This might sound silly but the more time goes by the more I miss the pre-streaming era of TV. It was so delightfully simple. Sitcoms slap so much harder when you see the same episodes more than once a week.

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Star Trek: Voyager

Yes this show ended some time ago; that doesn’t mean that it’s not still underrated.

A relative late convert to Star Trek, this author committed to traversing the Delta Quadrant having finished The Original Series, The Next Generation, Discovery & Picard to date. Deep Space Nine is next; like the Doctor I don’t know anything about this ‘Dominion’ but they seem important and we’ll get there.

Having now finished Voyager, here’s the (spoiler-filled) thoughts of someone who came to the bridge afresh and savoured the light-hearted nature of the show. Yes TNG demanded more attention and the episodes herein that do are generally better, but for relaxed, semi-serialised adventure Voyager is a high point.

We’ll start with the negative and get to the fun stuff.

From the get-go there was a jarring disconnect between the premise and goals of the show. If a ship more advanced than any in the region is travelling really fast in one direction they’re not going to keep running into the same people; better begetting a saga poised for episodic rather than serialised fiction. The writers and audience were evidently a little tired at this point of TNG’s slavish devotion to wrapping everything up in 40-odd minutes so wanted to try variations on a theme; it was the right approach for the time accompanied by a smart premise that didn’t match.

And a stellar premise it was only set to be buoyed by the Federation-Marquis dynamic. Also partly squandered, corresponding grounds for strong tension and stories were left by the wayside – characterised by Chakotay’s ill-established, apparently immediate and seemingly endless trust in Janeway; together major failings of the show.

On continuity, and just so it’s out of the way; no they don’t show it but it’s clear the crew just manufactured more photon torpedoes like they did so much else.

Commencing with one of the best episodes, there is rarely a subsequent moment as character-defining as Janeway destroying the array. Don’t get me wrong, Kate Mulgrew is great, but she alike Kirk and Picard are, as fleshed out as they become, for stretches bare variations on a tired theme; young headstrong hotshot dedicates their life to the stars to become a reasoned, seasoned Commander. ‘Tapestry’ did it best and there was no need to explore this further.

Voyager had a general problem with characters that took several seasons to grow; it was a long time before Neelix stopped being grating and his earnestness became endearing. There is too very little you can relay about Tuvak beyond his being a Vulcan and a little sardonic, or Harry besides his yearning for advancement or Chakotay aside his membership of the Marquis and focus on his cultural background.

The stand-out worst episode of the entire show was Chakotay finding out that the Sky Spirits central to his people’s religion were actually from the Delta Quadrant; you can garner Robert Beltran’s clear ambivalence (at best) to such material. This author is aware of the significant tension between the actor and others on set; I can understand the frustration at a lead cast member belittling the series in public but the directions and emphasis the character took in later seasons was something else, as were the music cues whenever his or some others’ cultures came up.

Star Trek, and notably The Original Series, is often (but not always) shrewd for both telling stories addressing the place of culture, religion and community in people’s lives while not overly if at all drawing attention to particular characters’ backgrounds. To Beltran’s credit, he only made the disaffection perceptible on screen in the episodes that were of poor taste, as opposed to the ones that were just bad. There are many lousy episodes of The Original Series but what near always makes it enjoyable is Shatner et al’s absolute commitment to the bit. One of the very worst episodes of Voyager is the one where Harry is lead to believe that he’s actually from a planet in the Delta Quadrant full of attractive women; yet no one in Star Trek ever needs to look bored reading their lines. There are good ones and bad ones and we’re along for the whole ride.

There’s also that one where Tom and the Captain turn into salamanders, start life on a random planet and somehow transform back into their usual selves with these shenanigans never brought up again. Yeah that was awful but it was preceded by a generally decent few acts centred on exceeding warp limits; reputation aside it wasn’t quite down there.

On Alpha Quadrant folks being in the Delta Quadrant, as much as I missed the Klingons they did not need to rock up latently and near the very end; there were plenty of better ways to give B’Elanna an arc. One of the more interesting characters, she offered a variation on Worf’s overwhelming pride as a Klingon, though she barely got enough episodes to shine and these were predominantly featured much later on. And when the show stopped pretending Tom was the cocky pilot we’ve seen dozens of times before he too managed to get a whole lot more interesting.

It would have made a lot more sense for McNeill to just directly continue his character from TNG’s ‘The First Duty;’ alas.

Also welcome were the insights into the Borg; even if they became a lot less eerie it was great to learn that much more about them, though nothing, save the introduction of Seven, bettered the recuperating drones who were the ship’s first Borg encounter. The Borg children were also very funny (the related Voyager pick-ups in Picard were excellent) and should have stayed on the ship longer so Seven could say more things like “fun will now commence;” she can only say “Naomi Wildman” deadpan, as good as it was, so many times.

Heralded by such a superb actress, Seven and the Doctor thrillingly shared dual arcs akin but distinct to Data’s and each other’s, permitting us to relish their gradual growth and revel in their leaps forward. Seven’s narrowing down of eligible crewmen, unlike Chakotay’s later courting, was a particular highlight, as was her month of isolation when the crew were in stasis and the one where the Doctor overtook her node.

The Doctor however emerges the best character, far and above all others save the near as interesting Seven. Picardo’s charisma and stage presence, well-befitting an exaggeratedly humanistic, bombastic piece of programming, only propelled the most relatable arcs in the series; his desire to fit in and, as any, make a contribution. The Doctor’s opening number in ‘Tinker, Tenor, Doctor, Spy,’ but one occasion where Picardo’s vocal abilities were graciously integrated into the series, by this author’s judgement is the funniest sequence in seven seasons.

‘Message in a Bottle’ with the Doctor centre was too among the very best of the series. Mining any opportunity for comedy we can nonetheless be grateful, alike TNG, that they kept the bald jokes to about one per season.

As asides, it was lovely to see Reginald Barclay return and realise his aspirations in one of the best and most heart-warming episodes of the saga, while the singular and very obvious inspiration one episode draws from Predator proved amusing for just being so unabashed.  

‘Scorpion’ was amazing as was anything to do with Species 8472. Captain Proton, acknowledging the entire franchise’s schlocky roots, was a definite recurring highlight, with Mulgrew in one installment clearly having no end of fun alike the cast’s enjoyable turns in late 90’s Los Angeles alongside Sarah Silverman. Speaking of guest stars, seeing The Rock was a nice surprise though with hindsight they may never have cast him given Star Trek shrewdly chose to not have celebrity appearances overshadow the show. But hey, they can’t see the future; at least cleverly opting to obscure Jason Alexander in piles of costuming.

‘Year of Hell’ is good, but the premise befitted an entire season and alike the lacklustre finale nothing really matters (with some well-executed exceptions) if you can just go back in or erase time. There were many, many episodes that shouldn’t have been contained within forty minutes and deserved longer-form devotion, ala ‘30 Days.’ ‘Timeless’was a much better (and unusually technically-focused) variation on the aforementioned themes and it was fun to catch Geordi, as it was Deanna and especially Sulu. ‘The Omega Directive’ was cool; ‘The Thaw’ was great.

The fable-esque nature of the franchise has always been enjoyable and digestible given the show is partially aimed at kids, though there are episodes where it’s just a little too direct, and characters take a little too much pause. ‘Alice,’ the one where Tom almost cheats with his ship as an overly obvious parallel about why you shouldn’t have sex with other people if you have a girlfriend, if a good lesson, in execution was a tad much.

On reflection this author was surprised to discover some of the least generally favoured episodes, among them the Fairhaven double. It may be my great personal affection for Ireland but it makes perfect sense that given the time available this sort of world would be created and characters might pursue holo-relationships, a theme underexplored in Voyager yet still covered to great effect. The established technical deficiencies of holo-technology in such regular use should not come as a surprise when they recur.  

The one where Kes comes back was actually a later highlight; her character was never very well handled and no it wasn’t that blast off into the sunset but sometimes old friends lose their way and it’s the job of old friends to set them on the right path.

Most surprising was the dislike directed at ‘Tuvix.’ The difference between Voyager and much heavier sci-fi is that herein characters make a lot of decisions that are hard, not ones that are difficult. The destruction of the array was devastating but not morally questionable within the confines of the show. As a tangent, you could argue that had Janeway made the decision to return to the Alpha Quadrant at the beginning of the series that it would have been the morally correct decision given that, as we see in ‘Hope and Fear,’ another highlight, the ship would not otherwise have been a factor in much disorder and destruction. The show was not however so expansive philosophically as to greatly tread such ground as the franchise otherwise managed in the likes of ‘City on the Edge of Forever.’

In ‘Tuvix’ Janeway, a figure, like Chakotay, who often shifted characterisation to fit the requirements of any given story, was faced with a difficult decision with no easy moral out nor ethically unquestionable approach. It was a refreshing change and correspondingly dark denouement to boot apparent in the likes of ‘Latent Image,’ another fine instalment with the Doctor.

‘Eye of the Needle,’ the only episode this author has watched twice to date and a deeply empathetic early high point, save ‘Balance of Terror’ is the best treatment of the guarded but necessarily relatable Romulans (I haven’t seen all the movies!). ‘The Void’ bookends the show as a later stand out while the in respects not dissimilar ‘Night’ bears one of the darkest challenges and finest, most resonant endings.

This brings us to the ‘best episode;’ one featured regularly in top ten lists but seemingly not a very favourite.

‘Blink of an Eye’ is everything that is exceptional and aspirational about Star Trek. Stranded in the stratosphere of a planet where time passes with greater rapidity, the curious presence of Voyager in the skies begins to influence the society to the point where the inhabitants develop space travel to face the spectre.

A commentary on the Prime Directive as deft as any and a relatively novel variation on both the time travel and petri dish tropes resplendent throughout sci-fi and Star Trek, the episode is also a fabulous meta-commentary on the place of the franchise in popular culture much less crude than Janeway bemoaning the Doctor’s fleeting interplanetary fans’ obsession with every aspect of his personal life. Incorporating a fair bit more science than is typically par, the astronaut’s moving decision to help them, as with his staring into the heavens as Voyager finally departs, speaks to the selfless ethos and sense of overwhelming curiosity so intrinsic to the most basic lore of Star Trek, the most beloved episodes and all that Gene Roddenberry best achieved.

It’s also an amazing meditation on first contact principles and pitfalls which unlike many episodes doesn’t borrow story bones from TNG.

A more than welcome reprieve from a pandemic, I didn’t spend as long in the Delta Quadrant as the crew but for what I did I was glad to relish with them.

Star Trek: Voyager is now streaming on Netflix

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Discover more: Media Acquiring Method: The Novice's Guide

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5 tips to accelerate your company’s AI implementation

30-second summary:

The potential of artificial intelligence is almost boundless. AI solutions are starting to be introduced by organizations across many industries and fields.

A strong starting point for any AI implementation is to get buy-in from company decision-makers. If key stakeholders understand AI’s potential, they’ll properly resource any transition.

AI is particularly useful in the field of data analytics. If you are going to join the ‘Big Data’ era, you need robust data governance.

There’s no one-size-fits-all approach to AI implementation. You need to explore and test the different tools and solutions available to you.

Don’t neglect the human side of your business in seeking AI-driven answers to your problems. Make sure you train staff effectively in all automation or AI tools you introduce.

It’s not insider information to know the unmatched potential of company-wide AI implementation. Even with all the advancement in recent years, it still feels like we’re only beginning to see what artificial intelligence can do.

There are countless examples of enterprises across dozens of sectors using AI for diverse tasks and processes. Algorithms help firms to predict customer behavior and buying patterns, optimize supply chains, personalize experiences, understand your workforce, and even help you find Waldo. 

For some companies, though, implementing and accelerating full-scale implementation is a daunting prospect. Many have concerns over vendors, integration ability, cost, and privacy and regulatory issues. Is the juice even worth the squeeze given these challenges?

