Thursday, October 12, 2023

New study reviews eight centers that are working to improve rural postpartum care through innovation and collaboration

A new case study highlights eight community-focused postpartum care centers working to address the unique challenges of postpartum health for rural women. The review from the University of Minnesota looked at programs serving rural communities in Colorado, Maine, Minnesota, Montana, Oregon, South Carolina and Washington.

The goal of each center is to reduce maternal mortality rates, which are disproportionally high in rural areas. Each organization reviewed provides support to rural women and their families through access to obstetric care, mental health services, logistical support and social services during pregnancy and after childbirth.

Researchers cite one of their key findings: "Despite challenges related to transportation, stigma, isolation, and affordability, the organizations profiled here innovate, including in their program offerings and finance models, and collaborate with local and national partners to provide a variety of critical resources to postpartum families in their rural communities. . . . Each organization expressed the importance of stable, secure funding for their work."

In the study, each center is reviewed for rural community context. The Postpartum Resource Group in Whitefish, Montana, is an example. The area "is a mountainous community located near Glacier National Park in northwest Montana. The town is one of only three in the [Flathead] county, which occupies 5,098 square miles and is home to about 108,000 people. . . . ."

Each center in the study is reviewed by discussing its services. In Whitefish, researchers spoke with Brooke Jaszczak, the Network Director of Postpartum Resource Group who gave a program overview: "The Postpartum Resource Group is a non-hospital-affiliated, community-based postpartum mental health support group that was founded in 2016 by a midwife who created a support group with her patients. She recognized the need for such support based on both professional and personal experience, as she was also experiencing postpartum mental health challenges at the time."

The researchers write, "Their mission is two-fold: to provide support, education, and resources for mothers and their families who are experiencing postpartum mood disorders, and to educate and inform the community and providers about postpartum mood disorders."

A discussion of each center's challenges is also shared. "In the Flathead Valley, many local residents struggle to afford basics like housing, food, childcare, and health care due to rising costs. Located near Glacier National Park, the region experienced a population increase during the Covid-19 pandemic, as people moved there to work remotely. The service industry workers were priced out of housing and health care, and a rationing of care and preventive services resulted due to their limited resources. Furthermore, the population is very spread out. Between winter weather and poor driving conditions through the mountain passes, it can be difficult to access areas of the community, its resources, and clinicians."

Researchers hope their analysis will inform and encourage other communities looking to bridge the gaps in rural postpartum health. 



Farmers are adapting to extreme weather; it takes time and planning

The Larsen farm has been in the family for seven generations.
(Photo by Martin Larsen via Successful Farming)
Extreme winds, pummeling rain, popcorn-sized hail and drought. Farmers have to work out a way in all those conditions to grow food and make a profit. Extreme weather brought on by climate change has added another twist, which has forced farmers to adapt. "If they don't, they may lose their land — and their livelihoods — forever," report Chelsea Dinterman and Alex Gray of Successful Farming.

Justin Gilsan, Iowa's state climatologist, told Successful Farming that the potential for run-off events caused by heavy rains has more than tripled. Minnesota farmer Martin Larsen from Byron, Minnesota, told Dinterman and Gray, "The continued loss of fertile soil from farmland will decrease its future productivity, and unfortunately make the land less able to soak up the increasing amounts of heavy rains." 

"The difference between climate and weather is simple: Weather is the highly variable day-to-day environment involving temperature, precipitation, and wind speed. Climate is the average of those weather patterns, commonly broken into 30-year periods for study," Successful Farming reports. Gilsan said: "That 30-year average is what we call climatology, and it is important because it gives us a baseline to rank events.."

Those trends point to climate change, no matter the politics. "Increased greenhouse gases in the atmosphere raise temperatures," Dinterman and Gray write. "Rising atmospheric temperatures allow the atmosphere to hold more water vapor. In turn, more water vapor needs to build for a rainfall event, making those events more intense and increasing the length of time between them."

For farmers like Martin Larsen, diversifying crops and changing tilling practices has helped him combat continuing bouts of drought followed by torrential rains. "Adding drought-resistant small grains to his operation has helped diversify that risk, allowing him to maintain profitability through unpredictable extreme weather. . . . Larsen adopted no-till practices over the course of three years, starting in 2013, to reduce the amount of soil shifted in rain events. Now, small grains and legume cover crops provide a strong root system to protect the soil."

Working together, area farmers can share solutions and support one another with a goal of protecting the land and their livelihoods. Successful Farming reports, "Larsen is part of a network of about 75 local farmers, representing roughly 25,000 to 30,000 total acres in the Byron area, who share knowledge about no-till, cover crops, diversifying crops, nitrate, water quality, and carbon sequestration with the goal of building farm resiliency."

Planning a trip to view fall leaves is all about timing, but predicting peak leaf color is getting harder

Plenty of rainfall can lead to brighter fall colors.
(Photo by Landon Speers, The Wall Street Journal)
Taking a trip to explore fall's vast array of leaf colors is a seasonal ritual for many people. With warmer temperatures occurring, finding the days when nature's dramatic shift is at its zenith has gotten trickier. "Millions of tourists travel to U.S. parks and parkways each year to glimpse the bright colors of autumn — but ecologists say the familiar reds, oranges and yellows of fall foliage are coming later in the season because of rising temperatures," reports Aylin Woodward of the Wall Street Journal. "Leaf senescence — the process that involves a tree's leaves changing color before eventually dropping off — has been pushed back about a week on average since the 1950s in New England, according to Colby College ecologist Amanda Gallinat."

When leaves turn and their colors' vibrancy "depends in part on the geographic area, the species in question and precipitation," Woodward explains. "Climate change can disrupt autumnal signals. Warmer fall nights can retard the cooling cue, delaying color changes. Ecologists say that extreme conditions associated with higher temperatures, such as drought or dry soil, stress tree health and trigger earlier, and duller, color change and leaf drop."

