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What an autopsy may (or may not) have revealed about Otto Warmbier’s death

(CNN)What happened to Otto Warmbier while he was in North Korean custody is a mystery. And it’s likely to remain that way. Following his death on Monday, Warmbier’s parents Cindy and Fred asked the coroner not to perform an autopsy on their son.

“The family’s objection to an autopsy was honored, and only an external examination was performed,” the Hamilton County (Ohio) Coroner’s Office said in a statement Tuesday.
“No conclusions about the cause and manner of Mr. Warmbier’s death have been drawn at this time, as there are additional medical records and imaging to review and people to interview,” the statement said.
    Forensic experts say autopsies can reveal important information about how or why a person died; in this case, determining what events may have led up to Warmbier’s arrival in the United States in a persistent vegetative state.

      What happens during an autopsy?

    “I think it’s a terrible mistake” not to perform an autopsy, said Dr. Cyril Wecht, a prominent forensic pathologist who was not involved in Warmbier’s case. “If you have something that could be anything other than a natural death, you’re obligated to do an autopsy.”
    As far as what put Warmbier in a coma in the first place, Wecht said it would be difficult to determine in someone who had been comatose for such a long time “because the brain continues to undergo decomposition.”
    The possibilities could have been any number of things, Wecht said, including strangulation, suffocation, medication or a botched suicide attempt. But “the basic cause, no matter what the mechanism, would have been … hypoxia,” the medical term for insufficient oxygen reaching the brain.

    What happened in North Korea?

    Up until last week, one of the last times the world saw Warmbier, an American college student, was at a news conference in North Korea on February 29, 2016. Warmbier stood accused of a “hostile act”: taking down a political poster in a hotel in Pyongyang. Through tears, the then-21-year-old begged for forgiveness but was ultimately sentenced to 15 years of hard labor during his one-hour trial on March 16, 2016.
    Then, on June 13, 2017: North Korea released Warmbier in a state of “unresponsive wakefulness,” according to doctors at the University of Cincinnati Medical Center, who examined him upon his return to the US. In a news conference last week, they disputed the North Korean regime’s claims that Warmbier had contracted botulism and slipped into a vegetative state after taking a sleeping pill.
    Dr. Daniel Kanter, director of UC Health’s Neurocritical Care Program, said Warmbier’s MRI scan showed “extensive loss of brain tissue in all regions of the brain” but no evidence of a skull fracture.
    “We have no certain or verifiable knowledge of the cause or circumstances of his neurological injury,” Kanter said. “This pattern of injury, however, is usually seen as the result of cardiopulmonary arrest, where the blood supply to the brain is inadequate for a period of time, resulting in the death of brain tissue.
    “He has spontaneous eye-opening and blinking,” Kanter continued. “However, he shows no signs of understanding language, responding to verbal commands or awareness of his surroundings. He has not spoken. He has not engaged in any purposeful movements or behaviors.”

    Determining cause of death

    According to the US Centers for Disease Control and Prevention, just two states — Arkansas and Nevada — have no conditions under which an autopsy is required by law.
    The remaining 48 states and the District of Columbia have different criteria as to when an autopsy is mandatory. In Warmbier’s home state of Ohio, an autopsy is required in five circumstances, including when a death is ruled a homicide, in cases where it is related to a public health threat, and when a “child death appears natural and occurs suddenly when in good health.”
    The Warmbier family has not said why they objected to an autopsy, but Wecht said some families cite religious reasons, overwhelming grief or a desire to more quickly move on.
    “It’s not that I’m insensitive or indifferent to family objections,” Wecht said. “When I was coroner, for 20 years, of Allegheny County (Pennsylvania), if I could bend, I bent. Other times, you cannot bend. This is a case of unknown etiology, and the only way to ascertain what may have gone wrong would be to do an autopsy.”
    Despite the tragic circumstances, CNN Chief Medical Correspondent Dr. Sanjay Gupta said the case was very interesting from a medical perspective.
    “For 15 months or so, (Warmbier) had a devastating neurological injury but was kept alive,” said Gupta, who is also a member of the American College of Forensic Examiners and a practicing neurosurgeon. “One of a few things likely happened here — and we may never know, especially if there’s no autopsy.
    “One thing to keep in mind is that he did just have a long flight from North Korea to the US,” he said. “Even healthy people can develop deep-vein thrombosis, or DVT. With someone who is not moving, the risk is even greater. The risk of a blood clot in the lungs is also a possibility, especially given how sudden this was.”
    Gupta, who has not reviewed Warmbier’s medical records, said Warmbier could have been given a new medication or have had an old medication withheld.
    For example, “he could have been treated for a body-wide infection such as sepsis, which is not uncommon in someone who is bedridden,” Gupta said. “The family could have decided to stop giving him antibiotics, then sepsis may have led to his death.”
    Given Warmbier’s prognosis last week, “this would not have been unreasonable,” Gupta said.