So, if you’re thinking of further adopting AI into your processes, or you have begun the transition and are finding it frustrating or tedious, here are five ways to reach your goals quicker.  

Source: McKinsey & Company

1) Secure executive sponsorship

Like SaaS examples before it, AI is ushering in a new way to do things compared to on-premise software. But with the change, comes challenge. Having C-suite buy-in is crucial for success.

The more informed and engaged the higher-ups are in the uses of AI, the better the chances of enterprise-wide adoption. “Strong executive leadership goes hand-in-hand with stronger AI adoption.

Respondents from firms that have successfully deployed an AI technology at scale tended to rate C-suite support nearly twice as high as those from companies that had not adopted AI technology,” according to this McKinsey Global Institute study. 

If there’s no business leader positioned to take the lead of your AI transition, you’re already off to a bad start. Make sure that those in executive positions are tasked with different facets of an AI integration program.

Each step also must be staffed appropriately to drive the process, without being afraid to change the management over the course of a campaign to be successful. 

Schedule a weekly teleconference with the key stakeholders to ensure roles are constantly refined, and everyone’s kept in the loop in terms of the adoption status. 

It’s also worth stressing that you – as the head of this campaign – need to be able to dictate resources, investment, and overall strategy across the organization. This includes actively engaging those around you for support with AI strategy, human and IT assets, and cultural adoption.

It would help if you made cultural adoption a priority by holding organizational leaders accountable as they execute the revisions needed to continue the transformation. C-suite must remove barriers and obstacles, both technical and cultural, to increase your chances of success. 

Once C-suite is aligned with your goals, you need to determine how you wish to manage and control the budget. That’s especially true if your current landscape is made up of competing internal analytics or AI efforts. 

Lastly, don’t forget to celebrate and communicate progress to your organization. This helps bolster the commitment from executives as well as gain support for the transformation.

Source: McKinsey & Company

2) Define data management and governance

Smarter and more accessible ‘self-service’ and team collaboration software brings with it an increase in data, data sources, and more end-user expectation.

As a result, the demand for proper data governance becomes essential. Without it, the data sits without a purpose in a data lake or warehouse. Look at it this way, more data without restriction can give businesses more freedom.

However, at an enterprise level, it can mean missed steps, inefficient outputs, and oversights. Faster analytics may become a problem before it feels like a solution.

It’s critical to address this with support from executives. This means defined resources to manage and enhance data collection, efficiency, and usage across all vital functions.

The data governance team must, additionally, set out and oversee data policies, standards, definitions, and manage data quality. 

Remember, not all data is equal. Define what needs executive control, and which data can be made publicly available for use. 

Given today’s availability of more user-friendly analytics and visualization tools, how much ‘self-service’ can be allowed to create better predictive models or different ways of creating new business processes? Who can define these datasets and use cases?

These are vital aspects to consider, as there’s a balance that needs to be struck between being rigid and protective and being flexible. This, again, highlights the importance of a useful data governance model.

Too much control can mean slow processes, lack of response, red-tape, the need for things like email verification, and overt use of business-led IT solutions.

Too much flexibility can mean different versions of the truth, leading to no real ownership or responsibility, conflict, and a reduction in productivity. 

Source: KPMG 

As you make decisions about AI, a data governance process allows you to implement and manage said decisions. Including who can access what, how much access, and what that access entails. 

3) Take a consider and test approach as opposed to success or failure

All AI adoptions are unique and present their own sets of challenges. And so, you need to begin all AI introductions with a ‘test and refine’ method as opposed to a ‘success or failure’ approach. 

Conventionally, analytical methods infer a defined relationship between variables. Trialing a one-sided hypothesis will either validate or reject it, but won’t uncover the hidden connection between the variables; the why. 

Creating hypotheticals for each step, and then using these learnings and experiences through the next ones is critical. It means refining and curating your AI deployment until it feels like a workable solution that delivers meaningful results is a much easier process. 

And, while this approach will inevitably extend deployment deadlines, it also allows you to fine-tune the outcome to incorporate real-life lessons learned.

If you’re integrating AI into computerised customer service like automated chatbots, it’s vital no matter where the customer goes there’s an answer waiting for them. It can’t work up until a certain point, it needs absolutes. Ultimate solutions will then align with the employee and end-user needs. 

Source: PWC

4) Spend time on change management and training

Deploying an AI API to ingest a new dataset is straightforward. However, altering the management and training for analysts who’ll be using these processes going forward is a challenge. 

Most forms of AI create automated decisions – “yes” or “no.” However, it is often the case that the integration of ML algorithms can allow for more subtle responses as well. These responses may be used in conjunction with existing processes to deliver the best results. 

For example, if an AI decision scores say, a loan application on a 1-10 scale of suitability, scores from 7-10 may yield an automatic yes.

However, anything lower will still require human input to grant or deny the application. If you’re integrating AI to analyze voice commands in a call center over VoIP communications, how can it distinguish commands deeper than just “option 1 or option 2”? 

Just as you would spend time training employees on how to use a specific process, the same is true for AI-based outcomes. 

Human employees may need to spend a few weeks analyzing the results coming back from the AI algorithms. That would give them a frame of reference in terms of how to interpret the scores best.

If you’re using an AI vendor, they can guide in terms of how to understand results and how employees can get the most out of the new system. Otherwise, learning how to create an online learning platform could be a worthwhile investment to get team members up to speed. 

AI isn’t ‘magic.’ It’s just a way to understand patterns and behaviors to deliver more accurate results and make predictions. AI only works when it has a defined problem to solve and the right metrics to succeed. If you haven’t clearly defined the issue you’ve bought AI in to solve, you won’t get the right solution. 

Source: Harvard Business Review

5) Consolidate and assimilate automation

As you ramp up enterprise-wide AI adoption, what these processes look like in the future will change with the introduction of a multitude of types of automation. From complete manual processes all the way to the adoption of RPA, and even more advanced AI protocols. 

It’s best to just (and I know it’s a big just) re-invent business processes from the ground up with AI in mind. You can then apply the best tool for the job at any given step.

Merely inserting RPA or AI into established processes may mean you miss out on all of its potential. You also need to consider the handoffs that need to happen as you further integrate. 

This includes human-machine or machine-machine learning. By streamlining the handoffs and making them more seamless and reliable, you can further enhance your future processes to be cost-effective, competitive, and agile. 

Source: Harvard Business Review

AI implementation can be sped up. However, it’s not necessarily about being smarter; it’s about making the right choices. Having executive buy-in combined with a defined data governance team is vital.

As is becoming fixated with data quality, dedicating enough time to change management, and having a test without defined expectations approach. 

If you’re finding your AI project taking up too much time, be patient. Like any kind of digital transformation, just as you’re approaching the finish line, you’ll likely encounter another hurdle. Overcome it, though, and the possibilities are boundless.   

John Allen is the director of global SEO at RingCentral, a global UCaaS, VoIP and video conferencing solutions provider. He has over 14 years of experience and an extensive background in building and optimizing digital marketing programs. He has written for websites such as Hubspot and BambooHR.

The post 5 tips to accelerate your company’s AI implementation appeared first on ClickZ.

source http://wikimakemoney.com/2020/06/30/5-tips-to-accelerate-your-companys-ai-implementation/

U.S. Medical Panel Thinks Twice About Pushing Cognitive Screening For Dementia

Navigating Aging

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment, click here.

Join the Navigating Aging Facebook Group.

See All Columns

[UPDATED at 11:30 a.m. ET]

A leading group of medical experts on Tuesday declined to endorse cognitive screening for older adults, fueling a debate that has simmered for years.

The U.S. Preventive Services Task Force said it could neither recommend nor oppose cognitive screening, citing insufficient scientific evidence of the practice’s benefits and harms and calling for further studies.

The task force’s work informs policies set by Medicare and private insurers. Its recommendations, an accompanying scientific statement and two editorials were published Tuesday in the Journal of the American Medical Association.

The task force’s new position comes as concern mounts over a rising tide of older adults with Alzheimer’s disease and other dementias and treatments remain elusive. Nearly 6 million Americans have Alzheimer’s disease; that population is expected to swell to nearly 14 million by 2050.

Because seniors are at higher risk of cognitive impairment, proponents say screening ― testing people without any symptoms — is an important strategy to identify people with unrecognized difficulties and potentially lead to better care.

“This can start a discussion with your doctor: ‘You know, you’re having problems with your cognition, let’s follow this up,’” said Stephen Rao of Cleveland Clinic’s Lou Ruvo Center for Brain Health.

Opponents say the benefits of screening are unproven and the potential for harm is worrisome. “Getting a positive result can make someone wary about their cognition and memory for the rest of their life,” said Benjamin Bensadon, an associate professor of geriatric medicine at the University of Florida College of Medicine.

The task force’s stance is controversial, given how poorly the health care system serves seniors with memory and thinking problems. Physicians routinely overlook cognitive impairment and dementia in older patients, failing to recognize these conditions at least 50% of the time, according to several studies.

Email Sign-Up

Subscribe to KHN’s free Morning Briefing.

Sign Up

Please confirm your email address below:

Sign Up

When the Alzheimer’s Association surveyed 1,954 seniors in December 2018, 82% said they thought it was important to have their thinking or memory checked. But only 16% said physicians regularly checked their cognition.

What’s more, Medicare policies appear to affirm the value of screening. Since 2011, Medicare has required that physicians assess a patient’s cognition during an annual wellness visit. But only 19% of seniors took advantage of this voluntary benefit in 2016, the most recent year for which data is available.

Dr. Ronald Petersen, co-author of an editorial accompanying the recommendations, cautioned that they shouldn’t discourage physicians from evaluating older patients’ memory and thinking.

“There is increased awareness, both on the part of patients and physicians, of the importance of cognitive impairment,” said Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center. “It would be a mistake if physicians didn’t pay more attention to cognition and consider screening on a case-by-case basis.”

Similarly, seniors shouldn’t avoid addressing worrisome symptoms.

“If someone has concerns or a family member has concerns about their memory or cognitive abilities, they should certainly discuss that with their clinician,” said Dr. Douglas Owens, chair of the task force and a professor at Stanford University School of Medicine.

In more than a dozen interviews, experts teased out complexities surrounding this topic. Here’s what they told me:

Screening basics. Cognitive screening involves administering short tests (usually five minutes or less) to people without any symptoms of cognitive decline. It’s an effort to bring to light problems with thinking and memory that otherwise might escape attention.

Depending on the test, people may be asked to recall words, draw a clock face, name the date, spell a word backward, relate a recent news event or sort items into different categories, among other tasks. Common tests include the Mini-Cog, the Memory Impairment Screen, the General Practitioner Assessment of Cognition and the Mini-Mental Status Examination.

The task force’s evaluation focuses on “universal screening”: whether all adults age 65 and older without symptoms should be given tests to assess their cognition. It found a lack of high-quality scientific evidence that this practice would improve older adults’ quality of life, ensure that they get better care or positively affect other outcomes such as caregivers’ efficacy and well-being.

A disappointing study. High hopes had rested on a study by researchers at Indiana University, published in December. In that trial, 1,723 older adults were screened for cognitive impairment, while 1,693 were not.

A year later, seniors in the screening group were not more depressed or anxious — important evidence of the lack of harm from the assessment. But the study failed to find evidence that people screened had a better health-related quality of life or lower rates of hospitalizations or emergency department visits.

Two-thirds of seniors who tested positive for cognitive impairment in her study declined to undergo further evaluation. That’s consistent with findings from other studies, and it testifies to “how many people are terrified of dementia,” said Dr. Timothy Holden, an assistant professor at Washington University School of Medicine in St. Louis.

“What seems clear is that screening in and of itself doesn’t yield benefits unless it’s accompanied by appropriate diagnostic follow-up and care,” said Nicole Fowler, associate director of the Center for Aging Research at Indiana University’s Regenstrief Institute.

