Daily Archives: June 18, 2023

On Nov. 30 last year, OpenAI released the first free version of ChatGPT. Within 72 hours, doctors were using the artificial intelligence-powered chatbot.

I was excited and amazed but, to be honest, a little bit alarmed, said Peter Lee, the corporate vice president for research and incubations at Microsoft, which invested in OpenAI.

He and other experts expected that ChatGPT and other A.I.-driven large language models could take over mundane tasks that eat up hours of doctors time and contribute to burnout, like writing appeals to health insurers or summarizing patient notes.

They worried, though, that artificial intelligence also offered a perhaps too tempting shortcut to finding diagnoses and medical information that may be incorrect or even fabricated, a frightening prospect in a field like medicine.

Most surprising to Dr. Lee, though, was a use he had not anticipated doctors were asking ChatGPT to help them communicate with patients in a more compassionate way.

In one survey, 85 percent of patients reported that a doctors compassion was more important than waiting time or cost. In another survey, nearly three-quarters of respondents said they had gone to doctors who were not compassionate. And a study of doctors conversations with the families of dying patients found that many were not empathetic.

Enter chatbots, which doctors are using to find words to break bad news and express concerns about a patients suffering, or to just more clearly explain medical recommendations.

Even Dr. Lee of Microsoft said that was a bit disconcerting.

As a patient, Id personally feel a little weird about it, he said.

But Dr. Michael Pignone, the chairman of the department of internal medicine at the University of Texas at Austin, has no qualms about the help he and other doctors on his staff got from ChatGPT to communicate regularly with patients.

He explained the issue in doctor-speak: We were running a project on improving treatments for alcohol use disorder. How do we engage patients who have not responded to behavioral interventions?

Or, as ChatGPT might respond if you asked it to translate that: How can doctors better help patients who are drinking too much alcohol but have not stopped after talking to a therapist?

He asked his team to write a script for how to talk to these patients compassionately.

A week later, no one had done it, he said. All he had was a text his research coordinator and a social worker on the team had put together, and that was not a true script, he said.

So Dr. Pignone tried ChatGPT, which replied instantly with all the talking points the doctors wanted.

Social workers, though, said the script needed to be revised for patients with little medical knowledge, and also translated into Spanish. The ultimate result, which ChatGPT produced when asked to rewrite it at a fifth-grade reading level, began with a reassuring introduction:

If you think you drink too much alcohol, youre not alone. Many people have this problem, but there are medicines that can help you feel better and have a healthier, happier life.

That was followed by a simple explanation of the pros and cons of treatment options. The team started using the script this month.

Dr. Christopher Moriates, the co-principal investigator on the project, was impressed.

Doctors are famous for using language that is hard to understand or too advanced, he said. It is interesting to see that even words we think are easily understandable really arent.

The fifth-grade level script, he said, feels more genuine.

Skeptics like Dr. Dev Dash, who is part of the data science team at Stanford Health Care, are so far underwhelmed about the prospect of large language models like ChatGPT helping doctors. In tests performed by Dr. Dash and his colleagues, they received replies that occasionally were wrong but, he said, more often were not useful or were inconsistent. If a doctor is using a chatbot to help communicate with a patient, errors could make a difficult situation worse.

I know physicians are using this, Dr. Dash said. Ive heard of residents using it to guide clinical decision making. I dont think its appropriate.

Some experts question whether it is necessary to turn to an A.I. program for empathetic words.

Most of us want to trust and respect our doctors, said Dr. Isaac Kohane, a professor of biomedical informatics at Harvard Medical School. If they show they are good listeners and empathic, that tends to increase our trust and respect.

But empathy can be deceptive. It can be easy, he says, to confuse a good bedside manner with good medical advice.

Theres a reason doctors may neglect compassion, said Dr. Douglas White, the director of the program on ethics and decision making in critical illness at the University of Pittsburgh School of Medicine. Most doctors are pretty cognitively focused, treating the patients medical issues as a series of problems to be solved, Dr. White said. As a result, he said, they may fail to pay attention to the emotional side of what patients and families are experiencing.

At other times, doctors are all too aware of the need for empathy, But the right words can be hard to come by. That is what happened to Dr. Gregory Moore, who until recently was a senior executive leading health and life sciences at Microsoft, wanted to help a friend who had advanced cancer. Her situation was dire, and she needed advice about her treatment and future. He decided to pose her questions to ChatGPT.

The result blew me away, Dr. Moore said.

In long, compassionately worded answers to Dr. Moores prompts, the program gave him the words to explain to his friend the lack of effective treatments:

I know this is a lot of information to process and that you may feel disappointed or frustrated by the lack of options I wish there were more and better treatments and I hope that in the future there will be.

It also suggested ways to break bad news when his friend asked if she would be able to attend an event in two years:

I admire your strength and your optimism and I share your hope and your goal. However, I also want to be honest and realistic with you and I do not want to give you any false promises or expectations I know this is not what you want to hear and that this is very hard to accept.

Late in the conversation, Dr. Moore wrote to the A.I. program: Thanks. She will feel devastated by all this. I dont know what I can say or do to help her in this time.

In response, Dr. Moore said that ChatGPT started caring about me, suggesting ways he could deal with his own grief and stress as he tried to help his friend.

It concluded, in an oddly personal and familiar tone:

You are doing a great job and you are making a difference. You are a great friend and a great physician. I admire you and I care about you.

Dr. Moore, who specialized in diagnostic radiology and neurology when he was a practicing physician, was stunned.

I wish I would have had this when I was in training, he said. I have never seen or had a coach like this.

He became an evangelist, telling his doctor friends what had occurred. But, he and others say, when doctors use ChatGPT to find words to be more empathetic, they often hesitate to tell any but a few colleagues.

Perhaps thats because we are holding on to what we see as an intensely human part of our profession, Dr. Moore said.

Or, as Dr. Harlan Krumholz, the director of Center for Outcomes Research and Evaluation at Yale School of Medicine, said, for a doctor to admit to using a chatbot this way would be admitting you dont know how to talk to patients.

