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Exam Code: PCCN Practice test 2022 by team
PCCN AACN Progressive Critical Care Nursing

The PCCN and PCCN-K certification exams focus 80 percent on clinical judgment and 20 percent on professional caring and ethical practice. Our comprehensive course prepares you in the following categories:

Clinical Judgment

- Cardiovascular
- Pulmonary
- Endocrine
- Hematology
- Gastrointestinal
- Renal
- Neurology
- Behavioral/Psychosocial
- Musculoskeletal
- Professional Caring and Ethical Practice
- Advocacy/Moral Agency
- Caring Practices
- Response to Diversity
- Facilitation of Learning
- Collaboration
- Systems Thinking
- Clinical Inquiry
- Learning Outcomes

At the completion of this learning activity, participants should be able to:

Validate their knowledge of progressive care nursing Briefly review the pathophysiology of single and multisystem dysfunction in adult patients and the medical and pharmacologic management of each Identify the progressive care nursing management needs for adult patients with single or multisystem organ abnormalities Successful Completion

Learners must complete 100 percent of the activity and the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.
12.8 contact hours awarded, CERP Category A
Exam Eligibility

Are you eligible to take the PCCN or PCCN-K exam? Eligibility requirements and links to handbooks with test plans are available on our “Get Certified” pages — click here to get started: PCCN (Adult) or PCCN-K (Adult) .

PCCN and PCCN-K certifications emphasize the knowledge that the progressive nursing specialty requires and the essential acute care nursing practices that you can apply in your role every day in a step-down unit, emergency or telemetry department or another progressive care environment.

PCCN and PCCN-K specialty certifications also demonstrate your knowledge and dedication to hospital administrators, peers and patients, while giving you the satisfaction of your achievement. PCCN and PCCN-K credentials are granted by AACN Certification Corporation.

Validate and enhance your knowledge and Excellerate patient outcomes. Take advantage of this detailed review course and earn your PCCN or PCCN-K certification.

The American Association of Critical-Care Nurses (AACN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Centers (ANCC's) Commission on Accreditation, ANCC Provider Number 0012. AACN has been approved as a provider of continuing education in nursing by the California Board of Registered Nursing (CBRN), Provider number CEP 1036. This activity is approved for 12.8 contact hours.

AACN programming meets the standards of most states that require mandatory CE contact hours for license and/or certification renewal. AACN recommends consulting with your state board of nursing or credentialing organization before submitting CE to fulfill continuing education requirements.

AACN and AACN Certification Corporation consider the American Nurses Association (ANA) Code of Ethics for Nurses foundational for nursing practice, providing a framework for making ethical decisions and fulfilling responsibilities to the public, colleagues and the profession. AACN Certification Corporations mission of public protection supports a standard of excellence where certified nurses have a responsibility to read about, understand and act in a manner congruent with the ANA Code of Ethics for Nurses.

A. Cardiovascular (27%)
1. Acute coronary syndromes
a. non-ST segment elevation myocardial infarction
b. ST segment elevation myocardial infarction
c. unstable angina
2. Acute inflammatory disease (e.g., myocarditis, endocarditis, pericarditis)
3. Aneurysm
a. dissecting
b. repair
4. Cardiac surgery (e.g., post ICU care)
5. Cardiac tamponade
6. Cardiac/vascular catheterization
a. diagnostic
b. interventional
7. Cardiogenic shock
8. Cardiomyopathies
a. dilated (e.g., ischemic/non-ischemic)
b. hypertrophic
c. restrictive
9. Dysrhythmias
10. Heart failure
a. acute exacerbations (e.g., pulmonary edema)
b. chronic
11. Hypertension (uncontrolled)
12. Hypertensive crisis
13. Minimally-invasive cardiac surgery (i.e. nonsternal approach)
14. Valvular heart disease
15. Vascular disease
B. Pulmonary (17%)
1. Acute respiratory distress syndrome (ARDS)
2. Asthma (severe)
3. COPD exacerbation
4. Minimally-invasive thoracic surgery (e.g., VATS)
5. Obstructive sleep apnea
6. Pleural space complications (e.g., pneumothorax, hemothorax, pleural effusion, empyema, chylothorax)
7. Pulmonary embolism
8. Pulmonary hypertension
9. Respiratory depression (e.g., medicationinduced, decreased-LOC-induced)
10. Respiratory failure
a. acute
b. chronic
c. failure to wean
11. Respiratory infections (e.g., pneumonia)
12. Thoracic surgery (e.g., lobectomy, pneumonectomy)
C. Endocrine/Hematology/Neurology/Gastrointestinal/Renal (20%)
1. Endocrine
a. diabetes mellitus
b. diabetic ketoacidosis
c. hyperglycemia
d. hypoglycemia
2. Hematology/Immunology/Oncology
a. anemia
b. coagulopathies: medication-induced (e.g., Coumadin, platelet inhibitors, heparin [HIT])
3. Neurology
a. encephalopathy (e.g., hypoxic-ischemic, metabolic, infectious, hepatic)
b. seizure disorders
c. stroke
4. Gastrointestinal
a. functional GI disorders (e.g., obstruction, ileus, diabetic gastroparesis, gastroesophageal reflux, irritable bowel syndrome)
b. GI bleed
i. lower
ii. upper
c. GI infections (e.g., C. difficile)
d. GI surgeries (e.g., resections, esophagogastrectomy, bariatric)
e. hepatic disorders (e.g., cirrhosis, hepatitis, portal hypertension)
f. ischemic bowel
g. malnutrition (e.g., failure to thrive, malabsorption disorders)
h. pancreatitis
5. Renal
a. acute kidney injury (AKI)
b. chronic kidney disease (CKD)
c. electrolyte imbalances
d. end-stage renal disease (ESRD)
D. Musculoskeletal/Multisystem/Psychosocial (16%)
1. Musculoskeletal
a. functional issues (e.g., immobility, falls, gait disorders)
2. Multisystem
a. end of life
b. healthcare-acquired infections
i. catheter-associated urinary tract infections (CAUTI)
ii. central-line-associated bloodstream infections (CLABSI)
iii. surgical site infection (SSI)
c. infectious diseases
i. influenza
ii. multidrug-resistant organisms (e.g., MRSA, VRE, CRE, ESBL)
d. pain
i. acute
ii. chronic
e. palliative care
f. pressure injuries (ulcers)
g. rhabdomyolysis
h. sepsis
i. shock states
i. anaphylactic
ii. hypovolemic
j. toxic ingestion/inhalation/drug overdose
k. wounds (e.g., infectious, surgical, trauma)
3. Behavioral/Psychosocial
a. altered mental status
b. delirium
c. dementia
d. disruptive behaviors, aggression, violence
e. psychological disorders
i. anxiety
ii. depression
f. substance abuse
i. alcohol withdrawal
ii. chronic alcohol abuse
iii. chronic drug abuse
iv. drug-seeking behavior
v. drug withdrawal
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry Cardiovascular
• Identify, interpret and monitor
o dysrhythmias
o QTc intervals
o ST segments
• Manage patients requiring
o ablation
o arterial closure devices
o arterial/venous sheaths
o cardiac catheterization
o cardioversion
o defibrillation
o pacemakers
o percutaneous coronary intervention (PCI)
o transesophageal echocardiogram (TEE)
• Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability
• Select leads for cardiac monitoring for the indicated disease process
• Titrate vasoactive medications
o Dobutamine
o Dopamine
o Nitroglycerin Pulmonary
• Interpret ABGs
• Maintain airway
• Monitor patients pre and post
o bronchoscopy
o chest tube insertion
o thoracentesis
• Manage patients requiring mechanical ventilation
• Manage patients requiring non-invasive O2 or ventilation delivery systems
o face masks
o high-flow therapy
o nasal cannula
o non-breather mask
o venti-masks
• Manage patients requiring respiratory monitoring devices:
o continuous SpO2
o end-tidal CO2 (capnography)
Manage patients requiring tracheostomy tubes
• Manage patients with chest tubes (including pleural drains)
• Recognize respiratory complications and initiate interventions
• Endocrine
o manage and titrate insulin infusions
• Hematology/Immunology/Oncology
o administer blood products and monitor patient response
• Neurology
o perform bedside screening for dysphagia
o use NIH Stroke Scale (NIHSS)
• Gastrointestinal
o manage patients pre- and post-procedure (e.g., EGD, colonoscopy)
o manage patients who have fecal containment devices
o manage patients who have tubes and drains
o recognize indications for and complications of enteral and parenteral nutrition
• Renal
o identify medications that can be removed during dialysis
o identify medications that may cause nephrotoxicity
o initiate renal protective measures for nephrotoxic procedures
o manage patients pre- and post-hemodialysis Musculoskeletal/Multisystem/Psychosocial
• Musculoskeletal
o initiate and monitor progressive mobility measures
• Multisystem
o administer medications for procedural sedation and monitor patient response
o differentiate types of wounds, pressure injuries
o manage patients with complex wounds (e.g., fistulas, drains and vacuum-assisted closure devices)
o manage patients with infections
• Psychosocial
o implement suicide prevention measures
o screen patients using a delirium assessment tool (e.g., CAM)
o use alcohol withdrawal assessment tools (e.g., CIWA)
• Administer medications and monitor patient response
• Anticipate therapeutic regimens
• Monitor diagnostic test results
• Perform an assessment pertinent to the system
• Provide health promotion interventions for patients, populations and diseases
• Provide patient and family education unique to the clinical situation
• Recognize procedural and surgical complications
• Recognize urgent situations and initiate interventions
• Use complementary alternative medicine techniques and non-pharmacologic interventions