Selective screening. “Selective screening” for cognitive impairment is an alternative to universal screening and has gained support.

In a statement published last fall, the American Academy of Neurology recommended that all patients 65 and older seen by neurologists get yearly cognitive health assessments. Also, the American Diabetes Association  recommends that all adults with diabetes age 65 and older be screened for cognitive impairment at an initial visit and annually thereafter “as appropriate.” And the American College of Surgeons now recommends screening older adults for cognitive impairment before surgery.

Why test select groups? Many patients with diabetes or neurological conditions have overlapping cognitive symptoms and “it’s important to know if a patient is having trouble remembering what the doctor said,” said Dr. Norman Foster, chair of the workgroup that developed the neurology statement and a professor of neurology at the University of Utah.

Physicians may need to alter treatment regimens for older adults with cognitive impairment or work more closely with family members. “If someone needs to manage their own care, it’s important to know if they can do that reliably,” Foster said.

With surgery, older patients who have preexisting cognitive impairments are at higher risk of developing delirium, an acute, sudden-onset brain disorder. Identifying these patients can alert medical staff to this risk, which can be prevented or mitigated with appropriate medical attention.

Also, people who learn they have early-stage cognitive impairment can be connected with community resources and take steps to plan for their future, medically and financially. The hope is that, one day, medical treatments will be able to halt or slow the progression of dementia. But treatments currently available don’t fulfill that promise.

Steps after screening. Screening shouldn’t be confused with diagnosis: All these short tests can do is signal potential problems.

If results indicate reason for concern, a physician should ask knowledgeable family members or friends what’s going on with an older patient. “Are they depressed? Having problems taking care of themselves? Asking the same question repeatedly?” said Dr. David Reuben, chief of geriatrics at UCLA’s David Geffen School of Medicine and director of UCLA’s Alzheimer’s and Dementia Care program.

A comprehensive history and physical examination should then be undertaken to rule out potential reversible causes of cognitive difficulties, implicated in about 10% of cases. These include sleep apnea, depression, hearing or vision loss, vitamin B12 or folic acid deficiencies, alcohol abuse and side effects from anticholinergic drugs or other medications, among other conditions.

Once other causes are ruled out, neuropsychological tests can help establish a diagnosis.

“If I detect mild cognitive impairment, the first thing I’ll do is tell a patient I don’t have any drugs for that but I can help you compensate for deficits,” Reuben said. The good news, he said: A substantial number of patients with MCI ― about 50% — don’t develop dementia within five years of being diagnosed.

The bottom line. “If you’re concerned about your memory or thinking, ask your physician for an assessment,” said Dr. David Knopman, a neurologist at the Mayo Clinic. If that test indicates reason for concern, make sure you get appropriate follow-up.

That’s easier said than done if you want to see a dementia specialist, noted Dr. Soo Borson, a professor emerita of psychiatry at the University of Washington. “Everyone I know who’s doing clinical dementia care says they have wait lists of four to six months,” she said.

With shortages of geriatric psychiatrists, geriatricians, neuropsychologists and neurologists, there aren’t enough specialists to handle demands that would arise if universal screening for cognitive impairment were implemented, Borson warned.

If you’re a family member of an older adult who’s resisting getting tested, “reach out privately to your primary care physician and express your concerns,” said Holden of Washington University. “And let your doctor know if the person isn’t seeing these changes or is resistant to talk about it.”

This happens frequently because people with cognitive impairments are often unaware of their problems. “But there are ways that we, as physicians, can work around that,” Holden said. “If a physician handles the situation with sensitivity and takes things one step at a time, you can build trust and that can make things much easier.”

We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips.

U.S. Medical Panel Thinks Twice About Pushing Cognitive Screening For Dementia published first on https://smartdrinkingweb.weebly.com/

U.S. Medical Panel Thinks Twice About Pushing Cognitive Screening For Dementia

Navigating Aging

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment, click here.

Join the Navigating Aging Facebook Group.

See All Columns

[UPDATED at 11:30 a.m. ET]

A leading group of medical experts on Tuesday declined to endorse cognitive screening for older adults, fueling a debate that has simmered for years.

The U.S. Preventive Services Task Force said it could neither recommend nor oppose cognitive screening, citing insufficient scientific evidence of the practice’s benefits and harms and calling for further studies.

The task force’s work informs policies set by Medicare and private insurers. Its recommendations, an accompanying scientific statement and two editorials were published Tuesday in the Journal of the American Medical Association.

The task force’s new position comes as concern mounts over a rising tide of older adults with Alzheimer’s disease and other dementias and treatments remain elusive. Nearly 6 million Americans have Alzheimer’s disease; that population is expected to swell to nearly 14 million by 2050.

Because seniors are at higher risk of cognitive impairment, proponents say screening ― testing people without any symptoms — is an important strategy to identify people with unrecognized difficulties and potentially lead to better care.

“This can start a discussion with your doctor: ‘You know, you’re having problems with your cognition, let’s follow this up,’” said Stephen Rao of Cleveland Clinic’s Lou Ruvo Center for Brain Health.

Opponents say the benefits of screening are unproven and the potential for harm is worrisome. “Getting a positive result can make someone wary about their cognition and memory for the rest of their life,” said Benjamin Bensadon, an associate professor of geriatric medicine at the University of Florida College of Medicine.

The task force’s stance is controversial, given how poorly the health care system serves seniors with memory and thinking problems. Physicians routinely overlook cognitive impairment and dementia in older patients, failing to recognize these conditions at least 50% of the time, according to several studies.

Email Sign-Up

Subscribe to KHN’s free Morning Briefing.

Sign Up

Please confirm your email address below:

Sign Up

When the Alzheimer’s Association surveyed 1,954 seniors in December 2018, 82% said they thought it was important to have their thinking or memory checked. But only 16% said physicians regularly checked their cognition.

What’s more, Medicare policies appear to affirm the value of screening. Since 2011, Medicare has required that physicians assess a patient’s cognition during an annual wellness visit. But only 19% of seniors took advantage of this voluntary benefit in 2016, the most recent year for which data is available.

Dr. Ronald Petersen, co-author of an editorial accompanying the recommendations, cautioned that they shouldn’t discourage physicians from evaluating older patients’ memory and thinking.

“There is increased awareness, both on the part of patients and physicians, of the importance of cognitive impairment,” said Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center. “It would be a mistake if physicians didn’t pay more attention to cognition and consider screening on a case-by-case basis.”

Similarly, seniors shouldn’t avoid addressing worrisome symptoms.

“If someone has concerns or a family member has concerns about their memory or cognitive abilities, they should certainly discuss that with their clinician,” said Dr. Douglas Owens, chair of the task force and a professor at Stanford University School of Medicine.

In more than a dozen interviews, experts teased out complexities surrounding this topic. Here’s what they told me:

Screening basics. Cognitive screening involves administering short tests (usually five minutes or less) to people without any symptoms of cognitive decline. It’s an effort to bring to light problems with thinking and memory that otherwise might escape attention.

Depending on the test, people may be asked to recall words, draw a clock face, name the date, spell a word backward, relate a recent news event or sort items into different categories, among other tasks. Common tests include the Mini-Cog, the Memory Impairment Screen, the General Practitioner Assessment of Cognition and the Mini-Mental Status Examination.

The task force’s evaluation focuses on “universal screening”: whether all adults age 65 and older without symptoms should be given tests to assess their cognition. It found a lack of high-quality scientific evidence that this practice would improve older adults’ quality of life, ensure that they get better care or positively affect other outcomes such as caregivers’ efficacy and well-being.

A disappointing study. High hopes had rested on a study by researchers at Indiana University, published in December. In that trial, 1,723 older adults were screened for cognitive impairment, while 1,693 were not.

A year later, seniors in the screening group were not more depressed or anxious — important evidence of the lack of harm from the assessment. But the study failed to find evidence that people screened had a better health-related quality of life or lower rates of hospitalizations or emergency department visits.

Two-thirds of seniors who tested positive for cognitive impairment in her study declined to undergo further evaluation. That’s consistent with findings from other studies, and it testifies to “how many people are terrified of dementia,” said Dr. Timothy Holden, an assistant professor at Washington University School of Medicine in St. Louis.

“What seems clear is that screening in and of itself doesn’t yield benefits unless it’s accompanied by appropriate diagnostic follow-up and care,” said Nicole Fowler, associate director of the Center for Aging Research at Indiana University’s Regenstrief Institute.

Selective screening. “Selective screening” for cognitive impairment is an alternative to universal screening and has gained support.

In a statement published last fall, the American Academy of Neurology recommended that all patients 65 and older seen by neurologists get yearly cognitive health assessments. Also, the American Diabetes Association  recommends that all adults with diabetes age 65 and older be screened for cognitive impairment at an initial visit and annually thereafter “as appropriate.” And the American College of Surgeons now recommends screening older adults for cognitive impairment before surgery.

Why test select groups? Many patients with diabetes or neurological conditions have overlapping cognitive symptoms and “it’s important to know if a patient is having trouble remembering what the doctor said,” said Dr. Norman Foster, chair of the workgroup that developed the neurology statement and a professor of neurology at the University of Utah.

Physicians may need to alter treatment regimens for older adults with cognitive impairment or work more closely with family members. “If someone needs to manage their own care, it’s important to know if they can do that reliably,” Foster said.

With surgery, older patients who have preexisting cognitive impairments are at higher risk of developing delirium, an acute, sudden-onset brain disorder. Identifying these patients can alert medical staff to this risk, which can be prevented or mitigated with appropriate medical attention.

Also, people who learn they have early-stage cognitive impairment can be connected with community resources and take steps to plan for their future, medically and financially. The hope is that, one day, medical treatments will be able to halt or slow the progression of dementia. But treatments currently available don’t fulfill that promise.

Steps after screening. Screening shouldn’t be confused with diagnosis: All these short tests can do is signal potential problems.

If results indicate reason for concern, a physician should ask knowledgeable family members or friends what’s going on with an older patient. “Are they depressed? Having problems taking care of themselves? Asking the same question repeatedly?” said Dr. David Reuben, chief of geriatrics at UCLA’s David Geffen School of Medicine and director of UCLA’s Alzheimer’s and Dementia Care program.

A comprehensive history and physical examination should then be undertaken to rule out potential reversible causes of cognitive difficulties, implicated in about 10% of cases. These include sleep apnea, depression, hearing or vision loss, vitamin B12 or folic acid deficiencies, alcohol abuse and side effects from anticholinergic drugs or other medications, among other conditions.

Once other causes are ruled out, neuropsychological tests can help establish a diagnosis.

“If I detect mild cognitive impairment, the first thing I’ll do is tell a patient I don’t have any drugs for that but I can help you compensate for deficits,” Reuben said. The good news, he said: A substantial number of patients with MCI ― about 50% — don’t develop dementia within five years of being diagnosed.

The bottom line. “If you’re concerned about your memory or thinking, ask your physician for an assessment,” said Dr. David Knopman, a neurologist at the Mayo Clinic. If that test indicates reason for concern, make sure you get appropriate follow-up.

That’s easier said than done if you want to see a dementia specialist, noted Dr. Soo Borson, a professor emerita of psychiatry at the University of Washington. “Everyone I know who’s doing clinical dementia care says they have wait lists of four to six months,” she said.

With shortages of geriatric psychiatrists, geriatricians, neuropsychologists and neurologists, there aren’t enough specialists to handle demands that would arise if universal screening for cognitive impairment were implemented, Borson warned.

If you’re a family member of an older adult who’s resisting getting tested, “reach out privately to your primary care physician and express your concerns,” said Holden of Washington University. “And let your doctor know if the person isn’t seeing these changes or is resistant to talk about it.”

This happens frequently because people with cognitive impairments are often unaware of their problems. “But there are ways that we, as physicians, can work around that,” Holden said. “If a physician handles the situation with sensitivity and takes things one step at a time, you can build trust and that can make things much easier.”