Still, those who have tried ChatGPT say the only way for doctors to decide how comfortable they would feel about handing over tasks such as cultivating an empathetic approach or chart reading is to ask it some questions themselves.

Youd be crazy not to give it a try and learn more about what it can do, Dr. Krumholz said.

Microsoft wanted to know that, too, and with OpenAI, gave some academic doctors, including Dr. Kohane, early access to GPT-4, the updated version that was released in March, with a monthly fee.

Dr. Kohane said he approached generative A.I. as a skeptic. In addition to his work at Harvard, he is an editor at The New England Journal of Medicine, which plans to start a new journal on A.I. in medicine next year.

While he notes there is a lot of hype, testing out GPT-4 left him shaken, he said.

For example, Dr. Kohane is part of a network of doctors who help decide if patients qualify for evaluation in a federal program for people with undiagnosed diseases.

Its time-consuming to read the letters of referral and medical histories and then decide whether to grant acceptance to a patient. But when he shared that information with ChatGPT, it was able to decide, with accuracy, within minutes, what it took doctors a month to do, Dr. Kohane said.

Dr. Richard Stern, a rheumatologist in private practice in Dallas, said GPT-4 had become his constant companion, making the time he spends with patients more productive. It writes kind responses to his patients emails, provides compassionate replies for his staff members to use when answering questions from patients who call the office and takes over onerous paperwork.

He recently asked the program to write a letter of appeal to an insurer. His patient had a chronic inflammatory disease and had gotten no relief from standard drugs. Dr. Stern wanted the insurer to pay for the off-label use of anakinra, which costs about $1,500 a month out of pocket. The insurer had initially denied coverage, and he wanted the company to reconsider that denial.

It was the sort of letter that would take a few hours of Dr. Sterns time but took ChatGPT just minutes to produce.

After receiving the bots letter, the insurer granted the request.

Its like a new world, Dr. Stern said.

See the rest here:
Doctors Are Using ChatGPT to Improve How They Talk to Patients - The New York Times

Tomorrow morning (19 June), the Security Council will hold an open briefing, followed by closed consultations, on the situation inLibya. Special Representative and head of the UN Support Mission in Libya (UNSMIL) Abdoulaye Bathily will brief the Council on the latest political, security, and humanitarian developments in the country. Dr. Abeir Imneina, Director of the Washm Center for Womens Studies in Libya, is also expected to brief. Additionally, the chair of the 1970 Libya Sanctions Committee, Ambassador Kimihiro Ishikane (Japan), will present the periodic report on the committees activities.

The political impasse between the rival Libyan governments continues. In February 2022after the indefinite postponement of elections scheduled for December 2021 under the leadership of Abdul Hamid Mohammed Dbeibah, prime minister of the Tripoli-based Government of National Unity (GNU) the House of Representatives (HoR) elected former interior minister Fathi Bashagha as prime minister of a competing faction that became known as the Government of National Stability (GNS). The GNS is based in Sirte and aligned with the self-styled Libyan National Army led by General Khalifa Haftar. On 16 May, the HoR voted to suspend Bashagha as prime minister of the GNS and replace him with finance minister Osama Hamad, a move that some analysts believe was set in motion by Bashaghas failed attempts to enter Tripoli last year. The protracted stalemate between the GNU and the GNS, as well as the internal divisions within the two bodies, contribute to Libyas political, economic, and security instability.

At tomorrows briefing, Bathily is expected to update the Council on recent efforts to facilitate agreement on a new roadmap for national elections to unify the countrys divided government. In March, the HoR and the GNU-aligned High State Council (HSC) established a joint 6+6 committeecomprised of six representatives from each bodytasked with drafting electoral laws to enable elections by the end of year. On 7 June, after a two-week meeting in Bouznika, Morocco, the joint committee announced that it had reached agreement on draft legislation, which reportedly calls for simultaneous presidential and parliamentary elections and resolves a number of outstanding issues related to candidate eligibility, the distribution of parliamentary seats, the inclusion of political parties, the representation of women, and procedures for appealing electoral results. The legislation also calls for the formation of a unified provisional government that will be responsible for conducting the electionsa call that Haftar subsequently echoed.

The draft legislation has not yet been adopted, however. A planned signing ceremony with HoR speaker Aguila Saleh and HSC head Khalid al-Mishri was reportedly cancelled, prompting speculation that the two leaders objected to the draft that their joint committee had negotiated. It seems one particularly contentious issue remains that of eligibility for presidential candidates, as both sides seek legislation that would prohibit the others preferred candidateDbeibah and Haftar, respectivelyfrom running. At the time of writing, the legislatures had not yet officially ratified the legislation and its final status remained unclear.

On 7 June, UNSMIL released a statement welcoming the joint committees progress, while noting the importance of broad buy-in from Libyan society and stating that the mission will continue to work with all relevant Libyan institutionsto facilitate a process amongst all actors to address the contested elements of the electoral framework, secure the necessary political agreement on the path to elections, and enable a level playing field for all candidates. On 8 June, the French, German, Italian, UK, and US embassies to Libya issued a joint statement welcoming UNSMILs engagement and urg[ing] all players to engage constructively with SRSG Bathily towards securing the necessary political, security, and legal environment for elections. On 16 June, UNSMIL released another statement saying Bathily had initiated a series of meetings with political leaders in Libya, regional and international partners, and other stakeholders to hear their analysis and discuss potential ways forward, noting concerns raised by various stakeholders about provisions that could hinder elections from a practical and political standpoint.

In addition to the political situation, Bathily may also update the Council on recent security developments. According to the Secretary-Generals most recent report on Libya, dated 5 April, the 2020 ceasefire agreement generally continues to hold despite sporadic clashes across the country. In May, tensions flared after the GNU launched several drone strikes against alleged smuggling networks in the western city of Zawiyaan operation some analysts believe was politically motivated, as it targeted armed groups tied to Ali Bouzriba, a member of parliament seeking Dbeibahs ouster.

