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US adults are more likely to have poor health than those in 10 similar countries, survey finds




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POSTPONED: Transitional Justice in Ukraine: What Might it Look Like?

Invitation Only Research Event

17 March 2020 - 9:30am to 1:00pm

Chatham House | 10 St James's Square | London | SW1Y 4LE

Event participants

Kirsty Brimelow QC, Barrister, Doughty Street Chambers
Miles Jackson, Associate Professor of Law, University of Oxford
Anton Korynevych, Representative of the President of Ukraine for Crimea
Oleksandra Matviychuk, Head of the Board, Centre for Civil Liberties
Taras Tsymbrivksyy, Head, USAID Human Rights in Action Program; Ukrainian Helsinki Human Rights Union

Still grappling with the war in the east and the occupation of Crimea, Ukraine’s new leadership has announced its intention to develop its transitional justice infrastructure to respond to the human rights violations arising from Russia’s aggression. 

Numerous reports (not least ones by the UN Human Rights Monitoring Mission in Ukraine) list persecutions, illegal detentions, enforced disappearances, torture and killings among the crimes perpetrated in Crimea and parts of occupied Donbas. 

As Ukraine has only just started developing its transitional justice roadmap, this event will seek to discuss viable initial approaches, such as a ‘truth-telling commission’ or amnesties. 

The panellists will also discuss the role for civil society and those directly affected by hostilities in the transitional justice process.  

PLEASE NOTE THIS EVENT IS POSTPONED UNTIL FURTHER NOTICE.

Event attributes

Chatham House Rule

Anna Morgan

Administrator, Ukraine Forum
+44 (0)20 7389 3274




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Acuna: 'I'd like to stay in the leadoff spot'

When the Braves re-signed Nick Markakis in January, they began leaning toward putting Ender Inciarte in the leadoff spot and moving Ronald Acuna Jr. to the cleanup role. But manager Brian Snitker said Acuna may still get his wish to stay at the top of the lineup.




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O's star prospects likely to get chance to shine

The Orioles' restocked farm system might inject some excitement into the club's retooled roster.




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What it's like to receive cardiac rehabilitation

With improved survival and and ageing population, the number of people living with coronary heart disease in the UK has increased to an estimated 2.3 million. There is increasing evidence that cardiac rehabilitation benefits these patients, and as such it has been included in international clinical guidelines. ​In this podcast, we're joined by...




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Zika virus - "it really felt like having bad sunburn, all over your body"

“Juliet”, a woman living in London, was diagnosed with a mysterious illness in November 2015, Ian Cropley, a consultant in infectious disease from The Royal Free London NHS Foundation Trust, was there to investigate. In this podcast, we find out how Zika, once a little known virus causing a rash and fever, has subsequently become a global health...




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Likelihood ratios in diagnostic tests

Andrew Elder, a professor at the University of Edinburgh talks about likelihood ratios in diagnostic testing, and how they’re helpful in thinking about how context changes the predictive value of a test. This is part of a wider discussion on the evidence behind clinical examination of the cardiovascular system...




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What Choosing Wisely looks like in the UK

Choosing Wisely was launched in the US, to much fanfare. Since then the movement has spread around the world, with successful chapters set up in Canada, Australia Brazil, Italy, Japan, new Zealand - and most recently the UK. The campaigns have not been without criticism – from how individual recommendations were chosen, to the way in which...




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Can we regulate intellectual interests like financial ones?

We talk about financial conflicts of interest a lot atThe BMJ - and have take taken the decision that our educational content should be without them. We also talk a lot about non-financial conflicts of interest, but the choppy waters of those are much more difficult to navigate. In this podcast, we discuss whether we should, or if we could even...




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What's it like to live with a vaginal mesh?

What can we learn from the shameful story of vaginal mesh? That thousands of women have been irreversibly harmed; that implants were approved on the flimsiest of evidence; that surgeons weren’t adequately trained and patients weren’t properly informed; that the dash for mesh, fuelled by its manufacturers, stopped the development of alternatives;...




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Bell names likely starting 5, staging 'pen battles

Unlike recent Reds Spring Trainings, much of the drama about who would comprise the rotation was already removed on the first day of camp. That's when manager David Bell revealed the starting five would likely be -- in no particular order -- Sonny Gray, Tanner Roark, Alex Wood, Luis Castillo and Anthony DeSclafani.