We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips.

from Updates By Dina https://khn.org/news/u-s-medical-panel-thinks-twice-about-pushing-cognitive-screening-for-dementia/

U.S. Medical Panel Thinks Twice About Pushing Cognitive Screening For Dementia

Navigating Aging

Navigating Aging focuses on medical issues and advice associated with aging and end-of-life care, helping America’s 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment, click here.

Join the Navigating Aging Facebook Group.

See All Columns

A leading group of medical experts on Tuesday declined to endorse cognitive screening for older adults, fueling a debate that has simmered for years.

The U.S. Preventive Services Task Force said it could neither recommend nor oppose cognitive screening, citing insufficient scientific evidence of the practice’s benefits and harms and calling for further studies.

The task force’s work informs policies set by Medicare and private insurers. Its recommendations, an accompanying scientific statement and two editorials were published Tuesday in the Journal of the American Medical Association.

The task force’s new position comes as concern mounts over a rising tide of older adults with Alzheimer’s disease and other dementias and treatments remain elusive. Nearly 6 million Americans have Alzheimer’s disease; that population is expected to swell to nearly 14 million by 2050.

Because seniors are at higher risk of cognitive impairment, proponents say screening ― testing people without any symptoms — is an important strategy to identify people with unrecognized difficulties and potentially lead to better care.

“This can start a discussion with your doctor: ‘You know, you’re having problems with your cognition, let’s follow this up,’” said Stephen Rao of Cleveland Clinic’s Lou Ruvo Center for Brain Health.

Opponents say the benefits of screening are unproven and the potential for harm is worrisome. “Getting a positive result can make someone wary about their cognition and memory for the rest of their life,” said Benjamin Bensadon, an associate professor of geriatric medicine at the University of Florida College of Medicine.

The task force’s stance is controversial, given how poorly the health care system serves seniors with memory and thinking problems. Physicians routinely overlook cognitive impairment and dementia in older patients, failing to recognize these conditions at least 50% of the time, according to several studies.

Email Sign-Up

Subscribe to KHN’s free Morning Briefing.

Sign Up

Please confirm your email address below:

Sign Up

When the Alzheimer’s Association surveyed 1,954 seniors in December 2018, 82% said they thought it was important to have their thinking or memory checked. But only 16% said physicians regularly checked their cognition.

What’s more, Medicare policies appear to affirm the value of screening. Since 2011, Medicare has required that physicians assess a patient’s cognition during an annual wellness visit if the patient asks for a checkup of this kind. But only 19% of seniors took advantage of this benefit in 2016, the most recent year for which data is available.

Dr. Ronald Petersen, co-author of an editorial accompanying the recommendations, cautioned that they shouldn’t discourage physicians from evaluating older patients’ memory and thinking.

“There is increased awareness, both on the part of patients and physicians, of the importance of cognitive impairment,” said Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center. “It would be a mistake if physicians didn’t pay more attention to cognition and consider screening on a case-by-case basis.”

Similarly, seniors shouldn’t avoid addressing worrisome symptoms.

“If someone has concerns or a family member has concerns about their memory or cognitive abilities, they should certainly discuss that with their clinician,” said Dr. Douglas Owens, chair of the task force and a professor at Stanford University School of Medicine.

In more than a dozen interviews, experts teased out complexities surrounding this topic. Here’s what they told me:

Screening basics. Cognitive screening involves administering short tests (usually five minutes or less) to people without any symptoms of cognitive decline. It’s an effort to bring to light problems with thinking and memory that otherwise might escape attention.

Depending on the test, people may be asked to recall words, draw a clock face, name the date, spell a word backward, relate a recent news event or sort items into different categories, among other tasks. Common tests include the Mini-Cog, the Memory Impairment Screen, the General Practitioner Assessment of Cognition and the Mini-Mental Status Examination.

The task force’s evaluation focuses on “universal screening”: whether all adults age 65 and older without symptoms should be given tests to assess their cognition. It found a lack of high-quality scientific evidence that this practice would improve older adults’ quality of life, ensure that they get better care or positively affect other outcomes such as caregivers’ efficacy and well-being.

A disappointing study. High hopes had rested on a study by researchers at Indiana University, published in December. In that trial, 1,723 older adults were screened for cognitive impairment, while 1,693 were not.

A year later, seniors in the screening group were not more depressed or anxious — important evidence of the lack of harm from the assessment. But the study failed to find evidence that people screened had a better health-related quality of life or lower rates of hospitalizations or emergency department visits.

Two-thirds of seniors who tested positive for cognitive impairment in her study declined to undergo further evaluation. That’s consistent with findings from other studies, and it testifies to “how many people are terrified of dementia,” said Dr. Timothy Holden, an assistant professor at Washington University School of Medicine in St. Louis.

“What seems clear is that screening in and of itself doesn’t yield benefits unless it’s accompanied by appropriate diagnostic follow-up and care,” said Nicole Foster, associate director of the Center for Aging Research at Indiana University’s Regenstrief Institute.

Selective screening. “Selective screening” for cognitive impairment is an alternative to universal screening and has gained support.

In a statement published last fall, the American Academy of Neurology recommended that all patients 65 and older seen by neurologists get yearly cognitive health assessments. Also, the American Diabetes Association  recommends that all adults with diabetes age 65 and older be screened for cognitive impairment at an initial visit and annually thereafter “as appropriate.” And the American College of Surgeons now recommends screening older adults for cognitive impairment before surgery.

Why test select groups? Many patients with diabetes or neurological conditions have overlapping cognitive symptoms and “it’s important to know if a patient is having trouble remembering what the doctor said,” said Dr. Norman Foster, chair of the workgroup that developed the neurology statement and a professor of neurology at the University of Utah.

Physicians may need to alter treatment regimens for older adults with cognitive impairment or work more closely with family members. “If someone needs to manage their own care, it’s important to know if they can do that reliably,” Foster said.

With surgery, older patients who have preexisting cognitive impairments are at higher risk of developing delirium, an acute, sudden-onset brain disorder. Identifying these patients can alert medical staff to this risk, which can be prevented or mitigated with appropriate medical attention.

Also, people who learn they have early-stage cognitive impairment can be connected with community resources and take steps to plan for their future, medically and financially. The hope is that, one day, medical treatments will be able to halt or slow the progression of dementia. But treatments currently available don’t fulfill that promise.

Steps after screening. Screening shouldn’t be confused with diagnosis: All these short tests can do is signal potential problems.

If results indicate reason for concern, a physician should ask knowledgeable family members or friends what’s going on with an older patient. “Are they depressed? Having problems taking care of themselves? Asking the same question repeatedly?” said Dr. David Reuben, chief of geriatrics at UCLA’s David Geffen School of Medicine and director of UCLA’s Alzheimer’s and Dementia Care program.

A comprehensive history and physical examination should then be undertaken to rule out potential reversible causes of cognitive difficulties, implicated in about 10% of cases. These include sleep apnea, depression, hearing or vision loss, vitamin B12 or folic acid deficiencies, alcohol abuse and side effects from anticholinergic drugs or other medications, among other conditions.

Once other causes are ruled out, neuropsychological tests can help establish a diagnosis.

“If I detect mild cognitive impairment, the first thing I’ll do is tell a patient I don’t have any drugs for that but I can help you compensate for deficits,” Reuben said. The good news, he said: A substantial number of patients with MCI ― about 50% — don’t develop dementia within five years of being diagnosed.

The bottom line. “If you’re concerned about your memory or thinking, ask your physician for an assessment,” said Dr. David Knopman, a neurologist at the Mayo Clinic. If that test indicates reason for concern, make sure you get appropriate follow-up.

That’s easier said than done if you want to see a dementia specialist, noted Dr. Soo Borson, a professor emerita of psychiatry at the University of Washington. “Everyone I know who’s doing clinical dementia care says they have wait lists of four to six months,” she said.

With shortages of geriatric psychiatrists, geriatricians, neuropsychologists and neurologists, there aren’t enough specialists to handle demands that would arise if universal screening for cognitive impairment were implemented, Borson warned.

If you’re a family member of an older adult who’s resisting getting tested, “reach out privately to your primary care physician and express your concerns,” said Holden of Washington University. “And let your doctor know if the person isn’t seeing these changes or is resistant to talk about it.”

This happens frequently because people with cognitive impairments are often unaware of their problems. “But there are ways that we, as physicians, can work around that,” Holden said. “If a physician handles the situation with sensitivity and takes things one step at a time, you can build trust and that can make things much easier.”

We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care and advice you need in dealing with the health care system. Visit khn.org/columnists to submit your requests or tips.

U.S. Medical Panel Thinks Twice About Pushing Cognitive Screening For Dementia published first on https://nootropicspowdersupplier.tumblr.com/

My Education in the Patriarchy

Garry Wills

In 1962, I began teaching ancient Greek in the graduate school of the Johns Hopkins University. I was twenty-seven and looked younger, and some of my graduate students were almost as old and looked older, so I tried to adopt the manner of a Hopkins “Herr Doktor Professor,” hoping that would give me some authority in the classroom. In my first course, which was on Homer’s Iliad, an argumentative student kept up a disagreement on one Homeric point. When I could not convince her of my position, I huffily quoted Dr. Johnson to her: “I have found you an argument; but I am not obliged to find you an understanding.”

When I told my wife, Natalie, about that day’s class, she was shocked. I had used my position to humiliate a student who was just trying to get to the truth. When I told her the student was a woman (the sole woman student I had amid that hostile university atmosphere of 1962—undergraduate “co-eds” would not be admitted to Hopkins for another eight years), Natalie was distressed. I was not only humiliating a student but bullying her. She asked how I would feel if that happened to our then one-year-old daughter, Lydia, when she went to college. After being put in my place by Natalie, I tried to stay there (it is very helpful to marry someone smarter than yourself).

Even after that correction, I was ill-equipped to cope with the presence of women in a university. There were none in my classes when I was a graduate student at Yale, where they would not be admitted as undergraduates until six years after I got my doctorate. The fact that there was a woman in my graduate class at Hopkins was an oddity, as it would have been at many of the major universities in America. Women had been admitted to graduate programs at Hopkins beginning in 1907, but in a probably apocryphal but typical story, the great classicist Basil Lanneau Gildersleeve (1831–1924) complained that he could not teach the racy Athenian comic dramatist Aristophanes to women. His class was known for its scholarly thoroughness in dragging to light all the slyly dirty jokes in the plays. If he was forced to admit a woman to his Aristophanes class, he said, she would have to sit behind a screen, presumably so he could not see her blush and she could not see him squirm. That was the condescending attitude toward “the fair sex” of the day.

But our day at Hopkins was not much better than Gildersleeve’s. Though I kept the respect instilled by my wife for the one woman in my class, I did not appreciate the effort that student had had to make just to get there. I learned a little about that at my first faculty meeting to allot fellowship money to applicants for the department. When the résumé came up of a woman who clearly merited admission, our archaeologist, John Young, said that no fellowship money should be given to her. “That is just throwing away money that should be saved for those who will advance the profession. Why give money to a woman who, as soon as she becomes pregnant, will drop the profession and start taking care of her babies?” Young was no shining star of the classics world himself, and I would find over the years that some of the people most intent on showing that women could not meet high standards had barely met those standards themselves, if at all. Yet I did not argue with Young. Since I knew that the head of our small department was with him on this, I went along with the policy. No woman received any money over the six years I was in the department.

I knew that opposing the admission of women to protect the standards of the classics profession was a phony argument. I had come to Hopkins from the inaugural year of Harvard’s Center for Hellenic Studies in Washington, where I was part of the first class of six junior fellows (young scholars of promise given time off from teaching to develop their research). There were three fellows from America and three from abroad—one from Germany, one from England, one from Italy. The Italian, and our lone woman, was Anna Morpurgo. She was the youngest and clearly the brightest of us. She knew more languages than we did and knew them better.