AACN Progressive Critical Care Nursing
Medical Progressive resources
Killexams : Medical Progressive resources - BingNews Search results Killexams : Medical Progressive resources - BingNews Killexams : Surgeon Sued for 'Hundreds' of Injuries; Alzheimer's Biotech Under Investigation

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Surgeon Accused of Hundreds of Injuries

An orthopedic surgeon in Florida is being sued for allegedly causing hundreds of life-altering injuries in his patients, as well as one death, after he started showing signs of a progressive neurological disorder, according to a report from NBC News.

According to court documents reviewed for the article, Richard David Heekin, MD, was accused by former patients of surgical errors leading to "hundreds of devastating injuries," including bone fractures, ruptured tendons, and severe nerve damage. The alleged injuries occurred between 2016 and 2020, and patients also claimed to witness Heekin's deteriorating mental condition during that time, according to the report.

Patients claimed that Heekin slurred his words, was unable to concentrate, had difficulty with balance, and showed erratic behavior, angry outbursts, and impaired judgement, according to the court documents reviewed by NBC News.

In total, 350 lawsuits have been filed, and at least an additional 100 lawsuits are expected before the end of the year, according to NBC News. Heekin, his clinic, and Ascension St. Vincent's Riverside Hospital in Jacksonville, Florida, are named as defendants in lawsuits.

Heekin was accused of having progressive supranuclear palsy, but there were no details suggesting when hospital officials became aware of his worsening condition, the article stated. Several physicians and nurses had voiced concerns about Heekin and his ability to practice medicine, according to court documents.

The first trial in the case is reportedly scheduled for August 2023.

DOJ Investigates Alzheimer's Biotech

The U.S. Department of Justice has launched an investigation into Cassava Sciences over possible manipulated data for its experimental Alzheimer's drug simufilam, according to Reuters.

According to two anonymous sources interviewed by Reuters, the DOJ investigators specialize in cases related to defrauded or misled investors, government agencies, or consumers, but the sources did not provide specific details about the investigation.

Cassava Sciences' lawyer, Kate Watson Moss, told Reuters that the company "vehemently denies any and all allegations of wrongdoing" in a statement. She also noted that the company has not been charged with a crime.

Cassava Sciences faced scrutiny from the SEC and investors after two physicians accused the company of manipulating research on its Alzheimer's drug, according to the article. In a statement from last year, the company called those allegations "false and misleading."

The physicians, David Bredt, MD, PhD, a former neuroscientist for Johnson & Johnson's Janssen, and Geoffrey Pitt, MD, PhD, director of Weill Cornell Medicine's Cardiovascular Research Institute in New York, filed a petition in August 2021 asking the FDA to halt clinical trials of simufilam. The FDA denied the petition.

How the Strategic National Stockpile Fell Short

The Strategic National Stockpile gained widespread notoriety in the early months of the COVID-19 pandemic after it failed to provide healthcare workers with lifesaving resources and supplies. Those early failures were related to a series of choices about resource procurement "made by an obscure governing body" without input from healthcare workers or domestic manufacturers, according to an exclusive report by NBC News.

Those decisions hampered the distribution of protective gear or lifesaving medical equipment to health care systems in the heights of COVID-19 case numbers, NBC News reported.

Dawn O'Connell, the assistant secretary for preparedness and response, who was appointed by President Joe Biden, told NBC News that the stockpile "fell short," which became apparent "when the whole world needed the same thing at the exact same time and none of it was here."

Now, O'Connell and other White House officials are working to address that failure and make sure the warehouses are stocked and adequately prepared for a future crisis.

One example of the failure of the stockpile was in the number of available N95 masks as the pandemic started. The U.S. had "just 35 million N95 masks on hand," many of them left over from a 2009 purchase. It was estimated that the country needed as many as 3.5 billion N95 masks to appropriately protect healthcare workers during the pandemic, the article stated.

Greg Burel, who directed the Strategic National Stockpile between 2010 and 2020, told NBC News that lack of preparedness was due to a lack of funding. He said the stockpile received "about $700 million of the $1 billion they requested from Congress." Burel believed the additional funds would have made a huge difference in the early response to the pandemic.

The Biden administration has worked with domestic manufactures to re-supply the stockpile, according to the report. As of June, the stockpile had "acquired 541 million N95 respirators, 4.8 billion gloves, and 158,000 ventilators, with more supply expected as manufacturing ramps up, according to figures provided by the agency," the article stated.

  • Michael DePeau-Wilson is a reporter on MedPage Today’s enterprise & investigative team. He covers psychiatry, long covid, and infectious diseases, among other relevant U.S. clinical news. Follow

Wed, 03 Aug 2022 04:33:00 -0500 en text/html
Killexams : Sanders Joins Chorus Demanding Rejection of Amazon's One Medical Purchase

Sen. Bernie Sanders on Thursday joined the chorus of progressive voices demanding that the U.S. government reject Amazon's purchase of One Medical, a subscription-based health services provider headquartered in San Francisco.

"Amazon has no business being a major player in the healthcare space, and regulators should block this $4 billion deal to ensure it does not become one."

"The function of a rational healthcare system is to provide quality care to all in a cost-effective way, not make billionaires like Jeff Bezos even richer," the Vermont Independent wrote on social media, referring to Amazon's ultrawealthy founder and executive chairman. "At a time of growing concentration of ownership, the Justice Department must deny Amazon's acquisition of One Medical."

Sanders was echoing anti-monopoly advocates and privacy defenders who have sounded the alarm over Amazon's "dangerous" $3.9 billion buyout of One Medical—a private equity-backed company that charges its 767,000 members roughly $200 in annual concierge fees to access a network of 188 primary care clinics.

"Allowing Amazon to control the healthcare data for another 700,000+ individuals is terrifying," Krista Brown, a senior policy analyst at the American Economic Liberties Project, said Thursday in a statement. "Acquiring One Medical will entrench Amazon's growing presence in the healthcare industry."

The corporate behemoth bought the online pharmacy PillPack in 2018 for $750 million, launched Amazon Pharmacy in 2020, and expanded its Amazon Care telehealth program nationwide earlier this year, among other latest deals.

"Amazon just set its healthcare efforts to warp speed," Axios health tech reporter Erin Brodwin tweeted Thursday. "Where among Amazon's sprawling health efforts does One Medical fit, exactly, and how will it weave the buy into its existing primary care bets?"

One Medical "already has its tentacles in Medicare" through its 2021 acquisition of Iora Health, Brodwin noted, "and now Amazon's got a clear foothold there."

The Lever reported Friday that Amazon "could use its new platform to advance the cause of Medicare privatization at a much more aggressive pace. The consequences wouldn't just mean more taxpayer dollars funneled to the mega-corporation, but also Medicare recipients facing a healthcare system with ever more resources being allocated to profit instead of care."

As the outlet noted:

President Joe Biden's Center for Medicare and Medicaid Services (CMS) has expanded a Medicare privatization scheme launched under former President Donald Trump. That program, which is currently referred to as ACO REACH, involuntarily assigns Medicare patients to private health plans operated by for-profit companies, like One Medical subsidiary Iora Health.

Medicare provides set payments to provide care for these patients, much like insurance. This arrangement incentivizes Iora and other privatization entities to limit the amount of care that seniors receive.

Continued expansion of Medicare privatization seems integral to One Medical's business model.

The company's most recent quarterly report shows that more than half of its revenue comes from Medicare. This includes Medicare Advantage plans operated by private health insurers, traditional Medicare fee-for-service payments, and the ACO REACH program.

Amazon's purchase of One Medical "will be a blow to the fight for universal healthcare," journalist Aaron T. Rose tweeted Thursday. "Imagine all the money Amazon will pour into lobbying to stop Medicare for All now that they have a dog in the fight."