    See the latest news and share your comments with CNN Health on Facebook and Twitter.

    Warmbier also may have been given new medications for comfort care in the US that he didn’t receive while in North Korea, which could have led to his death, Gupta said.
    Wecht said he was surprised the family didn’t want to make one last attempt at determining what happened to their son while he was a prisoner of what President Donald Trump has called a “brutal regime.”
    For their part, Cindy and Fred Warmbier said their son had “completed his journey home.”
    Otto Warmbier will be laid to rest Thursday after a funeral service at his high school in Wyoming, Ohio.

    Read more: http://www.cnn.com/2017/06/21/health/otto-warmbier-autopsy/index.html

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    Georgia special election: Republican Karen Handel beats Jon Ossoff in runoff

    Sporadic downpours and flash flood warnings helped to put a damper on Democratic turnout in base precincts

    In Georgia the resistance was stopped by the rain on Tuesday when Jon Ossoff, long the best hope of Democrats to win a special election in the Trump administration, suffered a narrow loss to Republican Karen Handel in the Sixth Congressional District.

    With 99% of precincts reporting, Handel had 52.4% and Ossoff had 47.6%

    Sporadic downpours and flash flood warnings helped to put a damper on Democratic turnout in base precincts and on the hopes of progressives to thwart Republican efforts to repeal and replace the Affordable Care Act. Combined with an energized Republican base that kept Ossoff from accumulating a significant lead among early voters, it doomed the hopes of the anti-Trump activists who made the first time Democratic candidate a minor political celebrity.

    The runoff came after a first round of voting in April where Ossoff won just over 48% of the vote and Handel finished second in a splintered Republican field with just under 20% of the vote. However, Ossoff struggled to match that total as Handel consolidated the Republican vote in a traditionally conservative district in the northern suburbs of Atlanta andended up falling a percentage point short of his much hyped performance in the first round of voting.

    Trump took to Twitter to hail the result as a personal victory Thank you @FoxNews Huge win for President Trump and GOP in Georgia Congressional Special Election.

    The seat had been vacated by Tom Price when the former congressman joined Trumps cabinet to become secretary of health and human services and previously held by Republican stalwarts like Senator Johnny Isakson and former speaker Newt Gingrich. Although Price won by 23% in 2016, Donald Trump only narrowly won this wealthy, well-educated district by just over 1%.

    Trumps narrow win sparked optimism among Democrats that the district, where nearly 60% of residents have a college degree, could flip as part of the political realignment around the presidents upset victory in 2016. Roughly $50m ended up being spent by both parties and allied groups in the race as it became the most expensive congressional campaign in the history of the United States.

    However, while Democrats had motivated their base and won over skeptical Republicans, the conservative slant of district proved too much even for the nearly unprecedented resources that Democrats invested in the race, even flying in volunteers for last minute doorknocking as local television stations had been saturated by 30-second advertisements.

    Although the race had been cast a referendum on Trump an opinion the President seemed to endorse after the result had been reported both candidates awkwardly danced around his looming presence on the campaign trail. At Handels campaign events, Trumps name went unmentioned by the candidate and introductory speakers. Instead, there was constant refrain of attack on Ossoff for his ties to House minority leader Nancy Pelosi and praise for previous holders of the seat like Price and Gingrich. Ossoff was regularly bashed for the amount of money he raised out of state and for having San Francisco values.

    Handel, who suggested in the first televised debate of the campaign that Trump should use Twitter less often, told the Guardian in an interview on Monday that she didnt pay attention to the presidents use of social media. She said I am focused on my campaign, I have precious little time to be on Twitter. Several hours later, her campaign sent out a fundraising email signed by the former secretary of state with the subject line did you see what Trump just tweeted? after the President used his ubiquitous social media account to tout her campaign.

    Ossoff has also been measured in his attacks on Trump in a traditionally Republican district albeit one that the president barely won in 2016. Instead, the lanky and measured political neophyte focused on banal and politically non-controversial issues like government waste and turning Atlanta into the Silicon Valley of the South and let the progressive anti-Trump enthusiasm of the Democratic base carry him.

