Daily Archives: February 21, 2021

Despite underrepresentation of women in academic arenas like STEM and business fields, as well as in recreational spaces such as fitness centers, many women-led CIOs at the University have risen to the challenge and continue to create spaces that offer support and empowerment to female students. As the spring semester begins, CIOs like Girls Who Code, Society of Women Engineers, Smart Women Securities and Changing Health, Attitudes and Actions To Recreate Girls are open to new women and non-binary and gender nonconforming peers who are looking for a community of supportive people with shared passions.

Entering into a male-dominated field as a woman can be intimidating and even off-putting, especially because of underlying possibilities to feel undervalued as a team member. With the intention of opposing this discriminatory dynamic, which is particularly dominant in STEM, Mara Hart, third-year College student and president of Girls Who Code, founded the organization to give people a community of support and solidarity.

The main mission of Girls Who Code at the core of everything we do is to create a more gender-inclusive tech field, Hart said. Whether that involves having more women, having more nonbinary people ... anything to build up that empowerment.

At the University, female students make up 55 percent of the general student body, but only 32 percent of the School of Engineering and Applied Science. Feeling intimidated by this disproportionate ratio, Rebecca Della Croce, fourth-year Engineering student and president of Society of Women Engineers an organization focused on empowering girls pursuing careers in engineering and technology joined the CIO her first year. Rising to her position of leadership within the organization, she has since continued to help her fellow female engineers to feel represented and appreciated.

When I got to U.Va. I felt how big of a deal it was to be a woman in engineering in some regards, Della Croce said. Not only was it weird to not see a lot of other women in the room, but sometimes my male peers really wouldn't take what I was saying seriously. I really wanted to find that community of other women in engineering, and I loved seeing how the women in SWE empowered each other.

Hart shared similar experiences of being blatantly disregarded and disrespected by her male colleagues in her computer science education internship. She has turned to the Girls Who Code community as a support system to learn from and grow with as she continues to face such challenges in the male-dominated field of computer science.

Regularly my boss would disregard what I had to say, including picking up his phone while I was talking during meetings then putting it down as soon as I stopped talking [and] making provocative comments toward me when I was talking about education and trying to discuss professional matters, Hart said. Aside from that, I have come back and learned that there may be a lack of representation, but there are people to reach out to.

The competitive nature of the Universitys STEM programs presents a challenge for women to overcome the existing gender barriers in many professional fields. However, this obstacle for women pursuing professional careers is not exclusive to STEM fields, as it exists in the business sectors as well. Claire Duffy, third-year McIntire student and chief executive officer of Smart Women Securities, was initially intimidated by the competitive applications required to join most investment clubs, so she decided to get involved in SWS because it was an open space for women to learn about investment with less pressure and more support.

SWS really prides itself on our focus on education, Duffy said. I know in general at U.Va. a lot of clubs have really competitive application processes [but] women are so underrepresented in finance, we want to give any girl who is interested in learning about finance and investing the opportunity.

SWS executes this mission of supporting all women interested in commerce by holding open seminars to educate students rather than expecting prior knowledge and experience. They also emphasize networking with women currently in finance to provide insight and expertise about navigating a career in the male-dominated finance industry.

Alongside education, we are very focused on mentorship and building connections between women currently in finance, especially those who have graduated from U.Va. and are alumnae of SWS, Duffy said. This semester in particular, we are putting a large focus on corporate events, so partnering with companies to come speak to our members and give them the opportunity to hear from women in finance. We want to be that lead into breaking more women into the industry.

Girls Who Code takes a similar approach by offering open instruction on the foundations of coding. They also bring these educational pursuits to the greater community in order to empower girls from a young age.

We want to make sure we are partnering with other members of our community, whether that is us teaching girl scouts or having Capital One come teach us, Hart said. Over winter break, the curriculum co-directors [and I] held a six-week coding workshop so that local girl scouts in middle school could earn all of their coding badges. We are all about integrating ourselves into the community and working to give back as much as possible.

Beyond academic and professional empowerment, woman-led CIOs at the University have dedicated their efforts to fostering personal growth by emphasizing physical and mental wellbeing. Cassie Korcel, third-year College student and president of CHAARG, has worked to establish a strong community of womens empowerment through physical health and group fitness.

Our mission is to show our members that fitness can and should be fun, Korcel said. We strive to remind our members to always be the best version of themselves and to take charge of their mental, physical and emotional health. We are encouraging people to make that change and live a healthy lifestyle.

Going to the gym and especially entering the weight room as a woman can be a very intimidating experience that can turn women away from working out. CHAARG strives to reduce that pressure by creating a community of supportive women with a shared passion for fitness.

Maybe it is unintentional that women feel pressured and even sometimes unwelcome in the space at the gym, but a lot of women do, so we can't discount that, Korcel said. Personally, even going to the gym sometimes can feel scary, you don't know what to do and you are unsure of where to go, but the beauty of CHAARG is being able to go with friends who make you feel comfortable to enter the space and to try new things.

The Universitys woman-led CIOs have created welcoming communities that are working hard to combat the gendered stigmas and barriers that women face in academics, the workplace and in their personal lives. The leaders of these organizations are setting great examples as women who are taking control of the space and opening the doors to empower other passionate women.

If you are in a situation and there is not a chair for you at the table, pull up your own chair, Della Croce said. Show up anywhere you want to be and make a place for yourself. It is OK for you to show up somewhere that you feel unwelcome because you can change that experience for the women who come after you.

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CIOs empower female students to achieve personal and academic success - University of Virginia The Cavalier Daily

Like a gale that rips off the roofs in a small town, the lingering trauma of Jan. 6 has exposed basic truths about American life. Some of these are intellectual, as they pertain to the U.S. Constitution. The 12th Amendment to our founding document was being implemented inside the U.S. Capitol at the moment violent insurrectionists were breaking down its doors and windows.

Another foundational element of American life was violated that day an aspect of American life that is more emotional than intellectual, but one with a profound influence on our national prosperity and level of contentment.

Many values constitute America. There is freedom of speech. Also freedom of religion. For many Americans, personal empowerment is defined by the right to bear arms.

Underneath these and other bedrock freedoms lies an emotional truth that is not written down. For lack of a better word, call it consistency. In the most basic terms, we have a justified expectation that when we wake up in the morning the lights will turn on. We expect that we will not find that theres been a coup overnight within City Hall. We expect that when we drive down our citys streets, well not be stopped by a mob. We assume the banks will operate.

We take all of this for granted. But that is not the case in many other countries. And thats one reason why the United States has always beckoned immigrants as well as investment.

Heres how one local immigrant sees it. The ordinary is truly precious. She adds: Immigrants know this. They have come to America from places where all manner of daily disruption is commonplace. This kind of chronic instability is like being in an inescapable bad relationship inescapable, that is, except by taking the drastic step of relocating to a different nation.

Countries that become mired in cycles of political volatility suffer brain drain, as those with gumption and resources seek security elsewhere. For the majority who either choose to endure in place or who have no practical choice, life becomes a toothache dogged by worry and underachievement. Who wants to start a new family or business in a place where officials are corrupt, where public services are undependable, where warring political factions can destroy decades of work in a single riot?

This is what the U.S. risks if we are unable to coalesce around a rational middle ground that cherishes an element of stability and predictability. Far from being boring, the traits that made America great serve as a foundation for creativity and risk taking. Just as children who grow up in supportive families with high expectations may never fully realize how lucky they had it, citizens of smoothly functioning nations can scarcely recognize how privileged they are.

The dividends of living in such a country may be invisible to most. But they enrich us in countless ways. Americas stability means we are able to inexpensively borrow whatever we need to springboard us out of what might otherwise be a pandemic-induced depression. Our reputation for strength shields us, to some extent, from attacks by our adversaries.

The horror show of Jan. 6 badly bruised our reputation for stability. Prolonged civil unrest has also stripped the luster off several U.S. cities, including Portland.

Its often said that the first step toward getting better is recognizing you have a problem. In todays U.S., theres no shortage of those who decry both real and imagined shortcomings nor should we ever cease striving to ensure political, legal and economic justice for all. Our problems are comparatively easy to see.

Ben Franklin, our pragmatic founding father, wrote in 1789 that, Our new Constitution is now established, everything seems to promise it will be durable; but, in this world, nothing is certain except death and taxes.

If transported to today, Franklin would worry about how many of us fail to appreciate what we have. Franklin would recognize citizens who cherish the extraordinary value of normal operations are the key to an enduring republic.

Even Franklin admitted he didnt like every bit of the Constitution, but he recognized the whole package was a recipe for enduring American success. Healing the damage to our nation starts with recommitting ourselves to preserving the preciousness of the ordinary.

Steve Forrester, the former editor and publisher of The Astorian, is the president and CEO of EO Media Group. Matt Winters is the editor of the Chinook Observer.

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Writer's Notebook: The preciousness of the ordinary | Columns | dailyastorian.com - Daily Astorian

Healthcare is never one-size-fits-all, and COVID-19 has brought this fact into sharp relief. A 65-year-old diabetic woman, a healthy 40-year-old man, a pregnant woman, and an elementary school student all take on a different level of personal risk every time they step outside. Each individual handles the mental toll of this prolonged pandemic differently, too. And those who live alone struggle with their health needs in different ways than those who live with others and in multigenerational households.

But some common needs unite all types of patients, no matter the circumstances. Everyone needs access to timely, accurate information and a better understanding of the care options they have. Everyone needs a safe, easy way to see doctors and monitor chronic conditions. People need greater control over their own care. They need to be able to take responsibility for the management of their health and well-being. And everyone including care providers needs to have their voice heard so they can function as co-creators in the healthcare experience. In short, patients, families, and healthcare professionals need to be empowered.

Everyone needs timely, accurate information. Everyone needs a safe, easy way to see doctors and monitor chronic conditions. And everyone including care providers needs to have their voice heard.

Achieving empowerment will require greater communication between and among the patient, family caregivers, and providers. It will also require an acute understanding and consideration of how social determinants of health such as where people live and their access to nutritious food, transportation, quality housing, and healthcare affect specific individuals and cohort groups.

These needs didnt originate with COVID-19, nor will they disappear once weve put the virus behind us. The urgent dynamics of the pandemic, however, have forced healthcare organizations to refocus and adapt in various ways that will help increase empowerment. Here are three areas where progress is already being made and where further developments could revolutionize the healthcare experience.

The move to virtual delivery during the pandemic has advanced the adoption of some of the technological innovations that had already started transforming the healthcare experience. Telemedicine, for example, has been around for a couple of decades, but the pandemic has made it commonplace. Remote monitoring of blood pressure, oxygen saturation levels, blood sugar readings, cardiac rhythms, and much more is now common. Long before the pandemic, apps that connect patients to medical expertise had been in development, and they continue to crop up. ResAppDx, developed by physicians at Massachusetts General Hospital, diagnoses acute respiratory disease in children by analyzing how their coughs sound. Another app, called i-Prognosis, coordinated by the Aristotle University of Thessaloniki, Greece, tracks a variety of biological cues that, when added together, can signal the onset of Parkinsons disease. And Instant Heart Rate, developed by researchers in Canada, analyzes blood flow in the tip of a persons index finger to indicate artery health. All of these technologies make it easier for patients and caregivers to proactively monitor their health, building a sense of empowerment.

Wearable health devices are another fast-growing and empowering technology. Canadian company Myant is pioneering connected apparel that features sensors and actuators knitted directly into everyday clothing. The company is partnering with leading technology and healthcare companies, such as Mayo Clinic and Carlisle Interconnect Technologies, to test and perfect its solutions. VitalConnect, a Silicon Valleybased company, has also been on the cutting edge of digital monitoring with devices such as a monitoring patch that continuously streams 11 vital signs using telehealth-enabled software and another patch, approved by the U.S. Food and Drug Administration, for monitoring COVID-19 patients.

The data from these sorts of devices can empower not only patients but employers and caregivers. For example, new predictive models used in some parts of the world employ artificial intelligence (AI) to analyze data related to the well-being of an entire organizations workforce, forecasting when an individual might become diabetic or develop other serious complications five, 10, or even 15 years in the future, and enabling early intervention.

Healthcare, especially among households sheltering in place, can be a family affair. Many patients rely on relatives, both inside and outside of their home, to help them coordinate care. Family members might be called on to administer medication, work with apps and other technology that the patient isnt familiar with, translate information, schedule appointments, and support care in other ways. A healthcare experience that empowers not just the patient but the entire household or support system is therefore necessary.

And there are other reasons aside from the purely practical aspects of shared responsibility for care that might make patients home situations relevant to their health. Social determinants of health have a significant impact on well-being. For example, a faith-based health system in the midwestern United States is working with a Fortune 500 technology company to factor social determinants of health into determining the likelihood that certain patients discharged from the hospital will be readmitted. These societal influences can help answer basic questions such as:

Historically, healthcare systems have lacked this context, limiting the effectiveness of the patient experience.

