is frequently invited to speak to national and international audiences including at the Rockefeller Foundation's Bellagio Conference Center in Italy.

Green will also be the Anna and Irving Brodsky Medical Professor and Professor in CCNY's Colin Powell School for Civic and Global Leadership. She takes up her appointment as CSOM Dean in Oct. 2021.

Contact: Jay Mwamba, 212.650.7580, [emailprotected]

SOURCE City College of New York, Office of Institutional Advancement and Communications

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CCNY appoints Carmen Renee' Green, MD and health policy expert, new Dean of CUNY School of Medicine - PRNewswire

2bPrecise acquired from Allscripts by AccessDX – Healthcare IT News

AccessDX Holdings, which develops an array of lab diagnostics and decision support tools, announced this week that it has acquired 2bPrecise from Allscripts.

WHY IT MATTERS2bPrecise specializes in helping health systems advance precision medicine projects by aggregating genetic and genomic data from labs and clinical data from electronic health records and helping bring it into clinician workflows helping with faster diagnosis of for heritable conditions, and more efficient targeting of personalized treatment plans.

Its addition to the AccessDX portfolio which includes the MedTek21 platform for diagnostic-based CDS will help provider and other customers as they establish, build and advance precision medicine programs.

THE LARGER TRENDClinical integration of genetics and genomics is advancing across an array of specialties not just oncology and cardiology but neonatology, pediatrics and behavioral health. But easy access to that data within the EHR is essential to gaining clinician buy-in and enabling precision insights for improved patient outcomes.

Still many smaller providers think precision medicine is beyond their means. That's not true, however. In interviews with Healthcare IT News, 2bPrecise co-founder and Chief Medical Officer Dr. Joel Diamond has said that pharmacogenomics is one logical entry point.

At HIMSS21 earlier this month, UPMC CMIO Dr. Robert Bart said he shared that sentiment.

"In the pharmacogenomics space, there's opportunity for all levels of healthcare systems to be involved," he said predicting that that precision med discipline would soon "filter down and become the standard of care."

He added: "One of the reasons I'm so high on pharmacogenomics is that there can be a big benefit on medication adherence.

"There's a nice opportunity where the payers are aligned, because they feel there's financial benefit in healthcare. The clinical side is aligned, because they feel that they can get better therapy and therapeutic treatment for the patient. And the patients are aligned because they want the right medication at the right dose for them personally."

ON THE RECORD"We're thrilled to welcome the 2bPrecise team and platform as we execute on our combined vision for democratizing the use, interpretation and delivery of advanced diagnostic solutions at the point of care," said Joe Spinelli, SVP of Product & Strategy for AccessDX. "Combined, our worldwide organization will be able to accelerate the pace of innovation and best serve the needs of healthcare organizations that continue to expand their adoption of actionable precision medicine solutions."

"AccessDX is a genuine leader in genomic information management. Our collective capabilities will serve as a force multiplier for the practical utilization of precision medicine," said Assaf Halevy, founder and CEO of 2bPrecise. "With a unified mission to drive dimensional change in healthcare, the combined talents and energy of 2bPrecise and AccessDX will compound acceleration in delivering on our vision of intelligent, personalized care for the good of healthcare organizations and the patients they serve."

Twitter:@MikeMiliardHITNEmail the writer:mike.miliard@himssmedia.comHealthcare IT News is a HIMSS publication.

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2bPrecise acquired from Allscripts by AccessDX - Healthcare IT News

Foundation Medicine, Epic collaboration focuses on genomics for precision oncology – Healthcare IT News

Foundation Medicine this week announced a new partnership with Epic to integrate its genomic profiling and testing services into its electronic health system.

WHY IT MATTERSCambridge, Massachusetts-based Foundation Medicine offers a suite of genomic profiling assays to identify the molecular alterations of patients' cancers and match them with targeted therapies and clinical trials. With this new collaboration customers will be able to electronically order Foundation tests within the Epic network, directly within the EHR.

The collaboration is aimed at oncology practices, hospitals, academic medical centers and health systems, to enable easy access to clinical and genomic information for more streamlined clinical decision support.

With the new integration, clinical teams can place orders for Foundation's comprehensive genomic profiling tests and receive and view results within their existing EHR workflow. The aim is to also reduce data entry while offering faster actionable insights to help physicians guide treatment planning.

The integration is expected to be available in 2022. Foundation Medicine says it is also partnering with organizations using non-Epic EHRs to meet their own oncology needs.

THE LARGER TRENDThis isn't the only news this week about genomics-focused precision decision support. On Wednesday, AccessDX Holdings, developer of lab diagnostics and CDS tools, announced its acquisition of 2bPrecise which helps health systems advance precision medicine by aggregating genomics from labs and clinical information from EHRs from Allscripts.

Earlier this month, in an interview with Healthcare IT News at HIMSS21, Dr. Robert Bart, chief medical information officer at Pittsburgh-based UPMC, highlighted the necessity of digitized discrete data, integrated into EHR workflows, for precision medicine to work.

"We really think that, when you're moving into the world of pharmacogenomics or genomic medicine, that you really need to embed decision support into your electronic health record," he said.

"And you have to really insist on taking the results only in digital format. So if we get external results from reference labs, we don't want PDFs. We want to actually discrete data, so we can trigger the decision support, as well as provide supporting content for interpretation by our clinicians and the content so the patient can understand what that result means for them."

ON THE RECORD"In order to bring the reality of precision medicine to more cancer patients, we need to simplify the process for getting oncologists access to the genomic insights they need for targeted treatment planning," said Kathleen Kaa, interim chief commercial officer at Foundation Medicine, in a statement about the new Epic integrations. She called it "one of our key efforts to improve the process for ordering our tests so care teams can focus on providing the best treatment for their patients."

Twitter:@MikeMiliardHITNEmail the writer:mike.miliard@himssmedia.comHealthcare IT News is a HIMSS publication.

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Foundation Medicine, Epic collaboration focuses on genomics for precision oncology - Healthcare IT News

Healthcare’s future resides in genetic research and genomic testing – Utah Business – Utah Business

Someday there will be an app on your smartphone that knows exactly what medicine will work best for you. It will warn you of your risk for developing certain diseases and offer a personalized plan for preventing them. It will even be able to determine your likelihood of passing on certain conditions to your unborn baby. Ultimately, it will increase your lifespan and help you enjoy a higher quality of life.

This will all be possible because of one thing: genomics.

To understand genomics, you first have to understand thedifference between genes and genomes.

Genomicsis the study of genomes specifically how your DNA functions and interacts within your body. Through genomics, scientists and researchers have sought to better understand how a persons genes interact with each other and with their environment.

Precision genomicstakes this one step further. Using genomic information, doctors can create more personalized healthcare options for individuals battling illness and disease.