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Despite Trump Invitation to Stop Taking Refugees, Red and Blue States Alike Endorse Resettlement

Forty-two governors, Republican and Democrat alike, have affirmed their consent for continued refugee resettlement, bypassing an invitation from the Trump administration to stop accepting refugees. These actions, which reportedly surprised the White House, suggest there may be limits to the Trump immigration agenda when it comes to refugees, as this Policy Beat explores.




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Boom heard in Washington state likely an exploding meteor

A loud booming sound reported by multiple witnesses in Washington state was likely a meteor exploding over the area, experts said.




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Glucagon-Like Peptide 1 Receptor Agonist or Bolus Insulin With Optimized Basal Insulin in Type 2 Diabetes

Michaela Diamant
Oct 1, 2014; 37:2763-2773
Emerging Technologies and Therapeutics




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Liraglutide, a Long-Acting Human Glucagon-Like Peptide-1 Analog, Given as Monotherapy Significantly Improves Glycemic Control and Lowers Body Weight Without Risk of Hypoglycemia in Patients With Type 2 Diabetes

Tina Vilsbøll
Jun 1, 2007; 30:1608-1610
BR Emerging Treatments and Technologies




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Insulinotropic Action of Glucagonlike Peptide-I-(7-37) in Diabetic and Nondiabetic Subjects

David M Nathan
Feb 1, 1992; 15:270-276
Short Report




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Long-Acting Glucagon-Like Peptide 1 Receptor Agonists: A review of their efficacy and tolerability

Alan J. Garber
May 1, 2011; 34:S279-S284
Diabetes Treatments




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Vasodilatory Actions of Glucagon-Like Peptide 1 Are Preserved in Skeletal and Cardiac Muscle Microvasculature but Not in Conduit Artery in Obese Humans With Vascular Insulin Resistance

OBJECTIVE

Obesity is associated with microvascular insulin resistance, which is characterized by impaired insulin-mediated microvascular recruitment. Glucagon-like peptide 1 (GLP-1) recruits skeletal and cardiac muscle microvasculature, and this action is preserved in insulin-resistant rodents. We aimed to examine whether GLP-1 recruits microvasculature and improves the action of insulin in obese humans.

RESEARCH DESIGN AND METHODS

Fifteen obese adults received intravenous infusion of either saline or GLP-1 (1.2 pmol/kg/min) for 150 min with or without a euglycemic insulin clamp (1 mU/kg/min) superimposed over the last 120 min. Skeletal and cardiac muscle microvascular blood volume (MBV), flow velocity and blood flow, brachial artery diameter and blood flow, and pulse wave velocity (PWV) were determined.

RESULTS

Insulin failed to change MBV or flow in either skeletal or cardiac muscle, confirming the presence of microvascular insulin resistance. GLP-1 infusion alone increased MBV by ~30% and ~40% in skeletal and cardiac muscle, respectively, with no change in flow velocity, leading to a significant increase in microvascular blood flow in both skeletal and cardiac muscle. Superimposition of insulin to GLP-1 infusion did not further increase MBV or flow in either skeletal or cardiac muscle but raised the steady-state glucose infusion rate by ~20%. Insulin, GLP-1, and GLP-1 + insulin infusion did not alter brachial artery diameter and blood flow or PWV. The vasodilatory actions of GLP-1 are preserved in both skeletal and cardiac muscle microvasculature, which may contribute to improving metabolic insulin responses and cardiovascular outcomes.

CONCLUSIONS

In obese humans with microvascular insulin resistance, GLP-1’s vasodilatory actions are preserved in both skeletal and cardiac muscle microvasculature, which may contribute to improving metabolic insulin responses and cardiovascular outcomes.




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U.S. fuel prices near last month's levels, unlikely to change

Average fuel prices in the United States started the week at $2.26 per gallon, showing little change from the last month or last week, and may remain flat.




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Study: Opioid overdose 14 times more likely in general public than cancer survivors

Cancer survivors have a lower risk for a fatal opioid overdose -- from prescription pain medications or illegal drugs -- than those without the disease, an analysis published Thursday by JAMA Oncology shows.