Empowering caregivers to attend to the needs of not only patients but themselves is also important. St. Elizabeth Health Care, in Toronto, created the website elizzbot, a self-described lifestyle destination that inspires daughters and sons to live well while caring for their aging parents. The interactive, confidential site provides on-demand, unbiased emotional support, including a chat feature, and resources such as psychotherapy techniques, self-learning AI, and a journal that caregivers can use to boost their mood and build resilience and self-awareness.

The Social Care Institute for Excellence in the U.K. has created an online guide for those who are supporting adults and children with learning disabilities or autism during COVID-19. The guide provides tips and facts for all aspects of the patient and caregiver journey during the pandemic.

Experience design teams are learning that small tweaks in the patient journey can provide benefits to one party while creating problems for another. Bringing everyone to the table patients, families, caregivers, partner organizations, community resources, local and national governmental agencies, and advocates during redesign brainstorming and implementation assures a greater opportunity for success and helps to prevent costly mistakes and do-overs.

Co-creation with key stakeholders and partner organizations is at the heart of the patient experience designed for the Ministry of Health in New South Wales, Australia. Patients were invited to offer feedback on pain points, such as accessing the online patient interface system, working within the system to make or cancel appointments, scheduling procedures, and obtaining clear and easy-to-understand post-discharge care information. And then, solutions were implemented in response, such as proactive reminders and delivery of the right information to the patient at the right time.

Another example of a co-created experience is a project in the works in Italy related to a womans pregnancy journey. This effort is a collaboration between experience designers, healthcare institutions, and pregnant women, together with their physicians and midwives.

At the beginning of her pregnancy, a woman in Italy today must complete a set of paper forms and submit them to her local health office. The forms, specific to the area in which she lives, are scanned and shared with those involved in her care. If she decides to change physicians for any reason or move out of the area, she must start all over to create a new paper record.

The new digital pregnancy journey eliminates the systems reliance on paper forms, makes transfer and sharing of records easy, and creates a real-time log of the womans condition and health needs so she and her caregivers can access critical information. Development of this digital system relied heavily on input from patients and caregivers about usability.

The pregnancy journey is a promising example of how the empowering healthcare tools that are being developed today might shape the future of the patient and caregiver experience. After a baby is born, the journey continues, after all. Health systems that can evaluate a mothers online search history, for example, or call up her and her childs previously recorded health records, couldsend push notifications to the mothers mobile phone, reminding her of any tests or health interventions her child might need or alerting her to discounts available on products or services that might be helpful to her.

One day, data analytics could track environmental conditions and match them to individual health issues. So, for instance, a person with asthma who is a runner could be alerted to poor air quality along her route on a certain day.

These scenarios arent some far-fetched vision of the future; they are very clearly possible when considered together with the advances we are seeing every day in all three of the critical areas weve covered technological innovation, whole-household solutions, and co-creation. And in all cases, it will be the empowerment of patients, families, and healthcare providers that will ensure our worlds collective safety and health.

PwC Italy senior manager Tommaso Nervegna and PwC Australia partner Diane Rutter also contributed to this article.

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Empowerment will be at the heart of the new healthcare experience - strategy+business Today

Over-the-Rhine venue Woodward TheaterPhoto: Hailey BollingerIts been nearly a year since the world ground to a halt under the deadly and disruptive coronavirus. 2020 easily could have been The Year Without a Santa Claus for the local music community, but Cincinnati musicians have shown resilience and resourcefulness in the myriad ways theyve worked within and around the pandemics fallout of closed venues, limited bookings and few opportunities to sling merch. And with COVID-19 sticking around a bit longer, theyre continuing to power through in 2021.

Some local musicians have used their quarantines to write, record and release new music, while others have poured their creative energies into music-adjacent activities. Some have blazed new trails down career paths unrelated to their musical directions. And a good many have advanced their personal lives while doing some or all of the above.

Electric Citizen lead vocalist Laura Dolan is one such human. Dolans father, Paul Busse, founded Applied Imagination three decades ago to provide botanical gardens with scale model landscapes made entirely of natural materials; the Krohn Conservatorys train display is an example of his work. Busse brought Dolan into a company leadership role in 2017, six years after his Parkinsons disease diagnosis, and she is now president and CEO.

Although Electric Citizen has been relatively inactive recently, Dolan notes that the group has been busy behind the scenes.

My intention is to absolutely keep going with the band. Its important to my dad that I do, she says. I restructured the company in 2019 to ensure I could step away for touring. I have yet to test that, but in theory, I should still be able to tour. Weve been using this down time to write a new album; Ross [Dolan] and I even built ourselves a little home studio. And [bassist] Nick [Vogelpohl] and his wife had a baby!

In their own words, heres what other Cincinnati-area musicians have been up to during live musics forced hiatus:

Jess Lamb, singer/songwriter and co-founder of the Factory with partner Warren Harrison:

In response to a year marked with isolation and polarity, we released our newest album, You Are, a collection of songs and mantras written over the past several years, celebrating personal empowerment, unity and the wonder of human life. I also began teaching a songwriting course at Xavier University, which was a happy, unexpected turn. I love teaching and mentoring. Going from performing three-hour gigs three days a week, to being more still with my Self gave me time to grow as a teacher and writer. I am grateful for that quiet time with Self, but I cant wait to hug all of you at a live, sweaty show soon. You are beautiful. You are powerful. You can make it. Enjoy being still. Just be.

Brian Kitzmiller, drummer for Van Echo and founder of marketing company Reveal Concepts:

Right now, business is going well, even though events have fallen off. Im currently working with Van Echo (Wes Pence, Randy Cheek and Ed Shuttleworth) to finish our record after two years. Also getting ready to organize songs with The New Usuals (Wes, Randy and Justin Lynch) and get some kind of recording out this year. Weve been in the studio almost every week this past year and ongoing now. Im also playing golf a ton with Wes. Even in the cold.

David Butler, frontman of Black Owls:

Ive been channeling my energy into my writing, fine art, design, and, ahem, athletics. The same impetus of the Black Owls aesthetic Ive been pouring into my own fine art pieces in collage and video. I set up my online presence (dwbfolio.com) and have been working on some multi-media (oh God, really?) comedy stuff with another local artist. Our project is a sort of Funny or Die thing. Well be rolling into 21 like a skateboard on early 70s urethane: brittle, tired, and yet somehow still brittle, tired. But honestly, having fun. Still planning on an Owl renewal. Also playing platform paddle tennis and still mountain biking, snowboarding and breaking things. I definitely had the COVID in February of 20 while snowboarding in Utah before it was a well-known deadly pandemic. Glad I didnt know... couldve killed me!

Kate WakefieldPhoto: Hailey Bollinger

Kate Wakefield, cellist, co-founder of Lung and session musician:

Ive been working at a restaurant during the pandemic, which has been interesting. Ive gotten really into online kickboxing. I like the free pre-recorded classes you can find on YouTube with the overly enthusiastic instructors who shout at you the whole time. Also, Ive been finding that playing Scrabble with my girlfriend is my Saturday-night substitute now that shows are not a thing.

Dave Purcell, former frontman for Pike 27 and drummer for the recently launched Ghost Man on Second:

GMOS has written a dozen new songs during the pandemic, mostly thanks to the wonderfully prolific Andy Hittle. My main quarantine activities are connected: (1) focusing on my drumming and composing, including studying with Mark Guiliana, a brilliant jazz and electronic drummer and composer best known for playing on David Bowies Blackstar; and (2) reconnecting with my Buddhist practice of mindfulness and meditation. The beautiful fusion of the two got me through a brutal year personally on top of the pandemic, the lowlights being three deaths close to me (none from COVID, oddly) including my mom.

Wes Pence, ex-Middlemarch/Ready Stance guitarist/vocalist, now playing with Van Echo and the New Usuals:

Both bands have continued playing and recording since the early weeks of COVID, but more notable is my personal story. Freed from the shackles of the workday week, there were finally enough hours in the day to pursue long-ignored personal priorities like intensive daily exercise, yoga and meditation regimens, growing and harvesting our own food, writing my memoirs, oil painting, translating the works of Schopenhauer from the original High German to the more contemporary form and many other pursuits. Those are all things I definitely would have done this year, if Id foreseen the lethargy and precipitous weight-gain brought by the first few months in pajama pants.

Kim TaylorPhoto: Hailey Bollinger

Kim Taylor, singer/songwriter:

My partner and I are moving to Berkeley, California. Hes in grad school, and its worked out for us to live there rent free so were heading out to be in the sunshine for a while. Well hopefully be back in 2022. Hoping to shake a record out of myself while Im there. Gardening was a grounding force for me while it was warm. I expanded a really lovely, mostly native garden on our acre of property in Loveland. I also practiced piano every day, focusing on sight reading classical music, something I dont do enough.

Mike Montgomery, guitarist for Ampline and R. Ring, and owner/ producer at Candyland Studio:

My wife and I had our first child at the end of 2019, so weve been raising our little boy. I halted client-attended sessions at Candyland in mid-March as the pandemic was taking hold. I set up a small studio at my house so I could work at either place. Ive stayed surprisingly busy despite not recording any bands for most of the year; Ive shifted to more mixing and mastering. Ive helped a lot of friends and clients set up or augment their own home recording studios so we could continue working on their projects together, and the flood of new music people have been generating is giving me renewed faith in the power of creative pursuits to function as a beacon of hope in the darkness. With my own music projects, Ive been sending way too many demos to my bandmates and writing partners, but its nice to know well have material to rifle through when we can finally be in a room together again. R. Ring finished a sophomore LP that well release either late 2021 or sometime in 2022. Ive just been trying to say yes to things as they come up to make sure I have fun stuff to keep my thoughts above water. Ive been cooking a lot more, really trying to grow into my new dad bod.

Maurice Mattei, singer/songwriter, frontman for the Tempers, graphic designer and photographer:

The new line-up for the Tempers - Debbie Immesoete on drums and Bryan Berwanger on upright bass - is, in my opinion, the best one Ive ever had, and were continuing to get together to rehearse as well as actually doing (very) occasional shows. The show we did for the Southgate House/Save Our Stages benefit (YouTube: bit.ly/3q6V1hS) in November turned out so well that were thinking of releasing it as a live album. The big news concerning the band is that weve been booked to perform May 1 on the nationally televised Song of the Mountains. It will be livestreamed the night of the show and then telecast at a later date. Were also working on new material for a possible upcoming new record. As far as my art work, even before COVID, I had been finishing up three major projects - my Italian photos, my Highs in the Low 90s USA Street Photo series, and my Urban Dweller drawings. The first two projects are complete and I am now finishing up scanning the last of my drawings.

David Rhodes Brown, frontman for Warsaw Falcons and pedal-steeler/vocalist for 500 Miles to Memphis:

Bobbi Jean and I are doing well or getting well. Its always something at our age. I gained 16 pounds and then lost 16 pounds. Ive been making single song videos for YouTube; String of Hope has a couple. The third one with Moriah Haven will be released soon, and were planning another together as well. My roofing company does new construction and residential replacement roofing. Just a ma and pa deal weve worked for almost 20 years now. And were new grandparents for the first time. Wolfgang, our oldest, and his wife, Jessica, have given us the gift of a grandson, Atticus Augustus Kayser. Being a provider and gramps at 70 keeps me pretty content. Its a great life if you dont weaken.

Musician updates have been edited for clarity and space.

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Here's What Cincinnati Musicians Have Been Up To Since the Pandemic Pushed Pause on Live Performances - Cincinnati CityBeat

Making an automated mechanism for building and deploying software workloads onto cloud platforms was a superb idea. Since 2015, the task of building a business around it has, at least on paper, been tackled by the open-source community. Today, its champions are the names we recognize: Google, VMware, Microsoft, Amazon (if reluctantly), Red Hat, and by extension, IBM. Containerized workload automation must be a somewhat viable business, otherwise, those companies wouldn't have swallowed it up.

"Cloud-native computing" is a great idea that would have been poison for any single vendor to have claimed and defended just for itself. Revolutions have always been great (at least the successful ones) as long as someone else leads the charge, and you're not the one getting bloodied. The overall goal of cloud-native is to unseat a dynasty: to eject virtualization from its throne at the center of the data center economy, and in its place install workload automation. From a distance, the task resembles replacing a refrigerator with a washing machine.