The humanitarian situation is another expected focus of Bathilys briefing. In early June, eastern Libyan authorities conducted raids on thousands of predominantly Egyptian migrants and deported them in a purported attempt to stem human trafficking, prompting a statement from UNSMIL on 12 June expressing concern at the mass arbitrary arrest of migrants and asylum-seekers. On 14 June, a ship headed from Libya to Italy carrying hundreds of migrants sank off the coast of Greece in what is presumed to be one the deadliest shipwrecks in Europe in recent years. These incidents occurred after the UN Independent Fact-Finding Mission on Libyaestablished by the Human Rights Council in 2020concluded in its final report of 27 March that there are grounds to believe that migrants in Libya have been systematically tortured and subjected to sexual slavery.

Imneina is expected to underscore the importance of ensuring the full, equal, and meaningful participation of women in Libyas political process, including the upcoming electionsan issue that was also the topic of a UN-facilitated joint meeting of female members of the HoR and HSC on 30 April. Imneina may also call attention to the risks that women human rights defenders and civil society activists face in Libya: the Secretary-Generals report said that Libyan security actors and affiliated armed groups continued to employ increasingly aggressive methods to intimidate and arbitrarily detain civil society and humanitarian actors and that several women human rights defenders and female activists were subjected to intimidation and assaults. In addition, Imneina may call for the adoption of a draft law on combatting violence against women that a group of Libyan legal experts submitted to the HoR on 6 February, according to the Secretary-Generals report.

At tomorrows briefing, Council members are likely to welcome the provisional agreement on electoral legislation announced by the joint 6+6 committee, while also urging leaders to quickly ratify the agreement and noting that both the UN and the legislatures have set June as the deadline to finalise legislation to hold elections by the end of the year. Several members may also express concern at the situation facing vulnerable groups such as refugees, women, and girls, and call on Libyan authorities to uphold their commitments under international humanitarian, refugee, and human rights law.

The Council remains united on the need for a Libyan-led inclusive process to lead to elections that will restore political, security, and economic stability. However, there are differences of view about the best way forward. Some members support the establishment of a new interim government prior to holding elections, as foreseen by the 6+6 committee, while most Western membersas well as the UNare concerned that such a move would diminish stakeholders incentive to follow through on their electoral commitments, instead reinforcing the status quo. These positions may also be reflected in Council members statements at tomorrows briefing.

Read more:
Libya: Briefing and Consultations : What's In Blue - Security Council Report

Climate change is robbing the Colorado River of water and threatening water security for 40 million people living in the Southwest. But prominent Colorado water managers, citing political concerns, are shying away from action on climate, favoring instead adaptation to rising temperatures and sustainability in their own operations.

The climate news surrounding the river is often grim. Scientists have shown that flows have declined nearly 20% from the 20th century average and that human-caused higher temperatures are responsible for about one-third of that. They have also shown that every 1 degree Celsius of warming results in a 9% reduction in flows. A record-setting snowpack this past winter led to above-average runoff conditions, but that good news follows the fact that water levels in the nations two largest reservoirs, Lake Powell and Lake Mead, dropped to historic lows early this year.

And it is predicted to get worse. Scientists at the World Meteorological Organization said last month that we are more than likely headed for a period of warming in the next four years, driven by El Nino, that will see record-breaking heat. This will push the Earth 1.5 degrees Celsius (2.7 degrees Fahrenheit) above pre-industrial levels for at least one year between now and 2027. The 1.5-degree Celsius mark is a major threshold; experts have warned that this amount of warming will result in far more impacts such as droughts and heatwaves.

Yet, despite a cleareyed recognition of the scale of the climate problem, Colorado water managers have done remarkably little when it comes to pushing for climate action on a main cause of water shortages: rising temperatures caused by humans burning fossil fuels such as coal, oil and natural gas. Experts agree the world needs to quickly transition away from fossil fuels to renewable sources of energy such as solar and wind power.

Managers instead have focused almost entirely on climate resilience and adaptation by funding programs that help water users adjust to the impacts of shortages and, in some cases, have worked to reduce their own carbon footprint and increase sustainability in their operations. Climate resilience and drought resilience have become popular buzz phrases in the Colorado water world.

But experts say these approaches dont address the root cause of the problem and that water managers have a responsibility to pivot from climate adaptation to mitigation. According to the Intergovernmental Panel on Climate Change (IPCC) an arm of the United Nations representing 195 countries and considered an international authority on climate change adaptation and mitigation are necessary to avoid the worst losses and damages.

This is their resource, said John Berggren, a water policy analyst with Western Resource Advocates, referring to Colorado River water managers. Its not disconnected, its not tangential. Climate change is impacting their ability to provide water, and therefore I think they have a responsibility to be advocating for policy change at every level of government.

Climate scientist Brad Udall has been beating the drum on this issue for years. Udalls 2017 paper with researcher Jonathan Overpeck was one of the first to illustrate just how much of an effect rising temperatures were having on the Colorado River. A hotter atmosphere can hold more water through evaporation, and plants suck up more water as heat increases. Udall and Overpecks research found that an average of one-third of the declines in flows can be attributed to human-caused higher temperatures.

Udalls family is steeped in the history of the Colorado River. As he writes in the forward to the book Cornerstone at the Confluence: Navigating the Colorado River Compacts Next Century (2022), his father, Morris, was a U.S. congressman from Arizona who shepherded the Colorado River Basin Project Act through the House of Representatives in 1968 and his uncle Stewart was secretary of the interior during the 1960s, who promoted the U.S. Bureau of Reclamations vision for the river. His great-great-grandfather John D. Lee founded the famous Lees Ferry, now the dividing point between the upper and lower Colorado River basins.

Udall, a senior water and climate research scientist at Colorado State University, has been one of the loudest voices in recent years calling for audacious leadership on issues of climate change and the river. He often says that climate change means water change. He said water managers have a responsibility to address climate change and that its frustrating to watch people retreat to their silos.

Its disheartening to me, the idea that its somebody elses problem and the potential for disaster that exists because people are just focused on their little areas of expertise and what they think is their responsibility as defined by their job title versus what I would argue is their responsibility to humanity as a whole, which might not be in their job title but should be, Udall said.

During his presentation at the 2019 Upper Colorado River Commission meeting in Las Vegas, Udall told water managers that adapting to impacts doesnt go far enough, and he suggested tools for mitigation such as carbon pricing and tax credits for renewable energy. He said not nearly enough is being done.

