Category Archives: Preventative Medicine

The need for healthcare in the U.S. is increasing, and many organizations are exploring alternative options to meet that demand. One possible solution could be EMS physician assistants (PAs).

PAs are medical professionals who can diagnose and treat patients, interpret laboratory data, and prescribe medications.1 In 2018 the PA field was the fifth-fastest-growing in the U.S.,2 and currently degrees are offered through 75 postgraduate PA programs with 25 specialties,3 with a third of those programs focusing on emergency medicine. However, despite the original PAs originating from military EMS in 1965,4 no program today concentrates specifically on EMS.5 To be able to deliver proficient EMS care, a provider must be well versed in the unique challenges, interventions, and situations posed by the EMS setting, all of which require education from specialized training programs.6

The purpose of this article is to propose such a program: a postgraduate EMS-focused PA program that would work to expand the current availability of PA education and prepare the EMS community to allow trained PAs to practice in the EMS setting.

In 2010 EMS was officially recognized as a subspecialty of emergency medicine,7 and the National Associated of EMS Physicians (NAEMSP) responded by accrediting EMS fellowships in 2012 to formally educate EM physicians to handle the unique situations EMS providers face.8 At this time 61 NAEMSP-accredited EMS fellowships are available to EM physicians in the United States.9

With the development of physician EMS fellowships also came physician response units, vehicles staffed by emergency medicine (preferably EMS) physicians and fellows dispatched directly as scene responders, usually alongside or in addition to the usual first responders. Physician response units have been shown to be efficient ways of delivering care beyond the scope of a regular ambulance.10

As PAs in the field would function as physician extenders, their most obvious entry into the world of EMS would be as an extension of current physician response units. Proposed functions would involve both prehospital care and administrative functions. As PAs can have vast differences in their scope of practice, this article primarily reflects the laws of Missouri. Consult and abide by relevant laws and regulations when adapting this information to your state.

With few exceptions, most PA programs graduate students with a focus on primary care medicine. Many PA programs provide only a single rotation in emergency medicine.

To assure new PA graduates can function in high-speed emergency medical situations, additional education in EM should be a requirement. This should be continued over the course of the PA EMS fellowship and, as in any realm of medicine, after graduation.

Specific emergency-based certification courses such as Advanced Cardiac Life Support, Pediatric Advanced Life Support, Basic Life Support, Advanced Trauma Life Support, the Incident Command Systems, and awareness-level hazardous-materials education should be considered mandatory and obtained within the initial month of training, prior to any scene response. It is essential for the initial month of training to focus on core emergency medicine topics, along with basic EMS scene safety, to provide some assurance the PA is proficient in EM and has a good foundation for the continued addition of EMS-specific knowledge.

For any EMS PA fellowship program to have credibility, it should have education goals aligned with the proven process of the physician EMS fellowship curriculum. Therefore, one major difference to consider is that EMS physicians seeking EMS fellowships already have had an intense EM residency, while PAs have general medicine experience. That makes EM education a necessity for the EMS PA candidates success.

Physician EMS fellowships are at present accredited by the Accreditation Council for Graduate Medical Education (ACGME),11 whose education goals are outlined in Section IV of the ACGME Program Requirements for Graduate Medical Education in Emergency Medical Services. A postgraduate program for PAs should strive to follow the example set forth in the EMS physician fellowship. PAs should be required to take similar coursework to the EMS physician, including courses in incident management, tactical medicine, emergency medical dispatch, and disaster management.

Proposed prehospital functions for EMS PAs would include critical care (trauma, cardiac arrest, mass-casualty/mass-gathering events); tactical operations; high-risk refusals; and mobile integrated healthcare, including high-use individuals and low-acuity patients.

Trauma and Critical Care

An EMS PA would be a prime candidate to deliver emergent critical care during complex traumas, cardiac arrests, and mass-casualty incidents (MCIs). Having a provider capable of bringing additional tools and skills to the prehospital response, such as point-of-care ultrasound (POCUS), has the potential to improve patient outcomes.12 Advanced intravenous access, including central venous catheterization in critically ill patients, is also improved with the use of POCUS.13 Advanced Trauma Life Support recommends early ultrasonography in trauma patients by utilizing expanded focused assessment using sonography in trauma (eFAST) exams.14 Completion of these exams with positive results has been shown to decrease time from injury to arrival in the operating suite.

Ultrasound can also be seen in confirmation of cardiac standstill during cardiac arrest events. In the event of cardiac standstill, the possibility of successful resuscitation drops extremely close to 0%.15

Another tool PAs could bring into field response is skilled video laryngoscopy. Video laryngoscopy has been shown to improve success rates in urgent intubations and decrease esophageal complications.16,17

In the event of an MCI or prolonged extrication, PAs can assume the important role of monitoring the critically ill patient. Interventions could include end-tidal carbon dioxide monitoring and pulse oximetry for evaluation of ventilation in both intubated and nonintubated patients.18 PAs can also insert arterial catheters for arterial blood pressure monitoring, rather than central venous catheters for central venous monitoring. Additional critical care monitoring skills would include placing a urinary catheter to monitor urine output (for severely prolonged extrication) and core temperature monitoring.

Mass-Gathering Events

During mass gatherings an influx of stable patients could present to a medical station. In these events a PA can provide online, on-scene medical control for prehospital providers. PAs have been able to decrease hospital lengths of stay when placed in triage, so it can be inferred they are capable of identifying the appropriate needs and dispositions for patients with acute presentations.19 Having a PA on scene may also help decrease the number of patients transported to a hospital or identify subtle presentations of more serious illnesses.

Tactical Operations

During law enforcement tactical operations, where situations demand deviation from established protocols, PAs can provide a higher level of care for officers and patients. All SWAT teams accredited by the National Tactical Officers Association require medical support, so having a PA on the team may prove beneficial not only for acute care of the ill and injured but for the preventative and long-term care of the team.20

High-Risk Refusals

Most EMS systems document that between 5%20% of their call volume results in patients refusal of medical treatment, with some systems indicating 30%.21 Many of these patients, especially those older than 65, will require some kind of follow-up care.22 These older patients are also more likely to die because of their illness within a week of their medical contact.23 Pediatric patients are also high-risk refusals due to the inclusion of parents and their requests. Psychiatric patients are also high-risk; therefore PAs may be able to bring additional medications not normally carried on ambulances for violent patients. They may also be able to provide a more thorough assessment, with the possibility of alternative dispositions to the ED.

High-Frequency Users

High-frequency users of EMS can also be reduced up to 30% through education and by providing the appropriate resources for alternative, more appropriate dispositions.24 In one example of a community paramedicine program in North Carolina, high-frequency user visits to the ED were cut by more than half under a program using paramedics with additional training.25 Utilizing PAs with prescriptive authority could reduce ED use even more.