One day, when we were debating which of Dostoevsky’s novels we considered his greatest, we were struck to find that she had not read any of them. But we soon learned the reason. She said she was waiting until she learned Russian to read him—which, we suspected, might happen tomorrow. Though all the members of this group except me went on to bright careers in philology, she became a particularly dazzling light at Oxford. Even while spending her year with us, she was making the world’s first lexicon of Mycenaean Greek, (“Linear B,” which had been deciphered just five years earlier), and she would prove later on, at Oxford, that the famed Hittite Hieroglyphics were not, in fact, Hittite. I cannot imagine any standards high enough to exclude (or even to faze) Anna.

*

My next full-time teaching job, after a decade as an adjunct professor at Hopkins, was in the history department of Northwestern University as its first Henry Luce Professor of American History. The opportunities available to women had changed dramatically in that interval. They were being hired for all kinds of jobs—never, of course, in proportion to their numbers in the population, but with increasing frequency. Once, when Natalie and I got on a commuter flight with a woman pilot (at a time when the major airlines were not hiring women), she said, “We were never safer,” since we knew that this pilot had to pass twice the scrutiny any male pilot did. Even advances for women, then, were also inhibitors: they had to earn it twice over.

The Northwestern history department that I joined in 1980 had a few women on the faculty, but two of them were especially overworked. There was such a demand, beyond their fields of American and Renaissance history, for their help—with women’s study groups and for individual counseling of women students—that the women on faculty kept asking for more women to be hired. That should not have been a problem, since there were plenty of candidates, as well as pressure from feminists to add female members of faculty as a mark of diversity.

That very demand made some uneasy about hiring women—or, for that matter, blacks or gays: Would we be seen as hiring them primarily because they were minorities? (Not that women are a minority except in the professional and governing ranks.) So there was especially intense scrutiny given to any of the women brought up for consideration and, once again, the most dubiously qualified male members of the faculty were often the most severe judges of candidates. This process was repeated often enough that our two star women faculty members soon left Northwestern and accepted offers at another school where they would not be overburdened in a department with so few women. That is, we lost two superb women colleagues because we would not hire completely qualified women who might not have been quite at their level.

This dynamic became clear to me when it was my turn to lead a search for our diplomatic historian post. The position had been empty after the retirement in 1980 of Richard Leopold, who had educated many political figures in his popular courses on international relations. Other searches had failed because diplomatic history was in that time a sensitive, if not radioactive, field: it had been in turmoil over cold war history, since bright young revisionists had put much of the blame for competition and escalation of nuclear threats on the United States, rather than laying all of the responsibility on the Soviet Union and its allies. To hire an eminent scholar—even if he (and they were still all men) were willing to move from the embattled post he had won—could be read as siding with the establishment, while hiring a younger voice might be seen, rightly or wrongly, as joining the revisionists.

Two searches had already foundered on this problem by the time my turn came to lead another. Prior effort had revealed that the least controversial senior professors were not interested in leaving their eminent posts, and the younger and more controversial ones had not found a receptive audience among my colleagues. Rather than repeat the earlier baffled searches, I corresponded with prominent older scholars who were above the field’s polarization, asking if they had recent or current students who deserved consideration and might be free of the bitterness of their seniors. After getting almost a dozen recommendations, I started reading just-finished or almost-finished dissertations of young candidates.

I circulated the more promising of these pieces of work to other members of the search committee, we conferred, and we agreed on what seemed an ideal candidate. She came with an enthusiastic recommendation from a famous scholar at the University of Chicago, who called her the best doctoral student he had ever had. Her dissertation was not complete, but it was already so solid that we sent it around the whole department and invited her to Evanston for an interview. She was asked searching questions, which was the praiseworthy practice of our history department, and she answered them carefully but timidly. She was understandably intimidated by a barrage of people determined to show they were not going to hire a woman unless she was above any suspicion of being chosen mainly or even partly because of her gender. Some said granting a position on the basis of an unfinished dissertation would set a bad precedent. I argued that her other work and interests, along with the championing of her adviser at the University of Chicago, made it certain that she would get the doctorate with honors. But she was rejected. I was so disgusted that I resigned my tenure as the Henry Luce Professor at Northwestern. I had spent most of a year hunting for this superbly qualified woman. I saw the same consideration at work that made us lose the two A-level women professors.

The university president, Arnold Weber, invited me to lunch to talk over my resignation. He asked me what had made me take such a rare step. I said I could not do the tasks rightly asked of me as a tenured professor: the time-consuming meetings for hiring, for firing, for tenure advancement, for curriculum changes, for debate on affirmative action and diversity. I told President Weber that these were appropriate debates, but I did not want to be perpetually embroiled in them. He said I could be excused from such debates and still maintain my tenure; but I did not think that was fair to other tenured members of the department. I said I could maintain a light teaching load as an adjunct professor spared all duties of tenure while I concentrated on writing books and long articles of political reportage for The New York Review of Books.

*

After observing the problems women encountered at the elite colleges where I taught, I noticed similar problems in the protest groups and radical communes I observed as a journalist covering the social turmoil around opposition to the Vietnam War. One commune in the Boston area was a kind of halfway house between the academy and the antiwar movement; several of its members were students or professors at Harvard. They claimed to be free of the “personality cult” found in other insurgent movements, but in fact they found it hard to ensure that they took turns at the “worker” chores with perfect equality. The most publicly recognized member was asked to write manifestos and recruit well-known participants to demonstrations, which made it hard for him to do his share of buying food, cooking, washing dishes, house-cleaning, ironing clothes, and taking out garbage. I was not surprised to find that the minority of women in the commune were doing a majority of these menial tasks.

In a different commune I wrote about in Canada, I found a tougher world of military deserters and draft refusers, and there as well I saw a natural leader doing the propaganda work of these activists, while the women complained that the political revolution their group was calling for did not reflect the sexual revolution actually happening in the world outside that of these radicals. The women were expected to service the men sexually, and they made little headway with their protests other than deserting the deserters.

The fact that such sexism was common on the left as well as the right really came home to me at the progressive Institute for Policy Studies in Washington. I had become a friend of the co-founders, Dick Barnet and Marc Raskin, who put me on the institute’s board. One of the most stylish and winning young fellows there was Ivanhoe Donaldson, the campaign genius of “Snick,” as the Student Non-Violent Coordinating Committee (SNCC) was known, who then became the campaign genius of Marion Barry, the District of Columbia mayor. Both Barry and Donaldson went to prison later—Barry for a few months on a drug possession charge, Donaldson for several years on an embezzlement conviction (he stole nearly $200,000 from city funds).

At the time I met him, though, Donaldson was a star of the early civil rights victories. He liked to tease a young fellow at the IPS for her earnest feminism. She had taken an early stand for a married woman’s keeping her maiden name, and Donaldson used to chant her “important” name as a way of lampooning her feminism. She called him a clear misogynist, but I wasn’t sure. Then, one night when I had been arguing with Donaldson and said I needed to drive home to Baltimore, he wanted to keep the argument going and invited me to dinner, saying I could spend the night in the apartment of a rich patron (he seemed always to have one) who was on a trip to Africa. On the way to dinner, we stopped by the home of a black congressman, who had a liberal white South African woman guest. She was defending a gradual elimination of her homeland’s apartheid system, and when she tried to shout down Donaldson’s objections, he slapped her, hard. He and I were thrown out of the house. Then I was ready to believe the common complaint of women that many of the civil rights leaders were sexual chauvinists.

The commune where I found the most nearly equal division of labor between men and women was different from others in that its pacifism was professedly religious. But this commune in Baltimore had different problems in sharing its workload. The political demonstrations it organized sometimes led to arrests, trials, or imprisonment. Those who were, at any time, engaged in an “action,” as they called it, or in court, or in jail, had to have their domestic assignments taken up by the members who remained at the communal home. And when their numbers were reduced in this way, the less committed members reverted to the stereotypes of “women’s work,” which reasserted themselves even here.

*

That I found women in these very different situations—the academy and the communes—having to fight for their rights is, with hindsight, not unusual, given the constraints that women faced until very recently. When my wife graduated from Sweet Briar in 1955, for example, there were few professional paths for women in her small town of Wallingford, Connecticut. They could marry and have children, a subordinate role economically, or they could try to make a living on their own—but as what? Friends of hers had to choose from a small range of possible jobs: some were teachers, some nurses, some nuns (who were themselves liable to work as teachers or nurses).

Natalie wanted to leave her small town, but her options were few. One path that was available was to become an airline stewardess (now called a flight attendant). But here, too, since the supply of women was ample, the demands of the airlines could be high: in those days, they hired only single women, chosen partly for looks, preferably with a college education. If a stewardess married, she lost her job. This made stewardesses a cut above a Playboy Bunny and a cut below a Miss America—all three emblems of that paternalistic era. An airline ad of the time promised “We really move our tail for you,” and showed attractive stewardesses serving food and drinks to airplane passengers like airborne Bunnies.

When Natalie went to Eastern Airline’s stewardess school in Florida, she was taught how best to use cosmetics for her face type. Though there was no swimsuit competition, her male interviewer asked her to wrap her skirt tight around her hips and derrière and turn around (it was a “New Look” skirt, voluminous and mid-calf, popularized in the 1950s by Christian Dior). The pretense for this demand was that it showed she could fit down the aisle of the plane, but it was clearly a way to grade her figure. As objectionable as this all was, I am glad she ran the gauntlet, since I would not have met her otherwise. She did not move her tail for me on the plane; she moved her mind, criticizing the book I was reading.

Today, though it is only a short time ago, it can be hard to remember the condition of women then. My wife and daughter often compared the differences for women in each of their generations. Natalie went to Sweet Briar, a women’s college, and became a stewardess. Lydia went to the recently gender-integrated Yale and became a literary agent. After Natalie and I were married, she could not get credit at our bank without my authorization. Just as I had seen at Hopkins and Northwestern, well into the 1960s, women were considered bad risks for professional positions.

At a 1992 American Bar Association meeting that I attended in San Francisco, there was a crowded lunch for the Bar’s women’s caucus. A speaker at the dais asked those in attendance to stand if they were, or had been, the first woman to be the editor of her law school’s journal, to be a partner in her firm, to be the dean of a law school, to be a state judge, a federal judge, a member of her state’s supreme court. By the end of this roll call, hundreds of women were standing, and this had all happened in their lifetimes. Nearly the same thing could have occurred at meetings of doctors, business executives, military leaders, or religious leaders. When I started using the library of the divinity school at Northwestern in 1980, almost all the students there were men preparing for the ministry. Today, most of the students I see in the library are women.

Alter the status of women and you have affected all the most intimate and significant nodes of life: the relation of wife to husband, mother to child, sister to sibling, daughter to parents, worker to coworkers, and employee to employer (or vice versa). This change in women’s standing that happened what seems like yesterday, and is still happening today at an accelerated rate, is the most profound revolution that can take place in a society. It takes and gives energy to all the other reforms of our time. After all, the civil rights movement involves black women, the LGBTQ movement concerns lesbians, the disability rights movement affects disabled women, health care reforms implicate women care-givers and the objects of their care. Raise any part of our society to a more just condition and justice for women is centrally at issue. It is the reform of all reforms and the basic measure of our progress.

November 4, 2019, 10:45 am

https://www.nybooks.com/daily/2019/11/04/my-education-in-the-patriarchy/

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10 of the Best Hip Stretches Ever

Life in the 21st century has given us many things: cheap communication… electric cars… personalized entertainment…

And tight hips.

Consider: all of the time you spend online (over 10 hours a day, by some estimates) — whether you’re drafting spreadsheets, posting on Instagram, or watching BatDad vine compilations — is also spent in a chair. That’s a lot of time for your hip joints to be stuck in a single position.