Human beings are more alike than they are different. In fact,research showsthat humans are 99.9 percent identical in their genetic makeup. Understanding the remaining 0.1 percent holds the clues about detecting and preventing certain diseases.Thats where genomics comes in.

Genetic testing looks for inherited mutations in healthy cells.Genomic sequencinglooks at genetic mutations in unhealthy cells.Heres why that matters for your health:

In the past, if you were diagnosed with cancer, your doctor would most likely recommend a standard form of treatment that worked for most people. But these days, healthcare providers can provide acustom-fit treatmentthats based on your specific DNA. They do this by identifying mutations in certain cells.

Dr. Lincoln Nadauld,chief of precision health and academics at Intermountain Healthcare, put it simply. [Precision genomics] means picking treatments for patients with cancer based on DNA changes in their cancer, he says.

And having more effective, personalized treatment plans means:

Genomics also helps identify certain health risks because these factors play a role in nine out of 10 of theleading causes of death.Knowing youre at risk for diabetes or heart disease could help you take steps to prevent their onset.

Genomic medicine is changing the way doctors approach individualized patient care particularly in the fields of oncology, pharmacology, and rare or genetic diseases.

1.Cancer treatment.Precision genomics improves cancer treatment by providing moretargeted therapiesthat are personalized to each patient.

Intermountain has long been recognized for its role in leading cancer research. By collaborating with other institutions and sharing data, doctors are learning how to best treat cancer. And now Intermountain is leading the charge in precision genomics research.

Through a variety of clinical trials, researchers study how different cancers respond to combinations of targeted treatment and immunotherapy (treatments that stimulate a persons immune system to fight cancer).

2. Matching medication.If youve ever been concerned about the potential side effects of certain medications, pharmacogenomics can help.

Pharmacogenomicsis the study of how genes can affect a persons response to medication. By studying your DNA, doctors can discover which drugs are most likely to work for you and what dosage your body might need. (This includes antidepressants, opioid pain relievers, heart medications, anti-inflammatories, antidiabetics, medications used before and after surgery, and more.) This process is called RxMatch testing. Pinpointing which drugs would be most effective for patients reduces the likelihood of negative side effects and repeat doctor visits.

3. Genetic counseling.Worried that cancer might run in your family? Want to know your chances of passing on conditions to your children?A genetic counselorcan assess your family history and genetic test results to determine if youre at risk of developing certain health conditions.

The National Society of Genetic Counselorssuggests the following as good reasons to see a genetic counselor:

The ultimate goal with each of these is to help patients live longer and better lives. The more you understand about your DNA, the better your chances for a high-quality life.

To see genomics in action, consider one Intermountainpatients story.

In 2013, Telitha Greiner had a colonoscopy that revealed cancer spread to her liver and lungs. A friend suggested she travel to St. George to see Dr. Nadauld, whose focus was extending the lives and quality of life for stage four cancer patients.

The genetic testing done by Dr. Nadauld revealed that one of the cancer drugs I was taking that had particularly painful side effects was not genetically effective, Greiner says. It wasnt doing me any good and caused a very painful skin condition. I am so grateful to know that I dont have to take it anymore and for the state-of-the-art care I am receiving at Intermountain.

Like Greiner, many patients have benefited fromIntermountain Precision Genomics.Its state-of-the-artTheraMap testoffers genetic testing for patients who havent found success with traditional treatment options.

For Nadauld, each individual patient serves as a reminder of how important this research is.

Though a lot of good has come from genetic research, theres still much work to be done. With further research prediction, prevention, and treatment can improve much faster. Thats where you have an opportunity to make a difference.

In order to discover new connections betweengeneticsand human disease, doctors and researchers are asking people to participate in theHerediGene: Population Study.This study is asking for 500,000 participants, including 50,000 children, over the course of five years.

Last year, Dr. Nadauld addressed the importance of HerediGene participation in a podcast episode ofThanks for Asking.

Theres extraordinary interest in this, primarily because it offers the opportunity to understand populations better and to start to predict the health across entire populations, he says. What that means is we could start to predict individuals in a population who might be at risk to get some forms of cancer or other individuals who might be at risk to have a heart attack or a stroke or to develop diabetes. And if we can predict that, then maybe we can work with those individuals to prevent some of those things from happening.

HerediGene participants are helping us piece together clues that will help doctors save lives and that could include your own.

If youre interested in furthering genetic research and benefiting future generations,find a participating location near you.No appointment is necessary. Participation is voluntary and provided at no cost to you.

Genomics is changing the way doctors practice medicine and treat disease. In the coming years, many more people will have access to targeted therapies and medicine designed specifically for them.

But healthcare is not one-size-fits-all. Finding the best healthcare solution for you or your loved ones requires open and honest conversations with your doctor.

If you think precision medicine could be right for you, here are a few suggestedtips for talking with your healthcare provider:

If you have questions or youre interested in learning more,visit the Intermountain Precision Genomics page for patients.

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Healthcare's future resides in genetic research and genomic testing - Utah Business - Utah Business

Talking to kids about gender and sexuality is harder these days or is it? – CBC.ca

Recently, controversy erupted over a P.E.I. radiopersonality's reposting of a social media meme that drew criticism from the local LGBTQ community.

Ocean 100 morning show co-host Kerri Wynne MacLeod and Stingray Radio apologized for the post, and in the social media furor that ensued, Pride P.E.I. issued a joint statement with the station supporting her.

The post was a meme that talked about the challenges of parenting and howdifficult it must be for parents these days to have the "birds and the bees" talk with their kids, since there seem to be more genders and sexual preferences than in the past.

But is it really more challenging to talk to kids about sexuality and gender now, as more people openly identify as lesbian, gay, bisexual, transgender, queer, non-binary or any other shade of the rainbow?

"No, I don't feel that," said Andrea MacPherson, corporate secretary with the LGBTQ advocacy group Pride P.E.I.,who came out as transgender about five years ago. She went from being "dad" to being "mom" to her now 11-year-old twins. She said it was not difficult, and her kids accepted it right away.

"It's a parent's responsibility to explain to the kid, what's going on in the world, and really, kids are sponges," she said.

MacPherson said she simply told her kids transgender people exist. "And they were like, 'OK!'" she said.

"Telling them that some people are boys, some people are girls, some people are both, some people are neither they accepted that," MacPherson said. "Kids don't care about things more complicated than that."

Angele DesRoches with PEERS Alliance, a group that promotes sexual health and drug-use harm reduction on P.E.I., doesn't have children but is an active aunt to seven kids and has been an early childhood educator in the past.