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Use of Glucagon-Like Peptide 1 Receptor Agonists and Risk of Serious Renal Events: Scandinavian Cohort Study

OBJECTIVE

To assess the association between use of glucagon-like peptide 1 (GLP-1) receptor agonists and risk of serious renal events in routine clinical practice.

RESEARCH DESIGN AND METHODS

This was a cohort study using an active-comparator, new-user design and nationwide register data from Sweden, Denmark, and Norway during 2010–2016. The cohort included 38,731 new users of GLP-1 receptor agonists (liraglutide 92.5%, exenatide 6.2%, lixisenatide 0.7%, and dulaglutide 0.6%), matched 1:1 on age, sex, and propensity score to a new user of the active comparator, dipeptidyl peptidase 4 (DPP-4) inhibitors. The main outcome was serious renal events, a composite including renal replacement therapy, death from renal causes, and hospitalization for renal events. Secondary outcomes were the individual components of the main outcome. Hazard ratios (HRs) were estimated using Cox models and an intention-to-treat exposure definition. Mean (SD) follow-up time was 3.0 (1.7) years.

RESULTS

Mean (SD) age of the study population was 59 (10) years, and 18% had cardiovascular disease. A serious renal event occurred in 570 users of GLP-1 receptor agonists (incidence rate 4.8 events per 1,000 person-years) and in 722 users of DPP-4 inhibitors (6.3 events per 1,000 person-years, HR 0.76 [95% CI 0.68–0.85], absolute difference –1.5 events per 1,000 person-years [–2.1 to –0.9]). Use of GLP-1 receptor agonists was associated with a significantly lower risk of renal replacement therapy (HR 0.73 [0.62–0.87]) and hospitalization for renal events (HR 0.73 [0.65–0.83]) but not death from renal causes (HR 0.72 [0.48–1.10]). When we used an as treated exposure definition in which patients were censored at treatment cessation or switch to the other study drug, the HR for the primary outcome was 0.60 (0.49–0.74).

CONCLUSIONS

In this large cohort of patients seen in routine clinical practice in three countries, use of GLP-1 receptor agonists, as compared with DPP-4 inhibitors, was associated with a reduced risk of serious renal events.




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Did you like our Facebook Page?

Stay connected with School Psychologist Files by joining the School Psychologist Files Facebook Page.  You can be one of the first to know about new articles on the School Psychologist Files website such as the brand new FAQ Parents ask about the IEP that I finished this weekend. 




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Intensive farming makes epidemics more likely

Intensive farming, characterized by the overuse of antibiotics, large numbers of animals and limited genetic diversity, increases the odds of animal pathogens making the jump to humans and triggering an epidemic.




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Unlike 'Jurassic Park,' real raptors may not have hunted in packs

While the coordinated attacks of Velociraptor dinosaurs depicted in the 1993 blockbuster made for compelling movie viewing, a study published this week claims raptors most likely hunted solo, not in packs.




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Early marine reptiles used pebble-like teeth to crush shellfish

Some early ichthyosaurs used rounded, pebble-like teeth to crush the shells of snails and clam-like bivalves, according to new research.




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[ Politics ] Open Question : Why are other countries like New Zealand and Australia destroying the virus while America is killing people off to restart the economy?




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[ Women's Health ] Open Question : Ovulation like discharge before period?

I have a 23 day cycle and around day 19 up until my period I produce a ovulation like discharge, it’s clear/ white and super stretchy. I don’t get this during the “ovulation” time frame, it tends to be thick and cloudy then. Why? And when am I ovulating?




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[ Polls & Surveys ] Open Question : How do you like your toilet paper?




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How Terrorist Organizations Work Like Clubs

Days before the Sept. 11, 2001, attacks, Osama bin Laden left his compound in Kandahar in Afghanistan and headed into the mountains. His driver, Salim Ahmed Hamdan, traveled with him. As U.S. and Northern Alliance forces stood poised to capture Kandahar a few months later, bin Laden told Hamdan t...




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What Should Successful Integration Look Like for Vulnerable Newcomers?

WASHINGTON — As host countries in Europe, North America and beyond prioritize getting refugees and other newly arrived migrants into work, another challenge has received less attention: Helping those who may never find jobs participate meaningfully in their new communities. Newcomers who are not in the workplace (particularly refugee women, migrants who are unskilled or illiterate and the elderly) are at high risk for social isolation.