That’s a problem. “Elongated periods of sitting sends messages to certain muscles to stay turned on which keeps other muscles turned off,” says Beachbody fitness expert Cody Braun. “This creates an imbalance, which can immobilize your hips.” Your hips are built to move in almost any direction, explains Braun, and when they’re stiff, they don’t just make exercise more difficult; they also make you more prone to pain in surrounding joints — including the oft-troublesome lower back.

If, like most of us, your hip joints could use some TLC, help has arrived. All you need to do is spend a moment or two before and after your workouts — or, heck, while watching TV — on a time-honored fitness activity that few of us do enough of: stretching. Below, we’ll show you some of the best hip stretches to improve flexibility and mobility, hopefully making up for all that time on the couch.

Why Hip Mobility Is Important

Quick physiology lesson: when a joint becomes stiff and immobile, the joint above and below it moves to compensate. So if you can’t move your hips, you’ll move your lower back instead.

Know anyone with lower back pain?

Oh, that’s right — the overwhelming majority of Americans has lower back pain. If that includes you, you may benefit from making some or all of the hip stretches below part of your regular routine.

But mobile hip joints don’t just relieve pain. They’re also essential for walking, hiking, running, jumping, dancing, playing sports, and pursuing virtually any fitness goal safely and effectively. Want to develop stronger, more muscular legs? Hip mobility allows you to lunge and squat more deeply so you can reach your muscles’ potential. Want to avoid injury? Hip mobility improves range of motion so you can perform exercises more safely.

Anatomy of the Hips

The pelvis, that sturdy, bony structure that houses your hip joints, is the Grand Central Station of the body: dozens of different muscles, nerves, and tendons attach to and pass through it. The main ones you’ll focus on in your hip stretches are:

Hip flexors

These muscles extend roughly from your spine to your thighs. Their main job is to pull your thighs toward your chest. When they’re tight, they can pull the front of your pelvis downward, causing strain and pain in your lower back.

Hamstrings

This muscle group, including the biceps femoris muscle, runs along the backs of your thighs from your hips to your knees. Your hams oppose your quadriceps, bending your knee and helping to extend (straighten) your hip joints behind you.

Adductors

Located on the insides of your thighs, these muscles squeeze your legs together, and can cause tightness and limitation when you step laterally (sideways).

Glutes

The butt muscles work along with the hamstrings to extend, or straighten, your hips, and, with the aid of the abductors on the outsides of your hips, raise your legs out to the sides.

Stretch these four main areas to help increase mobility, and you’ll be good to go.

2 Main Types of Stretching and When to Use Them

The 10 hip stretches below, all culled from the extensive library of full-body workout programs available at Beachbody on Demand, offer two different stretching techniques: dynamic and static stretches, which you should use at different times.

Dynamic stretching

These are large, full-range movements of one or more joints at once, often performed standing and sometimes while walking or jogging. They resemble old-school movements you might have done in calisthenics or gym class: arm swings, leg swings, high-knee walks. You usually count off reps, rather than time, on dynamic stretches, which work best as a warm-up activity before a workout, or any time you need a pick-me-up boost throughout the day.

Static stretching

These movements are slower and mellower; they’re the reach-and-hold stretches you might see in a basic yoga or stretching class. Forward bends, knees-wide butterfly stretches, the pigeon, or the figure 4 pose in yoga are classic examples.

Often you’ll perform static stretches seated or lying down, and focus on breathing slowly and deeply to facilitate relaxation — sometimes for several minutes at a time. Static stretches can be very effective at loosening you up, but they also inhibit performance in the stretched muscles for a short time afterwards. So they’re best reserved for after a workout, or as an any-time stress reliever — just not right before a workout involving the muscles you’re stretching.

10 of the Best Pre- and Post-Workout Hip Stretches

Together with a healthy diet and a great workout program, the following hip stretches will leave you feeling and looking your best.

Seated Leg Cradle

Type of Stretch: Static

Benefits: Lengthens and relieves tension in the glutes, adductors, and hamstrings.

Appears in: Yoga Studio – Hip Opening With Faith

• Sit on the floor with both legs extended straight in front of you, feet flexed.

• Keeping your back straight, draw your right knee toward your chest, and try one or more of the following variations:

Holding your right knee in your right hand, grab your right ankle with your left hand and draw it toward your chest as far as you can.

Draw your right ankle toward your chest and rest your lower leg inside the creases of your elbows, bending them to draw your leg as close as you can to your chest.

Draw your right ankle toward your chest and wrap your arms around the lower leg, interlacing your fingers with your knee inside the crease of your right elbow and your foot inside the crook of your left. Hug your lower leg toward your chest as far as you can.

• Keeping your back flat, your chest up, and both feet flexed, rock slightly left and right.

• Hold for 30 seconds, then repeat on the other side.

Standing Butterfly Lift

Type of stretch: Dynamic

Benefits: Activates the glutes while improving mobility in the hip capsule (the ligament that attaches the leg to the pelvis) and adductors.

Appears in: Yoga Studio – Get Well Rounded With Elise

• Stand with your feet shoulder-width apart about 18 inches behind two yoga blocks positioned on the floor at the tallest height.

• Hinge forward at your hips and place your hands on the blocks. (If that’s too difficult, use a taller surface like a chair instead.)

• Bend your right knee, pulling your heel towards your right glute, and keep it there throughout the set. This is your starting position.

• Keeping your back flat and standing leg straight, lift your right knee as far out to your right side as you can.

• Reverse the move, lowering your right knee until it’s close to your left.

• Repeat for 10-12 controlled repetitions, then repeat on your other side.

Frog Alternate Legs

Type of stretch: Dynamic

Benefits: Stretches the adductors and improves mobility in the hip capsule.

Appears in: Shift Shop – Shift Mobility

• Lie facedown, bend your knees about 90 degrees, and spread them as wide as you can. Fold your hands under your forehead to relax your upper body.

• Keeping your knees bent, slowly roll your right thigh inward, lowering your right foot toward the floor.

• Try to tap your right foot on the floor, and reverse the move, repeating on your other side.

• Continue slowly alternating sides for 30 seconds.

Batakatasana

Type of stretch: Static

Benefits: Lengthens the adductors and reduces tension along the entire spine and back of the neck.

Appears in: 21 Day Fix – Yoga

• Sit on the floor upright with your legs bent, the soles of your feet together, and your knees spread wide.

• Keeping your knees spread as wide as possible, take hold of your feet and slowly pull your forehead towards the floor.

• Hold this stretched position for 30-60 seconds.

Scorpion

Type of stretch: Dynamic

Benefits: Stretches the quads and hip flexors, and activates the glutes.

Appears in: P90X3 – Dynamix

• Lie on your stomach, with your legs straight, and arms extended out to the sides, forming a “T.” Your palms should face down.

• Keeping your left leg straight, lift your right leg off the floor, bend your right knee, and cross your right foot behind your left, continuing up toward your left hand.

• Try to tap your left hand with your right foot, and return to the starting position.

• Continue for 30 seconds, and repeat on your other side.

Runner’s Lunge

Type of stretch: Static or dynamic, depending on how long you hold the position.

Benefits: Stretches the adductors and glutes.

Appears in: 21 Day Fix Extreme – Yoga Fix Extreme

• Assume a pushup position: hands and balls of your feet on the floor, both shoulder-width apart, and your body straight from head to heels.

• Step your right foot to a point just outside your right hand. (Your right knee should be near your right shoulder.) If possible, lower your elbows to the floor.

• Hold for 15 seconds, and reverse the move to return to the starting position

• Repeat the entire sequence on your other side.

Sumo Reach

Type of stretch: Dynamic/static

Benefits: Strengthens the glutes and shoulders, stretches the adductors, opens the hip joints, and rib cage.

Appears in: Insanity – Max Recovery

• Assume a wide stance, turning both feet out about 45 degrees.

• Keeping your torso upright, and your core engaged, bend your knees and lower your trunk as you extend both arms straight out to the sides, palms down, forming a “T.”

• Perform three pulses downward, sinking more deeply into this wide-stance (“sumo”) squat each time.

• Keeping your back long and your arms straight, bend your torso to the left as far as you can, and try to place your left palm on the floor near the inside of your left foot.

• Look up at your right palm and hold the position for a 5- to 10-count.

• Brace your core to return to the starting position, and perform the entire sequence on your other side.

Inner Thigh stretch

Type of stretch: Static

Benefits: Lengthens the adductors and hamstrings.

Appears in: TurboFire – Stretch 40

• Sit on the floor with your right leg straight, your left knee bent and your left foot flat on the floor.

• Loop a strap around the arch of your right foot, and lie back as you raise your right leg straight overhead. This is your starting position.

• Lower your left knee outward toward the floor as far as you can, as if performing a half-butterfly stretch.

• Holding the ends of the strap in your right hand, pull it back until you feel a deep stretch in the back of your right thigh and, keeping your right leg straight, slowly lower it out to the right as far as possible.

• Place your left hand on the inside of your left knee and gently press it downward toward the floor, holding for 30 seconds.

• Slowly bring your right leg and left knee back to the starting position, and repeat the entire sequence on your other side.

Groiner

Type of stretch: Dynamic

Benefits: Stretches the glutes, adductors, and hip flexors.

Appears in: P90X3 – Dynamix

• Assume a pushup position: hands and balls of your feet on the floor, both shoulder-width apart, and your body straight from head to heels.

• Step your right foot to a point just outside your right hand.

• Sink into the move for a one-count, lowering your hips as far as possible.

• Return your foot to the starting position.

• Continue for 30 seconds, then repeat on the other side.

Too tough? Perform the move with your hands elevated on yoga blocks.

World’s Greatest Stretch

Type of stretch: Static

Benefits: Lengthens the hip flexors, adductors, chest, and rib cage.

Appears in: Clean Week: Mobility

• Start in a deep lunge with your right foot forward, your left knee and top of your left foot on the floor behind you, and your palms about hip distance apart on the floor inside your right foot.

• Keeping your back flat and both arms straight, lift your right hand up toward the ceiling as high as you can, twisting your torso into your right knee.

• Hold for 10 seconds, then return your right hand to the floor.

• Maintaining the same position in your lower body, lift your left arm up towards the ceiling in the same manner.

• Hold for 10 seconds, then slowly return your left hand to the floor.