Low-Acuity Patients

EMS providers are frequently dispatched to low-acuity, nonemergent patients, who often overlap with the high-frequency user subset. The Los Angeles Fire Department implemented a nurse practitioner-staffed ambulance that responded to many of these calls. In the first six months, their treat-and-release rate was 52% for the 329 patients to whom they were dispatched.26 One study noted that low-acuity ambulance users often had insurance and a primary care provider but lacked private transportation compared to those presenting via private transportation.27

These patients also believed enough ambulances were available for calls of all acuities and said they would continue to utilize ambulances for medical transportation.27 Another study demonstrated a reduction in ED visits through using other resources, such as telemedicine and urgent care centers.28 PAs could further reduce ED visits by appropriately triaging lower-acuity patients to these established resources.

ACEP suggests physicians with board certification in EMS are best prepared to fill the role of an EMS medical director.29 This role also includes dedication to continued EMS provider education, community evaluation, QI/QA, and EMS-focused research. The EMS PA can fulfill this role as an assistant medical director (though in Missouri EMS medical directors must be board-certified physicians).29,30

Administrative duties of the EMS PA can be subdivided into three categories: education (community and prehospital provider), QI/QA, and research.

Education

An EMS PA could provide medical education to two distinct audiences: the general community and EMS providers.

For community education, opportunities exist in settings such as community health fairs, specific targeted campaigns, and the promotion of celebration weeks (e.g., EMS Week, Health Literacy Week, etc.). These efforts should be focused on spreading health awareness, communicating the availability of resources, and assisting in the first steps toward health improvement.

For prehospital providers EMS PAs could teach initial education courses and provide continuing education on focused topics or skills with the appropriate simulation materials.

Quality Improvement

Since quality improvement is also among the responsibilities of the medical director, this task could be completed by a PA working as an assistant medical director. Responsibilities would include chart review, identification of common errors, and developing training courses and education materials to assist in continual improvement.

Research

Evidence-based practice has been shown to improve overall patient outcomes, and a commitment to research is another responsibility of the EMS medical director that could be executed by an EMS PA: seeking out new areas to investigate, completing or coordinating projects, and performing original research. Additionally, PAs could locate peer-reviewed, evidence-based best practices and develop new policies and protocols to incorporate them.

Several barriers likely exist to the immediate implementation of an EMS PA program such as the one described above. The first and foremost is obtaining funding. Most fellowship programs provide the student with a stipend, but there are also costs like liability insurance, vehicles, uniforms, training courses, and medical insurance. Ways to cover these costs include insurance reimbursement for patient care hours, grants, donations, and university input.

Furthermore, the emergency medical dispatch system must be assessed to ensure correct analysis of calls for the dispatch of appropriate resources. Studies have shown protocol-based EMD systems are consistently more accurate than those without EMD protocols.31

Because of a lack of current PA providers in the EMS setting, it is important that procedures, protocols, and policies be examined to ensure liability coverage.32 These policies should be set with the direct input of the division chief/medical director. They should specify who has ultimate on-scene authority for patients should a difference in opinion ever occur on the treatment plan.

As with all postgraduate academic programs, an EMS PA program must be affiliated with a university. Many existing physician response units are already aligned with major academic centers. This would also be beneficial toward future EMS research.

A prehospital-focused EMS PA postgraduate education program would be relatively easy to implement once these few small barriers are overcome. These providers would have the ability to improve the care and functioning of EMS, contributing to a more appropriate allocation of resources, reduced ED utilization, increased cost savings, and better overall health literacy.

1. American Academy of Physician Assistants. What is a PA? http://www.aapa.org/what-is-a-pa/.

2. Bureau of Labor Statistics. Fastest Growing Occupations, http://www.bls.gov/ooh/fastest-growing.htm.

3. Association of Postgraduate PA Programs. Postgraduate Pas Programs Listings, https://appap.org/programs/pa-programs-listing/.

4. American Academy of Physician Assistants. History of the PA Profession, http://www.aapa.org/about/history/.

5. Wright D. Physician Assistant Emergency Medicine Postgraduate Programs and Their Focus on EMS Education. Unpublished, 2019.

6. Widmeier K. Specialty Certifications in EMS. J Emerg Med Serv, 2015; http://www.jems.com/2015/09/08/specialty-certifications-in-ems/.

7. American College of Emergency Physicians. EMS the Newest Subspecialty of Emergency Medicine. ACEP Now, 2010 Nov 1; http://www.acepnow.com/article/ems-newest-subspecialty-emergency-medicine/.

8. National Association of EMS Physicians. EMS Subspecialty, https://naemsp.org/career-development/ems-subspecialty/.

9. National Association of EMS Physicians. Fellowship Programs, https://naemsp.org/career-development/fellowship-programs/.

10. Bell A, Lockey D, Coats T, Moore F, Davies G. Physician Response UnitA feasibility study of an initiative to enhance the delivery of pre-hospital emergency medical care. Resuscitation, 2006; 69 (3), 38993.

11. Accreditation Council for Graduate Medical Education. Emergency Medicine: Program Requirements and FAQs, http://www.acgme.org/Specialties/Program-Requirements-and-FAQs-and-Applications/pfcatid/7/EmergencyMedicalServices.

12. Btker MT, Jacobsen L, Rudolph SS, Knudsen L. The role of point of care ultrasound in prehospital critical care: a systematic review. Scand J Trauma, 2018; 26(1): 51.

13. Palepu GB, Deven J, Subrahmanyam M, Mohan S. Impact of ultrasonography oncentral venous catheter insertion in intensive care. Indian J Radiol Imaging, 2009; 19(3): 1918.

14. Bloom BA, Gibbons RC. Focused Assessment with Sonography for Trauma. StatPearls [Internet], http://www.ncbi.nlm.nih.gov/books/NBK470479/.

15. Cureton EL, Yeung LY, Kwan RO, et al. The heart of the matter: utility of ultrasound of cardiac activity during traumatic arrest. J Trauma Acute Care Surg, 2012 Jul; 73(1): 10210.

16. Kory P, Guevarra K, Mathew JP, Hegde A, Mayo PH. The Impact of Video Laryngoscopy Use During Urgent Endotracheal Intubation in the Critically Ill. Anesthesia & Analgesia, 2013; 117(1): 1449.

17. Sakles JC, Mosier JM, Chiu S, Keim SM. Tracheal Intubation in the Emergency Department: A Comparison of GlideScope Video Laryngoscopy to Direct Laryngoscopy in 822 Intubations. J Emerg Med, 2012; 42(4): 4005.

18. Andrews FJ, Nolan JP. Critical care in the emergency department: monitoring the critically ill patient. Emerg Med J, 2006; 23(7): 5614.

19. Nestler DM. Effect of a physician assistant as triage liaison provider on patient throughput in an academic emergency department. Acad Emerg Med, 2012 Nov; 19(11): 1,23541.

20. National Tactical Officers Association. Tactical Response and Operations Standards for Law Enforcement Agencies, https://ntoa.org/pdf/swatstandards.pdf.

21. Hipskind JE, Gren J, Barr D. Patients Who Refuse Transportation by Ambulance: A Case Series. Prehosp Disaster Med, 1997; 12(4): 4550.

22. Vilke GM, Sardar Wm, Fisher R, Dunford JD, Chan TC. Follow-up of elderly patients who refuse transport after accessing 9-1-1. Prehosp Emerg Care, 2002 OctDec; 6(4): 3915.