"Predicting how long fall colors will last is almost harder to predict than when the leaves will start to change color, said Mukund Rao, an eco-climatologist affiliated with Columbia University's Lamont-Doherty Earth Observatory and the Center for Ecological Research and Forestry Applications in Barcelona, Spain," Woodward reports. "Peak color used to last for about two weeks, according to Rao. For certain species, that period might become more condensed as higher temperatures persist later into the fall because the rate at which days get shorter throughout the season remains the same."

As climate change shifts periods of drought and rain, leaf-lookers could eventually have a hard time finding the magic window of glorious fall colors, which could cause a downturn in the "booming tourism industry surrounding leaf peeping, according to Sarah Blount, program director for research and evaluation at the National Environmental Education Foundation, a U.S.-based nonprofit focused on environmental education and conservation, who underscored how critical it is to try to improve peak timing predictions." Blount told Woodard: There's so much money attached to it. People want to buy a plane ticket to go somewhere and not have it turn out that it's too late and all the leaves are gone or it's too early, so there is a lot of focus on trying to improve the information we have about that."

Opinion: Take a moment on National Farmers Day to consider the many ways in which farmers help the country

Farm and ranch families comprise less than 2% of
the U.S. population. (Photo by Jed Owen, Unsplash)
Today is National Farmers Day, and Brent Murphree encourages all Americans to take a few moments and think about "just how much sits on the shoulders of our nation's farmers," in his commentary for Farm Progress.

"We also know that the world outside of the ag industry has a worrisome detachment regarding where their food comes from -- they either don't care, have no idea how much goes into getting their food to the table or are poorly informed about the effort to produce that food.

The producers that provide a safe, sustainable and secure food supply, not only produce the food and fiber for us all, but they also provide jobs and stimulate communities.

"In the last few weeks, I've seen some of those producers speaking at the United Nations and addressing Congress. They are exchanging ideas about plant genetics, financial viability and artificial general intelligence.

"Congress is developing the next Farm Bill, and the industry is abuzz as everyone involved is looking to have input. Farmers face the daunting task of sharing how important it is to have a workable bill to a crowd that is often stricken with their own agenda and posturing.

"Sen. Charles Grassley (R-IA) has submitted his perennial proposal to limit how much farmers can receive from the government. House Agriculture Committee Ranking Member David Scott (D-GA) has called out the Republicans' budget resolution for shortchanging the farm bill, focusing on tax cuts for the rich, and undermining the bipartisan work that is done in the House Agriculture Committee.

"While on the Republican side, far-right members of that party threaten to derail the bill because of concessions made with Democrats and the Biden administration. . . . If that's not enough, the EPA is rewriting rules for the use of crop protection tools and the use of American waterways. Increasing land values are putting farm ownership out of the hands of small and entry-level farmers, and interest rates have climbed in the last several years. Equipment costs have risen, and environmental initiatives have added yet another level of burden upon the farmer.

"And yet, as formidable as it all seems, farmers are some of the most optimistic people I know -- always looking to the future, the next crop, their best yield.

"Harvest time brings out communities for festivals, barbecues, and well, bringing in the crop. . . . I am proud to be part of this ag community and its innovation, spirit and hard work. . . . Thank you to the farmers who cover a spectrum of needs for us.

"Happy National Farmers Day."

Quick hits: Learning about guns the rural way; making 'pain-free' horseradish; inspiration from a farm girl; rugged art

Horseradish can have a mighty kick! "Making it from fresh roots is easy and rewarding, but the oil released during processing can be an assault on the senses if you're not careful," writes Eric Hurlock of Lancaster Farming. "Follow this quick guide to reap the pleasure of homemade horseradish. . . without melting your face."

Drawing by Navied Mahdavian, L.A. Times
When an urbanite cartoonist and writer moves to very rural Idaho, lessons about a different way of living and thinking abound in this Op-Comic, "What I learned about guns when I moved to rural America," by Navied Mahdavian of the Los Angeles Times. "Ironically, many people here expressed fear of cities because of perceived gun violence. . . . They view it as a city problem."

In rural Norway, the wool trade has thrived for centuries. "Viking life must have been like this — frigid, wild days in an open boat, constantly watching the waves and clouds to avoid disaster," writes Claire Eamer for Hakai magazine. "Wool was as much a part of that life as the sea and the ships. The Vikings were great sailors and fearsome warriors but couldn't have left port without wool. It provided the raw material for their clothes, their blankets, even the sails that harnessed the wind for their ships."

In the age of Amazon, it's good to see that some golden brick-and-mortar stores, such as Ranch-Land Western Store in the Sandhills of Nebraska, have managed to thrive, reports Natalia Alamdari of Flatwater Free Press. "Three generations of the McBride family have outfitted customers from Nebraska and beyond with boots and hats. . . . The store is filled to the brim with history and memories. It has survived a fire that threatened its existence, booms and busts in the cattle market, the economic strain of a global pandemic."
Brynn loves taking care of 'her' cows.
(Photo via DH)


"Sometimes the biggest inspiration comes in the smallest packages. This certainly holds true for Brynn Grewe from Cumberland, Wis. The pint-size dairy farm girl is not only well-known in the industry but also serves as a true inspiration, as she embodies strength, grit and perseverance," reports Karen Bohnert of Dairy Herd Management. When Brynn was 18 months old, she contracted an infection that went septic, and she eventually had to have amputations. But she has not lost her spunk. "Brynn is a true farm girl—she helps lead heifers, feed hay, and wash cattle as they prepare for shows. She has even called dibs on which heifers she wants to show in the future."


