Daily Archives: April 21, 2017

New York Times

White House Officials, Craving Progress, Push Revised Health Bill New York Times WASHINGTON White House officials, desperate to demonstrate progress on President Trump's promise to repeal the Affordable Care Act, are pushing to resurrect a Republican health care bill before his 100th day in office next week. Some members of the ... and more »

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White House Officials, Craving Progress, Push Revised Health Bill - New York Times

Kerry Yang speaks openly to foreigners about the bouts of depression that have haunted her for a decade her emotional meltdowns in college, the bruises she inflicted upon her body as a coping mechanism, her initial unsuccessful attempts at treatment.

Yet despite such candor, the 30-year-old public relations consultant from Beijing often can't bring herself to discuss her problems with her fellow Chinese, including members of her own family.

"There's a saying in China that if you display your emotions, you display weakness," Yang said.

Depression as an illness went widely unacknowledged for decades in China, even as the brutalities of the Cultural Revolution and, more recently, frenetic economic growth left emotional scars. Public attitudes have shifted in recent years, propelled in part by the adoption of the nation's first mental health law five years ago.

Yet Yang's case underscores that change is coming slowly within a society that traditionally viewed symptoms such as anxiety, sleeplessness or loss of appetite as isolated physical problems, not signs of mental disorder.

Families in China have been known to lock mentally ill relatives in cages or keep them in shackles for years because they were unable or unwilling to seek help. A rash of high-profile stabbings by perpetrators who were reportedly mentally ill over the past decade further highlighted the dearth of mental health services.

"Number one, it's probably not recognized and number two, if you have these problems it's personal, so 'take care of it on your own,'" said Michael Phillips, a professor of psychiatry at Shanghai Jiao Tong University School of Medicine.

More than 50 million people in the world's most populous country suffer from depression, according to the World Health Organization, which has made depression its signature issue for 2017. Apart from the toll on the afflicted, depression results in an estimated $8 billion in annual losses to productivity from missed work days, medical expenses and other costs, said WHO China representative Bernhard Schwartlander.

China's 2012 mental health law, almost three decades in the making, marked a major breakthrough. It gave political support to what was conceded to be a growing problem, invited collaboration from outside experts and restricted involuntary confinement of the mentally ill except in extreme circumstances a provision critics say still is sometimes ignored in the case of dissidents.

Previously, more than 90 percent of those with mental disorders had never sought any kind of professional help, according to a 2009 study by Phillips and several colleagues.

The new law placed schizophrenia and other psychological conditions out in the open, by expanding available treatments beyond psychiatric hospitals to include community-based services and encouraging scientific research. There's also been growing realization that mental illness can be just as burdensome to society as other chronic illnesses such as diabetes and hypertension, said Phillips, who also is director of the Suicide Research and Prevention Center at Shanghai Medical Center.

At the end of last year, 5.4 million people had been registered by China's government as having serious mental problems, according to the National Health and Family Planning Commission, which said the quality of treatment had been "gradually improving."

For years starting in college, Yang said she coped privately with periods of uncontrollable crying, anxiety and days when she didn't want to get out of bed. She excelled in her studies, yet still came up short of the perfection she'd been taught to demand of herself. Problems in romantic relationships added to the stress.

She recalled banging her fist repeatedly during arguments and pounding her chest until her body was bruised. Rather than disturb her, she found the bruises to be a soothing outlet for her emotional pain, an act known to therapists as self-harming.

Yang finally sought help five years ago, visiting two public hospitals, where she found the care impersonal and unhelpful, and then a private counselor.

"I actually have trouble talking to a Chinese therapist because I'm uncomfortable speaking about this in my native tongue," she said.

Yang's parents were supportive but somewhat baffled. She said her mother didn't know depression existed, while her father wanted to "fix" her, but didn't know how.

Only after leaving China for a master's degree program in Australia did Yang find help. She returned to Beijing three years ago and began seeing a Chinese-Australian psychotherapist, Sami Wong, after her depression returned last fall. They speak primarily in English.

Despite the progress in recent years, mental health resources remain stretched thin even in major cities such as Beijing and Shanghai. Nationwide, there are 27,733 psychiatrists or about two for every 100,000 people, according to the health commission. Russia and the United States have more than five times as many per capita, Schwartlander said.