23. Page D. Cancel with care. Which refusals can risk patient safetyand your career? J Emerg Med Serv, 2010 Dec; 35(12): 5661.

24. Pecci AW. Community-Based Program Cut ED Visits by Nearly 30%. Health Leaders, 2017 Oct 4; http://www.healthleadersmedia.com/clinical-care/community-based-program-cut-ed-visits-nearly-30.

25. Clarke JL, Bourn S, Skoufalos A, Beck EH, Castillo DJ. An innovative approach to health care delivery for patients with chronic conditions. Popul Health Manag, 2017 Feb; 20(1): 2330.

26. Eckstein M, Ito T, Guggenheim A, Sanko S. Nurse Practitioner Response Unit Launched in Los Angeles. J Emerg Med Serv, 2017; 42(2).

27. Pearson CP, Kim DS, Mika VH, et al. Emergency department visits in patients with low acuity conditions: Factors associated with resource utilization. Am J Emerg Med, 2018 Aug; 36(8): 1,32731.

28. Poon S, Schuur J, Mehrotra A. 172 Trends in Site of Care for Low-Acuity Conditions Among Those With Commercial Insurance, 20082015. Ann Emerg Med, 2017 Oct; http://www.annemergmed.com/article/S0196-0644(17)31099-5/fulltext.

29. American College of Emergency Physicians. The Role of the Physician Medical Director in Emergency Medical Services Leadership, http://www.acep.org/patient-care/policy-statements/the-role-of-the-physician-medical-director-in-emergency-medical-services-leadership.

30. Missouri Code of State Regulations. Rules of Department of Health and Senior Services, Division 30Division of Regulation and Licensure, Chapter 40Comprehensive Emergency Medical Services Systems Regulations; http://www.sos.mo.gov/CMSImages/AdRules/csr/current/19csr/19c30-40.pdf.

31. Clawson J, Olola CHO, Heward A, Scott G, Patterson B. Accuracy of emergency medical dispatchers subjective ability to identify when higher dispatch levels are warranted over a Medical Priority Dispatch System automated protocols recommended coding based on paramedic outcome data. Emerg Med J, 2007 Aug; 24(8): 5603.

32. National Association of EMS Physicians. EMS Physician-Performed Clinical Interventions in the Field Position Statement, https://naemsp.org/NAEMSP/media/NAEMSP-Documents/EMS-Physician-Performed-Clinical-Interventions-in-the-Field.pdf.

David Wright, MS, PA-C, NRP, is a physician assistant working in the Division of Pediatric Emergency Medicine at Washington University in St. Louis.

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The Benefits of an EMS PA Program - EMSWorld

Kathy Grant| What's Growing On

As the weather remains warm and our garden continues to surprise us with vigorous growth, you have probably also been plagued by the healthy insects and birds invading your tender greens.What to do is a challenge, especially if you are concerned about the residual effects of chemical sprays, either to yourself, or to your nearest waterway.

Theres hope!Hold back on heading to the store to buy what strikes your fancy, rather, spend a little time researching and reading about your options, then perhaps head to the store, or shop online, buying only what is safe and effective, or better yet, get to work to prevent problems prevent problems from happening in the first place.

Begin your fall gardening season with an IPM resolution to better garden housekeeping. Study the links below, and bookmark them below for easy reference.They also make a handy library if you have access to a printer.

This autumn, pest control in the landscape and veggie garden can include a little more than just a scarecrow and a garden shelf full of various sprays and pest control brews to keep your garden pest free.

So, what is Integrated Pest Control,(IPM), you ask?Check out the UCs IPM website for a fuller understanding: http://ipm.ucanr.edu/.But, basically, With IPM, you take actions to keep pests from becoming a problem, such as by growing a healthy crop that can withstand pest attacks, using disease-resistant plants, or caulking cracks to keep insects or rodents from entering a building. Rather than simply eliminating the pests you see right now, using IPM means you'll look at environmental factors that affect the pest and its ability to thrive. Armed with this information, you can create conditions that are unfavorable for the pest.

In other words, IPM acts at times like much like preventative medicine.

To properly adapt an integrated pest management (IPM) approach in your landscape gardening, it is best not to wait till you have problems in the garden.The University of California has created a wonderful regional checklist of monthly chores we should all be doing in the garden.

Start by going to the University of California Agriculture and Natural ResourcesIPM website, http://ipm.ucanr.edu/, and find the link to the Home, garden, turf, and landscape pests,then the Quick Link to the Seasonal Landscape IPM Checklist.

Choose the region and month you want to study, say San Joaquin,and November,then click to find a printable list of garden chores for you to work through for the month.Simple suggestions include pruning mistletoe from branches, or applying organic mulch below trees where soil is exposed, etc.

More long term goals are also stressed, which is key to IPMs effectiveness: Create an attractive landscape that reduces the need for pesticides and fertilizers, avoids runoff, and conserves water.An environmentally friendly landscape includes porous materials for walkways and other unplanted areas, good plant choices, proper site preparation, and smart irrigation equipment.A little study and small gardening changes can in the long run make your garden more sustainable.

To drill down to specific problems in certain plants, the UC IPM Plant Diagnostic Tool is a good resource to figure out solutions to specific pests in your garden.Find the tool athttps://www2.ipm.ucanr.edu/diagnostics/.

Subscribe to monthly blogs.https://ucanr.edu/blogs is a treasure trove of short, readable blog posts which keep you informed of the latest research and background to help you understand what are perceived as pests in the urban environment.

Finally, how do you control the birds, moths or squirrels in the garden, who love to nip at your veggie tender greens?The UC also has a series of Pest Notes, though a careful reading is required, since pests seasonal activities varies, as does their management. For the imported cabbage moths, Biological control and sprays of Bacillus thuringiensis and the Entrust formulation of spinosad are organically acceptable management tools,as reported in the UC ANR Publication 3442.As for the birds in the garden, a floating row cover is the simplest solution, or of course, a scarecrow, which is fun, and works for a while, until the birds figure out, its not you out there gardening!

For gardening-related questions, call the UC Master Gardener office at (209) 953-6112, or visit ourwebsite at ucanr.edu/sjmg.

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Beyond scarecrows and toxic brews: Using UC pest strategies in the autumnal garden - Stockton Record

In front of thousands who gathered to celebrate the countrys military parade on October 10, North Korean leader Kim Jong-un applauded his nations efforts in keeping out the novel coronavirus that has caused at least 1.2 million deaths around the world.

But behind the scenes, the number of citizens suspected of contracting the disease surged, according to data released by the World Health Organization.

Between October 1 and October 22, 3,373 North Korean nationals were added to the suspected patients lists, which likely occurred as the country was ramping up testing of attendees for the massive parade.

Just five days after the event, a total of 4,522 were suspected of being carriers of COVID-19. That figure quickly climbed to 5,368, including eight foreigners, by October 22. Many were quarantined but the data does not say whether anyone died from the virus.

Still, according to the WHO, no positive case was foundmeaning that North Korea has yet to report a single confirmed coronavirus case since the pandemic began roughly ten months ago. It is known that North Korea self-reports all coronavirus-related data to the WHO, so it is difficult to make a clear judgment on how factual the stated numbers are, according to experts.