    Instead, he has focused on Handels stint as Georgia secretary of state as well as her brief stint with the Susan Komen Race For The Cure, a charity which combats breast cancer, where she led an effort to cut off the organizations funding for Planned Parenthood. The decision sparked a major controversy and funding was eventually restored and Handel had to resign from the non-profit.

    In an interview with the Guardian, Ossoff slammed his opponent. Secretary Handels record as secretary of state is extremely weak perhaps because she was too busy preparing her next run for higher office to do her job. She quit her job early to run for higher office, as so many career politicians do. Her last significant private sector experience, her performance also lacked.

    The issue of civility and the growing toxic nature of American political culture became an issue late in the race in the aftermath of the shooting of House Minority Whip Steve Scalise. Handel pointed to social media and journalism as reasons for the decline of civility in American society in an interview with the Guardian. Journalism is not journalism any more, said Handel. Ossoff stuck to broader themes, telling the Guardian, this is a deep rooted problem in American politics right now which is going to take work and bipartisan commitment to trying to heal wounds and focus on substance instead of fear mongering and slander.

    Read more: https://www.theguardian.com/us-news/2017/jun/21/georgia-special-election-republican-karen-handel-beats-jon-ossoff-in-runoff

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    Medicine information leaflets ‘too scary’, say experts – BBC News

    Image copyright Science Photo Library
    Image caption Lots of information on the side effects of medicines are making people anxious, the report says

    There is too much focus on the potential side-effects of medicines on information leaflets inside packs and not enough on their benefits, says the Academy of Medical Sciences.

    Its new report calls for them to be rewritten to give a more balanced view.

    A survey by the academy found the public was confused by information on medicines and did not trust scientific research.

    Scientists said clear communication with patients was a priority.

    Unduly anxious

    The side-effects listed on patient information leaflets (PILs) are often very long and off-putting, the report says.

    They make people unduly anxious about taking medicines and could be the reason why fewer than 50% continue with drugs they have started taking.

    The likelihood of the side-effects occurring is also rarely explained – instead they are labelled “possible” or “serious”.

    And the benefits of the medicines are usually understated, taking up much less space on the leaflet than potential harms.

    Image copyright Science Photo Library
    Image caption Some information leaflets do show how common side-effects are – but many don’t

    Jargon overload

    Prof Sir John Tooke, chair of the Academy of Medical Sciences report, says there is too much “impenetrable” scientific language on leaflets.

    For example, the leaflet inside a box of paracetamol says that possible side-effects from taking the tablets are the chance of developing pancreatitis or hepatitis.

    However, there is no information on what the conditions are or how big the risk of getting them is in reality.

    Rather than clearly explaining how symptoms will reduce, too many leaflets describe what the medicine does in complicated biological terms.

    “They aren’t written from a consumer’s perspective,” Prof Tooke says.

    Image copyright Science Photo Library
    Image caption And the confusion is even worse if you’re taking multiple medications…

    Patients should feel confident about the medicines they are taking, rather than uneasy.

    If they do not understand the information provided, they are less likely to feel good about taking them.

    For legal and regulatory reasons, there is a lot of information provided – but the report asks whether it is really there to help the public.

    Image copyright SILVIA KIRK
    Image caption Silvia Kirk has a child with asthma

    Silvia Kirk is a mother of two from London, who took part in public workshops for the report.

    “I don’t always read the information leaflets in medicine packs, unless it’s for my children – one of whom has asthma,” she says.

    “Usually my heart is all over the place as I’m reading them, because I’m wondering whether the risks outweigh the benefits.

    “Some of the information doesn’t make sense at all. When you’re poorly you don’t want to feel anxious too – and I think it’s particularly confusing for older people.

    “I understand it all needs to be on the leaflets, but there’s too much crammed into one space. I tend to go by what the GP has said and written on the prescription.

    “I only check side-effects listed on the Yellow Card website [suspected adverse reactions to licensed drugs], which I find are useful.

    “A link to more detailed information online on individual medicines would be useful for me.”

    Tips on what to ask your GP

    • Is this medicine right for me? How will it improve my health?
    • What are its potential benefits and risks? Are they relevant to me?
    • How will this medicine make me feel? Will it affect my daily life?
    • How should I take it? Can I take it with other medication?

    The report is also calling for:

    • More efficient use of GP appointments, which may need to be longer – particularly for patients with multiple conditions
    • A “go to” source of trusted information online about medicines for patients and healthcare professionals

    The survey of about 2,000 British adults and 1,000 GPs found that a third of the public trusted evidence from medical research while two-thirds trusted the experiences of family and friends when it came to taking medicines.