The shortage of trained caregivers is most acute outside urban areas, said Zhang Yunshu, a psychiatrist who deals with rural patients in eastern China's Hebei Province. To fill that gap, the government has encouraged more students to enter the field and brought psychiatrists from the city out to the countryside to train general medicine doctors on the basics of psychiatric care.

Besides the cultural forces at play, Wong, Yang's therapist, said she sees a generational divide among her clients. That's particularly true of people like Wong's mother, who lived through the Cultural Revolution, a decade of political violence and chaos unleashed by Mao Zedong in which an estimated 1 million Chinese died from persecution, execution or suicide.

"Compared to that hardship, the feeling of depression is perceived as quite light," Wong said. "Compared to fear, depression is nothing."

WHO representative Schwartlander said China's contemporary rulers have accepted the need to address depression and mental illness. And just as the country has lifted hundreds of millions of people out of poverty in the recent past, he believes with enough political will it can address its mental health needs.

Yang said it will take more than the WHO depression awareness campaign motto of "Feeling down? Let's talk" to ease the stigma associated with the disorder. She said China also must expand services so those with depression will have someone to listen.

"Otherwise it just opens a wound," she said. "It's just slicing people open, and then they could become desperate."

Follow Matthew Brown on Twitter at https://twitter.com/matthewbrownap

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Progress on depression slow in China as stigmas persist - ABC News

It has been 20 years since Bill and Melinda Gates first started using their fortune to address global health issues. By focusing on the diseases that hit the poorest parts of the world the hardest, their foundation has since saved countless lives and prevented untold suffering. My enthusiasm and belief that this is the right way for this money to be spent is as strong as it was then, Bill Gates said in a telephone interview with Scientific American before attending a major international health meeting this week in Geneva. But he acknowledged that making progress has not been as simple a process as he at first assumed.

Some of the naivet that I had then was that if we created new tools [to identify and treat these diseases] that actually getting them out to people would be fairly straightforward, Gates says. And although I was also naive about some of the [drug] discovery stuff and the regulatory complexities, I was even more naive about how tough it is to do delivery. Fortunately, the Bill & Melinda Gates Foundation and its teams of experts have developed a knack over the past two decades for working out many of the nitty-gritty details of how to get effective treatments to some of the worlds most remote locationssometimes even redesigning products to make them easier to transport over long distances and across wide-ranging temperatures.

Nowhere has this sort of attention to detail paid off more handsomely than with the effort to reduceand potentially eliminatesome of the lesser-known ailments that plague the developing world. Collectively known as neglected tropical diseases, or NTDs, these illnesses include leprosy, rabies, blinding trachoma and lymphatic filariasis (also known as elephantiasis). Five years ago a wide range of international organizations (including the Gates Foundation), governments and pharmaceutical companies came together in London to adopt a plan to eradicate many of these diseases by 2020. The drug manufacturers agreed to donate billions of prescription medicines and other treatments if their partners could ensure that they would be used effectively.

The partners are holding a summit in Geneva this week to celebrate the successes they have achieved so far. Health experts have made record-breaking progress in getting some of these ancient scourges under control, Margaret Chan, director of the World Health Organization, said in a statement. For example, the organization says only 25 cases of Guinea worm disease were reported in 2016. The number of cases of sleeping sickness (African trypanosomiasis) fell from 37,000 new cases in 1999 to under 3,000 in 2015.

Looking ahead, some of the most exciting news is likely to come in the treatment of lymphatic filariasis, which infects tens of millions of people, causing severe pain and severe swelling in the limbs and other parts of the body. As part of an effort to develop new medications for the disease, researchers funded by the Gates Foundation decided they needed to better understand how current therapies work. In the course of their investigations they learned that if they combined three different current medications, they might be able to neutralize the worms that cause the disease in a matter of monthsas opposed to the more typical 15 years.

No one knows why the three-drug combination is better than the standard two-drug treatment. But the three-drug approach has since been fast-tracked for approval, assuming a large-scale efficacy test of 10,000 people confirms positive results at the end of May. Health experts are cautiously optimistic. We know that we havent had any serious adverse events from the combination," says Julie Jacobson, a senior program officer at the Gates Foundation. If this works, the gain will be huge.

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Bill Gates Enthusiastic about Disease-Fighting Progress - Scientific American

Jocelyn Noveck, Ap National Writer

Former Secretary of State Hillary Clinton speaks after accepting the Trailblazer Award during the LGBT Community Center Dinner at Cipriani Wall Street on Thursday, April 20, 2017, in New York.

