11. The Amway Dream – Business Insider – Business Insider

Amway is a multi-level marketing company: the structure is triangular, but don't call it a pyramid scheme. The Federal Trade Commission already tried and failed. Now, hundreds of MLMs like Amway are embedded in America's towns and cities, and in the highest offices in government. So how did this happen?

Produced by Anna Mazarakis and Clare Rawlinson, with Dan Bobkoff, Amy Pedulla, and Sarah Wyman, with reporting from The Dream's Jane Marie and Dann Gallucci.

Note: This transcript may contain errors.

DAN BOBKOFF: Jane Marie grew up in a small town near Flint, Michigan called Owosso. And back then, in the 70s and 80s, General Motors was the obvious place to work. But not for everyone.

JANE MARIE: My great grandma was an Avon lady. I grew up going to Tupperware parties with my mom and then my aunts and my grandmother and my uncle. And for me it's like an everyday part of my life.

DB: The thing about Michigan is that it is like a mecca for multi-level marketing companies like Avon, Tupperware, and Mary Kay. It's an MLM Heartland.

JM: Kind of everyone from back home has some connection, if not working as a distributor for one of these companies, you know going to parties.

DB: Jane was surrounded by MLMs, but skeptical of them. Except for one moment, when she had a brief flirtation with an MLM.

JM: I'd forgotten this, blocked it from my memory. But I remember right when I was 20 I hosted one at my house once.

DANN GALLUCCI: I didn't even know that.

DB: That's Jane's partner, Dan.

JM: I told you. (laughs) It was a lingerie one.

DB: Oh.

JM: And they brought in like a rolling wardrobe rack and then there were like prizes. And if you - if you modeled it in front of everyone, it was all ladies, but if you'd come out of the bathroom and like show the night gown or whatever you would get like extra prizes. So I got a lot of extra prizes because I have no humility, no shame.

DB: What were the prizes?

JM: Just like an extra pair of panties or you know a candle or it was gross, like don't get me wrong it was totally gross. But it was fun. I had a good time.

DB: How old were you?

JM: Twenty. Yeah yeah.

DB: And did you like have a conception of MLMs and all these reputations and all that back then?

JM: Me? Yes. I've never joined one myself.

DB: But she still couldn't fully avoid them.

When Jane moved to Los Angeles, she'd see Facebook posts from friends back home trying to recruit new distributors to this or that MLM and she'd wonder: how is this Ok? How is this not a pyramid scheme?

For the last year, she and Dann have been answering those questions.

And, to understand how this $200 billion industry exists, you have to start with one name

CLIP: Amway may be the answer.

From Business Insider and Stitcher, this is Household Name: brands you know, stories you don't. I'm Dan Bobkoff.

On this show, we look at how famous companies affect our lives and culture - sometimes on a national scale, sometimes just on a very personal level. And you might be surprised at how much Amway has shaped American life in the last half century.

Amway is the godfather of all multilevel marketing.

Amway is the oldest.

Amway is the biggest.

The most powerful MLM of them all.

About forty years ago Amway convinced a judge that it's not some illegal pyramid scheme.

That one moment emboldened an entire industry, leading to an explosion of MLMs.

Maybe your friends have tried to get you to buy some yoga pants or skin creams. Maybe they've tried to get you to sell them too.

So today, we're teaming up with Jane and Dann to find out how any of this is legal? Why do people sign up? And who's actually making the money here?

Stay with us.

ACT I

BERNIE SANDERS: Thank you Mr. Chairman and Mrs. DeVos...and thanks for being with us and dropping into the office a few days ago...

DB: It's early 2017. Senators are grilling Betsy DeVos on her way to becoming education secretary. She's a controversial pick. She didn't have much experience in education, but she's donated a lot of money to charter schools. Betsy DeVos is rich and Senator Bernie Sanders has a question about that.

BS: Would you be so kind as to tell us how much money your family has contributed to the Republican party over the past 30 years?

BETSY DEVOS: Senator thank you first of all for the question, I was pleased to meet you in your office last week. I wish I could give you that number, I don't know.

BS: I have heard the number is 200 million. Is that the ballpark?

BD: Collectively? My entire family? Yes that's possible

DB: It's possible because of Betsy's father in law, Rich DeVos, and the company he co-founded in 1959: Amway.

RICH DEVOS: I was 23 - All I know is this business - I spent my life at it - went pretty good but wasn't always easy.

DB: You could say Amway sells products. But really what Amway sells is something more quintessentially American the idea that anyone can be an entrepreneur and make a fortune.

If you don't know what multilevel marketing is, here's the short version. First it recruits regular people to sell its products. Those people then recruit more salespeople, and they earn commission from all the salespeople beneath them. They're called the "downline."

The early recruits come out the best because they earn commissions on what their recruits sell, and commissions on their recruit's recruits, and their recruits' recruits' recruits all the way down the line.

The higher you are on the chain, the better it is for you.

If all this sounds like a pyramid scheme, well. you're not far off. It is in the shape of a triangle, but legally, there is a line between a pyramid scheme and multi-level marketing.

Which brings us back to Jane Marie and Dann Gallucci. They both live in Los Angeles now. For the past year, they've been making a podcast that confronts head-on the world of multilevel marketing in America.

Jane was a reporter for This American Life, and Dann was a rock musician - until they became partners at their own production studio.

DB: What kind of partners are you? Professional romantic?

JM: Yeah. So we're both. As partners partners like sitting around Netflixing and chilling we were like 'We should have a recording studio. We should make the thing that we want, we should make the place where we want to work.'

DB: Nice.

JM: So we did.

DB: And last week, they launched a new show called The Dream. Here's a bit of their trailer.

TRAILER: Pyramid schemes are agains the law, ok? But this is not one of them.

In this area I was encountering women that didn't have bank accounts, that had their credit cards shut off.

People that failed were told, 'You failed because you didn't work hard enough.'

They know that what they're setting up is taking advantage of people.

No authority in the country right now will openly acknowledge this for what it is.

JM: you know all of those annoying Facebook ads you see. 'We have an incredible business opportunity for you. How would you like to earn a living working ten hours a week and only selling candles,' like that kind of thing.

DB: I don't get those ads.

JM: You don't get those ads?

DB: No but I get ads for Ziprecruiter telling me that they're sponsoring podcasts. So I think I've been very very typecast.

JM: You don't have enough cousins in rural Michigan. Female female cousins in rural Michigan who who really like make-up and that's all. That's my whole feed on Facebook. So we have this thread going throughout the series of my personal experience and my family and my hometown and how these companies flourish there and then you know our big question was why? Why are they flourishing? Why when we see the numbers and we know that people aren't making money, how is this a thing? And Dann discovered that the reason was Amway. So he's going to tell the story of all of that. Of the history of MLMs, of the history of Amway, and what happened to Amway and the industry of multilevel marketing after Amway beat the FTC.

DB: Okay so before I talked to Jane and Dann, I was only vaguely aware of Amway. I knew it sold a lot of things but I couldn't tell you what they were. So let's get a little Amway 101.

DG: Amway was started in 1959 by two people who - Rich de Vos and Jay van Andell. They had themselves started out as sales people for a company called Nutrilite which is arguably the first multi-level marketing company.

They had tried and failed at several different businesses and then became Nutrilite distributors and performed well because they got in really early. But one of the problems with Nutrilite was that they sold dietary supplements and at that time the FDA was cracking down on dietary supplements in a major way, and felt like Nutrilite's science was not really backing up their claims.

So Van Andel and De Vos decided that they shouldn't be in the supplement game and decided to sell a soap called Friske and that was their first product.

DB: So this is the birth of Amway. Soap!

But it's a lot more than that now. Today, Amway sells more than 450 products - beauty products, skincare, electronics, kitchen products and along the way, Rich Devos and Jay van Andel got over their fear of selling dietary supplements. Amway actually bought Nutrilite in the '70s..

NUTRILITE AD: Nutrilite pioneered nutrient supplements in 1934...

DB: Now it's the company's biggest seller.

DB: What made you so obsessed with Amway?

DG: The reason I became obsessed with them was specifically because as I would talk to various people who were experts on MLMs. And what people kept saying to me was there was a case that happened in 1979 and it was the FTC v. Amway where the government had been successfully prosecuting MLMs for the prior decade.

It seemed as though the government had decided that multilevel marketing was a fraudulent business model - for about ten years they were taking down several of the biggest companies and very high profile cases.

DB: Perhaps the most high profile takedown of an alleged pyramid scheme by Federal Trade Commission's was its case against a company called Holiday Magic in 1974. This was an MLM that sold scented cosmetics, and some kind of personal empowerment.

HOLIDAY MAGIC: Today, I am earning more money each week than 96% of the American people earn a year. Soon, my earnings per day will be likewise. This money will continue as long as I desire it to...Wealth comes from giving something of value to other persons who are willing to pay for this value...

DB: The FTC charged Holiday Magic with deceptive trade practices. It became a success story for the opponents of MLMs. In this moment it seemed the FTC was about to take down the whole industry.

DG: And then it changed with that Amway case, they used the same evidence and the same tactics going into this Amway case but they lost. And because of that loss, a lot of people feel like the industry was emboldened that they would be able to operate more freely.

DB: Amway insists it's not a pyramid scheme...it says it's possible to make more money than people above you on the chain. Amway even made a YouTube video explaining why it's not one.

YOUTUBE AMWAY CLIP: Unfortunately, people, companies and even countries get stuck with labels that aren't true. Those labels can ruin reputations. Amway has one of those untrue labels: pyramid scheme. So lets better understand that label, so we can remove it...