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Millions Will Feel Chilling Effects of U.S. Public-Charge Rule That Is Also Likely to Reshape Legal Immigration

The public-charge rule issued by the Trump administration in August 2019 will have profound effects on future immigration and on use of public benefits by millions of legal noncitizens and their U.S.-citizen family members. Complex standards for determining when an immigrant is likely to become a public charge could cause a significant share of the nearly 23 million noncitizens and U.S. citizens in benefits-using immigrant families to disenroll, as this commentary explains.




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Picking a Theory is Like Building a Boat at Sea


"We are like sailors who on the open sea must reconstruct their ship
 but are never able to start afresh from the bottom." 
Otto Neurath's analogy in the words of Willard V. Quine

Engineers, economists, social planners, security strategists, and others base their plans and decisions on theories. They often argue long and hard over which theory to use. Is it ever right to use a theory that we know is empirically wrong, especially if a true (or truer) theory is available? Why is it so difficult to pick a theory?

Let's consider two introductory examples.

You are an engineer designing a robot. You must calculate the forces needed to achieve specified motions of the robotic arms. You can base these calculations on either of two theories. One theory assumes that an object comes to rest unless a force acts upon it. Let's call this axiom A. The other theory assumes that an object moves at constant speed unless a force acts upon it. Let's call this axiom G. Axiom A agrees with observation: Nothing moves continuously without the exertion of force; an object will come to rest unless you keep pushing it. Axiom G contradicts all observation; no experiment illustrates the perpetual motion postulated by the axiom. If all else is the same, which theory should you choose?

Axiom A is Aristotle's law of inertia, which contributed little to the development of mechanical dynamics. Axiom G is Galileo's law of inertia: one of the most fruitful scientific ideas of all time. Why is an undemonstrable assertion - axiom G - a good starting point for a theory?

Consider another example.

You are an economist designing a market-based policy to induce firms to reduce pollution. You will use an economic theory to choose between policies. One theory assumes that firms face pure competition, meaning that no single firm can influence market prices. Another theory provides agent-based game-theoretic characterization of how firms interact (without colluding) by observing and responding to price behavior of other firms and of consumers.

Pure competition is a stylized idealization (like axiom G). Game theory is much more realistic (like axiom A), but may obscure essential patterns in its massive detail. Which theory should you use?

We will not address the question of how to choose a theory upon which to base a decision. We will focus on the question: why is theory selection so difficult? We will discuss four trade offs.

"Thanks to the negation sign, there are as many truths as falsehoods;
we just can't always be sure which are which." Willard V. Quine

The tension between right and right. The number of possible theories is infinite, and sometimes it's hard to separate the wheat from the chaff, as suggested by the quote from Quine. As an example, I have a book called A Modern Guide to Macroeconomics: An Introduction to Competing Schools of Thought by Snowdon, Vane and Wynarczyk. It's a wonderful overview of about a dozen theories developed by leading economic scholars, many of them Nobel Prize Laureates. The theories are all fundamentally different. They use different axioms and concepts and they compete for adoption by economists. These theories have been studied and tested upside down and backwards. However, economic processes are very complex and variable, and the various theories succeed in different ways or in different situations, so the jury is still out. The choice of a theory is no simple matter because many different theories can all seem right in one way or another.

"The fox knows many things, but the hedgehog knows one big thing." Archilochus

The fox-hedgehog tension. This aphorism by Archilochus metaphorically describes two types of theories (and two types of people). Fox-like theories are comprehensive and include all relevant aspects of the problem. Hedgehog-like theories, in contrast, skip the details and focus on essentials. Axiom A is fox-like because the complications of friction are acknowledged from the start. Axiom G is hedgehog-like because inertial resistance to change is acknowledged but the complications of friction are left for later. It is difficult to choose between these types of theories because it is difficult to balance comprehensiveness against essentialism. On the one hand, all relevant aspects of the problem should be considered. On the other hand, don't get bogged down in endless details. This fox-hedgehog tension can be managed by weighing the context, goals and implications of the decision. We won't expand on this idea since we're not considering how to choose a theory; we're only examining why it's a difficult choice. However, the idea of resolving this tension by goal-directed choice motivates the third tension.