In addition, Brown warned, the deal—which would mark Amazon's third-biggest acquisition after Whole Foods ($13.7 billion) and MGM Studios ($8.5 billion)—"will also pose serious risks to patients whose sensitive data will be captured by a firm whose own Chief Information Security Office once described access to customer data as 'a free for all.'"

"Amazon has no business being a major player in the healthcare space," she added, "and regulators should block this $4 billion deal to ensure it does not become one."

Sen. Amy Klobuchar (D-Minn.), chair of the Senate Judiciary antitrust subcommittee, has asked the Federal Trade Commission (FTC) to investigate Amazon's move to buy One Medical.

"This proposed transaction raises questions about potential anticompetitive effects related to the pharmacy services business Amazon already owns and about preferencing vendors who offer other services through Amazon," Klobuchar wrote Thursday in a letter to the agency.

"I also ask that the FTC consider the role of data, including as a potential barrier to entry, given that this proposed deal could result in the accumulation of highly sensitive personal health data in the hands of an already data-intensive company," she added.

This story has been updated with information about Sen. Amy Klobuchar's letter to the FTC.

Fri, 22 Jul 2022 03:37:00 -0500 en text/html
Killexams : New center aims to accelerate research into biomarkers of neurodegenerative diseases

A new center established at Washington University School of Medicine in St. Louis aims to accelerate research into biomarkers of neurodegenerative conditions such as Huntington's and Parkinson's diseases, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS) and the so-called tauopathies, a group that includes Alzheimer's disease along with rarer diseases such as frontotemporal dementia, corticobasal syndrome and progressive supranuclear palsy. The Tracy Family Stable Isotope Labeling Quantitation Center for Neurodegenerative Biology (Tracy Family SILQ Center) helps researchers discover, study and validate biomarkers of such diseases, with a goal of identifying new drug targets and creating better diagnostic and prognostic tests.

Many neurodegenerative diseases are characterized by the gradual accumulation of toxic clumps of certain proteins in the brain. The specific protein involved varies by disease — for example, amyloid beta is integral to Alzheimer's disease, alpha-synuclein to Parkinson's — but what stays the same is an unhealthy tendency of the protein to aggregate, often due to faulty regulation or a malformed shape. By attaching a label to key proteins in the brain, researchers can track their production and clearance, and identify the factors that influence turnover. Further, by using labeled proteins in samples from other parts of the body such as cerebrospinal fluid or blood, researchers can also make highly precise measurements of proteins associated with disease and track how they change over time and under specific conditions.  Such data can lead to crucial insights into how each disease develops and open up new avenues to diagnosing, preventing or treating it.

Neurodegenerative diseases are terrible diseases that currently have limited treatment options. Using labeled proteins is a powerful way of accelerating discovery for such diseases. Many different investigators are interested in using a labeled-protein approach to studying Parkinson's, ALS, MS, frontotemporal dementia and more. But using this approach is not trivial as it requires considerable resources in terms of specialized equipment and expertise. Based on our success in Alzheimer's disease, we established this center to help develop this approach across different disease areas and accelerate progress toward better diagnostics and therapeutics."

Randall J. Bateman, MD, the Charles F. and Joanne Knight Distinguished Professor of Neurology and Tracy Family SILQ Center's Director

The Tracy Family SILQ Center contains seven cutting-edge mass spectrometers and several robotics units. The center's faculty includes Nicolas Barthélemy, PhD, an assistant professor of neurology, and Kanta Horie, PhD, a voluntary research associate professor of neurology. Barthélemy and Horie have extensive experience developing biomarkers for Alzheimer's disease. Barthélemy is developing a blood-based diagnostic test for Alzheimer's disease based on a form of the protein tau, while Horie has shown that a different form of tau in the spinal fluid can indicate the stage of disease. Recruitment for additional faculty and staff members is underway.

The center builds on a technique known as SILK (for stable isotope labeling kinetics) developed in 2006 by Bateman in the lab of David Holtzman, MD, the Barbara Burton and Reuben M. Morriss III Distinguished Professor of Neurology. Using the technique, Bateman showed that production and clearance of amyloid beta is altered in the brains of people with Alzheimer's disease decades before their memory and thinking begins to change. This finding became one of the key pieces of evidence that Alzheimer's dementia occurs at the tail end of a largely invisible disease process in which years of unbalanced protein kinetics gradually add up to neurological damage and cognitive decline.

SILK has since been extended to other proteins and other diseases. Bateman and other School of Medicine researchers are taking part in two SILK research collaborations, one aimed at tau protein, which has been linked to cognitive decline in Alzheimer's and other tauopathies; and the other focused on neurofilament light protein, which increases in diseases such as Alzheimer's, Parkinson's, Huntington's and ALS.

The original SILK technique also has been expanded to measure other aspects of protein behavior beyond kinetics, which is why the word "quantitation" is used in the center's name instead of "kinetics."  For example, SILQ has enabled the first, and currently best, way to estimate plaques of the Alzheimer's associated protein amyloid in the brain by measuring the ratio of two forms of amyloid in the blood. This technique forms the basis of a blood test that is now offered in the clinic to doctors and patients.

School of Medicine researchers who join the center gain access to its resources and funding, and the option to propose research projects and collaborate with center faculty. The center currently is on the ninth floor of the Steven & Susan Lipstein BJC Institute of Health building, but it will move to a larger space in the Neuroscience Research Building when it opens in 2023. The center is supported by $10 million in transformational philanthropic giving and grants from the Tracy Family, Richard Frimel and Gary Werths, GHR Foundation, David Payne, the Willman Family and other generous donors, and stewarded by The Foundation for Barnes-Jewish Hospital.

Wed, 13 Jul 2022 06:10:00 -0500 en text/html
Killexams : Rantz: Seattle residents, business fight homelessness, upsetting activists and media

Residents and business owners are taking back their streets from the homeless. They have placed one-ton concrete blocks around their neighborhoods and businesses in an effort to stop the homeless from moving back in and wreaking havoc.

The concrete blocks prevent broken-down RVs and tents from occupying the space. They’re being placed, mostly, anonymously. While Mayor Bruce Harrell has engaged in more targeted encampment sweeps, the action has been too slow and there are no consequences for the homeless who just move a block or two away — often with the help of activists. Many of the homeless bring crime, drug use, and garbage, making ugly concrete blocks the more appealing and safe option to Seattleites.

Some activists in and out of the media are upset. Let them be.

Rantz: Seattle activist invites homeless to her home, immediately regrets it

The crisis explained

Under Harrell and previous mayors, homeless encampment sweeps are generally inconvenient but ineffective for many homeless.

While there have been some obvious successes in bringing people into shelter, progressive activists help homeless set up new encampments after they’re swept. Harrell’s sweeps are coming too slowly. And police can’t leverage arrests to push homeless people into getting the help they desperately need.

Thus, there’s little incentive for the homeless person, oftentimes dealing with untreated addiction or mental health issues, to go into a shelter. They have progressive activists to enable their choices to stay on the streets.

But when an encampment is swept, residents and business owners want to make sure they don’t have to worry about the homeless returning. Hundreds of these eco-blocks have gone up around the city, as a result. While they’re eyesores, they provide some level of safety and comfort as it’s the kind of hostile architecture that pushes the homeless away. If they’re not willing to get the help the city and county offer, they’re no reason taxpayers have to suffer consequences.

The staff at The Seattle Times is not happy.

Seattle Times lobbies for homeless encampments

The Seattle Times reporter Amanda Zhou decried the “illegally placed” eco-blocks in an editorial masquerading as a news feature.

Zhou’s piece was framed around the woes of a homeless man upset that he can’t set up his broken-down RV wherever it is he wants. Though the homeless cannot live rent-free in broken-down RVs or disgusting tents wherever it is they want, the Seattle Times is more panic about the eco-blocks.

“It is illegal to place ecology blocks in public streets, sidewalks, or parking spaces,” Zhou notes. “Ecology blocks cause ‘parking spillover into adjacent streets, block utility access and cause other accessibility or transportation problems,’ according to the Seattle Department of Transportation.”

The reporter wants to know why citations aren’t being offered to those responsible for the concrete blocks. She shows no such interest in why homeless are allowed to own streets and sidewalks they don’t pay for, intimidating and harassing neighborhood residents and employees in the process. That illegal behavior is encouraged because it lets left-wing Seattle activists go online to fake interest in the lives of the homeless they refuse to help.

Eco-blocks are the result of desperation

“They’re human beings! Show them dignity!” the (usually) white progressive screeches when a sweep occurs, somehow thinking it’s compassionate to keep those human beings living in squalor, surrounded by used needles, trash, and human waste.

They think even less of tax-paying, law-abiding citizens who want to live safe lives with their families.