    Doctors said they also needed better information to help them judge the benefits and harms of medicines for patients.

    What do scientists think?

    In general, they welcomed the whole idea of making information on medicines clearer – for patients and doctors.

    But they recognised that a degree of uncertainty was inevitable in medicine, because scientific research was always evolving.

    Dr Louise Brown, senior statistician at the MRC Clinical Trials Unit at University College London, said there were other challenges to face in the shape of the internet and social media.

    “We are all bombarded with an unrelenting stream of new information that is overwhelming and very difficult to process.

    “Unsurprisingly, this leads to feelings of scepticism and mistrust,” she said.

    Peter Openshaw, professor of experimental medicine at Imperial College London, said providing accurate and accessible information on new treatments was vital.

    “It is only by working in close partnership with patients, clearly and honestly explaining the scientific evidence, that we can fully realise the huge potential that 21st Century medical science offers.”

    Read more: http://www.bbc.co.uk/news/health-40329418

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    The Awful Truth Of Our Parents Dying One Day


    God & Man
    Paul Benedetti

    My grandparents adopted me. They raised me since I was a baby. The only drawback to this is that they were already well in their 40’s-50’s when I was born, so I have less time with them compared to what others have with their birth parents.

    My father is 72. My mother is 68. Even as a child I was already aware how old my parents were. Since I was so attached to them, Id often worry about their well-being.

    One time, when I was 4 or 5, my mother took me with her during a doctor check-up of some sort. She was groaning in pain as the doctor did the routine. After they were done, I was so angry and scared for my mother that I balled my tiny fists and punched the doctors legs. I huffed, which got a laugh out of them.

    20 years later and I can see time marked on my parents faces when I skype them. I live in a different country now and while Im fulfilled, I sometimes find myself being unnerved at the idea of them getting sick or even suddenly passing while I am miles away. I get scared shitless if my father just catches a fever or a cough or a cold.

    My worrying strengthened recently when my friends father was laid to rest. It got me fretting more than usual –

    How do we cope with our parents getting older? How do we prepare ourselves emotionally with the fact one day they will die (and probably soon)? How do we come to terms with the looming possibility of losing them?

    I guess theres no simple way to answer these questions. If we think about it, all of us reach the age 70, 80, 90 or even 100 eventually. Right at this moment, we, too, are aging.

    Our parents are growing old and so are we. Death is unavoidable. We cant really solve something as inevitable as aging. I guess all we can do is live our life as best as we know how and cherish our loved ones while they are still here.

    I searched for a solution, specifically a clear-cut method I could follow, yet there was no straightforward answer. It seems bleak, but when that time comes we just have to accept the situation as it is and hopefully remember people are capable of surviving tragedy (even more than we know).

    In case you are still struggling, too, take note of the following:

    – Spend time with your parents, especially if youre often busy.

    – Open up to them about how you feel.

    – Let them know how much you love them, both in actions and words. This can be difficult if you have a strained relationship with your parents or if you/your parents arent much for vocal vulnerability, but try so you know youve said everything you wanted to say to them.

    – Support your parents. Not only when theyre struggling with their health or growing older, but also when theyre celebrating their wins in life, too. You cant control their aging process, but you can care for them and help make it easier for them.

    – Prepare yourselves, literally. What do they want when theyre proper old? Do they want to stay at their house, with you, or at a home for the aged? What are the arrangements when they pass away? When youve planned out the trivial matters, then you will have more time to be with them now as well as space to grieve in the future.

    – Regard grieving as healing. Yes, it is difficult to see your parents slip from you and the loss later will be painful. But in time you will be okay, again, especially if you find and surround yourself with a support group.

    – Dont be ashamed of what you are feeling. Don’t shut out your emotions and remain in denial as itmay only make things harder for you. Hopelessness, fear, anxiety, sadness, anger – whatever youre going through right now is normal so find a way to accept it rather than sneak your way around it.

    – Forgive each other.Is there anything you want to ask forgiveness for? Is there anything your parents did that warrants your forgiveness? Talk it out – not to simply rid yourself of guilt, but to free yourselves from any unresolved issues, and hopefully build a better relationship together.

    RidiculousIncarnate

    Read more: http://thoughtcatalog.com/sade-andria-zabala/2017/06/the-awful-truth-of-our-parents-dying-one-day/

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    Coroner Reveals Details Of Carrie Fisher’s Death

    Actress Carrie Fisher, best known for her role in the original Star Wars trilogy, died from a combination of factors that included sleep apnea, the Los Angeles Coroners Office said in a statement Friday.