DB: The video goes on to explain the ways Amway avoids meeting the legal definition of a pyramid scheme. And it essentially lists the same reasons the judge gave in 1979 when he ruled Amway wasn't one.

Here are the main reasons.

To sell for Amway, you become what it calls an Independent Business Owner, or IBO. It costs almost nothing to become an IBO. Like $100 or less. And then consumers actually want the Amway products those IBOs are selling to their friends and family. Maybe many of them really do like the shampoo and knife sets. Amway always emphasizes this point. They did so again when we contacted them for comment, , writing that quote "Amway has long been recognized as a legitimate direct selling business, primarily because Amway business owners sell quality products to consumers and no one earns income unless products are sold." And if those products don't sell, Amway allows the IBOs to return the leftovers for a refund.

But then you read the company's business reference guide - which is this 56-page PDF that explains how IBOs actually make money - and it's not very enticing.

First of all, it said in 2016, less than half of Amway's Independent Business owners were active. Active means they did something Amway-related: like selling something or at least trying to sell a product. Or maybe they met with someone they're trying to recruit. And then for those who are active, Amway says the average income for its IBOs is less than $2500. Per year. That's like $200 a month. And that doesn't include a lot of expenses to run the business. Amway even admits, often those expenses a higher than what people earn...and there isn't an estimate of how much money people are losing, if they're not active every month of the year...which Amways says "of course some people choose not to be."

All that's in the fine print.

We asked Amway about this and the company wrote saying: "Amway is a low-cost, low-risk option for people to supplement their income. While most conduct their Amway businesses part-time, which is common in our industry, some grow their business beyond that."

The ways each MLM works is a little different. But if this is the picture we get just from looking at Amway, how do any of these schemes manage to attract people?

DG: Well the promises are that you can make - it's entirely up to you. But if you work hard enough, commit yourself to this, if you do everything that they tell you to do, and that's a long list, then you have the chance to make millions. One of my favorite quotes is a guy named Robert Fitzpatrick who is one of the experts that we talked to, was at an Amway meeting and someone spoke up and said 'you know well I'm a schoolteacher. I mean how is it - like how is this going to affect me?' Or whatever. And someone said 'well that's a loser job, being a schoolteacher. You don't want that, not for you or for your family. You know you want this. You want to be rich, you want to prove to everyone in your community, everyone in your family that you can do this, that you can provide for them, not only what you need but all of your dreams what you want.' I mean everything about the way these companies operates involves heightened emotion. And one of the reasons for that as well is that the last thing that they want anyone to do ever is to look at the actual numbers.

JM: And be rational.

DG: That's not what the conversation should be ever. Because if you were to look at those numbers, first of all, it takes so long and people will get bored and walk away. But ultimately you would find that it's next to impossible to be successful

DB: Is that true for Amway too? Are they all about emotion?

DG: Absolutely. Opportunity meetings. Yes.

ARCHIVAL: We didn't know when we would become financially successful but we knew it was coming soon because we have a system no different than you.

When we spout off to our friend we are putting stakes in the ground, and here's out company - they look at us - and if they don't see us making headway, we care creating doubt in them.

DG: They all follow the same line which is you know you're reaching out emotionally to people.

Link:

11. The Amway Dream - Business Insider - Business Insider

How Community and Sports Play a Critical Role in the Mental Health Recovery Process – James Moore

A new study, published in the Journal of Psychosocial Rehabilitation and Mental Health, explores the importance of social inclusion in the process of recovery from mental health and or substance abuse challenges. The study authors, led by Esther Ogundipe from the University of South-Eastern Norway, highlight the importance of social recovery in a street football (soccer) program the leveraged the community and camaraderie of sports toward improved mental health.

Social recovery takes into account a persons social contexts. Thus, the impact of culture and the structural elements of our socio-economic-political system is seen as relevant. The concept of social recovery demands for health services, policymakers, and practitioners to look beyond the person, and consider issues of social justice and social inclusion, Ogundipe and colleagues explain.

While the understanding of recovery has shifted over time, a dominant narrative remains that centers individual responsibility and minimizes social processes. However, a growing trend is moving away from individualistic ideas and toward an understanding of recovery that is about living a life of meaningful participation and belonging in the community. The authors write:

Another way of understanding social recovery is by referring to what is essential to us all as human beings; being loved, being with others, loving someone, and having fun. Central in social recovery is that the person is first and foremost seen and understood as a citizen, living in the community and being an active agent in his or her life processes as opposed to a victim of a disease.

A prominent focus of social recovery in the current literature is through sport, particularly street football (or soccer). The authors of the present article highlight previous studies that have drawn links between street football and the five concepts of recovery: Connectedness, Hope and optimism, Identity, Meaning and purpose, and Empowerment (CHIME).

The Football Association in Norway is an example of a social inclusion program where anyone with a mental health and or substance abuse problem can join. Their goal is to facilitate a meaningful everyday life for the players. The teams provide players with meaning and the opportunity to develop new coping skills.

While these types of community efforts are gaining traction, more research is needed to understand the connection between street football teams and the recovery process. Ogundipe and the study authors aimed to explore the relationship between the recovery process for those who experience mental health and or substance abuse challenges and their participation in street football teams.

In their study, Ogundipe and colleagues utilized the method of focus groups to explore their research questions. Eight focus groups were conducted between May and September 2018, which included over 50 participants. All participants were involved in the street football teams and were experiencing mental health and or substance abuse challenges. The interviews were transcribed verbatim and analyzed using thematic content analysis.

Findings of the qualitative study produced three themes: (1) The spirit of the football team, (2) More than just a pitch, and (3) The countrys best follow-up system.

In conclusion, the street football teams do not work as an island for recovery, instead, they connect individuals with others, give them a sense of meaning, and help them access services to make long term changes in their lives. While street football teams are just one example of social recovery, the concept is promising for those dealing with difficult life situations.

The study authors conclude with a quote from Pat Deegan in Realizing recovery:

What matters in recovery is not whether were using services or not using services; using medications or not using medications. What matters in terms of a recovery orientation is, are we living the life we want to be living? Are we achieving our personal goals? Do we have friends? Do we have connections with the community? Are we contributing or giving back in some way?

****

Ogundipe, E., Borg, M., Thompson, T., Knutsen, T., Johansen, C., & Karlsson, B. (2020). Recovery on the Pitch: Street Football as a Means of Social Inclusion.Journal of Psychosocial Rehabilitation and Mental Health, 1-12. https://doi.org/10.1007/s40737-020-00185-6 (Link)

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How Community and Sports Play a Critical Role in the Mental Health Recovery Process - James Moore

Eclecticism is the key to the electric energy of Jordin Sparks – Red Bull

"I don't have a box," declares US singer Jordin Sparks in the latest instalment of RedBull Studio Sessions. Sparks isn't in the throes of moving house. Instead, back in the studio to write and record her new six-track EP, Sounds Like Me (listen to it here), Sparks is talking about attempts to pigeonhole her musically and how determined she is to stick to her own wide-open path. "When you do something scary, that's how you know that's what youre supposed to be doing."Her adventurous approach to music-making is captured throughout her edition of RedBull Studio Sessions a filmed, fly-on-the-wall document of how Sounds Like Me was made. Working with guest producers, songwriters, rappers and singers, Sparks is just as comfortable collaborating with Lord Quest a producer best-known for working with hip-hop golden boys ScHoolboy Q, Raekown and Juice Wrld as she is with electronic-pop artist Sad Alex and the other stylistically varied talents (Zak Waters, Jordyn Dodd, P. Wright and Rami Jrade) invited to help make Sounds Like over three days in LA. Sparks is not, it seems, afraid of the unexpected.

Watch RedBull Studio Sessions: The Jordin Sparks Edition

The Jordin Sparks Edition

Sparks's approach is fuelled by an eclectic, electric energy she was able to harness early on. She's an artist who has absorbed influences from all corners of the musical spectrum, utilising her love of all music to power an impressive career that began, of course, when she won the sixth season of American Idol at just 17-years-old.

The ever-evolving production techniques that have propelled R'n'B through so many changes over the past four decades have played a big part in this. "I grew up in the '90s and '90s R'n'B is my favourite Mariah Carey, Whitney Houston, Boyz II Men, Babyface," Sparks told an interviewer a few years ago, citing Brandy and country pop star Martina McBride as major inspirations early on, too.

"It was kind of weird to have such a big voice and it was weird to try to figure out if that was normal or not. When I heard Mariah and Whitney, I was like, 'Oh, these girls have big voices like me, it's okay'."

US soul-pop star, Jordin Sparks

Aldo Chacon/RedBull Content Pool

Then there's her undying love of Motown, which inspired not just her singing, but helped kick-off her acting career, too, when, in 2012, she starred in Sparkle, a film about three singing teenage sisters from Detroit who form a girl group in the late 1960s. It was the final film role for her hero Whitney Houston before her death.

Lyrically, she's doing her own thing, too, shifting the focus away from self-centred braggadocio. "I really want some happiness, because my life is really good," she says during her episode of RedBull Studio Sessions, referencing her love of personal, confessional songwriting. Wearing her heart on her sleeve, Sparks discusses her desire to reflect her family life in her music and is overcome with emotion during a concept presentation of one track, with Sad Alex on piano, as she makes connections between its lyrics and her own life.

"It's so beautiful, so pretty and so many people go through this, too," she says, through tears. "Do you choose to stay or do you just give up? Thats the whole point you choose that person, you choose them every single day, no matter what you feel."

