NTIMES: March 2017

Wednesday, March 29, 2017

Reality Check On Trump Calling For Bipartisanship On Health Care - NPR

President Trump speaks at a reception for senators and their spouses in the East Room of the White House on Tuesday.

Andrew Harnik/AP

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Andrew Harnik/AP

President Trump speaks at a reception for senators and their spouses in the East Room of the White House on Tuesday.

Andrew Harnik/AP

The fallout from Friday's Republican health care bill collapse is still trying to be understood.

Right after the bill was pulled, President Trump teased that he wanted to work with Democrats and believed a bipartisan bill would be possible.

But it wasn't clear if that was just talk. On Tuesday night, he may have taken the first step to trying to reach across the aisle.

"I know that we're all going to make a deal on health care, that's such an easy one," Trump told a bipartisan group of senators gathered at the White House. "I have no doubt that's going to happen very quickly."

Trump Supporter Or Investigator? 5 Problems For Devin Nunes And Trump White House

Speed is relative. The Trump-Paul Ryan health care bill was fast-tracked and collapsed in 17 days. It took President Obama more than a year to pass the Affordable Care Act, with more members of his own party in the Senate than Republicans have now.

"We have all been promising it — Democrat, Republican — to the public," Trump said Tuesday night.

That's the rub for Republicans. Health care has been one of the most hotly partisan issues of the past decade. It has been the issue that has animated Republican opposition to Obama. The prospect of repealing and replacing Obamacare has been so critical to Republican success, it is arguably responsible for hollowing out the Democratic Party.

Obama's focus on instituting the law gave the Tea Party a clear focus.

"What brought everything together was the Obamacare idea, which contains every odiferous objection," Mark Williams of Tea Party Express told CNN in August of 2009.

House GOP Says Health Care Fight Not Over, But Offers No Path Forward

It was a staple of every Tea Party rally through that election cycle, so it is unlikely the GOP base shrugs its collective shoulders and moves on the way Trump promised to do Thursday and Friday — and wait for Obamacare to "explode."

FACT CHECK: Trump Says Obamacare Is 'Exploding.' It's Not

Waiting for the law to fall apart puts Republicans in a terrible bind. Trump could get it left, right and center. If the Trump administration doesn't work as hard as it can to implement and administer the law, and you start seeing reporting from unnamed career officials verifying that, it very well could mean the Trump administration is blamed for harming real people's lives.

That would enrage not just Democrats, but independents and some Republicans.

If the Trump administration does administer the law the way the Obama administration did, the GOP base would likely be enraged, especially without a repeal-and-replace option. Is this what they voted for all these years?

"We are going to be doing a great job," Trump added in his remarks to senators Tuesday night. "Hopefully it will start being bipartisan, because everybody really wants the same thing. We want greatness for this country that we love."

What Trump Misses About Energy Jobs In America

But there is little muscle memory for anything bipartisan with this Congress. And there are challenges.

Democrats may be open to it, but Senate Minority Leader Chuck Schumer said only if repeal is off the table. Would Republicans in Congress be OK with that? Maybe some, but it's unlikely — and could cost Ryan his job as speaker if he doesn't have the majority of his conference and winds up working with Democrats.

Plus, congressional Republicans viewed Trump's election as their chance, finally, to enact sweeping changes with traditional Republican agenda items. They won't give that up easily.

NPR's Susan Davis noted Tuesday that congressional Republicans are insisting they are closer now to passing health care than they were Friday and aren't giving up, reversing course on the tone Ryan took Friday that Obamacare is now "the law of the land." But, as Davis put it:

"House Republicans' optimism that they could find a GOP-based solution to health care is undercut by comments this week by the White House and Senate Republicans who say any future health care legislation will likely require Democratic support — a tacit acknowledgement that repealing Obamacare is off the table."

Will Trump really force their hand on "repair"? So far, there's no real evidence of that. His whole presidency to this point has been bold appeals to his base, not reaching across the aisle.

What's more, would rank-and-file Republican voters be OK with it? They'd be skeptical, and it'd be up to Trump to make the sale — something he didn't do the first go-round with health care.

"Bipartisanship" is just an idea at this point. There is no discernible White House strategy for getting a bill through right now, and no evidence to suggest his team could shepherd it through.

Trump took a first step Tuesday night. He acknowledged Schumer, whom he hasn't spoken with since shortly after the inauguration.

"I think we are going to have some very good relationships — right, Chuck?" Trump said. "I see Chuck. Hello, Chuck."

But, as the health care failure showed, legislating is a lot harder than talking.

Journalists in Pennsylvania are taking on state politics with a new print-only publication - Poynter (blog)

Earlier this year, a new publication started covering state politics in Pennsylvania in an old way — print.

The Caucus, a print-only publication from LNP Media Group, doesn't put stories online or break news on Twitter. The four-person staff is composed of two former journalists at the Pittsburgh Tribune-Review, an attorney and the content editor for LNP.

Every week, The Caucus gets delivered to Gov. Tom Wolf and the 253 members of the State Senate and House of Representatives. On launch day, Jan. 3, lobbyists and staffers got free three-month trials.

The ultimate goal is to build The Caucus into a must-read publication for influencers in the state of Pennsylvania, said Tom Murse, LNP's content editor at The Caucus' editor.

"We’re trying to do journalism that no one else is doing and that is essential for policymakers, those seeking to get before policymakers, and citizens who concerned about how their tax dollars are being spent," Murse said. "Our publisher and our owners believe that if we do this, we will achieve profitability."

For now, the number of subscribers is pretty low, Murse said. But the company expects those numbers to grow as the trials come to an end. And they have high hopes for bringing in more readers in an era of dwindling resources and coverage for statehouses nationwide.

The Caucus, which is seeking subscription and advertising revenue, has mostly found success landing ads with advocacy groups so far, he said.

Bureau chief Brad Bumsted, a veteran Pennsylvania journalist, spoke with Poynter about going back to print, what The Caucus hopes to cover and why he's glad to be away from digital journalism. Our conversation was edited for length.

Tell us a little bit about The Caucus.

In an age of Twitter and Facebook, some editors at LNP Media Group in Lancaster have long had a plan to do a print-only publication with a hyper-focus on state government and investigative reporting. In that sense, it is totally against the grain with what we see going on at capitals around the country where state press corps are shrinking. So this is different in a lot of respects.

