Gunk from Neanderthals’ teeth tells us they used medicine – The Verge – The Verge

How much can you learn from Neanderthal plaque? A lot, scientists have discovered: DNA from the plaque provides an amazingly detailed view into the life of our extinct human relatives, including what they ate, how they took medicinal plants to combat disease, and what their mouth bacteria was like. The discovery gives scientists a window into the precious microbial world inside our closest relatives; this information could be used to better understand how bacteria that live inside our own bodies, called microbiome, evolved and how these microbes affect our health.

The study, published today in Nature, shows the exact foods consumed by five Neanderthal specimens in Europe: woolly rhinoceros, moss, pine nuts, and wild sheep. One individual suffered from a tooth abscess and a stomach bug, and appears to have treated himself using plants that have the same pain-killing component as aspirin, as well as a natural antibiotic. Finally, the scientists analyzed the different bacteria found in the Neanderthals mouths, including one thats 48,000 years old and is still found in our mouths today.

We basically have a new window on the past for us.

We can now track [the human microbiome] in time and space, and understand the evolutionary process, study co-author Keith Dobney, the head of department and chair of human paleoecology at the University of Liverpool, tells The Verge. We basically have a new window on the past for us, but we also have a way to use that to understand the present.

Neanderthals lived between about 400,000 to 40,000 years ago in Europe and parts of Asia, where they were eventually replaced by Homo sapiens. Since they were discovered in the 1800s, hundreds of studies have come out about their diet and lifestyles. One study found that Neanderthals ate lots of meat, such as reindeer, woolly mammoth, and woolly rhinoceros. Other studies showed that they were pretty intelligent they made glue as far back as 200,000 years ago, and built complex structures about 176,000 years ago, way before modern humans were around.

Todays study adds to our understanding of Neanderthals, and gives direct evidence of what they ate and how they lived. The researchers sequenced DNA from the calcified plaque of five specimens in Europe dated from 42,000 to 50,000 years ago: two from Spain, two from Belgium, and one from Italy. Plaque the disgusting film coating our teeth is made of bacteria and bits of food. Analyzing it shows scientists what we eat and what diseases we have. The researchers found that the Neanderthals living in Belgium ate mostly meat, including woolly rhinoceros and wild sheep. The individuals in Spain, however, were on a veggie diet: they ate mushrooms, pine nuts, and moss. (The Italian Neanderthal failed to produce results.)

One specimen in Spain was also found to suffer from a tooth abscess, a painful bacterial infection, as well as a chronic stomach bug that today causes severe diarrhea in people, says Dobney. The plaque on his teeth also contained the DNA of a Penicillin-like fungus (a natural antibiotic), as well as poplar, a plant that has the same pain-killing component of aspirin. That suggests that Neanderthals in Spain were taking medicine when they were sick a pretty advanced behavior. The general public view of Neanderthals is a pretty kind of basic, stereotype cartoon version of simplistic knuckle-dragging cavemen, Dobney says. But thats changing now. These were sophisticated relatives of ours.

The Spanish specimen also preserved the DNA of a 48,000-year-old bacterium that is still found in our mouths today in a slight different form. The Neanderthals must have passed that bacterium to modern humans when the two interbred, Doney says. They were obviously passing pathogens and microbiome to each other, he says.

The researchers did the near-complete sequence of this ancient form of Methanobrevibacter oralis; by comparing this ancient bacterium, as well as the other Neanderthal bacteria, with todays, scientists can better understand how the human microbiome evolved. This opens a new chapter in understanding the evolution of the commensal bacteria we carry in our [mouths,] Johannes Krause, the director of the Max Planck Institute for the Science of Human History, who did not take part in the study, writes in an email to The Verge.

These were sophisticated relatives of ours.

The study has some limitations. The DNA analyzed by the researchers is extremely old, and may have been contaminated by the soil in the caves were the specimens were found, Krause says. Its possible, for instance, that Spanish Neanderthals werent actually eating moss, but ancient moss was in the surrounding environment. Anything from the cave environment could have contaminated the samples, Krause says. (Dobney says thats very unlikely, because the DNA of animals, plants, and fungi degrades quickly unless its enclosed in some protective environment, like the calcified plaque.) We also dont have a database of the complete genome of all plants, animals, and bacteria in the world, so the researchers may be mistakenly matching an ancient DNA fragment with a modern organism, while instead it belonged to another organism thats not in the database yet, Krause says.

The most interesting part of the study is the analysis of the Neanderthals mouth microbiome, says Christina Warinner, the co-founder of the Laboratories of Molecular Anthropology and Microbiome Research at the University of Oklahoma. In recent years, scientists have started studying the collection of bacteria and viruses that inhabit our bodies with renewed interest, and we have only begun to understand the role these tiny creatures play in our health and disease. Learning what body bacteria our human ancestors had, and how those bacteria evolved, will help us better understand our bodies today. The study is an important reminder of how we've really just scratched the surface of the human microbiome, and how much work there is to do to understand the evolution and ecology of this fundamental part of our human biology, Warinner writes in an email to The Verge.

Its just the coolest science on the planet at the moment.

Dobney agrees. Its fantastically relevant to how we understand health and diet today because we can track it in time and space, he says. Dobney began looking at calcified plaques in the 1980s, when he was in his 20s. But the technology at the time didnt allow him and his colleagues to really analyze ancient DNA. I knew this could be really cool, he says. But we just couldnt do it. Nobody believed it could be done and the technology wasnt really there. It was tantalizingly close.

That has all changed in the past few years, Dobney says, and the technology has finally caught up with his dreams. Its just the coolest science on the planet at the moment, its amazing, he says. The moral there is, never give up on a good idea.

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Drug Industry Bets Big On Precision Medicine: Five Trends Shaping Care Delivery – Forbes


Forbes
Drug Industry Bets Big On Precision Medicine: Five Trends Shaping Care Delivery
Forbes
The Death Of "One Size Fits Many" Care Models. Precision medicine promises a paradigm shift in care delivery, one that removes the need for guesswork, variable diagnoses and treatment strategies based on generalized demographics. Precision medicine ...

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Drug Industry Bets Big On Precision Medicine: Five Trends Shaping Care Delivery - Forbes

Sodium azide may have caused illness at Yale School of Medicine in New Haven, officials say – New Haven Register

NEW HAVEN >> Sodium azide, a substance commonly found in laboratories and used as a preservative, may have been the cause of four people falling ill at the Yale School of Medicine in February, officials said.

Four members of the Yale School of Medicine community became ill after drinking from a single-service, pod-style coffee machine Feb. 28 at the 333 Cedar St. facility.

They were monitored at Yale New Haven Hospital, but all four have since returned to work, Yale spokeswoman Karen Peart said Tuesday.

Yale Police, the New Haven Fire Department, the state Department of Energy and Environmental Protection and the Yale Environmental Health and Safety team responded and initiated an investigation.