"There's lots of reasons why I feel bad for parents today COVID, climate change. If acknowledging the diversity around human sexuality and gender throws off your quote-unquote 'birds and the bees'talk, then my concern is really how woefully inadequate that talk probably was," DesRoches said.

"The real issue is we still have parents who think of a sex talk as focusing on penis-vagina penetration, and a one-off conversation."

Talking to kids about human reproduction, preventing sexually transmitted infections or unplanned pregnancies, and communication and boundary-setting in personal relationships are worthwhile conversations, Desroches said.

"When we focus on penis-vagina penetration as the definition of sex, we're missing all kinds of sex that young people are having, that also have risks associated," she said, promoting conversations that can introduce strategies to reduce harm, such as condom use.

Adults who find it challenging to talk to young people about gender and sexual diversity may want to examine where that discomfort and fear comes from, she suggests.

"Sex is absolutely everywhere in our society, but we're still a very sex-negative culture. Sex is sinful, it's still dirty, it's something tobe hidden," she said. "Really, that's grownup baggage."

Some work is being done to educate Island students.The P.E.I. Public Schools Branch, withhelp fromPEERS Alliance and the P.E.I. Transgender Network,is developinggender diversity guidelines for Island schools, following many other provinces across the country thatalready have suchguidelines. The aim is tocreate more inclusive and safelearning environments for students while demonstrating respect for diverse sexual orientations and gender identities.

For children in kindergarten to Grade 4, DesRoches said, "what we really are focusing on is celebrating our uniqueness and identifying gender stereotypes where they exist, and giving students the tools needed to recognize and resist those stereotypes," she said.

For older kids, it's important to ditch the narrative that being transgender means transitioning wholly from one gender binary (man or woman) to another.

"We're at a pointnow where we just know that that isn't true ... gender diversity is much more nuanced, beautiful and complicated than that. And so we're really talking about an entire spectrum of diversity that ranges from cisgender to transgender to non-binary to gender-fluid to gender-queer. Gender can be exciting! Folks should play, and folks should have room to be who they are."

What children and youth need to know about just as much, or more, than gender or sexual preference are things like consent, DesRoches believes.

Historically traditional "scripts" around sexuality can be unhealthy, she said, including notions that men should pursue women and sex and "win" them, or that sex is a "prize" to be taken by men.

"One of the things I've been very keen on doing in my transition is involving my kids along theway," MacPherson said. "Setting expectations is the biggest key in making sure it's as stress-free as possible."

MacPherson's kids already knew about Jazz Jennings, a celebrity who came out as transgender at just six years old, when Barbara Walters interviewed her for the TV show 20/20. Jennings wrote a children's book calledI Am Jazz, which MacPherson's children had read and loved.

"I explained some people are like Jazz, but don't realize it till they're a lot older, and that's what I'm like," she said.

Her own children sometimes mix up her pronouns, referring to her as "him," or calling her "dad," but she said that's fine.

She also sat down with the kids' teachers and school administration to tell them about her transition, so the kids wouldn't have to faceuncomfortable questions, and they were "super supportive," MacPherson said.

And itdidn't take long for kidsand their parents to switch to using "her" and "Andrea."

"A few of their friends' parents have asked how they should refer to me, and I say I'm still their parent, my name is this now," she said.

"Some people might make mistakes and that's fine. Mistakes will be made, you don't make a big deal out of it."

MacPherson said kids especially are remarkably quick to correct themselves if they get it wrong, and just move on quickly with an "OK!"

When is it appropriate to introduce kids to the idea of different genders and sexual preferences? CBC Kidsproduced an animated primerabout this that parents can watch with their kids.

"I'm of the firm belief that there is no age that's too young to really explain to them," MacPherson said.

"As soon as my kids noticed that some things looked like 'boy' stuff and some things looked like 'girl' stuff, I made a point of saying 'some things are neither,'" sheexplains.

"Some people are boys, some people are girls, some people are both, some people are neither ... there's ways to talk about it at all ages that's age-appropriate."

DesRoches directs parents who seek information from PEERS about gender diversity and human sexuality to resources including Cory Silverberg'sSex is a Funny WordandWhat Makes a Baby,both books that explain sexuality while removing gendered assumptions. Use Google, she said, and find lots of good first-person stories from gender-diverse people on YouTube.

Don't wait until you are personally affected to get educated, either: sooner rather than later, you will likely meet someone who is transgender, MacPherson said.

"Even if kids aren't struggling with their own gender, just being able to explain it," she said. "So many people now just simply know a trans or non-binary person ... it's a good thing for everyone to know."

Knowledge can help make people more comfortable and reduce stigma, she said.

If you're a parent or caregiver of a transgender person of any age, PEERS has a program called Roots and Shoots parents can come together to "unlearn myths about gender identity and replace those myths with knowledge and support around issues of gender diversity," the PEERS website says. At the same time, their trans or gender-creative children aged five to 13 can participate in Sierra Club Wild Child programming and meet like-minded peers and play in nature "while being their awesomely unique and authentic selves."

PEERS also recommends those raising gender diverse young children check out a free online course offered by StanfordSchool of Medicine, Health Across the Gender Spectrum.

Want a short primer on terms you might want to use when discussing these issues with your kids? They might already know them, but they might be impressed you know them too!

asexual: someone who is not sexually attracted to anyone.

bisexual: someone who isattracted to their own gender and another gender. Often shortened to "bi."

dead name: a transgender person's former name, usually their birth name.Use that person's new name, as hearing their former name or pronouns can negatively affect many trans people.

gender-fluid: a person whose gender is fluid sometimes they may identify as and express themselves more as female, other times more as male.

gender non-conforming: people whodon't conform outwardly to the societal norms expected of their gender. For example, currently a boy who wears a dress could be seen as gender-non-conforming.

non-binary:someone whose identity doesn't fit into a strictly male/female binary, and usually uses they/them pronouns.Celebrity Demi Lovato recently came out as non-binary.

polyamory: love relationships involving more than a couple. Polyamorous relationships can take many shapes and sizes.

pronouns: he/him, she/her or they/them are pronouns. More people are introducing themselves and stating their pronouns, depending on how they identify. These are often seen on email signatures or social media profiles.

straight: straight people are attracted to those of the opposite gender.

top surgery: removal of breasts. Many trans and non-binary people get top surgery.

transgender: a person who changes their gender from that which they were assigned at birth. For instance male-to-female, female-to-male, female-to-non-binary, etc. Sometimes shortened to "trans."That change can be social (the way people appear and dress) and also medical (involving gender reassignment surgery). Halifax-born actor Elliot Page recently came out as transgender, transitioning from female to male.

trans man:a man who was assigned female at birth.

trans woman: a woman who was assigned male at birth.

queer:The LGBTQcommunity hasbegun to reclaimthe word queer, taking away past negativity and using it as a term to encompass anyone who is not straight or transgender.