Watch how Jordin Sparks wrote and recorded Red Sangria:

The making of Red Sangria with Jordin Sparks

There's a defiance that reverberates through Sparks's music, including on this new EP, that is, in part, informed by her experience of loss. Her step-sister died aged just 16 of sickle cell anaemia ("She inspired me so much, she was such a fighter," Sparks said in an interview last year) and she's seen close friends pass away.

But her positive, seize-every-moment outlook also stems from her belief in the power of sisterhood and her fight for female empowerment a topic that she sang so openly about on her 2011 track I Am Woman. "It's all about the amazingness of a woman," she said at the time. Which is something you'll know all about after watching Sparks at work in RedBull Studio Sessions.

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Eclecticism is the key to the electric energy of Jordin Sparks - Red Bull

It’s Time to Find Your Sense of Self – PsychCentral.com

Having a strong sense of self provides us with emotional fortitude and personal empowerment. Life is better when we experience life as sovereign beings. Having a sense of self allows us to navigate the world with confidence and autonomy.

What if we have yet to find our true self? Can we gain a sense of self while surrounded by global turbulence? Can we find our center and take charge of our spiritual journey when the world is spinning?

Many of us are feeling anxiety, despair, and hopelessness because we are energetically connected to each other and to the world. Our collective consciousness is reflecting our fears, attitudes, opinions, and disbelief. As the stress builds, our collective consciousness responds in kind. We find ourselves trapped in a pattern that is very difficult to escape and we can find ourselves in a tailspin. We have our independent tailspin and we are part of the collective tailspin. This is where many of us find ourselves now.

There is good news, however. We are at a place now between worlds, between eras where the next Golden Age awaits us. We each have an opportunity to heal our pain and step into the truth of who we are. Healed of the human experience and with a sense of our self, we can contribute to the new world.

This is the spiritual journey we signed on for at this exact time in our human evolution.

The goal is to attain spiritual growth and ascension by living a soul conscious life. We are born to have an embodied soul experience here on Earth. We are part of the new destiny creating heaven on Earth. We intuitively know is it our divine birthright.

The human experience is one that allows us free will and free choice. Our soul group, angels and guides can offer gentle guidance, but they cannot interfere with our free will. This is cosmic law. The free will choices we make independently and unconsciously can often produce less than desirable results leaving an imprint of karmic wounds that will require reconciliation before they can be released. The lessons are never intended to be punitive, but they are intended to teach us to choose better as we mature.

Karmic reconciliation does not have to be done in real time and physically experienced. Your intention to heal, supported by the gifts of a skilled healer and powerful modalities, will aid you to identify, release, and heal the wounds of karma. This will set you on your path enabling you to give to the collective from your healed heart. Your soul group and the cosmic hierarchy will celebrate your win and welcome you to the path of light worker, able to be in service to others.

A best use of free will and free choice is to heal your life. You come into this world contracted with your soul, your soul group, and individual souls to learn, grow, and ascend on the ladder of evolution. This truly is the time for humanity to change the course of their lives, evolve, and experience heaven on Earth.

The key is simple, but not necessarily easy. We all need help to make the journey. A guide, mentor, healer, mystic and/or shaman can awaken our intuition and natural self-healing abilities that may be dormant having atrophied over time.

The connection we have with each other allows us to join our intentions and receive healing and support through a remote connection. We are joined on this planet during this time to collectively create a better world. We dont need to travel physically to contribute or receive love, grace and healing. We can be together remotely and joined outside of time and space simultaneously. It is the high vibrational, healing remote connections that will take us forward.

My experience as a healer gives me absolute faith that all will be well. We are on the threshold of a new beginning. We will know peace, love, and joy. To be here now, to experience renewal with beautiful souls, and to celebrate our collective success will be a miracle come true.

This post courtesy of Spirituality & Health.

Related Articles

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It's Time to Find Your Sense of Self - PsychCentral.com

INCB, WHO and UNODC statement on access to internationally controlled medicines during COVID-19 pandemic – World Health Organization

Scope (COVID-19 and non-COVID-19 patients affected by the pandemic)

The International Narcotics Control Board (INCB), the World Health Organization (WHO) and the United Nations Office on Drugs and Crime (UNODC) call on governments to ensure that the procurement and supply of controlled medicines in countries meet the needs of patients, both those who have COVID-19 and those who require internationally controlled medicines for other medical conditions.

There is a need to ensure access to controlled medicines such as sedatives and analgesics for intubation protocols for the treatment of patients with COVID-19. Non-COVID patients continue to require controlled medicines for the management of pain and palliative care, surgical care and anaesthesia, mental health and neurological conditions, and for the treatment of drug use disorders.

It is important to remember the needs of existing patients who require controlled medicines for the management of these health conditions. These patients faced barriers to accessing controlled medicines before the COVID-19 pandemic. The COVID-19 pandemic has further resulted in interruptions of the medicines supply chain, and it is critical that access to essential health services and medications not be forgotten or de-prioritised during this pandemic.

As the pandemic increasingly affects countries with under-resourced health infrastructure and services, it is an ethical imperative to ensure that all people in all countries of the world are able to access essential medicines. This includes those medicines that are under international control.

Governments should ensure that sufficient quantities of internationally controlled medicines, of assured quality, are available and affordable to people under medical care. Throughout the duration of the pandemic and beyond the acute phase of burden on the healthcare infrastructure, it is critical that governments work cooperatively to ensure that no country, no region, no district, no city and no patient is left behind. Competent national authorities, manufacturers, suppliers and distributors play a crucial role in ensuring that internationally controlled medicines urgently needed for medical treatment are available within and across national borders. The supply chain is the foundation of quality medical care because without the necessary supplies, including essential controlled medicines, patients will suffer.

Governments are reminded that in acute emergencies, it is possible under the International Drug Control Conventions to utilize simplified control procedures for the export, transportation and supply of medicinal products containing controlled substances, especially in those cases where the competent authorities in the importing countries may not be operating at full capacity. Competent national authorities may permit the export of medicines containing narcotic drugs and/or psychotropic substances to affected areas even in the absence of the corresponding import authorizations and/or estimates. Urgent deliveries do not need to be included in the estimates of the receiving countries affected by emergencies. When possible, competent national authorities are also encouraged to issue electronic import and export authorizations through the INCB International Import and Export Authorization System (I2ES), PEN Online and share related contingency measures in the forum therein.

Countries should ease COVID-19 related transport restrictions for controlled medicines and consider local production solutions when feasible, to meet the COVID-19 driven demand spikes.

To assist countries as they work to find solutions to the lack of access and availability of controlled medicines, the three organizations suggest the following technical assistance and support documents:

The work of doctors, nurses, and health care professionals in general, who provide treatment and care to people including the most vulnerable, needs to be supported and safe and effective medicines should be available, accessible and affordable at all times for people who need them.

INCB, WHO and UNODC are committed to continue to work together to address this critical issue and will expand joint efforts to engage with other partners and increase advocacy and technical assistance to countries for improving access to controlledmedicines during the COVID-19 pandemic and mitigate barriers to ensure that both patients affected by COVID-19 or by other non-COVID-related conditions requiring medicines under international control have access to these medicines when they need them.

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INCB, WHO and UNODC statement on access to internationally controlled medicines during COVID-19 pandemic - World Health Organization

Flint physician focused on advocacy named Michigan Family Medicine Resident of the Year – mlive.com

FLINT, MI Dr. Julie Thai of McLaren Flint said she went into medicine to help her patients not just medically, but in a social context as well.

When I hear my patients stories about how theyre struggling to pay for rent or theyre struggling to find childcare so they can even go to work or come to their medical appointment, I feel compelled to help them, Thai said. When things are unfair in the healthcare system and my patients cant get access to the medications they need or diagnostic workup, I feel that I have this platform I can use to advocate for them.

Advocacy has been the central theme of her training in Flint, Thai said. She is in her final year of residency at McLaren Flint Family Medicine Residency and was recently recognized with a 2020 Michigan Family Medicine Resident of the Year Award by the Michigan Academy of Family Physicians. Not long before, she received the Association of Family Medicine Residency Directors Family Medicine Resident Award for Advocacy.

I try to do everything I can for my patients not only as their physician, but as their advocate. So as part of that, I was recognized for my work and that means a lot, Thai said. I am so fortunate to get to do what I love to do, and to be recognized for what I love to do is a huge honor.

Thais program director, Dr. Prabhat Pokhrel, nominated her for the award and said she has made a tremendous contribution to the Flint community. He said the advocacy and health policy curriculum she co-authored after completing a workshop with the Michigan Academy of Family Physicians has been built into the McLaren Flint Family Medicine Residency program and taken to the next level. The curriculum is getting state and national attention, and a toolkit has been made available for other residency programs looking to replicate it.

Before she came, we didnt have any advocacy curriculums, Pokhrel said. She came up with this idea.

Thai holds a masters degree in public health from Columbia University and went into research before deciding to become a physician. She said she felt an urge to do more public health and public service work, and came across the Michigan Academy of Family Physicians workshop by chance.

That was a life-changing moment for me because I got to hear from a lot of the people who work at the Capitol about physicians getting involved in advocacy work. And it made me feel empowered, because I realized that we are put in a position where we do have a voice where people do listen to us, Thai said. I felt that I had to speak up, I had to be a part of the group that fights for change. And I just never stopped doing it.

Thai attended Senate committee hearings on prior authorizations and said allowing insurance companies to dictate how physicians practice medicine is something she wants to fight against on a policy level, since she said a lot of their patients cant get the medication they need. In addition to pushing for change, Thai is conducting a study on the barriers to breastfeeding in the community after noticing a lot of new mothers at McLaren werent breastfeeding despite national recommendations.

