Daily Archives: August 6, 2022

FDA Approves New Treatment for People With Plaque Psoriasis – Everyday Health

Posted: August 6, 2022 at 8:25 pm

The U.S. Food and Drug Administration (FDA) approved Zoryve (roflumilast) cream 0.3 percent for the treatment of plaque psoriasis, including intertriginous areas (where skin rubs against other skin) in people 12 years of age and older, according to a press release issued by Arcutis, the manufacturer of the drug. Once-daily Zoryve is the first and only approved topical phosphodiesterase-4 (PDE4) inhibitor, the first and only FDA-approved steroid-free cream in its class.

PDE4 inhibitors suppress the immune system by reducing the action of an overactive enzyme (phosphodiesterase 4), thereby reducing inflammation.

It is always great to have another topical option to treat psoriasis, so this approval is exciting, says Marisa Garshick, MD, a board-certified dermatologist at MDCS Dermatology in New York City. Zoryve will be a good choice for those patients who prefer to avoid a topical steroid, she adds.

This approval offers yet another steroid-free option for people with plaque psoriasis; in May, the FDA approved Vtama (tapinarof) cream 1 percent for topical treatment of mild, moderate, or severe plaque psoriasis in adults.

FDA approval is based on data from two phase 3 randomized, double-blind, vehicle-controlled (Zoryve was compared to a placebo or dummy cream) trials that included a total of 881 people, called the DERMIS1 and DERMIS2 studies, presented at the 2021 Clinical Dermatology Conference in Las Vegas, Nevada.

The primary endpoint wasInvestigator Global Assessment (IGA)success, defined as clear or almost clear skin with at least a 2-grade improvement from baseline, and at least a 2-grade IGA score improvement from baseline at eight weeks. In the 2 trials, 42.4 percent and 37.5 percent of the patients treated with Zoryve achieved an IGA success rate, compared with 6.1 percent and 6.9 percent in the control groups, respectively.

Nearly 3 in 4 people (73.5 percent) completed 52 to 64 weeks of treatment, and fewer than 1 percent of participants discontinued because the medication didn't work.

In addition to clearing the skin, Zoryve improved the severity and impact of itch. Of participants with a Worst Itch-Numerical Rating Score (WI-NRS) of 4 or higher at baseline, 2 out of 3 people using Zoryve achieved at least a 4-point reduction at week 8. The WI-NRS is a questionnaire that asks patients to rate their itch from 0 (no itch) to 10 (worst imaginable itch) in the past 24 hours, according to an article published October 23, 2021, in BMC Health and Quality of Life Outcomes.

While topical steroids are a very effective option for psoriasis, their use over time should be limited, says Dr. Garshick. There are certain locations on the body, including the face and skin folds, where their use should be limited to prevent thinning of the skin, she adds.

Zoryve is the only topical that has data specifically focusing on the treatment of intertriginous plaques (those found in skin folds), said Frank Watanabe, the president and CEO of Arcutis, in the statement. For people who have psoriasis in those areas, which can include areas such as the underarms, under the breasts, or the groin area, Zoryve can be a safe and effective option, says Garshick.

Unlike steroids, there is no restriction on how long Zoryve can be used to treat plaque psoriasis, according to the approval statement. When used chronically (over a long period of time), topical steroids can cause stretch marks in areas like the thighs or the armpits, according to the American Academy of Dermatology (AAD).

In general, Zoryve is safe and easy to tolerate for those with psoriasis, says Garshick. The most commonly reported side effects in people using Zoryve were diarrhea (3.1 percent), headache (2.4 percent), insomnia (1.4 percent), nausea (1.2 percent), application site pain (1 percent), upper respiratory tract infection (1 percent), and urinary tract infection (1 percent).

The current wholesale acquisition cost (WAC) pricing is $825 for a 60 gram (g) tube of Zoryve, according toArcutis. The actual cost to the patient will depend on insurance coverage.