• Switch sides, and repeat the sequence.

from News About Health https://www.beachbodyondemand.com/blog/best-hip-stretches

Confront Trump or try to work with him? California Dems are at the forefront of the debateConfront Trump or try to work with him? California Dems are at the forefront of the debate SEO: California Democrats debate how much to oppose Trump Summary: Deep-blue California boasts of how it’s resisting the Trump agenda, but the Democrats are divided between “protesters” and “pragmatists.” Some of the opposition is more rhetorical than substantive, and the most ambitious item on the anti-Trump agenda, a statewide single-payer health-care plan, went down in flames. Takeaways: - California Democrats introduced more than 35 “#stateofresistance” bills meant to block the president’s policy agenda - “Donald Trump is a threat to everything that we stand for as a great state,” Senate Democratic leader Kevin de Leon recently told the Los Angeles Times. - Assembly Speaker Anthony Rendon said in February that he was tired of talking about Trump and fretted publicly last week that, at times, Democrats had “devolved into symbolism.” - The day after Donald Trump was elected president, California’s top two legislators announced in a joint statement that the Golden State would be “lead[ing] the resistance” to Trump’s agenda. “California will defend its people,” declared Assembly Speaker Anthony Rendon and Senate President pro Tempore Kevin de Leon, both Democrats. “We are not going to allow one election to reverse generations of progress.” For the next 10 months, much ado was made over California’s pugilistic posture toward the president. Ambitious left-coast politicians seized on every available opportunity to remind voters that they opposed the man in the Oval Office. Again and again, California touted itself the one place powerful enough — and progressive enough, with Democrats leading the entire government — to thwart the commander in chief. But how much of this “resistance” was rhetorical, and how much was substantive? Now’s the time to ask. On Friday, California’s legislative year finally ended. Lawmakers departed Sacramento for their home districts, not to return until January. In their wake they left a trail of legislative successes — and failures — that hold important lessons for national Democrats still figuring out how to move forward under Trump’s rule. The main takeaway? That even in a progressive paradise like California, where Republicans are almost entirely powerless, the Democratic Party is deeply divided over how, exactly, to resist: with protest or with pragmatism. On Sunday, Rendon described 2017 as California’s “most productive and progressive legislative session in memory.” He had a point. Legislators sent hundreds of bills to Gov. Jerry Brown, nearly all of which addressed key liberal priorities: lower drug costs, free community college, more parental leave, increased education funding, more affordable housing. It’s also true that most of Sacramento’s big, headline-grabbing moves wound up being about Trump in one way or another. Over the course of 2017, California Democrats introduced more than 35 “#stateofresistance” bills meant to block the president’s policy agenda; four have since become law or part of the state budget, and eight more await the governor’s signature. After Trump’s refused to release his income tax returns, for instance, Sacramento sent Brown a bill – not yet signed -- that would deny California ballot access to any future presidential candidate who does the same. When Trump yanked America out of the Paris climate agreement, Sacramento extended Brown’s landmark cap-and-trade program. When Trump continued to rail against illegal immigrants, Sacramento set aside $65 million to fund legal assistance for residents facing deportation — and then, after Trump announced that he was ending President Barack Obama’s Deferred Action for Childhood Arrivals (DACA) program, ponied up another $10 million in loans for college students brought to the country illegally as young children. The list goes on. When Trump’s education secretary Betsy DeVos moved to roll back Obama-era Title IX guidance, Sacramento beefed up state regulations designed to prevent sexual harassment and sexual violence at schools and colleges. And after Immigration and Customs Enforcement officers stepped up their raids under Trump, Sacramento passed a bill that would transform California into a “sanctuary state” of sorts by limiting communication between law enforcement and federal immigration authorities. The legislature’s resolutions, which do not carry the force of law, were even more antagonistic toward Trump. One demanded that Congress censure the president for his equivocal response to last month’s violent white supremacist rally in Charlottesville; another seized on his popular-vote loss to call for the end of the Electoral College. All in all, Sacramento passed more than two dozen Trump-bashing resolutions before adjourning for the year. And yet, despite the flurry of anti-Trump activity, serious fissures developed over the course of the session between two types of Democrats. Call them the Protesters and the Pragmatists. The protesters, led by De Leon, tended to be concentrated in the more liberal state Senate. “Donald Trump is a threat to everything that we stand for as a great state,” de Leon recently told the Los Angeles Times. “So, it’s not just as president of the Senate, or as a senator, but more importantly as an ordinary citizen and son of a single immigrant mother do I take these positions.” Meanwhile, Rendon emerged as brake on the Senate’s ambitions, declaring as early as February that he was tired of talking about Trump and publicly fretting last week that, at times, Democrats had “devolved into symbolism.” As a result, many anti-Trump bills were “scaled back from their original sweeping premise,” as the Times put it; others “flamed out entirely.” De Leon’s sanctuary state bill squeaked through at the last minute, but only after the governor and police softened its protections for undocumented immigrants convicted of certain crimes. De León’s proposal to enshrine federal air and water protections into state law — a preemptive response to likely rollbacks from the Trump administration — fizzled without a vote Friday night. And two bills meant to punish any private company willing to aid Trump in his bid to build a wall on the country’s southern border also failed to advance. Sacramento’s most spectacular flameout, however, involved single-payer healthcare (as we previously reported). With Trump’s push to repeal Obamacare dominating the agenda in Washington, D.C. — and California Democrats suddenly enjoying supermajorities in both houses of the state legislature — two state senators earlier this year introduced a bill (SB 562) designed to wipe out California’s private insurance market and create a single-payer system. The old barriers, it seemed, had finally broken down. The stars were aligned. But after SB 562 passed the Senate, Rendon (who insists he supports single-payer) abruptly intervened in late June and shelved the bill for the remainder of the 2017 session. “SB 562 was sent to the Assembly woefully incomplete,” Rendon snapped. “Even senators who voted for SB 562 noted there are potentially fatal flaws in the bill, including the fact it does not address many serious issues, such as financing, delivery of care, cost controls, or the realities of needed action by the Trump Administration and voters to make SB 562 a genuine piece of legislation.” Gov. Brown, meanwhile, piled on. “Where do you get the extra money?” Brown told reporters. “You take a problem and say I’m going to solve it by something that’s even a bigger problem, which makes no sense.” Progressive activists were furious. Rendon and his family received death threats. Outside the speaker’s Capitol office, one protester pretended to stab a bear in the back with a fake knife; the blade had “Rendon” written on it. Sacramento’s single-payer implosion neatly illustrates the larger conflict that will continue to bedevil national Democrats as they struggle to chart a path back to power in the Age of Trump. Is protesting the president with passionate rhetoric and pie-in-the-sky policy proposals the best way to regain control in Washington, D.C.? Or is pragmatism the smarter play? It’s a conflict that’s been on vivid display on Capitol Hill in recent days. Last week, Sen. Bernie Sanders finally introduced his signature “Medicare for all” legislation, and several top 2020 presidential hopefuls — Sen. Kamala Harris of California, Sen. Cory Booker of New Jersey, Sen. Elizabeth Warren of Massachusetts and Sen. Kirsten Gillibrand of New York — quickly signed on to cosponsor the bill. But Nancy Pelosi — the leader of the House Democrats, and a Californian herself — did not. “I don’t think [single payer] is a litmus test,” Pelosi told the Washington Post, instead calling on Democrats to release a wide range of proposals to fix and improve the Affordable Care Act (a.k.a., Obamacare). “It isn't helpful to tinkle all over the ACA right now," Pelosi added in an interview with MSNBC. "Right now we need to support the Affordable Care Act and defeat what the Republicans are doing." This isn’t the only time Pelosi has angered the protest wing of her party. Earlier this year, Pelosi refused to require that every Democrat support abortion rights, noting that many of her relatives “are not pro-choice.” (“You think I’m kicking them out of the Democratic Party?” she scoffed.) And in recent weeks, Pelosi and her Senate counterpart, Minority Leader Chuck Schumer, have struck a pair of deals with President Trump, first on the debt ceiling and then on DACA. In response, angry protestors confronted Pelosi in San Francisco on Monday, chanting “all of us or none of us” and “we are not a bargaining chip.” Pelosi’s strategy is fairly simple: accomplish as much as possible, given the circumstances — then let the electoral chips fall where they may. “You can never satisfy everybody,” she told the Post last week. “We don’t have a responsibility to get nothing done.” Whether that sort of pragmatism will pay off at the ballot box remains to be seen. Meanwhile, the protests will continue — in California and beyond.

Tempore Kevin de Leon, Anthony Rendon, Donald Trump. (Yahoo News photo illustration; photos: Mark J. Terril/AP, Rich Pedroncelli/AP, Mark Ralston/AFP/Getty Images, AP)

The day after Donald Trump was elected president, California’s top two legislators announced in a joint statement that the Golden State would be “lead[ing] the resistance” to Trump’s agenda.

“California will defend its people,” declared Assembly Speaker Anthony Rendon and Senate President pro Tempore Kevin de Leon, both Democrats. “We are not going to allow one election to reverse generations of progress.”

For the next 10 months, much ado was made over California’s pugilistic posture toward the president. Ambitious left-coast politicians seized on every available opportunity to remind voters that they opposed the man in the Oval Office. Again and again, California touted itself the one place powerful enough — and progressive enough, with Democrats leading the entire government — to thwart the commander in chief.

But how much of this “resistance” was rhetorical, and how much was substantive?

Now’s the time to ask. On Friday, California’s legislative year finally ended. Lawmakers departed Sacramento for their home districts, not to return until January. In their wake they left a trail of legislative successes — and failures — that hold important lessons for national Democrats still figuring out how to move forward under Trump’s rule.

The main takeaway? That even in a progressive paradise like California, where Republicans are almost entirely powerless, the Democratic Party is deeply divided over how, exactly, to resist: with protest or with pragmatism.

On Sunday, Rendon described 2017 as California’s “most productive and progressive legislative session in memory.” He had a point. Legislators sent hundreds of bills to Gov. Jerry Brown, nearly all of which addressed key liberal priorities: lower drug costs, free community college, more parental leave, increased education funding, more affordable housing.

It’s also true that most of Sacramento’s big, headline-grabbing moves wound up being about Trump in one way or another. Over the course of 2017, California Democrats introduced more than 35 “#stateofresistance” bills meant to block the president’s policy agenda; four have since become law or part of the state budget, and eight more await the governor’s signature.

After Trump’s refused to release his income tax returns, for instance, Sacramento sent Brown a bill – not yet signed — that would deny California ballot access to any future presidential candidate who does the same. When Trump yanked America out of the Paris climate agreement, Sacramento extended Brown’s landmark cap-and-trade program. When Trump continued to rail against illegal immigrants, Sacramento set aside $65 million to fund legal assistance for residents facing deportation — and then, after Trump announced that he was ending President Barack Obama’s Deferred Action for Childhood Arrivals (DACA) program, ponied up another $10 million in loans for college students brought to the country illegally as young children.

State Senate President Pro Tem Kevin de Leon, D-Los Angeles, from left, Gov. Jerry Brown and Assembly Speaker Anthony Rendon, D-Paramount, walk through the Capitol to a news conference to discuss the passage of a pair of climate change bills, Monday, July 17, 2017, in Sacramento, Calif. Brown backed the measures, which will extend the state’s cap-and-trade program and aims to improve local air quality. (Photo: Rich Pedroncelli/AP)

The list goes on. When Trump’s education secretary Betsy DeVos moved to roll back Obama-era Title IX guidance, Sacramento beefed up state regulations designed to prevent sexual harassment and sexual violence at schools and colleges. And after Immigration and Customs Enforcement officers stepped up their raids under Trump, Sacramento passed a bill that would transform California into a “sanctuary state” of sorts by limiting communication between law enforcement and federal immigration authorities.

The legislature’s resolutions, which do not carry the force of law, were even more antagonistic toward Trump. One demanded that Congress censure the president for his equivocal response to last month’s violent white supremacist rally in Charlottesville; another seized on his popular-vote loss to call for the end of the Electoral College. All in all, Sacramento passed more than two dozen Trump-bashing resolutions before adjourning for the year.

And yet, despite the flurry of anti-Trump activity, serious fissures developed over the course of the session between two types of Democrats. Call them the Protesters and the Pragmatists.

The protesters, led by De Leon, tended to be concentrated in the more liberal state Senate.

“Donald Trump is a threat to everything that we stand for as a great state,” de Leon recently told the Los Angeles Times. “So, it’s not just as president of the Senate, or as a senator, but more importantly as an ordinary citizen and son of a single immigrant mother do I take these positions.”

Meanwhile, Rendon emerged as brake on the Senate’s ambitions, declaring as early as February that he was tired of talking about Trump and publicly fretting last week that, at times, Democrats had “devolved into symbolism.”

As a result, many anti-Trump bills were “scaled back from their original sweeping premise,” as the Times put it; others “flamed out entirely.” De Leon’s sanctuary state bill squeaked through at the last minute, but only after the governor and police softened its protections for undocumented immigrants convicted of certain crimes. De León’s proposal to enshrine federal air and water protections into state law — a preemptive response to likely rollbacks from the Trump administration — fizzled without a vote Friday night. And two bills meant to punish any private company willing to aid Trump in his bid to build a wall on the country’s southern border also failed to advance.