I read some research that in a lot of urban underserved communities, moms dont tend to breastfeed because there isnt a lot of education around it, Thai said. That got me thinking about trying to identify barriers to breastfeeding in our community in Flint.

The survey study was approved by the Institutional Review Board at McLaren and is being conducted by Thai and two other faculty members.

Ive collected close to 100 questionnaires already from moms, and most of them want to participate, most of them want to share their experience, Thai said. It helps us figure out what is stopping them from breastfeeding and how we as healthcare providers can help increase the rate of exclusive breastfeeding in this community.

Thai is originally from California and came to Michigan by way of medical school, earning her degree from Michigan State University College of Human Medicine in 2018.

I really feel like Michigan has become a second home to me, she said. When I matched here in Flint, I thought this would be an amazing opportunity to learn how to provide care in an urban underserved community, similar to one that I grew up in.

Thai was elected by her peers and faculty at McLaren Flint Family Medicine Residency to serve as academic chief resident for the 2020-21 program year. She previously served as the programs assistant chief resident. Thai said shes thankful for Pokhrels support and the support shes received from hospital leadership as well as from her patients. After completing her residency training next year, she plans to pursue a fellowship in geriatrics.

The impact has been immense. The things Ive gotten to do here have shaped me as a person and as a professional, Thai said. A lot of my patients, when they tell me that they view me as not just their physician but as their friend, I feel very moved by that. I feel as though thats all Ive ever wanted, to have that meaningful patient-doctor relationship and be able to help individuals through a tough time in their life.

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Flint physician focused on advocacy named Michigan Family Medicine Resident of the Year - mlive.com

Support the Badger-Two Medicine Protection Act – Flathead Beacon

Opinion | LetterThe Badger-Two Medicine represents one of the largest unprotected roadless areas in the lower 48 states

By Louis Bruno // Aug 14, 2020

I am a retired school teacher and professional naturalist guide. I have lived at the foot of the Badger-Two Medicine for the past 45 years.

The Badger-Two Medicine represents one of the largest unprotected roadless areas in the lower 48 states. Taken on its own, it represents some of the finest wildlife habitat in the United States. It serves as critical habitat for moose, elk, grizzly and black Bear, wolf, mountain lion, westslope cutthroat trout and countless other sensitive species. When you consider its position in the Northern Continental Divide Ecosystem, it is crucial to its biological integrity. It also serves as the spiritual anchor for Blackfeet culture.

In 1984, I and other local residents, both tribal and non-tribal, formed the Glacier-Two Medicine Alliance in response to the threat of oil and gas development. The U.S. Forest Service provided a map showing a scenario of development for the area over the next 10 years. It showed 23 gas wells with inter-connecting roads and a gas processing plant in the center of the unit. Such development would have totally destroyed the area for recreation, wildlife and Blackfeet use for spirituality. The Blackfeet and other Montana citizens have spent the past 45 years advocating for a wild Badger-Two Medicine. In the ensuing years, countless United States citizens have urged protection for this area. Such upwelling of public support for protection led the Secretary of Interior to place a moratorium on future oil and gas leases in the area.

The Badger-Two Medicine Protection Act would permanently protect this area from industrial development. For this reason, I urge everyone to support this crucial piece of legislation.

Louis BrunoEast Glacier Park

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Support the Badger-Two Medicine Protection Act - Flathead Beacon

AINsight: Aviation Medicine in the Pandemic, Part 3 | Business Aviation – Aviation International News

The entire world continues to learn new adaptations and strategies to cope with the Covid-19 pandemic, with ongoing changes occurring literally on a day-to-day basis. Will children return to public schools at all this coming year? Many college sports seasons are now canceled entirely. Most of the remaining professional sports events are being played without spectators.

The most disappointing to me personally is being unable to go scuba diving nor make my near-annual trek to The Masters. But if I am healthy enough to lament the small stuff, then at the same time I need to feel grateful and fortunate. That remains something that I focus on during some of the ongoing frustrations and disappointments.

If I or family, friends, and colleagues are healthy, then we have plenty to be thankful for. Hopefully, in time, the societal burdens due to the pandemic will lessen. We all must exercise patience along the way.

All businesses are making adjustments, including those involved in both corporate and airline flight operations. At one moment there is some small optimism that airline bookings are improving, and then come the dire furlough warning letters being issued.

Aviation medicine is making adjustments, too. The FAA has realized that the process of obtaining a medical certificate is hindered by the pandemic, both in regard to the routine logistics of doing so and also for the inherent exposure risks to pilots and their AMEs.

In recent blogs, I discussed the adjustments being made regarding medical certificate extensions. The original ruling simply stated that the FAA would not take legal action against a pilot who continued to fly in non-compliance with medical certificate durations (for up to three months) as outlined in FAR 61.23. In other words, the pilot is knowingly breaking the rules, but no enforcement action will be initiated against that pilot.

More recent FAA clarifications have occasionally used softer wording, in that the validity period of the medical certificate would be extended by the noted three months (even though the non-compliance wording remained the seemingly controlling verbiage). Regardless of the ongoing nebulous nature of the wordings, all recent FAA statements make it clear that the FAA has sanctioned flying for up to three months beyond the typical medical certificate durations outlined in the FARsat least for the time being.

A special FAR (SFAR 118-1) was published on June 29, noting an effective date of June 25. This SFAR provides relief for both medical and operational certification date requirements. The FAA sent clarifications to AMEs on July 1, referencing some of the provisions of the SFAR.

The FAA notes that more than 57 percent of AMEs are over the age of 60, a demographic at higher risk of severe effects from Covid-19. I am one of that aging lot, but have continued to operate my office full time to support my pilot clients. My staff and I have made several accommodations to comply with accepted medical practices for reducing the risk of transmission of Covid-19.

These accommodations are somewhat inconvenient, of course, but we are happy to do our part to reduce risks to everyone. Pilots who come to my office have been all over the world and will soon leave to points afar once again. I do not want them to get sick from being in my office, and similarly, I do not want my staff or myself to get infected with Covid from a pilot who may be an asymptomatic carrier of the disease.

We cannot lead our lives in complete fear and paralysis, but prudent behavioral modifications and interventions are worth complying with while the virus situation is being sorted out.

In a more recent clarification to AMEs, dated July 7, the FAA stated that the non-enforcement of expired medical certificates is a rolling 90-day action. While again, there remained no true use of the word valid, the FAA does clearly support that medical certificates may be used for an additional three months.

However, the final rolling action timeline stated is that certificates that would normally expire Sept. 30, 2020, will now be in a non-enforcement status until Dec. 31, 2020. No extensions are stated beyond that date in this most recent guidance.

There is no way for me to predict whether the FAA will extend medical certificates yet again, beyond these stated dates. If they do not, the AME might be burdened with the expectation to perform up to three months of exams in December. I know that I will not have time to do that, and many of the other still-working AMEs may not either.

I recommend that pilots plan their renewal dates carefully and check with their AMEs well in advance to see if there will be available scheduling time should the pilot elect to fly beyond the usual expiration date of their existing medical certificate.

There remains confusion regarding how to handle expiring special issuances. These authorizations require a time limit to be placed directly on the medical certificate itself, stating that the certificate is not valid for any class after a specified date. This limitation, directly stated on the medical certificate, makes it impossible for me (or the aviation advocacy groups) to provide a blanket statement to pilots that it is OK to fly beyond that date. We have asked for more specific clarification on this from the Federal Air Surgeon, but so far there has been no formal guidance issued to AMEs.

While awaiting more specific guidance from the Federal Air Surgeon, the process for the AME to obtain a one-time case-by-case extension of a special issuance for a pilot requires direct communication with an FAA physician. This process itself is too involvedand is sometimes frustrating and time-consumingto discuss in this blog, and I encourage pilots to ask their AMEs to do so only if it has been truly impossible to obtain the required data as specified in the special issuance authorization.

The FAA continues to state on its website: If you are able, we continue to encourage airmen to accomplish their regularly required airman medical certificate exam with an FAA AME as per normal scheduling and FAR requirements. The extensions exist, but everyone involved, from the FAA to the AME, understands that pilots should stick to their normal renewal cycle if at all possible.

The requirements of FAR 61.53 are not waived by any of the advertised medical certificate extensions. As you know, FAR 61.53Prohibition on operations during medical deficiencyrequires pilots to self-ground should there be a new condition of aeromedical concern, worsening or exacerbation of an existing condition (which may already be addressed in a special issuance authorization), and/or if new medications of potential concern are prescribed (or may simply be non-prescription medications being taken on an over-the-counter basis, but have effects that would not be compatible with aviation safety).

Therefore, if a pilot has a new medical situation that may otherwise preclude the issuance of a medical certificate (or may be theoretically grounding at any other time), the extensions cannot be used as a vehicle to continue flying regardless of the new medical concerns. FAR 61.53 applies at all times that a pilot intends to exercise the privileges of a medical certificate, without exception.

I express hope that pilots, their families, ancillary aviation workers, and vendors, and, of course, we aging AMEs and our staff members, all maintain health during these troubled times. I also hope that the world economy recovers and that once again there will be a more prosperous and optimistic future ahead of us.

Lets support each other along the way, and be thankful for the health afforded by being careful and responsible with virus mitigation protocols.

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AINsight: Aviation Medicine in the Pandemic, Part 3 | Business Aviation - Aviation International News

Kyiv-based Liki24, an e-commerce platform for medicine delivery, raises 4.2 million to expand internationally – EU-Startups

Liki24, a Ukraine-based e-commerce platform for medicine delivery, has raised around 4.2 million from Horizon Capital and existing investors, bringing total funding raised to date to approximately 5 million. This new equity round will support the startups ambitious European expansion plans, with Poland being the first international market where Liki24 launched operations last month.