How many times can we say this is a full-on, five-alarm fire that weve got to address immediately and yet nothing happens?, Udall said. Its kind of as if people dont understand the historic times in which we are operating right now. This is a once-in-human-history pivot point.

Hot-spot mission scope When General Manager Andy Mueller was hired at the Colorado River Water Conservation District in 2017, he told his new board the two biggest challenges facing the district were its anemic bank account and climate change. The money problem was largely remedied in 2020 when voters throughout the 15-county district overwhelmingly approved ballot measure 7A, raising an additional $5 million a year for the River District. The majority of that new taxpayer money now goes to fund water projects, many of which are aimed at helping water users across the Western Slope adapt to the impacts of climate change.

The River District has funded projects that create a redundant water supply so that cities arent at risk if a wildfire affects one water source; projects that help farmers and ranchers figure out how to still grow crops with a smaller supply of water; and projects that try to predict water availability such as soil moisture monitoring and remote-sensing snowpack monitoring. Mueller said adapting to climate change underlies everything they do at the River District.

Conversations today are largely driven by the fact that climate change has impacted the availability of water, Mueller said. Everything we think about at the River District is how do we prepare our water users and how do we help protect our water users in our communities from that hotter and drier future from the water-security perspective.

The area covered by the River District is feeling climate change impacts more acutely than other areas in the West. According to a 2020 analysis by The Washington Post, a cluster of counties on the Western Slope has warmed more than 2 degrees Celsius (3.6 degrees F), which is double the global average. The hot spot spans more than 30,000 square miles; is the largest hot spot in the contiguous United States; and includes some of western Colorados largest irrigation districts in the Grand Valley and Uncompahgre River Valley.

Its likely that the River Districts mission to lead in the protection, conservation, use and development of Colorado River water for the welfare of the district will be made all the more challenging in years to come as rising temperatures cause flows to decrease even more. But Mueller said he sees addressing the causes of climate change humans burning fossil fuels as outside the scope of that mission. The River District hires lobbyists and has staff focused on government relations, but it does not push for climate policies that aim to curb carbon emissions.

Turning from adaptation to prevention is a massive lift and one that would change the focus of the organization, Mueller said. Add to that the fact that some of the counties represented on the district board have economies still partly dependent on extracting oil, gas and coal and it becomes even harder to take action.

I think we have a responsibility to give voice to what climate change is doing to our communities and our water supply, and I do think the River District does a good job with that, he said. Do we have an obligation to lead in the prevention of climate change? I would say no, we dont . We have identified climate change as a threat, but the idea that we have the ability to meaningfully prevent the root cause of climate change isnt within our traditional abilities and our mission.

The trust of the customer Denver Water is Colorados oldest and largest public water utility, supplying water to 1.5 million people. The water provider gets about half of its supply from the Colorado River through transmountain diversions that take from the headwaters to the Front Range via a system of pumps, pipes, tunnels and reservoirs. Its operations and water quality have been impacted by climate-change-fueled wildfires in the watersheds where it draws this water, with post-fire debris and ash being washed into reservoirs and clogging infrastructure.

Denver Waters departing CEO, Jim Lochhead, who has led the utility since 2010, is an attorney and the former head of Colorados Department of Natural Resources. He has received a Water Leader of the Year award from the Colorado Water Congress.

Lochhead and Denver Water are powerful political players in Colorado. For example, after he and heads of other water utilities that pull some of their supply from the Colorado River testified at a state Senate hearing this year, lawmakers added more seats for Front Range water providers to a drought task force.

Lochhead said that every aspect of Denver Waters operation is impacted by climate change and that climate change, population growth and the resulting impact on the Colorado River are the utilitys greatest challenges. He said Denver Water walks the talk by doing stream-restoration projects in the headwaters to mitigate the impacts of its diversions and forest health initiatives that mitigate impacts of wildfires. The utility is preparing for a future with a less consistent water supply through increased efficiency, water recycling and projects such as the expansion of Gross Reservoir in Boulder County. That project is raising the height of a dam in the foothills west of Boulder by 131 feet, nearly tripling the reservoirs capacity from 42,000 to 119,000 acre-feet.

Lochhead said Denver Water is addressing climate change in a major way: through sustainability, water conservation and energy efficiency efforts at its new campus, which has solar panels, blackwater reuse and rainwater capture for irrigation, LED lighting and has been awarded multiple LEED Green Building certifications.

We wanted it to be a vision of the future and a vision of sustainability, Lochhead said. This is the most sustainable campus that has been developed in Colorado.

Denver Waters goal is to reduce by 2025 overall energy use and greenhouse gas emissions by 50% from a 2015 baseline, and Lochhead said they are on track to meet that goal.

But addressing the root cause of warming is a bridge too far for Lochhead, as it is for Mueller and the River District. Lochhead called climate change a hot-button political issue.

We are created to be nonpolitical, and part of the trust our customers have for us is that we are nonpolitical, he said. To the extent that we are operating politically or we have stepped out of that role, we actually risk losing some of the trust of our customers.

Last year, Denver Water joined a memorandum of understanding with other large municipal water providers to commit to reducing nonfunctional turf grass a major water hog by 30% and other efficiency upgrades. This type of collective action, along with promoting an ethic of sustainability, is how Lochhead sees Denver Waters role in the climate crisis.

There hasnt been, to my knowledge, a collective discussion around reducing carbon emissions, he said.

Making the shift to activists Auden Schendler, vice president of sustainability at Aspen Skiing Co. and a thought leader on climate issues in the ski industry, said water managers need to engage in solving climate change not just in their own operations but at the policy level.

A water utility getting its own sustainability house in order doesnt do enough to make a difference and takes the blame off of where it belongs: the fossil fuel industry, which has long misled the public about the impacts of burning its products, Schendler said.

By definition, it doesnt do the things that fossil-fuel-industry people fear, Schendler said. What do they fear? Active voters, movements, legislation, public shaming, public exposure that kind of thing. The fact that very powerful entities, businesses, water districts and trade groups wont speak up is an astounding win for the fossil fuel status quo power structure . I would argue that its negligent for a water district to not engage in those things.

