Category Archives: Ascension

WWE releasedThe Ascension's Konnor and Viktor, the company announced Sunday.

Sin Cara and Luke Harper joined them in leaving the promotion. In those cases, both performers had previously requested to be released.

Konnor and Viktor last appeared in a televised match when they competed in the Andre the Giant Memorial Battle Royal at WrestleMania 35 in April.

The Ascension still own the record for longest reign as NXT tag team champions (343 days).They beat Adrian Neville and Corey Graves in October 2013 for the belts and held the titles until suffering a defeat to The Lucha Dragons at NXT TakeOver: Fatal 4-Way in September 2014.

They made their main roster debut in November 2014, earning a win over The Miz and Damien Mizdow on Raw.

The pair have basically been stuck in tag team purgatory since then, continuing what has been a trend for duos who achieved stardom in NXT.

Whereas NXT has historically put a big emphasis on tag team wrestling, Raw and SmackDown haven't provided the division with the same luxury. As a result, former NXT tag champions have either become afterthoughts (The Revival, The Vaudevillains) or gotten broken up shortly after their arrival (American Alpha, Sanity).

The Ascension's most memorable contributions on the main roster were when they involved themselves in Breezango's "Fashion Files" backstage segments.

Getting released by WWE will allow Konnor and Viktor to start booking independent dates together or go in separate directions.

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Konnor and Viktor of the Ascension Released by WWE After 8 Years with Company - Bleacher Report

WWE cleaned house with a handful of releases earlier this week, and more could be coming in the near ... [+] future.

WWE made a handful of releases earlier this weekletting Sin Cara, Luke Harper and The Ascension go in one fell swoopbut that may just be the tip of the iceberg.

The company released a statement on WWE.com on December 8 announcing the quartet of releases, with the former two departures coming as no surprise. Luke Harper had been linked to a possible WWE exit for much of the year after the former Wyatt Family member took to social media to request his release in April only to have injury time added to his deal before ultimately being let go this week. Likewise, Sin Cara revealed on Twitter that he asked for his release last month, and at the time, it was reported that he likely wouldnt have his wish granted before WWE ultimately changed course.

WWE has come to terms on the releases of Jonathan Huber (Luke Harper), Sin Cara and Ryan Parmeter(Konnor)and Eric Thompson (Viktor) of The Ascension.WWE wishes themall the best in theirfuture endeavors.

For most of 2019 and even in previous years, WWE had typically avoided releasing superstars in large part due to internal fear that theyd end up in All Elite Wrestling, New Japan Pro-Wrestling or another one of WWEs biggest competitors. But earlier this year as more and more superstars wanted out of WWE due to the lure of AEW, those within WWE began debating whether or not to let those superstars go, with some pushing for WWE to release disgruntled stars who probably wouldnt make a huge impact in AEW (or elsewhere) while others maintained that WWE shouldnt let any superstar get awayno matter who that superstar is.

As evidenced by the releases of Sin Cara, Harper and The Ascension, that former group won out, and according to PWInsider.com, there are rumblings of additional releases coming, though those releases were expected to happen earlier this week and havent as of yet. Fightful Select adds, however, that a number of NXT stars believe that cuts are coming to the yellow brand in either January or February, a move that wouldnt be all that surprising given thatas has been the case with Raw and SmackDowna number of NXT stars have reportedly been seeking their WWE exits due to broken promises, poor pay and creative dissatisfaction. Tom Colohue of Sportskeeda, meanwhile, adds that there are some additional WWE stars who may request their release soon:

In other words, the recent slate of WWE releases has opened the floodgates for a potential mass exodus of talent.

Paul Davis of WrestlingNews.co reports that WWEs sudden willingness to release superstars may truly be boiling down to one thing: Money. Heres what Davis wrote regarding the recent slate of WWE releases:

A WWE source told me that another reason why the company is more open to releasing some wrestlers is that it helps them cut down on salaries while freeing up more money to offer deals to mid and upper card wrestlers who they dont want to leave the company.

As noted, WWEs new stance is that it will release superstars who it believes likely wouldnt become huge stars in AEW, NJPW, ROH, Impact Wrestling, etc. That, of course, is almost impossible to predict as most within WWE likely didnt think that Cody Rhodes or a name like Juice Robinson would have as much success as they have when they left WWE a few years back. Still, its probably safe to say that names like Harper, Sin Cara and The Ascensionwhove all spent most of their careers as mid or lower card performersarent going to turn the tide in the new wrestling war if they end up in AEW, which made them expendable at a time when WWE could be looking to cut costs while still prioritizing signing superstars it deems to be more valuable to the company.