"Man With a Hoe" (1860-62) by Jean-Fran├žois Millet
(The J. Paul Getty Museum photo via WSJ)
Rural life can be diverse, beautiful and brutal. Jean-Fran├žois Millet's monumental "Man With a Hoe" (1860-62) "has enjoyed popular acclaim as an empathetic image of hardscrabble labor in a rugged, agrarian landscape," reports Mary Tompkins Lewis of The Wall Street Journal. Lewis offers inquiry and thoughts on the work and the artist who grew up in a small town. "Millet's painting of a beleaguered farmworker shocked viewers when it was first shown in 1863 Paris, but it has proved to be an enduring image of relentless toil."


Wednesday, October 11, 2023

The land holds more than food; it contains medical breakthroughs and new medicines

"The soil is the great connector of our lives, the source and destination of all." --- Wendell Berry, The Unsettling of America, 1977

The Scoop chart
The land Berry is talking about does more than bind us together, it contains gifts that stretch beyond food. Seventy-five years ago, in Sanborn Field soil plot #23 in Columbia, Missouri, the soil yielded an incredible medical breakthrough, reports Tyne Morgan of The Scoop. Before this discovery, physicians used penicillin alongside other antibiotics with mixed results. In the 1940s, scientists pushed to find more effective and non-toxic microorganisms for people or animals.

Dr. Tim Reinbott, the director of Sanborn Field at the University of Missouri, told Morgan: "Seventy-five years ago, we had known about penicillin and other types of antibiotics, but they were only about 40% effective. . . . [Scientists]were looking for that golden antibiotic, that one that would really be very effective and be taken orally, not by injection. . . . Benjamin Duggar was working for Lederle Laboratories at the time, and he knew the director of Sanborn Field, who was William J. Albrecht, who was the soil microbiologist. Duggar asked him for some soil samples from Sanborn Field so that he could begin to culture for these microorganisms."

Duggar's soil samples "contained a golden mold that suppressed the growth of many microorganisms, including streptococci, a bacteria that causes various types of infections," Morgan writes. "From the sample, researchers eventually created aureomycin, which proved to be an antibiotic effective against 90% of bacteria-caused infections in humans." Bob Kremer, adjunct professor of soil microbiology at the University of Missouri, told Morgan, "One of the interesting facts that is often overlooked is that in any soil, you will find antibiotics, because it's just the nature of how these bacteria survive in nature."

The Food and Drug Administration approved aureomycin for human illness in 1948, and "Reinbott says for the first 30 to 40 years after the discovery of aureomycin, it was the go-to antibiotic for human medicine, but it also grew in popularity within animal medicine," Morgan reports. 

"To celebrate the discovery of aureomycin, a soil sample from Plot 23 was sent to the Smithsonian Institution, where it still resides today," Morgan writes. "The discovery at Sanborn Field wasn't just a breakthrough for human medical science, it was also a breakthrough for livestock. . . . aureomycin is still widely used in cattle today. Such an antibiotic discovery is estimated to cost $1.5 billion in 2023."

Standing at Sanborn Field, Reinbott told Morgan: "We've more aureomycin discoveries out here -- we've just got to look for them. It may or may not be an antibiotic, but it can be something just as groundbreaking, and that's what gets me excited."


From 4-H to outer space -- this farm girl has logged more days in space than any woman in history

Whitson credits 4-H for helping her build confidence.
(NASA photo via Successful Farming)
From 4-H to outer space, female superpower Peggy Whitson is doing it all. "Before Dr. Peggy Whitson became America's most experienced astronaut — accumulating 675 days in space between her three NASA long-duration space flights and the Axiom Mission 2 — she was a farm girl in southwest Iowa and a member of the Beaconsfield Bomberettes 4-H Club, reports Lisa Foust Prater for Successful Farming. "During her 4-H days, Whitson was involved in projects including home furnishings, sewing, and baking and was selected to present two speeches at the Iowa State Fair. Whitson told Prater, "One was on how you dry flowers, and the other was on how to make dinner rolls all different kinds of ways. I remember the title of that one was called, 'Riot of Rolls.'"

Whitson credits her 4-H experiences with giving her courage and confidence. Prater reports, "Whitson says she wants to encourage today's students to follow their dreams. 'I grew up on a farm, and I had a dream of doing something that I didn't have any idea how to do, how to go about, how to accomplish. . . . I didn't become an astronaut just because I wanted to do it. It took ten years of applying and rejections and hard work, and I learned a lot along the way. . . . It's really important that you know your path isn't always a straight line to your goal, and that you have to work to achieve that goal. . . . That also means you might have to fail now and then because you'll push your limits."

Whitson now works for Axiom Space
(Photo via Successful Farming)
"She also says it's OK if kids don't know exactly what they want to do," Prater writes. Whitson told her, "I think it's important to expose yourself to as many different avenues out there as possible, because you might not know what your dream is. . . . It's important to look out there and see what's going on." Prater adds, "Whitson currently serves as an astronaut and the director of human space flight for Axiom Space, where in May 2023 she became the first female commander of a private space mission."

Aging populations and too few skilled workers has 42 states offering 'stay and we'll help you pay' student loan options

Mandy Dwinell opted to stay in Vermont.
(Photo by Oliver Parini, Hechinger)

States with aging populations are enticing skilled workers to stay in their state by paying down their student loans. "At least 42 states have enacted student loan repayment or forgiveness programs since 2018, according to the National Conference of State Legislatures," reports Jon Marcus for The Hechinger Report, which covers education. "Almost all of them are for professionals in specific areas of shortages — mostly teaching and healthcare — or who agree to work in underserved areas.