Jean Lee, the director of the Korea Center at the Woodrow Wilson Center, told The National Interest that with the borders so tightly sealed, and so few foreigners on the ground in North Korea right now, its hard for us to gauge how accurate the claims are.

She added: Its hard to believe there were no cases, given the long border North Korea shares with China.

The exact number of attendees at the military parade is unknown, but it could be anywhere from thousands to tens of thousands. Video footage showed mask-less cheering citizens standing shoulder to shoulder with one another at Kim Il Sung Square, where a new ballistic missile was unveiled to the public.

Social distancing was obviously not being observed and along with the fact that the attendees werent wearing any face masks or coverings, this parade had the potential to be a super-spreader event.

But according to Korea Health Policy Project Director Dr. Kee B. Park, of Harvard Medical School, he believes that it is entirely possible that North Korea has been successful in keeping the coronavirus out of the country.

I am not aware of any request from the DPRK for external health teams to help monitor. They seem confident that their strategy has been successful so far, he told TNI.

The country is capable of implementing effective mitigation measure if there was to be an outbreak. Yes, many will get sick and some will die but I suspect it will be quickly contained.

Lee, however, was markedly less confident in North Koreas ability to battle any large-scale outbreak.

What we do know is that North Koreas fragile health-care system would be ill-equipped to deal with a full-blown outbreak of a virus that has taxed even the most sophisticated health-care systems in the world, she said.

Without adequate medicine or equipment, North Koreas doctors rely heavily on preventative medicine. Their strategy is to prevent the virus from spreading or, ideally, coming into the country, and their tactic is to impose strict lockdowns and travel restrictions.

Dr. J. Stephen Morrison, the senior vice president at the Center for Strategic and International Studies and director of its Global Health Policy Center, echoed similar sentiments.

Outside of few urban centers, health centers around the country are primitive, he told TNI, adding that many facilities dont even have running water or electricity. North Korea is very vulnerable.

Morrison also doesnt anticipate international health organizations will get access into the country anytime soon.

North Korea has a history of denying access and throwing up barriers and walls, he said. There is very minimal external presence to monitor.

However, according to Park, the continued effort to keep the virus outside North Koreas borders may come with steep economic and social costs.

The human cost of the continued isolation and mitigation will likely surpass the expected death toll of the virus itself as the pandemic rages on, he said. I would point out that most countries are wrestling with the same problem.

The U.S. Centers for Disease Control and Prevention states on its website that COVID-19 risk in North Korea is unknown. CDC recommends travelers avoid all nonessential international travel to North Korea.

The agency offers a final warning: If you get sick in North Korea and need medical care, it may be limited.

Ethen Kim Lieser is a Minneapolis-based Science and Tech Editor who has held posts at Google, The Korea Herald, Lincoln Journal Star, AsianWeek, and Arirang TV. Follow or contact him on LinkedIn.

Image: Soldiers attend a parade to mark the 75th anniversary of the founding of the ruling Workers' Party ofKorea, in this image released byNorthKorea's Central News Agency on October 10, 2020.

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Has Coronavirus Finally Arrived in North Korea? - The National Interest

Time and time again, youve probably heard me mention the rapid growth of the older adult population in the next few decades. Nonetheless, its a reality that everyone must face. Modern medicine, from preventative care to increased health literacy, along with social services the Administration of Aging and geriatric services are some of the many factors contributing to such development. Seeing that the election will play an important role in the future of older adult care and services, lets double down on the role that we can play as college students in the near future.

The world of aging does not limit itself to our discussions in academia or the skilled nursing communities that I referred to in my last column. Aging, in many ways, is a marketable and interdisciplinary field. Looking at the tech sector, theres a clear and immediate need for gerontologists to help critique and develop simple and reliable technology geared more toward older adults. For the public policy and politically oriented folks, theres room for advocacy on behalf of those diagnosed with Alzheimers or various forms of dementia. As mentioned above, knowing the fundamentals in the psychology of aging can open pathways to academia and research. For myself, I plan to head off to medical school Caribbean or not, but probably the former and pursue a fellowship in geriatric medicine soon after. In short, theres definitely a niche or space for you.

I havent even touched on the media and journalism side of aging. You might have seen initiatives to help preserve the stories of older adults through video interviews, university oral history archives or movies. One that often comes to mind is the StoryCorp program geared toward those diagnosed with some form of dementia, named the StoryCorp Memory Loss Initiative. Here, the stories of older adults can be shared to the StoryCorp project and are automatically uploaded to the Library of Congress collection in conjunction with the StoryCorp collection. Working in the Davis School of Gerontologys Communication Office, I know that we have a handful of opportunities where we try not only to increase our presence in the world of aging but also to showcase intergenerational interactions at the University.

But Lois, you, the inquisitive reader asks. Isnt gerontology and the field of aging as a whole really just one massive interdisciplinary field that is working to better orient itself to the care and assistance of older adults?

A weirdly specific question, but yes. The field of aging continues to be an incredibly complex and interdisciplinary field given its implications for almost every job sector. Even more, theres an 18% increase in the number of older adults in our current workforce since 2015, illustrating the need and care these individuals may require once they opt into retirement options.

However, I implore that you learn more about older adults before jumping into the field via trial by fire. Many can join the age bandwagon and dig out a niche in the field. Upon doing this, however, they might realize that working with the older adult population may not necessarily be their forte. So, here are a few classes offered by the School of Gerontology that could ease the transition or affirm your passion of helping older adults.

Administrative Problems in Aging provides some insight into the field of aging from an administrative standpoint. Currently taught by adjunct lecturer Tameka Brown, the class delves into topics such as working with and developing a human resources department, delegating responsibilities to coworkers and establishing a healthy work environment, all while taking older clients and employees into consideration.

Medical Issues of Older Persons: An Introduction to Geriatrics illustrates the changes in preventative care and treatment of age-related diseases throughout history while also providing insight on the current steps being taken to tackle issues among todays group of older adults. With Ed Schneider, professor of gerontology and Emeritus Dean of the Andrus Gerontology Center, its sure to be an exciting and fun class.

Neurobiology of Aging with John Walsh, associate professor of gerontology and assistant dean of education at the Davis School, is another exciting class geared more toward the science component of gerontology, looking more at cognitive function and the nervous system.

There are plenty more classes in the gerontology school as well that you should definitely give a look, particularly Maymesters and some of the smaller two-unit classes.

Outside of taking those fun gero classes, try and find some opportunities to work with older adults where youre able. At the moment, it might be incredibly difficult to find any in-person opportunities, or even hybrid volunteering, for that matter. That being said, many opportunities for getting involved or even just learning about possible careers in aging are being hosted by some clubs on campus.

From the Student Gerontology Association to GeroTech to the Medical Gerontology Association, there are places that allow for interaction with older adults, albeit through Zoom or other means. Many older adults are learning to adjust to these new and constantly changing circumstances as they continue to stay indoors and hope the pandemic clears soon. Internships at institutes such as SCAN or the Milken Foundation at its Center for the Future of Aging can certainly give you a better look into how aging is being transformed and better understood.