It hasnt gone unnoticed, after all, that a talented tag team like The Revivalwhich has reportedly been seeking its WWE release for close to a yearhasnt been let go while WWE has also made re-signing Rusev a top priority amid reports that he could be looking to leave WWE as well. Names like The Revival and Rusev would probably make a much bigger splash outside of WWE than stars like The Ascension and Sin Cara, which is why WWE has put so much emphasis on re-signing those stars it believes are more critical to the success of the company. Among the names who have recently inked new long-term deals with WWE are Braun Strowman, Roman Reigns, and The Miz, who are all obviously featured much more heavily than Harper, The Ascension and Sin Cara were.

So, its apparent that WWE is still willing to shell out the big bucks to maintain talent, even at a time when its disappointing earnings have caused concern within the company. Its no secret that WWE has experienced sharp declines in many key metrics over the past year, including total revenue, live event attendance, merchandise sales and the WWE Network subscriber count, a reality that has caused some concern about WWEs financial future despite its huge TV rights deals that would seemingly keep the company financially secure for the foreseeable future. But the lack of WWE Networks growth, the companys signings of a number of top indie stars and its disappointing TV ratings have undoubtedly given WWE pause about whether or not to continue signing talents just to sign them.

As recently as a few months ago, WWE was in a position where it could sign any and all stars to lucrative long-term deals without fear about how that might affect its future. However, that was a short-sided strategy that didnt take into account what might happen if WWEs financial future seemed less secure or if it acquired more talent than it knew what to do with. Morale within WWE has plummeted this year due at least in part the sheer overload of superstars the company has, and with Vince McMahon potentially looking to cut costs, the most obviousand perhaps the easiestway to do that is to cut bait with disgruntled and/or seldom used stars who wont make the jump to AEW and immediately help pro wrestlings new No. 2 promotion.

With a boatload of WWE stars currently struggling to find a spot on TV and WWE looking to trim the fat where it can, it certainly looks like the releases of Sin Cara, Harper and The Ascension were just the beginning of what could be a long process of WWE cleaning house.

Excerpt from:

Even More WWE Releases Are Likely On The Way - Forbes

(Photo: Scooter Waller, 247Sports)

On Sunday, Virginia Tech appointed former Safeties Coach Justin Hamilton to the role of Defensive Coordinator. His ascension through the program is quite remarkable, as he reaches the highest defensive position title after two years at the university.

Playing Career

Hamilton, a former Virginia Tech player, played at the University until 2005. He played wide receiver, tailback and safety, recording three touchdown rushes, a touchdown catch and three interceptions in his career as a multi-position player.

He was selected in the 2006 NFL Draft by the Cleveland Browns in the seventh round. He played as a rookie but missed the next season due to injury and was waived. He jumped to the Washington Redskins, but only lasted until October 14 of the 2008 season. His NFL career would be over after two seasons.

Coaching Career

Following his playing career, Hamilton moved to University of Virginia - Wise. He served as the defensive coordinator. He then moved to VMI where he coached outside linebackers from 2014-2017.

He re-joined his Alma Mater nearly 12-years following his playing days. He joined as the Director of Plyaer Personnel in 2018. The next season he was appointed Safeties Coach, replacing Tyrone Nix.

Now in 2019, two years after joining the staff, Justin Hamilton has become the next Defensive Coordinator after Bud Foster.

Justin Fuente weighed in on the decision:

"Justin has earned this opportunity to lead our defense and our football team," Fuente said. "Everyone in our program has a great deal of respect for him and his abilities. Coach Foster has reiterated to me on several occasions that Justin is ready for this next step in his coaching career. I feel the same way and am convinced he's exactly the right fit for this role at Virginia Tech. Coach Hamilton is a talented coach and recruiter with a deep passion for both the game and Virginia Tech. He possesses a great knack for connecting with our players. His voice carries tremendous weight on the field and in the locker room because he's worn that helmet and experienced many of the same things the young men in our program are going through."

