Editor’s note: This is the first installment in a three-part series about the experience of LGBTQ students at Notre Dame in light of recent requests that the University grant club status to a gay-straight alliance. For more than 25 years, Notre Dame students have asked the University to formally recognize a student organization that addresses the needs of the lesbian, gay, bisexual, transgender and questioning (LGBTQ) community on campus. The requests have come in many forms, including student government resolutions, a report to the Board of Trustees and applications from student organizations requesting to be officially recognized as a club by the Student Activities Office (SAO). Each time, the University rejected the request, but also affirmed its commitment to meeting the needs of LGBTQ students in ways other than a student-to-student group, according to rejection letters. The University has historically cited a conflict with Catholic teaching as a reason for rejecting the clubs. Last week, students submitted the most recent application asking that SAO recognize a gay-straight alliance (GSA). It was the fourth application for a GSA in the last six years, Peggy Hnatusko, director of student activities for programming, said. Hnatusko said the proposed GSA is under review, but also said the current structures the University offers best meet the needs of LGBTQ students. “It remains the viewpoint of the Student Activities Office that due to the sufficiently complex nature of the issue, the needs of gay, lesbian, bisexual and questioning students can best be met through the structures that are currently in place,” she said. Student body president Pat McCormick said the University has made significant progress on addressing the needs of LGBTQ students over the years, but students have come to him asking for the next step. “Students are asking and seeking a peer-to-peer kind of group where gay and straight students can come together and have their own kind of independent group,” he said. “The core element that we’re trying to seek is whether we can make some kind of progress in trying to advance the spirit of inclusion further in ways that are consistent with Catholic teaching.” A long history The names and specific objectives of the groups have changed over the years, but since the 1980s, unofficial student groups for LGBTQ students have sought official University recognition. “There have been a number of applications received by the Student Activities Office whose purposes cover a wide array of gay and lesbian student issues,” Hnatusko said. “These proposals have ranged from providing a support group to establishing a gay- straight alliance.” Hnatusko and representatives from Student Affairs were unable to provide the exact number of times a student group serving the needs of LGBTQ students has requested club status and been denied. Based on interviews and copies of rejection letters obtained through student government records, The Observer verified seven requests. Senior Sam Costanzo, who submitted this year’s application for a GSA, puts it at around 15 times. University representatives could not confirm or deny this number, The first request on record dates back to 1986, when a group called Gays and Lesbians at Notre Dame/Saint Mary’s College (GLND/SMC) asked for club status. Student Affairs denied the request, according to rejection letters. “It is our judgment that formal recognition of GLND/SMC carries with it an implicit sanction for a homosexual lifestyle which is not in keeping with the values of the University or the teachings of the Church,” according to an excerpt from the 1986 letter. The next request came in 1992, when SAO denied GLND/SMC club status based on the 1986 decision, according to a copy of the rejection letter. That decision was appealed, and then-Vice President for Student Affairs Patricia O’Hara upheld the rejection. “And then it blew up,” Costanzo said. “In 1993 and 1994 this became like the Viewpoint war. And then 1995 was when it really reached fever pitch.” In 1995, student government’s Campus Life Council (CLC) passed a resolution asking the University to recognize GLND/SMC. The bylaws of CLC required O’Hara to publicly respond to its request. In an open letter to the Notre Dame community, O’Hara denied the request because the University did not think granting GLND/SMC club status was the “appropriate means to the agreed upon end of building a supportive environment for our gay and lesbian students.” Instead, O’Hara created an ad hoc committee to advise her on how, apart from recognizing a student organization, the University could do a better job serving LGBTQ students. In 1996, this committee’s recommendations led to a standing committee comprised of faculty, administration members and students to advise the Vice President of Student Affairs on how to address LGBTQ student needs. In 1997, the University added a Spirit of Inclusion to its student handbook, du Lac. It states that Notre Dame welcomes LGBTQ students and seeks to create an environment of “in which none are strangers and all may flourish.” “We value gay and lesbian members of this community as we value all members of this community,” it states. “We condemn harassment of any kind, and University policies proscribe it.” By 2006, the standing committee morphed into the Core Council, which is the University sanctioned structure in place today, Hnatusko said. Most recently, applications for club status have been