Original post:
Talking to kids about gender and sexuality is harder these days or is it? - CBC.ca

The Hate that Calls Itself Love pt 3: Reproductive Coercion – Patheos

Ive been writing about why I think the Churchs teaching on sexuality particularly homosexuality and contraception is evil. Mostly Ive been talking about history, and the question of how the teaching came to be what it is in the first place. I want to put that aside for the moment and talk about the present: how do these teachings cause grave and demonstrable harm to real human beings living in the world right now?

Im going to start with contraception.

In theory, the Catholic Church recognizes two essential (and essentially correct) principles regarding reproductive choice:1. That people should practice responsible parenthood, seeking to have children only when it is responsible and reasonable to do so, and 2. That the decision to seek or avoid pregnancy is private, that only the parents can determine whether they are financially, emotionally, physically and spiritually able to care for a child.What this means, actually, is that certain people within the hierarchy made good arguments in committee meetings showing that providentialism (the belief that you should just have as many children as you can because God will provide) is a terrible idea. One suspects that these individuals expected the Church to arrive at the obvious conclusion: that the teaching prohibiting contraception needs to be overturned because it is opposed to reason, common-sense, and the actual good of human beings. In practice, however, these obviously sane observations were incorporated into the documents in principle, but undermined in practice.

The problem is that responsible parenthood and parental discernment only become possible when people have access to reliable means of avoiding pregnancy. But thousands of years ago men who did not understand how human reproduction and sexuality actually work came to the conclusion that sex is fundamentally problematic and can only be grudgingly justified when it is necessary for procreation.

Overturning the flawed reasoning of these men would involve admitting that celibate guys might not have infallible insight into human sexuality and if that were admitted, the entire house of cards might start to collapse. People might see that priests, bishops, canonized theologians and even popes are just ordinary, fallible human beings and not specially selected ambassadors of the Holy Spirit with magical powers to know the truth about things they have no experience of.

So the Church came up with a compromise that provides the worst of both worlds: you are obligated to think carefully about whether having a child is a good idea and to choose responsibly and then you are supposed to effect those decisions using hideously unreliable means.

The Tree By Its Fruits

NFP allows the Church to maintain that they have been right for all of those centuries while acknowledging that choice and responsibility are necessary elements of any reasonable sexual ethic. Its a perfect solution with only one niggling drawback: it doesnt work. Of course, if youre an unmarried man who is only accountable to other unmarried men, this minor difficulty can be overlooked for the sake of the obvious institutional advantage of being able to claim infallible insight, prescient wisdom, and pastoral understanding while also shoring up the putative moral superiority of the celibate class.

This is why I call Humanae Vitae evil. It is a document whose fundamental purpose is to maintain the power and authority of the Catholic hierarchy regardless of the harm that this does to the people who have to practice it. Some of those responsible for formulating the doctrine, like Ottaviani, almost certainly knew this. I suspect that most of its supporters, however, have convinced themselves that there is no real conflict of interests, that on some deeper level the good of humanity is best served by upholding the power of the Church or that the doctrine really is about the truth and dignity of human sexuality and not about the need to avoid the embarrassment of admitting that over a thousand years of teaching had been wrong. Few people are genuine Machievellians, and theres been a lot of ink spilled trying to show that NFP is better for women, better for children, better for society If you and your colleagues dont have to actually live with the consequences of the teaching, its not that hard to assume that the rosier portrayals are probably the most accurate.

In reality, though, Humanae Vitae was not prescient, wise or merciful. Widespread access to contraception has not resulted in increased government interference in peoples reproductive lives: the forced sterilization campaigns and coercive birth-limiting policies that Paul VI predicted have not materialized. On the contrary, in the years since the publication of HV such policies have become increasingly unacceptable to individuals and to the international community. Why? Because it turns out that when you give people access to reproductive choice, they will generally make reasonable and responsible decisions. In areas with stifling population densities, like Japan, birth-rates fall. In times of traumatic population loss, like World War II, there are baby booms. Its almost as if our species has evolved to survive without the reproductive management of the Vatican.

The Churchs teaching on contraception is, however, deeply harmful to the minority of Catholics who sincerely believe that the Vatican has the right to regulate their sexual behaviour. It is coercive, misogynistic and harmful to children.

No Exit

For those who have never been a devout believer in an authoritarian religion, it can be difficult to relate to the way in which religious authorities are able to exercise control over adherents. Even now, as someone who had that experience, when I look in from the outside Im perplexed. It seems so obvious that there is no being outside of time and space who will torture people for eternity if they use a condom. That this has never happened. Could never happen. That even if God existed, it would still be a preposterous belief.

When youre in that world, though, it somehow seems real. And in the case of contraception, its particularly insidious.

With most sins, Catholicism offers an escape clause. In some cases, this takes the form of straightforward justification: stealing isnt stealing if its the only way to feed your children, killing isnt killing if you do it in self-defense or in war, missing Mass doesnt count if youre sick, etc. With contraception, however, there is no justification for married couples. It doesnt matter if youre trying to prevent the transmission of HIV, or if your children are literally starving to death, or if another pregnancy would put the mothers life at risk. Contraception, unlike driving a bayonet through someones innards, is intrinsically evil. This means it can never be morally acceptable.

The other escape clause in Catholicism is forgiveness: sure, youre not going to live a perfect life, God understands that. You will sometimes be overcome by temptation. Youll drink more than you intended, youll break down in a moment of weakness and watch porn, hell, you might even lose control of yourself and kill your spouse in a fit of rage. God understands. If you are sorry for what you have done, you can confess your sins confident in Gods forgiveness.

What you cant do is presume on Gods forgiveness. You cant set out to commit a sin thinking Meh, Ill do this now and go to confession later and itll all be good. This is actually an important idea: in the case of evils that are, you know, evil, its an essential safeguard. You cant be a serial rapist who scrupulously schedules your predations around the confession schedule at your local parish, and you cant be a gangster who plans to make it all good in the end with a deathbed confession and a hefty donation to Mother Church. You cant treat the confessional as a loophole that relieves you of your moral obligations to other people.

For most sins, this means that you can both believe in hell and exist as a human being without being in a state of constant, paralyzing terror. You try your hardest, sometimes you fail, God is merciful. But with contraception, if you are trying your hardest to avoid contracepting, you will in fact not succeed in avoiding pregnancy. You cant get your tubes tied or go get the shot with the intent of confessing it later thats presumption. If you go to confession and seek forgiveness for using a condom or taking the Pill, youre not really contrite (and therefore cannot receive absolution) unless you intend to throw away the rest of your contraceptives when you get home.