Jamie Kohn, senior research director for the human resources practice of the Gartner consulting firm, told Marcus: "Generally, there is a massive shortage of talent, particularly in certain skilled talent areas. Student loan repayment may be a way for states to mitigate some of the loss of wage growth that people are feeling, so they not only stay, but can afford to start families and buy houses."

Using student loan repayment options gives states latitude in targeting the types of skilled workers they need. For instance, in Utah, "Doctors, dentists and pharmacists who work for at least three years in underserved areas can get up to $75,000 of their student loans paid off," Marcus reports. "South Carolina will pay off up to $5,000 per year of student loans for teachers. Illinois will help repay the student loan debt of school social workers."

Maine and Vermont are states with some of the nation's oldest populations. Vermont has had a series of private colleges close that were once reliable conduits bringing in "young people there who put down roots and stayed," Marcus explains. "That leaves a smaller population of graduates, a decline that's beginning to happen nationwide and that can result in labor shortages, slower economic growth and declines in state tax revenues. Unemployment in Vermont is just 1.8 percent, third lowest in the country after New Hampshire and Maryland. Maine has projected a need for 75,000 more workers in the 10 years ending 2029."

"Two years didn't seem too much to ask from recent grad Mandy Dwinell, either — especially in exchange for help repaying the $20,000 student loan debt she racked up in a college career interrupted by family obligations. She now works for the Vermont Association of Snow Travelers. She told Marcus: "When I was in high school, I'm, like, as soon as I graduate, I'm out of here, I'm not looking back. . . . [But now] I absolutely love it here!"

Opinion: We could end poverty. 'Why don't we do it?'

Census Bureau graph
In 2021, U.S. poverty hit the resounding record low of 7.8% -- a good thing, but only a reprieve. Once pandemic benefits ended and inflation shot upward, the number of Americans living in poverty soared, with the Supplemental Poverty Measure posting a near 60% increase, with 11.4% of U.S. citizens living in poverty in 2022. "And it's all because politicians allowed proven income support programs to expire," writes Lakeisha McVey in her opinion for OtherWords.com.

"I'm an expert on poverty. I've lived it most of my life in Iowa. I studied it as a Bill Emerson National Hunger Fellow in rural West Virginia and in Washington, D.C., and now I help people experiencing poverty across the country tell their own stories to change policy.

"People can pull themselves up by their bootstraps, get an education, and work multiple jobs. But in the face of rising prices, low wages, high rents, and a broken healthcare system, it's often not enough. Without a safety net and a level playing field for families, financial security is often out of reach.

"When I was growing up in Des Moines, my mom had a stable job with the state, but her pay wasn't enough for a real home for my two siblings and me. Iowa, like every state, has a low-income housing crisis. And families of color like mine experience greater challenges obtaining affordable housing. We bounced around shelters, churches and motel rooms.

"Despite a stigma about accepting public assistance, we benefited from SNAP (aka 'food stamps') and the Women, Infants and Children program. But like other low-income families, we had to navigate the 'benefits cliff.' When my mother made just $10 more, we'd lose the benefits we needed for sufficient, regular meals.

"My father suffered from opioid addiction. When he was eventually able to get stable employment and rejoin our family, we finally got an apartment where the schools were decent. But a brain aneurysm suddenly took his life, and we ended up back on the opposite side of the city where the underfunded schools offered less opportunity.

"I wanted to stay in my school, so I spent four hours a day commuting on public buses and on foot. I knew I needed to get into college to be able to help my family financially. Now I have a steady job, and so does my husband.

"But everyday struggles don't end. The brokenness of our healthcare system burst into my life again when our baby was born with a fatal condition. The medical costs ran nearly $1 million in just the first few months of his tragically short life. . . . What could prepare someone for that?

"Thankfully, my employer pays 100% of my health insurance. That's a rarity. If I'd been out of work or worked elsewhere, we would've gone bankrupt as we suffered the most tragic thing that could ever happen to us as parents.

"These are just a few of the structural obstacles low-income people face every day. But there are solutions. The advocates I work with reported enormous relief after politicians finally agreed to invest in helping children and families during the Covid-19 crisis.

"The expanded Child Tax Credit cut child poverty nearly in half. Expanded food programs through SNAP lifted more than 3 million people out of poverty and staved off an expected spike in hunger. Housing subsidies kept nearly 2.5 million people out of poverty and in their homes. And Medicaid enrollment protections reduced the number of uninsured people by 1.5 million.

"The year those programs were implemented, the Supplemental Poverty Measure fell to 7.8% — its lowest ever level. But when politicians rejected continuing this vital help for families, it increased by a record amount. This is a failure for families across the country. We need to renew and expand those programs as soon as possible. . . . Poverty is solvable. We know what works. Why don't we do it?"

Lakeisha McVey is a bereaved mother, social justice advocate and leader of the Experts on Poverty Program at RESULTS.

Final resting choices include green burials, water cremation and human composting -- in addition to traditional options

The Forest Conservation Burial Ground in Ashland, Oregon, is a
green burial site. (Green Burial Council photo via Herald-Leader)
Ash and casket burials aren't the only final resting choices. Depending on state laws, water cremation, green burials and even human composting are options, reports Bill Estep of the Lexington Herald-Leader.

Nationally, cremation has become more popular. The process "uses flame and heat to reduce a body to ash and bone fragments. The brittle bone fragments are then put in a machine to pulverize them into pieces, usually no bigger than an eighth of an inch," Estep writes. "The deceased person is placed in the cremator in a flammable container such as wood, wicker or rigid cardboard. The process of cremation typically takes two to two and a half hours. The average weight of the remains of a cremated adult is four to six pounds."