for a GSA, rather than a group for LGBTQ students alone. Hnatusko said since she took her position in 2007, there have been four applications for a GSA. Room to work together Over the years, the University has expressed a desire to meet the needs of LGBTQ students, but in a way that is consistent with Church teaching. Core Council has become the University’s primary resource to do so. As an advisory board for the Vice President of Student Affairs, Core Council is comprised of four administrators and eight students, the majority of whom must identify as LGTBQ, said co-chair Sr. Sue Dunn. “We’re not a club, and that’s a great distinction to make, because we answer directly to, as an advisory group if you will, to the Vice President for Student Affairs,” Dunn said. Core Council works with organizations across campus to raise awareness and educate the community about LGBTQ issues. It also hosts a monthly coffee where students can get together to be social and monthly discussion groups regarding LGBTQ issues, Dunn said. This year, Core Council was given its own space in LaFortune, and it now hosts Safe Space hours several nights a week, where students can come in to talk or simply hang out. “We’re definitely in a good position of growth phase now,” Dunn said. Dunn said Core Council differs from a GSA in its composition and nature. “Some of the more pastoral needs are met by the Core Council’s structure,” she said. “Sometimes there is an ebb and flow to student groups that are only run by students … Part of the reasoning in coming up with this sort of structure is that there would be some stability.” Senior Jason G’Sell, who serves as co-chair with Dunn, said from the perspective of a gay student, the Core Council does not eliminate the need for a GSA. “Frequently, they say the Core Council is doing what the GSA is doing. We could have a thousand Core Councils and that wouldn’t be enough,” he said. “There will never be enough [safe] space.” G’Sell said a GSA could provide an option for students who do not like Core Council events, as well as appeal to students who are less comfortable with their sexuality. “There’s a conception that if you walk into our events, it’s like you’re going to have a rainbow flag stamped onto your forehead, [that] you’re outing yourself to the world and everyone’s going to know, and that’s scary for people who aren’t really comfortable with their identity,” he said. “[In a GSA], identity is less important because it’s for LGBT people, and questioning people and allies. You can perhaps choose which one you want to identify as. “And I would say at Notre Dame, that is particularly important.” AllianceND This year’s application for a GSA comes from an unofficial club, AllianceND, which meets biweekly, Costanzo said. The application comes after Student Senate passed a resolution last month asking the University to give club status to a GSA and in the wake of a video released last week by the 4 to 5 Movement, which advocates for an improved environment of inclusion for LGBTQ students, faculty and staff. “There is just a lot of energy and excitement in how we can continue the remarkable progress that’s been made in expanding inclusion at Notre Dame,” McCormick, student body president, said. Costanzo said the current proposal strived to work within the standards of the University and Church teaching. “There’s been this long standing perception or misunderstanding that we are a certain type of group of students and that we are seeking to get this approved for it to be like a locus of sinful interaction between students,” he said. “We’re going to be subject to the same standards and scrutiny as every other student club if we’re approved … We’re trying to make it clear that we’ll work within the boundaries [of Church teaching.]” Costanzo said if approved, AllianceND would not seek to usurp the responsibilities of Core Council. Rather, it would complement the structures already in place. He said Core Council is “a static hub of support,” whereas a GSA would be “peer to peer, not tied down to an institutionalized office.” Hnatusko, who is responsible for making the final decision regarding prospective clubs, said the GSA application is one of 22 applications for new clubs SAO received by the deadline last week. As the first step in the approval process, Hnatusko said she will review each proposed club and look at a number of factors related to the club’s purpose, proposed activities and feasibility. The club must also be consistent with the University’s mission and Catholic teaching, according to du Lac. “That’s usually where it’s been killed,” Costanzo said. Hnatusko said this process can take several weeks, but if the club meets University standards for recognition, it is sent to a branch of student government for approval. She said SAO will send letters regarding the status of proposed student clubs after all 22 have been reviewed, which must be finished by the end of next semester. If approved, Costanzo said AllianceND would be like any other student club. “We could flier. We could have our own events … We were kind of thinking of having a service component to the GSA too,” he said. “We could get out into the campus to change the culture. So in that sense, it’s proactive, but it’s not activist-y.” McCormick said the time is right to approve a GSA. “There is no better time. We’ve had progress for so many years now,” he said. “Why not continue that? Why not continue this march forward?”