"Beyond this island of meanings which in their own nature are true or false
lies the ocean of meanings to which truth and falsity are irrelevant." John Dewey

The truth-meaning tension. Theories are collections of statements like axioms A and G in our first example. Statements carry meaning, and statements can be either true or false. Truth and meaning are different. For instance, "Archilochus was a Japanese belly dancer" has meaning, but is not true. The quote from Dewey expresses the idea that "meaning" is a broader description of statements than "truth". All true statements mean something, but not all meaningful statements are true. That does not imply, however, that all untrue meaningful statements are false, as we will see.

We know the meanings of words and sentences from experience with language and life. A child learns the meanings of words - chair, mom, love, good, bad - by experience. Meanings are learned by pointing - this is a chair - and also by experiencing what it means to love or to be good or bad.

Truth is a different concept. John Dewey wrote that

"truths are but one class of meanings, namely, those in which a claim to verifiability by their consequences is an intrinsic part of their meaning. Beyond this island of meanings which in their own nature are true or false lies the ocean of meanings to which truth and falsity are irrelevant. We do not inquire whether Greek civilization was true or false, but we are immensely concerned to penetrate its meaning."

A true statement, in Dewey's sense, is one that can be confirmed by experience. Many statements are meaningful, even important and useful, but neither true nor false in this experimental sense. Axiom G is an example.

Our quest is to understand why the selection of a theory is difficult. Part of the challenge derives from the tension between meaning and truth. We select a theory for use in formulating and evaluating a plan or decision. The decision has implications: what would it mean to do this rather than that? Hence it is important that the meaning of the theory fit the context of the decision. Indeed, hedgehogs would say that getting the meaning and implication right is the essence of good decision making.

But what if a relevantly meaningful theory is unprovable or even false? Should we use a theory that is meaningful but not verifiable by experience? Should we use a meaningful theory that is even wrong? This quandary is related to the fox-hedgehog tension because the fox's theory is so full of true statements that its meaning may be obscured, while the hedgehog's bare-bones theory has clear relevance to the decision to be made, but may be either false or too idealized to be tested.

Galileo's axiom of inertia is an idealization that is unsupported by experience because friction can never be avoided. Axiom G assumes conditions that cannot be realized so the axiom can never be tested. Likewise, pure competition is an idealization that is rarely if ever encountered in practice. But these theories capture the essence of many situations. In practical terms, what it means to get the robotic arm from here to there is to apply net forces that overcome Galilean inertia. But actually designing a robot requires considering details of dissipative forces like friction. What it means to be a small business is that the market price of your product is beyond your control. But actually running a business requires following and reacting to prices in the store next door.

It is difficult to choose between a relevantly meaningful but unverifiable theory, and a true theory that is perhaps not quite what we mean.

The knowledge-ignorance tension. Recall that we are discussing theories in the service of decision-making by engineers, social scientists and others. A theory should facilitate the use of our knowledge and understanding. However, in some situations our ignorance is vast and our knowledge will grow. Hence a theory should also account for ignorance and be able to accommodate new knowledge.

Let's take an example from theories of decision. The independence axiom is fundamental in various decision theories, for instance in von Neumann-Morgenstern expected utility theory. It says that one's choices should be independent of irrelevant alternatives. Suppose you are offered the dinner choice between chicken and fish, and you choose chicken. The server returns a few minutes later saying that beef is also available. If you switch your choice from chicken to fish you are violating the independence axiom. You prefer beef less than both chicken and fish, so the beef option shouldn't alter the fish-chicken preference.

But let's suppose that when the server returned and mentioned beef, your physician advised you to reduce your cholesterol intake (so your preference for beef is lowest) which prompted your wife to say that you should eat fish at least twice a week because of vitamins in the oil. So you switch from chicken to fish. Beef is not chosen, but new information that resulted from introducing the irrelevant alternative has altered the chicken-fish preference.

One could argue for the independence axiom by saying that it applies only when all relevant information (like considerations of cholesterol and fish oil) are taken into account. On the other hand, one can argue against the independence axiom by saying that new relevant information quite often surfaces unexpectedly. The difficulty is to judge the extent to which ignorance and the emergence of new knowledge should be central in a decision theory.

Wrapping up. Theories express our knowledge and understanding about the unknown and confusing world. Knowledge begets knowledge. We use knowledge and understanding - that is, theory - in choosing a theory. The process is difficult because it's like building a boat on the open sea as Otto Neurath once said. 