The company offers a savings program; people with commercial insurance that provides Zoryve coverage will pay $25 a tube, and those with commercial insurance that does not cover Zoryve will pay $75 a tube. Financially eligible patients who dont have insurance or who are underinsured may access the cream through the Arcutis Cares Patient Assistance Program.

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Woman says 70% of her body is covered in red marks due to rare condition – The Mirror

Posted: at 8:25 pm

Bri Morrell from Leicester was diagnosed with psoriasis, an irritating skin condition which causes red, scaly patches to appear on her skin

Image: mediadrumimages/@thatgirlpatches)

A woman who says 70 percent of her body is covered in red marks has opened up about having psoriasis.

Bri Morrell from Leicester was diagnosed with the irritating condition, which causes red, scaly patches to appear on her skin, earlier this year.

The customer service advisor believes the condition was triggered after suffering a period of depression.

Psoriasis causes the skin cells to grow at a rapid rate, with new skin cells growing every three days, instead of at a one-month rate.

As a result, there is an excess of skin cells that pile up on the surface, causing inflammation, swelling and redness.

These patches cover nearly 70 per cent of Bri's body, causing itching, soreness and in some cases bleeding when her skin splits open.

Psoriasis affects every inch of Bri's body. It doesn't just affect her bare skin, but also her scalp and even her fingernails and toenails.

To ease the psoriasis and irritation, Bri wears baggy and loose-fitting clothes, lessening her contact to tight-fitting materials.

Bri's psoriasis started in her early 20s, slowly appearing before taking over her body.

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She believes it was triggered by a low period of her life when Bri suffered a period of depression.

Psoriasis can be brought on by stress, depression, or changes in hormones, as well as many other things.

Despite visiting the doctors, Bri says she didn't receive any treatment for her skin.

She was offered an immune-suppressing drug, however, she turned down the treatment due to the multitude of harsh side effects that accompany the drugs.

Instead, to manage the irritation, Bri uses a cream which reduces the soreness and dryness of the skin.

Bri wants to inspire others, using her Instagram as a platform to spread body positivity to others and reduce the stigma around the skin disease.

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"I never got psoriasis until I was in my early twenties," said Bri.

"There isn't one part of my body it doesn't affect.

"I have it on my scalp, face, back, chest, stomach, legs, toes, hands, nails.

"Around seventy percent of my body is covered.

"It was triggered by a low period in my life.

"My condition can cause me low periods, but that's generally when other things are bothering me, and the psoriasis is like a straw that broke the camel's back.

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"I find the itchiness and flakiness the most annoying part.

"It can be embarrassing when it's in my scalp or ears as I worry people may think it's down to me not washing my hair.

"When I'm not using my cream, I struggle to get about as my skin is so sore and literally splits open, but I used the regularly which helps control my psoriasis."

Bri says she has had to change her attitudes and has spoken about the amazing support she has had in place through her journey.

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"I've had to overcome caring what people think and learn to love myself despite not fitting into European beauty standards," she said.

"I've always been very fortunate to date understanding people who not only accept my psoriasis, but actually find it attractive as they say it's different and unique.

"If I dated a guy who was embarrassed or irritated by my skin then he wouldn't last long.

"My family is extremely supportive of my skin and have helped me to embrace it, as well as my ex-partner.

"I've never received hate online, but I have had funny stares from people before.

"I think there is a lack of education on skin conditions, so a lot of the time people don't know what they're dealing with."

Bri hopes to educate people about psoriasis and help people accept their individual beauty, regardless of their skin.

"I was confident enough to embrace it," said Bri.

"I'm proud of the fact that I embrace my skin and have helped others to feel less embarrassed about having a skin condition.

"I'm proud of building my Instagram with content that I've been told by others has inspired them not to hide their own skin.

"I think it's important to learn to love yourself so much that something like a skin condition won't get you down.

"Stop comparing yourself to other people on social media. I am really bad for that, and it's never done me any good. Ever since I stopped, I've felt so much better within myself."