As someone who researched cultural divisions for many years, Mary Ellen Konieczny had a way of bringing together those of differing opinions.“She was really interested in cultural conflict and, in particular, cultural conflict in religion and polarization in the U.S. Catholic church,” Linda Kawentel, a former Notre Dame doctoral student, said. “And so, one of her interests was actually getting people to talk to each other — not only about theology, but even just to get people to know each other.”Professor Konieczny, the Henkels Family Associate Professor of Sociology, died Feb. 24 at the age of 58 due to complications from cancer.She was known as a prominent sociologist and researcher in her field, Fr. Paul Kollman, an associate professor of theology and her former classmate and colleague, said.“I just appreciated having a friend on the faculty like her who knew enough about my field to be conversant and also was a good sociologist,” he said. “[She] helped me understand her field and study of religion from the perspective of her discipline. She was a very generous, acute, thoughtful person.”Professor Konieczny, who also went by “MEK,” was in the process of studying the role of religion at the U.S. Air Force Academy. She was also researching Our Lady of Kibeho — a Marian apparition in Rwanda — and its role in healing divisions in the country after genocide.“Everything she worked to study was somehow focusing on this question of polarization and connection, and I think that recurs again and again in her life, in how she lives as a person, how she wanted to always connect people and also what she wanted to study,” Ann Mische, associate professor of sociology and peace studies, said.Professor Konieczny and Mische formed a book-writing group with sociology professor Erin McDonnell to hold each other accountable during the writing process. Mische said these meetings formed some of her favorite memories with Professor Konieczny.“I really loved meeting with her every week, talking through our projects, seeing her figure something out,” Mische said. “She was struggling and struggling with something about her book, and as we would talk, seeing her excitement as she figured out the way that she was going to solve this problem in the writing of her book, that was really fun.”McDonnell said she came to know Professor Konieczny as someone who always pushed others to achieve their highest potential through this process.“I came to realize that Mary Ellen was someone who had very high standards and aspirations, but had that rare ability to be honest and vulnerable about her own uncertainties,” McDonnell said in an email. “At the same time, she was a stalwart cheerleader for her students and colleagues, always willing to be the mirror that reflected back our best selves when we were uncertain.”Professor Konieczny was a particularly objective instructor, junior Jeffrey Murphy said.“One of the four founding fathers of sociology, Max Weber, used to say that it is a great attribute of professors to be politically impartial,” Murphy said. “He basically said that students should walk away from your class and have no idea where you stand on the political spectrum. That’s how good you should be at not letting your political beliefs influence the way in which you present information, and to this day, I have no clue where she fell on the political spectrum.”Kawentel, who earned her Ph.D. under Professor Konieczny’s guidance, recalled their long discussions and ability to connect over a number of subjects.“We could easily jump from topic to topic and it would be an engaging conversation,” Kawentel said. “Anything from teaching to personal life to sociology and research to faith and feminism. She was just fun to talk to and whether that was like our meetings in her office or over a glass of wine at her house, she was a very lively conversationalist.”Through these conversations, Professor Konieczny also created a space for marginalized students to discuss their experiences, senior Salonee Seecharan said.“I’m a brown, first-generation immigrant woman, and that can be difficult at Notre Dame sometimes,” Seecharan said. “And I’m Hindu, I’m brown, I’m a woman — she understands some of those things, and some of those things she doesn’t. She’s Catholic, so there’s a big difference, but there was something very safe about walking into her office.”Seecharan said Professor Konieczny was also known for her sense of fashion.“She just wore things that were really flattering and very, very stylish. … [she wore] lots of bright colors,” Seecharan said. “It really reflected her person: very welcoming and very bright — very sunshiney, even in the winter.”Professor Konieczny went out of her way to help others, Seecharan said, even writing recommendations while she was ill.“She was one of my application [recommenders], and that was when she was sick,” Seecharan said. “I didn’t know at the time, because she didn’t tell us — it was kind of a surprise for the students, we knew she wasn’t doing well — but I was applying in November, December and she wasn’t feeling well at the time, and she still did it. She could have told me she just couldn’t, but she did it.”Abigail Jorgensen, a doctoral student, also noted Professor Konieczny’s influence on her life. She first met Professor Konieczny as an undergraduate student and when she decided to pursue a Ph.D. in sociology, Professor Konieczny became her advisor.