Founded in 2017, Liki24.com is a marketplace aggregating offers from thousands of pharmacies and facilitating transactions between pharmacies and consumers. Liki24 launched in Ukraine first, addressing three consumer pain points: significant variation in pricing among market players, limited availability of medicines in one point of sale, and lack of home delivery. In less than 3 years since inception, the company has connected 5,000+ pharmacies and completed over 500,000 orders powered by a proprietary software system that integrates with pharmacies ERPs, instantly analyzing prices and availability of medicines, developing optimal routes for couriers, thus allowing for rapid delivery to customers at affordable prices. Today, Liki24 has been described as a lifeline for the most vulnerable consumers, often the only viable option for the elderly to receive medicines, as well as people with limited mobility and those living in remote areas.

Liki24 played a crucial role during the coronavirus lockdown in Ukraine to ensure people sheltering at home had access to lifesaving medication. The company partnered with local logistics operators to offer free delivery of medication during the quarantine.

Our business model proved to be successful in Ukraine, helping customers access more affordable medicines and convenient delivery. This capital raise will enable us to expand our team as well as extend our winning model to the Polish market and finance further international expansion at a time when safe and rapid delivery of medication is critical to the wellbeing of society, commented Anton Avrinsky, CEO and founder of Liki24.

Horizon Capital is delighted to partner with Liki24 talented founders and join the companys impressive existing investor base. We look forward to contributing to the companys continued growth in the years ahead. Liki24 has an attractive mix of elements crucial for success, including strong founders with a bold vision, drive and demonstrated execution-ability, backed by a highly professional management team. Our investment in Lik24 is consistent with our focus on visionary founders with a clear expansion strategy who seek out a partnership with Horizon Capital to reach new heights, said Lenna Koszarny, Founding Partner and CEO at Horizon Capital.

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Kyiv-based Liki24, an e-commerce platform for medicine delivery, raises 4.2 million to expand internationally - EU-Startups

Why ‘Zoom medicine’ is not the answer to all our ills – The Guardian

Telemedicine has arrived in the NHS. The pandemic has seen a dramatic shift in the provision of healthcare, away from in-person appointments and towards remote arrangements. While this might appear to be a temporary measure for social-distancing purposes, at the end of last month, the health secretary Matt Hancock, said the changes are here to stay. The UK needs more Zoom medicine, he said, telling the Royal College of Physicians that from now on, all consultations should be teleconsultations unless theres a compelling clinical reason not to.

While Covid-19 has catalysed the shift towards telemedicine, it is not the cause. The virtualisation of healthcare has been on the cards for some time, and a small but non-negligible group of NHS patients were already receiving care through e-consulting apps such as Livi and Babylon. But the scale of the change is significant and unexpected, with GPs reporting that a transition that they had imagined would take years had in effect happened within just a few weeks.

Doctors and patients groups are not convinced. Martin Marshall, head of the Royal College of General Practitioners, told the BBC that remote consultations, whether by telephone or video, wont be suitable for everyone, while Mencap have warned that the proposals could be disastrous for those with learning disabilities. And yet the government persists.

Hancocks enthusiasm for telemedicine makes a lot of sense when one considers his longstanding tech-solutionist streak. In 2018 he infamously launched his own app, simply titled Matt Hancock MP. As Wired reported at the time, it collected reams of user data including photos, videos, contact information, and check-ins. Big Brother Watch said it steals data, and called it a fascinating comedy of errors.

Of course, the Matt App is just the ego-massaging tip of the tech-solutionist iceberg. As Sean McDonald has argued, we are in the era of technology theatre, in which governments launch tech-enabled solutions to problems they are fundamentally incapable of solving or unwilling to actually tackle. The NHS Covid-19 app is the perfect example: a project from the health services digital transformation unit that was loudly hailed as the fix for coronavirus, only to be abandoned months later after being found to be almost entirely useless in comparison to human foot-soldiers carrying out contact-tracing. Meanwhile virtual therapy apps are now a staple part of mental healthcare provision, with patients self-referring to online cognitive behavioural therapy companies so they can have counselling delivered through their phone rather than languish for years on NHS waiting lists.

Indeed, it is in areas like mental healthcare that the paucity of tech-solutionist thinking becomes most apparent. Technologies like telemedicine tend only to work for the median case. If you fit within the narrow boundaries of the patient profile for which these services are designed, you will probably benefit from them. But, as is so often the case in healthcare, those with serious or complex health problems will be left out in the cold an experience that is all too familiar to patients with chronic and long-term mental health needs. For this group, as for so many other high-risk patient demographics, face-to-face contact is an absolute necessity for effective ongoing care.

For many, healthcare appointments are the closest thing to a routine, while healthcare professionals are the very fundament of patients personal support networks. Mental healthcare in the UK is already in a parlous state. Care for children and young people with mental illnesses lags dramatically behind much of Europe. In a report in January, the Childrens Commissioner for NHS England found that the NHS spends just 92 per child per year on mental health services, while the UK has just 4.5 psychiatrists per 100,000 young people far below Finlands 36 or Estonias 16.8. Any move away from in-person care will significantly compound the problems already faced by people who have mental health problems.

The government will insist that those who require in-person consultations will still be able to get them, but in reality remote care will almost certainly be foisted upon those who dont want it but who realise that Zoom medicine is suddenly the quickest or only reliable way to access care from an overworked and underfunded health service.

Zoom medicine, disastrous digital transformation projects, and virtual therapy are all part of a trend in which shiny new apps are used to mitigate the symptoms of serious structural problems. Decades of underinvestment have left the health service struggling for survival, and getting GPs on Zoom is not going to solve much. Post-pandemic, telemedicine is seen as the route forward in great part because it will ease the burden on under-resourced GPs. Virtual therapy, meanwhile, is popular not because there is any real evidence to suggest that a bot delivering cognitive behavioural therapy through your smartphone can actually cure your anxiety, but simply because it is all but impossible to get a timely NHS therapy referral in most areas of the UK. These are not solutions they are diversions.

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Why 'Zoom medicine' is not the answer to all our ills - The Guardian

Vaping linked to COVID-19 risk in teens and young adults – Stanford Medical Center Report

Vaping is linked to a substantially increased risk of COVID-19 among teenagers and young adults, according to a new study led by researchers at the Stanford University School of Medicine.

The study, which was published online Aug. 11 in the Journal of Adolescent Health, is the first to examine connections between youth vaping and COVID-19 using U.S. population-based data collected during the pandemic.

Among young people who were tested for the virus that causes COVID-19, the research found that those who vaped were five to seven times more likely to be infected than those who did not use e-cigarettes.

Teens and young adults need to know that if you use e-cigarettes, you are likely at immediate risk of COVID-19 because you are damaging your lungs, said the studys senior author, Bonnie Halpern-Felsher, PhD, professor of pediatrics.

Young people may believe their age protects them from contracting the virus or that they will not experience symptoms of COVID-19, but the data show this isnt true among those who vape, said the studys lead author, postdoctoral scholar Shivani Mathur Gaiha, PhD.

This study tells us pretty clearly that youth who are using vapes or are dual-using [e-cigarettes and cigarettes] are at elevated risk, and its not just a small increase in risk; its a big one, Gaiha said.

Data were collected via online surveys conducted in May. Surveys were completed by 4,351 participants ages 13 to 24 who lived in all 50 U.S. states, the District of Columbia and three U.S. territories. The researchers recruited a sample of participants that was evenly divided between those who had used e-cigarettes and those who had never used nicotine products. The sample also included approximately equal numbers of people in different age groups (adolescent, young adult and adult), races and genders.

Participants answered questions about whether they had ever used vaping devices or combustible cigarettes, as well as whether they had vaped or smoked in the past 30 days. They were asked if they had experienced COVID-19 symptoms, received a test for COVID-19 or received a positive diagnosis of COVID-19 after being tested.

The results were adjusted for confounding factors such as age, sex, LGBTQ status, race/ethnicity, mothers level of education, body mass index, compliance with shelter-in-place orders, rate of COVID-19 diagnosis in the states where the participants were residing, and state and regional trends in e-cigarette use.

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Vaping linked to COVID-19 risk in teens and young adults - Stanford Medical Center Report

‘The Future of Medicine’: Local Partnership Enhances Muncie as One of The State’s Leading Medical Hubs – Muncie Journal

By: Melissa Jones

MUNCIE, IN According to Robert Wood Johnson Foundation, Delaware County has the fourth-highest number of primary care physicians per capita in the statea ranking that should mean the county is one of the healthiest. But its not.

Of Indianas 92 counties, Delaware County ranks 85th. So wheres the disconnect?

Even with Indianas fourth-highest primary care physicians per capita, the county has just one primary care physician per 1,030 patients. In fact, the United States as a whole is facing a shortage in physicians. So in an effort to boost local physician training programs and retention, a number of healthcare entities in Muncie have partnered to form a long-term initiative, with funding from Ball Brothers Foundation, called Optimus Primary.

Optimus Primary is about taking all of the best pieces that we have in healthcare assets in Muncie and assembling them together in a way to improve the health outcomes of our community, said Derron Bishop, associate dean and director of Indiana University School of MedicineMuncie.

Bishop was a founding member of Optimus Primary, which officially formed in 2016. He worked with Jud Fisher, president and chief operating officer of Ball Brothers Foundation, and Dr. Jeff Bird, president of the IU Health East Central Region, to bring the program to fruition.