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Woman says 70% of her body is covered in red marks due to rare condition - The Mirror

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Spending time in the sun can be good for eczema or psoriasis, but doctors say don’t overdo it – Your News Now

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Kim Kardashians daughter North, 9, shocks fans by showing off moms REAL skin including pores and pso… – The US Sun

Posted: at 8:25 pm

KIM Kardashian has shown off her real skin texture in her daughter North's latest TikTok.

The reality star, 41, displayed her visible pores and psoriasis in a video the nine-year-old shared on Sunday.

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Kim, 41, posted a new clip over the weekend to the TikTok account she shares with her eldest daughter.

In the video, the preteen gave her famous mom a very distinctive makeover.

At the start of the clip, Kim's pores could be seen on her cheeks as well as pink patches on her neck from psoriasis.

Psoriasis is a skin condition that causes flaky patches of skin which can look pink or red.

North gave her mom the full Minions treatment complete with yellow face paint, purple lips, and black lines around her eyes to resemble the characters famous goggles.

Kim added the text Mommy Minion, to describe the finished result.

The Keeping Up With the Kardashians-alum has previously revealed that North loves makeup and special FX, so its no surprise that she has to volunteer as a model sometimes.

North is one of four children that Kim shares with Kanye, along with Saint, six, Chicago, four, and Psalm, three.

Kanye has said in the past that he is not happy with his daughter being on TikTok, although the account is managed by an adult.

But the new video comes amid fan rumors that Kim and Kanye might have rekindled their relationship.

Many fans believe that a number of clues recently suggest that Kim and Kanye have reconciled.

On Friday, Kim took to her Instagram Stories to post a photo ofNorth modeling a pair of Yeezy sunglasses designed by her rapper dad.

Similarly,Kris Jennerwas spotted on Wednesdaywearing a pair of Yeezy sneakerswhile preparing for a Christmas photoshoot withKhloe Kardashian.

But thats not all.

Kim posted on social media earlier this week to reveal that she waswatching The Truman Show, which the Donda star has previously said is one of his favorite movies.

It came after she had alsoshared an image from American artist James Turrell, whom Kanye has previously collaborated with.

The dad-of-four was recently spotted looking so happy as he took North to her basketball game with Chicago.

Meanwhile, Kims new boyfriend Pete Davidson wasspotted looking downcastin Australia this week, where he is away filming a movie.

The actor will now be away from Kim for even longer than he had planned because his new movie, Wizards, has suffered a delay in production.

Kim hadtraveled to Australiaearlier this month to spend time with her beau, who has a busy work schedule just like her.

Things appear to have to been going well between the two in recent months, with Pete even hinting that hewould like to get married and have childrenwith the Hulu star.

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Kim Kardashians daughter North, 9, shocks fans by showing off moms REAL skin including pores and pso... - The US Sun

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This Michigan college alum is blasting off to the International Space Station – MLive.com

Posted: at 8:22 pm

ALBION, MI - There are numerous astronauts who hail from the state of Michigan. Almost all of them studied or taught at the University of Michigan in Ann Arbor.

One about to go to the International Space Station now, however, is an Albion College Briton.

Josh Cassada, a 1995 alumnus of the private college in Calhoun County, is part of the NASA SpaceX Crew-5 mission heading to the space station orbiting more than 250 miles above the Earth.

Cassada will join his crew for a launch tentatively scheduled for late September, Albion College officials said.

We are honored and excited to have Josh represent our great nation and Albion College in space, said Joe Calvaruso, the colleges interim president.

Along with three members of his crew, this is a first-time flight into space for Cassada, he said in a Thursday afternoon NASA news conference. The months-long stay in the ISS is a part of the Artemis missions, or an effort by NASA to land the first woman and person of color on the Moon prior to branching out to Mars.

Whats so great about this is that were doing something greater than ourselves, Cassada said during the Aug. 4 conference. Those first-time fliers, were bringing a lot of energy to the ISS.

The International Space Station Crew includes NASA astronaut Nicole Mann, Japanese astronaut Koichi Wakata and Russian cosmonaut Anna Kikina. This is NASAs fifth crew rotation flight carrying personnel to the station, which operates as a microgravity laboratory, officials said.