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On Tuesday, officials learned that an independent laboratory test on items removed from the area indicated the presence of sodium azide, Peart said. The potentially deadly chemical is commonly found in air bags, farming and hospital laboratories, according to the Centers for Disease Control and Prevention in Atlanta. It is odorless as a solid, but when mixed with water or an acid, sodium azide changes rapidly to a toxic gas, according to the CDC.

The single-serve coffee machine was not connected to a water source and the area was evaluated and declared to be safe by Yale Environmental Health and Safety, Peart said Tuesday. The Yale Police Department is continuing its investigation in collaboration with local, state and federal law enforcement.

At the same time, staff are reviewing security and safety procedures with its public safety team, Peart said.

Out of an abundance of caution, we have let the Yale School of Medicine community know that the symptoms of exposure to sodium azide are dizziness, headache, nausea and vomiting, rapid breathing and rapid heart rate, she said. Weve let the School of Medicine community know that if they experience these symptoms, they should contact Yale Health Acute Care. Weve also asked that anyone with any information regarding this incident to please contact Yale Police.

Robert J. Alpern, M.D., dean of the School of Medicine, has shared this update with those who were affected, as well as members of the School of Medicine community, Peart said.

Gathering complete information will take some time, she said. As always, the safety and security of the Yale community is our utmost priority.

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Sodium azide may have caused illness at Yale School of Medicine in New Haven, officials say - New Haven Register

Incredible Medicine: Real-life superhero SMELLS Parkinson’s disease before it’s diagnosed – Express.co.uk

The future of Parkinsons disease diagnosis could be completely changing and its all thanks to one extraordinary woman.

In this episode of the BBC Two programme Incredible Medicine: Dr Westons Casebook, Dr Weston investigated cases of people with phenomenal brains all over the world.

In one of the most amazing stories, one woman, Joy Milne, shares her unique ability to smell things others cant.

As a nurse I found I could smell a lot of things, like blood, she said. I didnt realise not everyone could smell them.

This didnt affect her life too much until she stumbled across what has become known as her sensory superpower.

GETTY/BBC TWO

It's a heavy, musky smell

Joy Milne

When her husband Les hit his mid-thirties, Joy started to notice his smell had changed. She said: I started to nag him that he needed to shower a bit more and brush his teeth better.

But Les insisted he was washing just as frequently as before.

Soon after, he was diagnosed with Parkinsons disease, a progressive neurological condition for which there is no cure. The main symptoms are tremors, rigidity and slowness of movement.

Its not easy to diagnose, and there are currently no laboratory tests to confirm it but this could all change thanks to Joys ability.

As her and her husband encountered other Parkinsons patients, she discovered why Les had smelled so different to her.

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Tremor - One of the most noticeable signs of Parkinson's is a tremor that often starts in the hands or fingers when they are relaxed

After the first group we went to I said, they smell the same as you Les. These people smell like you.

She described the Parkinsons scent as a Heavy, musky smell.

In 2012 Joy attended a talk by Tilo Kunath, a Parkinsons specialist. At the end she stood up and asked a question: Why arent we using the smell of Parkinsons?

A bemused Tilo contacted her after the talk and was shocked to hear how she had noticed Less scent difference even before he was diagnosed.

Tilo recruited 12 volunteers, six with Parkinsons and six without, and Joy was given their t-shirts to smell.

She identified all six of the Parkinsons sufferers but said one of the non-Parkinsons volunteers had the condition too. However, six months later that person was also diagnosed with the disease.

Tests show that Joy really can smell Parkinsons and can detect it before patients have any symptoms and this is good news for scientists.

The scent was strongest for Joy on the backs of the t-shirts, meaning it was coming from the volunteers sebum, an oily or waxy matter thats secreted to lubricate and waterproof our skin and hair.

Chemists tested this and found 9,000 molecules made up this sebum. If they could isolate the ones that differ between Parkinsons sufferers and non-sufferers, they could potentially create an accurate diagnostic test to detect Parkinsons much earlier.

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Incredible Medicine: Real-life superhero SMELLS Parkinson's disease before it's diagnosed - Express.co.uk

Medicine Has a Problem with Racism – in-Training

With the future of the Affordable Care Act uncertain under President Trump, many Americans are left worrying how they will manage without health care. The Americans who must shoulder this burden are disproportionately people of color. It should come as no surprise to those familiar with the history of health care in this country that once again, our system, purportedly built to protect and promote health, is systematically ignoring the right to health care for communities of color.

The very structure of modern medicine in this country is rooted in the supremacyof white physicians. This is unsurprising, given the larger context of the institutional racism that pervades our society as a legacy of slavery. The 1910 Flexner report, which many credit for the legitimization of the medical profession in the United States, closed all but two African-American medical colleges. While encouraging the integration of men and women students, the report accepted racial segregation in medical education and further suggested that physicians of color should be trained differently; namely, to humbly serve their people as sanitarians. Today, the majority white voice in medicine and medical education persists; the 2015 American Association of Medical Colleges diversity report demonstrates that only 3 percent of full-time medical school faculty identify as black or African-American.

The structural racism that pervades the medical profession extends beyond physicians to the people they serve. Patients of color, and African-American patients in particular, have been subjected to racism in their care for as long as physicians have served them. Takethe case of segregation of hospital admissions: when patients of color were relegated to separate and unequal hospital wards where they suffered from demonstrably worse outcomes than did their white peers.

In 1931, Ms. Juliette Derricotte, the Dean of Women at Fisk University, was critically injured in amotor vehicle accident. The closest hospital, nearby Hamilton Memorial Hospital in Dalton, Georgia, did not admit patients of color. After six hours of searching for a hospital that would accept her as a patient, a Chattanooga facility located 35 miles away agreed to care for Ms. Derricotte. She died in transport.

The injustice of racism in health care is further underscored when one acknowledges how physicians have systematically exploited patients of color for medical experimentation. White physician Thomas Hamiltonleft African-American slaves in burning-hot pits as he sought a cure for sunstroke. White researchers studied syphilis in black men in the Tuskegee Study, watching them die until 1972 27 years after penicillin was proven to bethe life-saving treatment of choice for the disease.A young black Henrietta Lacks cervical cancer cells were harvested by white physicians without her informed consent and became the first immortal cell line, used across the globe for scientific pursuit. And yet, the scientific gains from these and scores of other unethical studies remain less accessible to patients of color than to their white peers.

Since the 1930s, our nation has taken several steps toward the creation of a more equitable health care system. One of the boldest and most successful steps towards health equity on a federalscale waswhen Lyndon B. Johnson signed Medicaid and Medicare into law in 1965. These programs expanded health care access for the elderly and the poor, regardless of race. It also condemned hospital segregation and required hospitals to comply with Title VI of the Civil Rights Act in order to be certified. Before Medicare and Medicaid, wealthy patients received twice as much care as the poor. By 1977, poor patients received 14 percent more care than the wealthy. The reversalwas and remains much needed, as poor patients continue to suffer worse health outcomes at disproportionately higher rates.