    Fisher, 60, had fatty buildup in the walls of her arteries and had taken multiple drugs before her death, the statement said. Officials were unable to conclusively determine the exact cause of her death, according to The Associated Press. The manner of death would be listed as undetermined, the coroners office said.

    The coroners office did not immediately respond to HuffPosts request for further details.

    Sleep apnea is a disorder in which breathing pauses for up to several minutes during sleep, according to the National Institutes of Health. Untreated, it can increase the risk of high blood pressure, heart attack, stroke, obesity and diabetes.Fisher had a history of drug addiction and a heart condition.

    Fisher was stricken by a cardiac medical emergency during a flight from London to Los Angeles in December. The actress was hospitalized after landing and died less than a week later, on Dec. 27. Her mother, the actress Debbie Reynolds,died from a stroke the following day.

    Fisher rose to fame at age 20 after playing the original Princess Leia in the Star Wars film, A New Hope. She kept the role as the series continued in the early 80s. She most recently appeared in the franchise as Gen. Leia Organa in The Force Awakens, released in 2015.

    She was vocal about her history with bipolar disorder and drug addiction, which she detailed in a memoir and one-woman stage show, both titled,Wishful Drinking.

    Todd Fisher, Carrie Fishers brother, confirmed his mothers death to Variety and told the magazine: She wanted to be with Carrie.

    Read more: http://www.huffingtonpost.com/entry/carrie-fisher-cause-of-death_us_59447f56e4b0f15cd5bb82ec

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    The best and worst countries to be a kid

    (CNN)Children growing up in Niger are at the highest risk of having their childhood cut short, according to a report by Save the Children.

    The nongovernmental organization’s report for 2017 ranked the country as the worst place to be a kid, globally.
    Norway and Slovenia share the top position as the best places to grow up. (The top 10 best and worst places are listed below)
      The End of Childhood Report ranked 172 countries from best to worst in an effort to explore the main reasons why childhood comes to an early end in certain places.
      The rankings were determined by measuring the average level of performance across eight topics: under-5 mortality, malnutrition that stunts growth, out-of-school children, child labor, early marriage, adolescent births, displacement by conflict and child homicide.
      The United States, at 36th on the list, was not found to be exempt from the threats that contribute to premature death among children. It is one of seven countries where half of all teen births occur, and its number of infant deaths was 23,455 in 2015: more than those of 40 European countries combined in the same year.
      Richard Bland, Save the Children’s national director of policy, advocacy and development, was most surprised by the country’s low ranking and its position between Bosnia and Russia.
      The US “is falling behind some countries that have had some pretty severe economic turmoil like Greece or Ireland, and yet a number of those nations are prioritizing childhood,” Bland said. “They are investing in childhood and ensuring access to proven programs for childhood.”
      Bland said the three most noticeable global trends this year that may not have been occurring at as high a rate in past years were violence, famine and displacement.
      West and Central Africa, where the 10 worst countries to be a child are located, are particularly affected by famine and displacement, states the report. In Niger, the lowest-ranked country, 43% of children 59 months or younger have stunted growth from malnourishment. The Central African Republic, ranked the fourth worst for children, has 19.3% of its population forcibly displaced by conflict, with evidence of recruitment and use of child soldiers.
      “More people are fleeing war and persecution than ever in history,” Bland said.
      Syria has the highest percentage of a forcibly displaced population on the list, at 65.4%.
      In 2015, 263 million children were out of school, 168 million were involved in child labor, and nearly 28 million were forced to leave their homes globally, according to the report.
      The 10 countries with the highest child homicide rates are in Latin America and the Caribbean, according to the report. This is due to a combination of gang- and drug-related violence, Bland said.
      A positive trend, Bland noted, is that the movement on maternal, newborn and child survival has cut infant mortality by half since 1990.
      But he is concerned by President Donald Trump’s proposed fiscal budget for 2018, which diminishes foreign aid by 31%. This includes humanitarian assistance as well as maternal and newborn child health programs.
      “We’re talking about children dying,” Bland said. “I mean, there is no greater childhood-ender than mortality and infant mortality, and to us, that’s unconscionable to consider cutting programs that have been so successful.”
      The report lacks an exploration into the root causes of why certain countries made the top of the list or why places like Niger were at the bottom, said Lindsay Stark, an associate professor of population and family health at Columbia University’s Mailman School of Public Health.
      But it can be assumed that it has to do with levels of economic development, fertility rates and family planning, strong social supports and the absence or presence of conflict, she said.
      Save the Children admits that the report has limits, Stark said. A crucial limitation is that the data were drawn from household surveys, missing children who are homeless or living in orphanages, she said.