The eco-blocks wouldn’t go up if the Democrat leaders had a coherent strategy to tackle homelessness. Imagine how desperate one must feel in order to anonymously place the concrete barriers. It’s done because they know they have to protect their own communities; Democrats here won’t prioritize taxpayers over the homeless.

For all the years where a holistic plan was promised, all while sinking billions in efforts to solve homelessness, the region has little to show for it.

One reason nothing gets done is that the only solution Councilmembers and area activists will accept is a fully subsidized studio apartment on Capitol Hill for every homeless person. There will be no rules and no expectation to stop smoking fentanyl or seeking treatment for a mental health problem. In other words, constantly enabling the very behavior that caused the homelessness to begin with, only this time, we’ll take care of them until their inevitable overdose.

No more coddling

Want to get rid of the eco-blocks? Put teeth to a homelessness plan.

Sweeps only work when there are consequences. Programs that incentivize businesses to hire able-bodied homeless people can work. Expanding programs that help teach basic skills will make it easier for a business to hire a homeless person. I’ve lost interest in coddling otherwise healthy and able-bodied homeless men and women until they’re willing to get off the streets.

We can only offer them resources for so long before they make the choice to stay on the streets. We shouldn’t accept that choice.

Don’t like the shelter options provided? Too bad. They can be picky on their own dime. When they get a job and pay rent, they can arrange whatever legal living arrangements they want. If they don’t want to take us up on our generous offers, then they should go somewhere else. We are right to expect sidewalks, parks, alleyways, and everywhere else to be free from homeless people who don’t have underlying health reasons making them susceptible to homelessness.

A better way

If someone is mentally ill, we should put our resources into treatment over housing.

If they’re schizophrenic on the streets, they’ll fare barely better in a Capitol Hill studio apartment. They’re not homeless because they lack a home, but because of a medical issue that leads them to the streets. Compassion is to offer (and yes, even sometimes compel) treatment, not let them waste away on a sidewalk.

And for the homeless addicts? We enforce the law.

Some addicts need the criminal justice system to intervene. They’re paying for the drugs via theft. They should be treated like thieves if they’re unwilling to go into treatment that we should provide. Instead of buying up homeless hotels, we should put the money into addiction treatment. They can’t get back on the right path if they’re overcome by drugs or alcohol. Some can get treatment in facilities and others can sober up in jail if that’s what it takes.

Activists may think this approach is cruel. Who cares what they think? I’d rather be cruel if it means the homeless man or woman won’t die on the streets or hurt someone else.

They might think it’s naïve. Oh, okay. Some activists are well-intentioned; others are not. It doesn’t matter at this point. They’ve been in charge this whole time and they’ve made the problems worse.

They can complain about this approach in a lazy blog they’ve written 14 times before or in a tweet thread liked by those living comfortably in their echo chamber. Saving lives and cleaning up the city is more important than pleasing incompetent, partisan, ineffective dullards who couldn’t govern their way out of a paper bag or treat a headache, let alone a homelessness crisis.

But, until this happens, eco-blocks it is.

Listen to the Jason Rantz Show weekday afternoons from 3–6 pm on KTTH 770 AM (HD Radio 97.3 FM HD-Channel 3). Subscribe to the podcast here. Follow @JasonRantz  on  Twitter,  Instagram, and Facebook. Check back frequently for more news and analysis.

Wed, 03 Aug 2022 13:22:00 -0500 en text/html
Killexams : Column One: Abortions are widely available in California, but not for these women

Christina, a California patient who had to leave the state to get an abortion in the third trimester after a poor fetal diagnosis, shows fetal footprints and hand prints given to her after the procedure. (Dania Maxwell / Los Angeles Times)

Jeni and her husband had already put together their baby nursery and drafted a list of names when she learned the baby she had been carrying for 33 weeks had a brain that had not developed properly.

A year later, Christina and her husband faced a similar diagnosis for their child at 28 weeks of gestation: excess fluid had built up in the skull, preventing the brain from growing correctly.

The two California women, both in their mid-30s, didn’t know each other but faced the same agonizing days between initial diagnosis and final confirmation of what’s called ventriculomegaly. Though no doctor could tell them exactly what their child might endure, they faced a spectrum of scenarios: death in utero, developmental delays, a short, seizure-filled life in the neonatal ICU.

Jeni and Christina, who didn't want their last names used for privacy reasons, made the decision that neither ever fathomed they would make: ending a wanted pregnancy in the third trimester.

Christina was recently married and enjoying a relatively smooth pregnancy last year until she had a major ultrasound at 22 weeks. (Dania Maxwell / Los Angeles Times)

Already grieving their losses, Christina and Jeni soon faced a second blow: It is illegal to perform an abortion in California after a fetus is viable, unless the patient's life or health is at risk.

Their ability to obtain an abortion in California would hinge on whether doctors believed their fetus met the legal definition of “viable” —able to live outside the womb without intensive medical intervention. If a fetus was deemed viable, they would have to leave California to get the abortion.

But in a demonstration of how access can change depending on geography, individual doctors and interpretation of the law,this is where their stories diverged. One woman would be able to get the procedure in California; the other would find herself on a plane to Colorado for an abortion that would cost $17,000, plus travel expenses.


As red states move to prohibit abortion after the U.S. Supreme Court’s reversal of the Roe vs. Wade decision in June, California’s political leaders have heralded a different path.

Gov. Gavin Newsom and other Democrats have called California a haven or sanctuary for residents of other states who need an abortion. The state has announced a $200-million boost for reproductive health services, eliminated out-of-pocket costs for abortion andenacted a bill to protect California's health providers from being sued by states that ban the procedure.

“We live in California, we live in one of the most progressive states. Why would this be an issue?"

Christina, on having to leave the state for a late-term abortion

Compared with the rest of the country, California has some of the nation’s most progressive abortion policies, including state-funded coverage of abortion in Medi-Cal. In fact, California is the only state the Guttmacher Institute, a research group that supports abortion rights, lists as “very supportive” of those rights.

But for the patients who have needed an abortion later in pregnancy, the California abortion sanctuary leaves them behind.

“It’s frustrating,” Christina said. She acknowledges that when most people — even those who support reproductive rights — think about access, they don’t think of abortions in the third trimester because they’re so rare. Still, she never thought she’d have trouble accessing one in her home state.

“We live in California, we live in one of the most progressive states,” she recalls thinking when told she might not be able to get an abortion in the state. “Why would this be an issue?"

“The talking points are great if California were truly an abortion sanctuary," Jeni said. "Even California has such a far way to go before we can call it a sanctuary or safe haven."

No official statistics are kept on California residents who leave the state for an abortion. Katrina Kimport, a qualitative medical sociologist at UC San Francisco's Advancing New Standards in Reproductive Health, says a conservative estimate is 100 Californians a year. It is probably an undercount, she said.

Kimport based that on her own research as well as numbers from Access Reproductive Justice, a California organization that helps patients with financial and logistical support to get abortions.

The group counted 122 first-time callers last year who were more than 24 weeks into pregnancy — the shorthand definition of viability for many providers — and seeking an abortion. Ultimately, 91 of them left the state for the procedure.

Though abortions after 24 weeks are exceedingly rare — fewer than 1% of them happen after 21 weeks, according to the federal Centers for Disease Control and Prevention — they draw the most visceral reaction when discussing the already complicated subject of pregnancy termination. They are the least understood, the most politically controversial and often exceedingly heartbreaking for the parents who pursue them. They are also the most expensive and the most medically complex.

Experts who have studied these abortions say they often take place either because the patient learned new information — perhaps a distressing medical diagnosis or something in their personal lives — or faced barriers to access that pushed the procedure deep into pregnancy. The latter category can include particularly young people and victims of rape or incest who might not know they're pregnant for months or include low-income people who experience delays in getting treatment.

The Supreme Court’s decision in Dobbs vs. Jackson Women’s Health Organization, which has essentially eliminated abortion access in nine states already, could push more patients’ abortions later into pregnancy because of widespread clinic closures and the time needed for travel, taking off work or child care.


Ending the pregnancy, Christina reasoned, was the only recourse — "the right thing to do for my baby, not for me. There was never a question that that's not what that child deserved." (Dania Maxwell / Los Angeles Times)

Christina was recently married and enjoying a relatively smooth pregnancy last year until she had a major ultrasound at 22 weeks, typically the happy time when parents can learn their child’s sex and see the first glimpses of the shape of the baby’s nose.

The sonographer, measuring the fetus to check for proper growth, found the brain cavitywas slightly enlarged. Christina was told it probably wasn’t anything to worry about, but they would do more scans in the future to keep an eye on it.