This is going against the grain in that, as you said, coverage of state government is shrinking, but also this is print-only. What's the strategy behind print-only?

I think part of the idea is not to give the content away. So much of what we see online winds up being aggregated. I think it's also to be different and to really have a focus on investigative reporting, which is harder to do, in a way I think, digitally.

What about digital journalism do you think makes investigative reporting harder?

It's just spending so much time with the medium that it becomes more of a desire for graphics and fact boxes. We have some of those, but you can get absorbed in that culture, and then it is something that must go out quickly. We're weekly. I've never worked for a weekly in 40-some years in journalism. When you're doing digital journalism, it's by the minute.

We're not. We have time to put stories together.

Normally when I talk to people about their publications, one of the things I ask are about metrics: What are your pageviews like, your subscribers? I know you've been in the business awhile. So what metrics are you using to judge how successful The Caucus is?

One of the metrics, from Bob Krasne, (chairman and publisher of LNP Media Group) is what impact we can have on making things more transparent in Pennsylvania. That is really the goal of the paper.

Anything we can do to write about and show weaknesses in the state's sunshine law, the Right to Know law... Those aren't the only things we write about and we don't write about them every week. But when there's an opportunity, we do.

Paula (Knudsen, an attorney and staffer) comes into play there, also, because as an attorney she worked for the Pennsylvania NewsMedia Association and tracked a lot of this. So she knows who lobbied against the sunshine laws, who the legislators are, what the pressure points are, what's been talked about in hearings. That's the number one metric.

The number two metric, of course, is how many people we sell it to, and who they're selling it to is who they want to sell it to, and that is lobbyists and law firms within the belt of the capital.

You’ve gone from a newspaper that became a digital site back to something that's strictly a print product. Has anything changed for how you view local journalism?

Yes. And I fell victim to this, too. So often, in the digital, 24-hour news cycle that I was part of, everyone's out to break stories. And what breaking stories meant was, who posted it first online? And if you beat somebody by five minutes, you scooped them. But who has the best story at the end of the day? Who tells the readers about this issue? Who gives all sides of this that they hadn't even thought of? That, to me, is far more important than being first on a story. And I was first on a lot of them. I was totally into that culture.

One story that we did recently I had started working on four months ago and had to go through two cycles of right to know law requests. It's harder to do that for a daily newspaper.

Despite choosing to be print-only, it looks like you're not totally ignoring the digital world. You have a site that's kind of a front window and a Twitter account. How are you having conversations with your audience? Politicians and lobbyists are just like journalists in that they're pretty active on Twitter.

I'm not doing any of that. There's a PR person for LNP Media Group who's doing most of the tweeting. It's basically for promotion, and I would argue that the website is the same thing. It's for promotions and subscriptions. There's no news content on there, other than samples of stories. We're not really doing digital journalism that way.

What else do you want us to know about this?

If I were able to create my own job description, this would be it. I've always been inclined to do in-depth stories. I really like, as much as possible, getting to the truth about something, as elusive as that can be. To peel layers away, I think, should be the goal of all journalists. That's what we're able to do with The Caucus.

LiveSmart, a London-based employee health platform, raises £700000 - TechCrunch

LiveSmart, a London-based startup that offers a platform to help employees track and improve their health, has raised £700,000 in funding.

Investors include Matt Merrick (formerly the managing director of Virgin Active Health Clubs) and Lawrence Mitchell (formerly global marketing director and global wellness lead at Reed Business Information); the capital will be used to grow LiveSmart’s B2B offering and bridge the gap to a Series A round later this year.

Competing with more traditional offerings from companies like Bupa and Nuffield, LiveSmart combines employee health screening with what founder Alex Heaton describes as health coaching. The idea is to take data gleaned from various tests offered, as well as pulled in from other sources, such as fitness trackers, and use this as the basis to encourage actual behavioral change.

Unlike yearly or one-off screening, the process is ongoing and, says Heaton, more holistic than many existing employee health programs.

“The vast majority of the world’s population make poor lifestyle choices which affect their long-term health,” he says. “We believe that the solution is to provide a better behavior change platform. This starts with an affordable and repeatable measurement platform — a scale for your health. We then provide education, support and goal setting to help people to improve using health coaches delivered over the phone and through our online platform.”

Heaton says LiveSmart typically looks at more than 100 health data points — including offering a convenient blood screening service via a home kit, clinic visit or on-site — and puts an emphasis on health improvement over time.

“Most people that have had a health screen go on to do very little if anything as a result, our coaching program delivers measurable results,” he says.

In addition, LiveSmart offers a custom-built cognitive test that claims to assess memory and processing speed. The startup also packages employee health data in aggregate (anonymously, of course) so that employers can get an overall sense of the health of their workforce and make company-wide changes, if needed.

“We use data to help our customers to better understand where they are versus other people like them and what their health trajectory is like over time. Data will increasingly be important to us as we grow,” adds Heaton.

“Ultimately, technology is critical to our success, it’s how we are bringing together a complex set of providers and how ultimately we will reduce costs enabling us to improve our margins and/or launch cheaper products, as well as providing better insights to our customers.”

Video games may protect mental health and avert trauma, addiction - Ars Technica

Video games often blamed for rotting minds may actually protect them, according to a series of studies.

Researchers report that Tetris—a classic game that takes hold of spatial and visual systems in the brain as players align irregular polygons—seems to jumble the mind’s ability to process and store fresh traumatic memories. Those improperly preserved memories are subsequently less likely to resurface as intrusive, distressing flashbacks, which can contribute to post-traumatic stress disorder, depression, complicated grief, and other mental health issues.

For those struggling with cravings or addiction, other research has found that Tetris’ mental grasp can also diminish the intensity of hankerings and help game players fight off real-life dependencies.

Though the conclusions are based on small studies in need of repeating and further investigation, one thing is clear: the potential video-game therapy has scant side-effects and potential harms. Twenty-minutes of Tetris is just good fun, if nothing else.

In the words of the authors of a new study, Tetris is a “promising new low-intensity psychiatric intervention.”