Former Secretary of State Hillary Clinton speaks after accepting the Trailblazer Award during the LGBT Community Center Dinner at Cipriani Wall Street on Thursday, April 20, 2017, in New York.

Hillary Clinton: Progress in LGBT rights may not be secure

NEW YORK (AP) Hillary Clinton told an audience of LGBT advocates Thursday night that the progress they've achieved in recent years may not be secure under the Donald Trump administration, and urged them to keep fighting.

"I know that the election hit a lot of us hard," Clinton said of her bitter loss to Trump in November. "But I can tell you this: Even when it feels tempting to pull the covers over your head, please keep going."

The audience at the fundraising dinner for The Center, an LGBT community group in New York, greeted Clinton with multiple standing ovations and cheers as she accepted the organization's Trailblazer Award. One of the biggest cheers came when she reiterated remarks she made in Geneva in 2011 as secretary of state: "Gay rights are human rights, and human rights are gay rights."

"But I think we have to face the fact that we may not ever be able to count on this administration to lead on LGBT issues," Clinton said. "Let's remember, 2018, the midterm elections ... We can never stop fighting."

It wasn't just in the U.S., Clinton said, that "we're seeing clouds gathering on the horizon."

"We've heard terrifying accounts from Chechnya of gay and bisexual men being taken from their homes and families, tortured, even killed," she said. "The United States government yes, this government should demand an end to the persecution of innocent people."

In America, she said, "the progress that we fought for ... that we celebrated and maybe even (took) for granted may not be as secure as we once expected."

She spoke of protections for transgender students being rescinded, and proposed cuts in funding for HIV and AIDS research.

"I thought of all our efforts to try to achieve an AIDS-free generation, and we were on the way," she said. "We can, if we stay on that path, finally realize that dream but not if we are forced off."

Clinton's appearance was one of several in recent months where she has been greeted with huge ovations including several at Broadway shows. She joked at the dinner that she realized she was "preaching to the choir," but added: "That's OK, I love standing ovations."

She also quipped that the evening had posed a dilemma for her: She'd had the choice, she said, of attending the dinner or seeing Bette Midler in "Hello, Dolly!"

"I really struggled to figure out which event would best reflect my commitment to the community," she said, adding that she had struck a compromise she put on her "Sunday Clothes" a song title in the show and came to the dinner.

Clinton ended her speech by sharing what she called her new mantra "the kind of thing that does pop into your head when you're out in the woods."

"When a good friend or loved one says, 'Quit yelling at the television set,'" she said, "Just remember: we need to resist, insist, persist and enlist."

Also honored was designer Marc Jacobs, who received the group's Visionary Award and is a longtime Clinton supporter. When asked what he thought Clinton should do now she has said her only plans for the moment are working on her book and finding new ways to help people he said, "I wish she were doing what we voted for her to do. But that didn't happen."

Clinton herself gave no hints in her speech about her future, but did note that she had made a new discovery: "Sleep is good."

"I highly recommend it," she said. "When I wasn't walking in the woods, I was catching up on my sleep."

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Hillary Clinton: Progress in LGBT rights may not be secure - Midland Daily News

LOS ANGELESSpring is a time for progress, not final decisions. For Matt Lynch and Devon Modster, its a time for competition.

The redshirt freshmen are vying for the backup quarterback job, which Coach Jim Mora said remains open after almost three weeks of practice.

Theres not going to be a day where we dont stop competing, Lynch said.

During the first 10 practices, it was typically Modster first off the bench to lead the second offense in team periods. The former four-star prospect out of Tesoro High was elevated to the backup position in November after Josh Rosen was ruled out for the year. UCLA avoided the disaster of having to burn Modsters redshirt during its lost season as Mike Fafaul stayed healthy.

Although he was powerless to help UCLAs sputtering offense last year, Modster said he was glad to have retained his extra year of eligibility.

It was just a learning experience, kind of getting used to the system and how the game is going, he said.

Lynch was a three-star recruit from Broomfield, Colo., and enrolled early last season. He spent the offseason ironing out his throwing motion with quarterback coach Warren McCarty, trying to shorten the motion while fighting the desire to drop his shoulder. Going through his second spring practice, Lynch said his knowledge of the game has increased the most in the past year with the help of Rosen.