The 2010 Affordable Care Act (ACA) represents another important, though insufficient, step toward health equity in the United States. Among its successes was the provision of coverage to many Americans of color. Of those gaining coverage from 2010 to 2015, 57 percent were patients of color. These patientsare disproportionately likely to live in poverty and qualify for Medicaid coverage, and systemic discrimination and marginalization maintain this status quo.

Should the ACA be repealed, 30 million people will become newly uninsured. This includes not only the 19.2 million individuals who gained coverage under the ACA, but an additional 11.8 million served by the individual insurance market, which would collapse after repeal.

The ACA largely accomplished this coverage growth through the expansion of Medicaid to all those earning less than 138 percent of the federal poverty level ($27,821 for a family of three in 2016). However, while expansion was intended to be nationwide, 19 states most of them Republican-led Southern states with histories of racial segregationhave opted out and Medicaid coverage in those states remains limited. The median income qualification for parents in many of the states not participating in expansion is just 44 percent of the poverty level, or $8,870 for a family of three. Childless adults remain unqualified.

Despite somesignificant achievements, the U.S. health care system remains unfair on multiple levels. First, people of color continue to experience inequitiesin health outcomes. Minority and low-income patients with breast and colorectal cancer are less likely to receive recommended treatments as compared to white patients. Black males have a life expectancy almost five years shorter than that of white males. Second, low-income communities including poor white people continue to bear a disproportionately high burden of the cost of their care under the ACA, facing skyrocketing deductibles ($3,064 in silver plans, and $5,764 in bronze plans) and unaffordablecopays. When one considers that half of Americans cannot afford an unplanned $400 expense, we must acknowledge that health care reform in this country has not gone far enough in erasing its clear history of racism and inequity.

Any health care system in our country will, to a certain extent, be burdened by institutional racism as a result of the legacy of slavery in the United States. Even so, research suggests that a single-payer system could radically reduce health inequity, even if biases persist. Single payer national health insurance would be a system in which a single public agency, rather than private insurance companies, provides health care financing whilethe provision of care remains largely with private institutions. The evidence to suggest how single-payer would help lessen racial inequity in health care comes in part from the Veterans Administration (VA), a quasi-single-payer system here in the United States, in which black patients actually fare better than white patients in multiple measures of health. In the same measures, black Americans outside of the VA system fare much worse.

While it may be comforting to simply defendour current health care system in this time of immense change under a Trump administration, it is important to remember its limits. We cannot ignore that the health inequitygap continued to rise under President Obama and that poor Americans and Americans of color have never been adequately protected by our system. Let us struggle not only against the policies that promise to take us back to greater and less equal American health system but also for a change that would promise true equity in health care for all Americans. If we want to improve health equity in our nation and fight for racial justice, the answer is a system that provides universal, equal health care for all.

Contributing Writer

Boston University School of Medicine

Armide Storey is medical student at Boston University School of Medicine. She is particularly interested in understanding health as it intersects with class, race, ability, sexuality, and gender.

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Medicine Has a Problem with Racism - in-Training

Med School Professors Worried About Federal Budget – Harvard Crimson

As Congress begins formulating a new budget, some professors and researchers at Harvard Medical School are concerned about potential cuts in federal funding.

While Harvard as a whole received almost $600 million from the federal government in 2016, 69.9 percent of that came from the National Institutes of Health, and Medical School professors say that federal research funding is particularly important for their work. Federal funding for research at Harvard has steadily declined since 2009, leading University President Drew G. Faust to cite the NIH as a major focus of concern during a visit to Washington D.C. in February.

NIHs funds in research grants allow investigators to pursue interesting and novel ideas with a lot of academic freedom and intellectual freedom, said Medical School and pediatrics professor Kenneth D. Mandl. Its a very well-designed system to promote high quality medical research.

Mandl said while he doesnt expect any tectonic shifts in research funding, he thinks there are certain research agencies such as the Agency for Healthcare Research and Quality and Patient-Centered Outcomes Research Institute whose very existence may be in question with the new budget.

If we see those agencies diminished, we would see less research thats evaluative of the healthcare system itself, Mandl said.

Aaron S. Kesselheim 96, a Medical School professor who studies drug approval and drug development laws, said that the potential decreases in funding, combined with inflation, is worrying.

Unfortunately, it may drive some smart people out of the field and out of academia because there just isnt as much funding available to go around, Kesselheim said.

Kesselheim said that most transformative drugs that have been approved by the United States in the last 25 years have had direct origins in publicly funded research.

The kind of therapeutic innovation that is most likely to move the needle clinically comes from these publicly funded origins, Kesselheim said.

Mandl also noted that in the past two years, requirements for receiving NIH funding have also increased, resulting in a more competitive process for grant-seekers and a push for diversification of funding sources. He said he expects that trend to continue in the future.

John N. Campbell, a researcher at the Medical School, said that potential budget cuts made him nervous. Last year, Campbell catalogued 50 distinct brain cell types associated with appetite using a relatively expensive technique called gene expression profiling.

Funding is a worthwhile investment because we learn things we cant find out in any other way, Campbell said. The progress being made now in terms of understanding how the brain works will lead to breakthrough after breakthrough for medicine.

I think we are all a bit nervous about [potential budget cuts], but were staying optimistic and investment in science is always a priority, Campbell said.

Campbell said that in the event of budget cuts, researchers would most likely seek alternative sources of funding through non-profit organizations. Otherwise, Campbell said, the scope of research projects could be reduced.

Beyond the Medical School, professors across Harvard are worried about cuts in research funding despite a record fiscal year. In February, humanities professors expressed concern about the potential cuts to the National Endowment for the Arts and the National Endowment for the Humanities. Environmental studies professors also expect to be affected by potential budget cuts to the Environmental Protection Agency.

Staff writer Alexis J. Ross can be reached at alexis.ross@thecrimson.com. Follow her on Twitter @aross125.

Staff writer William L. Wang can be reached at william.wang@thecrimson.com. Follow him on Twitter @wlwang20.

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Med School Professors Worried About Federal Budget - Harvard Crimson

WSU, UW look to strengthen their Spokane medical schools | The … – The Seattle Times

Washingtons two major universities are once again asking lawmakers for more money for medical education, but the fighting over who is best equipped to teach doctors seems to be a thing of the past.

Washingtons two research universities are once again asking lawmakers for extra money for both of their medical-school programs in Spokane.

But the frosty relationship between the University of Washington and Washington State University over medical-school funding seems to be a thing of the past.

Finally, we see this as behind us, said WSU President Kirk Schulz, speaking during a joint interview on the Seattle Channel show Civic Cocktail on Wednesday with UW President Ana Mari Cauce.