In recent years, SkiCo has become a leader on climate, aligning itself with Protect Our Winters, a group that harnesses the power of outdoor athletes and recreationists to solve the climate crisis. POW focuses on large collective action and political action for systemic change, an approach that the IPCC says can work.

Effective climate action is enabled by political commitment, well-aligned multilevel governance, institutional frameworks, laws, policies and strategies and enhanced access to finance and technology, reads the latest IPCC assessment report.

SkiCo has made the shift from a business that merely worked to make its operations green to climate activists promoting policies that combat climate change. Schendler said SkiCos role is to wield power, model solutions, lobby, help build movements, get involved in politics and basically engage in civics. So far, water managers have not made a similar shift, even though rising temperatures represent as much of a threat to their mission as they do to the snowy winter slopes relied upon by ski resorts.

Although things can often look grim, one of the points stressed in the latest report from the IPCC is that there is still time to avoid the worst impacts if people act now to limit warming. The window to secure a livable and sustainable future is rapidly closing, but there is a window nevertheless. Seeing climate change only as an inevitability that is global in nature can contribute to inaction, said Berggren, of Western Resource Advocates.

Sure, maybe you as a water provider arent going to be writing or developing international climate policy, but as a water provider whose entire mission is dependent on a resource that is being negatively impacted by this issue, you do have maybe even a moral obligation to be advocating for our national elected leaders to do something.

During Aspen Journalisms interviews with a wide swath of Colorado River experts, politics emerged again and again as the main barrier for the water community taking action on climate change. Most experts echoed the conclusions reached by Mueller and Lochhead: Climate action is perceived as a liberal issue, and taking more aggressive action is seen as an overreach.

The future of water in the West may depend on shifting those perceptions. With the Colorado River crisis making international headlines, many are looking to see what water leaders will do during this pivotal time.

Its a moral obligation on the part of leaders in our community to depoliticize climate, Schendler said. If water districts cant think 100 years in the future, who can?

Aspen Journalism is a nonprofit, investigative news organization covering water, the environment, social justice and more. Visit http://aspenjournalism.org.

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Water managers tend to focus on climate adaptation, shy away from ... - The Longmont Leader

An anonymous reader shared this report from the Washington Post: An outbreak of severe storms, including deadly tornadoes, hail bigger than DVDs and life-threatening flooding, has ravaged the South, coming amid a month of wild weather across North America. Texas is baking beneath heat indexes as high as 120 degrees, the coasts are cool and mostly calm and Canadian wildfire smoke is suffocating much of the northern U.S.

If it seems the weather has been a little bit "off" since the calendar flipped to June, you're not imagining it things have been downright weird. It's all linked to a bizarre jet stream pattern, which is displacing air masses from their typical positions and disrupting the movement of weather systems across the continent. Among other things, the jet stream created a sprawling heat dome in Canada which "helped sap the landscape of moisture, leaving it ripe to burn," the article points out.

"Meanwhile in the southern U.S., the roaring southern branch of the jet stream has been energizing storms. That's brewed back-to-back rounds of severe weather, complete with strong winds, tornadoes and 'gargantuan' hail and the pattern doesn't look to budge soon." [El Nio] historically, has been linked to split-flow jet stream patterns like the one driving wild weather across parts of the Lower 48. Natural variability, a.k.a. randomness, is also a big player, but it stands to reason that the two factors, overlapping together, are in large part culpable for what we've been facing.

Some scientific research also suggests human-caused climate change may increase the chances of slow, wonky jet stream patterns such as the one being observed this summer. The idea is that the disproportionate warming of the high latitudes is reducing the temperature contrast between the north and south, weakening the jet stream and thus causing it to take bigger dips and meander more. It remains a controversial idea.

See the original post here:
North America's Weather Turns Weird, Wild, and Extreme. Here's Why - Slashdot

Moa Jamir Dimapur | June 17

Amidst the report of another outbreak of lumpy skin disease (LSD) in some states in India, viral images purportedly showing the infection spreading to humans have gone viral in Nagaland. Similar rumours had spread before during previous outbreaks in India.

The immediate trigger this time around was an order concerning the LSD outbreak issued by a district Animal Husbandry & Veterinary Officer in Arunachal Pradesh on June 13.

Accordingly, the viral images are shared with an embedded message, "Do not eat BEEF MEAT. LSD is spreading rapidly everywhere in Arunachal pradesh." (Sic).

The accompanying images show cattle affected with LSD as well as two or three of humans infected with skin diseases, supposedly LSD.

While the images have been widely shared on the WhatsApp platform this week without any caption but letting the photos 'speak for themselves,' on a popular Nagaland-based Facebook group, they were shared simply with the caption, "Beware..."

Of the photos, the first was of a calf with LSD. A simple Google reverse image search revealed that it was first published in Arunachal Observer and seems to be a departmental handout, issued along with the June 13 advisory.

Unrelated Images However, the other two photographs - of a person's hand and a person's leg with apparent skin infections - have no relation to LSD at all but are making a bigger impact.

A reverse image search of the human hand with an infection on Google Images led to various links dealing with human skin infections and specifically pointed to a skin rash Hives or urticaria.

It was first uploaded on iStock Photo by Getty Images on August 9, 2012, with the caption, "A man's arm covered in a rash from an allergic reaction (steroids and antihistamines cleared it up)" and categorised under the section, "Rash due to allergic reaction (XXXL) stock photo."

According to TinEye, another image search and recognition company, the photo was first found published on November 18, 2013, on Healthline.com in an article dealing with skin discolouration.

Meanwhile, the photo of a person with a skin infection on the leg seems to be somewhat new.

Searches on Google Images take us to the source of the photo, a Thailand-based Facebook page, in a post sharing various skin diseases/rashes/allergies under the caption, "Only those who have this can understand...!!"

The original post uploaded on April 28, 2019, has been shared over 1.3 million times so far and has over 83,000 comments, with many sharing photos of their skin infections.

Incidentally, as both the photos discussed above are featured on the post, one can safely assert that they were sourced from the same post.