Effective contraception involves a committed, deliberate, long-term, rational choice. You have to think ahead, discuss it with your partner, and take responsibility for your reproductive life. Its not something that you do on the spur of the moment, in a fit of weakness, because your flesh got the better of you. Weakness, lust and irresponsibility are much more likely to result in failure to use contraception, and possibly in unplanned pregnancy. People dont get vasectomies because they are overcome by temptation they get vasectomies because theyve concluded that it is the rational, moral, responsible thing to do.

It is exactly this kind of deliberate, conscientious, rational discernment that the Church cannot tolerate if it leads to the conclusion that the Church is wrong.

The Existential Smoking Gun

This is why the teaching on contraception becomes so burdensome, so coercive. You are quite literally being told that if you make a responsible decision the right decision for yourself and for your family you risk eternal torture. Good Catholics are encouraged to meditate on the Last Things, and there is a great deal of spiritual art and writing that describes in vivid, lurid detail the horrors that await the damned. Also, even if you are reasonably confident that God will be merciful and you wont suffer forever, the Church assures you that you will face the pains of purgatory: hundreds of years of horrific misery and torment where you receive a temporal punishment for your sins that vastly exceeds any actual harm and suffering that you might have brought about by, say, masturbating in the shower or sleeping in instead of going to Church on Sunday.

In the case of contraception, you will have to suffer for the harm that you have caused to the Church by selfishly refusing to be open to life.

Heres where the snake starts to eat its tail. On the one hand, you are supposed to practice responsible parenthood. On the other, you are always supposed to be open to life. Even if you have carefully discerned that it would be an absolutely terrible idea to have a child right now, you are still supposed to be open to the possibility that God wants you to have a child. How do you know God wants you to have a child even though it seems like a bad idea? Well, you will know if you find yourself facing an unplanned pregnancy. So if, for example, you use a highly ineffective method of family planning because its the only one you are permitted to use, and it fails, thats not evidence that the method is hideously flawed and unreliable its evidence that God really wanted you to have a child right now. It is therefore very selfish of you to practice responsible parenthood in a way that has a reasonable chance of succeeding.

A woman in this position feels as if she has a massive existential gun to her head. The threat of hell has been reinforced and magnified by repeated graphic depiction and internalized through meditation practices designed to instill intense fear in the believer. Authorities that you trust have told you that you will be punished with pain so severe that it exceeds your most horrific imaginings, and that this pain will go on for periods of time that you cant even begin to wrap your head around. If you selfishly withhold your reproductive labour from your husband and from the church, you are not only doing evil, you are turning yourself into garbage that deserves to be burned in eternal fire.

But if you just give up control of your life and your body and endure the finite and measurable sufferings that you face in the present, then you will be redeemed. So which is it gonna be, doll?

This kind of coercion is traumatic. You are psychologically held down by the weight of hundreds of years of tradition and the authority of thousands of powerful men, selected by God to enforce his commandments. You are terrified to struggle free or to try to run because you sincerely believe that there is an all-powerful, all-seeing deity who has your body and your soul in his crosshairs. You are also terribly confused because youve been told that this psychological violence is the only true kind of love and that this is being done to you because its the only way to make you into a worthwhile person.

Women and Children Last

So you submit. You obey. You hope and pray and plead with God and try different kinds of NFP and every time it fails, you blame yourself for having failed yet again. Youre told that NFP is as effective as the Pill. Youre told that the problem is you. And you dont find that hard to believe. After all, even if youve only just done one year of praying the rosary every day, you will have repeated to yourself that you are a sinner over 20 000 times and pleaded to be saved from the fires of hell 1825 times. Thats only one year, one type of prayer Catholicism is very good at imprinting the idea that if there seems to be a problem, its probably you.

The second worst thing about it is that NFP fails the most spectacularly for the people who need it the most. It doesnt work for the poor because its success rate plummets without consistent support from a qualified NFP instructor and access to good, free, support is spotty at best. It doesnt work for women in abusive marriages because its success is completely dependent on the idea that the couple is a unit, that they are working together in a mutually supporting way to make the method work. It doesnt work for women who are overworked or have complicated schedules like, say, mothers with lots of children because the success rates plummet if you arent able to take measurements and record symptoms consistently at the exact same time each day. It doesnt work for women who are stressed and sick nobody has even gathered statistics on whether the method is successful at all for women with irregular menstrual cycles. It doesnt work for women struggling with addiction or mental illness because it relies on a womans consistency and control over her actions.

In other words, many of the more serious reasons for avoiding pregnancy reduce the likelihood of being able to effectively use NFP.

The worst thing about it, though, is that when you force women, especially women in poverty, in abusive situations, in crisis, to rely on a method of family planning that does not work, the result is that children are born into poverty, abuse and crisis. Its not just that the hierarchy is shoring up its own infallible authority at the expense of women. It is also doing it at the expense of children. In almost every case where a woman does not think it is a good idea for her to have a child, it is not a good idea for her to have a child. Having more children than you can handle is not good for the children. Having children in an abusive marriage is not good for the children. Having children because you are afraid of hell is an absolutely terrible reason to have children.

Using coercive threats to force women to risk pregnancy against our better judgement is an act of violence against women and children. The Church engages in this violence because the hierarchy is too arrogant and stubborn to be able to say You know, we have learned a lot in the past centuries and we got some things wrong.

This is evil.

Next time, well look at how the same kinds of misogyny and power-lust are at the heart of the Churchs teachings on homosexuality.

Read the rest here:
The Hate that Calls Itself Love pt 3: Reproductive Coercion - Patheos

Sorrento Therapeutics Announces Entry Into Option Agreement to Exclusively License MPRO Inhibitors Against SARS-CoV-2 and Variants of Concern,…

MPro is a SARS-CoV-2 enzyme that catalyzes the formation of a number of essential proteins for the viral reproduction.

MPro inhibitors block this catalytic process to potentially inhibit the viral replication in human cell hosts and prevent viral infection.

The lead compound, MPI8, exhibited potent in vitro antiviral activity against SARS-CoV-2 and all of the major Variants of Concern (VoCs) (alpha, beta, delta and gamma) tested.

Sorrento intends to develop the lead MPro inhibitor in oral administration form and as a component of an antiviral cocktail therapy to potentially eliminate current and emerging coronavirus infections.

SAN DIEGO, Aug. 24, 2021 (GLOBE NEWSWIRE) -- Sorrento Therapeutics, Inc. (Nasdaq: SRNE, "Sorrento") today announced that it has entered into an option agreement (Option) with The Texas A&M University System (TAMUS) for exclusive rights to the intellectual property covering highly potent main protease (MPro) inhibitors against SARS-CoV-2. This latest agreement bolsters Sorrentos wide-ranging portfolio of preclinical and clinical therapeutic candidates targeting COVID-19, including new and emerging variants of concern of the SARS-CoV-2 virus. Under the terms of the agreement, Sorrento has an exclusive option to exclusively license patents covering the MPro inhibitor drug candidates.