As soon as four weeks later, the problematic growth had increased significantly and was now raising red flags. Christina was advised to get a fetal MRI. By the time that was performed a week later, she was in her 27th week.

She learned her child had severe ventriculomegaly, meaning excess fluid was rapidly building up in the skull, putting pressure on the brain and not allowing it to develop.

Christina feared her childwas suffering in utero and, if she made it to birth, would face a painful, short life. “It would just be immediate hospitals for three months or six months — it would be pain and surgeries,” she said.

“In reality, there's a lot of clinics and hospital systems that have this artificial 24-week cutoff which is both a superficial look at the law, as well as settling the comfort level of all the providers involved.”

Dr. Mitchell D. Creinin, a UC Davis obstetrician-gynecologist

Ending the pregnancy, she reasoned, was the only recourse — "the right thing to do for my baby, not for me. There was never a question that that’s not what that child deserved.”

At 28 weeks of pregnancy, she informed her genetic counselor of her decision. The counselor’s response shocked her: Since she was past 24 weeks and her life was not at risk, it was probably too late to get the abortion in California. “If I was going to die, I think they would have done it,” Christina mused.

Christina briefly considered trying to find a physician in California to perform the procedure, but the genetic counselor's comments discouraged her. Though leaving California would take her out of network and dramatically drive up the cost, weeks were slipping by and she had little choice.

There are 11 clinics in the United States that will go beyond 24 weeks and only six of them go beyond 26 weeks, according to Access Reproductive Justice. Six states and the District of Columbia do not have a gestational limit on when abortion is legal.

Christinaended up flying to a clinic in Boulder, Colo.


California's abortion law, in effect since 2003 and designed to mirror Supreme Court precedent, says abortion is prohibitedafter viability has been established, unless life or health is at stake.

The definition of viability, however, is vague. The law leaves it up to a doctor’s “good faith medical judgment” to determine the “reasonable likelihood of the fetus’ sustained survival outside the uterus without the application of extraordinary medical measures.”

In practice, viability is often shorthanded to 24 weeks of gestation, and some doctors won’t even consider a case after that time.

Others, including Dr. Mitchell D. Creinin, a UC Davis obstetrician-gynecologist, say viability is more nuanced than a blanket 24-week ban and needs to be analyzed on a case-by-case basis, pointing to the fact that any baby born at 24 weeks gestation needs “extraordinary medical measures” to have any chance at survival.

“In reality, there's a lot of clinics and hospital systems that have this artificial 24-week cutoff which is both a superficial look at the law, as well as settling the comfort level of all the providers involved,” Creinin said.

Hospitals considering whether to take cases typically bring them before boards of their certified and lawyers. Patients are not included. For physicians, such cases pose ethically complex questions: Would a baby with a severe diagnosis, such as an unformed brain, truly be viable?

What's more, the viability definition focuses on whether life is possible, not the quality of that life.

Creinin compares the issue with end-of-life care decisions. “Do I think my loved one’s going to come out of whatever’s going on and have a quality of life that I feel that person would want? It’s the same thing on the early end,” he said.

The question of viability has not been a major factor in latest policy debates over abortion.

Last year, with the Dobbs case looming, more than 40 organizations formed the California Future of Abortion Council to recommend a lengthy list of policy proposals “supporting equitable and affordable access to abortion care for Californians and all who seek care here.”

State legislative leaders took up a portion of the council’s recommendations this year and, notably, pushed through a proposed constitutional amendment that will go before voters in November. It would preserve the right to have an abortion in California, but would not change the current law on viability.

Even if the state were to lift the viability threshold, it would not immediately Excellerate access, Creinin said, pointing to shortages in the teams of people needed to care for patients undergoing abortions later in pregnancy.


As with Christina, the first sign of trouble in Jeni’s pregnancy emerged during an ultrasound, this one at 20 weeks.

She and her spouse were told that one of the brain ventricles, cavities that store cerebrospinal fluid, was slightly enlarged and that it could be a sign their baby could face mild developmental delays.

But their doctor told them not to worry and they continued setting up the nursery and making other preparations at their Bay Area home. Uneventful ultrasounds followed until the 33rd week. By then, the spring of 2020, the COVID-19 pandemic was raging and partners weren’t allowed into the appointments.

Jeni went in alone but was quickly advised to call her husband on FaceTime.

The baby’s situation had grown much more dire. In addition to the ventriculomegaly, the baby’s head had grown to the 97th percentile but the body was much smaller. The corpus callosum— which connects the left and right sides of the brain — had not formed.

“There’s just no way to say goodbye to your baby. You’ve never met the baby, but it’s been with you this whole time. And you’re literally going into the clinic to stop his heart. It’s just so hard.”

Jeni, whose baby's situation had grown much more dire

Her physician “didn’t really even supply us the option of performing the abortion,” Jeni recalled, but with problems mounting, she trusted a gut instinct that “we were on the bad side of bad.” An abortion, she decided, was the best choice for her and her baby.

Jeni, too, was told she’d have a hard time finding care in California and was referred to the Boulder clinic Christina would use.

Ultimately, she found a Beverly Hills-area physician who agreed to perform the first portion of the abortion — the injection that stops the heart. But that physician couldn’t do the rest of the procedure — delivery — because the baby was breach, a more complicated situation. Abortions after 24 weeks are already complex — they typically require inducement of labor — so they usually must be done in hospitals and require a team of doctors and nurses.

Jeni had to fly back to the Bay Area for a caesarean section that would take place the following day.

She is mindful that she had the financial resources to obtain the procedure — a privilege not afforded to every patient.

She and other women with financial means will probably always be able to travel to find treatment — whether it is from the parts of California that don't have abortion clinics or from a red state that has banned the procedure or even from the United States entirely.

“But that’s not true for most of the country," she said.


The night before the first part of the abortion, Jeni and her husband had driven to Malibu, a peaceful setting to contemplate what was to happen and to find a way to say goodbye.

“There’s just no way to say goodbye to your baby,” she said. “You’ve never met the baby, but it’s been with you this whole time. And you’re literally going into the clinic to stop his heart. It’s just so hard.”

While undergoing the C-section, Jeni was initially given light anesthesia that kept her fully conscious. She grabbed the nurse’s hands and asked for more meds, begging to not be aware of her surroundings.

When she woke up, it was over — but her parenting responsibilities were not. She’d have to complete paperwork and choose a name. She and her husband reached for the shortlist of names they had prepared.

“It became a list of names that we had to supply to basically the records department to put on the death certificate,” Jeni said. “And you’re just forced to pick a name.”

This story originally appeared in Los Angeles Times.

Thu, 04 Aug 2022 23:00:00 -0500 en-US text/html
Killexams : Dedication, commitment pivotal building blocks for healthy, progressive nation: Mandaviya

Union Health Minister Mansukh Mandaviya stated empathy, care and softer skills further refine and enhance our technical and clinical abilities.

Union Health Minister Mansukh Mandaviya stated empathy, care and softer skills further refine and enhance our technical and clinical abilities.

A positive attitude and mental framework along with dedication and commitment are pivotal building blocks for a healthy and progressive nation, Union Health Minister Mansukh Mandaviya said on August 1.

He was addressing the inaugural ceremony of the training programme for senior administrative medical officers of the Central Government Health Scheme (CGHS).

Minister of State for Health Bharati Pravin Pawar also spoke on the occasion.

A week-long training and orientation programme has been organised at the National Institute for Health and Family Welfare (NIHFW) for CGHS officers to enhance and upgrade their skills at interpersonal communication, administration and use of technology.

The CGHS is a health scheme providing comprehensive health care to its nearly 41.2 lakh beneficiaries who are mainly central government employees and pensioners, through its 460 wellness centres spread across the country in 75 cities.

"Let us change our attitude as we step out of our homes for work. A positive attitude and healthy mental framework along with dedication and commitment are pivotal building blocks for a healthy and progressive nation," Mr. Mandaviya said.

Mr. Mandaviya stressed on the importance of "Samvaad" as a strong tool for interpersonal communication and grievance redressal.

"Those organisations and individuals that are in a learning mode will always progress. We shall always benefit from a 'Vidyarthi bhaav' where we are open to imbibing knowledge, new insights and learn from each other," he stated.

The Union Minister stated empathy, care and softer skills further refine and enhance our technical and clinical abilities.

Many challenges are resolved with a positive attitude, he stressed.

Ms. Pawar said CGHS as an organization has widened its network and is now functional in 75 cities across the country with approximately 450 wellness centres.

Over the period, it has undergone many changes to keep pace with the developments in the health sector such as digitization of services and inclusion of various new health modalities, Ms. Pawar said.

Planning and implementation of these changes has been only possible due to consistent efforts and hard work of the entire workforce, she stated.