The key to Optimus Primary, Bishop says, is the number of anchor institutions located in Muncie: IU Health Ball Memorial Hospital, IU School of MedicineMuncie, Ball State University, Meridian Health Services and more.

Were all basically co-located together, and thats extraordinarily powerful. Communities all across the country would love to have this, Bishop said.

By connecting each of these healthcare organizations in a strategic partnership, Optimus Primary positions Muncie as one of the leading physician training centers in the state.

Muncie is the only place outside of Indianapolis that you could take someone from high school, into college, into medical school, into residency, and ultimately become a board-certified position in multiple areasand youd never have to leave Muncie, Bishop said.

But the effects of Optimus Primary extend beyond training physicians. Theres a huge economic benefit too, Bishop said. He explained that every physician who establishes a practice generates, on average, six to seven jobs and approximately $300,000 in regional tax revenue.

On a larger scale, Optimus Primary initiatives have powerful potential to strengthen the broader pipeline of medical professionals being trained in Indiana, to make a significant economic development impact and to improve population health in East Central Indiana, Ball Brothers Foundations Jud Fisher said. To date, the foundation has committed $1.8 million to Optimus Primary efforts.

With Ball Brothers Foundation backing the initiative, Bishop said the partner organizations have been able to explore innovative solutions to affect positive change to Muncies medical landscape and health outcomes.

The way that Ball Brothers Foundation does their funding is that they give you a chance to try something, Bishop said. They really allowed all the different groups in Optimus Primary to innovate together with a common goal.

One of these innovative ideas was to partner with Muncie Threat Assessment Center in a Law Enforcement Operations 101 course for medical students. The course was designed to help the medical students bond and improve their communication skills.

A good team-building activity has to be fun, it has to be something theyve never experienced, and also it needs to be something where they make really difficult decisions together under stress, Bishop said. So we said, Whats the most difficult decision to make under stress? And what we came up with was probably when a law enforcement officer has to pull the trigger.

In Law Enforcement Operations 101, medical students learn firearm safety and how to shoot a gun (all guns in the course used non-lethal rounds). They even learn how to conduct traffic stops, how to negotiate domestic disputes and how to clear housesand theyre put to the test through life-like run-throughs of each scenario.

The innovative idea was a bit of a risk, as Bishop said he didnt exactly know if it would work as he had hoped. But in the end, it was a successsome of Bishops students told him they had bonded more in the three hours of the course than they had in the past three months of school.

Bilal Jawed, a former IU School of MedicineMuncie student, was one of the first students to participate in the course.

On the surface, it seems like shooting firearms and clearing houses is not a very applicable experience for medical professionals, but I would definitely argue against that, Jawed said. I learned a lot about working as a team in high-pressure situations and also how to communicate effectively and efficiently when time is of the essence. It was also very informative to actually interact with law enforcement officers, because medical professionals often work indirectly with them.

Jawed was part of several other Optimus Primary programs too, like a full-body assessment at Ball State Universitys Clinical Exercise Physiology Program.

Jawed and his classmates were put on treadmills and hooked up to machines to measure their own strength, pulmonary function, muscle composition, bone density and more.

It was neatalso very scaryto have the performance of my own body plotted on a graph and compared against averages, he said. Im seeing a lot of little ways and reasons to integrate these practices into care of future patients. Its all about the little interactions youre exposed to, and weve honestly been exposed to so many special, cutting-edge experiences.

And thats exactly the purpose of Optimus Primary: to train future physicians to think differently about medicine.

If we can get our physicians that we train to understand the benefits of exercise, theyre more likely to advocate for this for their patients, Bishop said. We want them to directly see the benefits of lifestyle modifications, because this is a way that we can fundamentally change the way we do medicineto really infuse that idea of lifestyle.

No program embodies this emphasis on lifestyle better than the Healthy Lifestyle Center, a student-run clinic formed in partnership between Ball State University, IU School of Medicine Muncie and Meridian Health Services. The HLC has two clinic locationsone in the new College of Health building at Ball State University and another on Meridian Health Services Tillotson Avenue campus. Jawed describes the HLC as the future of medicine.

Right now, in medicine in general, our system is a very reactive system, where people come in with illnesses, get those illnesses resolved, and then move on, he said. What the HLC is doing is very unique. Were actually dealing with issues proactivelyaddressing illnesses before they even become illnessesand thats how its going to be in the future.

HLC is a free resource to the community, offering a range of services from dietetics, to audiology, to diabetes management and more. Students and professionals from various majors and fields come together to prepare comprehensive health and wellness plans for each patient, creating an inter-professional setup that is very rare.

Medicine really is a team sport, and Im learning how to be a team member by being in these roles, Jawed said. Its really incredible to be able to work alongside all these different professions to actually help the community at such an early phase in my medical education.

Bishop said Muncie has the best available infrastructure to help patients change their lifestyle and improve their health. By leveraging the communitys existing assets, Optimus Primary is changing the way physicians in Delaware County will provide care, ultimately improving overall health outcomes for the region.

And, just four years after first taking shape, the strategic initiative seems to be working.

Theres such a diverse group of experiences with Optimus Primary, both from the health providing side and from the health receiving, Jawed said. Its been nice to plant little seeds on how Im going to incorporate these lessons in my future practice.

Some of these other diverse programs supported through Optimus Primary include:

Ivy Tech Community Colleges newly renovated School of Nursing and School of Health Sciences in downtown Muncie with state-of-the-art simulation spaces that mirror the setup of operating and patient rooms at IU Health Ball Memorial Hospital. The new spaces allow for expanded program capacity and can be used as actual healthcare delivery rooms in the event of a major disaster.

IU Health Ball Memorial Hospitals partnership with Ivy Tech to match nursing students with mentor nurses for more hands-on patient care and customized learning in a groundbreaking program that re-imagines nursing rotations.

IU School of MedicineMuncies development of a new scholarly-concentration in community health promotion and disease prevention to recruit students to Muncie who are specifically interested in improving patient health through lifestyle modification and healthy behaviors.

IU School of MedicineMuncies new Bachelors to MD program, which launched in fall 2019, to allow eight Ball State University pre-med students per year to also be granted simultaneous, provisional admissions to the IU School of MedicineMuncie, working to attract high school students to commit to local universities and to encourage them to stay in the surrounding community to practice medicine when they graduate.

Maplewood Mansion Learning Laboratory, which provides short-term accommodations for IU School of MedicineMuncie students in one of the Ball mansions along Minnetrista Boulevard. A recent publication stated that it may be the finest medical student housing anywhere in the United States. Under the direction of Ball State University Professor Chris Flook, a team of BSU telecommunications students recently produced a video on Optimus Primary, showcasing Maplewood Mansion and some of the other unique aspects of IU School of MedicineMuncie.

IU Health Ball Memorial Hospitals hiring of a licensed psychologist to serve as inpatient behavioral health faculty, expanding its behavioral health services across thecontinuum of care.

Meridian Health Services exploration of creating an Integrated Care Institute that would train individuals and organizations in the model of integrating physical, mental and social health.

As Optimus Primary turns toward its next phase of operations and funding, Bishop said theyre looking to get the community involved more. One way they plan to do this is through standardized patients, which are community volunteer actors. Each actor is given an extensive backstory and symptoms to exhibit, and then they are placed in a mock clinical setting with medical students.

What happens in this is we have community members helping to train future healthcare workers in the community and they become better patients in the process, because theyre learning whats supposed to happen, Bishop said.

Bishop also said, now that Optimus Primary has a few programs under its belt, the next phase of the partnership is to begin quantifying data and, hopefully, spread the momentum to other communities.

Were looking now at how we can quantify the work that were doing and then we can begin seeking additional funding sources from outside entities, he said. Ball Brothers Foundation gave us the base to do this next level, which is going to be the large community-based research where we can say whether something is working. If we find out something is working, we can take it and we can export it to other communities.

In all, Bishop is confident about where Optimus Primary is headed.

The future is very bright, he said. I have dedicated our regional medical campus to doing this. This is our future.

About Ball Brothers Foundation

Ball Brothers Foundation is one of the states oldest and largest family foundations. Annually, the foundation makes approximately $8 million in grants to support arts and culture, education, the environment, health, human services, and public affairs. The Muncie-based private foundation gives priority to projects and programs that improve the quality of life in the foundations home city, county and state.

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'The Future of Medicine': Local Partnership Enhances Muncie as One of The State's Leading Medical Hubs - Muncie Journal

Silverthorne’s Axis Sports Medicine studies masks and oxygen saturation with varying results – Summit Daily News

SILVERTHORNE In the wake of Gov. Jared Polis mandate to wear face coverings during indoor recreation, Axis Sports Medicine in Silverthorne shared the results of a nonscientific evaluation of masked and non-masked exercise indoors and outdoors.

Terri Stashick, Axis physical therapist and owner, said the sports medicine company decided to conduct the study of a few patients after several said they were feeling short of breath while exercising indoors and wearing a mask.

After Axis monitored the patients oxygen saturation, heart rate and general feeling of well-being while exercising with a mask indoors as well as with and without a mask outdoors, Stashick said the general outcome was that oxygen saturation did drop with a mask but generally not below the critical level of 88%. In one reading, taken after a participant ran a quarter-mile, oxygen saturation dropped to 84%, she said.

I think its safe to say exercising with a mask on, theres no danger, Stashick said. Youre not in critical danger of your O2 saturation dropping too low. But you also want to use your symptoms as a guide. If you are starting to feel short of breath, you should probably either back down on the intensity or stop. Let your heart rate come back down. Let your body recover a little bit.