Bud Foster also chimed in on the decision:

"I couldn't think of anyone better to continue our tradition of Virginia Tech defense than Justin Hamilton," Foster said. "Justin embodied our team-first mentality as a player and did anything and everything we ever asked of him. He was a gritty player and he's exactly the same way as a coach. He's fought and competed for every opportunity he's earned in the coaching profession and I respect the way he's approached it from day one. When we brought Justin back to Virginia Tech, in the back of my head I was hoping that I could help groom him to someday become a defensive coordinator. While I didn't know when or where that opportunity might come, I'm thrilled that it's happened for him at Virginia Tech. "When Coach Fuente asked whether Coach Hamilton was ready, my answer was, 'Absolutely, he's ready. He's a guy who will evolve, learn and get better from every experience,'" Foster continued. "I know Coach Fuente didn't have to ask my opinion, but when he did it just confirmed what we were both already thinking, that we had the right man already in the building to carry the torch for the Lunch Pail Defense. I couldn't be more proud of Justin and I'll continue supporting him and the Hokies in any way I can in my new role away from the field."

Link:

The Ascension of Justin Hamilton to Defensive Coordinator - 247Sports

Look up the next few evenings! Venus and Saturn will appear near each other in the night sky this week.

The cream-colored inner planet and its ringed solar-system sibling will be at conjunction, or their closest apparent proximity to one another in the sky, tonight (Dec. 10) at 11:41 p.m. EST (0441 GMT on Dec. 11). The planets will appear low in the sky if you are looking southwest, no higher than 16 degrees above the horizon, according to In-the-Sky.org.

To spot Venus and Saturn , search for the constellation Sagittarius. You can also try finding it by first locating the stellar beacons Altair and Vega, which will shine overhead, according to a new video from NASA's Jet Propulsion Laboratory. The huddled pair of planets will be visible together through Dec. 13, according to the space agency.

Related: December Full Moon 2019: The 'Cold' Moon Joins Venus and Saturn

Now, if you're trying to see Venus and Saturn, keep in mind that, while both planets will appear near to each other to the naked eye, they won't be close enough to both be seen in the viewfinder of a telescope, so for telescope users, some adjustment will be necessary!

During this event, Venus will be the brightest of the two with its magnitude of -4.0. Saturn will shine at a magnitude of 0.5.

The conjunction of Venus and Saturn doesn't mean they are physically near each other there are three planets and a whole asteroid belt that separate the two worlds they will just look like close neighbors, as they'll be sharing the same right ascension.

Just like with a map on Earth, the celestial sphere can also be broken up into a grid. Our planet is marked with a grid of longitude (east-west lines) and latitude (lines running north-south). Similarly, finding locations of interest in the sky is made easier through the imposition of a grid, which uses right ascension (left-right lines) and declination (top-down lines).

Right ascension is measured in units of time. So, when Venus and Saturn share the same right ascension, its value will be 19h 21m 10s. Declination is measured in degrees, arc-minutes (') and arc-seconds ("), starting at 0 at the celestial equator (the projection of the equator onto the night sky). The celestial North Pole would be +90 and the celestial South Pole would be -90. Venus' declination tonight will be just 148' south of Saturn; the terrestrial planet will have a declination value of -2351' during conjunction, and Saturn's declination will be -2202'.

The Space.com staff has put together several telescope guides for the holiday season. Visit lists like "Best Telescopes for The Money" for recommendations on the perfect skygazing gift.

Follow Doris Elin Urrutia on Twitter @salazar_elin. Follow us on Twitter @Spacedotcom and on Facebook.

View original post here:

See Venus Near Saturn in the Night Sky This Week and Make Your (Skywatching) Season Bright! - Space.com

Editors note: Our Posts from the Community feature is a platform for community announcements and event postings. If you have a post to be considered, send it to info@milwaukeenns.org or submit it directly.

The award provides $250,000 in funding and additional resources to support community-driven strategies in the Sherman Park neighborhood. The overall objectives of the project are to increase resident well-being and prevent violence by advancing strategies in Milwaukees Blueprint for Peace.

In addition, Ascension Wisconsin has committed to provide $336,000 in matching support toensure the projects success.

The project will be called BUILD Sherman Park.

BUILD is a national program designed to support the kind of partnerships United Way invests in every day: collaborations between community-based organizations, health departments, and hospitals that address important health issues in our community, said Nicole Angresano, vice president of community impact at United Way.

Milwaukees Sherman Park neighborhood, long associated with the systemic inequities its residents experience, is poised for rebirth. BUILD Sherman Park will engage community members around The Milwaukee Blueprint for Peace, a community-driven agenda for addressing the complex factors that drive violence in our city.

With trauma finally being acknowledged as a public health issue and epidemic in this community, we must invest in our human resources (people) to address the complete health of residents, said Mabel Lamb, executive director of The Sherman Park Community Association, Inc. The BUILD Health Challenge will focus on the social, environmental, and economic factors that have the greatest influence on the health of our community.