Two years ago, the two schools fought publicly over which one was more qualified and capable of quickly expanding doctor training in the state. WSU proposed and ultimately won the right to open its own medical school on its Spokane campus.

That school the Elson S. Floyd College of Medicine is on track to admit its first group of students this fall. Its reviewing 340 applications for 60 slots for its program.

The UW, which had partnered with WSU to teach medical students in Spokane, went its own way last year, starting a partnership with Spokanes private Gonzaga University to host its medical-school program. (The UWs cooperative, five-state medical education program is known as WWAMI an acronym formed by the names of the five states that participate: Washington, Wyoming, Alaska, Montana and Idaho.)

Schulz was not WSU president during the medical-school fight; he joined WSU in June 2016. Cauce became president of the UW in the fall of 2015, after the debate was largely over.

I hate to say it, but I actually like this guy, Cauce joked about Schulz on Wednesday, noting that the two became presidents of their respective universities at similar times, and most of the issues were dealing with are incredibly similar.

Cauce said all of the states four-year public universities and two-year colleges are approaching Olympia this year with a common agenda, in hopes of accomplishing more.

The truth is, a stronger WSU makes the UW stronger, and a strong UW makes a stronger WSU, she said. This state has plenty of room for two top universities.

In the Legislature this year, WSU is requesting $10.8 million to fund 60 first-year and 60 second-year medical school students over the biennium.

The WSU school received preliminary accreditation from the Liaison Committee on Medical Education in October. It is named after the universitys late president, Elson Floyd, who died in 2015.

Meanwhile, the UW which is teaching 60 first-year and 40 second-year medical students at Gonzaga this academic year is hoping to add 20 additional students, eventually bringing the total to 80 first-year and 80 second-year students. Its requesting $9.2 million in state funding.

For now, theres enough physical space in Spokane for both programs to continue to share an anatomy lab thats located on the WSU campus, which is located directly across the Spokane River from Gonzaga. The rest of the UWs classes are taught at Gonzagas Schoenberg Center building.

But if the UW gets the OK to increase the size of its program, it will require a new building, said Suzanne Allen, vice dean for academic, rural and regional affairs for the UW School of Medicine.

The lab, where first-year students take anatomy lessons using cadavers in the ground-floor lab on the Riverpointe campus, will be used by medical students from both programs for the next three years, while the WSU ramps up the size of its classes.

The plan is for Gonzaga to raise private funding for a building on its campus, for both anatomy and other classes. The building would be leased to the UW. Its likely to take three or four years to raise the money and construct the building, Allen said.

In 2015, when WSU and UW were battling over funding, it became clear that one of the bottlenecks was a lack of residency positions the finishing years for medical-school graduates that allow them to work with patients and complete their educations.

The Legislature that year put $16 million toward increasing family residency slots, said Ian Goodhew, director of government relations for UW Medicine.

Residencies are funded by federal dollars, but the state money helped make sure there were enough faculty for the programs to be fully accredited, Allen said. As well, it allowed residents to do rotations in clinics; federal dollars only pay for residency rotations that are done in hospitals.

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WSU, UW look to strengthen their Spokane medical schools | The ... - The Seattle Times

San Bernardino County awards new Colton medical school a $10 million contract – San Bernardino County Sun

SAN BERNARDINO >> San Bernardino County Supervisors on Tuesday approved, without discussion, a $10 million, five-year agreement to support the effort for a new medical school in Colton.

The California University of Science and Medicines School of Medicine is expected to open in summer 2018 inside temporary headquarters in San Bernardino and then move to its permanent home just north of Arrowhead Regional Medical Center, the county hospital in Colton, said Dr. Dev GnanaDev, founder, president and CEO of CalMed.

Remodeling for the temporary site is ongoing at the former Everest College site at 217 E. Club Center Drive, just west of Waterman Avenue and south of the 10 Freeway.

GnanaDev is also chief of surgery at ARMC and president of the Medical Board of California. Previously, he was a longtime ARMC medical director and is a past president of the California Medical Association.

Originally, CalMed had hoped to open the new medical school in Colton this fall, but GnanaDev said Tuesday, during an interview following the supervisors vote, that it is easier to get necessary accreditations from an existing structure than from a new building.

The initial class will grow from 60 students to 90 the second year and 120 the third year. From then on, each graduating class will start with 120 students, he said.

The new medical school will work to develop additional residency slots at several hospital locations to place its graduates, GnanaDev said.

At another location, also adjacent to ARMC, the California University of Science and Medicine will ultimately include a school to train biomedical engineers, physician assistants and physical therapists, as well as provide nurses with graduate-level education opportunities.

The memorandum of understanding calls for a collaboration in clinical research studies, education and in the delivery and improvement of health care services at Arrowhead Regional Medical Center.

The memorandum will result in the use of the countys discretionary general funding in the amount of $1 million annually for five years, while ARMC will provide an additional $5 million from its Enterprise Fund, according to county documents.

The agreement will terminate if CalMed fails to obtain appropriate accreditations on or before July 1, 2018.

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The agreement is a cause of concern for Pomona-based Western Universitys College of Osteopathic Medicine of the Pacific.

Dr. Paula Crone, medical school dean, said, Western U has a 40-year track record of service and success in the Inland Empire and Southern California, and is an essential source of the badly-needed primary care providers in this region.

We have a long-standing relationship with San Bernardino County and ARMC, where our graduates have filled literally thousands of rotation and residency slots over the years, without public funding coming to the university or the college to support that. So anything that might diminish training opportunities for our students and graduates is a blow.

Robert Lovingood, chairman of the county Board of Supervisors, explained in a statement why the board approved the memorandum of understanding.

ARMC has a number of agreements with universities, colleges, junior colleges, and technical and trade schools through which it provides on-site clinical training for students. The training provided at ARMC prepares medical students to obtain their degree, license and/or certification, Lovingood said in the statement.

Riverside and San Bernardino counties have one of the lowest ratios of active patient care physicians. The agreement supports the creation, maintenance and growth of jobs and economic value in the county by offering medical education locally with preference to county residents, which will result in an increased pool of locally-trained health care workers remaining in the area, Lovingood said.

The contribution announced today (Tuesday) from the County of San Bernardino is a wonderful testament to the faith in the mission of California University of Science and Medicine and the value it will provide to the county, community and Arrowhead Regional Medical Center, said Elizabeth Nikels, spokeswoman for the Prime Healthcare Foundation.

California University School of Medicine and the Prime Healthcare Foundation are grateful to San Bernardino County and Arrowhead Regional for their partnership and support as we build a world-class medical school dedicated to training future leaders that will give back to underserved areas like San Bernardino County, she said in a statement.

The CalMed medical school is being financed primarily through a $40 million donation from the Prime Healthcare Foundation, which was founded by Dr. Prem Reddy, a cardiologist who is founder, chairman and president of Ontario-based Prime Healthcare Services.

GnanaDev said he is working to secure additional funding from the state of California.