Yet witness how Google swiftly and adeptly pulled off this masterstroke: At exactly the time that Docker, a workload deployment system, sought to leverage the gains from the movement it sparked, Google started its own movement at a campsite down the road. It took an in-house workload orchestration project (even its original name, Borg, delivers gorgeous irony); offered it up as an open-source initiative; stewarded its evolution into the raison d'tre for workload portability; marginalized the Docker whale; infused Red Hat, VMware, to a lesser degree Microsoft, and kicking and screaming, Amazon with the workload portability bug; and cemented Kubernetes' place as the axis around which a software ecosystem revolves -- all without ever "pulling a Microsoft" or being accused of monopolizing a market, and all by leveraging other people's efforts.

Minimum investment, maximum payoff, clean shirts. A clinic on influencing an industry. If only all insurgencies could work like this.

But is the scale of this revolution broad enough to have genuinely changed the way we live and work? That's the type of question we've created Status Report to help us answer. It aims to take the ten most important categories for any technology's or platform's capability to influence its users' businesses and livelihoods, examine each one in isolation, score its positive and negative factors separately, then toss them all onto a graph to see if its capacity for change is as great as our proclivity for emotion. Through this cleansing process, we may be able to extrapolate pertinent, relevant facts about whether technology makes a genuine difference.

Today, when I refer to "cloud-native" technologies, there's a general presumption that I'm referring not just to "containerization" (another terrible word) but specifically to Kubernetes, and the ecosystem of open source components that comprise its "stack." The Linux Foundation maintains a project called the Cloud Native Computing Foundation, whose job is to nurture new technologies in this space, as well as promote and support all of them.

Three years ago, I was told emphatically that presuming containerization meant Docker or Kubernetes, or any one name, would be contrary to the spirit of the open-source movement. Openness, I was sternly corrected, was all about choice, and ensuring that customers are never again locked into one way of doing things. Now, of course, it's an all-Kubernetes stack all the time. The CNCF's accreditation program for IT professionals in the cloud-native space is called Certified Kubernetes Administrator. Its competition has been kicked to the curb, then stomped on and flattened, followed by being declared not only irrelevant but never all that relevant to begin with.

The original, and still true, meaning of containerization is the method of packaging any workload with all the tools and dependencies it needs so that it can run on any cloud platform without modification. Think of a camper who carries everything she needs in her backpack, as opposed to a traveler who carries a light briefcase but expects to stay in a hotel. (Actually, virtualization would be like a traveler who drags the entire hotel behind him on chains.)

The problem with the term "cloud-native" is that it implies a software workload stays in one place throughout its lifecycle. That's not what "cloud" is about. A cloud platform is an abstract plane whereby a workload is addressable through the network at all times, regardless of where it is. This is the actual value of the concept: It ensures isolation (for security), portability, and at the same time, accessibility. This reduces the cost of change for enterprises charged with maintaining it. Historically, IT has kept costs low by maintaining system configurations until their platforms can no longer sustain them, and usually beyond that time. "Cloud-native" flips the whole maintenance cost argument on its head: Ideally, it ends up costing organizations less to continually adapt their own workloads to new situations and requirements at a moderate pace, than to constantly pour more effort and capital into maintaining IT systems' stability.

In the end, this is why Kubernetes won. (I expect to be told once again, it's not about winning or losing. The people telling me this will, without exception, be the victors.) Yes, it's the packaging of the workload that enabled its system of orchestration. But it's in the orchestration that customers find value.

The software industry is, first and foremost, about intellectual property. The open-source movement is largely an effort to neutralize the legal, financial, and other natural advantages a competitor may attain by having thought of the idea first. It forces its market to be about something else.

In a market where the incumbent is the leader by way of ingenuity, that something else is usually an effort to drive the value of that advantage down through product homogenization, and substitute service and support as value-adds. This is how Linux first gained a foothold in the enterprise. However, in an infrastructure market, where the incumbents reinforce their value propositions by stifling change instead of driving it, an open-source player has the unusual opportunity to reverse the situation: to encourage the developer community to foster ingenuity among themselves, as a tool for disruption.

As Docker, and immediately afterwards Kubernetes, proved, this plan can work out rather well at the outset. But then suddenly it hits a wall. It takes tremendous human effort to sustain even a moderate pace of change for any technology that has established itself in its market -- an effort that has traditionally been supported through vendors' IP license fees. When IP is at the core of a market, its incumbent has the luxury of slowing down ingenuity to a pace it can comfortably manage (see: Apple, Microsoft, Qualcomm, Amazon). That method doesn't work anymore if the incumbent is a shared entity: It must evolve or die. And since the benefits of that ingenuity are shared by design, it takes even more effort to spark the incentive that encourages ingenuity in the first place, especially when everyone knows ahead of time that such ingenuity must be short-lived (see: "Union, Soviet").

A successful business is all about minimizing risk. Information technology is the most volatile component of any business. The types of organizations that take a risk here are often the newer ones, or perhaps the very old ones for whom casting off their mortal coils has become a mandate -- companies with very little pre-existing baggage that's not worth losing anyway. Early adopters are the groups that have calculated the potential for significant gains, either through disruption or just pure innovation.

But the earliest adopters of Kubernetes and cloud-native technologies include public cloud service providers (of which there are few), communications providers (of which there are few), small businesses, and startups. Although they're arguably reaping benefits, they have yet to lay down the kinds of patterns for success that other industries can follow. In financial services, healthcare, government, and incredibly, logistics, there remain highly placed individuals in IT, including at the CIO level, who have never heard of Kubernetes or "cloud-native" or containerization. Not that they've rejected them, or would want to do so -- they don't even know what these things are. Such individuals tend to be myopically focused on other institutions less risk-averse than their own. Until these other firms take the plunge, they won't know a plunge can be taken.

Now let's score each component of our evaluation individually:

What the cloud-native ecosystem (CNE) intends to do is give vendors, both old and new, something amounting to a freeze-dried infrastructure kit. They can get into the business of producing products and services, so long as they don't make their involvement about intellectual property or exclusivity. [+7] What its benefactors do not do -- perhaps because they cannot -- is provide instruction or guidance about how to provide distinguished services around this business [-4], which is one reason why the earliest open-source trailblazers, such as Red Hat, have come out on top thus far. [Net: +3]

From the outset, Kubernetes' engineers have said they'll know their efforts have pierced the envelope into the realm of permanent success once everyone finds it a dull and boring topic already. Their experience comes from Linux. Linux is dull and boring. Take it from a journalist who has been paid to come up with reasons to make Linux exciting again.

But Linux established itself through homogenization -- by driving down the advantages gained through ingenuity. Kubernetes actually took the reverse route: It disrupted a market that could have comfortably fed off of the first-generation virtualization until the end of time. From the outset, however, no single player has attained a native competitive advantage -- no one has "come out on top." This is a problem for prospective customer organizations that typically wait for someone to emerge from the rubble, before investing in IT. [+2 | -7, net: -5]

This is Kubernetes' present dilemma: For the CNE to thrive, it must continually spawn new entities and innovative projects. Because Kubernetes is the axis of the ecosystem, those projects cannot be another orchestrator, but rather another service mesh, logging analytics tool, or key/value store. Because the axis of the ecosystem is strong, you can build a business around a product or service that orbits it. . . for a while. [+5]

Actual map of the CNCF's Cloud-native Ecosystem. Magnification available from CNCF.io

As the CNCF's own landscape map reveals all too clearly, even without a magnifying glass, this leads to dozens of startups essentially competing for the same market spaces. Venture capitalists will find it difficult to invest in a project that, by design, must compete with dozens of other projects that appear on the surface to be functionally identical. While we may call this a meritocracy, Charles Darwin would have called it something else. [-7, net: 2]

As noted in the Executive Summary, the components of the CNE must evolve or die. That's not necessarily a bad thing; indeed, it leads to consistent improvements. [+8] But it requires a long-term vision -- for 10, 15 years down the road -- that few, if any, have yet articulated. To withstand a threat from a future disabler, Kubernetes and its satellites cannot afford to become, like Linux, dull and void. They must continue a level of sustained pressure just to remain relevant. They are, in a word, hungry. Over time, this creates a vulnerability, increasing the likelihood of a future competitive challenge. [6, net +2]

At a certain point, a product or service becomes so fundamental to a market that its existence as an enabling factor is mandated. The Kubernetes model of application deployment is now a fact of the public cloud. [-7] It has yet, however, to significantly penetrate the small enterprise data center, and not even its integration into the latest VMware vSphere appears to be changing this fact measurably. So if you're in the cloud services business, and your customers include medium to large enterprises, you have to position yourself differently than you would for a small company that's starting fresh with the newest tools and methods. [-5, net +2]

The shift to a cloud-native operating model can, and has, revolutionized corporate IT [+7]. . . for those organizations capable of understanding it, and meeting its requirements. Kubernetes is a hungry beast. As of yet, there has yet to be a single, successful, persuasive initiative to educate the organization as a whole, including the C-suite, as to the end value of cloud-native, outside of IT departments and software developers who have already been convinced. [-6, net: +1]

Through having infiltrated the mindsets of the leading data center virtual infrastructure vendors, the CNE is now a measurable contributor to the world's gross domestic product. [+7] While some effort and capital continue to be expended toward buttressing pre-existing systems and methods, most of those expenditures have yet to be directed specifically against the advancement of the CNE. [-3, net: +4]

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Perhaps the best measure of whether a concept has thoroughly permeated the fabric of a society is the degree to which its peoples benefit without their having to pay attention to it. The public cloud sustained the tremendous surge in user demand brought on in the onset of the global pandemic. No other industry has fared as well in the face of potential economic peril. [+8] What has yet to materialize, although it still could, is a sustainable system of education and certification around cloud-native IT, beyond just a bunch of YouTube videos and TED talks. [-2, net +6]

Has this integration helped advance people further forward, making them more capable? Through the enablement of real-time video communications that were not feasible with the first-generation virtualization, undoubtedly yes. [+6] Through the incidental enablement of certain negative aspects of social media that would not have been feasible otherwise, no. [-2, net: +4]

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The cloud-native ecosystem is the strongest collective community of software developers and IT engineers ever assembled. [+9] Granted, it did not metastasize under its own power -- it required leadership and, certainly at the outset, a positive vision. It also adopted a mandate for personal empowerment and even betterment that no other information technology initiative has ever achieved.

Yes, there are pockets of community initiatives to reinforce those resources devoted to maintaining old, and admittedly dated IT systems. But these pocket communities do not form an ecosystem themselves. What's more, we're seeing evidence that these efforts are at last collapsing. [-3, net +6]

As technologies fare with this new series, a score of +2 or above is very strong. As a geometry teacher may point out, it's possible for an evaluated technology to post weaker net scores in one or more categories, and end up yielding stronger final influence scores. This is intentional. These categories are not intended to represent cumulative virtues. Should Kubernetes ever find that magic formula that guarantees its vendors revenue for the long-term, as it very well may, that final score could be pulled closer to 0, or at least toward the centerline of the X-axis?

But if a technology cracks the customer value barrier, so that not only is it necessary but desired, then that final influence score could skyrocket. What company has ever sustained itself in business for an extended period of time, earning value for its shareholders and also benefitting communities and society as a whole, without also generating products and services that have high perceived value? And what industry has ever come to fruition with a plurality of organizations that could successfully accomplish the first two, but not the third?

Here for the first time, we have enough background data to render a comparison between evaluated technologies. Notice in this comparison, we've zoomed in somewhat, narrowing our scale from 10 points in both directions to 3 points. Our benchmark is the World-Wide Web as of September 12, 2001, when that new technology faced the opportunity to bring a society together. It posted a strong positive score that leaned somewhat toward societal benefits, and away from corporate benefactors. 5G edge computing has nearly found that balance between altruistic and self-serving interests and could post a much stronger influence score if it can make a stronger value proposition.

The CNE is highly slanted toward the altruistic, self-sacrificing, part of the chart. That's a good thing, but only for a short time -- which is why the metaphor for this series is a pendulum.

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Is cloud-native computing as influential as its stacked up to be? [Status Report] - ZDNet

The pace of digitization is accelerating. The volume, velocity, and variety of data is exploding.

Customers, clients, partners, and programs are screaming for more data, faster. Central IT is under more pressure than ever, but our budgets are neutral, so we have to do more with less. At times, it can feel like were trapped in a perpetually spinning wheel with no destination.

But there is a way out:

The answer is the democratization of data through empowerment and advanced automation strategies. When secure, relevant data is readily available to all of our users, we can build a culture of data self-reliance, get more from our existing data resources, and promote innovation across an organization.

These are the ingredients of a new recipe for agile and responsive self-serve analytics.

A business user needs to have confidence in the data they are using. Implementation of solutions that automatically assess the health, relevance, and usefulness of the data and point out any problems, provide an easy way to remedy any trust issues.

Data preparation is a vital step that will ensure your data is accurate, of the required quality, and useful for specific situations including machine learning. For example, if a non-business user is combining data from two different sources and they are different formats, errors and analysis problems can arise.