Stashick said the participants consisted of healthy, fit, post-operation surgical knee patients. They executed exercises like squats and lunges as well as dynamic strength training and some running while wearing homemade cotton masks.

Stashick said the normal percentage of oxygen carried in the blood at Summit Countys elevation is 96% to 98%. At rest with the mask off, Stashick said all of the clients were sitting at about 98%.

Summit County resident and participant Meredith Smith said she felt the mask did not inhibit her exercise as long as she was not spiking her heart rate too high.

But once the heart rate is high enough, its hard to get a second wind, and its hard to work out with a mask on, Smith said. The fabric of the mask is up against your mouth, and you cant breathe efficiently.

Smith said her oxygen was four points higher outside when exercising without a mask on: She and Stashick said her oxygen dipped to 84% after running a quarter-mile lap compared to 88% after the lap without a mask.

As a result, I dont plan to run inside the rec center until we can work out without a mask on, Smith said. I just dont think I can work out as hard as I want to, so I will be outside without a mask.

Participant Christina Moody said her resting oxygen without a mask was 98% while her pulse was 84 beats per minute. That compares to 97% and 92 beats per minutes outdoors with a mask. When exercising outdoors without a mask, her oxygen was 97% and pulse was 176. She said that after 40 minutes of exercise outdoors without a mask, she was able to breathe faster and deeper, with no negative effects and quick recovery.

When exercising indoors with a mask, she said her oxygen was 94% to 95% and pulse was 146. Then, 20 minutes into her exercise, she said she began to develop some chest pain, dizziness and nausea as her oxygen dropped to 90%, and she found it took longer to recover.

It was obvious my body was working a little harder to maintain its oxygen level, Moody said. But my pulse, I really could only get up to 146, and thats not an ideal cardio level for exercise.

With this little experiment, I determined definitely the mask dictates duration and intensity of exercise, Moody said. But everyones impacted differently. For me, wearing the mask indoors increased my inhalation of my own carbon dioxide. Breathing through the mask, I could not get a deep breath.

Smith said her and Stashicks exercise solution following the test was to opt for five-minute exercise intervals before a minute of recovery.

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Silverthorne's Axis Sports Medicine studies masks and oxygen saturation with varying results - Summit Daily News

Governor Cooper Announces Genetic Medicine Company Will Create 201 Jobs in Durham County – NC Dept of Commerce

Governor Roy Cooper announced today that Beam Therapeutics (Nasdaq; BEAM), a biotechnology company developing precision medicines through DNA base editing, plans to build a manufacturing facility in North Carolinas Research Triangle Park, creating 201 jobs. Over a period of 5 years, the company expects to invest $83 million in the facility, which will support clinical and commercial manufacturing for the companys novel base editing programs.

"North Carolina is a leader in biotechnology, from the research in our labs to the states biomanufacturers, said Governor Cooper. Companies like Beam Therapeutics work in developing precision medicines will help keep North Carolina on the cutting edge of this industry.

Beam Therapeutics, with headquarters in Cambridge, Massachusetts, develops precision genetic medicines through base editing. The foundational level of genetic information is a single base letter in DNA, and an error to a single letter, known as a point mutation, can cause disease. Base editors have the ability to rewrite just a single letter, and thereby intervene at the most foundational level. Beams proprietary base editors create precise, predictable and efficient single base changes, at targeted genomic sequences, without making double-stranded breaks in the DNA. This enables a wide range of potential therapeutic editing strategies that Beam is using to advance a diversified portfolio of base editing programs.

We believe investment in strategic manufacturing capabilities is an important component of fully realizing the power of our base editing technology and achieving our vision to provide life-long cures to patients suffering from serious diseases, said John Evans, CEO of Beam Therapeutics. Research Triangle Park is a thriving biopharmaceutical hub, providing significant access to the broad range of talent we will need to make this vision a reality.

Although wages will vary depending on position, the average salary for the new positions will be $102,654. The average wage in Durham County is $71,756. The state and local area will see a yearly economic impact of more than $20.6 million from this companys new payroll.

"North Carolina has been a world leader in biotechnology for many years, but were not resting on our past accomplishments, said North Carolina Commerce Secretary Anthony M. Copeland. Beam Therapeutics joins a host of gene therapy companies that are keeping North Carolina at the forefront of this new frontier of medicine.

Beam Therapeutics project in North Carolina will be facilitated, in part, by a Job Development Investment Grant (JDIG) approved by the states Economic Investment Committee earlier today. Over the course of 12 years, the project is estimated to grow the states economy by $1.36 billion. Using a formula that takes into account the new tax revenues generated by the new jobs, the agreement authorizes the potential reimbursement to the company of up to $3,237,750, spread over 12 years. Payments for all JDIGs only occur following performance verification by the departments of Commerce and Revenue that the company has met its incremental job creation and investment targets. JDIG projects result in positive net tax revenue to the state treasury, even after taking into consideration the grants reimbursement payments to a given company.

Because Beam Therapeutics chose a site in Durham County, classified by the states economic tier system as Tier 3, the companys JDIG agreement also calls for moving as much as $1,079,250 into the states Industrial Development Fund Utility Account. The Utility Account helps rural communities finance necessary infrastructure upgrades to attract future business. Even when new jobs are created in a Tier 3 county such as Durham, the new tax revenue generated through JDIG grants helps more economically challenged communities elsewhere in the state. More information on the states economic tier designations is available here.

In addition to the North Carolina Department of Commerce and the Economic Development Partnership of N.C., other key partners on this project were the the North Carolina Community College System, the North Carolina Biotechnology Center, Durham County, and the Greater Durham Chamber of Commerce.

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Governor Cooper Announces Genetic Medicine Company Will Create 201 Jobs in Durham County - NC Dept of Commerce

Why I gave up my dream of leading diversity efforts in medicine – AAMC

After forcing myself out of bed, I made it to my rounds with less than a minute to spare. It had been only three months since I started seeing patients and teaching trainees at a major academic medical center, and already I was feeling overwhelmed.

I had discovered that my assigned 1 1/2 days of clinical duties in a psychiatric clinic actually required three days of work to oversee the care of more than 100 mostly poor Black and brown patients. Many had substance use disorders and very serious mental illnesses. As a woman of color, I wanted to serve them well because they seemed to trust me more than their prior providers. That meant I often found myself working far into the evening. In addition, as an attending at a major teaching hospital, I had numerous other obligations. On paper, I had my dream job. In reality, I often felt dragged down.

Not much earlier, while in residency, I dreamt of becoming a leader in the field of diversity education, hoping one day to be a dean of diversity or a dean of students. I had become the go-to person in my academic medical community for lectures on bias, consultation on diversity curricula, guidance on working with minority patients, and more. I also published research papers and narrative articles to educate my community about diversity. Though demanding, I loved this work. I truly believed that academia could support patients, providers, and communities of color with the help of engaged stakeholders like me.

Only things did not go as Id planned.

While working in the psychiatric clinic, where I was the fourth attending in almost as many years, I had two other jobs: I led efforts to develop a social justice curriculum for the Department of Psychiatrys residency program, and I served as the director of the standardized patient program for the School of Medicine, which involved recruiting and training laypeople to act as patients for students learning to become physicians. I often felt overworked and unsupported.

I had become the go-to person in my academic medical community for lectures on bias, consultation on diversity curricula, guidance on working with minority patients, and more. ... Though demanding, I loved this work.

Through all this, I also wanted to continue to serve as a mentor to Black and brown medical students, residents, and colleagues, sharing any professional guidance I could offer. Soon, they began to come with their personal, gut-wrenching stories of discrimination. I even found myself in a position of having to decide whether to report a former supervisor who was now a colleague.

I felt terribly alone. So few of my colleagues shared my identities: Im a Black, queer woman, and many of them were White men. As a new faculty member, I often felt unable to turn to my prior sources of social support given that they were now technically my subordinates. And I bore the stress of feeling other outside work as well. I was frequently the only African American when I went out to a restaurant, and the national sociopolitical climate felt increasingly hostile to people like me.

The stress was longer than a moment or moments it was endless. It started to affect my ability to function well. I lost track of emails, and I tossed and turned most nights. My immune system became weak from all the stress. I got the flu, twice.

So, I decided to leave.

As long as the culture discouraged asking for help, didnt fully value those who focus on innovative diversity education, and failed to provide sufficient support to minority faculty, I would never feel truly safe. I knew members of my medical community appreciated me and my work, but unless they intended to use their privilege to prevent Black and brown faculty from leaving, it was not worth it to stay.

Although it was the most difficult decision I have ever had to make, I know it was the right one.

I felt terribly alone. So few of my colleagues shared my identities: Im a Black, queer woman, and many of them were White men.

Yet I continue to feel like I abandoned my Black and brown patients, trainees, and colleagues. I cry when I learn of the distress of my friends and former colleagues. Often when we catch up, I cannot help but feel re-traumatized by their experiences and weighed down by a heavy sense of guilt for leaving. Im also terribly sad that nonminority allies dont speak up or provide them with support.

I have since found a relationship with an academic institution that feels safe, but I still struggle. I continue to see patients and handpick teaching opportunities. I cautiously choose diversity efforts that allow me to go beyond conversations about implicit bias and really get into the complicated nature of systemic racism. Meanwhile, I find myself hoping for progress in academic medicine, though Im not completely optimistic.

Senior physician-leaders of most academic communities continue to look the same, unlike the rest of the United States, which is becoming increasingly diverse. Senior leadership in many places also continue to express support for diversity without actually providing real support for diverse faculty, educational initiatives, or institution-wide policies that foster inclusivity and equity.