Discovered and developed by Dr. Wenshe Ray Liu and his research team at Texas A&M University, the MPro inhibitors have demonstrated strong cellular antiviral potency against SARS-CoV-2 in preclinical studies. Several MPro inhibitors were identified that exhibited antiviral effects against diverse SARS-CoV-2 variants, including Indian (Delta), UK (Alpha), Brazilian (Beta) and South Africa (Gamma) variants of concern. The potential advantage of using small molecules, in oral and/or intravenous administration, that target MPro is that they are not affected by mutations in the SARS-CoV-2 spike protein, which may enable MPro drugs to be effective against SARS-CoV-2 and its variants of concern (VOCs), as well as against other coronaviruses that currently exist or might emerge in the future.

Story continues

MPro is a SARS-CoV-2 enzyme that catalyzes the formation of a number of essential proteins for the viral reproduction. MPro inhibitors block this catalytic process to inhibit the viral replication in human cell hosts achieving the eradication of the virus, according to Dr. Liu.

We are excited to be collaborating with Dr. Liu and his team at Texas A&M and look forward to advancing the development of these novel drug candidates to address COVID-19, and a multitude of other respiratory viruses, stated Dr. Henry Ji, Chairman and CEO of Sorrento. This agreement further strengthens our dynamic COVID-19 product portfolio and is well aligned with our overall strategic plan to combat COVID-19 through a combination of potent small molecules and antibodies, cellular therapies and vaccines.

Sorrento may exercise its right to enter into a worldwide exclusive license agreement at any time during the option period.

About Sorrento Therapeutics, Inc.

Sorrento is a clinical stage, antibody-centric, biopharmaceutical company developing new therapies to treat cancers and COVID-19. Sorrento's multimodal, multipronged approach to fighting cancer is made possible by its extensive immuno-oncology platforms, including key assets such as fully human antibodies (G-MAB library), clinical stage immuno-cellular therapies (CAR-T, DAR-T), antibody-drug conjugates (ADCs), and clinical stage oncolytic virus (Seprehvir). Sorrento is also developing potential antiviral therapies and vaccines against coronaviruses, including COVIGUARD, COVI-AMG, COVISHIELD, Gene-MAb, COVI-MSC and COVIDROPS; and diagnostic test solutions, including COVITRACK, COVISTIX and COVITRACE.

Sorrento's commitment to life-enhancing therapies for patients is also demonstrated by our effort to advance a first-in-class (TRPV1 agonist) non-opioid pain management small molecule, resiniferatoxin (RTX), and SP-102 (10 mg, dexamethasone sodium phosphate viscous gel) (SEMDEXA), a novel, viscous gel formulation of a widely used corticosteroid for epidural injections to treat lumbosacral radicular pain, or sciatica, and to commercialize ZTlido (lidocaine topical system) 1.8% for the treatment of post-herpetic neuralgia. RTX has completed a Phase IB trial for intractable pain associated with cancer and a Phase 1B trial in osteoarthritis patients. SEMDEXA is in a pivotal Phase 3 trial for the treatment of lumbosacral radicular pain, or sciatica. ZTlido was approved by the FDA on February 28, 2018.

For more information visit http://www.sorrentotherapeutics.com.

Forward-Looking Statements

This press release and any statements made for and during any presentation or meeting contain forward-looking statements related to Sorrento Therapeutics, Inc., under the safe harbor provisions of Section 21E of the Private Securities Litigation Reform Act of 1995 and subject to risks and uncertainties that could cause actual results to differ materially from those projected. Forward-looking statements include statements regarding Sorrentos pipeline and plans with respect to its preclinical and clinical COVID-19 programs, including the MPro inhibitors to which Sorrento has certain exclusive license option rights; the antiviral properties of these MPro inhibitors, including MPI8, and the potential advantage the MPro inhibitors offer against SARS-CoV-2, its variants of concern and other coronaviruses; Sorrentos plans to develop the MPro inhibitors to address COVID-19 and other respiratory viruses; and Sorrentos strategic plan to address COVID-19 with a combination of treatments and therapies, including small molecules and antibodies, cellular therapies and vaccines. Risks and uncertainties that could cause our actual results to differ materially and adversely from those expressed in our forward-looking statements, include, but are not limited to: risks related to Sorrento's technologies and prospects, including, but not limited to risks related to seeking regulatory approval for MPro inhibitors against SARS-CoV-2, its variants of concern and other respiratory viruses; clinical development risks, including risks in the progress, timing, cost, and results of clinical trials and product development programs; risk of difficulties or delays in obtaining regulatory approvals; risks that clinical study results may not meet any or all endpoints of a clinical study and that any data generated from such studies may not support a regulatory submission or approval; risks that prior test, study and trial results may not be replicated in future studies and trials; risks of manufacturing and supplying drug product; risks related to leveraging the expertise of its employees, subsidiaries, affiliates and partners to assist Sorrento in the execution of its therapeutic antibody product candidate strategies; risks related to the global impact of COVID-19; and other risks that are described in Sorrento's most recent periodic reports filed with the Securities and Exchange Commission, including Sorrento's Annual Report on Form 10-K for the year ended December 31, 2020, and subsequent Quarterly Reports on Form 10-Q filed with the Securities and Exchange Commission, including the risk factors set forth in those filings. Investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this release and we undertake no obligation to update any forward-looking statement in this press release except as required by law.

Media and Investor Relations ContactAlexis Nahama, DVM (SVP Corporate Development)Email: mediarelations@sorrentotherapeutics.com

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Farmers manage more than half of Australia. We all have a stake in them getting it right – The Guardian

Strip away modernity. Unlearn everything you know about the complexity of your average day. The ordinary interaction, the workaday worries, the pinging of your phone, the relentless roll of the inbox. You are left with the human condition. Our most basic needs, as the American psychologist Abraham Maslow noted, are the physiological needs: food and water, sufficient rest, clothing, shelter, health and reproduction.

In Australia and much of the developed world, we often forget that food and water are central to the human story. Food is so plentiful, so present, it is not even secondary.

Yet in 2020, when we saw the shelves stripped empty in a Covid panic, how quickly the instinct to protect those basic needs kicked in. Those of us in developed countries were transported back through history, to the many moments of scarcity, as if living past lives or responding to genetic memories. In a flash, the basics became important. The impermanence of gathering food was underlined.

Although I am primarily a journalist, I have been living alongside food production for 25 years since I moved to a sheep and wheat farm. As I moved my political journalism away from insider reporting to outsider rural coverage, I was alerted to fractures in the farming system that are becoming clear after decades of economic reforms.