“She just really took what I wanted to do and made it into something that I could see as a reality which was really cool, especially for a job like being a professor where less than 1 percent of the population has a Ph.D. so it doesn’t seem all that attainable especially if you’re from somewhere in Minnesota that has one stoplight,” Jorgensen said. “But it was really cool for her to take that and make it into a visual reality that I could see and work toward.”Taking a holistic approach to education, Professor Konieczny was interested in all aspects of her students’ lives, Jorgensen said.“Just as an advisor she really cared not just about what I wrote that day or what I had written the week before [or] what conferences I had applied to,” Jorgensen said. “ … She really cared about the whole person, not just the work you produced.”Tags: Mary Ellen Konieczny, professor, sociology
FacebookTwitterLinkedInEmailPrint分享Renewables Now:The share of renewables in electricity generation in Spain jumped to 48.6% this November from 30.4% recorded the month before, according to provisional data by Spanish grid operator Red Electrica de Espana (REE).During the first 11 months of the year, 36.2% of all electricity in the country was produced from renewables.Spain’s wind farms produced 7,396 GWh in November, up 62.2% year-on-year, and succeeded in dethroning nuclear power. The wind share rose to 32.7% from 18.1% estimated in October.Spain’s demand for electricity declined by 0.4% year-on-year to an estimated 21,966 GWh in November, and by 1.7% to 242,395 GWh in the first 11 months of 2019.The Spanish mainland registered a drop in demand to 20,785 GWh, down by 0.6% year-on-year in November, with renewables producing 50.4% of all electricity. Production from wind farms grew to 7,271 GWh, registering a 60.6% year-on-year boost. The share of wind power in the peninsula reached 33.8%.More: Spain’s renewables hit 48.6% share with Nov wind power Renewables have accounted for 36% of Spain’s 2019 electricity generation through November
Contributing Author: Amy Rapp, VirtualCorps 37SHARESShareShareSharePrintMailGooglePinterestDiggRedditStumbleuponDeliciousBufferTumblr,Ken Bator Ken Bator, owner of Bator Training & Consulting, Inc., has more than 20 years of experience in helping organizations reach new levels of effectiveness by aligning their brand, culture, and … Web: www.btcinc.net Details Earlier this past spring, Deb Schaffer of Chatter Yak! posted a great article titled: “Have you woven together your credit union’s marketing efforts, brand, and culture?” here in the CUInsight Community article section. After reading her article, one area that I was struck by and nodded my head in agreement with was her wise insight about the following statement that so many CUs and other mainstream businesses misinterpret about Brand Culture:“Too many people say (when referring to their logo), “But, that is our brand.” Your organization’s brand is not a color or image. Your brand is the emotion that people feel when thinking about your organization or seeing your logo. Much like culture is not what you say, a brand is not what you do…but rather, how you make people FEEL….Make sure your marketing efforts and brand truthfully tell your members who you are, what you do, and leave them feeling something positive.”CUs have been notorious for stating the philosophy of serving the undeserved, of promoting financial literacy; we believe in the philosophy of the movement and seek to live out that philosophy. However, how good are you, REALLY, at defining your CUs brand culture? Do you make the members feel positive? Or, is your brand culture disguised in the form of something else and you have deluded yourself along with your staff into thinking that you really have a brand culture that works well? How’s your growth? How’s engagement or participation in CU events? What types of feedback are you soliciting and are you willing to address the areas that may need some attention, specifically your brand culture?Here is an article written by Ken Bator, which defines a few additional steps on Brand Culture, that I want to share with you. Maybe you think it’s a culture like Google you’re after. As Ken states, it’s your own brand culture that you’re looking for, if you never have found it. Be yourself – be authentic.Google’s Brand Culture“I want to have a culture like Google!” I’ve heard this type of statement more than once from potential clients. Usually it’s from tech entrepreneurs that want to emulate a well-known brand. The last time I heard it was from the founder of an industrial lighting company of all places.Too their chagrin I informed them that they couldn’t have Google’s culture. Their essence will always be uniquely theirs. Just as Home Depot’s culture will always be theirs, Southwest Airlines’ culture will