Cassada earned his bachelors degree in physics from Albion College before earning a masters and doctorate in physics from University of Rochester in New York. He served in the U.S. Navy as an aviator aboard P-3C patrol planes, accumulating more than 4,000 flight hours and 23 combat missions.

Cassada has spent the larger part of the last decade preparing to enter space, as NASA selected him for its Astronaut Group 21 in 2013. After completing two years of training, he supporting ISS operations until in August 2018, he was one of two astronauts selected for the CTS-1 program, which would fly Boeings CST-100 Starliner aircraft into space.

He was reassigned to SpaceX Crew-5 due to delays in the Starliner project, according to Space Explored.

During Thursdays conference, Cassada expressed excitement for the various science experiments he will conduct up in space alongside Mann, Wakata and Kikina. For the six months he is in space, he also plans to watch a lot of movies from the 1980s, he said.

We will watch (the Chevy Chase comedy) Fletch every Friday so Nicole can get my references, he said.

Experiments in the ISS include the Cold Atom Lab, which is used to study the behavior of atoms in extremely cold temperatures. As a physicist, these excite him for the journey ahead.

That one is near and dear to my heart, Cassada said. Were lucky we get to do all kinds of science.

To view the press conference, visit nasa.gov/nasalive.

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Local Students to Hear From NASA Astronaut Jessica Watkins, Live From Aboard Space Station Pasadena Now – Pasadena Now

Posted: at 8:22 pm

NASA astronaut and Expedition 67 Flight Engineer Jessica Watkins familiarizes herself with systems and procedures aboard the International Space Station having been aboard the orbiting lab for just a few days in this image from May 1, 2022. [NASA]

Providing direct access to astronauts aboard the International Space Station, Caltech students, faculty, and staff members on campus and at JPL will interact with NASA astronaut Jessica Watkins on Tuesday, Aug. 9, through a unique question-and-answer NASA in-flight education event.

Participants in Pasadena will be able to see and hear Watkins live from space responding to their pre-recorded questions.

For the public, the NASA Earth-to-space call will also air live at 9:55 a.m. on Tuesday, August 9 on NASA TV and streamed live on the NASA website at http://www.nasa.gov/nasatv.

Jessica Watkins was selected by NASA to join the 2017 Astronaut Candidate Class. Watkins reported for duty in August 2017 and completed two years of training as an astronaut candidate, according to NASA.

Her astronaut candidate training included scientific and technical briefings, intensive instruction in International Space Station systems, spacewalks, robotics, physiological training, T-38 flight training, water and wilderness survival training, geology training, and expeditionary skills training.

Watkins is currently serving as a mission specialist on NASAs SpaceX Crew-4 mission to the International Space Station, which launched on April 27, 2022.

Watkins conducted her graduate research on the emplacement mechanisms of large landslides on Mars and Earth. At NASA, she worked at the Ames Research Center and JPL and was a science team collaborator for the Mars rover Curiosity program.

Laurie Leshin, JPL Director and Caltech Vice President, will deliver the opening remarks for this event.

Members of the Caltech community will watch the livestream together inside Caltechs Beckman Auditorium.

Providing students direct access to astronauts aboard the International Space Station delivers an exceptional, unique experience, designed to enhance student learning and interest in STEM fields. Caltech and JPL have a keen interest and dedication to encouraging STEM learning, Caltech said in a statement.

Get all the latest Pasadena news, more than 10 fresh stories daily, 7 days a week at 7 a.m.

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Earth sets record for the shortest day – Space.com

Posted: at 8:22 pm

Scientists have recorded Earth's shortest day since its rotational period began to be recorded with highly precise atomic clocks: On June 29, 2022, Earth's spin was completed in 1.59 milliseconds under 24 hours.

A day lasts 24 hours because the Earth completes a full spin on its axis roughly every 8,640,000 milliseconds. In the short term, this speed can fluctuate by factions of a millisecond from day to day. This means that the length of a day can vary, but only usually by a tiny amount.