Other alternatives include green burials where the deceased is put "into the ground in a shroud or other biodegradable container — or no container — without being embalmed. Supporters see green burial as better for the environment," Estep reports. "Another method of disposition is called alkaline hydrolysis, or water cremation. As the name indicates, the deceased person is placed in a watertight container with water and alkaline chemicals that are heated. The process breaks down the body into a sterile solution that can be put down a drain, and the bones are pulverized as in flame cremation."

Natural organic reduction, or human composting, is legal in a few states. Estep explains, "In that process, a person’s body is put in a container with materials such as hay, straw and wood ships that help turn the body into soil, according to a document explaining the law in Oregon. The process takes about about four to six weeks, with additional time needed to dry the soil."

And finally, is it legal to be buried in your own backyard? It depends. Sidney Fogle, executive director of the Funeral Directors Association of Kentucky, told Estep, “People bury on private property all the time." Estep reports, ". . . there may be city or county ordinances that prevent it, but in the absence of those prohibitions, it is legal for people to be buried on their own property, Fogle said. . . . It would be best for a funeral home to handle the burial, however. One reason is that the state and other agencies, such as the Social Security Administration, are supposed to be notified of deaths, and funeral homes know how to complete that process."

Tuesday, October 10, 2023

Shortage of rural attorneys leaves judges and citizens to wade through proceedings together

Judge Lori Bolton Fleming, top, helps some citizens complete
legal paperwork. (Photo by Dominick Williams, WSJ)
With a dwindling number of rural attorneys, many judges have lawyerless courtrooms and need to help some citizens navigate the civil court proceedings and paperwork, reports Shannon Najmabadi of The Wall Street Journal. Kansas is among the states facing a shortage. "Eighteen of the 105 counties in Kansas have two active attorneys or fewer, according to recent data from a Kansas Supreme Court committee addressing rural lawyer shortages. Two of those counties have no active attorneys. . . . Organizations such as Kansas Legal Services receive federal funding to represent low-income people in civil matters but say they are overstretched."

In civil matters, people can opt to self-represent, but only some citizens can navigate complex legal processes and paperwork, which leads to delays and judges spending time they don't have to assist. "Some litigants reference documents they have, such as pay stubs, but fail to admit them as evidence. Others leave out key facts," Najmabadi writes. "Recent studies estimate that in civil and family law cases, more than 70% that go to court have at least one party self-represented, according to the Institute for the Advancement of the American Legal System."

Not all civil cases require attorney know-how; many districts have online forms and instructions. Kansas courts have set up self-help centers and made legal records accessible online. Bolton Fleming, who is chief judge of Kansas's 11th Judicial District, "has begun helping pro-se litigants fill out divorce decrees in court in the last five years, even though they are supposed to bring completed copies to hearings," Najmabadi reports. "Others want to encourage lawyers to move to less-served areas by reducing higher education costs so law-school graduates don't feel pressure to take high-paying corporate positions. Courts have also experimented with allowing non-lawyers to practice, similar to how some areas let physician assistants and nurses provide medical care typically provided by doctors."

Forty years ago, there were enough "attorneys to take on cases, said Glenn Braun, chief judge of Kansas' largely rural 23rd Judicial District, but the lack of attorneys in rural areas has long been a problem without a realistic solution," Najmabadi writes, "The Kansas Supreme Court recently convened a committee focused on finding ways to address a rural attorney shortage."

Vermont utility has a faster, cheaper way to protect consumers against outages during extreme weather

Green Mountain Power proposed installing batteries like this
Tesla battery. (Photo by Caleb Kenna, The New York Times)
In the ongoing balancing act between electrical grids and extreme weather preparation, Vermont's Green Mountain Power is asking state regulators to "let it buy batteries it will install at customers' homes, saying doing so will be cheaper than putting up more power lines," reports Ivan Penn of The New York Times. "The plan is a big departure from how U.S. utilities normally do business. Most make money by building and operating power lines that deliver electricity from natural gas power plants or wind and solar farms to homes and businesses. Green Mountain — a relatively small utility serving 270,000 homes and businesses — would still use that infrastructure but build less by investing in television-size batteries that homeowners usually buy on their own."

This past year, severe storms, flooding and power outages have pushed Green Mountain to change its business model in favor of a cheaper, quicker solution. "As the company ran the numbers, it realized that paying recovery costs and building more power lines to improve its system would cost a lot more and take a lot longer than equipping homes with batteries," Penn writes. "Green Mountain's plan builds on a program it has run since 2015 to lease Tesla home batteries to customers. Its filing asks the Vermont Public Utility Commission to authorize it to initially spend $280 million to strengthen its grid and buy batteries, which will come from various manufacturers."

Green Mountain's chief executive, Mari McClure, told Penn, "We don't want the power to be off for our customers ever. People's lives are on the line. That is ultimately at the heart of why we're doing what we're trying to do." The company will still control the batteries "allowing it to program them to soak up energy when wind turbines and solar panels were producing a lot of it. Then, when demand peaked on a hot summer day, say, the batteries could release electricity."

Part of the problem with big energy projects is how long they take to complete. Penn reports, "Green Mountain's proposal seems to recognize that reality, said Leah Stokes, an associate professor of environmental politics at the University of California. Stokes told Penn: "It really is the model, especially if you're worried about power outages. It really could become the example for the rest of the country."

Have you ever wanted to know more about your family's history? This book helps generations connect with questions

TarcherPerigee image via The Atlantic
How much do you know about your mom or dad's life before they became a parent? Many of us know precious little, and when it comes to grandparents, aunts and uncles, we know even less. Anthropologist and professor Elizabeth Keating takes us on the journey of how her book, The Essential Questions: Interview Your Family to Uncover Stories and Bridge Generations, came to be in her story for The Atlantic.