always be theirs, and Pete’s Body Shop and Sushi will always be theirs.While there is usually a furrowed brow for a few seconds when I tell prospects this, I get a smile when I explain that they can have something better. That “something better” is something uniquely their own.A culture is the sum of a few key elements including the people that comprise the organization, their attitudes and personalities, and what the leadership will continually reinforce. Even if you recruited employees from Google they wouldn’t have the same environment and wouldn’t have the exact same culture guidance.While there may be a few elements you would like to mimic, steal, borrow, or copy from cultures of other businesses it would be just that. Much like I tell credit unions when they tell me “I want to implement a sales culture,” wouldn’t you like to build your own distinctive culture that works uniquely for your business rather than try to stamp another organization’s process or set of principles on your company as if it were a sticker?In the continuum of brand, culture, and strategy alignment – what I call B + C + S formula – it is often the “C” which is the most elusive and the hardest to figure out. This is particularly important, as it is the culture that supports the brand and allows it to flourish. It is also the culture that allows for proper implementation of the strategy. A dysfunctional culture will only tarnish the brand and place speedbumps, or even brick walls, on the road to strategy execution.So how do you build a unique and aligned culture? Here are a few critical first steps:Define your company values. The values are one of five organization drivers of the B + C + S formula. Much like the mission statement is the “why we are in business” and the vision statement is the “where we’re going” the values are the “who we are.” These are the non-negotiables that we need to exemplify on a daily basis that provide the foundation to our culture. For example, maybe you want to create a laid back atmosphere but also one of respect for each other. In that instance you may decide to not have “professional appearance” as one of the values as you want people to dress comfortably without a dress code. However, you may adopt a value of “timeliness.” While people can dress however they want, you still want to make sure each employee respects each other’s time by being on time.Work with the entire team to develop service standards. Service standards are the fifth element of the aforementioned organization drivers. They are the “how we are going to live our values every day.” It’s critical that you elicit the opinions, guidance, and help of your team in this process. Doing so creates instant buy in and develops a “We’re all in this together” feeling within the culture. Keeping with the example introduced above, you would ask staff what “timeliness” means to them and ask them to define it into a standard for your business. The staff may then develop service standards such as “We will arrive to meetings five minutes prior to their start times” and “We will provide proposals to clients a day earlier than promised.”Reinforce the heck out of both the values and service standards. Celebrate what you have created together. Put the values and service standards on laminated cards, on posters in the lunchroom, on the company intranet, etc. Use the language of the values and service standards during meetings, one-on-ones, reviews, mentoring sessions, reprimands, and coffee breaks. Remember that employees are your first customers. Like customers and prospects they need to see a message multiple times before they truly “get it.” So when you feel like you have reinforced the values and service standards too much go ahead and reinforce them again.Following these steps may not create a culture like Google within your business but you may find that you are creating something better. That “something better” may also be just what you need to guide your team to greatness. And, by the way, if you ever do come across a Pete’s Body Shop and Sushi franchise please let me know.
—– DOB: Dec. 25, 1935Height: 5 feetWeight: 150 poundsEyes: BrownHair: Gray She was last seen wearing a light-blue sweatshirt, light-blue denim jeans, polka-dot socks and tan slip-on sneakers. She could be wearing glasses. Anyone with information about Jeuck’s whereabouts is asked to contact the Broome County Sheriff’s Office at 607-778-1911 or 607-778-2053 for detectives. You may also reach out to deputies on the department’s social media pages. The sheriff’s office noted Jeuck does not have oxygen with her. Jeuck’s description: The woman, Joyce S. Jeuck, left a relative’s house in Chenango Bridge Sunday around 5:45 p.m. toward the town of Kirkwood. She was last seen on the Vestal Parkway around 8:45 p.m. in a tan 2010 Toyota RAV-4. Her license plate is number is 616542 and has the handicapped symbol on it. (WBNG) — The Broome County Sheriff’s office needs the public’s help in finding an 84-year-old missing woman who suffers from dementia and is oxygen dependent. (WBNG) — The sheriff’s office says Jeuck has been found safe and healthy.