Nintendo therapy

For long-term Ars readers, the intervention may not seem that new. Back in 2009 and 2010, we covered preliminary work from one of the same lead researchers, clinical psychologist Emily Holmes, who is now at the Karolinska Institute. From early studies, Holmes and colleagues suggested that playing Tetris could interrupt memory processing immediately after a traumatic experience. The findings backed up the authors’ hypothesis that, after a traumatic experience, there’s an opening lasting several hours in which a visual, traumatic memory “stabilization” can be disrupted. By hijacking the visual and spatial processing power of the brain with an enthralling game—enter Tetris—the memories can be disrupted during that window, the researchers found.

But, those early experiments relied solely on study participants who were “traumatized” by watching grim footage of fatal traffic collisions and gory surgeries. In the new study, again led by Holmes and published in Molecular Psychiatry, researchers tested Tetris therapy on victims of real-life traffic accidents.

Seventy-one patients that arrived in an Oxford, UK, hospital emergency department within six hours of being involved in a traffic accident were enrolled in the study. In all cases, the participants’ accidents met the medical criteria of a traumatic event. That is, each participant “experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury.”

Thirty-seven participants were randomly chosen to play about 20 minutes of Tetris on Nintendo DS while they were in the hospital. The remaining 34 just logged their activity while they were in the hospital. They recorded things like reading, texting, getting care, chatting, or doing a crossword puzzle.

A week later, the Tetris players reported that they, on average, were hit with an intrusive, disturbing flashback 8.7 times during the week. The activity-logging group reported an average of 23.3 upsetting flashbacks. That suggests that 20 minutes of Tetris cut flashbacks by around 62 percent. When the researchers checked back with the participants a month later, they didn’t note any statistically significant differences in the overall mental health of the two groups. But this, the authors argue, could simply be due to the small, short-term design of the study. Larger trials and potentially more Tetris are needed to assess potential long-term effects.

Visualizing health

In all, the researchers conclude that the “brief, science-driven intervention offers a low-intensity means that could substantially improve the mental health of those who have experienced psychological trauma.” And, they go on, “not only Tetris, but any task with high visuospatial demands is likely to be useful within the procedure (e.g. games such as Candy Crush, drawing).”

Such visuospatial usurping may not just be useful for trauma victims, other research suggests. In late 2015, a group of English and Australian researchers reported that playing Tetris could dampen cravings for addictive substances, such as nicotine, alcohol, and drugs, as well as other vices, such as food and sex.

The study, published in Addictive Behaviors, followed 31 undergraduate volunteers who carried around iPods for a week and filled out surveys seven times a day about their cravings. Fifteen of the participants also got to play three minutes of Tetris after the surveys, then report on their cravings again. When the week was up, the researchers found that playing Tetris consistently reduced craving strength by 13.9 percent—about a fifth. That, the authors explained, could be just enough for people to ignore those cravings and avoid their vice.

The researchers again hypothesized that the game’s ability to seize visual and spatial processing in the brain is key to the health benefits. In this case, addiction and cravings are often driven by visual fantasies of having that drink, drug, or what-have-you, the authors explained.

As before, more and larger studies are needed to line up the true benefits. Still, with this experimental treatment, it’s safe to try at home.

Molecular Psychiatry, 2017. DOI: 10.1038/mp.2017.23 (About DOIs).

Addictive Behaviors, 2017. DOI: 10.1016/j.addbeh.2015.07.020 (About DOIs).

Trump tells lawmakers he expects deal 'very quickly' on health care - CNBC

U.S. President Donald Trump told a group of senators on Tuesday that he expected lawmakers would be able to reach a deal on health care, without offering specifics on how they would do it or what had changed since a health-care reform bill was pulled last week for insufficient support.

"I have no doubt that that's going to happen very quickly," Trump said at a bipartisan reception held for senators and their spouses at the White House.

"I think it's going to happen because we've all been promising — Democrat, Republican — we've all been promising that to the American people," he said.

A Republican plan backed by Trump to overhaul the U.S. health-care system was pulled on Friday after it failed to garner enough support to pass the Republican-controlled House of Representatives.

Trump, a Republican, did not mention that failure at the reception nor did he offer specifics on how he planned for lawmakers to reach a consensus on a health-care bill that would repeal and replace the Affordable Care Act, familiarly known as Obamacare.

Trump told lawmakers at the reception that he would be talking about infrastructure and investing in the military, without offering a time frame or details.

"Hopefully, it will start being bipartisan, because everybody really wants the same thing. We want greatness for this country that we love," he said.

Hillary Clinton criticizes photo of male Republicans talking women's health coverage - Fox News

Hillary Clinton on Tuesday gave one of her first public speeches since losing the presidential election and criticized the much-circulated photo showing an all-male group of Republican lawmakers last month negotiating women’s coverage in health care legislation.

She mentioned a social-media parody of it that showed an all-dog panel deciding on feline care.

“I am here today to urge us not to grow tired. Not to be discouraged and disappointed. Not to throw up our hands because change is not happening fast enough,” Clinton said. “We need more women at any table, at any conference call or email chain where decisions are made.”

Without mentioning President Trump by name, Clinton faulted the Republican presidential administration repeatedly, including calling its representation of women in top jobs “the lowest in a generation.”

She rebuked White House press secretary Sean Spicer, again not by name, for hours earlier Tuesday chiding a black woman journalist during a news conference for shaking her head.

“Too many women have had a lifetime of practice taking this kind of indignity in stride,” Clinton said. “I mean, it’s not like I didn’t know all the nasty things they were saying about me. I thought some of them were kind of creative."

Clinton cracked jokes about her November defeat and her months out of the limelight since, Clinton spoke to thousands of businesswomen in San Francisco, joking there was no place she’d rather be, “other than the White House.”

Trump has named four women to his Cabinet, the same number as in former President George W. Bush’s first Cabinet. Trump earlier this week pointed to the work he planned to have his daughter, Ivanka Trump Kushner, do on childcare and other issues involving working women and men in her unsalaried role in his administration.

The Associated Press contributed to this report

County Health Rankings show Black Hawk slipping - Waterloo Cedar Falls Courier

WATERLOO — Black Hawk County has fallen in the latest health rankings.

The report released today shows Black Hawk County ranking 85th of Iowa’s 99 counties in health outcomes. The rankings measure lifespan and quality of life in nearly every county in the nation.