Our planet is also experiencing long-term changes as well. Previously, the planet had been observed to be spinning more slowly and taking longer to complete a day. As a result, with every passing century, Earth has been taking a few milliseconds longer to complete a spin.

Related: How fast is Earth moving?

In recent years, however, this long-term trend has been reversing. The Earth seems to be speeding up and taking progressively less time to complete its spin meaning days are shortening.

In December 2020, the website Time and Date reported (opens in new tab) that during that year the Earth had experienced its 28 shortest days since scientists began measuring the length of a day with atomic clocks in the 1960s.

July 19, 2020, was a record-breaking short day that year with Earth completing a rotation in 1.47 milliseconds under 24 hours. The record remained unchallenged during 2021 before being broken by a minus 1.59 millisecond day on June 29, 2022.

And July 19, 2020, would not stay in the second-fastest day placement for long either. Just a month after the record for the fastest day was shattered, that second place day was once again dethroned further when Earth experienced a -1.50 millisecond day on July 26, 2022.

Scientists have several ideas regarding what could be causing Earth to suddenly begin speeding up its rotation and shortening its days. These ideas can involve processes in the planet's inner or outer layers, oceans, tides, or even its climate.

One team of researchers thinks that the shortening of days could be related to a small irregular movement in the Earth's geographical poles and its axis of rotation that shifts them by a minuscule amount across its surface called the 'Chandler wobble.'

"The normal amplitude of the Chandler wobble is about three to four meters at Earth's surface, but from 2017 to 2020 it disappeared." HSE University associate professor Leonid Zotov told Time and Date. (opens in new tab)

If the decrease in day length continues then it may necessitate the introduction of a negative leap second to keep 'civil time' measured by highly reliable atomic clocks in sync with solar time, the movement of the sun through the sky from sunset to sunrise.

Zotov isn't convinced that this measure, which could cause difficulty for some computer systems, will be needed. He thinks day lengths may not shorten by much more.

"I think there's a 70 percent chance we're at the minimum and we won't need a negative leap second," he said.

This week Zotov and his colleague will present their hypothesis at the 2022 annual meeting of the Asia Oceania Geosciences Society (opens in new tab) which is broadcast online.

Follow us on Twitter @Spacedotcom (opens in new tab) or on Facebook (opens in new tab)

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How has Spacestation Gaming fit Dexter into the roster? – SiegeGG

Posted: at 8:22 pm

Image: Ubisoft/Kirill Bashkirov

After missing two Six Major events in a row, Spacestation Gaming opted to drop Alexander "Skys" Magor from the roster on Jul. 16. In his place, the team has trialled Dexter, an upcoming Brazilian tier-two player, at the ongoing Gamers8 tournament in Saudi Arabia.

With his debut game on the team now completed against South Koreas DWG KIA, heres what weve learnt about where Dexter may fit into the roster and how the team dynamics looked to have changed since the end of Stage 2.

Starting on the attack, its useful to see what gap in the team was left open for Dexter to fill. Obviously, we have to look at what the team does, not necessarily what they mean to do as we dont have an insight into the teams game preparations.

During SSGs more successful tournaments with this lineup. Skys primarily played a hard support role. However, Dylan "Bosco" Bosco took this role up in recent times, and Skys moved to a flexible position, playing operators such as Lion.

Similarly, recent years have seen a pretty big change in whos taking those opening engagements on the attack. Despite Matthew "Hotancold" Stevenss success in this area at the end of the 2021 season, Alec "Fultz" Fultz and Nathanial "Rampy" Duvall have gone back to this position as they previously played here during their SI 2020 title run.

The entry positions have changed once again now as Dexter locked in Finka immediately each round for the first two maps, before moving to Iana on Bank. This is obviously unsurprising, as putting a young gunner on Lion or Thatcher would put his skills somewhat to waste.

Unlike other teams, Dexter was usually sent off without drone support (particularly on Chalet) and he also roamed on the opposite side of the map to the rest of the team to less than stellar results. By the time Bank came around, Dexter was kept much closer to the team. Here, Fultz was off on his own more often.