Automated, intelligent self-serve analytics solutions recognize and fix issues, so the organizations data is useful for everyone involved in the environment.

Todays modern data lakes and complementary technologies for data integration and governance are also working to set users up for self-service success. They help empower business users to easily gain access and analyze data in a cloud data warehouse from either an on prem or a SaaS application.This is where a number of non-tech user focused data ingestion tools come in.Then, your next step is to get out of the way.

Lets explore possibilities

CIOs are responsible for satisfying the data demands of every department across the organization. Their customers don't want them to be a bottleneck just as much as CIOs don't want to be the bottleneck; they're just trying to solve problems.

Some of those problems require a lot of data analysis, but there are many narrower problems that only require a subset. It just doesnt make sense to treat every problem the same way.

Central IT is a necessary resource for questions that demand a lot of analysis. But its often delivering an overpowered solution for simpler problems with smaller, department-specific datasets. We need to do something different to accelerate the process a newer methodology to liberate our customers.

Most lines of business have somebody who is data literate. They're usually not technologists, but they have enough technical skill to build a complicated spreadsheet or run some basic SQL. Lets look at some modern solutions that can leverage the data-savviness of many of todays knowledge worker without all the IT over-engineering.

Nimble datasets: New data lake technology makes it possible to empower these users to get the data for themselves. They are already familiar with the business, and they understand the data. Users can provide a copy of a dataset so that they can help shape the data and improve its quality of the data by doing simple tasks.

These nimble datasets dont require a very high degree of technical skill or time. Most importantly, they don't need to bring a developer into the picture. With modern data lakes, the cost of liberating data is surprisingly low. You can give users a view of the data, instead of creating a full duplicate.

Best of all, users can still hide sensitive or personal information and expose only what is necessary, so you can comply with all the governance and policy rules. And when users create a copy in modern technologies, you don't consume a whole new infrastructure or double your data storage.

User-Friendly Data Catalogues: Another tactic is to provide a data catalog which provides an inventory of all the data that is available within a company. It essentially maintains all the metadata that describes the data and shows users that have access to the catalog what data is available, where and how to find it, and how to use it.In some cases, there are also some additional capabilities that allow users to put their own tags, ratings, etc. on a dataset to give further information on the relevance and usefulness of the dataset.

Data catalogs have traditionally been used by IT organizations.That said, as they are more and more being made available to non-IT business users, they also need to become more user friendly and easier to use by these non-tech users.

Rapid access to information changes the way we make decisions.

For example, say you wanted to add more headcount to your SMB segment. You dont have the data, but your gut tells you that this segment has potential. Suddenly you get an SMB segment report that tells you, Oh, by the way, the southeast quadrant is doing really well.

You would never have seen that if you didn't have the right breakdowns, but now you wont waste resources on a region where theres already a natural demand and can instead invest more heavily in the regions that need help. You may have spread headcount equally in all regions, rather than by demand, if you didn't have insight at this level of detail.

We make such decisions all the time, but we are not 100 percent data-driven by any means. As we receive more data, we become better and better at assessing it. Once you see the data clearly, you will find more opportunities. You always do.

The transition and transformation to user self-sufficiency is just beginning its a journey, as they say. There's plenty of opportunity for growth and innovation. Whats exciting about this evolution is that it does not preclude central IT from doing all the right things in the right way for the future.

CIOs can empower departments to take care of their business and still do everything they need to do for the long-term health of their data. The secret to success is to get away from central planner thinking. Central IT doesnt have to be the source of all innovations for your data. In fact, there are benefits to a more de-centralized approach.

For instance, when you so much data at the central level, you have to worry about every action. One wrong step can compromise the business by exposing the data to the wrong people.

But now, IT doesnt have to design and deploy everything. IT is now empowered to enforce policy throughout the process.

It works like this:

IT continues to own and configures the storage and the computing environments. Meanwhile, The team prescribes the framework for integrating new data in a way that everyone can follow. They establish policy and standardize tools every step of the way, from collection to storage, to wrangling, to analysis. With these methods and models in place for all the standard data processing, IT just has to deal with exceptions, not every request.

As humans, we have our failings, and by bringing more humans into the picture you could multiply the failings, as well. But with more people doing more things, any one mistake is more likely to be caught and less likely to be catastrophic. And when you work with data constantly, you get better at it.

By empowering our customers with self-service access to the data they need, we free up IT to think about higher-level, higher-order functions that provide so much value and facilitate data literacy. We can anticipate the next big thing and gain insight with an incredible amount of detail instead of reacting to the last one and, more importantly, help our customers anticipate.

This is the future. Our customers demand it, our performance requires it, and our success depends upon it. The time has come to wake up and solve the need.

As CTO at Talend, Krishna Tammana is responsible for scaling the companys product and engineering organizations. Previously, Krishna spent nearly a decade as VP of Engineering at Splunk where he led global engineering teams and cloud operations during the companys successful portfolio expansion and transition to the cloud.

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Self-Service is the Future And It's Time To Embrace It - Integration Developers

The shift to widespread digitalisation has been expedited by the Covid-related chaos and economic decline globally. Companies are fast adopting new strategies and processes to keep up with the hybrid world in the South African context digitalisation doesnt happen in a vacuum; the government plays a critical role in scaffolding the adoption and success of digital economies.

The Ramaphosa presidency has paid a lot of lip service to the Fourth Industrial Revolution (4IR), but does it end there? Where are we, digitally speaking?

A handy metric is the Digital Evolution Index, which measured the trust in the digital economy and its evolution across 90 economies as they grappled with the pandemic. Currently, South Africa sits at the 54th spot and is under the indexs Watch Out category (the others are Stand Out, Stall Out and Break Out).

How does the country move out of that ominous section and into the realistically obtainable and more favourable Break Out one? For the most part, the answer lies in investing in infrastructure to give our whole population access to digital education and improve digital innovation incentives to drive consumer products and services. This, of course, can only be put in motion if the government plays its part in driving digital adoption and cheerleading transformation. Credit must be given where it is due; they are trying, but is it enough?

South Africa is consistent in publishing reports and policies aimed at propelling us into the digital age. The latest instalment is the Draft ID Management Bill, which seeks to introduce a new ID system to act as a single source of information on all citizens. This would undoubtedly help the Department of Home Affairs (DHA) catch up to more established economies.

The ins and outs of ID management in South Africa

As it stands, the DHA is the sole authority on issuing and regulating official South African identity and citizenship (this ranges from identity documents and birth certificates to marriage certificates and passports). According to the Constitution, no citizen must be deprived of citizenship. Every child has a right to a name and nationality from birth. The concepts of identity and citizenship are also essential for enabling the empowerment and economic development of the people of the nation.

The push towards modernising the National Information System

In a nutshell, the identity management policy sets out the vision, goals and objectives of the DHA regarding the creation of a modern and secure National Information System (NIS). This is long overdue, as the DHAs current National Population Register is not only outdated (it was established in 1982), its by no means inclusive. The register was used to determine a persons identity, linked to biometric data and personal information, but limited to citizens and permanent residents. The new system will include citizens and non-citizens within the territorial jurisdiction of the Republic. At present, the DHA operates without an approved identity management framework that can address how the DHA would regulate personal information under the protection of the Personal Information Act 4 of 2013. The NIS is set to interface with other government identity management systems and generate critical data needed by e-government and e-commerce.

The 10 principles of the modernised identity management system in South Africa

This includes providing legal identification to all residents, including immigrants, via a system free from unfair discrimination. To mitigate this risk, vulnerable groups must be identified. The Identification Act and Births and Deaths Registration Act does not provide birth certificates to children whose parents are not citizens or under permanent residence. Furthermore, the status of a child who is born intersex is not covered at birth registration. The draft makes great strides in recognising marginal groups and bringing gender and self-identification into a new era. All deaths will be registered to avoid theft of the deceaseds birth certificate.

This is primarily focused on making ID service affordable and accessible for those in remote areas. Currently, individuals who cannot afford identity documents are excluded from the identity management system.

To mitigate any risk of information being stolen, tampered with or misused, the classic green ID books must be phased out. The DHA must embrace automation to enhance and modernise its operations. Registration must be verified by the rigorous checking of the accuracy and authenticity of any supporting documents.

Essentially, this means that identification and verification services must be flexible and scalable to meet end-users needs. Interoperability involves different functional units communicating, and exchanging data through systems, databases and applications. To achieve this, the official data management system must be developed. All databases must be integrated and allow governments to verify the information. Interoperability also applies to cross-border operations. It seeks to facilitate mutual recognition of physical and digital IDs issued by another country to increase trade and enable safe and orderly migration.

The primary goal here is to make sure the systems design is fit for purpose and able to meet policy and development objectives. Robust procurement guidelines will help ensure healthy competitions and innovation. Additionally, facial biometrics, virtual identity and use of digital travel credentials, including the use of advanced electronic signatures, will result in improved functionality of identification systems.

The onus of protecting personal data should not be on the individual. This means that implementing top-notch privacy-enhancing technologies and security systems is crucial.

There is a need to develop different business models that cater to reasonable and appropriate service fees for verification of identity. Currently, the DHA does not have a defined funding model to sustain its ID management system through revenue generation. Some of the recommended revenue generations include low-cost fees, market-related fees for the private sector, pricing discount for frequent users and pricing based on the type of data requested for authentication and verification services performed online.

Promoting trust in a system is always vital. That can be achieved by prioritising the safeguarding of data privacy, upping securing and, ultimately, reassuring users. The regulations must be crystal clear about the purpose of an identification system, its roles and responsibilities of various stakeholders, how data is going to be collected and stored, and liability and recourse for ID holders. To succeed, the government must own critical information infrastructure by creating and maintaining technology sovereignty when designing the NIS.

The terms and conditions that apply to institutional relations among parties must be clear to all involved, including accountability and transparency processes around the roles and responsibilities of identification system providers. South Africa does not provide any legislation to affirm that the sole provider for official identity services is the DHA; thus, the DHA cannot challenge these entities.

To help ensure stakeholders use identification systems appropriately, they must be monitored independently. Currently, this is not the case, and it certainly doesnt help that the Protection of Personal Information Act (POPI) isnt operational yet. However, the Information Regulator of South Africa could be declared an independent oversight authority, ensuring compliance with our privacy and data laws. Another important aspect is establishing an independent body that is legally empowered to oversee official identity processing and hold parties accountable.

What about POPIs impact?

This specific piece of legislation regulates how public and private entities process personal information that gives effect to the right to privacy, subject to certain limitations aimed at protecting other rights. The POPI Act seeks to protect personal information and prohibit unlawful collection, dissemination, and use of personal information. In this specific context, any data handled by an organ of the state that qualifies as personal data will need to comply with the POPI regulations.

For instance, it means that one department cannot dump its data onto another, which would curtail some benefits of information-sharing, like better government service delivery, improved risk management, and duplicated work. However, this kind of inter-institutional sharing could lead to an infringement of the right to privacy and data protection. The acts stance is clear: personal information can only be processed with the persons in questions consent.

Funding and implementing the identity management policy

This is a roadblock in our journey to digital empowerment. The DHAs current budget of R8-billion is simply not enough, resulting in many people not accessing their right to citizenship and an influx of illegal immigrants. A well-funded DHA, with modern systems and empowered professional staff members is a crucial enabler to achieving economic development and unlocking new revenue and investment streams.

And when it comes to the roll-out, there are three horizons planned:

Navigating the pandemic with a Covid-19 passport and electronic vaccination data system

As the vaccination initiative gets going in South Africa, the government is developing an electronic data system to track and monitor the progress. This will not only assist with the roll-out of Covid-19 vaccines, but it will also aid with managing and monitoring the vaccination programme. In addition to patient and safety information, the system will be designed to send notifications to people due for a second jab; track and trace defaulters; and capture reasons of those who refuse to be vaccinated. South Africas Department of Health states that all those who will be vaccinated will be placed on the national register and be provided with the vaccination card.

Over these next few crucial months, a form of ID and proof of vaccination will be necessary, particularly for international travellers: Denmark is developing a digital vaccine passport so that its citizens can prove that theyve been vaccinated; Spain is compiling a database for anyone who refuses vaccination, which they will share with the European Union; and Greece is calling for a vaccination certificate that will be approved across all member states. Estonian and United Nations health agencies are currently creating an e-vaccination system that issues certificates known as the smart yellow card. On the business side of things, many entities, such as Oracle and Microsoft, are developing systems that allow individuals who have been vaccinated to access vaccination records in a secure and privacy-preserving way.

Can South Africa become a digitally evolved economy?

In short, the answer is yes. But the question remains whether our country will embrace open data-flow policies that make digital business activities more accessible and promote data generation by reassuring citizens of robust privacy protections and digital security. As always, the proper foundation needs to be in place for a digital ecosystem to thrive.