Members of the California Nurses Association and supporters rally in the rotunda at the Capitol calling for a single-payer health plan, Wednesday, June 28, 2017, in Sacramento, Calif. The demonstrators were demanding that Assembly Speaker Anthony Rendon, D-Paramount, bring a health care bill, SB562, by state Senators Ricardo Lara, D-Bell Garden, and Toni Atkins, D-San Diego, to a vote in the Assembly. (Photo: Rich Pedroncelli/AP)

Sacramento’s most spectacular flameout, however, involved single-payer healthcare (as we previously reported). With Trump’s push to repeal Obamacare dominating the agenda in Washington, D.C. — and California Democrats suddenly enjoying supermajorities in both houses of the state legislature — two state senators earlier this year introduced a bill (SB 562) designed to wipe out California’s private insurance market and create a single-payer system.

The old barriers, it seemed, had finally broken down. The stars were aligned. But after SB 562 passed the Senate, Rendon (who insists he supports single-payer) abruptly intervened in late June and shelved the bill for the remainder of the 2017 session.

“SB 562 was sent to the Assembly woefully incomplete,” Rendon snapped. “Even senators who voted for SB 562 noted there are potentially fatal flaws in the bill, including the fact it does not address many serious issues, such as financing, delivery of care, cost controls, or the realities of needed action by the Trump Administration and voters to make SB 562 a genuine piece of legislation.”

Gov. Brown, meanwhile, piled on.

“Where do you get the extra money?” Brown told reporters. “You take a problem and say I’m going to solve it by something that’s even a bigger problem, which makes no sense.”

Progressive activists were furious. Rendon and his family received death threats. Outside the speaker’s Capitol office, one protester pretended to stab a bear in the back with a fake knife; the blade had “Rendon” written on it.

Sacramento’s single-payer implosion neatly illustrates the larger conflict that will continue to bedevil national Democrats as they struggle to chart a path back to power in the Age of Trump. Is protesting the president with passionate rhetoric and pie-in-the-sky policy proposals the best way to regain control in Washington, D.C.? Or is pragmatism the smarter play?

It’s a conflict that’s been on vivid display on Capitol Hill in recent days. Last week, Sen. Bernie Sanders finally introduced his signature “Medicare for all” legislation, and several top 2020 presidential hopefuls — Sen. Kamala Harris of California, Sen. Cory Booker of New Jersey, Sen. Elizabeth Warren of Massachusetts and Sen. Kirsten Gillibrand of New York — quickly signed on to cosponsor the bill.

But Nancy Pelosi — the leader of the House Democrats, and a Californian herself — did not.

“I don’t think [single payer] is a litmus test,” Pelosi told the Washington Post, instead calling on Democrats to release a wide range of proposals to fix and improve the Affordable Care Act (a.k.a., Obamacare).

“It isn’t helpful to tinkle all over the ACA right now,” Pelosi added in an interview with MSNBC. “Right now we need to support the Affordable Care Act and defeat what the Republicans are doing.”

Rep. Nancy Pelosi, the top Democrat in the U.S. House, discusses immigration reform before a group of students, faculty and others at California State University, Sacramento, Monday, Sept. 18, 2017, in Sacramento, Calif. Earlier she was shouted down by young immigrants at an event in San Francisco where she was trying to drum up support for legislation the would grant legal status to young immigrants. (Photo: Rich Pedroncelli/AP)

This isn’t the only time Pelosi has angered the protest wing of her party. Earlier this year, Pelosi refused to require that every Democrat support abortion rights, noting that many of her relatives “are not pro-choice.” (“You think I’m kicking them out of the Democratic Party?” she scoffed.) And in recent weeks, Pelosi and her Senate counterpart, Minority Leader Chuck Schumer, have struck a pair of deals with President Trump, first on the debt ceiling and then on DACA. In response, angry protestors confronted Pelosi in San Francisco on Monday, chanting “all of us or none of us” and “we are not a bargaining chip.”

Pelosi’s strategy is fairly simple: accomplish as much as possible, given the circumstances — then let the electoral chips fall where they may. “You can never satisfy everybody,” she told the Post last week. “We don’t have a responsibility to get nothing done.”

Whether that sort of pragmatism will pay off at the ballot box remains to be seen. Meanwhile, the protests will continue — in California and beyond.

_____

Read more from Yahoo News:

Fish it out, dry it out, throw it out — how one family is coping with the Houston flood

In the age of Trump, tired are the peacemakers

Too close for comfort: How social media changed how we talk to (and about) each other in America

Matt Bai: Is sexism what happened to Hillary?

Photos: Striking a pose – Trump makes his United Nations debut

http://ift.tt/2rO3sBl

Authored by Brandon Smith via Alt-Market.com,

After the Manchester suicide bombing only two weeks ago I warned my readers that the repetition of terror attacks is breeding complacency within the public, in Europe most acutely. It is not uncommon now for attacks killing dozens to be forgotten within a week of the event. The news feeds are awash in distraction, and of course, sometimes these events themselves act as distractions.

In a recent newscast of MSNBC's “Morning Joe”, BBC anchor Katty Kay stated:

“Europe is getting used to attacks like this, Mika. They have to, because we are never going to be able to totally wipe this out...”

To me, this attitude is rather indicative of the European victim-culture mindset. Many in Europe (not all, but many) seem to enjoy a steady routine of self-flagellation. Countless centuries of the feudal serf system will do that to a society. The British still pay taxes to maintain a royal family, after all. I also think that the results of the Brexit vote in the UK might mislead those of us in America into thinking that the the British are turning over a new leaf in terms of liberty and conservative-like values. While I do think there is a fierce underlying drive to protect sovereignty of the British nation, the British individual has all but abandoned any hope of their own personal sovereignty and self determination.

In mainland Europe the self-loathing natural born citizen has become a bit of a mainstay and has been exploited quite successfully by the globalist establishment. In particular, the great fear among predominantly liberal Europeans is a return to the nationalist fervor that they believe spawned the rise of Nazism and the Third Reich (I have written numerous articles outlining the involvement of the corporate and banking elite in funding and supplying vital technology to the Nazis before and during WWII). It is this “guilt” of association with the Nazi legacy that has left Europe vulnerable to manipulation from the other end of the political spectrum – the socialist/Marxist end.

It is also this mindset that allowed globalists to forcefully inject millions of Muslim immigrants through open border policies and refugee policies into EU nations without proper vetting procedures. The majority of Europeans that saw the policy as irrational and dangerous were afraid to say anything for fear that they would be labeled “fascists”.

The greatest threat is not only the conditioning of the population to accept cultural invasion without assimilation. Nor is the greatest threat the pacification of the populace in the face of rampant terror attacks. No, the pinnacle threat is what will inevitably come next – the apathy of a nation in the wake of incremental martial law and the death of personal liberty.

This past week, a team of three Muslim men struck pedestrians with a white van, then emerged wielding hunting knives in a rampage through a crowded London night spot. This is only one attack in a steady stream that have plagued Europe ever since the Cloward-Piven program of Muslim relocation allowed millions of “refugees” into the EU's borders. The vaporous ISIS terror group has since claimed responsibility.

In response, Prime Minister Theresa May has declared “enough is enough”, and demanded a review of the UK's counter-terrorism strategy. London police have been asked to adjust to new tactical conditions, patrolling streets heavily armed and utilizing surveillance helicopters with the aid of special forces units.

NOTE - After finishing this article on Sunday, I find this quote from Theresa May on Tuesday:

“We should do even more to restrict the freedom and the movements of terrorist suspects when we have enough evidence to know they present a threat, but not enough evidence to prosecute them in full in court."

  "And if human rights laws get in the way of doing these things, we will change those laws to make sure we can do them..."

The deployment of over 5000 British troops at strategic locations by Theresa May is all part of a plan established in 2015 called “Operation Temperer”. The plan calls for the deployment of troops within the UK border in response to “major terrorist threats”. Essentially, it is a martial law program that acts incrementally, rather than overtly. Once implemented, Temperer would be difficult to reverse. As UK military chiefs warned when the operation was publicly exposed, troops would likely not be pulled back after commitment unless the terror threat was “reduced”, leaving the definition of the “threat level” open for rather broad interpretation.

Operation Temperer is now in full swing as police departments ask for military aid. The prime minister has obliged, replacing officers in numerous locations with military units on patrol. So, is this “martial law”? Perhaps not quite, but it is damn close to the line, and this is how tyranny is commonly implemented; not all at once, but a stepping stone at a time.

First, I would point out that May introduced Temperer measures after the Manchester bombing, and they do not seem to have done much to disrupt the latest attack in London. Second, I would also point out that the UK general elections for parliament are only a today, and it is highly likely that the latest attacks will solidify Theresa May and her Brexit base.

The timing is rather interesting...

Many in the Liberty Movement would say that this is a good thing; that finally the British will be able to reverse the forced cultural invasion of an incompatible Muslim mass. I would say that this is all part of the plan.

As I have argued since before the Brexit vote last year, we are witnessing perhaps the largest 4th Gen psy-op in history. The globalists have deliberately engineered conditions by which European nations in particular will either be enveloped by an alien ideology with no protection from their own governments, or, they will have to respond with overarching countermeasures. Meaning, Europeans have been given a false choice between the ideological cult of multiculturalism, or, martial law conditions.

In my view, the UK has been slated for the latter measure, and this makes perfect sense if you understand the game plan of the globalists.

Brexit and by extension the rise of Donald Trump in the US has been ALLOWED to happen. Despite the delusions of some in the liberty movement, the so-called “deep state” is perfectly positioned to take advantage of both events. They are not opposed in the slightest. Why? Because this is about destroying the name of sovereign nationalism and conservative principles. This is about the long game.

The UK appears to be first in the line-up. Terror attacks are mounting, May has already initiated Operation Temperer, and the attacks have continued anyway. The solution they will present will be MORE militarization, not less. It is my prediction that after a year of incrementalism and continued attacks, the entire UK will be in the midst of what many would define as full spectrum martial law. The UK government might not openly call it that, but that is what it will be.

While I personally find Muslim based societies to be abhorrent in their attitude towards individual liberty, I do see a disturbing trend developing on the other side of the coin. Western nations like the UK and the US have every right to defend their borders, to deny immigration from ANYWHERE for any reason, and to deport illegal immigrants and immigrants with provable ties to terror groups. However, the line that should not be crossed but probably will be crossed is the persecution or deportation of people merely for holding particular ideological views.

Even if the majority of citizens don't necessarily support an outright broad brush response towards all people that hold Muslim views as potential terrorists, the temptation will be overwhelming, and our respective governments will oblige it. Once we step into the world of thought crime, there is no turning back.

And, what this does is paint conservative/nationalist movements as monstrous in the eyes of future generations. They will be taught that the globalists “warned the world” about the dangerous “racist” populists and alt-right groups, and look what happened when they came to power; they vaporized the economy (see my previous articles on the Trump scapegoat narrative) and rounded up innocent people because of their belief system even though they committed no specific crimes. My fear is that what is happening here is that conservative movements are going to be driven to such madness in the name of security that we will actually make the globalists look like “good guys” by comparison.

So, what is the solution? Well, look at the choices the British people have been given: Accept multicultural sublimation without question, or, initiate complete military oversight and sacrifice personal liberty. Are there no other options available?

What about this: The UK citizenry DEMANDS the return of their right to self defense and the legalization of firearms ownership for those without a criminal background? The real solution is for UK citizens to begin providing their own security, not handing over their country to militarization because they are all disarmed and afraid.

Will this happen? I seriously doubt it. But, I do want to point out that there is clearly another path far superior to the two being offered.

Again, I believe the UK will be under martial law in a year's time. Unless the people of the UK do something NOW to assert their right to determine their own security, they will fall to a complete totalitarian framework. And, in the long run, they will only be helping the very globalists the Brexit movement in particular sought to fight against. They will do this by trampling the image of nationalism and sovereignty with the jackbooted philosophy of externalized security and government dependency, making globalism, the offered antithesis, look pleasant and tolerable in retrospect.

June 08, 2017 at 09:38AM http://ift.tt/2rNE9Q4 from Tyler Durden http://ift.tt/2rNE9Q4