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Women Who Buy Sex: Why They Do It, And What Their Experiences Are Like

Most research on people who patronize sex workers has focused on men. In some ways, this isn’t surprising because men are much more likely to report having paid for sex than are women. For example, in a recent YouGov survey of 1,000 adult Americans, 12% of men reported having paid for sex before compared to just 1% of women. Similarly, in a nationally representative survey of more than 20,000 Australians aged 16-69, researchers found that 17% of men said they had paid for sex, while only 0.3% of women said the same [1]. However, these figures may significantly underreport the actual number of women who have ever engaged the services of a sex worker.




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Lockdown Reading Recommendations for People Who Like to Read About Sex

I know that many of you are bored and horny right now during this lockdown and quarantine period, so allow me to recommend some of my favorite sex books! If you follow me on Instagram, you’ve probably already seen a few of my recommendations, but here’s a more extensive reading list.



  • Featured Books and Films

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What it's really like to have autism | Ethan Lisi

"Autism is not a disease; it's just another way of thinking," says Ethan Lisi. Offering a glimpse into the way he experiences the world, Lisi breaks down misleading stereotypes about autism, shares insights into common behaviors like stimming and masking and promotes a more inclusive understanding of the spectrum.




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In uncertain times, think like a mother | Yifat Susskind

There's a simple and powerful way to confront the world's most pressing crises, says women's rights activist Yifat Susskind: think like a mother. As she puts it: "When you think like a mother, you prioritize the needs of the many, not the whims of the few." Follow along as she shares moving stories of people around the world who embody this mindset -- and shows how it can also help you see beyond suffering and act to build a better world.




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How Do Films Like ‘Joker’ Shape Attitudes Towards People With Mental Health Issues?

By Emily Reynolds. Study finds viewers had slightly more negative perceptions of people with mental illness after seeing the movie.




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WATCH: What It's Really Like for Homeschooling During Coronavirus

Coronavirus has shut down schools across the country, forcing millions of students to learn at home. In this video, families from Seattle to Maine describe how they are adjusting to this new reality.




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Like College Athletes, These High School Players Get an Assist on Academics

An unusual program in Cincinnati provides academic coaches to help high school players meet eligibility requirements to stay in the game.




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American public space, rebooted: What might it feel like?




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American public space, rebooted: What might it feel like?




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Decision on NJ schools likely on Thursday, Murphy says




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Dealing With Dyslexia: 'It's Almost Like It's a Naughty Word' (Video)

When Scott Gann learned his son Dustin had dyslexia, he was shocked at the school's reaction. No one there wanted to use the word.




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NFL wants college football to proceed (but if not would likely move games to Saturdays)

The NFL is indeed discussing the possibility of playing games on Saturdays in the event that college football doesn't proceed with a season from September through December. As one source with direct knowledge of the discussions tells PFT, however, the league's strong preference is for college football to happen, as scheduled. No college football season [more]




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Emmert: Unlikely all schools will start seasons at same time

NCAA President Mark Emmert says the coronavirus is making it unlikely all schools will be ready to begin competing in college sports at the same time. Emmert appeared with Dr. Brian Hainline, the NCAA's chief medical officer, in an interview shown on the NCAA's official Twitter account Friday night. Major football conference commissioners have stated their goal is for all 130 teams in 10 conferences across 41 states to begin the season at the same time.




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NCCP: The likely medium- to long-term ecological outcomes of major carp population reductions final report / Nichols S.J., Gawne B., Richards R., Lintermans M. and Thompson R; prepared by the Institute for Applied Ecology, University of Canberra for Fishe




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The courage to be disliked : how to free yourself, change your life and achieve real happiness / Ichiro Kishimi and Fumitake Koga.

Self-actualization (Psychology)




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What Remote Learning Looks Like During the Coronavirus Crisis

We asked parents, students, and educators to share what their home learning environments look like as nearly all schools are shut down for extended periods because of the coronavirus pandemic.                          





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'Just Like Them': Urban and Rural Students Make Friends on the Alaska Frontier

A group of high school students from Anchorage spent spring break at a remote Native Village as part of an unusual cultural exchange program in Alaska. See what they learned.