This meant that at the beginning, the duo of Fultz and Rampy remained working together even without Finka to use as Fultz replaced Skys more flexible role. By the end of the game, Rampy ended with the most opening kills in the game, while primarily playing on Sledge. Bosco and Hotancold remained in their more supportive roles.

In effect, Dexter has picked up Fultzs role while Fultz has slipped into Skys old position. This is quite a change for Fultz, as he has been on entry longer than anyone else on SSG. Considering he ended the game with the worst kill differential on his team, this is probably a role that will take time to get used to.

Team plans are harder to deduce on the defence as they heavily rely on the site being defended. SSG also only played Chalet once recently, while this was the first time they played on Theme Park in a professional game since October 2020.

Nevertheless, Dexters addition clearly caused some waves on Chalet, as he played primarily Wamai while Bosco and Hotancold sat on Jager. This is odd, as these two operators have been very consistently played by Rampy over the last year.

On this map, Rampy was instead playing a range of operators, including Oryx, Melusi, Mute, and Smoke, as he moved into Skys more flexible role. To simplify it on Chalet, Rampy replaced Skys, and Dexter has replaced Rampy.

After losing five rounds in a row on their defensive half, Theme Park saw them revert back to what they knew. Rampy played Wamai when needed, while Dexter was on Alibi and Melusi.

Finally, Bank is a map with which SSG does have a history, but they opted not to play it in Stage 2. Since then, they clearly have mixed up their play style; for instance, Hotancold became the teams Castle player rather than Bosco. Amidst all these changes, Dexter was put on Azami.

For obvious reasons, its possible that these roles dont stick around until the beginning of Stage 3 in September as they work further to fit their new fifth into their roster and work with the upcoming Singaporean operator.

This was just a single game and Dexters very first match against a tier-one or global opponent, so how Dexter or the team generally performed is not too important.

Nevertheless, for those interested, Dexter had a mixed performance with kill and death counts of 1-11 on Chalet, 13-6 on Theme Park, and 12-7 on Bank, totalling 26-24.

Chalet saw SSG lose five rounds in a row on the defence as DWG beat them 7-5. Over on Theme Park, Dexter notably won a 1v1 clutch on the attack on their way to a 7-5 win. Finally, Bank decided the game in SSGs favour with a 7-4 scoreline, which included another 1v1 clutch from Dexter.

Whether Dexter becomes a permanent member of the team or not, this does show the role that SSG is looking to fill in and how the team may operate come Stage 3.

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Guest opinion: The time has come for Central Iowa Water Works – Business Record

Posted: at 8:20 pm

Submitted by: Jay Byers,president and CEO of the Greater Des MoinesPartnership, andSteve Gaer, former West Des Moines mayor and COO of R&R Realty Group

We live in a community experiencing significant momentum. Central Iowa continues to grow in both residents and amenities, and we are nationally recognized as a great place to live and work. This growth is intentional. It is the result of our collective ability to work together as one region. Whether you live in Des Moines or Waukee, Ankeny or Norwalk, or anyplace in between, we are one community. Our ability to think with a regional mindset has led to transformational success in our community.

This year marks one of the most important metro-area partnerships to date a regional drinking water entity called Central Iowa Water Works (CIWW). The collaboration for this initiative began in 2017 with all of the affected stakeholders participating in discussions. This will be one of the most important quality-of-life aspects to ensure adequate, affordable and safe drinking water for all of us, which will also provide an economic development advantage for our community.

Coming together as a region has long been part of the fabric of Central Iowa. Des Moines Water Works (DMWW) has provided drinking water to multiple communities across the metro for decades. In 1934, Urbandale entered into the first contract with DMWW, and since then many other communities have signed similar agreements.

Since that initial agreement for services almost 90 years ago, the Des Moines metro has changed significantly. In the past two decades, our community has been the fastest-growing major metro in the Midwest and is now home to more than 700,000 people. Countless businesses have expanded and relocated to the metro, including large data centers, manufacturers, insurance and financial services headquarters, warehouses and distribution centers, shopping complexes, and the list goes on.