Perhaps when people are empowered by the constitutional concepts of identity and citizenship, which will be streamlined with digital IDs, they will also become proponents of a digitally evolved country. This sets South Africa on a new trajectory with the likes of Estonia a country well known for its digital governance. It paves the way for tremendous opportunity.

Will we finally Break Out? DM

Information pertaining to Covid-19, vaccines, how to control the spread of the virus and potential treatments is ever-changing. Under the South African Disaster Management Act Regulation 11(5)(c) it is prohibited to publish information through any medium with the intention to deceive people on government measures to address Covid-19. We are therefore disabling the comment section on this article in order to protect both the commenting member and ourselves from potential liability. Should you have additional information that you think we should know, please email [emailprotected].

Advocate Jackie Nagtegaal is the Managing Director at Law for All.Through her work atLaw for All,Nagtegaalendeavours to make the law more affordable and accessible to all South Africans. Nagtegaal has a keen interest in future studies.

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One ID to rule them all: How South Africas journey to digital empowerment stacks up - Daily Maverick

Ruth Coker Burks and Billy, one of her "guys"

Ruth Coker Burks

Of the many brilliant things about Its a Sin like Colin, La! and hearing Erasures Oh Lamour on the telly the most enduring legacy of the Russell T Davies drama may be the way it has inspired a new conversation about Aids and HIV. In the UK, where it first aired, the series has even driven a welcome rise in testing for the virus, according to the Terrence Higgins Trust.

Its also offered the chance to reconsider the reality of the Aids crisis. Its a Sin is the first major British dramatisation of the pandemic, and its creator drew on his and others real-life experiences growing up in the shadow of Aids in the Eighties. Daviess story centres on four young, gay men and their straight mate, Jill, who is drawn from the writers real-life friend, Jill Nalder. Her role is singular: its been rare enough to see the Aids pandemic on television, but rarer still to hear the story of the women who lived through it. People have been telling me they havent heard this story before", says Nalder, on a Zoom call from Cambridgeshire where she is seeing out the current lockdown. It is incredible because there are a lot of stories out there.

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Nalder, who also appears in the show as the mother to her younger self, played by Lydia West, met Davies at youth theatre in Glamorgan, Wales, where they became firm friends. When he went to Oxford to study English Literature, she moved to London for drama school and into a student flat that she and her housemates called the Pink Palace. This became the fictionalised setting for Its a Sin, with some real-life details, like the 20 a week rent. The Pink Palace was truly pink, Nalder says, with pink carpets, curtains and furniture. It was a strange taste, I suppose.

The series also closely reflects how Aids entered Nalders and Daviess lives, first as rumour, then as fact. I had a friend from college, whod gone to America for the summer holidays and I remember writing a letter, saying Id heard of this gay flu, says Nalder. I wrote: please be careful, because its in America. That's my first memory of it.

When Aids landed in the UK in the Eighties, Nalder took on many roles. She drove her friends to hospital for blood tests and viral load counts. She became their confidante and got to instinctively know when a friend was going to tell her about their diagnosis. She helped found West End Cares, a charity that staged cabaret nights, raising money for Aids research and, in one instance, buy an oven for an Aids ward.

She was also a keeper of secrets, often from families. I had to call a friends family from a phone box and say I think you need to come to London because hes very sick, she says. I didn't say it was Aids, because he didn't want me to. That was terrifying, to have to phone someones parents. It was quite horrible. The real horror followed, when Nalder lost three of her closest friends to the disease. Their stories have never gone away, she says, just as the Aids crisis is not over for many in other parts of the world. You still remember people. When I look back on it now, it was not an easy time.

He wanted his mother. I thought no matter what you had done, your mother could come. I didn't know that they didn't. Ruth Coker Burks

Ruth Coker Burks has never forgotten the gay men she cared for either. They have been alive and with me every day since, she says, on a WhatsApp call from home in Bentonville, Arkansas. Hers is another unforgettable story about what it was like to be a woman in the Aids crisis, finally told in a remarkable new memoir, All the Young Men.

It was spring, 1986, in Little Rock, Arkansas, when Coker Burks, visiting a friend with throat cancer in hospital, saw three nurses drawing straws, then refusing to go inside a room that was covered up by a blood red tarp. They warned her not to, either, because of the gay disease. Coker Burks, then a 26-year-old single mother who worked in real estate, didn't know anything about Aids, only that it made her afraid. But that wasn't enough to stop her going in and meeting Jimmy, a young man who, weighing about 85 pounds, was dying, and calling for his mother. When they wouldn't go into his room, I just couldn't imagine it, Coker Burks says now. He wanted his mother. I thought no matter what you had done, your mother could come. I didn't know that they didn't.

Ruth Coker Burks

Coker Burks got a number from the nurses and rang Jimmys mother, who said her son was dead to her already. Coker Burks then sat with Jimmy for 13 hours until he passed away, and when no one would take responsibility for his body, she arranged his cremation. Weeks later, she was sent his ashes in the post. A family feud meant that, luckily enough, Coker Burks family had a huge plot in a local cemetery her mother had bought up all two hundred and sixty-two plots to deny her uncle a final resting place with his loved ones so she bought a cookie jar in a local pottery store and buried Jimmys ashes in her fathers grave.

She didn't tell anyone initially. At the time in Arkansas, consensual sex between two men was punishable by up to a year in prison and she, as a single mother, was already a social pariah. She was concerned about the consequences if people found out. There wasn't a judge alive in the United States that wouldn't have taken my daughter away from me and given her to her daddy, with no visitation rights, she says. That's what I was afraid of.

But word had gotten out about Ruth Coker Burks. A nun at the local Catholic hospital called her next. Ronald, an Aids patient, had been dumped at the ER, but as Sister Angela Mayer explained, the hospital was not equipped to deal with him. Besides, they didn't want the reputation. Ronald died before Coker Burks could help him, but soon she was fielding calls from other men with Aids, seeking her help.

All the Young Men: How One Woman Risked It All To Care For The Dying

Coker Burks always gave it, even though she had no medical training, and no help. She nursed patients in hospital when even medical personnel refused to go into their rooms. She took in home cooked meals, made from food shed scavenged from neighbours and local deer hunters. She fought for benefits and temporary accommodation, and after it was all over, shed go to court to fight for burial rights. She did it alone. There was opposition from doctors, neighbours, and she lost friends. When they got wind, the Ku Klux Klan burned crosses on her lawn. But she wasn't dissuaded by that. Oh gosh, those crosses. I mean, what a bunch of cowards, that they couldn't even say anything to a woman, she says. But the thought of stopping didn't cross my mind. I loved my guys.

All the Young Men is a love letter to her guys. Tim and Jim, Paul, Norman, who ran the local gay bar, the drag queens Billy and Misty. The names go on. In the Nineties, care for people with HIV/Aids improved, alleviating the burden on Coker Burks. By then, she had cared for scores of gay men and buried over 40 in her family plot. She keeps one cookie jar still. Hers is a heroic personal story thats only belatedly been recognised, with honours in the gay press and several film adaptations in the works. But she didn't get the attention when it mattered. They didn't listen to anything a woman said back then. I was young and blonde and pretty, and I wasn't married, so no one paid any attention to me. No ones been ready to hear my story until now.

That experience of being forgotten, ignored is shared by many of the women who lived through the Aids crisis. Women living with HIV/Aids have largely been unrepresented, which is not just giving them their place in history more than half of people living with HIV globally today are women. Lesbian women were vital allies in the fight against Aids. They donated blood, ran food banks, worked on wards and stood in solidarity with their gay brothers, but they have yet to tell their stories. One person dedicated to hearing these voices all voices, in fact is the queer activist, author and playwright, Sarah Schulman, whose life work, alongside a prolific fiction and nonfiction writing career, has been preserving the memory of the most significant political movement of the Aids crisis.

TL Litt

Schulman was a rank-and-file member of the direct-action group ACT UP, which, through eye-catching protests (storming Wall Street; covering senator Jesse Helmss house in a giant condom) and in-the-detail, wide ranging strategies, forced government and health agencies to change access to experimental drugs that then hastened the advent of life-saving protease inhibitors in 1996. In 2001, Schulman and filmmaker Jim Hubbard began the ACT UP Oral History Project, taping interviews with more than 180 surviving members of the group. Those recordings form the basis for her new book, Let the Record Show, a sprawling, uncompromising account of everyone who made ACT UP happen.

Up to now, accounts of ACT UP like accounts of the wider Aids crisis have been told from the white male perspective that dominated the movement. Schulmans book covers everybody with a stake in the fight (and at over 600 pages, she is not exaggerating). I include Haitians, homeless people, drug users, prisoners, mothers, she says, all the different constituencies that made the larger coalition of which ACT UP was one organisational nexus. Let the Record Show is also a vital record of womens role. ACT UP was predominantly white and male, she acknowledges, however theres a difference between predominantly and exclusively; because with women and people of colour in a movement, they impact it enormously.

Allan Clear

Its a story about individual women, like chemist Iris Long, who didn't know anyone in the gay community, went to an ACT UP meeting, and started treatment activism that would go on to change the way patients could become involved in their health outcomes. Its about Phyllis Sharpe, a formerly homeless woman who co-founded Anger into Direct Action, a self-empowerment group for homeless and formerly homeless persons living with Aids and HIV. Its also about Karin Timour, a woman who conducted a years-long campaign to win insurance eligibility for people with Aids.

Let the Record Show demonstrates how these individuals forged real change and collectively women influenced the movement in untold ways. Many of these men have had no political experience whatsoever and some of the foundations of ACT UP came from the previous feminist movement, Schulman says, speaking from her home in New York. [ACT UPs commitment to] non-violent civil disobedience similarly came from people who were in the womens peace movement in the Seventies. Women brought all those skills with them. Women were the theoreticians of the movement.

ACT UPs work had profound effects for women living with HIV/Aids. The movement successfully campaigned for a broader definition that included symptoms experienced by women. That change, says Schulman, was ACT UPs greatest achievement. It meant true numbers of women with Aids were recorded and allowed women into experimental drug trials. That means that every woman in the world today who is taking medication, got medication that was finally tested on womens bodies because ACT UP changed that definition.

No two stories are the same, and over the course of Schulmans work, from starting out as a reporter in her twenties, she has listened to a lot of those from the Aids crisis. What has she learned about the people, like her, who were willing to get in the fight? I was trying to figure out what these people had in common and what I finally came to was character illogical, that it really wasn't based on peoples experiences. It was that these were the type of person who could not be a bystander in the face of the cataclysm.

Let the Record Show: A Political History of ACT UP, New York, 1987-1993

27.19

Coker Burks is always asked why she stepped into the room with the Aids patient when no one else would. She can only think it was God directing her, she says. And why did she continue, with the threat to her family and the sacrifices she made? Because there wasn't anyone else doing it, she simply replies.

Jill Nalder was never the only one on hospital wards. There were partners, gay friends, sisters, lots of other women too, she says. It was a privilege to do what she could at the time. She makes it sound less than it was, even though it took over her life. I could do three hospital visits in one day or not go home at all, if something was drastically wrong, she recalls. Don't forget that someone could be sitting there all day, theyre on their own and theyve had no other visitors and youd think, oh I better had.

We are finally recognising that she, and many other women, did so much.

All the Young Men is out now on Trapeze. Let the Record Show: A Political History of ACT UP New York, 1987 - 1993 is published by Farrar, Straus and Giroux in May

Read more from the original source:

The Hidden Women of the Aids Crisis Are Finally Telling Their Story - esquire.com

1School of Health Sciences, University of Notre Dame Australia, Fremantle, Western Australia, Australia; 2Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Nedlands, Western Australia, Australia; 3Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia; 4Division of Obstetrics and Gynecology, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia

Correspondence: Sharolin BobanSchool of Health Sciences, University of Notre Dame Australia, Fremantle, Western Australia, AustraliaEmail 32009365@my.nd.edu.au

Purpose: By directly engaging with women diagnosed with ovarian cancer, this study aimed to explore and identify their view of the health symptoms and outcomes that matter most to them as they traverse their disease pathway.Background: Patient-reported outcome measures in ovarian cancer have tended to focus on physical symptoms rather than the more complex psychosocial aspects of living with the disease. Using a ground-up approach, this study sought to comprehensively understand the health concerns that matter most to women with ovarian cancer as a first step in generating items for development into an ovarian cancerspecific patient-reported outcome measure.Patients and Methods: Following an extensive literature review, we sought to capture the patient voice through a qualitative descriptive approach including a community conversation with ovarian cancer patients, their carers and clinicians, and interviews and focus groups with women with ovarian cancer. Thirteen women were interviewed individually, and two focus groups were conducted. A template thematic analysis was used to analyze the data.Results: Key themes included challenges related to clinical diagnosis, treatment phase, altered relationships with family/friends, financial issues, relationships with health professionals and coping strategies. Within each key theme, several sub-themes emerged that were identified as various challenges experienced by participants. Diagnostic delay, chemotherapy and surgery-related challenges, negative impact of sexual well-being on partner relationship, communicational challenges with health professionals were among the few issues identified. In addition, self-empowerment was identified as a coping mechanism among participants.Conclusion: By identifying priorities for women diagnosed with ovarian cancer we have highlighted the need for strategies to reduce diagnostic delays and improve quality of life for these women. Data will inform the development of an ovarian cancerspecific patient-reported outcome measure.