How food is grown and where it comes from are choices for every individual and country to make.

Think about how this currently happens in Australia. At its most basic, farmers use soil and water to grow crops and raise animals. In the act of growing, farmers must look after landscapes. Australian farmers manage up to 60% of the countrys land mass and account for up to 70% of its diverted fresh-water extractions. So we all have a stake in farmers doing their job well.

But it is not only that. Farmers are at the interface of the worlds most wicked problems.

Farming both contributes to and is endangered by the biggest existential threats of our time: climate change, water shortages, soil loss, energy production, natural disasters, zoonotic diseases, population displacement and geopolitical trade wars.

In the face of such pressure, there is a barrage of contradictory policies around food growing, and no Australian political party is doing serious thinking about how to knit together food, farming and environmental policies to continue feeding the population while mitigating climate change and biodiversity loss.

Here are some messages farmers receive from governments and consumers.

We want clean, green food to feed the world. We want scale because we want cheap food. We want family farmers. We want the mums and dads. We want big global capital. We want lots to export to help our balance of payments. We want resilience. We want farmers to stand on their own two feet. We want to pay no subsidies. We want farming to be like any other business. We want farmers to use the latest technology for productivity. We want them to look after the environment. We want farmers to look after native habitat for declining species. And now we want them to sequester carbon to turn around both their own emissions and some of the rest of the populations emissions. I think that just about covers it.

It is a lot to get your head around, so here are three things to ponder as we reimagine Australia in the pandemic world.

Firstly, the only way most farmers currently get a pay rise is to make cheap food cheaper. Australia is one of only eight countries where households spend less than 10% of their income on food.

Farmers are paid on yield. Pushed by governments under the deregulation agenda, farmers largely traded the market power of compulsory trading desks and cooperatives for greater freedom to manage their own affairs. This has left them on a productivity treadmill that requires farmers to grow more with less.

The rules of the economy, the policies laid down by our governments, are set on one goal only: farmer economicus maximising economic profit as a food producer. Those are the only signals food producers get right now, and a farmer needs to feed their family.

Secondly, expectations are rising that all land managers look after the environment.

Global food processors want food production that meets their Environment, Social and Governance requirements. A cohort of eaters want to know their food is grown without harming the environment. They want to know animal welfare practice is sound. Global governments need to meet their climate change commitments.

But the simple truth is the food price does not account for the environmental costs and, sometimes, the labour costs in the modern farming system. We have seen this labour shortage play out in the pandemic. Australia farmers are some of the least subsidised food growers in the world.

As a result of these pressures, global governments have starting paying farmers for environmental services to meet their commitments and ensure farmers have an adequate income source. This will require strong environmental accounting of natural systems to ensure farmers are making verifiable improvements.

By 2028, for example, the United Kingdom is phasing out the 1.6bn subsidy farmers receive every year for owning or renting land. Instead the funds will pay farmers to restore wild habitats, create new woodlands, boost soils and cut pesticide use.

This will change the economic signals away from production and towards restoration and regeneration of the landscape. Agriculture minister David Littleproud is working with the Australian National University on a biodiversity package, announced in this years budget, to verify environmental improvements in return for payments. This is a heartening policy development but we can only watch this space.

In Australia, Indigenous farmers, custodians and land managers need parity on this count too. Already some Indigenous managers are paid for cool burning and ranger programs. These could be expanded if we are to change the way we think about this as a revolution for land management.

Thirdly, the shift is away from small to mid sized family farms towards niche producers on one end and large agribusiness in the form of global companies or large family businesses. Big corporates can access cheaper finance and bulk buying outside the regions. This is causing the great hollowing out of farming and rural communities.

High-revenue farms now account for one fifth of the broadacre population but two thirds of land, income and output, according to the Australian Bureau of Agricultural and Resource Economics and Sciences. In 2021, a Weekly Times investigation found the top three Australian landowners by value were the Canadian Public Sector Pension Investment Board, Macquarie Agriculture (as in the bank) and the New York based pension fund Teachers Insurance and Annuity Association of America.

A 2021 Guardian Australia investigation of pastoral-lease data found the person who held the most land was Western Australian mining magnate Gina Rinehart. She controls 9.2m hectares, or 1.2%, of Australias land mass, through three different corporate entities. Corporate interests are bullish and larger family farms are buying out the neighbours.

Here is the bottom line. In the face of tectonic shifts in economic, environmental and social systems, government policy to promote economically and environmentally diverse, robust food and farming systems remains contradictory at best. Silent at worst.

Meanwhile, our communities and landscapes warp and change. Single farm failures are often put down to useless management, lack of scale, bad seasons and bad luck. You were not nimble enough for the marketing demands. You were not big enough at 500 hectares. You were not fast enough to buy the temporary water. Those high jumps keep creeping up. You are not big enough at 5000 hectares. You were not nimble enough to do the future trades. You didnt have the nous to do the water trades. You dont have the technology to shave your production costs.

Right now, the water market is designed to favour high return products. Currently that is nuts. So do we say to whole food-growing industries, sorry, dairy farmers, you werent nimble enough. Milk doesnt earn enough. Sorry, wine grape growers, almonds make more money. Sorry, rice growers, we will buy from Vietnam (until they turn off the tap in a pandemic as they did in 2020). Eventually 90,000 farm businesses may drop down to 9000. Or even 900. Just as the supermarkets have settled into a duopoly over my lifetime. Thats how it works. We turn around one day and the landscape has changed.

The good news is that Australians have created a lot of innovative natural resource management programs, which have brought together formerly warring tribes like the green movement and the farmer groups. The bad news is that in the past decades, small-minded political parties have thrown out many policy programs because they were implemented by the opposite side of politics.

We have killed more clever policy institutes than Ive had hot breakfasts: the National Water Commission, Land and Water Australia and the National Climate Change Adaptation Research Facility, to name a few. All were doing good work to try to synthesise and build the foundations for some connected food and farming policy solutions for managing our very tricky and ancient land mass.

We dont back good ideas for the long term and then we wonder why evidence-based policies dont work.

We are bright enough to reimagine an interconnected system that rewards economic diversity in farming that produces healthy food and landscapes. We just need to start connecting the dots.

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Farmers manage more than half of Australia. We all have a stake in them getting it right - The Guardian

U.S. Court of Appeals for the Fifth Circuit quotes Professor O. Carter Snead in major decision | The Law School | University of Notre Dame – Notre…

Notre Dame Law Professor O. CarterSneadwas quoted last week in a major decision by the U.S. Court of Appeals for the Fifth Circuit in a case upholding a Texas ban on a second-trimester abortion procedure. The procedure, officially named dilation and extraction,is referred to as live dismemberment in the challenged Texas statute.