It’s the lowest rating for Black Hawk since the County Health Rankings, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, were first released in 2010.

“When I look at the snapshot for Black Hawk, I think the obesity rate is something that is well worth addressing,” said Mary Bennett, a community coach with County Health Rankings and Roadmaps.

Bennett said a high obesity rate can have a “tremendous” impact because ailments like heart disease and diabetes are connected to obesity.

Other risk factors for the county include a lack of physical activity, a rise in violent crime and a high rate of sexually transmitted infections — Black Hawk is the second-worst county in the state in newly diagnosed chlamydia cases per 100,000 people.

“You’re ranked 85, but the social and economic factors are really, it looks like, the ones to pay the most attention to, besides the adult obesity, which is also connected to social and economic factors,” Bennett said.

Black Hawk ranked 90th in social and economic factors like high school graduation rates, percent of children living in poverty and violent crime.

The rankings are meant to show where a community can make improvements or build on strengths. Examples of community success stories, as well as additional data, are available at www.countyhealthrankings.org/.

Statewide

While Black Hawk slipped — it ranked 73rd in 2016 and has ranked between 68th and 82nd in eight years of the rankings — the picture is not all bleak throughout Northeast Iowa.

Two counties are in the top five in terms of health outcomes, and Bremer County was sixth.

Sioux County remains the healthiest in Iowa, followed by Winneshiek, Lyon, Chickasaw and Cedar counties. The least healthiest are Lee County at 95th, followed by Pocahontas, Wapello, Decatur and Monona counties.

Bennett noted clinical care as a strength in Black Hawk County and across the state. Iowa ranks well in access to primary care physicians and dentists and has a relatively low uninsured rate.

New data

The County Health Ranking began measuring two new factors this year: deaths due to drug overdoses and youth disconnectedness. Though neither were included in the rankings, both can help a community understand underlying issues.

Black Hawk County’s youth disconnectedness rate is 7 percent, compared with 9 percent statewide. It’s drug overdose death rate is six per 100,000 people; the highest rate in the state is 18 per 100,000 in Scott County.

Many counties, however, were not included in the latter measure, Bennett said, because there is a lack of data.

Drug overdoses are one reason premature deaths are on the rise across the nation after dropping for years.

Bennett said the new figures can help communities address risk factors for health.

“What’s really working is when people look at the issue, get a clear understanding of what’s happening and come up with solutions that really address the cause and not just a Band-Aid, and that’s going to be the return on investment,” Bennett said.

This Self-Taught Programmer Is Bringing Transparency to California Politics - Reason

Rob Pyers didn't set out to bring transparency to establishment politics. In fact, he didn't even have any programming experience before he built the electronic systems for the California Target Book, a go-to resource for political transparency in the state. He initially came to Los Angeles with aspirations of becoming a screenwriter, but ended up stuck in his day job, bagging groceries. Then Walgreen's laid him off, and he needed something else to do.

After joining the Target Book, Pyers taught himself how to code, mostly by watching YouTube videos. Two years later, the 41-year-old has built its systems from the ground up, and now runs the website from his cramped West Hollywood one-bedroom. He is often the first to publicize major donations and new candidates, making his Twitter feed invaluable to campaign consultants and journalists alike.

Pyers, who describes himself as "95 lbs of concentrated tech geek," has become an expert on pulling data from hundreds of voter databases, election filings, and campaign finance disclosures. He's done all this despite the fact that the state's main resource for campaign information is an inaccessible hodgepodge of ZIP archives and tables that even the current Secretary of State has called a "Frankenstein monster of outdated code."

"California's Cal-Access website is notorious for being just sort of an ungodly, byzantine mess," says Pyers. "If you have no idea what you're doing, it's almost impossible to get any useful information out of."

The state is currently working on a multi-million dollar upgrade to the site, with an expected rollout in 2019. But while the government builds its new system, the Target Book has already proven its worth. During one 2016 Congressional race, the L.A. Times used Pyers' data to reveal that candidate Isadore Hall may have misused hundreds of thousands of dollars of campaign cash.

Pyers believes radical transparency is the best method for rooting out corruption because regulatory interventions tend to backfire. He bases this belief on the real-world effects he's seen in California. In 2010, the state revamped primary elections to make them nonpartisan. Reformers promised this system would help moderates and minor party candidates, but Pyers says it has only increased the power of special interests and cemented Democratic Party rule in the state.

Another popular reform is campaign finance limits, but again, Pyers believes such regulations backfire and actively hurt candidates who aren't backed by a major party or special interest. According to Pyers, their campaigns end up being dominated by PACs and dark money organizations that aren't legally required to disclose their backers, and with which the candidates are legally prohibited from coordinating.

Watch the video above for the full story.

Produced by Justin Monticello. Cameras by Monticello, Alex Manning, and Zach Weissmueller. Music by Grégoire Lourme, Hare, Kevin MacLeod, and MK2.

Inspired Kevin MacLeod (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0 License
http://creativecommons.org/licenses/by/3.0/

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Embattled DNC Asks All Staffers For Resignation Letters - NBCNews.com

Democratic National Committee Chairman Tom Perez has launched a major overhaul of the party's organization, which has been stung by recent crises — and the DNC has requested resignation letters from all current staffers.

Party staff routinely see major turnover with a new boss and they had been alerted to expect such a move. However, the mass resignation letters will give Perez a chance to completely remake the DNC's headquarters from scratch. Staffing had already reached unusual lows following a round of post-election layoffs in December.

Immediately after Perez's selection as party chairman in late February, an adviser to outgoing DNC Interim Chair Donna Brazile, Leah Daughtry, asked every employee to submit a letter of resignation dated April 15, according to multiple sources familiar with the party's internal workings.

A committee advising Perez on his transition is now interviewing staff and others as part of a top-to-bottom review process to decide not only who will stay and who will go, but how the party should be structured in the future.

Major staffing and organizational changes will be announced in coming weeks, one aide said.

"This is longstanding precedent at the DNC and has happened during multiple Chair transitions," said DNC spokeswoman Xochitl Hinojosa. "The process was started before the election of the new Chair. From the beginning, Tom has been adamant that we structure the DNC for future campaigns. Current and future DNC staff will be integral to that effort. Over the last few months, the DNC staff has done incredible work under immense pressure to hold Trump accountable."