Keywords: focus groups, health-related quality of life, qualitative descriptive, patient-reported outcome measures, semi-structured interviews

Ovarian cancer (OC) affects women of all ages but is most commonly diagnosed after menopause. More than 75% of affected women are diagnosed at an advanced stage because early-stage disease is usually asymptomatic, and symptoms of late-stage disease are nonspecific. The strongest risk factors are advancing age and family history of ovarian and breast cancer.1 Currently there is no effective population-level screening test for OC.2,3 Treatment usually involves radical surgery and chemotherapy with subsequent lines of chemotherapy for disease recurrence.4 Treatments can impair health-related quality of life (HRQOL), a concept that pertains to general well-being or outcomes surrounding a specific disease.5,6

Over the previous two decades, patients have had increasing roles in providing information and participating in clinical decisions for managing their cancer. Structured patient provided information without clinician modification and/or interpretation is termed a patient-reported outcome measure (PROM).7 PROMs can be either generic tools such as the hospital anxiety and depression scale or disease-specific tools designed for specific groups of patients such as those with gynecologic cancers.8 Patient involvement has a profound impact on PROM development as it is only the patients who can determine item relevance and comprehensibility of the tool.9,10

Currently, four validated OC specific PROMs have been developed to measure HRQOL of the patients: The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire of Cancer Patients Ovarian Cancer module (EORTC QLQ-OV28), Functional Assessment of Cancer Therapy Ovarian Cancer (FACT-O), FACT Ovarian Symptom Index (FOSI) and Measure of Ovarian Symptoms and Treatment Concerns (MOST).1113 However, these tools do not identify all aspects of HRQOL and differences exist in the level of patient involvement in the development of these PROMs, which is vital for PROM development.14

This study is affiliated with an overarching project, Patients First: Continuous Improvement in Care-Cancer (CIC Cancer), that aims to develop an OC PROM to measure HRQOL, through a ground-up approach that includes meaningful patient involvement. As an initial step, this phase of the study involved the collection and analysis of qualitative data to inform the subsequent generation of items necessary for the development of an ovarian cancerspecific HRQOL tool.

Based on an extensive literature review and assessment of the content of existing cancer PROMs, this study utilized a qualitative descriptive approach. A qualitative descriptive approach enables the researcher to obtain comprehensive details of personal events as experienced by individuals and is appropriate for health science researchers as it provides rich and descriptive information from the participants perspective.15 This study employed a community conversation for women with OC, their carers and a clinician (PAC) to shape the subsequent semi-structured interviews and focus groups.

Purposive sampling (non-probability) using a maximum variation sampling strategy was used to identify participants. Purposive sampling enables the researcher to intentionally select participants who have in-depth personal knowledge of the topic which will contribute to the study in alignment with the research aims.16 The participant inclusion criteria were women diagnosed with OC aged above 18 years, who were living in Western Australia and fluent in English. Carers of participants were also invited to participate in the study. Participants were recruited at various time-points from their diagnosis.17

Community conversation, interview and focus group participants were recruited through an advertisement distributed through the media and relevant agencies including Cancer Council Western Australia (CCWA) and Ovarian Cancer Australia (OCA). Interested participants were asked to contact the researcher(s) and/or CCWA & OCA directly. Thereafter, the participants were contacted by the researchers (CB, SB) who provided them with the choice to participate in either interviews or focus groups. Details of date and time along with venue for the community conversations, interviews and focus groups were sent out by e-mails to participants through both the CCWA member database and the OCA networks along with the CCWA regional support coordinator. The initial community conversation facilitated by a qualitative research expert (CB) was held with 15 women with OC (different to those who participated in the interview and focus groups), two consumer advocates, and a gynecologist with experience in gynecological oncology (PAC) to explore some of the key issues of personal importance to key stakeholder groups.

Ethics approval for this study was granted by the Human Research Ethics Committee at University of Notre Dame Australia (018158F) and conforms to Australian 2018 Update of the National Statement on Ethical Conduct in Human Research. The participant information sheet and consent form were provided to participants and the signed consent form was obtained from the participants prior to data collection. All participants provided consent for their de-identified data to be published. Guided by the literature review and the field notes during community conversation, similar question formats were formulated for both interviews and focus groups, Figure 1. In addition, our study processes complied with the Declaration of Helsinki.

Figure 1 Question format used during semi-structured telephone interviews and focus groups.

Along with the qualitative research expert, the student researcher (SB) independently conducted individual telephone interviews of approximately 30 minutes duration with 13 OC patients at their place of convenience. The research team (CB, SB) then conducted two focus groups in metropolitan Perth, Western Australia. A total of 13 participants attended one of the two focus groups, each lasting approximately 90 minutes, with participation of three carers in the second focus group. Participants varied in their age. Most participants were employed and were married/defacto. Four participants were over 5 years since diagnosis, but one participant had received a diagnosis less than 6 months at the time of the interview. Disease status of the participants at the time of the interview was obtained. Six participants were undergoing active treatment, with a completion of at least two full cycles of chemotherapy. The remaining participants confirmed that they were in remission or awaiting treatment. The number of cases of OC in Western Australia is small compared to some other cancers (eg breast, prostate) and it was important to recruit as many women with OC across the disease trajectory as possible. Thus, the focus of this study was the importance of the different experiences of the participants.

Data saturation was achieved, and collected data were audio-recorded and transcribed verbatim by the student researcher (SB). Template thematic analysis was performed which included open and axial coding using the qualitative data management program, QSR NVivo (version 12), Figure 2.18 Template analysis is defined as a method for identifying, analysing19 and reporting themes in the data based on the task question format. It enables the researcher to identify emerging themes in understanding a phenomenon or event.20,21 Key themes identified were categorized as core themes and further emerging themes then became the categorical sub-themes for analysis.

Figure 2 Stages of qualitative analysis process: an illustration.

Member checking also included sending the summary of coding and themes back to four participants who had indicated that they were willing to receive this summary via the CCWA and OCA support group coordinators.

Six key themes emerged regarding various aspects of illness and treatment experiences described by the women and their carers (Figure 3). Within each key theme, several sub-themes and relative sub-themes emerged that were identified as various challenges experienced by participants as detailed below.

Figure 3 Representation of key themes emerged from interviews and focus groups.

Four factors were identified in relation to the symptomatic presentation pertaining to the disease and are shown in Table 1. Participants experienced pre-diagnostic symptoms including abdominal/bowel discomfort and pain, urinary urgency, fatigue, weight gain, abnormal menstrual bleeding and/or menopausal symptoms. Lack of awareness of disease symptoms by both patients and health professionals (HPs) was a related issue. Due to work and family commitments, several participants intentionally ignored their symptoms. In further, majority of the participants expressed diagnostic delay as another challenge faced during their clinical diagnosis phase.

Table 1 Percentage of Participants with Symptoms and Presentation

Challenges related to receiving treatments were highlighted with at least half of the participants feeling vulnerable at times since receiving their diagnosis. Most of the participants were challenged by side-effects. Fatigue, nausea, neuropathy, memory loss and loss of appetite were the most common side-effects identified, with less common side-effects such as mucositis and organ failure also described. Support of family and friends provided strength for the majority of the participants. Some women indicated having to modify their usual diet, lifestyle and physical activity during treatment. Activities such as meditation, cycling, gardening and yoga helped them cope during and after treatment. However, some participants also mentioned how empowering themselves during treatment was vital. Maintaining and having a relaxed mind, a positive attitude and a sense of humor were practiced by a few, despite the situations they were facing at that time.

Another participant spoke of how she had lost the chance of experiencing motherhood. Rurally located participants faced further travel challenges of time and distance. And furthermore, two participants highlighted the issues around having lack of treatment options while travelling, either it be a rural destination or an interstate travel.

Other key themes related to living with a diagnosis of OC across the disease trajectory.

All participants agreed that relationships with their family and friends influenced their lives. Some participants spoke of experiencing lack of support with unpredictable reactions and withdrawal of family and/or friends. Other participants spoke of being avoided and noticed that people around them react differently which then created emotional reactions such as upset and insecurity. Furthermore, sexual relations and a changed level of intimacy with a partner/spouse were identified as an important subtheme in their lives. Many participants described how a lack of intimacy had put pressure on their partner/spouse relationship and affected their emotional well-being. A few participants described their sexual relationship as non-existent and that a counsellor had been consulted.

Most of the participants agreed and acknowledged having support from family and/or friends had a profound impact on their lives. A positive relationship with close family boosted their journey particularly following the diagnosis and during treatment. Participants described drawing strength and emotional support, and an increased interpersonal relationship bond with family and friends.

Almost all participants reported having financial issues such as out-of-pocket expenses for scans, surgery and other practical issues including hospital parking and medication costs. Several participants reported lack of information about accessing health services. Some mentioned the financial toxicity associated with their illness and that they lacked knowledge of how to access support services such as paying the bills without going into debt and having to access their superannuation funds for urgent and necessary expenses.

I guess it was not even initially when I wasnt told about certain things I could access like my super. I had to find out I think two years down the track or something. So it wasnt, nobody even gave me that sort of information.

Some participants had to stop work during treatment and others had to reduce their workload to cope with the challenges and issues faced during their clinical journey.

Participants spoke of their relationships and experiences with their respective HPs. In general, most participants acknowledged having a positive relation with HPs including general practitioners (GPs), gynecological oncology and medical oncology providers in terms of the support and medical treatment provided to them. The advice received by the oncology team was described by one participant as absolutely phenomenal (they) answered any questions with patience and understanding.

Meanwhile, some participants spoke of a perceived negative relationship with their HPs. Overall, many participants felt there were communication gaps in the healthcare system, particularly during treatment, and participants experienced various forms of communication challenges either with or between oncologists and GPs and specialist departments.

Because of my complex medical problem, Ive been out for a few months affected by surgery and by several treatments. So, I found that (hospitals) communication between the different departments just wasnt there.

Furthermore, issues around clinician lack of empathy and compassion, and providing inconsistent information about prognosis negatively impacted the emotional well-being of many participants. A majority had a less than satisfactory relationship with GPs. Half of the participants described the excessive length of time for their symptoms to be investigated leading to a delay in their diagnosis. Some perceived being ignored or that GPs were pretty dismissive about their symptoms thinking they were due to a urinary tract infection or perimenopause and no further action was taken. Furthermore, participants mentioned having difficulties requesting tests such as ultrasound scans and pressed for these.

Insufficient provision of information was one of the key issues in relation to treatment and participants complained that oncologists, did not fully explain the side effects of the prescribed medications. Some participants also reported a lack of involvement in decisions about their treatment and not being provided with treatment options including at disease recurrence.

Participants were asked to share their experiences on how they coped with difficult situations through their clinical journey. They described support from family and friends, lifestyle and physical activity assisted them to cope with difficult situations and kept them moving forward. Walking, listening to music, meditation, nutrition and crafts were some examples. Two participants mentioned how making time for themselves was important for both their mind and body. Several participants sought help from support group organisations through which telephone support services, information booklets and complementary services such as yoga were provided.

Some participants emphasized that taking control of their own lives was their one main strength. Identified factors were being able to look forward, having an attitude of not giving up and learning how to stick up for oneself. Participants expressed that by being independent and knowing their innermost selves provided them motivation and strength throughout their lives. In addition, providing self-encouragement through positive attitude and feeling gratitude helped them.

I do need and want to practice gratitude every day. I am grateful for what Ive got. And Im much more in tune with the little things in life.

Further to this, having a strong spiritual belief system helped to calm them and became a source of comfort explicitly during chemotherapy. In addition, having spiritual belief helped not only the participants but also their families to gain strength in order to cope with difficult situations.

In this study women with OC were able to express their own voices based on their individual experiences. Therefore, the six themes identified describe both HRQOL and contextual themes. Post diagnosis and treatment-related issues, relationships and supports with family and friends, financial issues, relationships with healthcare providers and self-perceived coping strategies were the key themes identified. Each theme had a number of overlapping sub-themes that were identified as priorities for the women. In particular, challenges related to relationships, financial issues, relationships with health-care providers and coping strategies were experienced during and after diagnosis and treatment.