Oct 12, 2009 (CIDRAP News) – A collection of new studies is demonstrating once again the ability of the pandemic H1N1 virus to make some people desperately sick and is raising questions about the potential strain on critical-care resources this fall and winter.Researchers in Mexico and Canada reported that severely ill patients in the early weeks and months of the epidemic spent upwards of 12 days in intensive care units (ICUs) on mechanical ventilation, according to two reports published online today by the Journal of the American Medical Association.About 17% of the Canadian patients and 41% of the Mexican patients died. Both groups were relatively young overall, and sizable minorities were obese. Hospitals in both countries struggled to meet the demand for intensive care, and four of the Mexican patients died before they could get into the ICU.A third report says that 68 patients with confirmed or suspected H1N1 in Australia and New Zealand were treated with the sophisticated heart-lung bypass technology called extracorporeal membrane oxygenation (ECMO) during the countries’ recent winter flu season. The patients, most of whom were young, were on the treatment for a median of 10 days, and 14 of them (21%) died.Given that 80% to 90% of ICU beds are filled at any given time, the findings suggest that the US critical care system could come under heavy strain as the pandemic spreads this fall and winter, several professionals involved in critical care told CIDRAP News.They agreed with two JAMA editorial writers who said the studies highlight the need for hospitals to “develop explicit policies to equitably determine who will and will not receive life support should absolute scarcity occur.”Canadian and Mexican studiesThe Canadian researchers, a large team led by Anand Kumar of St. Boniface Hospital in Winnipeg, Man., gathered data on all H1N1 patients treated in Canadian ICUs from Apr 16 through Aug 12. They identified 162 confirmed cases and 6 probable ones.The mean age of the patients was 32.3 years, and 50 were children. A third of the patients were obese, and 67% were female, a gender imbalance that was unexplained. The group included 43 aboriginal Canadians, and 52 patients were from the greater Winnipeg region.Eighty-one percent of the patients required mechanical ventilation for a median of 12 days, which was also their median time in intensive care. Fifty-one patients had major underlying conditions, with chronic lung disease, obesity, hypertension, and smoking the most common. Evidence of bacterial pneumonia was seen in 24%. The death toll was 29 patients (17%), including four children.Critical care capacity in the Winnipeg area was “seriously challenged” at the peak of the outbreak in June, with all regional ICU beds filled, much as in the SARS (severe acute respiratory syndrome) epidemic in Toronto in 2003, the report says.In Mexico, researchers tracked 58 patients who were critically ill with confirmed or suspected H1N1 cases at six hospitals from March 24 to Jun 1. They were among 899 patients with confirmed or suspected cases who were admitted to the hospitals during that time; many of them faced delays in admission to the ICU, and four died in emergency departments.The median age of the patients was 44.2 years; only two were children. Obesity was the most common “comorbid” condition, found in 21 (36%) of the 58 patients, followed by smoking, hypertension, and diabetes.All but two patients received mechanical ventilation for acute respiratory distress syndrome (ARDS). Twenty-four patients (41%) died. Those who survived were in the ICU a median of 13.5 days and on a ventilator a median of 15 days (many received ventilation outside the ICU).In the JAMA editorial, Douglas B. White, MD, MAS, and Derek C. Angus, MD, MPH, write that the similarities in the main findings of the Canadian and Mexican studies are striking. They cited the relatively young age of the patients and the prolonged and severe hypoxemia, which required frequent use of rescue therapies. They also note that there were no documented cases of nosocomial transmission of H1N1 in either case series.ECMO cases Down UnderThe third report, by a large team called the Australia and New Zealand Extracorporeal Membrane Oxygenation Influenza Investigators, covers all patients treated with ECMO for H1N1-related ARDS in the two countries from June through August.The group identified 68 patients with confirmed (61) or suspected (7) H1N1 at the 15 institutions that had ECMO capability. Their median age was 34 years; there were three children and no elderly people. The most common underlying conditions were obesity, in 50%; asthma, 28%, and diabetes, 15%. Another 15% of the patients were pregnant or in the postpartum period.Fourteen patients died by the close of the study period, while another 6 remained in intensive care.The report says the 68 patients represent an ECMO treatment rate of 2.6 per million people, and the ECMO capacity was never exceeded. Given a similar incidence of ECMO use for H1N1 patients, “rough estimates are that the United States and European Union might expect to provide ECMO to approximately 800 and 1,300 patients” this winter, the authors state.Possible shortages aheadSeveral experts involved in critical care said the reports released today suggest the potential for rough times ahead, given the small surge capacity in the US critical care system.For example, Daniel O’Laughlin, MD, medical director for emergency preparedness at Abbott Northwestern Hospital in Minneapolis, said that only 10% of the 513 adult, acute-care ICU beds in the Twin Cities area were unfilled at the time of an assessment in early September.Likewise, John L. Hick, MD, an emergency medicine physician and director of disaster preparedness at Hennepin County Medical Center in Minneapolis, commented by e-mail, “We know that most days we are running 80-90% capacity (and a