Bringing it all together, careers in aging are for any and all majors, and the opportunities in this promising field are endless and malleable to your personal and professional goals. Hopefully by the time were older maybe after retiring from a career in aging we look back at the progress weve made for the field of gerontology and reminisce, saying, Back in my day

Lois Angelo is a sophomore writing about the intersections of gerontology and social issues. He is also co-chief copy editor of the Daily Trojan. His column, Back In My Day, ran every other Tuesday.

Excerpt from:
Back in My Day: Careers in aging are diverse and aplenty - Daily Trojan Online

By Staff

Dr. Lynn Noseworthy, medical officer of health for the Haliburton, Kawartha, Pine Ridge District Health Unit, was scheduled to retire in June of 2020 then the coronavirus pandemic hit, delaying her departure.Last week, the health unit announced that Noseworthys last day would be Dec. 11, 2020 and that Dr. Natalie Bocking would be taking over starting in April 2021. In the interim, Dr. Ian Gemmill, former medical officer of health for Kingston, Frontenac, Lennox and Addington Public Health, will be filling the position.

Bocking has worked for the last four years as a public health physician at the Thunder Bay District Health Unit and Sioux Lookout First Nations Health Authority. She received her medical doctorate from McMaster University and is a public health and preventative medicine specialist. During her time in northern Ontario, she was also a locum family physician. She and her family now live in City of Kawartha Lakes.

She has a wealth of knowledge and experience in providing public health programs and services in rural areas of the province and has most recently worked with northern First Nations communities to provide public health services, Doug Elmslie, chair of the board of HKPR District Health Unit, said.

He thanked Noseworthy for her time with the health unit. Dr. Noseworthy has guided this health unit through some challenging times and we wish her all the best for her well-deserved retirement, he said. Dr. Noseworthy has worked tirelessly to help provide quality public health programs and services to the residents in our communities and I know Dr. Bocking will do an excellent job in carrying on that work.

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New medical officer of health to begin April 2021 - Haliburton County Echo

(Image sourced via Team Rubicon website)

While the amazing humanitarian work being undertaken by NGOs around the world, particularly in disaster zones, is rightly widely recognized and lauded, most of us fail to consider the huge logistics challenges involved in ensuring that everything works smoothly and efficiently.

Justin Spelhaug, Vice President and Global Head of Tech for Social Impact at Microsoft, explains the challenge:

Responding to a disaster is a huge supply and demand problem. It's not just about getting a person to volunteer, but it's how does that organization leverages data and intelligence to get the right' person on the ground based upon experience, skillset, proximity, availability and a number of other factors? To mobilize that many volunteers a day almost overnight, you have to have the systems and infrastructure to do it.

One NGO faced with just that issue isTeam Rubicon, a US-based organization that uses the skills and expertise of military veterans to help rebuild underserved communities around the world hit by natural disasters ranging from hurricanes and wildfires - and lately Covid-19. To help it in its mission, it has been working on a digital transformation roadmap over the last two and a half years, which it is currently about half way through.

This digital transformation has resulted in it introducing a Microsoft Dynamics 365-based enterprise management and volunteer mobilisation system, which runs on the software vendor's Azure cloud platform. As Raj Kamachee, Team Rubicon's chief information and chief technology officer, points out though, the Covid-19 pandemic "threw us off course", not least because:

The model of a traditional event, such as an earthquake or storm, is that they're instantaneous and based in a single location - they don't generally happen at the same time. But our challenge in this instance was how to respond to a number of events all happening simultaneously.

These events at home in the US ranged from wildfires on the West Coast to Hurricanes Laura, Sally, Delta and Zeta as well as the pandemic itself. Such a complex situation meant that Team Rubicon needed to modify its existing centralised system, which was used by staff based at headquarters to deploy volunteers around the country.

The idea was to introduce a more distributed model in which 25 individual territories were given more control over mobilising the support required locally, a shift that was introduced in as little as five weeks. This mobilisation process includes vetting available skills and ensuring volunteers in vulnerable categories are not put in harm's way but are still able to make a useful contribution.

The benefits of adopting a decentralised model have already been considerable, says Kamachee:

Rather than deploy grey shirts' [volunteers] to one location at a time, we can now deploy them simultaneously. So the volume of volunteers is now larger and their impact is higher and deeper than in the past, which is important as we're not just providing a single service - we're doing everything from providing emergency food and medicine to Covid testing sites.

The NGO also partners with other organizations, including food banks, some of which can connect to its system to share data using an application programming interface, while in the case of others, data entry is a more manual process. Digitalisation is currently somewhere between 95% and 98%, but the idea of achieving "connectedness" is a key priority "to enable information to flow", Kamachee explains.

One means of achieving this information flow is by adoptingMicrosoft's Common Data Model, which will be used to link the organization's finance and delivery systems. The aim here is to track the journey each dollar makes from the time it leaves a donor's hand. Understanding the impact of that dollar on the ground will then make it possible to report back to donors what it has been used for and how it has benefited service users.

But there are other benefits to be gained from enabling "connectedness" too. Kamachee explains:

When all of your different data pipelines become a single conduit, it's better and faster for decision-making. It improves your operational efficiency and security, and means you can tap into data for things like customer and marketing analysis. That was the goal when we set up the system. We're about half way there and success will be when we have consistently flowing data that provides a feedback loop. The end goal is to ensure we can tap into the power of AI to augment our decision-making, whether we're talking about deployment, mobilisation, predicting training requirements, revenue analysis so the finance team can project what the budget needs to be for x number of projects, and asset tracking and logistics, so we know which goods are expiring or not.

To this end, the NGO already has access to a "huge data lake" on Azure, which takes raw structured and unstructured data in real time and helps staff make cost-effective rapid response decisions in emergency situations. Curated data is also siphoned off into a data warehouse, where it informs the body's enterprise resource planning and fundraising systems for organizational decision-making purposes.

As to where Team Rubicon intends to go from here, it has a number of plans in the offing. For example, it is currently adding a new Dynamic 365 module to provide omnichannel customer service and also launched an "Uber-style" emergency foodassistance schemefor vulnerable people, although it unfortunately closed on 8 October due to lack of funds.

In the pipeline for the first quarter of this year though is an AI-based program that assesses volunteers' skills and experience against the requirements needed to deal with a particular incident and contacts the most appropriate individuals to see if they are willing and able to help. Another system, which is also in testing, is an AI-based optical character recognition system that assigns a validity score to volunteers' documentation and certificates and alerts an administrator to any apparent discrepancies.

Over time though, the NGO's aim is to move beyond simply reacting to crises as they happen towards preventative work in order to help to build resilience within vulnerable communities with the help of local authorities and community leaders. This would mean providing post-disaster education, such as rebuilding homes, and creating networks of partners to "provide services we can't", says Kamachee. He explains:

The end goal is to ensure client services aren't single point in time-based but are provided continuously to ensure people's needs are met all the time. For that, we have a huge need for systems interoperability so we can work with our partners' data. It's what we're heading out to do because the more data we harness, the more AI and machine learning can come into the equation. The aim is to remove and automate mundane tasks, while interacting directly with the people we serve through our volunteers.