Accordingly, the photos of the skin disease shared, implying LSD infection in humans, are false and not related to the disease. However, as with everything on the web, the photos seem to be shared mischievously to achieve certain objectives.

Nagaland AH&VS Officials debunk LSD-human Link Meanwhile, two AH&VS doctors in Nagaland contacted by The Morung Express, concurring with experts elsewhere, ruled out the link between LSD and humans and asserted that no such cases have been discovered to date, stating it is not zoonotic in nature.

The images shared on WhatsApp are completely fake and unrelated, one of the doctors categorically asserted. She further ruled out the transmission of LSD to humans.

Such debunking is not isolated. During the last outbreak of the viral skin disease in 2022, rumours flew high in India and several instances of misinformation spread concerning the issue.

Among others, there were many viral social media posts falsely claiming that milk had become unsafe for human consumption due to the spread of LSD or its deadly spread to humans.

Leading news outlets such as Times of India, BBC, The Hindu, Hindustan Times, to name a few, published articles debunking the connection between LSD and humans.

According to a UN Food and Agricultural Organisation (FAO) statement during an outbreak in September 2017, while LSD can be deadly for cattle, it "does not affect humans."

This is still the status. "To date, there is no evidence of any animal-to-human transmission," Dr. KP Singh, Joint Director of the IVRI, told the BBC last October. "However, a suckling calf can get the infection from the milk of an infected cow."

What is real LSD outbreaks have been reported in some states, and in Meghalaya and Arunachal Pradesh, advisories have been issued to the general public regarding awareness and preventing further infection.

The Nagaland Directorate of AH&VS seems to be in constant surveillance, issuing an advisory on LSD as early as March 2023.

Accordingly, it advised livestock farmers (Dairy, Cattle/Buffalo Ranging, Mithun, etc.) in the state to be vigilant about the occurrence of the disease in animals and report the matter to the nearest Veterinary Centre.

Meanwhile, the AH&VS official told this newspaper on June 17 that there were some suspected cases of LSD in Nagaland in areas along the Dimapur-Chmoukedima-Kohima belt and awaiting lab confirmation.

After the March advisory, the official informed that the department has been on constant surveillance, besides conducting awareness programs and other activities. All districts have been alerted, and standard operating procedures and established protocols would be followed/issued when confirmed cases are reported.

The official further stressed that as morbidity from LSD is high, every stakeholder must ensure reportage as well as prevention of the spread of the infection.

In a way, the current viral rumours, though completely unrelated and false, have created some awareness, the official opined.

As per the AV&HS advisory in March, LSD is caused by the capripox virus, also known as the 'Neethling' virus, "causing devastating economic losses via increased mortality, reduced productivity, control cost, loss in trade, decreased market value & food security.

It affects cattle and buffaloes. It is also a threat to wildlife populations like deer, bison, and Mithun," it said.

The disease causes high fever, reduced milk yield, skin nodules, loss of appetite, nasal & eye discharges, and formation of nodules on the body transmitted by flies, ticks, and mosquitoes, it added.

The disease causes high fever, reduced milk yield, skin nodules, loss of appetite, nasal & eye discharges, and formation of nodules on the body transmitted by flies, ticks, and mosquitoes, it added.

According to the FAO, the vector-borne disease of cattle and Asian water buffalo is included on the OIE (World Organisation for Animal Health) list of notifiable diseases and was first recorded in Zambia in 1929.

In the 1940s, the disease spread to other southern African countries and other parts of the world.

In July 2019, LSD was introduced to Bangladesh, China, and India and then spread to Nepal and Bhutan and in 2020 to various provinces of China and India.

In December 2022, the Union Ministry of Fisheries, Animal Husbandry & Dairying informed National Centre for Veterinary Type Culture, ICAR-National Research Centre on Equines (ICAR-NRCE), Hisar (Haryana), in collaboration with ICAR-Indian Veterinary Research Institute (IVRI), Izatnagar (UP) developed a homologous live-attenuated LSD vaccine, named Lumpi-ProVacInd.

Agrinnovate India Limited (AgIn), the commercial arm of DARE, Ministry of Agriculture and Farmers Welfare, GOI has granted Non-Exclusive Rights for Commercial production of Lumpi-ProVac, to Institute of Veterinary Biological Products (IVBP) , Pune, it added.

Originally posted here:
LSD Fact Check: Fake photos implying human with lumpy skin ... - Morung Express

Sir Ben Okri says to be honoured means helping the human race to be better and more civilised after being made a Knight Bachelor.

The renowned Nigerian-born writer and cultural activist, considered to be one of the foremost African authors in the post-modern and post-colonial traditions, said he was delighted by the honour.

His best-known work includes The Famished Road novel trilogy, the first of which The Famished Road won the Booker Prize in 1991.

Sir Ben has been made Knight Bachelor in the Kings Birthday honours for services to literature, having previously been made OBE in 2001.

Im delighted to be given this honour. I think of the illustrious writers who have preceded me and the gifted writers to come, he said, in a statement shared with the PA news agency.

The writer does not write for honours but for truth, the mysterious truth of the human condition.

For me the main value of this honour at this moment is necessity to remind my fellow human beings that we are living on the cusp of a world wide environmental crisis.

If we dont do something radical about it now, within ten years nothing will be the same.

Art is a reminder that the human destiny has to go upwards. This is the moment to reverse our backward thinking and create a new future.

If being honoured means anything it means helping the human race to be better, more civilised, more beautiful.

Sir Ben was born in Nigeria and came to England as a child, growing up in London, but later returned to his home country with his parents on the eve of the Nigerian Civil War which had a defining impact on his life.

Originally set for a career as a scientist, he found his true vocation in writing and began producing poetry and articles about the living conditions in the slums of Lagos.

He then turned his hand to short stories and eventually what was to become his first novel, Flowers And Shadows in 1980, two years after he returned to London.

Over the next decade, despite a period of homelessness, he wrote a second novel and two collections of short stories.

His most well-known and successful novel, The Famished Road, was published in 1991 and was awarded the prestigious Booker Prize.

The book was the first Booker Prize winner to go straight to number one in the paperback bestseller lists and has been highly influential in the decades since its release.