In her work, Keating explored how family tales passed through generations, but as she researched the topic, a surprising pattern emerged. Keating writes, "I have been astonished to find that so many people know little of the lives of their parents and grandparents, despite the fact that they lived through some pretty interesting decades. Even my students, some of whom majored in history and excelled at it, were largely in the dark about their own family history."

As it turns out, many of us spent holidays, birthdays and family celebrations with loved ones we barely knew. "The reason many people don't know very much about their grandparents or even their parents is surprisingly simple: They've never thought to ask and didn't have the right questions," Keating explains. "When I saw how much I was learning as I interviewed families, I decided to ask my students at the University of Texas to do the same, tasking them with interviewing one of their grandparents using my questions."

As many a journalist can testify, interviews can go in surprising directions. Keating writes, "In one interview, a grandmother shared that when she was a girl during the Nazi era, one of her classmates suddenly disappeared, and none of the adults around her would talk about it. . . . . Another student's grandma talked about having to wait at the back of a restaurant to have her food handed through a window, because she was Cajun and couldn't go inside."

Keating's guide uses questions spanning 13 topics. "They include basic background information, such as where someone was born, as well as more abstract inquiries, such as how someone conceives of their identity, what they believe in, and what they've noticed about the passage of time," Keating notes. "Specificity is key. . . . And remember that the most important questions can also be the plainest. One of my favorites is just 'What do you wish people knew about you?'"

As people learn about their family members, they are keeping memories alive for the next generation. "Just as precious oral literatures and histories of whole communities are being lost the world over through rapid change, migration, language death, and a failure to ask, there is a risk that your family’s personal stories, too, will be lost forever," Keating writes. "Your parents and grandparents have unique snapshots and memories of the world they knew, and in learning about them, you can not only preserve the past but also create lasting meaning and connection. In families and communities, there are secrets to be discovered."

Two companies aim to reduce emissions: One splits molecules and the other heads into the wind

Prototype of Electric Hydrogen’s humble electrolyzer, a.k.a. the
'unicorn' (Photo by Cassandra Klos, The Wall Street Journal)
One company is diving all-in to lessen greenhouse emissions with science-savvy and financial moxie. Another company, with a similar goal, revived an ancient transportation practice to change sea frieght pollution. What do they have in common? Both companies use water as a solution.

"Hundreds of companies have promised to produce large amounts of green hydrogen, but none have succeeded. Electric Hydrogen believes the secret to success is finding a better way to split a molecule, reports Amrith Ramkumar of The Wall Street Journal. "Investors believe it too. The company is the green hydrogen industry's first unicorn. It recently raised $380 million from backers including BP, United Airlines, Microsoft and iron-ore producer Fortescue Metals. That pushed it over the magical $1 billion mark."

The secret to splitting a water molecule with less greenhouse emissions is a better electrolyzer, Ramkumar writes. However, previous electrolyzers used too much energy and were costly. "Electric Hydrogen's secret sauce is new materials and designs," Ramkumar reports. "The company's engineers made all of the critical electrolyzer components in-house, following Tesla's model. By boosting performance, they drove down costs. . . . Electric Hydrogen plans to sell cheaper electrolyzers to hydrogen producers just like solar panel manufacturers sell panels to clean-energy developers."

The company will open its first electrolyzer factory in 2024, but the technology's "success or failure won't be known for years," Ramkumar reports. "As it ramps up supply and customers install the machines, get permits and connect the electrolyzers to green power. Gregory Constantine, chief executive of startup Air Company, which hopes to use hydrogen to make clean jet fuel, told him: "It's kind of like Netflix waiting for high-speed broadband and internet to get there. . . . When it does, it unlocks all of these other areas."

Photo by David Hurn via The Atlantic
Meanwhile, transportation is a polluter that needs better options. It's "responsible for nearly one-fifth of all the carbon emissions in the food system, and between 75% and 80% of all goods are transported via sea freight, which typically relies on container ships powered by dirty bunker fuel," reports Whitney Bauck of Ambrook Research. "Despite international agreements forged this summer to slash global shipping emissions by at least 20% by 2030, the past 10 years have shown 'no progress in terms of actual emission reductions' from the industry. . . . What's the solution? Bring back sailboats."

Sailing per-ton cost is far more than trade with traditional container ships; however, it is being successfully used for smaller, high-end niche sea trade. That still leaves huge commodity sea freight and all its polluting emissions, but the industry is working on other solutions. "Agricultural giant Cargill announced a collaboration with BAR Technologies, Mitsubishi Corporation, and Yara Marine Technologies to pilot WindWings, another form of wing sails that can be added to existing fuel-based cargo ships," Bauck writes. Jan Dieleman, president of Cargill ocean transport, told Bauck: "A retrofit solution that is capable of decarbonizing existing vessels through wind technology is a great place to start, given that 55% of the world's bulker fleet are up to nine years in age and most remain in service for decades. That's not just good for the planet — it's also good for the bottom line."

Some aquifers are drying up; a scientist explains how understanding groundwater changes could help

James Dennedy-Frank is a hydrologist
researching groundwater recharge.
Can we solve America's groundwater crisis? That depends on a lot of things, but scientists like James Dennedy-Frank, an assistant professor of marine and environmental sciences and civil and environmental engineering at Northeastern University in Boston, are working on understanding the multi-faceted issue and finding solutions. In this condensed version of his Q & A with Tanner Stening of Northeastern Global News, Dennedy-Frank explains some of the groundwater crisis highlighted by the recent The New York Times' investigation and details how his research can help.

What is going on with our groundwater, and what prompted the Times investigation?

"The problem is we know that reliable water resources are a critical need, and we’re seeing a lot of places where water resources are becoming less reliable. The Times put together a whole new database of declining water levels nationwide. As we are experiencing more severe drought in lots of places. . . . We’re seeing groundwater levels drop everywhere.