Often, academic medicine focuses on implementing effective medical education for trainees and thats important. But medical schools and teaching hospitals need to do much more to create a culture of inclusivity at every level across the entire institution.

They need to create clear, strong policies that support employees from racial and ethnic minority backgrounds. Then they need to train all staff in those policies, support reporting of breaches, and make sure to enforce the institutions rules and values.

Medical schools and teaching hospitals need to do much more to create a culture of inclusivity at every level across the entire institution. Verbal support is not enough anymore.

Institutions also need to make long-term investments in hiring and promoting faculty of color, providing administrative support for faculty of color, and funding diversity education at levels comparable to that of other initiatives.

All this needs to happen not just during newsworthy moments of controversy, legal action, or protest. What happens when the public shifts its attention away? More importantly, what happens to those who need initiatives that never get implemented or that run out of funding in a few years?

We need real change with strong policies and programs backed by solid funding for them. Verbal support is not enough anymore. If we dont make these changes, minority members like me who once hoped to help educate trainees and support patients will leave as they find they cannot shoulder the burden alone.

Kali Cyrus, MD, MPH, is a practicing community psychiatrist in Washington, D.C., an assistant professor at Johns Hopkins University School of Medicine, a founding member of Time's Up Healthcare, and a diversity consultant.

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Why I gave up my dream of leading diversity efforts in medicine - AAMC

Active COVID-19 cases in Medicine Hat down to three – CHAT News Today

Dr. Deena Hinshaw said her next in-person update will be on Tuesday. The next update of online numbers will be Monday.

The South Zone has a total of 1,710 cases 1,644 recovered, an increase of six, and 45 active, a decrease of seven.

There are five people in the zone in hospital, three of which are in ICU, and there have been 21 deaths.

Cypress County has totalled 31 cases all recovered.

The County of Forty Mile has 20 total cases, six active cases and 14 recovered.

The MD of Taber has 38 total cases one active, 36 recovered and one death.

Special Areas No. 2 has 15 total cases, all of which are recovered.

Brooks has 1,125 total cases 1,114 are recovered and two active. Brooks has recorded nine deaths. The County of Newell has a total of 29 cases five active, 23 recovered and one death.

The County of Warner has 55 total cases. There are now 53 recovered cases, one new active case and one death in the county.

The City of Lethbridge has a total of 143 cases. Of those, 12 are listed as active and 129 recovered and there have been two deaths there. Lethbridge County has 30 cases, three active cases and 27 recovered.

The figures on alberta.ca are up-to-date as of end of day Aug. 13, 2020.

Saskatchewan reported 30 new cases of COVID-19 on Friday, 29 in the South Zone.

A news release from the province says all of todays 30 new cases and 108 of 174 active cases are in communal living settings.

Saskatchewan has a total of 1,541 cases, 174 considered active. There are 1,347 recovered cases and there have been 20 COVID-19 deaths in the province.

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Active COVID-19 cases in Medicine Hat down to three - CHAT News Today

After nearly 50 years in medicine, Brandon doctor dies of COVID-19 – FOX 13 Tampa Bay

Doctor said he would never retire, dies of COVID-19

Josh Cascio reports

BRANDON, Fla - The medical community is mourning the loss of longtime-doctor at Brandon Regional Hospital, Sam Scolaro.

He said, 'I made a promise to God at 20 years old that Id serve my patients 'till the day I die, so Im never going to retire,' his daughter, Stephanie Scolaro told FOX 13.

At 75 years old, Dr. Scolaro passed away Friday from complications from COVID-19.

Since I was a little kid, I was so proud to tell people my dads a doctor because he helped everybody, she said.

Dr. Scolaro tested positive for COVID-19 on his 53rd wedding anniversary -- June 25.

When we went to the hospital, my mom told me she knew it would be the last time we saw him. He was very sick, Stephanie said.

But even in his final days, Dr. Scolaro never stopped thinking of others.

He told his nurses, 'We need to hurry and get me out of here, my patients need me,' Stephanie said.

It was just the doctor in him, honoring the promise he made all those years ago.

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After nearly 50 years in medicine, Brandon doctor dies of COVID-19 - FOX 13 Tampa Bay

Couple charged in $4M gambling scheme at Livermore casino – Pleasanton Weekly

A husband and wife have been charged with allegedly conspiring to steal approximately $4 million from Parkwest Casino 580 in Livermore in a baccarat scheme, state prosecutors announced on Monday.

Eric Dat Nguyen and Khan "Tina" Tran each face two felony counts of grand theft and eight felony counts of conspiracy to commit grand theft, plus special allegations -- as to all counts -- of an aggravated white collar crime enhancement in excess of $500,000.

Nguyen, 38, and Tran, 32, were arrested in Texas in May on felony warrants out of California.

"My office stands ready to fight back against those who try to get rich quick by breaking the law," California Attorney General Xavier Becerra said in a statement. "Mr. Nguyen and Ms. Tran now face serious criminal charges for their actions. The California Department of Justice will do its part to tackle criminal activity in our state."

The criminal complaint alleges the couple conspired to cheat at EZ Baccarat with Panda 8 Rules during 2015 and 2016 while Tran worked as a card dealer and Nguyen gambled at the casino on North Canyons Parkway in Livermore. Nguyen previously worked at the casino.

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Couple charged in $4M gambling scheme at Livermore casino - Pleasanton Weekly

Penn National Initiated Buy on Sports-Gambling Potential – TheStreet

Penn National Gaming (PENN) - Get Reportshares on Thursday rose after Goldman Sachs analyst Stephen Grambling initiated coverage of the casino company with a buy rating and $60 share-price target.

Hes enthusiastic about the Wyomissing, Pa., company's sports-gambling potential.

The stock recently traded at $51.69, up 3.9%. The stock has traded up as much as 7.7% on Thursday, and it has more than doubled year to date.

PENN sits at the cross-section of a rapidly rebounding regional casino space and inflecting growth in sports betting, Grambling wrote in a commentary obtained by TheStreet.com.

Penn National "has unique positioning relative to peers based on mobility and covid-19 data analysis, he said. This guides our near-term segment earnings before interest, taxes, depreciation and amortization above consensus expectations.

In addition, we believe Barstool Sports embedded customer base and content creationengine will drive one of the lowest customer acquisition costs in the sports betting industry, allowing PENN to quickly take share within our proprietary iGaming and sports betting models, Grambling says.

As the company delivers on existing and mobile growth opportunities, we see upsideto consensus estimates driving a multiple rerating from about 8.3 times next-12-months enterprise value/[Ebitda and restructuring and rent costs] today to our target of 10.5 times EV/Ebitdar.

Penn National last week reported that second-quarter revenue plunged to $305.5 million from $1.32 billion in the year-earlier quarter.

The coronavirus pandemic hammered the company and the industry, shutting casinos and keeping gamblers at home.

Despite starting the second quarter with our entire property portfolio closed due to the pandemic, we ended the quarter in a significantly improved financial position," Penn National Chief Executive Jay Snowden said in a statement.

That came "as a result of continued mitigation efforts that contributed to significant margin improvement, a successful capital raise, and very strong financial performance at our properties since reopening.

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Penn National Initiated Buy on Sports-Gambling Potential - TheStreet

Online Casino Gamblers in Germany Increasingly Looking to Bitcoin as a Payment Option – Pokerfuse

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While the use of Bitcoin for online gambling transactions is popular in many parts of the world, those that gamble online in Germany are looking to cryptocurrency in growing numbers as the government cracks down on other common forms of payment ahead of a new online gambling law scheduled to take effect next year.

Looking beyond the debate over whether Germanys online gambling restrictions are actually legal given they are in contravention of European Union law, the government has been taking steps to curb online gambling in the country by enacting restrictions on financial transactions, a common method for limiting the access to online gambling used around the world including the US.

But with the emergence of cryptocurrencies such as Bitcoin, those that want to gamble online have options to move money on and off of their favorite online casinos, and the number of people opting for those alternative payment solutions is growing with every new restriction on more traditional payment methods.

The latest restriction comes from Visa, who in May alerted payment processors in the country that they are no longer allowed to process transactions related to for illegal online casinos.

It is suspected that pressure from gaming regulators in Germany has been driving the new limitations on processing payments related to online gambling.

In October, global e-wallet PayPal halted online casino transactions in Germany after what is believed to have been a threatened with sanctions by the German state of Lower Saxony. The state had previously announced that it had privately warned a large global payment processor to stop accepting transactions to and from online gambling operators.

In recent months, large international online gaming companies that still serve Germany under what they perceive as a loophole in the law have had to drop deposit and withdrawal options for PayPal and now a large number of major credit cards.

And with the options for online gamblers at fully regulated international online gaming providers shrinking, Bitcoin casinos are popping up to fill the demand of those still looking to gamble online in the country.

Sure there are other payment options available in the country such as Amazon Pay, Neteller and Apple Pay, but those options may have some restrictions of their own (or may be the next target of the German governments crackdown) when it comes to online gaming.

And so for now, Bitcoin and other cryptocurrencies are rising in popularity in the country, a trend that could reduce the effectiveness of the regulations that are expected to be enacted in July 2021.

One of the biggest justifications for regulating online gaming is to protect consumers, but in order to do that, those consumers must stop utilizing the services of illegal operators and be channeled to the regulated sites that are held accountable by the government.

But humans are creatures of habit, and online gamblers that are using Bitcoin casinos now until more traditional forms of payment processing return to the big name operators may find that they would rather stay at the casino they have grown to know and like instead of patronizing the casinos that could no longer meet their needs in 2020.

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Online Casino Gamblers in Germany Increasingly Looking to Bitcoin as a Payment Option - Pokerfuse