Prime Healthcare owns and operates 44 acute-care hospitals in California, Florida, Georgia, Kansas, Michigan, Missouri, Nevada, New Jersey, Ohio, Pennsylvania, Rhode Island, Texas, Alabama and Missouri.

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San Bernardino County awards new Colton medical school a $10 million contract - San Bernardino County Sun

UK announces regional medical school partnership with NKU … – Kentucky Kernel

UK announced plans last week to develop a regional medical school campus in Northern Kentucky, in partnership with Northern Kentucky University and St. Elizabeth Healthcare.

Working with outstanding regional partners universities and hospitals we can educate and train more potential doctors and help address the physician shortage in the commonwealth, UK College of Medicine Dean Dr. Robert DiPaola said.

The Lexington campus reached capacity in the number of students its facilities and infrastructure can support.

Currently, the UK College of Medicine enrolls 547 students, with 139 in the most recently admitted class, the class of 2020.

The curriculum and education will be the same as what is provided at the Lexington campus.

UK HealthCare saw NKU and St. Elizabeth as outstanding and qualified institutions in higher education and as regional providers of healthcare.

We will be able to educate more outstanding students. This will be a new opportunity to offer to NKU students and others in the region to continue their education at the highest levels closer to home, DiPaola said. The region, potentially, will have more outstanding clinicians, serving the state and, in particular, Northern Kentucky. It is a win-win-win for the university, the region and our partners.

Four-year regional campuses in Bowling Green and Morehead were also proposed in 2016 by UK.

UK plans to open the regional campus with NKU and St. Elizabeth as early as 2019.

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UK announces regional medical school partnership with NKU ... - Kentucky Kernel

Culinary Medicine: Teaching the importance of nutrition in medical school – Penn State News

HERSHEY, Pa. During future physicians four years in medical school, they expect to be exposed to many different environments. They become acquainted with the emergency room, operating room, delivery room and every other room in between. Instructors at Penn State College of Medicine hope to help their students become familiar with one more room the kitchen.

Fourth-year medical students at the college now have an opportunity to participate in a culinary medicine course to learn cooking and nutrition basics, which they can then pass on to patients. Culinary medicine is a new evidence-based field in medicine that blends the art of food and cooking with the science of medicine.

In the United States, the traditional medical approach has been to focus on treatment rather than prevention of disease and illness, said Tomi Dreibelbis, Culinary Medicine course co-director, senior director of educational affairs, and instructor of public health sciences. For the past 100 years, the standard medical school curriculum has required spending only a few days in four years discussing how nutrition affects wellness and the risk of progression of disease. Diet and nutrition will take us either on the path to wellness or on the path to disease.

Dreibelbis has a background as a public health nutritionist and holds a graduate degree in health education. She was inspired by the culinary medicine program at Tulane University School of Medicine and its teaching kitchen where students are required to take nutrition courses throughout their four years of medical school. She visited Tulane in July 2016 and worked with her counterparts there to bring the program to Penn State. The first class launched in September 2016.

Dietary intervention can positively impact health outcomes across the lifespan. Optimal nutrition throughout all phases of life, especially for the population groups that are at high risk for health disparities, must be the primary focus of health promotion and disease prevention, she said.

Nine students have completed the course this semester, which is currently offered as an elective.

The course is held at the Mohler Senior Center, which is located on the edge of the College of Medicine and Penn State Health Milton S. Hershey Medical Center campus. Use of its kitchen adds an additional dynamic to the course, as members of the senior center participate in the course alongside the students.

Learn more about the course in this Penn State Medicine article.

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Culinary Medicine: Teaching the importance of nutrition in medical school - Penn State News

Professors at Dell Medical School bring new way of patient-to-physician communication – UT The Daily Texan

Patients are not as comfortable disclosing health disparities to their physicians as they are with other patients experiencing similar disparities, an issue two Dell Medical School professors hope to address.

The professors, Scott Wallace and Elizabeth Teisberg, are the managing director and executive director of the schools Institute for Value in Health and Care. They developed the idea of Experience Groups, which allow patients with similar health issues to sit together and discuss health challenges, about a decade ago. The group size ranges from six to 10 participants with two facilitators who oversee the group, take notes and pose questions to guide the group toward discussion.

Often time, (health care) services are designed from a physicians point of view, not designed from a patients point of view, Wallace said. We use these Experience Group sessions to bring groups of patients who share a set of circumstances together to talk about what is it like to live with their condition.

Wallace said Experience Groups have been conducted at other hospitals, and they hope to bring the idea to the Dell Medical School soon.

Most hospitals have patient advisory groups (with a mixed group of patients), and what they talk about is parking, food and whether the televisions worked and whether the nurses have been nice to them, because thats the only thing they have in common, Wallace said.

Deborah Kennedy, who has facilitated about seven Experience Groups, said the groups provide clinicians with valuable information about their patients they might not have known before.

As clinicians, we automatically think we have the answer, Kennedy said. If we dont, we like to at least postulate what might be a solution.

The Experience Groups Kennedy oversaw involved people struggling with their weight. Kennedy said she learned to be a part of the background of the discussion and to let the participants speak for themselves, which showed her that having people with similar issues come together can enlighten physicians on issues that might not have come up in a clinical setting.

One of the things (the patients) actually said to me several times is, We dont want a skinny person telling us what to do, Kennedy said. They felt like (the physicians) had no understanding.

Wallace said he and Teisberg decided to share their idea with the Dell Medical School in order to directly help the community, one of the schools core missions.

It was a really appealing idea to come down here and actually be a part of creating a health care system that was committed to improving the health of the people in the community, Wallace said. We described it as (taking) on responsibilities of improving the health of our neighbors, and thats a phenomenal opportunity for someone who is interested in dramatically changing health care.

School Dean Clay Johnston said the Experience Groups provide an innovative outlook on how medicine should be provided for the patients at the school.

Experience Groups are about people at an individual level what theyre experiencing, where they want to go and what they want to do with their lives, Johnston said. They demonstrate the kind of innovation that the school is already catalyzing in a variety of communities and settings throughout Austin and Travis County.

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Professors at Dell Medical School bring new way of patient-to-physician communication - UT The Daily Texan

2018 Best Graduate Schools Preview: Top 10 Medical Schools – Yahoo News

Thinking about applying to graduate school? Whether you're interested in pursuing an MBA or attending law school or medical school, there are some big decisions to make. To help students find the right school for them, U.S. News & World Report surveys more than 1,970 graduate schools and programs and ranks them according to our methodology.

Here, we offer a sneak peek at the 2018 Best Graduate Schools rankings.

U.S. News surveyed 170 fully accredited medical and osteopathic schools. In alphabetical order, here are the top 10 medical schools for research.

Below are the top 10 schools for primary care, in alphabetical order. More than 10 schools appear because of ties.

The actual ranking and score of these and other graduate schools will be available March 14, 2017, on usnews.com. Use #BestGradSchools to continue the conversation on Twitter and Facebook.