"And that has all kinds of effects. It has effects on the availability of water. A lot of rivers and streams are supported by groundwater, especially through dry seasons. So those rivers and streams are getting lower and flowing less. . . . As a result, [they're] getting warmer because you have less of that cold groundwater flowing in. . . . There’s a whole set of effects here — and this isn’t only happening in the 'arid' West, where you tend to hear about it. . . . I’ll say one thing about groundwater, which is that where there are permits, they’re not usually well enforced, and in many places there aren’t even things like permits, so there are very loose regulations."

How can your research help find solutions?
"I am a hydrologist, and I primarily do watershed simulations. I use computers to represent these watersheds, with the goal of trying to better understand how we can more sustainably manage them.
Most recently, a lot of the work we’ve been doing looks at how groundwater is being recharged, and how rain and snow are related to the streamflow and evapotranspiration — so the water coming through the rivers, and the water being used by vegetation.

"We found that what most recharged the groundwater [water added to the aquifer through the unsaturated zone after infiltration and percolation following any storm rainfall event] in our model of this California watershed is actually the snow from less severe storms. So these really big severe storms recharge that groundwater a lot less. That has important implications as the climate shifts. . ."

Where do you think we’ll be in a decade’s time on this problem?

"Moving forward, our abilities to simulate and better understand these systems are improving, and I think the hope is that people in management roles and government are using these tools and working with academics to better plan and manage the water resources for those hard-hit areas, and thus push towards a more sustainable future."

Monday, October 09, 2023

U.S. physician shortages expected to increase dramatically as older doctors retire or quit because of heavy workloads

Lack of doctors will mean a sicker population.
(Photo by J.C. Gellidon, Unsplash)
U.S. physician shortages are expected to increase substantially as aging doctors retire or extreme workloads push them out. "As the aging population's need for care grows, retirement and burnout are both driving swaths of health care workers out of the field, fueling a crisis that shows no signs of stopping,"  reports Alejandra O'Connell-Domenech of The Hill. "The country is expected to suffer a shortage of up to 124,000 physicians in the next 12 years, according to a 2019 report from the Association of American Medical Colleges." American Medical Association President Jesse Ehrenfeld told O'Connell-Domenech: "When people don't have access to routine primary care and preventative services [due to no physician access], they live sicker and die younger. . . . These are things that are only going to get worse as we put more pressure on the physician workforce." In many rural areas, the lack of doctors is already a stark reality.

If there aren't enough physicians, those who are working will have to work longer hours with sicker patients, which leads to burnout and more doctors deciding to retire or leave medicine altogether. "A 2022 study found that nearly 63 percent of physicians experienced symptoms of burnout by the end of 2021, representing a 19 percent increase from 2017," O'Connell-Domenech reports. "Another 2022 study determined that one out of five doctors said they were likely to leave their current practice within two years, citing burnout and workload as two major reasons."

The numbers explain another reason for the shortage. "There are about 55.8 million people aged 65 and older in the United States, according to Census Bureau," O'Connell-Domenech explains. "Their numbers are growing and will continue to do so. . . . Almost half of working physicians in the United States are 55 and older, according to the AMA. Thirty-five percent of the physician workforce will reach retirement age within the next five years."

Possible solutions include lessening student loan debt and increasing the number of physicians allowed to train. "The Resident Physician Shortage Reduction Act of 2023 could help by lifting the cap on residency programs," O'Connell-Domenech adds. "The bill. . . would expand the number of Medicare-supported medical residency positions by 14,000 over seven years. . . . Another piece of legislation that could help stem the shortage is the Conrad State 30 and Physician Access Reauthorization Act, according to Ehrenfeld. Under the bill, international doctors could stay in the U.S. after their residency programs as long as they committed to practicing medicine in parts of the country with physician shortages. . . . Easing medical student debt could also potentially increase the amount of doctors willing to work in underserved areas, Ehrenfeld said."

Opinion: Millions of Americans have stopped going to church, but what they've lost is more than religion

Paul Wesslund
(Photo via USA Today)
As Americans leave church behind, many fail to see it's more than religion they're giving up. "Record numbers of Americans have quit going to church. Studies and personal stories describe people either leaving churches or just drifting away for reasons like being too busy or disagreeing on social issues," writes Paul Wesslund in his opinion for the Courier Journal in Louisville, Kentucky. "The odd thing is that these former churchgoers seem to be searching for some kind of community. . . . And those pulling away from religion don't take into account what a church can offer that addresses what people say they're searching for: Friends, and being part of something larger than themselves.

"I attended the Kentucky United Methodist Annual Conference this year, where disaffiliations were approved for the last wave of the more than 300 churches that left our conference. At the meeting, I sensed the hundreds of remaining delegates going through the classic stages of grief, including depression and acceptance. It's a denomination figuring out how to navigate a new world, working hard at keeping hope alive.

"Much of the current commentary on church attendance refers to the new book, The Great Dechurching, by Jim Davis and Michael Graham. It takes a deep dive into surveys about why so many have stopped going to church. The studies found plenty of reasons, from wanting to sleep in after being kept awake by a new baby to attending brunch with friends. . . . Other widely reported reasons cut even deeper – the widespread child abuse in the Catholic church, the use of the Bible to score political points and the too-frequent requests for money.

"The U.S. Surgeon General issued a report this year on loneliness and isolation, comparing its health effects to smoking 15 cigarettes a day. He created the report, he says, after Americans repeatedly told him they felt invisible and insignificant. That's a condition every church seeks to address, however imperfectly. . . . We overlook defects in other parts of our lives. Who hasn't had a less-than-perfect experience at what is still their favorite restaurant? Or stayed loyal to their team despite a series of boneheaded plays?