Were excited about this opportunity to actively partner with United Way, The City of Milwaukee Health Department Office of Violence Prevention and The Sherman Park Community Association, Inc. to address some of the toughest issues that lead to health inequity, said Bernie Sherry, senior vice president, Ascension, and ministry market executive, Ascension Wisconsin. Together, we are creating an innovative model of care to achieve our shared vision of a healthy, safe and prosperous Sherman Park community.

Strategies for engagement will focus on fostering safe, strong neighborhoods, as well as strengthening capacity, coordination, and collaboration for health and safety.

The Milwaukee Health Department is elated to partner on this national funding opportunity which will help build capacity by supporting community partners, including our Office of Violence Prevention, serving Sherman Park, said Dr. Jeanette Kowalik, commissioner of health for the City of Milwaukee. The Sherman Park community has been hit hard by a number of disparities related to the Social Determinants of Health (e.g. healthy and safe housing, unemployment, healthy food options). However, we remain committed to addressing these issues and supporting the work in this area.

We are honored to be a part of this cross-sector partnership to strengthen resident-led strategies to advance safety and wellbeing in Sherman Park, said Reggie Moore, injury and violence prevention director for the City of Milwaukee Health Department, Office of ViolencePrevention. Advancing the Blueprint for Peace requires partnerships and engagement from every segment of our community. The BUILD Health Challenge is a bold example of that.

Those interested in getting involved are invited to save the date for the BUILD Sherman Park Kickoff event, to be held on Tuesday, December 17, 2019, at 5:30 p.m. at the Sherman Phoenix.

For ongoing updates on this project, please share your contact information at UnitedWayGMWC.org/BUILD-Sherman-Park

ABOUT UNITED WAY OF GREATER MILWAUKEE & WAUKESHA COUNTYUnited Way of Greater Milwaukee & Waukesha County fights for the health, education, and financial stability for every person in our local community.

ABOUT THE BUILD HEALTH CHALLENGEThe BUILD Health Challenge is a unique national program focusing on bold, upstream, integrated, local, and data-driven projects that can improve community health. The BUILD Health Challenge award provides funding, capacity building support, and access to a nationalpeer learning network to enhance collaborative partnerships here locally to address our communitys most pressing health challenges. Special thanks to the BUILD Health Challenge for its support of this initiative.

The BUILD Health Challenge is made possible with the support of: BlueCross BlueShield of South Carolina Foundation, the Blue Cross and Blue Shield of North Carolina Foundation, Blue Shield of California Foundation, Communities Foundation of Texas, de Beaumont Foundation, Episcopal Health Foundation, The Kresge Foundation, Methodist Healthcare Ministries of South Texas, Inc., New Jersey Health Initiatives, Robert Wood Johnson Foundation, and W.K. Kellogg Foundation.

ABOUT ASCENSION WISCONSINIn Wisconsin, Ascension operates 24 hospital campuses, more than 100 related healthcare facilities and employs more than 1,300 primary and specialty care clinicians from Racine to Eagle River. Serving Wisconsin since 1848, Ascension is a faith-based healthcare organizationcommitted to delivering compassionate, personalized care to all, with special attention to persons living in poverty and those most vulnerable. Ascension is one of the leading non-profit and Catholic health systems in the U.S., operating 2,600 sites of care including 150 hospitals and more than 50 senior living facilities in 20 states and the District of Columbia.

ABOUT SHERMAN PARK COMMUNITY ASSOCIATIONThe mission of Sherman Park Community Association is to make Sherman Park an attractive, interesting neighborhood where people of all races, religions, and national origins come together to celebrate and respect our differences, as well as our shared values.

ABOUT THE CITY OF MILWAUKEE HEALTH DEPARMENT, OFFICE OF VIOLENCE PREVENTIONThe Office of Violence Prevention provides strategic direction and oversight for City efforts to reduce risk of violence through linked strategies in partnership with government, non-profit, neighborhood, and faith organizations.

http://www.unitedwayGMWC.org/BUILD-Sherman-ParkTweets by UnitedWayGMWChttps://www.facebook.com/UnitedWayGMWC

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Original post:

Post from Community: United Way, Ascension St. Joseph, Office of Violence Prevention & The Sherman Park Community Association receive BUILD health...

The nations second-largest health system, Ascension, has agreed to allow the software behemoth Google access to tens of millions of patient records. The partnership, called Project Nightingale, aims to improve how information is used for patient care. Specifically, Ascension and Google are trying to build tools, including artificial intelligence and machine learning, to make health records more useful, more accessible and more searchable for doctors.