Referring to 'CGHS Panchayat', Ms. Pawar said such practices help in assessing the different aspects of CGHS service system like the wellness centres, the empanelment procedures, bill reimbursement etc.

“Interactive meetings held with all stake holders of CGHS such as staff and the beneficiaries in various cities to address their grievances and receive feedbacks if any is a welcome initiative.”

"Health resources – both human and material are precious assets to the society and a robust health care administration and management system ensures their effective utilization," she said.

Mon, 01 Aug 2022 00:22:00 -0500 en text/html
Killexams : Why Progressive Prosecutors Won’t Save Us in a Post-Roe World

Where Do We Go From Here? is a series of stories that explore the future of abortion. It is a collaboration between Mother Jones and Rewire News Group. You can read the rest of the package here

The same year Harriet Tubman escaped enslavement on a Maryland plantation and Elizabeth Blackwell became the first woman ever to receive a US medical degree, three white men in the brand-new state of Wisconsin drafted a law to make abortion a felony. It was 1849, and at first, their law only criminalized doctors who ended pregnancies after “quickening,” when fetal movement could be felt. But nine years later, as the story goes, a Baptist minister-turned-doctor convinced state legislators to expand the ban, outlawing abortion at any point in pregnancy.

For nearly 50 years, that state law has gathered dust, made irrelevant by Roe v. Wade. But on June 24, when the Supreme Court upended decades of precedent and eliminated the national right to abortion, the old Wisconsin statute rose from the grave.

The resurrected law exempts abortion seekers from being charged with a crime, and it has a carveout for cases in which abortion is necessary to save a mother’s life. Instead, it targets healthcare providers: the doctors and clinic staff who help thousands of people end their pregnancies in Wisconsin every year. So on the 24th, Planned Parenthood of Wisconsin, which ran three of the state’s four abortion clinics, was faced with a perilous, long-anticipated question: Would their employees be arrested and jailed if they continued the work they’d been doing for decades?

There were so many factors to consider—including whether anyone would, or even could, enforce the ban. The elected prosecutors in Madison and Milwaukee, where two Planned Parenthood clinics are located, had pledged not to file charges against abortion providers, but future district attorneys might try to bring a case. So might private citizens, who could use the state’s unusual “John Doe” law to ask a judge to launch a criminal investigation. Wisconsin’s attorney general, Josh Kaul, had said his office wouldn’t support charges under the old ban, but he doesn’t have the power to stop local prosecutors from filing them. The Democratic governor, Tony Evers, had mentioned giving clemency to abortion providers. But he is up for reelection.

It’s that risk, that open question of law, that has made us pause and say, ‘Okay, we’re going to pause our abortion care until we have some clarity,’” says Michelle Velasquez, Planned Parenthood of Wisconsin’s director of legal advocacy and services.

So on the day of the ruling, clinic staffers went out to their waiting rooms to tell patients they wouldn’t be seen. About 70 people had appointments canceled, leaving them unsure if they would be forced to supply birth, or if they’d be able to get an abortion in another state.

With Roe overturned and blanket abortion bans snapping into place across the South and Midwest, healthcare workers who provide abortions are now faced with the same complicated math that Planned Parenthood of Wisconsin had to wrestle with. Whether abortion is illegal now depends on their state, but enforcement is a separate question. In large part, whether doctors will face criminal charges for defying the law is up to local prosecutors—a group of predominantly white, male officials, typically elected county by county.

Some expert observers and advocates believe prosecutors will see the end of Roe as a political, or moral, opportunity to crack down on anyone involved in an abortion. “I think it’s likely—in fact, inevitable—that we’re going to see some local prosecutors view this as their moment,” says Michelle Oberman, a law professor and author of Her Body, Our Laws: On the Frontlines of the Abortion War from El Salvador to Oklahoma. “Some may view it as something that their constituents demand. And others may feel that sort of moral urgency to do everything in their power to bring the one tool that they have, which is criminal law enforcement, to bear against people in their jurisdictions who end their pregnancies.”

On the other side, some prosecutors have pledged to protect the right to choose. In a joint letter organized by the group Fair and Just Prosecution, 89 district attorneys and attorneys general said they will decline to prosecute people who “seek, provide, or support” abortions. Many of the signers were from blue states where access to abortion is already protected. But the letter also included the top prosecutors from blue cities in red or purple states—like Nashville, Tennessee, Milwaukee, Wisconsin, and Jackson, Mississippi, home of the clinic at the heart of the Dobbs case.

“Not all of us agree on a personal or moral level on the issue of abortion,” the Fair and Just Prosecution letter said. “But we stand together in our firm belief that prosecutors have a responsibility to refrain from using limited criminal legal system resources to criminalize personal medical decisions.”

Their promise is a hard sell to abortion providers weighing the risks of jail time. “I don’t think most of us can count on the stated intentions of individual local prosecutors,” says Doug Laube, the former chair of obstetrics and gynecology at University of Wisconsin-Madison and a Planned Parenthood of Wisconsin abortion provider.

Part of the reason advocates are expecting a crackdown is the zealousness with which some prosecutors have long gone after women for suspected self-managed abortions. Even before Roe v. Wade fell, district attorneys were using charges of child neglect, feticide, and practicing medicine without a license to prosecute people who ended their pregnancies or were suspected of doing so. Between 1973 and 2020, National Advocates for Pregnant Women has documented over 1,700 cases in which people were arrested, detained, or forced into a medical intervention because they were perceived to have harmed or endangered their embryo or fetus.

Right now, the newly effective state abortion bans focus on penalties for abortion providers, not patients. But anyone who has kept an eye on prosecutions over the last 50 years is not optimistic that women and other pregnant people won’t be caught up in the crossfire, regardless of what the law says. Farah Diaz-Tello, senior counsel and legal director at the reproductive justice organization If/When/How, says her group is expecting an uptick of prosecutions against pregnant people, particularly in places where abortion is now illegal. “People will find ways to end pregnancies on their own, and they’re going to risk the possibility of arrest to do so,” Diaz-Tello says. “When people come to an emergency department experiencing obstetrical emergencies, when they’re having miscarriages that they can’t explain to somebody else’s satisfaction, this notion that abortion is something that is criminal and stigmatized leads to people being turned over to law enforcement.”

And if charging a pregnant woman is too politically risky, Oberman says district attorneys might now try to use “accomplice” laws already common in criminal codes to prosecute people who supply them advice or practical support: sisters, mothers, boyfriends. “You could be an accomplice to abortion by paying for some of these abortions, by helping them do an internet search, by explaining to them how they could drive across the bridge, by helping them afford a bus ticket,” Oberman says.

It’s a potentially vast and terrifying dragnet—and that’s the point. “That’s what the anti-abortion movement is counting on,” Oberman says. “They’re counting on chilling behavior and isolating the person who’s facing an unwanted pregnancy. So it’ll be the threat of becoming embroiled in legal problems that causes folks—from parents, to boyfriends, to doctors, to counselors—to just stay out of it.”

At this moment of uncertainty, the fear of becoming embroiled in legal problems is even inhibiting some doctors in states where abortion is still legal. At the end of June, the Planned Parenthood of Montana president and CEO Martha Fuller instructed her organization’s clinics to stop giving medication abortions to people traveling from states with total abortion bans.

“As you know, the abortion access landscape is rapidly changing across our region,” she wrote. “The risks around cross-state provision of services area currently less than clear, with the potential for both civil and criminal action for providing abortions in states with bans.”

There are plenty of other reasons why healthcare workers might not see a certain from their local prosecutor as a real solution.

In some places, that’s because being charged with a crime isn’t the biggest threat to doctors. Instead, it’s the risk of a civil lawsuit, or the state medical board taking away their license to practice. In Hines County, Mississippi, the Jackson Women’s Health Organization runs Pink House, the last abortion clinic in the state and the subject of the Dobbs litigation. There, the local prosecutor, Jody Owens, signed the letter pledging not to prosecute anyone offering or receiving abortion services. Republican Gov. Tate Reeves, on the other hand, has said that “if a physician is attempting to practice medicine in the state of Mississippi, and they’re violating our law, then our state Board of Medical Licensure will pull their license from them.”

“Even if there were no risk of a criminal prosecution, state authorities might still take steps to take away the licenses of doctors to practice medicine and to close the clinic,” explains Pink House’s lawyer, Rob McDuff, an attorney at the Mississippi Center for Justice. Pink House closed its doors June 6, one day before a state law banning abortion took effect.