Team Rubicon demonstrate that with a shrewd vision for the future, smart partnering and the judicious use of technology, NGOs can teach the private sector a trick or two about how to innovate with tight resources.

The rest is here:
NGO Team Rubicon partners with Microsoft to move from reactive to preventive disaster zone response - Diginomica

Introduction

The Sunstar/RDH Award of Distinction is presented to licensed dental hygienists who go above and beyond typical hygiene practice. They serve as role models and mentors to us all and use their education and talents to make this world a better place. Traditionally, award recipients are honored at RDH Under One Roof, a three-day action-packed event offering quality hygiene education and a chance to mingle with fellow hygienists. Due to the COVID-19 pandemic, this years event was held virtually on October 911.

Although the 2020 recipients of the Sunstar/RDH Award of Distinction were unable to receive their awards in person this year, we still take immense pride in introducing the four recipients of the award to you here. Jennifer Geiselhofer, Jaci Klepadlo, Lisandra Maisonet, and Karen Thomas are the four newest dental hygienists to join this prestigious group of key influencers. Congratulations to the 2020 Sunstar/RDH Award of Distinction recipients! You make us all proud to be dental hygienists!

(Denver, Colorado)

Like most hygienists, Jennifer Geiselhofer began her career in private practice. During her 23 years in a general dentistry practice, she found that her real passion was for dental Missions of Mercy. This passion for the underserved led her to create a portable preventive dental business called Dental at Your Door.

Jennifer Geiselhofer, RDHDental at Your Door is a for-profit business that brings much-needed oral health care to Denvers homeless and underserved population. Jennifer brings preventive dental care to those in homeless shelters, correctional facilities, substance abuse facilities, group homes, womens shelters, runaway youth shelters, human trafficking recovery facilities, and more.

The mission of Dental at Your Door is to provide access to high-quality preventative dental health care. This includes serving patients of all ages with significant health issues, mobility challenges, and financial limitations.

But still, Jennifer worried about those whom she couldnt treatthe people who had to be turned away because they did not have private insurance or did not qualify for state assistance and couldnt afford to self-pay. So she created a 501(c)(3) nonprofit called Deserving Dental, which is funded through grants and donations.

Jennifer has three dental assistants and four hygienists working with her to provide preventive oral health services to those who would not be able to afford it otherwise. They provide prophies, scaling and root planing, digital x-rays, oral cancer screenings, exams, sealants, silver diamine fluoride, and referrals to dental and medical officesall while providing their patients with hope and teaching them the value of a clean mouth and how it can affect their overall health.

One of Jennifers dental assistants nominated her for the Sunstar/RDH Award of Distinction. She stated, After having a dental visit with Jennifer, a lot of patients are so happy with their care that they leave emotional, grateful, and even like to give hugs.

Many of their male patients have shaved their beards after a cleaning because they dont want to hide their teeth anymore!

Referrals to dentists and physicians are important for patients who have completed visits with Jennifer and her team. Jennifer has partnered with several Medicaid-approved providers such as general dentists, oral surgeons, head-and-neck physicians, and ENTs for continuing-care referrals.

One nominator stated, Dental at Your Door was a huge accomplishment considering how many hoops she had to jump through, tears shed, and countless hours spent getting everything in order that she needed to start her dream! Because Jennifer followed that dream of serving the underserved, she has become a recipient of the 2020 Sunstar/RDH Award of Distinction.

Congratulations, Jennifer Geiselhofer!

(Mays Landing, New Jersey)

Invest in yourself and give back to others is Jaci Klepadlos advice to other hygienists. Giving back to others is second nature to Jaci. In addition to working as a clinical hygienist for 13 years, she has served as past president of the New Jersey Dental Hygienists Association (NJDHA) and is currently cochair of Veterans Smile Day Foundation. According to one of Jacis nominators, Finding out Jaci was cochair on the team was no surprise at all. Her hard work and determination are a force to reckon with. She could get through any hurdles thrown her way.

Jaci Klepadlo, BSDH, RDHAs president of the NJDHA, Jaci introduced a bill for dental hygienists to have direct access to providing oral health care, because she strongly believes that public health dental hygienists are willing and fully qualified to reach the underserved where they live.

Jaci became involved with Veterans Smile Day Foundation with her employer, a former navy dentist. After serving in Afghanistan, her employer returned to New Jersey and learned that veterans receive dental benefits only if they have retired from the military or were injured in the line of duty. This information left the vast majority of those who served without dental care, and those who do receive it have to travel great distances to get to a VA clinic that has a dental component on-site.

Jaci and her employer made it their mission to give back to veterans, and they founded the Veterans Smile Day Foundation. As cochair, Jaci has spent the past six years working with our nations veterans and dental providers across the nation to deliver free dental care to the men and women who have served selflessly for our country but who do not receive dental benefits. Each year you will find her offering her expertise to the local veterans for free to help make a difference in their oral care and overall health. She strongly believes in helping our veterans live a better life.

The Veterans Smile Day Foundation is a nonprofit 501(c)(3) whose mission is to recruit dental professionals and corporate sponsorships to help fill in that void by Serving Those Whove Served. Since its inception in 2012, it has grown to include private dental offices, dental schools, hospitals, and dental societies throughout the United States.

Jaci invites you to volunteer with the Veterans Smile Day Foundation. Find out how you can use your dental hygiene skills to serve those whove served by contacting Jaci at jaciklepadlo@gmail.com. Because Jaci followed her passion for serving our veterans, she has become a recipient of the 2020 Sunstar/RDH Award of Distinction.

Congratulations, Jaci Klepadlo!

(Pennsylvania)

Mentoring, educating, creating systems within the dental office, igniting passion in dental hygienists, meeting challengesthese are all aspects of Lisandra Lisandra Maisonet, BS, RDH, PHDHP, EFDAMaisonets present day-to-day life. But she began her career as a clinical hygienist in a pediatric dentistry practice. In that capacity, Lisandra implemented a strong preventive protocol that led to an incredible decrease in dental disease in the practice. She was able to inspire every team member to actively participate in the efforts to improve the oral health of thousands of patients.

While working in both the preventive and restorative aspects of dentistry and assisting in IV sedation cases in the pediatric practice, Lisandra questioned why they were treating a disease that was totally preventable. Answering this question became the driving force that brought her to her current role as director of operations and hygiene and leader to 50 dental hygienists in 22 practices, where she has created strong systems that focus on disease prevention and education on oral-systemic health.

Lisandra has made a positive impact on her community in many ways. She is an educator for the Healthy Teeth Healthy Children program, where she goes to pediatricians offices and educates medical professionals on the importance of oral health and fluoride application. She is a volunteer for Mission of Mercy, providing dental care to the underserved in her state, and she has presented numerous courses for the Cavity Free Kids program in Pennsylvania to educate the community on the importance of oral health.

During her active membership with the Pennsylvania Dental Hygienists Association (PDHA), Lisandra served as president for three years. In that time, she worked hard to push initiatives forward to enhance the profession of dental hygiene. She mentors and inspires hygienists to become involved and serve in their association.