Through it all, DMWW engineers worked with city officials in growing communities, developers, and its partner drinking water utilities and boards to appropriately lay out the water service grid and construct the water treatment and storage facilities that were needed and will be needed to provide water to new developments and our growing communities.

While this partnership has served all of us well, the time has come to create a regional drinking water production utility in order to ensure that we have the water we need at the lowest possible cost. The leaders of DMWW, West Des Moines Water Works and Urbandale Water Utility have demonstrated bold and thoughtful leadership in developing a framework and draft agreement to create CIWW. This drinking water production utility will be governed by a new board made up of representatives from each community and utility that chooses to join CIWW during this creation phase.

CIWW is designed to give every participating community a seat at the table in discussions, so we have the most cost-effective and efficient way to manage the production of drinking water. It is projected this regional model will provide the quantity of water needed while also minimizing future cost increases with collective purchasing and joint decision-making. This plan ensures protection of our water system in case of a power outage, flood at a treatment plant, during drought conditions or another natural disaster. Strategically locating treatment plants throughout the region provides a backup system that ensures our drinking water needs will be met where growth occurs.

To date, the following entities have passed a resolution supporting participation in the development of the CIWW Agreement: Altoona, Ankeny, Bondurant, Clive, DMWW, Grimes, Johnston, Norwalk, Polk City, Urbandale Water Utility, Waukee, West Des Moines Water Works and Xenia Rural Water District. Currently, these utilities and communities are reviewing the draft agreement and providing feedback and comments. The goal is to finalize the agreement this year and seat the new CIWW board in 2023.

We came together after the 1993 flood to make significant investments in the facilities that supply drinking water to all of us in this region. Now, almost 30 years later, we are again coming together to create a new framework, board and entity that will protect this critically important natural resource and ensure we meet the water demands of our rapidly growing region.

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How not to become a global health expert – Speaking of Medicine and Health – PLOS

Posted: at 8:20 pm

By guest contributor Chiamaka Precious Ojiako

There is neither a universally accepted definition of global health expertise nor credentials, checklists, or guidelines on how to become a global health expert. However, the definitions of expertise provide useful hints. Swanson defines expertise as the optimal level at which a person is able and/or expected to perform within a specialized realm of human activity. According to Herling, human expertise is a displayed behavior within a specialized domain in the form of consistently demonstrated actions of an individual that are optimally efficient in their execution and effective in their results. From these definitions, optimal performance, consistency, competence, and execution are indispensable for becoming an expert.

The absence of established credentials for becoming a global health expert is both a blessing and a curse. On the one hand, global health is a beautifully interdisciplinary field, drawing on knowledge from communities, medicine, policy, and more this flexibility accommodates unique paths, contextual factors, and the evolving nature of global health practice.

On the other hand, the lack of consensus on what makes a global health expert has created global health experts by default, based on a health professionals nationality or country of residence, resulting in an uneven skew of global health experts from high-income countries. This skewed distribution perpetuates a history of colonialism and exploitation that elevates access to resources and branding as key factors for developing expertise rather than experience and competence. Furthermore, it has excluded health professionals in the Global South and caused them to be hesitant about declaring their expertise even when they are in the proper sense.

For those of us working in the field of global public health, it is therefore pertinent to understand that you are not a global health expert because you got a graduate degree from a prestigious college or university without prior experience; travelled to a village in an LMIC for a week or a year for an internship or project; worked with a nonprofit with a global health focus or a global health organisation for more than a decade; or are fluent in English. This has been the subject of many vibrant conversations regarding expertise, so I reached out to health professionals to get their perspective on what makes a global health expert.

Lazenya Weekes-Richemond, a global health practitioner, said that the traditional definition of a global health expert is a White Westerner who studied global health at a prestigious university in the West and is working on large-scale public health projects to improve the health of people in LMICs. This definition is problematic for me, as it erases and undermines the lived experiences and deep contextual knowledge of people living in LMICs. For me, the true global health experts are those with lived experiences of health inequalities and proximity to health issues affecting their communities. They are the unpaid community health workers who go from house to house to check up on their patients; the midwives at the rural health post who work round the clock to give care to laboring women; and the district health officer who drives hours on their motorbike to provide bedside care. These heroes may not have the academic degrees behind their name, but they are passionate and continue to serve their communities long after the donor project funding dries up and the Western global health experts move on to another flashy donor project.