Diagnostic delay was a key concern and our data suggested that lack of early symptom awareness due to insufficient OC knowledge and symptom recognition by participants and HPs contributed to the delay. This is consistent with studies that have low levels of OC symptom awareness are associated with delayed diagnosis.2224 While, lack of cancer detection and inexpedient referral patterns influenced incorrect diagnosis by the physicians,25 and greater public education to increase knowledge of disease symptoms could be helpful.26,27

Most participants received a combination of surgery and chemotherapy. Treatments adversely affected physical well-being with prevalent symptoms such as fatigue, nausea and neuropathy. Research is now focusing on symptom management interventions guided by the implementation of PROMs into clinical settings and trials.5,28,29 Several surgery-related outcomes including change in body image, premature and sudden onset of menopause, and loss of reproductive function may affect psychological well-being.30 The possible loss of fertility during treatment with cancer can be more distressing than cancer itself, according to recent reports where efforts to maintain fertility through techniques such as fertility-sparing surgery are essential in younger women diagnosed with gynecological cancers as they could lead to an improvement in quality of life.31 Another recent study indicated high levels of psychological distress when diagnosed women reach childbearing age as menstrual function and fertility were lost. It is therefore important to monitor the progression of cancer but should also provide appropriate fertility preservation counselling. This has potential to alleviate stress, anxiety and depression and a smaller negative effect on the quality of life.32 Consistent with our findings, a past study showed that those who underwent surgery have experienced psychological distress such as lack of self-esteem, self-worth and loss of femininity.33,34

Survivorship is important in cancer care and recent improvements in treatment have resulted in an increased number of survivors.35 However, our findings highlighted the need for patient-centered care. Patient involvement is vital in clinical care, where a recent study pointed to the significance of patientclinician communication. This communication style provides patients with the platform to raise and discuss issues with clinicians thereby shaping subsequent clinical care processes and outcomes.36

One of the contextual themes of HRQOL identified was perceived lack of provision of adequate information and services. Studies show that educating and communicating patients and their families regarding treatment options and their underlying side-effects will prepare patients to realize the likely outcome of treatment and will assist them in facing upcoming challenges.30,37 Inadequate services such as counselling were identified. Studies show that psychological and other supports are essential in these womens lives, focusing on psychological well-being as well as counselling related to financial and nutritional needs.30,38

Further, our findings illustrated some communication gaps between the women and their health-care providers. Research shows that engagement of patients with their health-care team strengthens and increases the provision of patient-centered care and thus potentially aids cancer control.39 A 2013 study described that patientclinician communication may assist adherence and agreement to treatment, where, for example, two-way communication on treatment-based symptoms could aid in symptom management.40 A recent study that focused on the sexual function of women diagnosed with OC reported that not only was there a communication gap between patient and clinicians, the clinicians expected patients to have disease-related sexual problems and waited until patients spoke about their concerns.41 Improving survival, functional recovery and quality of life while minimizing long-term side-effects are key priorities in cancer care.

Social well-being is consistent with the concept of HRQOL. The importance of being supported by family and friends, especially partners/spouses, was a critical factor for well-being. Some participants experienced changes in their relationships. Time spent with family was reduced due to treatment demands and withdrawal of loved ones from them. Previous studies have reported that women have felt displeasure from their friends and were unwilling to discuss about the disease.37

Overall, participants experienced highly compromised HRQOL, around the time of diagnosis and during treatment. There is an urgent need to develop new strategies for early detection and screening,3 as diagnostic delay was associated with psychological distress such as anxiety, fear of death, parental stress and uncertainty in the current study and has also been previously reported.37 Additionally, participants experienced challenge in obtaining appropriate information to access and benefit from the healthcare system post diagnosis. Multiple studies have found that unreliable provision of knowledge and information is a driver of poor medical care in many high-income countries, including Australia.42 Involvement of patients in decision-making and public engagement could improve the evidence-based value of their health care43

Emotional domain is another aspect of HRQOL. Emotional distress was experienced particularly during treatment phase. Fear of recurrence was a source of emotional distress. Previous studies related to gynecological and OC research show that women have fear of disease recurrence during the treatment and post-treatment phases and that these fears are poorly understood.44,45 Frustration was also of concern with almost all women frustrated due to their treatment side-effects and symptoms. A 2020 qualitative study that investigated the life experiences of women diagnosed with OC found similar results on how women fall into frustration following treatment completion.46

Understanding and measuring HRQOL outcomes related to the sexual well-being of women diagnosed with OC is vital. Half of the participants had poorer sexual function impacting their overall health and well-being. Changes to body image, sudden onset of menopause, infertility and lack of intimacy were identified and negatively impact emotional well-being with a sense of losing feminine identity. It has also been found that difficulties with body image and lack of intimacy are associated with impaired quality of life.41

Not only do individuals diagnosed with cancer have detrimental impacts on their sexual functioning, it often influences their partners. Studies suggest that cancer partners may suffer equal or even higher levels of distress relative to their sick spouses. Partners of cancer survivors do not often have the resources to offer sufficient care to their female partners.47 Findings from a 2009 study indicate that the sexual perceptions of the partners were influenced by loss of interest in the individual with cancer and tension and fatigue correlated with care tasks. Carers agreed that reduced happiness with the partnership could be followed by poorer quality of life as well as higher levels of anxiety and depression.48

Financial aspects were described, and this influenced participant wellbeing. Due to the amount of time required to spend in treatments, some participants had lost their income stability either due to change to their employment status or being unable to continue in the workforce, impairing their emotional well-being and overall HRQOL.49 Some issues might appear to be more minor, such as related to the lack of car parking availability at respective clinical settings, but when needed on multiple occasions, this was a more major concern. Studies in women with OC found that disease and treatment-related burdens create several issues including social and financial effects on their lives.38,50

Participants also described current strategies they used in daily life. Participants utilized numerous coping strategies such as modified diet and lifestyle, which could be considered as a contextual factor that could influence HRQOL. Family and friend support was another major help sought by these women, which in turn helped improve and maintain their quality of life.51 Self-empowerment techniques such as ability to look to the future, having positive attitude and sense of humor were a few techniques employed by the participants. Recent studies also show similar coping strategies used by women and how changed views and adding humor to their personal experiences was a means of self-healing.52,53 Overall, the participants were able to maintain their HRQOL and continue a modified normal life with the implementation of various strategies and self-management techniques into their lives.54

There are approximately 115 new diagnoses of OC per year in Western Australia,55 potentially compromising data collection using a small sample size. However, maximum variability and data saturation were achieved using small sample size56 and thus should not be considered as a limitation but a strength. While the study sought to explore patient outcomes across the clinical trajectory, participants might not have accurately recalled their perspectives, constituting another limitation.

Moreover, rich and descriptive data were obtained using the qualitative methods,57 where intentionality of the participants and their carers were explored. In addition, utilizing a qualitative approach has enabled a holistic understanding of patients and carers lived experiences. The bottom-up approach of involving patients from commencement and throughout the study will ensure that going forward, priorities are clearly identified by the consumers (women with OC themselves) in consultation with clinicians. We envisage that the proposed OC specific PROM to be developed in a future study would be used in clinical settings to identify and measure specific problems that patients encounter that needed to be discussed.

By identifying key priorities for women with OC using a ground-up community-based approach, we have highlighted the need for strategies to reduce diagnostic delays, assist patients in navigating the healthcare system, and improve their HRQOL and potentially develop a OC specific PROM that will enable better identification and earlier treatment of symptoms during the entire course of the disease.

CCWA, Cancer Council Western Australia; CIC Cancer Project, Continuous Improvement in Care-Cancer Project; GPs, general practitioners; HPs, health professionals; HRQOL, health-related quality of life; OC, ovarian cancer; OCA, Ovarian Cancer Australia; PROMs, patient-reported outcome measures.

We are thankful for the generous involvement of participants, and their carers for sharing their experiences with us.

All authors made significant contributions to the study conception and design, execution, performance of the research, data acquisition, analysis and interpretation of data, took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

This work was carried out with the support of a Grant provided by the Cancer Research Trust and is part of the CIC Cancer Project, a multi-institutional program of research that seeks to bring value-based health care public and private health-care settings in Western Australia.

Paul Cohen reports personal fees from Seqirus, outside the submitted work. The authors report no other potential conflicts of interest in this work.

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[Full text] Women Diagnosed with Ovarian Cancer: Patient and Carer Experiences and | PROM - Dove Medical Press

In his new book, How to Avoid a Climate Disaster, Bill Gates argues that there are really only two data points that matter when it comes to tackling humankinds existential challenge: 51 billion and zero. The first is the number of tonnes of greenhouse gases that are typically added to the atmosphere every year. The second is the number we need to arrive at to avoid catastrophe.

While acknowledging that the challenge is daunting, and how we make things, grow things, move around, keep cool and stay warm will all need to fundamentally change, Gates argues that wholesale transformation is possible while maintaining lifestyles in high income countries and continuing to lift billions out of poverty. And he has a plan.

He employs the concept of the green premium. Carbon remains cheaper as a source of energy because its negative impacts or externalities arent priced in. Governments subsidise fossil fuels because they are reliable and proven. The green premium is the additional cost of using a green alternative. In some instances such as producing electricity using wind turbines or solar energy it can be zero, depending on the country. In other sectors, such as concrete, fertiliser or steel production, its enough to deter the use of clean alternatives. While wealthy countries might be able to pay a premium for these zero carbon options, that isnt currently possible for some fast-growing nations in Asia, Africa and South America. The green premium needs to be so low as to make sense to switch.

Sat at a large conference table wearing a blue pullover, Gates spoke with WIRED in December 2020 from his office overlooking Lake Washington in Seattle. He outlined how a number of different technological breakthroughs, large-scale investment in infrastructure, patient capital, government policy and individual action can have an impact, and provides a roadmap to getting to zero carbon emissions by 2050.

Zero is important: just reducing the carbon were putting into the atmosphere, simply extends the extremely limited amount of time humankind has until we hit planetary boundaries. Currently, the concentration of carbon dioxide in Earths atmosphere is around 414.68 parts per million (ppm) there is consensus that, once the level reaches 450ppm it will raise the global temperature above 2 degrees Celsius, triggering extreme weather events and irreversible, catastrophic change. While some advocates of change suggest that the target should be 2030, Gates believes thats unrealistic carbon is too deeply woven into the fabric of everything we do and could provide a distraction to the more significant goal of zero emissions by 2050.

WIRED: Why this book and why now?

Bill Gates: I did a TED Talk in 2010 on climate and five years later there was the Paris climate talks, and Id been saying: Hey, how come when they have these meetings, they never talk about R&D? They never talked about innovation, and if you looked at the energy R&D budgets of the rich countries they hadnt increased at all.

So everybody's getting together and talking about the short-term reductions, but the only areas you can make short-term reductions are electric cars and using solar and wind for electricity generation. That's less than 30 per cent of the game 70 per cent is steel, cement, aviation, land use... People arent doing anything about those. If you want to get to a goal, you should start working on the hard things, not just on the easy things. I'm not saying the easy things are easy, they're just relatively easy.

These nationally determined metrics the short-term reductions don't really tell the story. I'm not saying they should go away, those are good things, but what is the true metric of by 2050 can you get to zero?

The resonance of the topic [climate change] is very high now, despite the pandemic, which is impressive. But if we don't have a plan to go with that positive energy it's going to be very sad. You're going to get attenuation: people will almost be cynical that we didn't really get going on the 70 per cent that's the hardest.

So that's why I wrote the book, to suggest that the green premium is a metric that when you call up India in 2050 and say, Hey, when you're building new buildings, use this cement, use this steel will determine whether they tell you get lost, or OK, we'll pay a slight premium. If youve innovated enough and the green premium is zero, they'll say, Of course.

Some green premiums for electricity, for instance are within reach. Others will involve huge amounts of R&D and investment. How do you think about that?

The brute force way to solve climate change is to figure out how to do direct air capture, get the cost per tonne down and then just write the cheque. Unfortunately, if you call up Climeworks [the Swiss company that filters CO2 from the air], its list price is $600 (435) a tonne, and they have some government subsidies. So, even if you dream that you can get to $100 (72) a tonne, youve got 51 billion tonnes of emissions, so that's a $5 trillion (3.6 trillion) a year price tag to brute force climate change.

Only by going into the individual areas and changing the way that, say, you make cement, or the way you power cars to be electric, do you get something that's under $100 a tonne. Electric cars are the magic one as battery volumes go up, charging stations get out there and battery energy density increases to the point that range and charging speed isn't that much worse [than combustion engines]. Eventually you can say the green premium for passenger cars ten years from now will be about zero.

Vaccines typically take a decade or more to produce Covid-19 proved we can accelerate that process, but it took a pandemic to show us whats possible. How can we communicate the urgency of the climate emergency?