With financial help from the PDHA, Lisandra was given the opportunity to create a video that highlights the dental hygienist. While working diligently on this video, she was diagnosed with an autoimmune disorder and hospitalized. Nevertheless, Lisandra continued with editing of the video with the desire to leave it as a legacy at the end of her PDHA presidency. The goal of the video was to share with patients and legislators the fact that dental hygienists are educated preventive specialists who are willing and capable of providing care to the most vulnerable populations. While daunting at times, her passion for this project was what kept her going through difficult times. Lisandras hope is that, through this video, hygienists will finally gain the respect they deserve.

Because Lisandra followed her inner drive to make a difference on so many levels, she has become a recipient of the 2020 Sunstar/RDH Award of Distinction.

Congratulations, Lisandra Maisonet!

(Raleigh, North Carolina)

Karen Thomas began her career as a clinical dental hygienist in Florida. She later became a research dental hygienist at the University of North Carolina at Chapel Hill and was the examiner for patients with temporomandibular disorder (TMD), fibromyalgia, chronic fatigue, episodic headaches, and pelvic pain. It broke her heart to see patients in so much pain. As an examiner, she gathered data but did not have the opportunity to make a personal connection with the Karen Thomas, MSc, BS, RDH, CNS, LN, ND, FDN-P, CHHC, Biological RDHpatients. She thought, Thereve got to be better ways to help these people.

Then, life took a turn in Karens career and her health. Her future mother-in-law became seriously ill days before her wedding. Over a short period of time, the house she was selling caught fire the day before closing, her father passed away, her new home needed significant renovations, and her new husband ended up in the hospital. Karen was told he would not make it. Unfortunately, her mother-in-law did pass on, but Karens husband came home from the hospital and is fine today.

The stress became too much to bear and, as Karen puts it, her body simply shut down. She took a medical leave from her job and spent the next two years in bed, doing little more than sleeping.

After two years of doctors appointments, 15 different diagnoses, multiple medications, and still no improvement, Karen took matters into her own hands. She had been diagnosed with Hashimotos thyroiditis as a teenager. Karen found research stating that 2%5% of people with Hashimotos also have celiac disease, but no doctor had tested her for that. Karen ordered tests on her own and presented the results to her doctor, who finally diagnosed her with celiac disease. She gave up gluten, among several other dietary changes, and got her life back. As one of her nominators for the award said, Thankfully, the dental hygiene curriculum and the way we as RDHs are taught to decipher information are ultimately what helped her heal herself through food.

Karen had regained her life but still wanted to help others. She went back to college to learn more about integrative medicine and combined that education with her dental hygiene training to help others link oral health with systemic health. She attained a master of science in human nutrition and functional medicine and became a licensed nutritionist, a certified nutrition specialist, a certified integrative nutrition health coach, and a certified functional diagnostic nutrition practitioner. Karen is also the award-winning author of Overwhelmed and Undernourished: Use Food as Medicine and Turn Your Life Around. She currently works as a functional medicine nutritionist and teaches continuing education in dentistry.

It is easy to see why Roy T. Bennett's quote is one of Karens favorites: Your hardest times often lead to the greatest moments of your life. Keep going. Tough situations build strong people in the end.

Congratulations, Karen Thomas!

Originally posted here:
Recipients of the Sunstar|RDH Award of Distinction 2020 | Registered Dental Hygienist - RDH

news, latest-news, men, movember, bendigo, victoria, moustache, men'shealth, health

John McIlrath knows first hand the crucial role preventative medicine plays in longevity. At the age of 31, Mr McIlrath from Bendigo, Victoria, was diagnosed with advance stage testicular cancer and given just a five per cent chance of survival. Almost 10 years on, he's growing a mo and fundraising for Movember, in the hope of generating discussion about men's health. "Men are notoriously bad at talking and going to the doctor," Mr McIlrath said. "The more the message gets out there, the more men's health outcomes will improve." Bendigo Health's chief nursing and midwifery officer David Rosaia said surveillance is important. "If you show any signs and symptoms, don't wait, go to your GP," MR Rosaia said. "Particularly when it comes to mental health, don't be afraid to share what concerns you. "As men, we need to be able to express ourselves." Mr McIlrath, a former police officer and heavy diesel mechanic in the Australia Army, said prior to his diagnosis, he noticed his body changing. "I did nothing about it," he said. "I waited six months from first noticing things and found excuses for why I was feeling tired or why my fitness was down." Months later, after coughing up blood and experiencing unbearable pain, Mr McIlrath visited his GP. "I had only visited a few months ago and didn't want them to think I was a malinger," he said. "That goes back to my army days. I just didn't want to think it was real. "It was the mindset I operated in at the time." READ MORE: Mr McIlrath couldn't believe what was to follow, a diagnosis of cancer. "You know the news isn't going to be good when you walk in and the clinic is packed with people and the receptionist ushers you straight through," he said. "I was in a completely different world. "I was prepared to die." Following numerous chemotherapy treatments and surgeries, Mr McIlrath is in remission. "I'm lucky to have the best wife in the world, a great family and great friendship group," he said. To donate to Mr McIlrath's Movember fundraiser, visit au.movember.com/mospace/9745485

https://nnimgt-a.akamaihd.net/transform/v1/crop/frm/nicholas.nakos/6578dd53-d053-4d48-b289-54bd834d7da2.jpg/r10_216_4219_2594_w1200_h678_fmax.jpg

John McIlrath knows first hand the crucial role preventative medicine plays in longevity.

At the age of 31, Mr McIlrath from Bendigo, Victoria, was diagnosed with advance stage testicular cancer and given just a five per cent chance of survival.

Almost 10 years on, he's growing a mo and fundraising for Movember, in the hope of generating discussion about men's health.

"Men are notoriously bad at talking and going to the doctor," Mr McIlrath said.

"The more the message gets out there, the more men's health outcomes will improve."

Bendigo Health's chief nursing and midwifery officer David Rosaia said surveillance is important.

"If you show any signs and symptoms, don't wait, go to your GP," MR Rosaia said.

"Particularly when it comes to mental health, don't be afraid to share what concerns you.

"As men, we need to be able to express ourselves."

Mr McIlrath, a former police officer and heavy diesel mechanic in the Australia Army, said prior to his diagnosis, he noticed his body changing.

"I did nothing about it," he said.

"I waited six months from first noticing things and found excuses for why I was feeling tired or why my fitness was down."

Months later, after coughing up blood and experiencing unbearable pain, Mr McIlrath visited his GP.

"I had only visited a few months ago and didn't want them to think I was a malinger," he said.

"That goes back to my army days. I just didn't want to think it was real.

"It was the mindset I operated in at the time."

Mr McIlrath couldn't believe what was to follow, a diagnosis of cancer.

"You know the news isn't going to be good when you walk in and the clinic is packed with people and the receptionist ushers you straight through," he said.

"I was in a completely different world.

Following numerous chemotherapy treatments and surgeries, Mr McIlrath is in remission.

"I'm lucky to have the best wife in the world, a great family and great friendship group," he said.