few weeks ago had to cancel a few elective cases due to lack of ICU beds), so it won’t take much to bring the house down.”Last February, said O’Laughlin, several hospitals in the region ran out of ventilators, for reasons unrelated to flu. They couldn’t obtain any extra ones from suppliers immediately and therefore had to postpone some elective procedures that would’ve required the machines.The JAMA reports also make clear that not just any ventilator will be adequate for treating patients with severe H1N1 illness, according to Robert Dunne, MD, vice chief of emergency medicine at St. John Hospital and Medical Center in Detroit.”There are stockpiles of ventilators, but they tend to be very simple ventilators more for nerve agents” such as botulinum toxin, he said. “Very complex ventilation is needed in these flu patients, and these stockpiled vents may be of use to free up better ventilators but likely have little use for the flu patients.”Given the geographic progression of disease, it may be possible to move vents from areas that are having decreased activity to areas that are starting to peak, but this requires a national strategy that is not there at this time.”Nick Kuhnley, manager of respiratory care at North Memorial Medical Center in Robbinsdale, Minn., said sophisticated ventilators are needed in particular for patients who are obese, which was the case for many of those in the JAMA reports.”The common factor for that is that these people are extremely difficult to ventilate; they’re very restricted,” he said. “It’s the same exact problem as for pregnant women—you’ve encroached on your thoracic space. When you get the pneumonias in a restricted lung, it is very severe.”Kuhnley said many hospitals have a “hodgepodge” of ventilators. He said his center has 10 that are “high-acuity,” and another 19 are medium acuity, adding, “Medium-acuity ones may or may not be effective for a lot of these severe cases.”However, O’Laughlin said ventilators in state and federal stockpiles, while not as sophisticated as some high-end models, would be adequate for most patients, including most influenza patients.Another resource that could cause problems in the pandemic is the tubing, or circuits, that connect a ventilator to the patient’s airway, said Kuhnley. He said hospitals and health officials in Minnesota have been working to ensure an adequate supply of circuits and have made progress in the past year, so that they should be able to weather the pandemic, provided the distribution system remains “mostly intact.”But he said hospitals in other states may not be as well prepared.The experts noted that the availability of ECMO is very limited in the United States, as is true in Australia and New Zealand. Dunne said probably only one or two institutions in each state or region have the capability.”Since [ECMO] is not ‘standard of care,’ it is not included in preparedness efforts, and maybe it should not be,” O’Laughlin commented. “Some discussion of this is important especially given the pediatric case mix.”First pandemic in critical care eraA noteworthy aspect of the H1N1 situation is that it’s the first pandemic to occur since critical care emerged as a specialty, said O’Laughlin.”I think one of the key things is that both the Canadian and Mexican articles identified that most of the patients that did present requiring critical care resources could be supported through the illness,” he said. “This is the first pandemic we’ve experienced in the era of critical care medicine. . . . We do have the ability to utilize these critical care resources and have an impact on the patients that have experienced the 2009 H1N1 influenza and have success in having them recover.”But he cautioned that there will be difficult choices if and when ICU space and equipment run short in the course of the pandemic. “That’s where it becomes absolutely necessary for hospitals to have those discussions on how to equitably distribute the scarce resources,” he said.Kumar A, Zarychanski R, Pinto R, et al. Critically ill patients with 2009 influenza A (H1N1) infection in Canada. JAMA 2009 Oct 12;302(17):(Early online publication) [Full text]Dominguez-Cherit G, Lapinsky SE, Macias AE, et al. Critically ill patients with 2009 influenza A (H1N1) in Mexico. JAMA 2009 Oct 12;302(17):(Early online publication) [Full text]The Australia and New Zealand Extracorporeal Membrane Oxygenation Influenza Investigators. Extracorporeal membrane oxygenation for 2009 influenza A (H1N1) acute respiratory distress syndrome. JAMA 2009 Oct 12;302(17):(Early online publication) [Full text]White DB, Angus DC. Preparing for the sickest patients with 2009 influenza A (H1N1). (Editorial) JAMA 2009 Oct 12;302(17):(Early online publication)
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Topics : The decree had been set to expire on July 31. Italy’s Senate on Tuesday night gave its approval to extend the state of emergency, followed by the chamber of deputies on Wednesday, which voted 286 to 221 for the measure, with five abstentions.”Unfortunately, the pandemic today is not fully over, even though its effects are more contained and geographically limited,” Prime Minister Giuseppe Conte said Wednesday, assuring MPs that the extension did not necessarily mean new lockdowns.More then 35,000 people have died due to coronavirus in Italy, which has seen more than 246,000 infections. Italy’s parliament on Wednesday gave the go-ahead to extend the country’s state of emergency until October 15, allowing the government more flexibility to fight the lingering coronavirus pandemic.The state of emergency serves primarily to cut red tape and accelerate decision-making for the government when faced with disasters such as earthquakes, floods and other catastrophes.Italy was the first European country to be hit by the coronavirus crisis and a more than two-month lockdown dealt a severe blow the economy.