Perez is the party's third leader in the past year, which was one of its most difficult on record.

It began with accusations that the DNC favored Hillary Clinton over Bernie Sanders in the Democratic primary, continued with the wrenching exposure of hacked emails and the abrupt resignation of former chair, Rep. Debbie Wasserman Schultz, and concluded with the shocking defeat of its presidential nominee and a divisive race for the new party chairman.

The grueling experience, which followed years in which many Democrats felt the Obama White House ignored the party organization, has left the DNC with a crisis of confidence and competence.

Now Perez, who spent most of his career in government and not politics, needs to rebuild the beleaguered party, take on President Donald Trump, tap into a unique moment of progressive activism across the country, and replenish the party's coffers.

"I wouldn't wish that on anybody," California Gov. Jerry Brown told Chuck Todd on NBC's "Meet the Press" on Sunday. "I was the Democratic Party chairman in California — it's a miserable job. So, Tom, too bad."

Sanders said Wednesday on MSNBC's "Morning Joe" that the DNC "absolutely" needed to be overhauled.

"Clearly, the Democratic Party needs a top-down overhaul," Sanders said. "And that top down overhaul means that instead of becoming dependent and being dependent on big money interests for campaign contributions, it has got to become a grassroots party."

The Vermont lawmaker added the Democratic party "programmaticaly, in terms of how it does business, has failed. I mean the evidence is obvious. It's not just that we've lost the White House and the U.S. Senate and the U.S. House. We've lost 900 legislative seats in the last eight or nine years."

Perez has spent his first weeks on the job in "active listening mode," hearing from Democrats in Washington and in small group meetings across the country before making any big moves.

"What we're trying to do is culture change," he told NBC News between stops of a listening tour in Michigan on Friday. "We're repairing a plane at 20,000 feet. You can't land the plane, shut it down, and close it until further notice."

It's a whirlwind job that took Perez from being feted at a donor conference at the Mandarin Oriental in Washington Thursday night to playing Solitaire on his iPhone in row 31 on a Delta flight to Detroit shortly after dawn the next morning.

The DNC will embark on a national search to fill key party positions, overseen by the 30-odd members of the transition advisory committee.

The committee is also reviewing the DNC's contracts with outside vendors and consultants, a source of complaints from many Democrats.

Progressives also criticized the transition committee's initial makeup, leading the DNC to add several more members from the left's ranks.

Earlier this month, Perez held a meeting to discuss the issue with Senate Minority Leader Chuck Schumer and Sanders, both of whom supported Rep. Keith Ellison in the DNC chair race.

Schumer, pointing to Ellison and Sanders, told Perez, "If he's happy, and if he's happy, then I'm happy," according to two sources.

Perez has included Ellison in many of the DNC's public events so far, but the party's charter makes no provision for a deputy chair, so Ellison does not have vote on the DNC. That could be fixed by naming the Minnesota congressman to one of the 75 slots the chairman gets to appoint to the national committee.

Ellison's political director has also been helping to oversee staffing decisions in some key departments in the DNC, according to several sources.

Analysis: Many rural millennials are alienated from politics - PBS NewsHour

Precinct volunteer David Smith carries a voting sign to the edge of SC Highway 278 outside the Horse Gall precinct in Varnville, South Carolina. The precinct is in the garage of Smith’s home in the rural county of Hampton. Photo taken in February 2016. Photo by Randall Hill/Reuters

Like older voters, young ones were divided by the 2016 presidential election.

A recent study of millennial voters by Tufts University found that young people had starkly different opinions about politics and civic institutions based on race, gender and social class.

One important dividing line separated rural and urban youth.

Rural youth defied a stereotypical notion of young voters as uniformly liberal. Exit polls conducted by news media on Election Day showed that although 55 percent of voters under 30 nationwide supported Hillary Clinton, young rural voters supported Donald Trump by 53 percent.

Researchers at Tisch College’s Center for Information and Research on Civic Learning and Engagement (CIRCLE) have studied young voters and their civic and political development for over 15 years, but this urban-rural gap took us by surprise. We set out to learn where this stark difference in opinion came from.

It’s not just about geography

Using data from CIRCLE’s survey of 1,000 millennials after the 2016 election, we wanted to find out how living in a rural area could potentially result in different levels of political involvement and opinions, leading to such different candidate choice.

In other words, did young rural voters seek an outsider candidate like Trump because they are more politically alienated and skeptical about government and the value of their own political involvement?

Approximately 14 percent of young voters live in rural areas. While not huge, this group is roughly the size of the black youth voting bloc. But unlike black youths, rural youth voting habits have been rarely studied.

So just what does living in a “rural area” mean? Exit polls classify “rural” by small population (fewer than 50,000) and location outside of metro areas. Of course, however, there is more to rural identity than geography. Sociological research suggests that it is also about power and access to institutions that benefit individuals such as youth and recreation programs, nonprofit and civic organizations. It’s also about the closeness of relationships between residents. That said, rural areas are not all the same and they face different challenges and opportunities.

We therefore decided to classify the millennials in our survey by access to opportunities for building interpersonal connections and by their civic and political engagement.

Youth with access to no resources, or only one, were classified as living in Civic Deserts. “Civic Desert” is a new term that we coined to describe places characterized by a dearth of opportunities for civic and political learning and engagement, and without institutions that typically provide opportunities like youth programming, culture and arts organizations and religious congregations.

Here’s what our study found:

1. The majority of rural youth live in Civic Deserts

Civic Deserts can be in any type of geography, but they are most common in rural areas.

Sixty percent of rural youth live in a Civic Desert compared to just about 30 percent of their suburban and urban peers. That means rural youth face a significant civic disadvantage. They have fewer opportunities to observe, participate and learn about civic and political engagement.

Just like millions of Americans who live in a food desert, an area that lacks access to healthy food choices, a majority of rural youth experience Civic Desert and lack access to meaningful civic engagement options.

2. Civic Deserts may contribute to alienation

As UC Berkeley Sociologist Arlie Russell Hochschild wrote in her recent book “Strangers in Their Own Land,” residents of a community experiencing a severe lack of access to government resources, opportunities for advancement and a decline in community cohesion may develop a sense of alienation from and distrust in aspects of civic life, such as community organizations, government agencies – and even neighbors.