View post:
Movember raises awareness of men's health issues - The Canberra Times

Vicki Fichter works as a dispatcher for Chicago Board Up Services, but lately she has also been asked to moonlight as a crystal ball. This week, around fifty businesses in the city have called requesting quotes for a disturbing scenario: They want to shutter storefronts ahead of election day.

Everyone asks me, what will the next couple of weeks bring? Will the unrest come next week? Fichter told The Daily Beast. Im like, Dont ask me. Im not going to be the judge of anything political.

The week before Election Day, social media filled with images of major cities seemingly closed down, expecting unrest to come. I never thought I would see so many buildings here in the nations capital boarded-up on the eve of a presidential election in anticipation of possible unrest, CNN anchor Wolf Blitzer tweeted. And its not just in D.C. Its happening in New York, Los Angeles, and elsewhere around the country. So sad!

Donald Trump Jr. responded, You a-holes and your liberal agenda built that, failing to acknowledge his fathers habit of stoking potentially violent election day interference.

Of course, November 3 will not be the first time this year that commercial neighborhoods braced for impact. Wood paneling drilled over windows has become a ubiquitous sight in shopping districts since May, when the murder of George Floyd fueled a national protest movement. Though the majority of those demonstrations have been peaceful, in some instances that anger has erupted into raucous unrest.

Fichter has worked in the industry for a decade; shes never dealt with the kind of demand 2020 has required. This has just been a very unsettling six months, she said. So many things have happened in a row. We have been very busy, on and off, since [protests began] in May. Then we were busy in August, and again now. But weve never done this for any election. This is a first for all of us.

WWD reported that the New York flagship stores for Macys, Bloomingdales, and Saks Fifth Avenue have been boarded up. Outside of Saks, the joyless display of drilled-down wood clashes with its gilded facade.

Downtown, SoHo outposts of Louis Vuitton, Dior, and Moncler were also blacked out. A rep for Nordstrom, on 57th Street, told the trade publication that the department store would close early on Election Day.

According to The New York Times, Beverly Hills police will close Rodeo Drive as a proactive approach. Last week, representatives for Walmart told The Wall Street Journal that the mega-chain would remove guns and ammunition from sales floors. They later reversed this decision.

When Marshalls customers in Detroit and Dearborn, Michigan, saw two storefronts boarded up, the Dearborn Police Chief Ronald Haddad released a Facebook statement that read, There is nothing to be concerned about at this time and the police department will continue to work to provide a safe and secure election.

A USA Today/Suffolk poll revealed that 3 out of 4 surveyed voters express[ed] concerns about the possibility of violence on Election Day. Boarded-up shops serve as an immediate visual reminder of nationwide anxiety.

The Sunday and Monday before Election Day, Fichter had booked 12 jobs around the city of Chicago. Right now, were doing a lot of preventative medicine, so to speak, she said. Were a bit swamped, because I only have two trucks [to send out].

Theyre worried about rioting, whether its Trump winning and people are pissed off or its Biden winning and theyre celebrating.

James Smythe

Owners want to wait until the last minute to put up wood panels. The biggest concern is how it looks, Fichter said. As of yesterday and today, nobody wants to board up too early. You dont want it to look crappy. I dont blame them.

According to Fichter, services in Chicago can cost between $500 and $850. A lot of those little mom and pop retail places would rather spend $500 to board up than $5,000 to fix broken glass, she said. And unfortunately, insurance doesnt pay for preventative work. There is no government grant for these owners, and thats whats sad. No one will reimburse them.

James Smythe, general manager of New Yorks Cipco Boarding, Inc, added that his office is going a little crazy right now.

Everyones calling up for prices, he said. We started getting phone calls on Wednesday, and by Thursday we were blowing up. By Election Day, the company will have boarded about a dozen or two dozen big retail stores and 20 mom and pop shops.

Theyre worried about rioting, whether its Trump winning and people are pissed off or its Biden winning and theyre celebrating, Smythe said, adding, This is the worst Ive seen for an election.

Here is the original post:
American Businesses Board Up Their Windows, AgainThis Time for the Election - The Daily Beast

The race to represent the 11th Senatorial District in Harrisburg pits a Democratic incumbent against a Republican challenger.

The district includesReading, Birdsboro, Centerport, Fleetwood, Kenhorst, Kutztown, Laureldale, Leesport, Lyons, Mohnton, Mount Penn, New Morgan, Shillington, St. Lawrence, Topton, West Reading and Wyomissing; and Alsace, Bern, Brecknock, Caernarvon, Centre, Cumru, Exeter, Lower Alsace, Maxatawny, Muhlenberg, Oley, Richmond, Robeson and Ruscombmanor townships.

State senators serve a four-year term and receive an annual salary of $90,300.

We asked the candidates to respond to this question:

Question: The impact of the coronavirus pandemic has been widespread and severe, affecting everything from the economy to health care to education. As the state fights to recover from this global health crisis, what specific steps do you feel need to be taken to aid that recovery?

Background: Incumbent, previously served as dean of agricultural and environmental science at Delaware Valley College, former Berks County commissioner for eight years, former chief executive of 10,000 Friends of Pennsylvania.

Answer: The pandemic has presented us with unprecedented challenges that we must still overcome, but I believe that it also provides us with an opportunity to reimagine the way we deliver government services to build a brighter future for all Pennsylvanians.

In the short term, as we take prudent steps to reopen our economy and achieve a new sense of normality, we must continue to provide the unemployed a financial lifeline until jobs reopen for them, offer businesses especially small businesses the resources they need to recover, and tackle the tough task of completing the 2020-2021 state budget to meet the needs of our citizens within the revenues available.

Long term, making health care, including preventative medicine, more accessible possibly via technology like telemedicine; increasing access to high-quality, affordable child care; offering more educational opportunities across our lifespans, promoting lifelong learning and attainment; developing a more equitable way to pay for education that has school property tax elimination in mind; improving our road, water, sewer and technology (particularly broadband) infrastructure; working to mitigate the impacts of climate change with renewable energy and regenerative agriculture and, making government a better partner with business will help us achieve prosperity beyond COVID.

Annette Baker

Background: Homemaker and home-school teacher, local radio personality, chairwoman of the Berks County Republican Committees southern region and former environmental scientist.

Website: annettecbakerforsenate.wordpress.com

Answer: The citizens of our commonwealth have suffered greatly because of the pandemic and we will be feeling the effects of COVID-19 for many years to come. No sector of our economy has been left untouched.

Rebuilding must begin with helping small businesses and restaurants. Many of them are on the verge of closing permanently. They must be able to reopen at full capacity. Educational institutions must also open, supporting parents returning to full employment.

Employers and employees, while following guidelines, are capable of solving the problems facing the reopening of our state. When the government gets out of the way, people can find solutions to difficult problems. By getting people back to work, we will begin to provide stability to families and businesses in the commonwealth. This is important not only for our economic well-being but for the physical and mental well-being of our residents.

I will support legislation such as House Bill 836 because it is time to reopen our economy. The governor and General Assembly should be working together to determine whether emergency declarations should be extended. It is time to unite together to move forward and restore normalcy to our commonwealth.

Here is the original post:
Election 2020: The contest in the 11th Senatorial District - The Mercury