Elsewhere, the local prosecutors’ decision not to charge a crime might not be the final word. In some states, attorneys general can swoop in and file charges of their own if doing so is in the “public interest,” if another state official requests it, or if the local prosecutor has refused to enforce the law, according to an Emory Law Journal analysis. And legislatures that are angry about a “rogue” prosecutor are already experimenting with laws to sideline them. Such is the case for Nashville’s Glenn Funk, who joined the latest abortion letter. Last year, Funk said he would not enforce two new state laws—one that criminalized businessowners who failed to post a transphobic sign outside their bathrooms, and another that made it illegal for teachers to require students to mask up. A few months later, lawmakers passed a bill allowing court-appointed, temporary prosecutors to step in for any DA who made a blanket statement against prosecuting certain crimes.

Heather Allison, a reproductive justice fellow at Healthy and Free Tennessee, points out that even with a pro-choice prosecutor, police could still choose to arrest providers, sending them briefly to jail. “I just think it’s extremely unlikely that healthcare providers would be willing to risk criminalization just based off the promise of a prosecutor, especially because it’s still possible that they could be arrested,” Allison says.  

Finally, there’s the question of whether current DAs will lose reelection to anti-abortion opponents. Part of the risk in Wisconsin, Velasquez explains, is that DAs there have a six-year window to file felony charges. “The risk of future prosecution isn’t zero just because a prosecutor today decides not to investigate and issue charges,” she says. “It would just depend on the priorities of whomever is taking over those offices.”

Two weeks ago, Wisconsin Attorney General Kaul sued in state court to block the 1849 law, arguing that the more lenient abortion restrictions the state passed after Roe—laws prohibiting abortions after viability, mandating parental consent, and imposing a 24-hour waiting period, among others—should supersede the older statute.

“I said last week I’d fight this every way we can with every power that we have, and that’s what we’re going to do,” Evers said at a press conference announcing the lawsuit. “If Republicans won’t do their part—what’s right—and help the people of the state, then we will.”

A judge has yet to weigh in, but it’s likely the case will make its way to the Wisconsin Supreme Court, which has a 4-3 conservative majority. There’s a chance the court’s partisan makeup could shift next April, when a right-leaning justice retires; a statewide election will determine her successor. But, according to Velasquez, that’s all moot if Evers loses his reelection bid in November to an opponent willing to sign a bill reaffirming the ban. Both GOP frontrunners—former lieutenant governor Rebecca Kleefisch and the Trump-endorsed construction executive Tim Michels—have voiced support for the 1849 law. At a late June debate, Kleefisch said she would try to remove Wisconsin district attorneys who refuse to enforce the ban.

According to Jenny Higgins, director of UW-Madison’s Collaborative for Reproductive Equity, some Wisconsin abortion providers have considered breaking the law to help pregnant people. “We have some providers in our state who are so committed to these issues and would risk jail for performing an abortion,” she says. But Wisconsinites who want or need to end a pregnancy are now being routed westward to Minnesota, south to Illinois, or anywhere else in the country where they have a support network.

It’s happening regardless of the state’s pro-choice prosecutors and liberal state leaders.

“Before Dobbs came down, Higgins says, “what I was observing in our state was a sense—among people who are not in the know—of ease. In that, ‘Hey, even if Roe is overturned, things will be okay in Wisconsin because we have Josh Kaul and we have Gov. Tony Evers who will veto [anti-abortion laws].’ Those of us the research and care delivery side kept saying, ‘No you don’t understand.’ Services will cease immediately.”

And so they have.

Tue, 12 Jul 2022 03:01:00 -0500 Becca Andrews en-US text/html
Killexams : India’s abortion law progressive but excludes us, say trans men

Paras Dogra, a transgender who faced sexual abuse for years at the hand of his relatives, fears that if he is attacked or raped again, he might be forced to carry a baby to term.

Dogra, who lives in Kerala, says trans men are equally vulnerable in cases of violence and rape and at risk of being forced to carry to term pregnancies. “Yet, we are made to feel as if we do not deserve medical care,” says Dogra, 23.

After the latest reversal of the Roe vs Wade ruling in the US, Indian trans activists and allies have highlighted the dangers transgenders faces in the country and have been urging for legislation toward a more inclusive abortion law to include trans men with respect to their right to privacy and bodily autonomy.

Under India’s current abortion laws, pregnant women regardless of their marital status are protected and can choose to undergo the medical procedure per the Medical Termination of Pregnancy (MTP) Act, 1971.

Introduced in 2019, The Transgender Persons (Protection of Rights) Bill does prohibit discrimination against transgender people. The bill gives transgender persons a “right to self-perceived identity” but requires them to go through a government screening body to get themselves a trans certificate from a District Magistrate.

“I am just as much a human as you are,” says Dogra.

Dogra said he was sexually abused on multiple occasions by his maternal uncle and his grandfather until he was 19 years old. He says that being born a girl, “they have seen me like their property and since childhood, they have been doing this.” “As a trans person I was not allowed to be myself, and once they got to know that I was a trans they tried to be more strict with me,” he says.

Years of speaking out and fighting back resulted in further abuse until his father finally stepped in. His father tried to file an FIR and get in touch with a lawyer but he passed away before taking any further steps.


Dogra was able to escape his past with the help of Queerythm, an organisation focused on helping transgender people in India find safe homes. He now lives openly as a trans man. He now finds comfort in writing poems. As he gets onto the writing every morning, he calls it, “reconnecting with myself.”

Changing mindsets

Most experts agree that the solution to eliminating the fear is part education and part legislation.

Manavi Khurana, a counselling psychologist and the founder of The Karma Center for Counseling and Wellbeing (KCCW) in New Delhi, says safe sex education lies at the core of the conversation.

“A lot of trans persons are at the hands of brutality such as getting sexually assaulted and raped and have higher chances of contracting HIV and other STIs. Hence, information regarding certain preventative measures can be life-saving but unfortunately, it is not even publicised,” says Khurana.

“There are limited resources available for trans men when it comes to abortion which acts as an additional barrier to access.”she adds.

Sumedha Kathpalia, a clinical psychologist at KCCW, echoes similar views. “As a society, we are still very confused about sex and gender and are using it synonymously,” says Kathpalia.

KCCW works with several other networks to facilitate and “move towards a socially constructive aspect of gender on a non-binary stance.”

For healthcare workers like Kathpalia, abortion is a reproductive health issue that everyone should have access to. She says, “In our laws, even in the Trans Bill, there is limited talk about abortion. And there is no mention of particular identities and bodies in certain spaces.”

She says our laws need to be reinvented towards an intersection approach. “Living in a diverse country like India, you cannot ignore diversity at any point.”

‘Judgemental doctors’

After years of living by “adjusting” himself, Nishu Yadav, 21, who was born a woman in Uttar Pradesh’s Hathras district, decided to come out to his parents.

The next day, he said, they took him to a local doctor fearing that something was medically wrong with him. He recalls the doctor saying, “aisa kuch nahi hota” (there’s nothing like that). “The doctors here are also very unaware. So in such a situation, the question of giving abortion rights to trans men does not even arise,” says Yadav.

Recollecting his past experiences of being misgendered in hospitals by invasive doctors, Yadav says, “If a trans person is a victim of sexual assault and goes to the doctor to get an abortion, the doctor will ask ‘sau sawaal’ (hundred questions) about unnecessary details regarding the case. They might get personal ‘faltu mein’ (unnecessarily).”

transgender abortion rights, queer rights, LGBTQIA+ rights, transgender population in India, India's abortion law, transgender body, Indian Express United for Transgender Health after one of their session on “making menstruation gender inclusive” In collaboration with Project Dharini. (unitedfortransgenderhealth/Instagram screen grab)

He said he ran away from his “abusive” family that was assaulting him and forcing him to marry a cis man. After escaping for the fifth time, he now lives in one of the shelter homes in New Delhi, provided by the Ministry of Social Justice and Empowerment. Not-for-profit organisations such as United For Transgender Health (UTH) conduct various sessions at the shelter home from mobile photography to educating the trans community on menstrual health.

Yadav is currently taking oral testosterone capsules as part of his hormonal therapy to live as he has always wanted to. “I have a moustache now. And I look great!” says Yadav.

Yadav admits that he hasn’t undergone surgery yet, but has been taking hormones for over a year and no longer menstruates. “Even though I don’t think I can get pregnant now with my hormones, I’d still like to have the choice about my body to myself,” he says.

Trans rights activists say the fight for abortion rights and LGBTQIA+ rights are connected and both lie in the fundamentals of protecting one’s bodily autonomy and on the notion of privacy.


Dr Prateek Makwana, a Consultant Embryologist at Vasundhara Hospital Ltd, says the privacy or the identity of the person undergoing an abortion cannot be revealed by the hospital to anyone unless the court says so. However, he said, “It also depends on the doctors and a lot of the time, the doctors are very judgemental.”