(Im) always learning from Josh because theres always something new that comes up in practice or different plays, so just trying to pick his brain a little bit, Lynch said.

Instead of rushing to identify a backup quarterback, Mora is content watching the redshirt freshmen progress while learning UCLAs new scheme this spring.

What I see is two guys who are getting better every practice, Mora said. So Im just encouraged by the way both of those guys are coming along.

SPRING SCRIMMAGE PLANNED

UCLAs spring game will indeed be a real game. Probably. Knock on wood.

Barring significant injuries in the final week of spring practice, the Bruins will punctuate their monthlong spring camp with an official scrimmage in Drake Stadium, Mora said.

UCLA has been fortunate to avoid major injuries this spring with only DeChaun Holiday being the major loss. The safety/linebacker suffered a right shoulder injury last week and hasnt returned to the field, but was seen Thursday without his sling for the first time since the injury occurred. Tight end Austin Roberts was sidelined with an undisclosed injury, but returned to the field Thursday.

I see them understanding how to practice with a level of physicality without cheap shots, Mora said of weathering injury concerns this spring. The defensive backs understand that theyre not going to blow a receiver up just to blow him up. They know how to practice.

The last time the Bruins capped off a spring practice slate with an official spring game was 2014 at StubHub Center. The previous two years, the team just held a structured practice, citing a growing list of injuries that cut the teams already thin roster. Instead of having a draft to determine the two teams, Mora and the coaching staff will likely divide the roster into blue and white squads next week, taking into account minor injuries.

I dont want it to be a bloodbath, Mora said. I want it to be competitive.

Tickets are $5 in advance and $10 at the door, with a team autograph session and Adidas surplus sale to take place after the scrimmage.

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UCLA seeks progress, not separation, in backup quarterback competition - OCRegister

Kinder Morgan (NYSE:KMI) started 2017 off with a solid performance in the first quarter, after its results came in slightly ahead of expectations. That performance gave the company the confidence to reaffirm its full-year guidance.

Meanwhile, the company announced progress on several strategic initiatives during the quarter, which puts it on pace to potentially boost the dividend by year's end.

Data source: Kinder Morgan Inc. Chart byauthor. In millions of dollars.

The pipeline giant's results were down but still ahead of expectations:

Image source: Getty Images.

CEO Steve Kean commented on the results:

We are pleased with our operational performance, which is slightly ahead of guidance we provided in January for the quarter, and we remain on target for the year. We generated earnings per common share for the quarter of $0.18 and distributable cash flow of $0.54 per common share, resulting in $935 million of excess distributable cash flow above our dividend.

As Kean noted, the company didn't run into any problems during the first quarter, putting it on pace to meet its full-year guidance. Instead, the most noteworthy events during the quarter were its strategic moves. Founder Richard Kinder provided those details by noting that the company "made additional progress on our two largest growth projects: Trans Mountain expansion and Elba Island liquefaction." He continued:

These are signature energy infrastructure assets for North America, and we expect they will contribute greatly to Kinder Morgan's future growth. With respect to Trans Mountain, after receiving approval from the Canadian federal government and the province of British Columbia to proceed with the project, we completed our final cost estimate review process with the shippers. Despite the shippers' right to terminate their contracts during this process, 100% of the original committed capacity (707,500 barrels per day) remains under contract. Additionally, while making steady progress constructing our Elba Island liquefaction facility, we welcomed EIG Global Energy Partners as a 49% joint-venture participant in that project.

Kinder Morgan still does have some work left to do on Trans Mountain. The company's goal is to find a financing alternative for the project similar to Elba Island. The company continues to explore both a joint-venture option and an IPO of Trans Mountain and its other Canadian assets. The culmination of that process will enable the company to remain on track to hit its leverage target of around 5.0 times net debt-to-adjusted EBITDA. That will improve the company's financial flexibility so it can allocate capital to other options, including share buybacks, new growth projects, additional debt reduction, and a dividend increase.

Matt DiLallo owns shares of Kinder Morgan and has the following options: short January 2018 $30 puts on Kinder Morgan and long January 2018 $30 calls on Kinder Morgan. The Motley Fool owns shares of and recommends Kinder Morgan. The Motley Fool has a disclosure policy.

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Kinder Morgan Inc.'s Forward Progress Continues - Motley Fool