      See the latest news and share your comments with CNN Health on Facebook and Twitter.

      “Given what we know about the risks to children who are not even living in a household, I think that this is very true that these are conservative estimates,” Stark said.
      But Stark approves of how the methodology equally weighed the eight indicators of a childhood’s end in order to determine the global rankings.
      “Some might say ‘if a child dies, that’s the end of childhood in a very different kind of way, and so we’re going to give that more weight in the index,’ ” she said. “But Save the Children actually chose to give equal weight, which I personally quite like, because I think it highlights the severity and importance of other issues, which I think might receive less attention.”

      Best countries to be a kid

      1. Norway, Slovenia (tie)
      3. Finland
      4. Netherlands, Sweden (tie)
      6. Portugal
      7. Ireland
      8. Iceland, Italy (tie)
      10. Belgium, Cyprus, Germany, South Korea (tie)

      Worst countries to be a kid

      1. Niger
      2. Angola
      3. Mali
      4. Central African Republic
      5. Somalia
      6. Chad
      7. South Sudan
      8. Burkina Faso
      9. Sierra Leone, Guinea (tie)

      Read more: http://www.cnn.com/2017/06/15/health/best-worst-places-to-be-a-kid/index.html

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      Four employees fired over day care van death

      (CNN)Four Arkansas day care employees were fired Wednesday after the death of a 5-year-old who was left inside a van all day.

      The staff did not follow company policies and procedures, Ascent Children’s Health Services CEO Dan Sullivan said in a statement. Had they followed protocol “this tragedy would not have occurred,” he said.
      “There are simply no words to express the overwhelming sadness we feel at the death of this child. We are heartbroken and our thoughts and prayers go out to the family. Ascent will continue to fully cooperate with the authorities and state agencies as they investigate this tragic incident,” Sullivan said.
        The West Memphis, Arkansas, location has been closed since the Monday incident.
        The boy’s mother told CNN affiliate WMC the van picked him up around 6:30 a.m. He may have been asleep when the van arrived at the day care early Monday and never got off the van, West Memphis Police said.
        The van remained in the parking lot all day. The day care’s staff found him dead in his booster seat when they came to load children in the van to go home after 3 p.m., police said.
        Police said the temperature in the day care parking lot was 91 degrees Monday afternoon when authorities responded to the incident.
        Officials with the Arkansas Department of Human Services, which regulates day care centers in the state, are investigating, police said.
        Ascent’s CEO said he had spoken with the child’s family to express his “deepest sympathy.” He said he has offered to assist with funeral expenses.

        Read more: http://www.cnn.com/2017/06/14/us/arkansas-child-death-employees-fired/index.html

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        One in 10 in serious debt ‘have no bed’ – BBC News

        Image copyright Getty Images

        One in 10 clients of a debt charity have no bed to sleep in and eight in 10 say their financial situation leads to sleepless nights.

        A review of visitors to Christians Against Poverty also found that three-quarters of them were afraid to open their post.

        The charity said that the survey exposed the day-to-day realities of living with unmanageable debt.

        The average debt of new clients seeking help last year was 14,298.

        Among the practical effects of debt identified by the charity were:

        • A third of clients having gone without at least one essential item, such as a washing machine, causing inconvenience and extra cost by visiting laundrettes and other services
        • A fifth of those asked had rented or bought at least one item on hire purchase
        • A fifth had no internet access

        Some 91% of clients had used some form of credit to pay an essential bill or other debt.

        This money was borrowed primarily from friends and family (64%), and credit cards (64%) followed by overdrafts (55%).

        “This is an unsustainable solution that pushes the financial crunch point further down the line, but escalates the level of debt when this happens,” the charity’s annual review found.

        “Shame, fear and believing no one can help cause clients to delay seeking help for two years on average. This extended period of financial hardship and worry sees living standards and mental health deteriorate as debts spiral out of control.

        “This means seven in 10 end up behind with a priority bill and average debt levels hit more than 14,000 before clients get the help they need.”

        Image copyright Google

        A separate survey of debt by financial services company True Potential suggested that debt tolerance was higher among men.

        The average debt threshold was 1,797, with men reaching debts of 1,960 before recognising it as a problem, compared with 1,645 among women. Adults under 25 reached 748 of debt before worries set in, compared with a figure of 2,299 among 45 to 54-year-olds.