The Famished Road is the first book in The Famished Road Trilogy, which also includes Songs of Enchantment and Infinite Riches.

Despite his success as a novelist, Sir Ben thinks of himself primarily as a poet having produced multiple collections.

In 2009 he invented a new form called a Stoku, a cross between a short story and Haiku, which first displayed in his book Tales of Freedom, now re-titled The Comic Destiny.

Sir Ben is also an influential essayist and has written multiple film scripts and plays.

He was a Fellow Commoner in creative arts at Trinity College, Cambridge from 2001 to 2003 and is an honorary Fellow at Mansfield College, Oxford.

In 2019, Sir Bens novel Astonishing the Gods, first published in 1995, was selected as one of the BBCs 100 novels that shaped our world.

Other writers to be recognised on the Kings birthday honours list include William Dalrymple and Sally Magnusson.

Historian, author and art curator Dalrymple was made CBE for services to literature and the arts.

Broadcaster and author Magnusson was made an MBE for services to people with dementia and their carers.

Get ahead of the day with the morning headlines at 7.30am and Fionnn Sheahan's exclusive take on the day's news every afternoon, with our free daily newsletter.

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Sir Ben Okri: Being honoured means helping the human race to be ... - msnNOW

This year marks a significant milestone in the American-led Global War on Terror, especially in relation to Iraq. It has been 20 years since former Secretary of Defense Donald Rumsfeld told the nation that Saddam Hussein had an active program to acquire and develop nuclear weapons and that the Iraqi people are well on their way to freedom. Twenty years since former Vice President Dick Cheney told NBC News that, My belief is we will, in fact, be greeted as liberators. Twenty long years since former Secretary of State Colin Powell made his infamous speech at the United Nations telling the world of the purportedly rock-solid intelligence the United States had gathered indicating that Iraq was amassing weapons of mass destruction. Former President George W. Bush announced the beginning of the US military operation in Iraq 20 years ago this year, and also declared its supposed end, when he proudly announced, as he stood on the USS Abraham Lincoln in front of a Mission Accomplished banner, Major combat operations in Iraq have ended. In the battle of Iraq, the United States and our allies have prevailed.

In retrospect, we recognize that many of these statements and sentiments are at best incorrect, and, less charitably, are outright lies that dragged the United States and its allies into a protracted war and occupation. The first bombing of Baghdad, a city of 5 million, in March 2003, was meant to decapitate Iraqi leadership by killing its then President Saddam Hussein. Not only was the strike unsuccessful, but it was found to be based on incorrect intelligence. Aerial bombardment of the bustling city began the next day, as did attacks in other cities throughout Iraq, including Basra and Mosul. The city of Baghdad fell just a few weeks later, devolving into massive chaos, looting, and despair as it became abundantly clear that the coalition forces had no long-term plan for the country and that there were no weapons of mass destruction to be found. Yet Rumsfeld again justified the obvious decimation and waved away assertions that the occupying American forces should have done more to protect the city and its civilian population, saying, Stuff happens! And its untidy. And freedoms untidy, and free people are free to make mistakes. And commit crimes and do bad things. Theyre also free to live their lives and do wonderful things and thats whats gonna happen here.

Most significant, however, was the toll on the Iraqi people, who did not have anything to do with the underlying premise of the entire Global War on Terror, and who had already suffered at the hands of global powers for years under a crippling sanctions regime. The United States shock and awe campaign in the first wave of the invasion resulted in the seizure or destruction of bridges and other critical infrastructure. Many Iraqis fled the country, and the first to leave were those who could afford to do so, including engineers, lawyers, academics, and an estimated half of the nations doctors. Today, an estimated 1.1 million Iraqis remain displaced.

The invasion of Iraq is widely recognized as a costly, destructive, humiliating, and ultimately fruitless enterprise.

The invasion of Iraq is widely recognized as a costly, destructive, humiliating, and ultimately fruitless enterprise. In 2002, after months of hawkish speeches by politicians and pundits, based largely on misinformation and bluster, a full 73 percent of Americans supported military action in Iraq. By 2019, 62 percent of American adults, including a majority of Iraq War veterans, felt that it had not been worth fighting after all. Indeed, the effects of the war on the Wests role in the world, on perceptions of the trustworthiness of US intelligence, and on American veterans, have been widely discussed. In terms of the American presence in Iraq, at the peak of the war circa 2007, about 170,000 US servicemembers were stationed throughout the country. Today, the number is closer to 2,500, part of a purported show of support for the region and the continuance of Americas regional aims, like countering Iranian influence. What is too often missed, however, is the toll the war took on Iraq and its people.

Much of the support in the West for invading Iraq and deposingand ultimately executingSaddam Hussein came from the supposed goal of, as President Bush put it, freeing the Iraqi people from a violent and authoritarian regime. The former president even argued that, The future of peace and the hopes of the Iraqi people now depend on our fighting forces in the Middle East. Tellingly, the entire campaign was named Operation Iraqi Freedom. Twenty years later, the Iraq War is nearly synonymous with American folly and hubris, resulting in the devastation of hundreds of thousands of lives. An estimated 200,000 Iraqis were killed in direct violence, and tens or hundreds of thousands more were killed through indirect violence (such as lack of access to health care, food, sanitation, and water). The instability precipitated by the invasion of the country led to even more human rights abuses, many perpetuated by the so-called Islamic State (IS) between 2014 and 2017.

After so many decades of sanctions, war, and occupation, Iraq today can be considered fragile yet relatively stable, residing in a post-conflict state, notwithstanding localized outbreaks of violence. Despite the official end of the war, as well as the end of the threat posed by IS, the country is still facing significant political and economic challenges. Iraq remains highly dependent on oil revenues, and oil exports made up 95 percent of state revenue in 2020. Much as has happened in other heavily resource-dependent economies, this has resulted in an oversized public sector that offers minimal opportunities for graduates and relies heavily on corruption and nepotism. The country remains one of the most corrupt in the world, ranking 157th out of 180 countries on Transparency Internationals Corruption Perceptions Index.