For more in-depth rankings, searchable data and an expanded directory of programs, sign up for the U.S. News Medical School Compass.

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2018 Best Graduate Schools Preview: Top 10 Medical Schools - Yahoo News

Family of slain Delphi teen Liberty German to speak Thursday morning – Fox 59

Photo of Abigail Williams and Liberty German

Photo of Abigail Williams and Liberty German

DELPHI, Ind. For the first time since the deaths of two teens in Delphi, well hear from the family of one of the girls.

The grandfather of 14-year-old Liberty German will speak to the media at the Carroll County Courthouse at 10 a.m. Thursday. Its the first time anyone related to the girls has made a public statement since their bodies were found more than three weeks ago.

Liberty and her friend, 13-year-old Abigail Williams, went for a hike near the Monon High Bridge on Feb. 13 but didnt arrive at a prearranged meeting point later in the afternoon. They were reported missing, and their bodies were found a day later.

Police said foul play was involved in their deaths. Over the last few weeks, investigators have received thousands of tips and the reward for information continues to grow. Two key pieces of evidence released in the case include a photo of a man and an audio recording of a voice saying, Down the hill. Both pieces of evidence came from Libby Germans phone, police said.

Local investigators are working with the FBI to create a profile of the suspect. Police are still consideringthe possibility that the killer could be local.

While investigators have made progress in the case, theyre still waiting for the tip or piece of evidence that provides a breakthrough. Anyone with information should callthe Delphi Murder Tip Line at 1-844-459-5786. Tips can also be reported by emailing abbyandlibbytip@cacoshrf.com.

Well stream Thursdays news conference live on FOX59.com and the FOX59 app.

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Family of slain Delphi teen Liberty German to speak Thursday morning - Fox 59

Liberty Property to Develop Distribution Center for STIHL – Zacks.com

Liberty Property Trust (LPT - Free Report) , the Malvern, PA-based real estate investment trust (REIT) has announced that it will develop a build-to-suit project for STIHL Southeast, Inc., at Liberty Park at AIPO in Orlando. Notably, STIHL Southeast, Inc. is the exclusive distributor of STIHL outdoor power equipment for Florida, Georgia, Alabama and portions of the Caribbean. The deal is likely to be accretive for Liberty Property going forward.

Currently, STIHL Southeast is a long-term tenant of Liberty Property at 2304 West Taft Vineland Road, a 75,000-square-foot building. The huge growth of independent servicing dealer network has necessitated the requirement of a larger distribution center. Close association with Liberty Property, has prompted STIHL Southeast roping in the REIT again for this project.

The 154,400-square-foot center will be situated in Tradeport Drive. STIHL Southeast has inked a long-term lease for the multi-use facility. This will include around 20,000 square feet of office space and a 25,000-square-foot climate-controlled order assembly area. The remaining area will be utilized for warehouse and distribution.

Currently, Liberty Property carries a Zacks Rank #3 (Hold).

Shares of Liberty Property underperformed the Zacks categorized REIT and Equity Trust Other industry over the past three months. During that time frame, shares of the company lost 4.5%, whereas the industry gained 2.9%. Investors interested in the REIT and Equity Trust Other industry, may consider stocks like Global Net Lease, Inc. (GNL - Free Report) , CoreSite Realty Corporation (COR - Free Report) and CorEnergy Infrastructure Trust, Inc. (CORR - Free Report) . All these stocks carry a Zacks Rank #2 (Buy). You can see the complete list of todays Zacks Rank #1 (Strong Buy) stocks here.

In the last 30 days, Global Net Leases funds from operations (FFO) per share for first-quarter 2017 escalated 11.1% to 60 cents.

In the last 30 days, CoreSite Realtys FFO per share for first-quarter 2017 increased 5% to $1.06.

CorEnergy Infrastructure Trust first-quarter 2017 FFO per share estimates moved up 4.7% to $1.12, in the last 30 days.

Note: FFO, a widely used metric to gauge the performance of REITs, is obtained after adding depreciation and amortization and other non-cash expenses to net income. All EPS numbers presented in this write up represent FFO per share.

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Liberty Property to Develop Distribution Center for STIHL - Zacks.com

Liberty Mutual layoffs technology workers in New Hampshire … – The Boston Globe

Liberty Mutual is laying off up to 360 technology workers, primarily in New Hampshire, as the insurance company aims to become faster at developing and introducing new products and services in a competitive market.

The Boston-based insurer told workers on Tuesday about the reductions, nearly 190 of which will be in New Hampshire. About 20 people will lose their jobs in Boston and Weston and the remaining layoffs will be elsewhere in the country, said John Cusolito, the companys spokesman.

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Among the positions being cut are business systems analysts, project managers, and quality assurance workers, he said.

Affected workers will be allowed to apply for other jobs within Liberty Mutual and for a 12- to 14-week coding program to expand their skills. Liberty officials were unsure how many workers affected by the cuts would eventually get other positions.

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Its never pleasant to affect people on a personal level like this, said James McGlennon, Liberty Mutuals chief information officer. We have no choice but to compete in the marketplace and get our products to the market more quickly.

The company has about 6,000 technology employees and plans to hire about 340 more this year. But the way they do their jobs is changing, he said.

Liberty Mutual has built smaller product teams in an effort to move faster, and workers need to have a broader range of skills, McGlennon said. For example, a software developer also needs to know how to test the product, he said.

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Liberty Mutual is moving away from the multi-year megaprojects, McGlennon said. No work will be outsourced as a result of the staffing cuts, company officials said.

Overall, Liberty Mutual is growing its workforce worldwide, Cusolito said. The company plans to hire about 5,000 workers this year and in five years expects to have added 25,000 workers, he said. Liberty Mutual currently has 1,600 open positions.

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Liberty Mutual layoffs technology workers in New Hampshire ... - The Boston Globe

What Republicans really mean by ‘states’ rights’ and ‘individual liberty’ – Wisconsin Gazette

According to Republican Party orthodoxy, the federal government is a greedy, malevolent giant that must be contained before it swallows up states autonomy and imposes the liberalism of intellectual elites on real Americans who happen to be white, straight, evangelical Christians.

But the states rightscheerleaders and big-government foes have a serious hypocrisy problem: They consider federal intervention perfectly appropriate when it comes to forcing their own views on other people.

Take pot, for instance.

Attorney General Jeff Sessions believes states should not be allowed to legalize medical and recreational marijuana use as long as federal law bans it.

One of Sessions arguments is that having a checkerboard of different marijuana policies in the nation creates jurisdictional chaos and unwanted pot spillover from states where marijuana is legal into adjacent states where it isnt.

Sessions also argues that marijuana use increases crime, even though the opposite is true. Taking marijuana sales out of the hands of organized crime and drug gangs and instead making it a controlled substance can decrease the crime that comes with illegal activity and save a fortune in law enforcement and incarceration costs.