Our analysis indicates that youth living in a Civic Desert are generally less experienced in civic and political life and largely disengage from politics; have few, if any, opinions about current affairs; and are less likely to believe that civic engagement like voting and civic institutions – from Congress to local nonprofits – can benefit the community. They were also less likely to help others in informal ways, like helping neighbors and standing up for someone who is being treated unfairly.

The factors that normally predict political engagement, such as education and income, are not strong enough to negate the effect of living in a Civic Desert.

3. Voting for Trump related to many factors

Coming back to our initial reaction to the rural-urban vote divide, did Civic Deserts drive young people to vote for Donald Trump?

During the 2016 presidential election, young people who live in Civic Deserts were less likely to vote compared to others with more civic resources.

If they did vote, they were slightly more likely to choose Trump than those with better access to civic resources. However, supporting Trump was related to many other things as well, including being white, male and not having a four-year college degree.

In our data, millennial support for Trump was particularly high among whites who live in Civic Deserts (39 percent) and rural areas (43 percent), compared to whites living in urban areas with high access (17 percent).

Additionally, these findings suggest that it is incorrect to assume that young Trump voters only live in rural areas. Instead, many of his supporters lived in urban and suburban areas where they lack access to civic resources.

Although many factors attribute to young people’s choice of a presidential candidate, one key explanation appears to be a sense of alienation from politics, which is a common phenomenon in Civic Deserts where young people have little to no opportunity to develop as active citizens. Civic Deserts are most prevalent in rural areas, suggesting it is important to strive for expanded access to civic engagement opportunities in these areas.

Kei Kawashima-Ginsberg, Director, Center for Information and Research on Civic Learning and Engagement in the Jonathan M. Tisch College of Citizenship and Public Service, Tufts University and Felicia Sullivan, Senior Researcher at Center for Information and Research on Civic Learning and Engagement in the Jonathan M. Tisch College of Civic Life, Tufts University, Tufts University

This article was originally published on The Conversation. Read the original article.

Riding a Hobbyhorse: Yes, It's an Organized Sport - WSJ - Wall Street Journal (subscription)

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Riding a Hobbyhorse: Yes, It's an Organized Sport - WSJ
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Thousands of young competitors in Finland are competing in equestrian jumping and dressage events while riding horses on a stick; telling naysayers to hold ...

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The Audi Sport Quattro Concept Is Dead Despite A New Boss From ... - Jalopnik

Despite Lamborghini’s Stephan Winkelmann moving over to head Audi Sport GmbH—the ‘fun’ side of the German brand—no fun is to be had in anything resembling the desirably derivative Audi Sport Quattro concept from 2013. It is officially dead.

The bossman himself has confirmed there will not be a production model of the Audi Sport Quattro anytime soon or probably ever, according to Car And Driver.

Sure, you can call me ridiculous for waiting five years for a low-volume heritage sucker punch of a concept car and still think it might have a shot, but I’d point you to two things. The first is that the man behind the crazy-ass Lamborghinis of recent years became responsible for making the call on that dreamer’s dream of a concept car, and second, the new Acura NSX still happened somehow.

It just isn’t going to happen, though. Audi is too busy making money and adding ‘S’ and ‘RS’ to everything. From Car And Driver:

“It’s a nice dream,” new Audi Sport boss Stephan Winkelmann admitted, “but I think we have so much in front of us that the most important thing is to get the lineup where we need it. I think there is the opportunity for a very limited car, but this is not my top priority at the moment.”

Instead, Audi Sport will focus on making RS Audi models more distinct from the S trims by adding power and more, like, lips and curves and stuff to existing surfaces. Also, there will be a lot of very quick SUVs and crossovers coming very soon. Those will kind of be like a new Quattro, if you’re a perpetually depressed marketing asshole somewhere within Audi.

Car And Driver also mentioned the likelihood of the next RS6 wagon hopping the pond and becoming available in the US, which is information that seems like it was offered up as some sort of apology for Audi continuing to not make the one model everyone’s been asking for over the last few decades. But I’ll take the RS6 wagaon for now. Or after 2019 or whenever it’s supposed to happen, if it happens.

Physician Burnout Is A Public Health Crisis: A Message To Our ... - Health Affairs (blog)

The Quadruple Aim recognizes that a healthy, energized, engaged, and resilient physician workforce is essential to achieving national health goals of higher quality, more affordable care and better health for the populations we serve. Yet in a recent study of U.S. physicians, more than half reported experiencing at least one symptom of burnout—a substantial increase over previous years—indicating that burnout among physicians is becoming a national health crisis. Leadership is needed to address the root causes of this problem and reposition the health care workforce for the future. The authors of this paper—the CEOs of our respective institutions—are committing to do just that.

Reasons For Physician Burnout

Burnout is an experience of emotional exhaustion, depersonalization, and feelings of low achievement and decreased effectiveness. Although the focus of this blog is physicians, burnout is also a serious problem for nurses and other health care workers. National studies indicate that burnout is more common in physicians than U.S. workers in other fields and that the gap between physician burnout and other workers’ experience is increasing. This difference is not because of physician shortcomings. The physician selection process is rigorous and eliminates those unable or unwilling to accept this lifestyle. Most physicians are altruistic and committed to their profession. They are taught to address complex problems and to embrace challenges, including grueling training, ongoing night call, and long work hours.

The spike in reported burnout is directly attributable to loss of control over work, increased performance measurement (quality, cost, patient experience), the increasing complexity of medical care, the implementation of electronic health records (EHRs), and profound inefficiencies in the practice environment, all of which have altered work flows and patient interactions. The result is that many previously well-adjusted and engaged physicians have been stressed to the point of burnout, prompting them to retire early, reduce the time they devote to clinical work, or leave the profession altogether.

Why Burnout Matters

The consequences of physician burnout are significant, and threaten our U.S. health care system, including patient safety, quality of care, and health care costs. Costs are impacted by burnout in direct ways (e.g. turnover, early retirement, less than full time work) and indirect ways (e.g. poor quality , including medication and other errors, unnecessary testing and referrals, greater malpractice risk, and possibly higher hospital admissions/readmissions). Prospective longitudinal studies from the Mayo Clinic demonstrate that for every 1-point increase in burnout score, there is a 43 percent increase in likelihood a physician will reduce clinical effort in the following 24 months. The experience from Atrius Health suggests that replacing a physician who retires early or leaves to pursue other career opportunities can cost between $500,000 and $1 million due to recruitment, training, and lost revenue during this time. All of this is in addition to the significant toll, sometimes with tragic consequences, that burnout exacts on physicians and their loved ones.