Ascension did not announce the partnership: The Wall Street Journal first reported it.

Patients and doctors have raised privacy concerns about the plan. Lack of notice to doctors and consent from patients are the primary concerns.

As a public health lawyer, I study the legal and ethical basis for using data to promote public health. Information can be used to identify health threats, understand how diseases spread and decide how to spend resources. But its more complicated than that.

The law deals with what can be done with data; this piece focuses on ethics, which asks what should be done.

Beyond Hippocrates

Big-data projects like this one should always be ethically scrutinized. However, data ethics debates are often narrowly focused on consent issues.

In fact, ethical determinations require balancing different, and sometimes competing, ethical principles. Sometimes it might be ethical to collect and use highly sensitive information without getting an individuals consent.

Public health ethics are useful to evaluate activities that affect population health. A recent report by the World Health Organization (WHO) describes public health ethics with four principles:

Public health ethics is an appropriate framework for evaluating Project Nightingale, given its massive scale. But the current health care context is relevant.

The System and Its Struggles

For over a decade, scholars have argued that technological solutions are needed to address three major challenges to how the health system uses information.

First, the health system struggles to integrate new knowledge into patient care. New medical evidence takes 17 years to change clinical practice, on average. The breakneck pace of science challenges doctors to keep up. And, applying modern medical knowledge requires doctors to consider more factors than is humanly possible.

Second, information is central to preventing many medical errors, the third leading cause of death in America. Communication problems, judgment errors and incorrect diagnosis or treatment decisions can have devastating consequences for patients.

Third, the system does not learn from care. For example, a doctor and patient might try several different medications before finding the right one. One medication might not help, another might cause awful side effects, and finding the best medication might take months or years. The health system does not learn from that care process. Individual providers will gain knowledge over a lifetime, but that knowledge is never aggregated or shared efficiently.

To help address these challenges, the Institute of Medicine in 2007 introduced a vision for a learning health system that would quickly learn from patient care and use that knowledge to improve future care.

The concept is simple, but learning health systems require sophisticated information technology platforms capable of extracting knowledge from the existing evidence and millions of treatment records.

The Benefits of Project Nightingale

Project Nightingale appears to align with the learning health system concept. Systematically improving health care is a clear common good.

Although a learning health system requires sharing patient data, patients stand to benefit from improved health care. Reciprocal data sharing by patients for a collective benefit is a prototypical example of the common good principle in public health ethics.

Project Nightingale might also improve health equity. For example, minorities and pregnant women are underrepresented in research studies, raising concerns that some medical knowledge might not be well tailored to these patients. A learning health system would improve understanding of what treatments are effective and safe for these underrepresented populations.

For small-scale activities, respect for persons usually demands giving people an opportunity to make a free and informed decision to participate. However, for activities carried out at the scale of the whole population, it is possible to show respect for persons by engaging the public and inviting them into the decision-making process. It is not clear whether Ascension or Google involved the public or patients in Project Nightingale.

The Downsides

Some patients have criticized Project Nightingale because it does not have an opt-out for patients who do not want their information shared.

However, opt-out systems raise ethical concerns, too. They permit free riders who will benefit from the knowledge gained from the participants. Second, knowledge from a learning health system could be biased if enough people opt out. If so, opting out could expose others to riskier health care.

Good governance is critical to support a common good activity that conflicts with some individual interests. Transparency and accountability are crucial to keep the parties honest and open to public scrutiny. They also empower people to demand government action against an activity that cannot be ethically justified. There is little, if any, reported evidence that Project Nightingale has sufficient transparency or accountability processes. This is likely to be the biggest ethical challenge to Project Nightingale.

Issues of Consent

Some of the biggest concerns have been about consent. However, public health ethics do not always require consent. One recent WHO ethical guideline says:

Individuals have an obligation to contribute when reliable, valid, complete data sets are required and relevant protection is in place. Under these circumstances, informed consent is not ethically required.

The basic argument is that individuals have a moral obligation to contribute when there is low individual risk and high population benefit.

Currently, the public does not know enough about Project Nightingale to make definitive ethical judgments. However, public health ethics likely provides some support for what Google and Ascension are trying to do. The more critical ethical issue might turn on how Google and Ascension are doing it.

Cason Schmit is assistant professor of law at Texas A&M University.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

See the rest here:

The Tricky Ethics of Google's Project Nightingale Effort to Learn from Millions of Health Records - Nextgov

(The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.)