Not to mention that the criminalization of pot is largely to blame for the high rate of incarceration among young African-American males in cities such as Milwaukee.

So how will Sessions handle the marijuana issue? States rights?

States such as Colorado, where legal pot added nearly $2.4 billion and over 18,000 full-time jobs to the states economy in 2015, have a lot riding on the elderly ex-senator from Alabama.

When it comes to same-sex marriage and transgender bathroom rights, however, Sessions and the rest of his ilk embrace the state-based checkerboard: They believe that states should be able to create their own laws. Damn the evidence of the many legal problems that leaving it to the states caused for same-sex couples as well as local authorities before the Supreme Court struck down state gay marriage bans.

In Wisconsin, weve seen our Republican leaders wave the flag of liberty while centralizing control of municipal and county governments. Theyre all for individual liberty except for a womans individual liberty to control what goes on inside her body, the liberty of Wisconsinites suffering from Parkinsons disease to use marijuana to alleviate their symptoms, the liberty of consumers to order contact lenses from overseas, or the liberty of landowners to prevent oil companies from burying pipelines on their properties.

Municipal sovereignty has fared as badly under Republican control as individual liberty has. For example, Wisconsin municipalities cant set their own water quality standards or enact bans on firearms that are stricter than state laws. They cant change the minimum wage within their jurisdiction.

Wisconsin is tied with the other Republican states of Tennessee, Michigan, Louisiana and Florida for having the second largest number of state intrusions on municipal ordinance or authority. Those five areas concern: minimum wage, paid leave, ride sharing, municipal broadband, and tax and expenditure limits. North Carolina is the only state that undermines local authority in more areas than Wisconsin.

As a comparison, 21 states preempt local authority in two or fewer areas.

States rights and individual liberty are clearly not real Republican principles. Rather, theyre fig leaves, attempting to hide the imposition of their religious views and their lust for one-party rule. So when you hear that a Republican law is going to protect your states rights or your individual liberty, be afraid be very afraid.

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What Republicans really mean by 'states' rights' and 'individual liberty' - Wisconsin Gazette

Sons of Liberty toasted as best craft whiskey distiller in country – Boston Herald

Americas best craft whiskey is distilled right here in New England.

Sons of Liberty Spirits Co. of South Kingstown, R.I., was named American Craft Producer of the Year last week at Whisky Magazines annual awards ceremony at Brandy Library in New York City, the best of the 1,400 small distillers across the country.

Tiny Sons of Liberty produces but 60,000 bottles per year, and its spirits are available only in Connecticut, Massachusetts and Rhode Island, two factors which made its nations-best distinction all the more improbable.

I thought wed never win because we dont have a national brand, said Michael Reppucci, who founded Sons of Liberty in 2011. This honor shows that the people who are into whiskey and who read publications like Whisky Magazine are involved and have heard of us and respect what we do.

Sons of Liberty has proven an innovator in the spirits industry for pioneering both seasonal whiskeys and the connection between whiskey and beer. Its seasonal whiskeys include Gala Apple, Honey Chamomile and Pumpkin Spice.

Both beer and whiskey, meanwhile, begin life as a mash of malted grains. That liquid is fermented to create beer; that beer is then distilled to create whiskey.

Most distillers simply ignore the relationship. Few consumers know the relationship. Sons of Liberty celebrates the relationship.

The distillers Uprising American single malt is brewed much like a stout, with the deeply roasted malts that give the beer style its famously dark color and roasted flavor. Its then double distilled and aged in charred American oak with toasted French oak.

Battle Cry single malt uses rye and honey malt in the mash, and is then fermented with a Belgian-style Trappist ale yeast, adding to its dark fruit and spice character. Its distilled and aged in charred American oak.

True Born Gin Belgian Wheat Act begins with a brew of barley, wheat and oats. The mixture is then infused with spices and aromatics coriander, juniper, orange peel, lemongrass plus cascade and chinook hops.

Sons of Liberty also creates what Reppucci calls a family tree of products from the same mash.

Were making a stout, then distilling it to make whiskey, then aging the whiskey in oak, then bottling whiskey and aging beer in the same wood used to age the whiskey, Reppucci said. Nobody nationally is doing that. I think efforts like that are why were getting so much attention.

(Sons of Liberty Spirits Co., 1425 Kingstown Road, South Kingstown, R.I., 401-284-4006, http://www.solspirits.com)

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Sons of Liberty toasted as best craft whiskey distiller in country - Boston Herald

Remember when the wind blew down the Liberty Pole? – Rochester Democrat and Chronicle

WINDS UP TO 81 MPH DOWN TREES, POWER LINESWindstorm of 2017 | 0:48

What we know Virginia Butler

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Strong winds topple tree into dentist office in Irondequoit. Video by Shawn Dowd Shawn Dowd

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Wind gusts Wednesday afternoon surpassed 80 mph, downing trees and power lines, leaving nearly 100,000 people in the Rochester area without power. Wochit

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High winds knocked down trees and tree limbs and whipping up waves on Lake Ontario. Tina MacIntyre-Yee

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Windstorm of 2017

Wind storm whips Rochester

WATCH: Windstorm of the decade

RAW video: High winds down trees, power lines.

Dec. 27, 1889 Democrat and Chronicle.(Photo: Provided photo)

Wednesday's wind gusts had the Christmas light-bedecked wires swinging wildlyon the downtown Rochester Liberty Pole but at least the whole thing didn't come crashing down.

That's what happened Dec. 26, 1889, in another legendary windstorm. The pole, then made of wood, snapped into three massive fragments, bringing the wires down with it. It was 101 feet in height, 3 feet around at the base and sunken 7 feet into the ground.

It had been tottering throughout the day in heavy wind, according to the next day'sDemocrat and Chronicle. The fire department was called, and a doughty firefighter named John McDermott clambered up the pole and tied a wire around it, hoping to secure it to the Sibley building.

No sooner had McDermott stepped back onto the ladder than: "the lofty pole ... swayed back once to the west and then with a slow lingering motion, while the hundreds of onlookers held their breath, fell obliquely across East Main Street, with the top pointing almost directly up East Avenue."

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A carriage with a driver and two young men stood in the street directly in the pole's downward path, but a piece of it snagged on overhead electric wires and fell astray.

Many of the people gathered around took home splinters of the pole as mementos; the firefighters hauled away a large piece to carve into wooden canes.

That original wooden pole was first installed July 3, 1859, with a finely designed weather vane and ball on the top.

The current, 190-foot steel pole was installed in 1965.

Wind records from the 19th century are spotty, so it's difficult to know how hard the wind was blowing that day in 1889. The website thelibertypole.org pegs it at 72 miles per hour.

Read the full newspaper account here.