The decision in the case, Whole Womans Health v. Ken Paxton, was issuedAugust 18.

Judge James C. Ho quoted Professor Snead in the concurring opinion.

Someday, scientists may look back on todays abortion debates as shocking and barbaric just as we look back in disbelief at those who ridiculed and ostracized proponents of handwashing and sterilizing surgical instruments to prevent disease and infection, Judge Ho wrote.

Indeed, many have that view today. According to CarterSnead, one of the nations leading scholars on public bioethics and an expert witness in this case, 132 countries out of 194 that I looked at ban abortion outright, at all gestational stages, with certain exceptions defined by law,while 178 countries generally ban abortion after a gestational age of 12 weeks. So 92 percent of all countries presumptively ban abortions at 12 weeks or less.

Texas does not ban abortion until 22 weeks, the judge concluded. So Texas law is not only valid under the Constitution and Supreme Court precedent its also more permissive than the overwhelming majority of laws around the world.

Snead, who also directs the University of Notre Dames de Nicola Center for Ethics and Culture,is one of the worlds leading experts on public bioethics the governance of science, medicine, and biotechnology in the name of ethical goods. His research explores issues relating to neuroethics, enhancement, human embryo research, assisted reproduction, abortion, and end-of-life decision-making.

In 2018, he and Notre Dame Law School graduate Laura Wolk 16 J.D. co-authored an article on this case for the Harvard Journal of Law & Public Policy titled, Irreconcilable Differences? Whole Womans Health, Gonzales, and Justice Kennedys Vision of American Abortion Jurisprudence.

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U.S. Court of Appeals for the Fifth Circuit quotes Professor O. Carter Snead in major decision | The Law School | University of Notre Dame - Notre...

Male fertility is declining studies show that environmental toxins could be a reason – North Carolina Health News

By Ryan P. Smith Associate Professor of Urology, University of Virginia for The Conversation

In the U.S., nearly 1 in 8 couples struggles with infertility. Unfortunately, physicians like me who specialize in reproductive medicine are unable to determine the cause of male infertility around 30% to 50% of the time. There is almost nothing more disheartening than telling a couple I dont know or Theres nothing I can do to help.

Upon getting this news, couple after couple asks me questions that all follow a similar line of thinking. What about his work, his cellphone, our laptops, all these plastics? Do you think they could have contributed to this?

What my patients are really asking me is a big question in male reproductive health: Does environmental toxicity contribute to male infertility?

Infertility is defined as a couples inability to get pregnant for one year despite regular intercourse. When this is the case, doctors evaluate both partners to determine why.

For men, the cornerstone of the fertility evaluation is semen analysis, and there are a number of ways to assess sperm. Sperm count the total number of sperm a man produces and sperm concentration number of sperm per milliliter of semen are common measures, but they arent the best predictors of fertility. A more accurate measure looks at the total motile sperm count, which evaluates the fraction of sperm that are able to swim and move.

A wide range of factors from obesity to hormonal imbalances to genetic diseases can affect fertility. For many men, there are treatments that can help. But starting in the 1990s, researchers noticed a concerning trend. Even when controlling for many of the known risk factors, male fertility appeared to have been declining for decades.

In 1992, a study found a global 50% decline in sperm counts in men over the previous 60 years. Multiple studies over subsequent years confirmed that initial finding, including a 2017 paper showing a 50% to 60% decline in sperm concentration between 1973 and 2011 in men from around the world.

These studies, though important, focused on sperm concentration or total sperm count. So in 2019, a team of researchers decided to focus on the more powerful total motile sperm count. They found that the proportion of men with a normal total motile sperm count had declined by approximately 10% over the previous 16 years.

The science is consistent: Men today produce fewer sperm than in the past, and the sperm are less healthy. The question, then, is what could be causing this decline in fertility.

Scientists have known for years that, at least in animal models, environmental toxic exposure can alter hormonal balance and throw off reproduction. Researchers cant intentionally expose human patients to harmful compounds and measure outcomes, but we can try to assess associations.

As the downward trend in male fertility emerged, I and other researchers began looking more toward chemicals in the environment for answers. This approach doesnt allow us to definitively establish which chemicals are causing the male fertility decline, but the weight of the evidence is growing.

A lot of this research focuses on endocrine disrupters, molecules that mimic the bodys hormones and throw off the fragile hormonal balance of reproduction. These include substances like phthalates better known as plasticizers as well as pesticides, herbicides, heavy metals, toxic gases and other synthetic materials.

Plasticizers are found in most plastics like water bottles and food containers and exposure is associated with negative impacts on testosterone and semen health. Herbicides and pesticides abound in the food supply and some specifically those with synthetic organic compounds that include phosphorus are known to negatively affect fertility.

Air pollution surrounds cities, subjecting residents to particulate matter, sulfur dioxide, nitrogen oxide and other compounds that likely contribute to abnormal sperm quality. Radiation exposure from laptops, cellphones and modems has also been associated with declining sperm counts, impaired sperm motility and abnormal sperm shape. Heavy metals such as cadmium, lead and arsenic are also present in food, water and cosmetics and are also known to harm sperm health.

Endocrine-disrupting compounds and the infertility problems they cause are taking a significant toll on human physical and emotional health. And treating these harms is costly.

A lot of chemicals are in use today, and tracking them all is incredibly difficult. More than 80,000 chemicals are registered in the U.S. and nearly 2,000 new chemicals are introduced each year. Many scientists believe that the safety testing for health and environmental risks is not strong enough and that the rapid development and introduction of new chemicals challenges the ability of organizations to test long-term risks to human health.

Current U.S. regulations follow the principle of innocent until proved guilty and are less comprehensive and restrictive than similar regulations in Europe, for example. The World Health Organization recently identified 800 compounds capable of disrupting hormones, only a small fraction of which have been tested.

A trade group, the American Chemistry Council, says on its website that manufacturers have the regulatory certainty they need to innovate, grow, create jobs and win in the global marketplace at the same time that public health and the environment benefit from strong risk-based protections.

But the reality of the current regulatory system in the U.S. is that chemicals are introduced with minimal testing and taken off the market only when harm is proved. And that can take decades.

Dr. Niels Skakkebaek, the lead researcher on one of the first manuscripts on decreasing sperm counts, called the male fertility decline a wake-up call to all of us. My patients have provided a wakeup call for me that increased public awareness and advocacy are important to protect global reproductive health now and in the future. Im not a toxicologist and cant identify the cause of the infertility trends Im seeing, but as physician, I am concerned that too much of the burden of proof is falling on the human body and people who become my patients.

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Male fertility is declining studies show that environmental toxins could be a reason - North Carolina Health News