Cason Schmit, Texas A&M University

(THE CONVERSATION) The nations second-largest health system, Ascension, has agreed to allow the software behemoth Google access to tens of millions of patient records. The partnership, called Project Nightingale, aims to improve how information is used for patient care. Specifically, Ascension and Google are trying to build tools, including artificial intelligence and machine learning, to make health records more useful, more accessible and more searchable for doctors.

Ascension did not announce the partnership: The Wall Street Journal first reported it.

Patients and doctors have raised privacy concerns about the plan. Lack of notice to doctors and consent from patients are the primary concerns.

As a public health lawyer, I study the legal and ethical basis for using data to promote public health. Information can be used to identify health threats, understand how diseases spread and decide how to spend resources. But its more complicated than that.

The law deals with what can be done with data; this piece focuses on ethics, which asks what should be done.

Beyond Hippocrates

Big-data projects like this one should always be ethically scrutinized. However, data ethics debates are often narrowly focused on consent issues.

In fact, ethical determinations require balancing different, and sometimes competing, ethical principles. Sometimes it might be ethical to collect and use highly sensitive information without getting an individuals consent.

Public health ethics are useful to evaluate activities that affect population health. A recent report by the World Health Organization (WHO) describes public health ethics with four principles:

- Common Good Does the activity promote collective benefit?

- Equity Does the activity reduce the burdens or risks to health or opportunity?

- Respect for Persons Does the activity support individual rights and interests?

- Good Governance Does the activity have processes for public transparency and accountability?

Public health ethics is an appropriate framework for evaluating Project Nightingale, given its massive scale. But the current health care context is relevant.

The system and its struggles

For over a decade, scholars have argued that technological solutions are needed to address three major challenges to how the health system uses information.

First, the health system struggles to integrate new knowledge into patient care. New medical evidence takes 17 years to change clinical practice, on average. The breakneck pace of science challenges doctors to keep up. And, applying modern medical knowledge requires doctors to consider more factors than is humanly possible.

Second, information is central to preventing many medical errors, the third leading cause of death in America. Communication problems, judgment errors and incorrect diagnosis or treatment decisions can have devastating consequences for patients.

Third, the system does not learn from care. For example, a doctor and patient might try several different medications before finding the right one. One medication might not help, another might cause awful side effects, and finding the best medication might take months or years. The health system does not learn from that care process. Individual providers will gain knowledge over a lifetime, but that knowledge is never aggregated or shared efficiently.

To help address these challenges, the Institute of Medicine in 2007 introduced a vision for a learning health system that would quickly learn from patient care and use that knowledge to improve future care.

The concept is simple, but learning health systems require sophisticated information technology platforms capable of extracting knowledge from the existing evidence and millions of treatment records.

The benefits of Project Nightingale

Project Nightingale appears to align with the learning health system concept. Systematically improving health care is a clear common good.

Although a learning health system requires sharing patient data, patients stand to benefit from improved health care. Reciprocal data sharing by patients for a collective benefit is a prototypical example of the common good principle in public health ethics.

Project Nightingale might also improve health equity. For example, minorities and pregnant women are underrepresented in research studies, raising concerns that some medical knowledge might not be well tailored to these patients. A learning health system would improve understanding of what treatments are effective and safe for these underrepresented populations.

For small-scale activities, respect for persons usually demands giving people an opportunity to make a free and informed decision to participate. However, for activities carried out at the scale of the whole population, it is possible to show respect for persons by engaging the public and inviting them into the decision-making process. It is not clear whether Ascension or Google involved the public or patients in Project Nightingale.

The downsides

Some patients have criticized Project Nightingale because it does not have an opt-out for patients who do not want their information shared.

However, opt-out systems raise ethical concerns, too. They permit free riders who will benefit from the knowledge gained from the participants. Second, knowledge from a learning health system could be biased if enough people opt out. If so, opting out could expose others to riskier health care.

Good governance is critical to support a common good activity that conflicts with some individual interests. Transparency and accountability are crucial to keep the parties honest and open to public scrutiny. They also empower people to demand government action against an activity that cannot be ethically justified. There is little, if any, reported evidence that Project Nightingale has sufficient transparency or accountability processes. This is likely to be the biggest ethical challenge to Project Nightingale.

Issues of consent

Some of the biggest concerns have been about consent. However, public health ethics do not always require consent. One recent WHO ethical guideline says:

Individuals have an obligation to contribute when reliable, valid, complete data sets are required and relevant protection is in place. Under these circumstances, informed consent is not ethically required.