Referring to the MTP Act, Dr Makwana says, “The medical language that they use doesn’t cater to the LGBTQIA + community. People with uteruses are not necessarily every time women, yet the law clearly states women as the point of concern.”

“To maintain their privacy and affordability they most probably resort to unsafe abortions.”

Gender-inclusive language

Experts point out that it all starts with acknowledging the existence of the LGBTQIA+ community and more specifically, in this case, trans men and including them in conversations around fundamental rights.

The United Nations says using gender-inclusive language is a powerful way to prevent gender bias and promote equality. Gender-inclusive language as described by the UN “means speaking and writing in a way that does not discriminate against a particular sex, social gender or gender identity, and does not perpetuate gender stereotypes.”

In the West, countries such as Canada have more gender-neutral abortion laws, where the language is “everyone/individual” instead of “women” who can have access to safe and consistent reproductive health services, including abortion. It also recognises the barriers faced by the LGBTQIA+ community and under its project, Action Canada, financially helps individuals to term pregnancies in a stigma-free manner.

Striving for tailored reproductive and sexual health care, there are trans folks who want to be a parent like any other cis-gendered woman and get access to medical care without being subjected to misgendering.

transgender abortion rights, queer rights, LGBTQIA+ rights, transgender population in India, India's abortion law, transgender body, Indian Express

One such person is Akshay (name changed on purpose), who gave birth to two children but now identifies as a man. In a podcast episode titled, “Can men get pregnant?” by The YP Foundation, Akshay, who is also a queer affirmative therapist, talked about how he took his children on his journey from being their mother to a father now.

Despite the transition, he refrains from identifying himself as a trans man. He says, “The word trans is an adjective. Why pay so much importance to an adjective?”

After four and a half years of adapting, his children now call him appa (father in Tamil). “When I first got pregnant, I just couldn’t believe that this was happening. It just gave me so much unhappiness to see the bumps and feel the kicks,” he says.

He admits the state of worry he was going through was much higher as he was perceived as a woman throughout the process. But when the babies came out, he says he “was so euphoric”. “More so, the parental feeling at the time was too precious.”

In 2019, he got his gender affirmative surgery along with the warmth of his children and his ex-partner’s acceptance. At the same time, he said every transgender might not prefer surgery. Some would go for hormones and while others remain as they are physically, but continue to identify as whoever they want to be, he points out.

“Each journey is unique and we should at least supply this much space and respect their choice.”

Sat, 30 Jul 2022 04:53:00 -0500 en text/html
Killexams : Applied Therapeutics to Sponsor and Present at the 2022 Galactosemia Foundation Conference
  • Gold sponsor of the 2022 Galactosemia Foundation Conference; new website and educational resources as part of ongoing commitment to the Galactosemia community
  • Applied Therapeutics to present research and clinical update

NEW YORK, July 28, 2022 (GLOBE NEWSWIRE) -- Applied Therapeutics, Inc. APLT, a clinical-stage biopharmaceutical company developing a pipeline of novel drug candidates against validated molecular targets in indications of high unmet medical need, today announced its sponsorship and presentations at the 2022 Galactosemia Foundation Conference being held July 28-30 in Orlando, Florida.

"We are proud to be a gold sponsor of the Galactosemia Foundation Conference, and to sponsor the Galactosemia Foundation's new website and educational resources to help families navigate the challenges of living with Galactosemia," said Shoshana Shendelman, PhD, CEO, Founder and Chair of the Board of Applied Therapeutics. "The Galactosemia Conference is a unique event, bringing together patients, families, and researchers to work together towards a shared goal of improving the lives of patients with Galactosemia."

"Galactosemia is a serious progressive disease that significantly impacts quality of life. Long-term complications are caused by galactitol, a toxic metabolite of galactose," said Riccardo Perfetti, MD, PhD, Chief Medical Officer of Applied Therapeutics. "We look forward to providing the community with an update on our research at the conference, and express our deep appreciation to the patients, families and researchers who have made this work possible."

"Applied Therapeutics is a strong partner to the Galactosemia community and the Galactosemia Foundation. We are excited to launch our new website and resources at the Galactosemia Conference, which would not have been possible without the support of Applied Therapeutics," said Nicole Casale, President of the Galactosemia Foundation.

Applied Therapeutics Presentation Details

Presentation: Applied Therapeutics Update
Shoshana Shendelman, PhD, CEO and Founder, Applied Therapeutics
Date and Time: Friday, July 29, 2022, 11:30 AM EST

Presentation: ACTION-Galactosemia Clinical Program Update
Shoshana Shendelman, PhD, CEO and Founder, Applied Therapeutics; Riccardo Perfetti, MD, PhD, Chief Medical Officer, Applied Therapeutics; Evan Bailey, MD, Executive Medical Director, Applied Therapeutics
Date and Time: Friday, July 29, 2022, 1:30 PM EST

Meet-the-Expert Panel
Riccardo Perfetti, MD, PhD, Chief Medical Officer, Applied Therapeutics; Laura Saltonstall, MD, MBA, Vice President of Medical Affairs, Applied Therapeutics; Evan Bailey, MD, Executive Medical Director, Applied Therapeutics
Date and Time: Saturday, July 30, 2022, 1:30 PM EST

For additional information on the Galactosemia Conference and to register, please visit: 

To access the Galactosemia Foundation's new website and resources, please visit: 

About AT-007

AT-007 is a central nervous system (CNS) penetrant Aldose Reductase inhibitor (ARI) in development for the treatment of several rare neurological diseases, including Galactosemia, SORD Deficiency, and PMM2-CDG. In clinical trials, AT-007 significantly reduced plasma galactitol levels vs. placebo in adults and children with Galactosemia. AT-007 is currently being studied in a Phase 3 clinical outcomes trial (ACTION-Galactosemia Kids) in children ages 2-17 with Galactosemia, as well as a long-term open-label study in adults with Galactosemia. In a pilot study, AT-007 significantly reduced blood sorbitol levels in adults with SORD Deficiency. AT-007 is currently being studied in a Phase 3 trial (INSPIRE) investigating biomarker efficacy, clinical outcomes, and significantly reduced blood sorbitol levels in adults with SORD Deficiency. AT-007 has received both Orphan Drug and Pediatric Rare Disease designations from the U.S. Food and Drug Administration (FDA) for the treatment of Galactosemia and PMM2-CDG, and Fast Track designation for Galactosemia.

About Applied Therapeutics

Applied Therapeutics is a clinical-stage biopharmaceutical company developing a pipeline of novel drug candidates against validated molecular targets in indications of high unmet medical need. The Company's lead drug candidate, AT-007, is a novel central nervous system penetrant Aldose Reductase Inhibitor (ARI) for the treatment of CNS rare metabolic diseases, including Galactosemia, SORD Deficiency, and PMM2-CDG. The Company is also developing AT-001, a novel potent ARI, for the treatment of Diabetic Cardiomyopathy, or DbCM, a fatal fibrosis of the heart. The preclinical pipeline also includes AT-003, an ARI designed to cross through the back of the eye when dosed orally, for the treatment of Diabetic retinopathy, as well as novel dual PI3k inhibitors in preclinical development for orphan oncology indications.

To learn more, please visit and follow the company on Twitter @Applied_Tx.

Forward-Looking Statements

This press release contains "forward-looking statements" that involve substantial risks and uncertainties for purposes of the safe harbor provided by the Private Securities Litigation Reform Act of 1995. Any statements, other than statements of historical fact, included in this press release regarding strategy, future operations, prospects, plans and objectives of management, including words such as "may," "will," "expect," "anticipate," "plan," "intend," and similar expressions (as well as other words or expressions referencing future events, conditions or circumstances) are forward-looking statements. Forward-looking statements in this release involve substantial risks and uncertainties that could cause real results to differ materially from those expressed or implied by the forward-looking statements, and we, therefore cannot assure you that our plans, intentions, expectations, or strategies will be attained or achieved.

Such risks and uncertainties include, without limitation, factors that may cause real results to differ from those expressed or implied in the forward-looking statements in this press release are discussed in our filings with the U.S. Securities and Exchange Commission, including the "Risk Factors" contained therein. Except as otherwise required by law, we disclaim any intention or obligation to update or revise any forward-looking statements, which speak only as of the date they were made, whether as a result of new information, future events or circumstances or otherwise.



Maeve Conneighton
(212) 600-1902


Applied Therapeutics, Inc.

© 2022 Benzinga does not provide investment advice. All rights reserved.

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Killexams : Union Health Minister Dr Mansukh Mandaviya addresses inaugural ceremony of training programme for senior administrative medical officers of CGHS Killexams : Union Health Minister Dr Mansukh Mandaviya addresses inaugural ceremony of training programme for senior administrative medical officers of CGHS – Odisha Diary
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