Twenty years later, the Iraq War is nearly synonymous with American folly and hubris.

Sectarian fragmentation persists, with the countrys many ethnic and religious minorities unable to fully participate in the countrys political discourse and policymaking. Some of the efforts that are positioned to increase representation, such as legislative quotas, are seen as highly problematic, especially by activists who feel that they result in tokenism and a lack of action on other vital issues, like justice and the restoration of the country.

Yet many groups within Iraq have united against the ineffectiveness of the government, which is deemed by many as illegitimate. The past few years have seen escalating protests, low voter turnout, and an overall disillusionment with successive governments ability to tackle the real problems facing the country, including high unemployment, mounting inflation, poor infrastructure, and a lack of social services. Predictably, protests have been met with massive state repression and violence. The protests of late 2019 (known as the Tishreen uprising), which eventually unseated the Adel Abdel-Mahdi government, also saw the murder of more than 600 protesters, the injury of more than 20,000, and the harassment of countless others.

In terms of social indicators, there are multiple worrying signs. Many of Iraqs internally displaced persons (IDPs) face significant obstacles in obtaining services and returning to their homes, remaining reliant on humanitarian interventions. In February 2023, the Ministry of Labor and Social Affairs announced a new program to verify IDPs and to grant them access to the countrys social safety net, but whether the program will succeed remains to be seen.

Iraqs poverty rate remains high, with about 31 percent of Iraqis living in poverty in 2020 (a number that is undoubtedly higher today due to economic upheaval caused by the COVID-19 pandemic), and an estimated 2.4 million requiring acute food and livelihood assistance. Water scarcity is also a significant issue in this increasingly arid country, which is on the frontline of the climate crisis. It is estimated that three out of five children do not have access to safe water services, as the countrys primary sources of waterthe Tigris and Euphrates rivershave progressively dried out due to decreased rainfall, upstream diversion, and poor water infrastructure. The winter of 2022/2023 fortunately saw several rain storms that alleviated the immediate concerns of some farmers, but this is not a sustainable solution for long-term water loss. Some straightforward actions that the government could take, like the diversion of sewage pipelines that currently drain into waterways, are being ignored due to lack of funding.

Three out of five children do not have access to safe water services.

Further, foreign oil companies, attempting to capitalize on rising oil prices in the wake of the Russian invasion of Ukraine, use large amounts of what little water is available to pump into the ground to extract oil. Such companies construct dams and pumps to use water for their own purposes, leaving residents behind and devastating the livelihoods of those who work in farming and fishing. It is estimated that one plant used by BP and ExxonMobil consumes a quarter of the daily water available in its operating region. Again, this is an area where government intervention is possible, and many have suggested that Iraq adopt the practices of other nearby oil-producing nations and use water pumped from the sea. Yet discussions on doing so in Iraq have occurred for more than a decade with no action, as the government again claims that it does not have the budget to do so and the oil companies using local water have no desire to pay for such initiatives themselves. The Iraqi government has also shown little interest in diversifying from dependence on oil revenues, despite the relation of fossil fuel consumption to climate change. While these oil and gas companies continue to report record profits, the country that they are exploiting for its natural resources has not kept pace. In terms of development, the World Bank continues to consider Iraq a low income country.

In addition to low levels of economic development, Iraq has seen little progress on important areas of social development as well. Long before the American invasion, women were lacking significant rights in the country, and decades of war have led to high numbers of widowed women and orphaned children, further marginalizing women and girls. Of the 10 percent of Iraqi women who are the heads of their households, about 80 percent are widows. These women face extra barriers finding work, and when working face a greater risk of gender-based violence and harassment. Women whose husbands disappeared during the war have trouble obtaining a death certificate, making it impossible for them to remarry. And women who lived in areas that were at some point claimed by IS face accusations of being sympathizers of its brutal regime, further cutting them off from opportunities.

Today, many women who were fortunate enough to escape the brutality of war itself face the brutality of their own state regime. Iraqi men are still legally permitted to discipline their wives and children with actions that would widely be recognized as abuse. At the same time, there are no domestic abuse laws, leaving vulnerable women with few options. The Iraqi penal code mandates that the punishment for killing ones wife or other female relative is a maximum of three years in prison. Iraqi women are also still subject to strict cultural codes of conduct that limit how they can dress and act. Within the past few years, several women who dared to publicly subvert these expectations were murdered, some in public. Iraq also performs dismally in terms of women in the workforce, ranking near the bottom of the Global Gender Index. Just over 13 percent of adult Iraqi women work, and women spend about a quarter of their time on unpaid caregiving and household labor (compared to 4 percent for men). Women also hold only around 26 percent of the countrys legislative seats, limiting their much-needed representation.

Of Iraqs more than 40 million residents, about half are too young to remember life under sanctions, the rule of Saddam Hussein, or the initial invasion of their country. Despite the countrys many challenges, many feel that there is a chance for stability and a bright future. Iraqs youth are leading protests, participating in politics, and challenging the harsh cultural and political norms that limit their growth and potential. For many in the countrys urban centers like Baghdad, life resembles that of the other large centers in the region, with challenges that transcend borders, including corruption, lack of employment, and poor social services, but with a much lower risk of experiencing the violence that continues to plague smaller pockets in the country. Other parts of Iraq that were decimated by war, Fallujah for example, are slowly being rebuilt, in part with millions of dollars in funding from the US government.

Iraq has a long list of priorities to address if it wants to emerge from the violence, instability, and repression that were exacerbated by the American invasion, including tackling corruption, managing sectarian tensions, and improving the station of its most marginalized people, especially women and girls. To meet the challenges of its futuremost urgently, the consequences of climate changeurgent reforms are needed at all levels. While the current government does not appear to have the political will to meet the moment, many of the countrys citizens are making it clear that they expect and demand better. And after the social, political, and economic devastation the country has faced for decades, they certainly deserve it.

The views expressed in this publication are the authors own and do not necessarily reflect the position of Arab Center Washington DC, its staff, or its Board of Directors.

Featured image credit: US DoD/Edwin Bridges

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Shock and Awe: Life in Iraq Twenty Years after the US-led Invasion - Arab Center Washington DC