Illustration purposes only (Image courtesy of Prima Strategic Group)Prima Strategic Group has been awarded a five-year contract by the Federal Energy Regulatory Commission to provide support to perform post authorization compliance inspections of LNG projects being constructed in the United States of America.The contract scope includes performing LNG post authorization compliance inspections of all the LNG projects currently being constructed in the United States.The first contract period started in February this year, Prima Strategic Group said in a statement.“It is our highly important association with FERC, as these projects are very critical to the American energy industry and our LNG experts will play an important role in minimizing the risks associated with these projects to the communities these will be operated,” said Mohan Sharma, CEO and managing director of Prima Strategic Group.Sharma noted the LNG inspection company has been working with FERC for the past several months, making inspections visits to LNG projects.
The Globe and Mail 15 February 2014What happens when your son tells you he’s really a girl? Twenty years ago, you probably would have crossed your fingers and tried to wait it out. Today, you might buy him a whole new wardrobe, find someone to prescribe hormone blockers, and help him live as a girl. Maybe he’ll even become a celebrity. A recent Maclean’s magazine cover, posing that very question, featured a lovely 11-year-old with long, flowing locks and enormous eyes. His name used to be Oliver. Suddenly transgender kids are everywhere – in the news, on Dr. Phil and in your neighbourhood. School boards have developed detailed transgender policies. Clinics to treat transgender kids have sprung up. A condition that used to be vanishingly rare, perhaps one in 10,000 children or less, now seems common. In a random sampling of 6th- to 8th-graders in San Francisco, kids were asked if they identified as male, female or transgendered – 1.3 per cent checked off the transgendered box.What’s going on? To find out, I sat down with Dr. Ken Zucker, one of the world’s foremost authorities on gender identity issues in children and adolescents. As head of the Gender Identity Service at the Centre for Addiction and Mental Health in Toronto, he has worked with hundreds of kids like Olie. “The No. 1 factor is the Internet,” he said. “If you’re struggling to find out where you fit, the Internet is filled with things about gender dysphoria.” But for kids, especially younger ones, the issue is much more problematic. Gender confusion is often temporary. About three-quarters of little kids who have issues with their gender – boys who want to be princesses, girls who throw their dresses in the garbage – will be comfortable with it by adolescence, according to Dr. Zucker. (Many of them will grow up to be gay or bi.) Gender confusion can also be a handy label for whatever ails a child (or her family). That’s why Dr. Zucker takes a watch-and-wait approach. He even advises parents of princessy six-year-olds to say, “You’re not a girl. You’re a boy.”…Alice Dreger is a bioethicist and professor at Northwestern University’s Feinberg School of Medicine in Chicago. She calls herself an (im)patient advocate who prefers evidence to ideology. She is a strong supporter of transgender rights. But she thinks the pendulum has swung too far. One reason is that social norms have dramatically changed. It is now fashionable to embrace your diverse child. Parents who encourage their kids to change gender “are socially rewarded as wonderful and accepting,” while parents who try to take it slow “are seen as unaccepting, lacking in affection and conservative,” she says. These days, parents who don’t like the slow-and-careful answer can shop for another one. Ms. Dreger is highly critical of what she calls the “hasty clinics,” which are happy to help a kid transition right away. “Parents don’t like uncertainty,” she says. “They’d rather be told, ‘Here’s the diagnosis, and it’s all gonna turn out fine.’” Teenagers can find fast help, too. Plenty of doctors are happy to help them out with hormone treatments just for the asking. For some people, including some adolescents, transgender treatment is lifesaving. But these treatments are neither simple nor benign. They may, among other things, retard maturation, suppress your growth or render you sterile. And in the end, medical science cannot create a body that makes you forget you were born the other sex. “Some kids need it, but for the kids who don’t, it’s dangerous,” she says. “All else being equal, it’s better to avoid long-term hormone therapy and major surgery that removes a lot of tissue.”http://www.theglobeandmail.com/globe-debate/transgender-kids-have-we-gone-too-far/article16897043/