The basic argument is that individuals have a moral obligation to contribute when there is low individual risk and high population benefit.

Currently, the public does not know enough about Project Nightingale to make definitive ethical judgments. However, public health ethics likely provides some support for what Google and Ascension are trying to do. The more critical ethical issue might turn on how Google and Ascension are doing it.

[ Expertise in your inbox. Sign up for The Conversations newsletter and get a digest of academic takes on todays news, every day. ]

This article is republished from The Conversation under a Creative Commons license. Read the original article here: http://theconversation.com/the-tricky-ethics-of-googles-project-nightingale-an-effort-to-learn-from-millions-of-health-records-127219.

See more here:

The tricky ethics of Google's Project Nightingale, an effort to learn from millions of health records - Jacksonville Journal-Courier

DONALDSONVILLE The Ascension Parish School Board and the parish government are looking at jointly tackling carpool traffic problems at some of the older schools in the parish, with a new venture at one of those schools, Galvez Primary.

Under a proposed agreement, the School Board would provide the design and construction materials and the parish will provide the labor to extend the carpool line which is now simply one lane of two-lane Bayou Henderson Road in front of the school with a gravel drive onto unused property on the school site, to get more carpool traffic off the road.

"This is the first of what could be more, future agreements," Chad Lynch, the district's director of planning and construction, told the board's facilities management committee at its meeting Tuesday.

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The committee voted to recommend that the full board approve the Galvez Primary agreement at its next meeting.

Older schools don't have the turn lanes that the fast-growing school district incorporates at the entrances to the schools it has built since 2000, Lynch said.

Parish council members this past summer asked Lynch and his staff to meet with the council's transportation committee to start working out a solution for the carpool traffic problems.

PRAIRIEVILLE Daniel Johnson and his neighbors in Parker Place Estates face an either-or choice on school mornings, they say.

In addition to Galvez Primary, other schools facing those traffic woes include Prairieville Primary, Oak Grove and Central Primary.

The School Board will vote on the Galvez Primary proposal at its first meeting in the new year, on Jan. 7.

The board will also be voting at that meeting on the renewal of another intergovernmental agreement between the school district and the parish, an existing one set to expire on Dec. 31, that allows the parish to use four schools as shelters in time of emergency.

The four-year agreement allows the parish to use Dutchtown High and Dutchtown Middle, on the east bank, and Donaldsonville High and Lowery Middle, on the west bank, as emergency shelters.

See the rest here:

Joint effort by Ascension Parish, school district aimed at easing carpool traffic woes - The Advocate

The nations second-largest health system, Ascension, has agreed to allow the software behemoth Google access to tens of millions of patient records. The partnership, called Project Nightingale, aims to improve how information is used for patient care. Specifically, Ascension and Google are trying to build tools, including artificial intelligence and machine learning, to make health records more useful, more accessible and more searchable for doctors.

Ascension did not announce the partnership: The Wall Street Journal first reported it.

Patients and doctors have raised privacy concerns about the plan. Lack of notice to doctors and consent from patients are the primary concerns.

As a public health lawyer, I study the legal and ethical basis for using data to promote public health. Information can be used to identify health threats, understand how diseases spread and decide how to spend resources. But its more complicated than that.

The law deals with what can be done with data; this piece focuses on ethics, which asks what should be done.

Beyond Hippocrates

Big-data projects like this one should always be ethically scrutinized. However, data ethics debates are often narrowly focused on consent issues.

In fact, ethical determinations require balancing different, and sometimes competing, ethical principles. Sometimes it might be ethical to collect and use highly sensitive information without getting an individuals consent.

Public health ethics are useful to evaluate activities that affect population health. A recent report by the World Health Organization (WHO) describes public health ethics with four principles:

Public health ethics is an appropriate framework for evaluating Project Nightingale, given its massive scale. But the current health care context is relevant.

The system and its struggles

For over a decade, scholars have argued that technological solutions are needed to address three major challenges to how the health system uses information.

First, the health system struggles to integrate new knowledge into patient care. New medical evidence takes 17 years to change clinical practice, on average. The breakneck pace of science challenges doctors to keep up. And, applying modern medical knowledge requires doctors to consider more factors than is humanly possible.

Second, information is central to preventing many medical errors, the third leading cause of death in America. Communication problems, judgment errors and incorrect diagnosis or treatment decisions can have devastating consequences for patients.

Third, the system does not learn from care. For example, a doctor and patient might try several different medications before finding the right one. One medication might not help, another might cause awful side effects, and finding the best medication might take months or years. The health system does not learn from that care process. Individual providers will gain knowledge over a lifetime, but that knowledge is never aggregated or shared efficiently.