The high level of burnout among physicians should be considered an early warning sign of dysfunction in our health care system. Professional satisfaction for physicians is primarily driven by the ability to provide high-quality care to patients in an efficient manner. Dissatisfaction is driven by factors that impede this effort, including administrative and regulatory burdens, limitations of current technology, an inefficient practice environment, excessive clerical work, and conflicting payer requirements. High levels of physician burnout can thus be seen as an indicator of poor performance by the underlying system and environment.

The Role Of Technology In Driving Burnout

One of the key contributors to burnout involves the aforementioned EHRs. While they have the potential to make a major contribution to patient safety and enhanced coordination of care, EHRs have also radically altered and disrupted established workflows and patient interactions, become a source of interruptions and distraction and are very time intensive.

While EHRs are evolving in a meaningful way in some institutions, the pace of enhancement must accelerate across the board. Health care delivery organizations, organized medicine, payers and other interested parties need to work with EHR vendors to improve their product offerings, which could reduce EHRs burden on physicians.

Leadership’s Role In Responding To Burnout

Executive attention to the issue of burnout in physicians and other health professionals is paramount to make the changes necessary to improve the health care environment. To further this objective, the CEOs of 10 leading health care delivery organizations held a summit meeting at the American Medical Association (AMA) headquarters in Chicago in September 2016. We reviewed the compelling data on the extent of physician burnout and the consequences for health care delivery systems. After reviewing this data and sharing the experiences of our organizations, we unanimously concluded that physician burnout is a pressing issue of national importance for patients and the health care delivery system.

As leaders, we must recognize burnout in physicians and other health care workers as a serious problem and respond vigorously. This is especially true if we want to maximize the effectiveness, productivity, and longevity of clinicians. More than words are needed. Leaders of health care delivery organizations must embrace physician well-being as a critical factor in the long-term clinical and financial success of our organizations. We must make both the prevention of burnout and the restoration of the joy of a career in medicine core priorities, and address this issue with the same urgent methods we would use to solve any other important business problem: commit to measurement, develop strategy and tactics, and allocate the resources necessary to achieve success. Boards should hold CEOs accountable to implement these approaches to address physician burnout.

The leadership characteristics of a physician’s immediate supervisor also matter. Each 1-point increase (on a 5-point scale) in the leadership score of a physician’s immediate supervisor decreases the odds of burnout by 3.3 percent and increases the likelihood of satisfaction by 9 percent. Successful leaders hold career development conversations with their physicians, inspire and empower their physicians to do their job well, and recognize the physician for a job well done.

CEO Commitment And Call To Action

There was clear consensus among all present at the AMA summit that addressing the issue of burnout is a matter of absolute urgency. We candidly acknowledge that we don’t have all the answers, or know for certain what the most impactful interventions are, but we are beginning to learn and progress is being made in some areas. Throughout the course of our meeting, we shared effective interventions and successful practices from our own institutions. We acknowledged that not all of the issues we explored were equally weighted in all institutions, and that each CEO needs to examine—and address—the specific issues that contribute to burnout in their respective organization. At the end of the summit, we committed to continue educating ourselves and to take action.

Specifically, we committed to:

Regularly measure the well-being of our physician workforce at our institutions using one of several standardized, benchmarked instruments.

Where possible, include measures of physician well-being in our institutional performance dashboards along with financial and other performance metrics.

Evaluate and track the institutional costs of physician turnover, early retirement, and reductions in clinical effort.

Emphasize the importance of leadership skill development for physicians and managers leading physicians throughout our organization.

Understand and address more fully the clerical burden and inappropriate allocation of work to physicians that is contributing to professional burnout.

Support collaborative, team-based models of care where physician expertise is maximally utilized for patient benefit, with tasks that do not require the unique training of a physician delegated to other skilled team members.

Encourage government/regulators to address the increasing regulatory burden that is driving inefficiency, redundancy, and waste in health care and to proactively monitor and address new unnecessary and/or redundant regulations.

Encourage and support the AMA and other national organizations to work with regulators and technology vendors to align technology and policy with advanced models of team-based care and to reduce the burden of the EHR on all users.

Encourage and support the AMA and other national organizations in developing further initiatives to make progress in this area by compiling and sharing best practices from institutions that have successfully begun to address burnout, profiling case studies of effective well-being programs, efficient and satisfying changes in task distribution, and outlining a set of principles for achieving the well-being of health professionals.

Continue to educate our fellow CEOs as well as other stakeholders in the health care ecosystem about the importance of reducing burnout and improving the well-being of physicians as well as other health care professionals.

Support and use organizational research at our centers to determine the most effective policies and interventions to improve professional well-being among our physicians and other health care professionals.

We believe that our patients deserve care from a compassionate, competent, engaged, and resilient health professional workforce. We are committed to working together as CEOs as well as with other stakeholders within the health care ecosystem to make progress in this critical arena. We invite you to join us.

With God on Their Side: How Evangelicals Entered American Politics - New York Times

One major question dominates FitzGerald’s treatment, and it is suggested by her subtitle. Why should the faithful try to shape America at all? To a strong believer, God’s kingdom is the one that matters, and it is not of this world; America, from such a perspective, is just a tiny speck in a vast world unknowable to us. Get right with the Lord, not the Republican Party.

As if to demonstrate such a sentiment, separation from, not engagement with, the world around us was the major tendency in conservative American Protestantism during the first half of the 20th century. Baptists were strict adherents to the separation of church and state. Religious entrepreneurs like William B. Riley in the North and J. Frank Norris in the South concentrated on building fundamentalist fiefs rather than political movements. Another important separationist, according to FitzGerald, was J. Gresham Machen, expelled from the Presbyterian general assembly for his strict and sectarian screeds against both theological liberalism and spreading fundamentalism. Separationism, FitzGerald writes, “inspired conspiracy theories of the vilest sort, but it also fostered group solidarity and attracted Bible-believing Protestants alienated in the strange new world of global depression and global war.” Whatever you think of the separationists and their ideas, shaping America was not high on their list of priorities.