JMURPHY7@Gannett.com

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Remember when the wind blew down the Liberty Pole? - Rochester Democrat and Chronicle

Iowa Libertarian Party official party – DesMoinesRegister.com

Libertarian Party(Photo: Courtesy/Special to Poweshiek County CR)

The Iowa Secretary of State has announced that the Libertarian Party of Iowa has obtained official political party status in Iowa, effective March 1. The Libertarian Partys presidential nominee, Gary Johnson, received 59,186 votes, which was 3.8 percent of the vote in the November 2016 general election, surpassing the two percent threshold required by Iowa Code to obtain official political party status.

Johnsons 3.8 percent of the vote in Iowa was slightly more than the 3.3 percent he received nationally

I would like to congratulate the Libertarian Party of Iowa on being recognized as an official political party by the state, Secretary Paul D. Pate said. I encourage all Iowans to become and remain active in the political process.

Prior to the 2016 election, the Libertarian Party in Iowa was considered a non-party political organization (NPPO) and did not have some of the privileges granted to the Democratic Party and the Republican Party, two parties with political party status.

NPPOs must have their presidential or gubernatorial candidate receive more than 2 percent of the vote to be recognized as a full-status political party. If a partys nominee does not receive two percent of the total votes cast, the partys status is cancelled.

Political party status gives the Libertarian Party the ability to participate in primary elections in 2018. The Libertarian Party will be included as an option for Iowans on voter registration forms as well.

Libertarian Party state chair, Keith Laube, stated, Having our candidates be part of the Primary Election will allow voters to become familiar with our candidates earlier in the election season. Our candidates will know they are on the November ballot in early June rather than late August. This will help organize stronger campaigns and provide voters more opportunity to understand Libertarian views. Laube added, Having more candidates share their ideas by being involved in the entire election cycle is good for Iowa.

The last instance when a non-party political organization was successful at gaining political party status in Iowa was in the year 2000. Iowa Green Party nominee Ralph Nader received 29,374 votes, or 2.2 percent of the total votes cast for president.

The current number of voters registered as Libertarian in Iowa is 9,100.

Iowa voters could start registering as a Libertarian in. Since January 2016, voters are able to register to vote and change their political party affiliation on the Iowa Secretary of State website. Major party status will become effective 21 days from the filing.

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Iowa Libertarian Party official party - DesMoinesRegister.com

Conservative and libertarian health care experts pan GOP’s Obamacare lite plan – Washington Post

Speaker of the House Paul Ryan speaks on the proposed American Health Care Act.

On Monday, congressional Republicans rolled out their new health care plan, which is supposed to repeal and replace Obamacare. Donald Trump hailed our wonderful new Healthcare Bill. But his enthusiasm for the proposed American Health Care Act is not widely shared. In addition to the expected critiques from the left, the bill has been forcefully condemned by a wide range of conservative and libertarian health care experts. These leading critics of Obamacare argue that the GOP proposal is just as bad, and possibly even worse.

Michael Cannon, well-known health care analyst for the libertarian Cato Institute, offered a particularly harsh appraisal, denouncing the new bill as Obamacare lite or worse:

This bill is a train wreck waiting to happen The Obamacare regulations it retains are already causing insurance markets to collapse. It would allow that collapse to continue, and even accelerate the collapse.

Republicans dont seem to have any concept of the quagmire they are about to enter with this bill.

If this is the choice, it would be better if Congress simply did nothing.

As Cannon explains,the new GOP plan has a similar structure to Obamacare, fails to address most of its flaws, and may well make some of them worse. Republicans should take note: If one of Obamacares leading critics concludes that your repeal and replace bill is even worse than Obamacare, and worse than doing nothing, thats a pretty damning indictment.

Other right of center economists and health care experts have offered similarly damning assessments, including Megan McArdle, Peter Suderman, Scott Sumner, and Avik Roy. Roy argues that the proposal includes some valuable reforms for Medicaid, but concludes that this benefit is outweighed by the many harmful aspects of the plan. Sudermans bottom line is even more negative: In general, its not clear what problems this particular bill would actually solve.

I am no fan of Obamacare myself, and was involved in helping develop the constitutional case against it that led to the Supreme Courts controversial ruling in NFIB v. Sebelius. But I find it sobering that even many of the ACAs toughest critics fear that the GOP alternative is likely to be worse.

A crucial point emphasized by many of these critics is that the GOP plan does little or nothing to constrain health care costs or open up the insurance industry to wider market competition. As Cannon puts it, Congress needs to enact reforms that make health care more affordable, rather than just subsidize unaffordable care. The GOP plan, he explains, does mostly the latter, often even more inefficiently and coercively than Obamacare.

McArdle points out that the new plan is as much a gigantic Rube Goldberg contraption as Obamacare is. She also notes that the GOP hopes to use many of the same procedural tricks to disguise its flaws as Democrats did with those of the ACA. It is far from clear they will manage to get away with it.

Because the plan is so enormously complicated and has so many moving parts, it could easily unravel in a wide range of unexpected ways, as the different components fail to interact as expected. For reasons F.A. Hayek famously explained, even the wisest of bureaucratic central planners lack the knowledge to foresee and offset such problems. And todays Republican Party is not exactly overflowing with wisdom and competence.

If the GOP plan falters like Obamacare has, its flaws will be exacerbated by another feature the two policies have in common: lack of bipartisan support. If it gets through Congress at all, the AHCA is likely to pass on a strict party-line vote or close to it, just like the ACA. From the standpoint of the opposition party, the optimal political strategy will be sit back, watch the trainwreck happen, and saddle the party that passed the plan with the blame.

Just as Republicans had no incentive to help Obama fix the flaws in the ACA, so Democrats will have no incentive to help fix problems with the new GOP plan. Partisan bias is a powerful and increasingly pernicious force, and it could potentially undermine the GOPs health care policy. Admittedly, Democratic opposition may not matter much if the Republicans expand their congressional majorities in 2018 and 2020. But recent history suggests that neither party can count on controlling Congress for long. And in the Senate, many bills are subject to filibuster, effectively requiring 60 votes to pass.

This entire sorry state of affairs is even more the fault of congressional Republicans than Donald nobody knew health care could be so complicated Trump. These had seven years to come up with an alternative to Obamacare, and so far their work product is far from impressive. Sad! Nonetheless, Trumps ignorance, reckless statements, and disdain for free market ideas have also contributed to the problem.

Despite GOP control of both houses of Congress, there is a very real chance that the new bill will not pass. It has already come under fire from both conservative and moderate wings of the party. Given the narrowness of the 52-48 Republican majority in the Senate and the unyielding opposition of Democrats, the plan will be defeated if even as few as three Republicans defect.

In fairness, given the divisions within the party, it is not an easy task to cobble together a bill that is both an improvement over Obamacare and acceptable to all the key factions within the GOP. Whether Republicans can overcome these problems and come up with something better than this initial effort remains to be seen. At this point, it is hard to be optimistic.

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Conservative and libertarian health care experts pan GOP's Obamacare lite plan - Washington Post