There is an analogy to the pandemic which is that citizens depend on their governments to understand natural disasters, meteors, climate change and respiratory viruses. These problems are way too complex individuals aren't going to study climate models. For the pandemic, the risk was there and the idea of how you orchestrate a testing capacity and make a vaccine should have been there.

After Ebola in 2015 there were a few things done such as the creation of CEPI [The Coalition for Epidemic Preparedness Innovations] along with Wellcome in the UK, ourselves [the Bill and Melinda Gates Foundation] and 12 governments. And we've been funding mRNA stuff (mRNA medicines instruct cells in the body to make proteins to fight diseases) for a long time. But, governments have to take complex problems and essentially think through what you have to do. Unfortunately, when it comes to the climate, it's not like there's any vaccine-like thing, where theres a solution and six months from now things are going to feel utterly different.

With climate, when you have to replace every steel plant, every cement plant, take the electric grid and make it two and a half times bigger with intermittent sources this is the entire physical economy. The physical economy is a miracle. Its taken us since the Industrial Revolution to figure out how to make this stuff so cheap and so reliable that we all just take it for granted. Most people flip that light switch and the miracle of innovation that allows their lights to turn on 99.99 per cent of the time, they have no idea. It's so cost-optimised, but now that we have this constraint on it: how quickly can you switch all that around?

So climate is like a pandemic in that governments need to work on behalf of their citizens and anticipate what will happen in the future, but it's way harder than making a vaccine. If the pandemic had come 20 years ago, we wouldn't have been able to make that vaccine. If it came 10 years from now, with mRNA we'll be able to make it faster, we'll be able to scale up more of those vaccines at a cost of $1 (72p) each. We caught mRNA halfway in its maturity cycle, we hadnt made a single vaccine. CureVac is developing mRNA-based vaccines designed to prevent malaria infection. Moderna is focused on HIV and other diseases.

In order to get to net zero by 2050, we have to innovate at an unprecedented pace. How do we best address that challenge?

We need to up the supply side of innovation and the demand side for innovation. The supply side has got many components, it's got your basic energy R&D budget where you just have a bunch of professors or national labs messing around with different ideas, and that's pre-commercial research. In the US, more than half the federal money spent on biomedical research comes from the $43 billion (31 billion) a year National Institutes of Health (NIH) budget. Weirdly these energy R&D budgets haven't had the examination they deserve when it comes to climate events.

Then venture capital has to be willing to take huge risks, and be very patient and orchestrate way more capital than you need for software, microchips or for medicine. Thats because these are big plants and you have to replace a lot, you have to scale these things up so you need to work on the supply side and innovation.

On the demand side, you could put on a big carbon tax but politically its difficult such as when they increased the price of diesel in France even though economists say that it would be good. In most countries well probably end up with a sector-by-sector approach where we say that, for instance, every building has to have five per cent clean cement, or maybe the highly profitable tech or finance companies pay a premium for buildings.

Everybody mistakenly thinks the learning curve means that you make something, and then it gets cheaper than you expected. That is true for wind, solar and lithium ion batteries, the learning curves have been phenomenal. But how do you bootstrap the clean aviation fuel learning curve, or clean steel?

There's a lot of talk that the recovery funds in Europe will get focused on things such as clean hydrogen. But we really need a mechanism to find who in the world has the best ideas about clean steel or clean cement. And the green premium is the metric.

You had an ambitious aim when you started Microsoft a computer in every home. What lessons did building and scaling a company with that impact have that can be applied to getting to net zero?

I'm amazed at what a nice business software is you get feedback from your customers and you add features. And I was optimistic: I would invest in things that would take ten years to get done. I tried multiple approaches, so we often had teams that might develop a database in two different ways to see which would succeed. I had to anticipate advances in hardware [that would impact] our software. We spent a lot of R&D money, but we had enough products that were always fairly profitable.

I had a broader view that we were going to develop many types of software most of our competitors were single-product companies, and we saw ourselves as a software factory independent of word processing or spreadsheets or operating systems. We had a more crazy view that we were going to do every type of software in one company and we had this vision of personal empowerment through software.

We were able to create this research group Google is the only other company to put money into fundamental research. Because, at first, we all just benefited from what the universities or even Xerox PARC had done that they failed to exploit. We hired specific people from Xerox PARC that helped us with graphics interface, networking and other things, and we almost felt guilty that we needed to get back to this pool of intellect.

Some policymakers and leaders are aiming at 2030, but youre fully focussed on 2050. Why that time frame?

In 2050 I'll be 95 years old and I will be super happy if I live to see the day that we're anywhere near zero. This is very, very hard, as it requires all countries to get involved. And so the 2050 date was picked as the best case because a lot of things have to work. But if you innovate for ten years, deploy for 20 years, and you create the right incentives through government policy, you can get to zero by 2050. You have to get going now on the hard stuff and you have to admit: do we have even a clue how we're going to do the hard stuff and find the craziest thinkers?

I'm not smart enough to know all the different ways you might replace cement or steel. You better be searching the entire IQ of humanity globally to find that person or find ten of them and hope that, even if nine are wrong, one will get you there.

I don't know if that will happen by 2050. If we take the idealism and energy the younger generation has created around this and we make it a priority Biden has it right up there with the pandemic, European recovery funds have it very high then, yes it's doable.

Getting to net zero by 2050 is not going to be easy. So anybody who says, Oh, let's just get it done in 10 years, I want them to go tour all the Chinese steel and cement plants and tell me what I'm going to see there ten years from now.

The digital economy has fooled us in terms of how quickly things can change, because you don't need the reliability and scale, and therefore the capital and the regulations. With software, if it has mistakes its not good, but it evolves quickly.

Institutions deploying capital banks and pension funds are going to be crucial in this process. There's a lot of rhetoric at the moment with businesses claiming to be purpose-driven. How can we best measure the actions large investment funds are making, and keep big organisations honest about their actions?

Most of thats all bullshit. The return on a bond for a wind farm is no different than the return on a bond from a natural gas plant, so it's nonsense. The people who put money into Breakthrough Energy Ventures [the venture arm of Gates organisation Breakthrough Energy thats working towards net zero], that's real. The governments that raise their energy R&D budget and manage to spend it well, the near-billion dollars put into TerraPower [Gates nuclear company] to see if this fourth-generation fission reactor can be part of the solution... Those things are real.

All this other stuff like, we're gonna make companies report their emissions. The idea that some financial metric reporting thing or some degree of divestment how many tonnes? Youve got 51 billion tonnes [of CO2 that needs to be removed]: when you divested, how many of those 51 billion tonnes went away?

Youve got to invest not divest. And the notion that you just happen to own equities or bonds related to the easy things that are already economic, such as solar farms or wind farms... Whenever somebody says there's something called green finance, I say let's be numeric here: is the risk premium for clean investing lower than the risk premium for non-green investing? The answer is: just look at the numbers.

The idea that banks are going to solve this problem or that these metrics are going to solve this problem, I don't get that. Are they going to make the electricity network reliable? Are they gonna come up with sustainable aviation fuel? It's just disconnected from the problem and allows people to go off and blather as though something's happening.

The last couple of weeks have seen the Covid-19 vaccine roll-out begin. Do you think that will increase trust in science, which will impact the urgency to act on the climate crisis?

Whenever you do innovation like social networks, at first you're not sure what phenomenon will emerge out of that. I do think the pandemic has helped social networks realise that the First Amendment is nice, but allowing lots of vaccine misinformation is not good for society.

Drawing the line between the crazy all vaccines are bad, everybody will get autism versus legitimate [commentary] on people who have allergic reactions is very hard. At first the [social networks] thought we will just let the craziness flow, but the fact that the wrong stuff is so titillating draws people in.

We hope that this process has accelerated some maturing of the social networks so that the things that get a lot of attention and are really wrong, that these are greatly reduced or put alongside the truth. I don't know if that will happen, but I have seen it including conspiracy theories that relate to me they're doing a better job of saying, OK, we don't want ten million people to see that today because it doesn't serve their interests or society's interests.

People are more educated today than ever and somehow we've gotten to this point where climate change has become political, mask wearing has become political.

For some types of innovation this has been a period where the normal rules don't apply. The idea of 100 companies all working on one disease is insane, because five or six of these vaccines at most, will end up getting used. So you've got 94 companies efforts that are completely redundant, particularly now.

We still need Johnson & Johnson, AstraZeneca and Novavax, because those [vaccines] are more scalable, cheaper and more thermally stable. But, once we get those five [including Pfizer and Moderna] then we probably don't need any more, because fortunately it turned out it was easier to make a vaccine for this disease than we might have guessed: the first that are proven are working very well.

Science has become politicised in the past few years. We're seeing a transition between administrations in the US, do you think that's going to impact policy as relates to getting to net zero?

In the Democratic primaries people were talking about trillions of dollars being spent against climate. Well there's two problems with that: a) that money will never be allocated and b) spending that scale of money doesn't really connect to the problem, its more about creating jobs [by doing things such as] insulating homes.But those homes should use electric heat pumps, and you should get electricity to zero. You must have people who are in the centre and saying, yes, this is a good goal, but how do you realistically achieve that, and at the minimal price for doing so? You want debate about that, and market-based pricing actually allows a lot of resource choices to be made in a very efficient way. That's why, if you could have a properly done carbon tax, it would be a nice thing, but that's not going to happen in most countries.

So, yes the Biden election is fantastic. He's got climate as one of his top priorities along with the pandemic, he's picked people that know this topic and he's put them not just in specific roles like the Department of Energy, but even people such as Brian Deese to head the National Economic Council. He was the [Obama] White House climate person, and I got to know him when we were doing the Paris climate stuff.

You acknowledge early in the book that youre an imperfect messenger a rich, white guy some people will accuse of having a god complex. How do you communicate the idea that forget Bill Gates in all this its a problem that all of us have to fix?

The fact that we need better metrics in this field surprises me. It's a field with a lot of positive energy but without a plan. And so you have to work backwards from zero. If there was some book that had already explained all this, I wouldn't have written it. I can write books about malaria and HIV and diarrhoea. Now, maybe not as many people would read those, but that global health work we do is truly neglected. You can save millions of lives. And it's hard stuff we don't have an HIV cure yet, but we're trying to use gene therapy and make that super cheap so there's plenty of interesting work for the Gates Foundation, such as improving agriculture with new types of seeds, and even improving photosynthesis.

This field [climate] as I learned about it, the framing wasn't quite right. I actually resisted the idea that I should choose to speak out. Instead I thought, I'll just do a little bit, like that 2010 TED Talk that I did. And then this field, because people care so much about it, would then mature in terms of its metrics and working on the hard things. When we were talking about the 2015 Paris talks, it makes no sense why am I at it, saying there should be an R&D section?

So, I'd say it's strange that the background I have of systems thinking to drive innovation brings a slightly richer perspective. OK, not everybody reads Vaclav Smil, not everybody is that numeric. People read articles saying, this is the equivalent of 20,000 houses or, you know, 50,000 cars, and they don't call up the publications involved and say, why are you spewing these completely confusing metrics?

I have this effort to create an open-source model of electricity demand generation that includes weather models, so the countries that have made really aggressive commitments about renewable use can see that their grid is going to start being reliable. Now that the utilities are being told, Oh, you have to sign up to these things, you need an open-source model that really shows, do you have enough transmission, storage or non-intermittent sources like nuclear fission or fusion?

The fact that Im running an open-source model to test whether these aggressive goals are achievable, it blows the mind why am I funding this model for these electric grids, which is the most obvious thing to do when you look at climate change?

If you had to bet on a single breakthrough happening in the next decade that really was a game changer, what do you think it would be?

Well, part of the point of the book is that [we cant rely on a] single breakthrough, we need artificial meat, we need lithium... But I would say, if you can get super-cheap green hydrogen, it sits in terms of the industrial economy at the peak. So, if you pencil in ridiculously low-cost hydrogen, then I can tell you how to make clean fertiliser and clean steel, and even clean aviation fuel.

We have to be careful: some scientific miracles like a storage one may never occur. Some people are now talking about super-clean hydrogen. They don't get how hard it is, and there's a good chance it will never be possible to make cheap, green hydrogen.

In this space we need about ten breakthroughs before you can really see a path to 2050, but clean hydrogen is higher than most people would expect. And storage miracles, and either fission or fusion. The book is supposed to make you think it's not like the pandemic vaccine, though.

Are you optimistic that we can get to net zero by 2050?

Absolutely. But thats just my personal bias I'm an optimistic person. I lived through the digital revolution, where every dream we ever had about computing came true. So, I don't have proof, but yes I am optimistic.

Greg Williams is the Editor of WIRED. This conversation has been edited for clarity and brevity.

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