Billy Graham and Richard Nixon, Knoxville, Tenn., May 1970.

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BETTMAN, via Getty Images

A Positive Outlook May Be Good for Your Health - New York Times

Even when faced with an incurable illness, positive feelings and thoughts can greatly improve one’s quality of life. Dr. Wendy Schlessel Harpham, a Dallas-based author of several books for people facing cancer, including “Happiness in a Storm,” was a practicing internist when she learned she had non-Hodgkin’s lymphoma, a cancer of the immune system, 27 years ago. During the next 15 years of treatments for eight relapses of her cancer, she set the stage for happiness and hope, she says, by such measures as surrounding herself with people who lift her spirits, keeping a daily gratitude journal, doing something good for someone else, and watching funny, uplifting movies. Her cancer has been in remission now for 12 years.

“Fostering positive emotions helped make my life the best it could be,” Dr. Harpham said. “They made the tough times easier, even though they didn’t make any difference in my cancer cells.”

While Dr. Harpham may have a natural disposition to see the hopeful side of life even when the outlook is bleak, new research is demonstrating that people can learn skills that help them experience more positive emotions when faced with the severe stress of a life-threatening illness.

Judith T. Moskowitz, a professor of medical social sciences at Northwestern University Feinberg School of Medicine in Chicago, developed a set of eight skills to help foster positive emotions. In earlier research at the University of California, San Francisco, she and colleagues found that people with new diagnoses of H.I.V. infection who practiced these skills carried a lower load of the virus, were more likely to take their medication correctly, and were less likely to need antidepressants to help them cope with their illness.

The researchers studied 159 people who had recently learned they had H.I.V. and randomly assigned them to either a five-session positive emotions training course or five sessions of general support. Fifteen months past their H.I.V. diagnosis, those trained in the eight skills maintained higher levels of positive feelings and fewer negative thoughts related to their infection.

An important goal of the training is to help people feel happy, calm and satisfied in the midst of a health crisis. Improvements in their health and longevity are a bonus. Each participant is encouraged to learn at least three of the eight skills and practice one or more each day. The eight skills are:

■ Recognize a positive event each day.

■ Savor that event and log it in a journal or tell someone about it.

■ Start a daily gratitude journal.

■ List a personal strength and note how you used it.

■ Set an attainable goal and note your progress.

■ Report a relatively minor stress and list ways to reappraise the event positively.

■ Recognize and practice small acts of kindness daily.

■ Practice mindfulness, focusing on the here and now rather than the past or future.

Dr. Moskowitz said she was inspired by observations that people with AIDS, Type 2 diabetes and other chronic illnesses lived longer if they demonstrated positive emotions. She explained, “The next step was to see if teaching people skills that foster positive emotions can have an impact on how well they cope with stress and their physical health down the line.”

She listed as the goals improving patients’ quality of life, enhancing adherence to medication, fostering healthy behaviors, and building personal resources that result in increased social support and broader attention to the good things in life.

Gregg De Meza, a 56-year-old architect in San Francisco who learned he was infected with H.I.V. four years ago, told me that learning “positivity” skills turned his life around. He said he felt “stupid and careless” about becoming infected and had initially kept his diagnosis a secret.

“When I entered the study, I felt like my entire world was completely unraveling,” he said. “The training reminded me to rely on my social network, and I decided to be honest with my friends. I realized that to show your real strength is to show your weakness. No pun intended, it made me more positive, more compassionate, and I’m now healthier than I’ve ever been.”

In another study among 49 patients with Type 2 diabetes, an online version of the positive emotions skills training course was effective in enhancing positivity and reducing negative emotions and feelings of stress. Prior studies showed that, for people with diabetes, positive feelings were associated with better control of blood sugar, an increase in physical activity and healthy eating, less use of tobacco and a lower risk of dying.

In a pilot study of 39 women with advanced breast cancer, Dr. Moskowitz said an online version of the skills training decreased depression among them. The same was true with caregivers of dementia patients.

“None of this is rocket science,” Dr. Moskowitz said. “I’m just putting these skills together and testing them in a scientific fashion.”

In a related study of more than 4,000 people 50 and older published last year in the Journal of Gerontology, Becca Levy and Avni Bavishi at the Yale School of Public Health demonstrated that having a positive view of aging can have a beneficial influence on health outcomes and longevity. Dr. Levy said two possible mechanisms account for the findings. Psychologically, a positive view can enhance belief in one’s abilities, decrease perceived stress and foster healthful behaviors. Physiologically, people with positive views of aging had lower levels of C-reactive protein, a marker of stress-related inflammation associated with heart disease and other illnesses, even after accounting for possible influences like age, health status, sex, race and education than those with a negative outlook. They also lived significantly longer.

Tuesday, March 28, 2017

Trump to GOP: Pass health care bill or seal your fate - CNBC

The GOP bill would scale back the role of government in the private health insurance market, and limit future federal financing for Medicaid. It would repeal tax increases on the wealthy that Democrats used to pay for Obama's coverage expansion. Fines enforcing the Obama-era requirement that virtually all Americans have coverage would be eliminated.

The nonpartisan Congressional Budget Office estimates that 24 million fewer people will have health insurance in 2026 under the GOP bill.

Trump warned House Republicans they'd seal their political doom if they waver, with the party potentially losing control of the House. Still, several conservatives were steadfast in their opposition even after the session with Trump.

"The president wouldn't have been here this morning if they have the votes," said Rep. Rod Blum, R-Iowa, a member of the Freedom Caucus who complained that the GOP bill leaves too much government regulation in place.

Rep. Chris Collins, R-N.Y., said Trump told Republicans he would campaign for them if they backed the bill. Trump didn't indicate what he would do to those who vote against the bill, but during the caucus, he singled out Rep. Mark Meadows, R-N.C., an outspoken critic of the bill.

Collins said Trump asked Meadows to stand up, called him a great guy and said he is counting on Meadows to get this over the line.

"The president is very adroit at putting somebody on the spot and he did that today with Mark Meadows," Collins said. Asked if there was a threat to Meadows in that, Collins responded: "There was no threat whatsoever."