        “Personal debt is the elephant in the room. Consumer confidence and spending have been creeping up but there is growing concern that it is built on quicksand in the shape of rising individual debts. Underpinning this is easy access to debt, the costs of which are poorly understood,” said managing partner David Harrison.

        “But this is not just about people splashing cash they don’t have. A big worry is the proportion of people needing debt just to get by. That’s a bubble waiting to burst. The cost of living is 2.7% higher today compared to a year ago, adding an extra 468 to household bills.”


        ‘The floor was covered in rotting clothes’

        In its report, Christians Against Poverty highlights the story of one of the charity’s clients – Mark.

        “My situation went downhill when my mental state deteriorated. I became anxious and depressed. I lost interest in life,” he says.

        “My studio flat fell into disrepair. It was dusty, dirty, full of broken furniture. The boiler didn’t work. I slept on the floor. The bathroom pipes were broken and the floor was covered in rotting clothes. It was in an appalling state. I couldn’t deal with the wreckage.

        “I approached a number of services for help, but I never quite seemed to fit the category. I wasn’t ill enough for one group, I wasn’t drinking enough for another. So they kept referring me on and I became socially isolated.

        “I had difficulties paying my mortgage, and I was in no position to work to earn the money to pay what I owed. It’s fair to say I didn’t know what my options were. I wondered if I’d be evicted and made homeless, if I’d have to kill myself. I wondered if I’d have to commit a crime so I could go to jail instead.”

        He says that the charity helped him start applying for jobs, to begin sorting out his debts and to put his flat on the market to avoid repossession.


        Bank’s concern

        The City regulator – the Financial Conduct Authority (FCA) – and the Bank of England have warned of an acceleration in consumer borrowing, such as loans, overdrafts, credit card debt and car finance.

        The FCA is already conducting is own inquiry into overdrafts, door-to-door lending and other forms of loans. Consumer groups have consistently argued there should be an overdraft cap in place.

        A Lords committee also recently called for stronger controls such as a cap on “rent to own” products.

        On Tuesday, the Financial Ombudsman Service said it had seen a nine-fold rise in complaints about payday loans in the last two years.

        Read more: http://www.bbc.co.uk/news/business-40259946

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        Trump admin ending program for mothers, children seeking asylum

        Washington (CNN)The Trump administration is shuttering a program designed to keep vulnerable asylum seekers — mainly mothers and young children, including pregnant and nursing women — out of detention.

        The program was piloted by the Obama administration after a 2014 crisis in detention centers brought on by a surge of families and unaccompanied minors trying to cross the border with the US.
        The move is the latest effort under President Donald Trump to prioritize immigration enforcement and deportations over policies he argues incentivized people trying to come to the US illegally. But critics say it will place an undue burden on traumatized families with legitimate asylum claims.
          As of April 19, the Family Case Management Program had 630 families enrolled in it, but it will be phased out by June 20, according to Immigration and Customs Enforcement.
          ICE introduced the program as a pilot in September 2015. According to an Obama administration fact sheet about the program, it specifically prioritized “families with certain vulnerabilities, including pregnant or nursing family member; those with very young children; family members with medical/mental health concerns; families who speak only indigenous languages; and other special needs.”
          The idea was to offer an often traumatized population an alternative to being held in crowded detention centers as they awaited the court process on their asylum claims to finish — a process that can often take years.
          A federal appellate court subsequently ruled that the US government could not hold children in detention at length, and though the ruling didn’t apply to parents, the government opted to release families together rather than separate them.
          Cutting the program will save $12 million a year, said ICE spokeswoman Sarah Rodriguez.
          Other “alternatives to detention” cost the government less and result in a much higher number of ultimate deportations and removals than the family case program, Rodriguez said in a statement.
          The change was first reported by the Associated Press.
          Alternatives to detention include measures like ankle monitors, requiring in-person and telephone check-ins and home visits. It was not suggested by ICE that these families would end up back in detention.
          But advocates for refugees and asylum seekers say that the alternatives can be burdensome and even painful. Archi Pyati, chief of policy and programs for the Tahirih Justice Center, which protects and advocates for immigrant women and girls fleeing violence, said that ankle monitors can cause burns, swelling and other injuries, as well as imposing a social stigma on wearers. Excessive check-in requirements, she added, can impede womens’ abilities to care for their children, and none of the programs help provide counseling or legal assistance.
          “These are women and children we can assume have already experienced untold hardship, violence we can’t even imagine, governments that won’t protect them from rape and trafficking, and they’ve made the arduous journey up to our country and now they are branded with an ankle monitor which makes them seem like criminals, when in fact they are refugees seeking asylum,” Pyati said. “That is not the way they should be treated.”