To help address these challenges, the Institute of Medicine in 2007 introduced a vision for a learning health system that would quickly learn from patient care and use that knowledge to improve future care.

The concept is simple, but learning health systems require sophisticated information technology platforms capable of extracting knowledge from the existing evidence and millions of treatment records.

The benefits of Project Nightingale

Project Nightingale appears to align with the learning health system concept. Systematically improving health care is a clear common good.

Although a learning health system requires sharing patient data, patients stand to benefit from improved health care. Reciprocal data sharing by patients for a collective benefit is a prototypical example of the common good principle in public health ethics.

Project Nightingale might also improve health equity. For example, minorities and pregnant women are underrepresented in research studies, raising concerns that some medical knowledge might not be well tailored to these patients. A learning health system would improve understanding of what treatments are effective and safe for these underrepresented populations.

For small-scale activities, respect for persons usually demands giving people an opportunity to make a free and informed decision to participate. However, for activities carried out at the scale of the whole population, it is possible to show respect for persons by engaging the public and inviting them into the decision-making process. It is not clear whether Ascension or Google involved the public or patients in Project Nightingale.

The downsides

Some patients have criticized Project Nightingale because it does not have an opt-out for patients who do not want their information shared.

However, opt-out systems raise ethical concerns, too. They permit free riders who will benefit from the knowledge gained from the participants. Second, knowledge from a learning health system could be biased if enough people opt out. If so, opting out could expose others to riskier health care.

Good governance is critical to support a common good activity that conflicts with some individual interests. Transparency and accountability are crucial to keep the parties honest and open to public scrutiny. They also empower people to demand government action against an activity that cannot be ethically justified. There is little, if any, reported evidence that Project Nightingale has sufficient transparency or accountability processes. This is likely to be the biggest ethical challenge to Project Nightingale.

Issues of consent

Some of the biggest concerns have been about consent. However, public health ethics do not always require consent. One recent WHO ethical guideline says:

Individuals have an obligation to contribute when reliable, valid, complete data sets are required and relevant protection is in place. Under these circumstances, informed consent is not ethically required.

The basic argument is that individuals have a moral obligation to contribute when there is low individual risk and high population benefit.

Currently, the public does not know enough about Project Nightingale to make definitive ethical judgments. However, public health ethics likely provides some support for what Google and Ascension are trying to do. The more critical ethical issue might turn on how Google and Ascension are doing it.

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The tricky ethics of Google's Project Nightingale - EconoTimes

More than 1,500 community members gave input for the Milwaukee Blueprint for Peace, the city's violence prevention plan.(Photo: Provided photo)

Nearly $600,000 for the BUILD Health Challengewill come to the Sherman Park neighborhood, Ald. Khalif Rainey announced.

Part of the money for the project, called BUILD Sherman Park, will be used to implement recommendations from Milwaukee's Blueprint for Peace, a community-based violence prevention initiative created in 2017.

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The funds will come, in part, from an award of $250,000 won by the City of Milwaukee Health Department's Office of Violence Prevention, Ascension SE Wisconsin Hospital at the St. Joseph campus, United Way of Greater Milwaukee & Waukesha County and the Sherman Park Community Association. Ascension Wisconsin has pledged to provide $336,000 in matching support of the grant, bringing the total funds to $586,000.

Ascension Wisconsin officials said the health system's participation is proof of how it is committed to Milwaukee's underrepresented communities.

The BUILD Health Challenge, is a national program meant to improve community health through community and health system partnerships, according to the website. The award requires hospitals to at least match the BUILD grant and will include other tools, such as coaching, support services and specialized training. The money for BUILD Sherman Park will be distributed over the next two years.

Rainey described the investment in Sherman Park as "transformative" for its residents.

Milwaukee joins over a dozenother cities who won the national challenge for the 2019 year, including Oakland, California; Houston, Texas and Washington, D.C.

There will be a kick-off event for the BUILD Sherman Park project Tuesday, Dec. 17 at 5:30 p.m. at the Sherman Phoenix, 3536 W. Fond Du Lac Ave.

Contact Talis Shelbourne at (414) 223-5261 or tshelbourn@jrn.com. Follow her on Twitter at @talisseerand Facebook at @talisseer.

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Nearly $600,000 to come to Sherman Park neighborhood for the BUILD Health Challenge and Ascension Wisconsin - Milwaukee Journal Sentinel