Jonathan Ajah, a UK based Nigerian Academic, Physician & Health Tech Innovator, equally finds the recent trend of self-acclaimed global health expertise concerning and erroneous and believes that most true global health experts neither profess nor self-acclaim. In reality, global health expertise is really a journey of education, field experience, real-life problem solving and giving back in some meaningful shape or form.

Marie-Claire Wangari, a Kenyan General Practitioner, aptly explained the double standard in becoming a global health expert by stating that There is no one size fits all when defining who a global health expert is. Every health issue a person interacts with is a global health issue and the Global South houses most of the global health problems worldwide. The sad part is that if I, a young Global South thought leader, proffers a solution or insight on a solution for my people, based on things I have seen, I will most likely need to provide academic papers and evidence to substantiate my claim and prove my credibility. Conversely, if the same solution emanated from someone in the Global North, the person might not undergo the same level of scrutiny because their systems are more trusted. This is one reason so many brilliant research papers emanate from the African continent, albeit with little visibility. I think it is time to acknowledge that experts do not fit in one particular framework and that the Global South is indeed home to some of the top Global Health experts.

Ascribing global health expertise for unsubstantiated considerations has grave consequences on health outcomes and the attainment of global health goals. Highly qualified health experts in the Global South are sometimes subjected to lower paying roles with more workload, leading to low morale. Also, prioritizing showmanship over content by sidelining health professionals with ground experience and deep knowledge of communities equally jeopardizes peoples health.

So, this brings us to the question: what constitutes global health expertise, and how can one acquire it? I would argue that a way forward is to follow who know road as my fellow Nigerians say, which means mimic the success journey of others. Hence, if you desire to become a global health expert, focus on acquiring knowledge, developing skills and competence, creating value, and being visible.

Visibility is an area several professionals from LMICs fall short. Brenice Duroseau, an infectious disease nurse practitioner and emerging sexual reproductive health scholar, opined that structural systems of oppression, intentional gatekeeping, and power dynamics contribute to the limited construct of global health expertise. Many currently recognized global health experts continue to gatekeep by not extending community members publication opportunities, even though publications are social and professional currencies. By gatekeeping publication opportunities, these experts are securing their positions, while contributing to the marginalization of those most impacted and often exploited. Additionally, paternalistic approaches to research disempowers these communities and positions those from resource rich settings, as the ones who have all the answers to complex problems even when they are unaccustomed to the context. In the pursuit to decolonize global health, we need to be intentional about including and recognizing those from the communities as experts.

The visibility gap is rectifiable by publishing thought-leadership pieces, articles, leading panels, and networking actively and strategically. People can only know what you are doing and appreciate your contributions when you are on their radar. Be humble, prove your salt by solving difficult problems, remain a constant learner, and be open to feedback and dissenting opinions. Also, be comfortable being uncomfortable because the journey to developing expertise in global health may require walking lonely paths and being the odd voice in the room.

Expertise in global health is not attained by wishful thinking or declarations on social media headers or timelines. Aspiring to become a global health expert is a goal worth having and not everyone desires it, but if you do, be prepared to go beyond speaking it into existence by taking deliberate steps to build expertise.

About the author:

Chiamaka P. Ojiako is a lawyer and health policy professional with diverse work experience in the public, nonprofit and international development sectors. She has an MPA in Health Policy and Management from New York University. Her work is at the intersection of law, research, policy analysis and advocacy, with a focus on addressing health system governance gaps and fostering health equity. She can be found on Linkedin and Twitter @FavouredAmaka

Disclaimer: Views expressed by contributors are solely those of individual contributors, and not necessarily those of PLOS.

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How not to become a global health expert - Speaking of Medicine and Health - PLOS

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