          Read more: http://www.cnn.com/2017/06/12/politics/trump-admin-ending-women-children-asylum-program/index.html

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          This hackathon wants to help destigmatize the sex tech industry

          In a pitch presentation that capped off hours of collaboration at New York’s first SexTech Hackathon, the subject turned to a decidedly unsexy scenario: Parents talking to their kids about sex.

          “How can we foster a safe environment at home for children having conversations about sexual education with their parents?” asked one of the hackathon’s more than 40 participants during a pitch presentation for what would become the event’s winning project.

          Better communication would emerge as a theme as hopeful entrepreneurs many of them new to sex tech considered how tech can be used to enrich human sexuality.

          Participants get to know one another before breaking into teams.

          Image: sextech.nyc

          For six hours on Jun 10 at New York’s ThoughtWorks, participants with a range of backgrounds from coding to design to sex therapy worked in teams to imagine products that fall under the vast umbrella of sex tech. Though the term often covers forms of adult content VR pornography, for example the event’s website made clear the criteria for hackathon participation : “While we recognize sexuality is a diverse field, we will not be accepting hack teams for anything related to pornography or entertainment.”

          Rather, Saturday’s event was meant to push ideation in the realm of sexual education and pleasure. Following a pitch and feedback session, a panel of sex tech entrepreneurs would select a winner.

          Seven teams, formed just a few hours earlier, pitched their visions to the judges panel. “Spinucation” a connected game that aims to start conversations about sex between parents and children took home the top prize: one month to develop the project at Galvanize, a “learning community for technology.”

          The winning team’s concept features an app-connected toy, modeled after Spin the Bottle, that determines who will answer a question prompt from the app. Questions would come from an AI built into the app that would use news items on sex and sexuality to generate content. Made for children between ages 5 and 18, the game would also allow parents to choose which topics they want to discuss with their children.

          “This is a tech environment, obviously, and we are very critical about technology and how we often end up hiding behind avatars instead of having a more human one-to-one interaction,” said Elena Habre, a designer who worked on the concept. “So we were also thinking how can we leverage AI, but not to hide behind it, but [to] have it facilitate a conversation.”

          The winning team answers questions from the judges panel.

          Image: sextech.nyc

          Other team presentations included concepts for VR that simulates sexual situations for educational purposes, an app or website that would help users understand if they perpetuate rape culture, a subscription box that helps couples in long-term relationships try new things in the bedroom and, the event’s runner-up, an app that facilitates conversations about sex between partners.

          While the event’s goal was to encourage female-led innovation in this space, the hackathon open to all genders featured a near fifty-fifty split between men and women participants. The organizers acknowledged a need for a future hackathon organized entirely for people who identify as women.

          But though the event was open a diverse set of genders, Bryony Cole hackathon mentor and host of the Future of Sex podcast says the goal was to create a safe environment where women can feel comfortable exploring what might be an unfamiliar industry.

          The day started off with a talk from women sex tech entrepreneurs including Mal Harrison, director of the Center for Erotic Intelligence and Kris Jandler, co-founder and CMO of Emojibator. The event also included an ice breaker and discussion session where participants could get to know one another.

          Encouraging women-led innovation in sex tech is critical at a time when it’s such a challenge for female entrepreneurs to secure funding in a still-stigmatized industry.

          Cole belongs to Women of Sex Tech, a New York-city based group of more than 70 entrepreneurs dedicated to increasing the number and diversity of women working in sex tech. Per its Facebook page: “We want to increase access to funding for female-founded startups in sex tech and decrease the stigma of female sexuality.”

          “The interesting thing about that community is they would traditionally be considered competitors,” Cole said. “So we have a group of women that are making sex toys for pleasure, there are people who are doing sex educational apps, and we think these are competitors, but … because the industry is so small and there’s so much stigma, it forced people to band together and go, hey, we need to break through these walls first before we even start to tackle things like how do I sell my vibrator over yours.”

          And while these women work to create better opportunities for themselves and their peers, the aim is also to encourage women-led tech industry’s overlooked areas: education, pleasure and, as we saw Saturday, improved communication.

          “If you were to look right out to the frontiers of what’s happening in sex tech that’s in VR or teledildonics or AR,” said Cole. “[At this hackathon], we want to solve a really simple problem: We want to get more education about sexual health and awareness to children, or we want to improve the intimacy between couples … That’s nothing crazy and out there that’s just simply the cultural moment we’re at right now.”

          Read more: http://mashable.com/2017/06/11/new-york-sex-tech-hackathon/