"My disagreement with one of the church's policies didn't drive me away – I helped organize a group of church members to hold forums on the [LGBTQ+] issues, to let people know that at next year's United Methodist General Conference, there could be a vote to change those policies. . . . I choose to stay because no person – or institution – is perfect. Because leaving a more diverse group of thinkers and believers for people who are closer to being exactly like me seems sad – and even wrong – because it would just contribute to today's tendency to listen only to ourselves.

"A church's hold on people doesn't come with the drama of watching a sport or offer a dinner menu. It's bigger than that. I can't help but feel that both the church and its former members are wandering around looking for each other. . . . Maybe they'll meet again."

Small town grocer co-ops and technology offer innovative answers for residents living in food deserts

CoBank map, from USDA Economic Research Service
Food Access Research Atlas data
 
 

It's more common for rural U.S. households to experience food insecurity, and while finding reliable access options has proved difficult, new business delivery options are offering solutions to hunger, reports Billy Roberts of CoBank. "Rural communities comprise 63% of all U.S counties but 87% of the counties with the highest food insecurity rates. . . . The Brookings Institution found delivery zones are concentrated in larger metropolitan areas, with only 37% of rural residents having access to any of the analyzed food delivery services."

While convenience and "dollar" stores have increased in rural towns, their ability to supply fresh food is still limited by population density. Additionally, when community revenue is compared between a dollar store and a local grocer, the local grocery store is a far better investment. Roberts reports, "CoBank and Food Co-op Initiative have worked together to expand programs for rural communities that have lost (or are at risk of losing) local grocery options. . . . An example is Marmaton Market in Moran, Kansas. A for-profit corporation operating under cooperative principles proved to be the solution for the town of 500. . . . The store emphasizes local as a means of supporting the economy, building morale and creating a stronger sense of community."

Beyond co-ops, current shipping and technology-based rural food delivery systems offer solutions. "Particularly for shelf-stable food and beverage, delivery mechanisms exist, even if it takes the form of FedEx, UPS or USPS. Fresh food offerings present another challenge altogether, but more direct-to-consumer approaches should, in the long term, be able to capitalize on improvements in technology (whether drone delivery or driverless trucks) to reach those who don't live near a grocery store," Roberts reports. "In collaboration with Gatik, Tyson Foods will deploy AI-assisted autonomous trucks to haul prepared meats over predetermined short-haul routes to distribution and storage facilities in northwest Arkansas."

As online options and technology improve, more delivery possibilities are created. "Whole Foods has made hundreds of its 365 private-label products available for U.S. shipping through Amazon," Roberts adds. "For its part, Walmart and Google subsidiary Wing are teaming up to test 30-minute drone delivery of household essentials and groceries to customers' homes within a six-mile radius of two stores in the Dallas-Fort Worth area. . . . These examples indicate where retailers — whether grocery stores or even convenience stores or dollar stores — could serve rural consumers and offset the issue of food insecurity stemming from limited access."

Rural towns facing meat plant closures struggle to find a new path forward

Noel officials hope that recreation options can fill some
economic losses. (Photo by Harlan Bozeman,WSJ)
Over the next few months, six rural counties will face Tyson chicken plant closures, with residents, small-business owners and county officials facing tough choices," reports Patrick Thomas of The Wall Street Journal. Tyson is one of many companies shrinking its operations. "Meat processors are closing plants across the country in response to what they say is slackening consumer demand and persistently high costs for livestock, feed and wages."

The Tyson plant in Noel, Missouri, pop. 2,220, will close this month. While many employees have already quit and left town, small-business owners like Angel Saldivar are also considering leaving. "Saldivar​ wasn't among the 1,500 Tyson workers affected by the plant's shutdown," Thomas writes. "He and his family run a restaurant across the street, Tony's Burritos, which his grandmother opened in the 1990s as a lunch spot for plant employees. With the plant scheduled to close by mid-October, Saldivar says Tony's probably will, too. . . . Tony's sales have fallen 40% to 50% from August."

Noel is one of several towns facing plant closure fallouts. "Poultry company Perdue Farms said in August it was closing a meat plant in Michigan that employs 130 people, and pork giant Smithfield Foods closed a 1,800-person California facility this year," Thomas explains. "The closures spell economic turbulence for towns such as Noel, where meatpacking plants are major employers, customers of local farmers and truckers, and cornerstones of the tax base."

It can take years for a rural town's economy to rebound from a plant closure, and some do not recover. "In Plainview, Texas, agriculture giant Cargill a decade ago closed a beef plant, the town's largest employer with more than 2,000 workers," Thomas reports. "Charles Starnes, Plainview's mayor, said restaurants and other businesses around the plant laid off staff or closed completely, leading to about 3,000 total jobs lost in Plainview. The city's population has declined by about 2,000 people since the year the plant closed, he said."

In some areas, a plant's closure could open the door for new opportunities. Thomas writes, "For Noel, local officials said that without the plant's noxious smells, the city's location on the Elk River in southwest Missouri could make it a more popular tourist destination and attract outdoor activities such as kayaking. Lance said the site could attract a new hotel or a casino."

Sunday, October 08, 2023

Loyal Jones, interpreter of Appalachian culture, dies at 95

Loyal Jones
Loyal Jones, whose Kentucky pastor called him "the indefatigable and beloved interpreter of Appalachian life and culture," died Saturday morning in Black Mountain, N.C. He was 95.

The author and co-author of several books and dozens of published articles about Appalachian culture, people and humor, Jones wrote about the resiliency of mountain people and their culture and said the region should be judged by its own values—family, land, and traditionalism—rather than mainstream values of accumulation, wealth and power, said Ron Eller, former director of the Appalachian Center at the University of Kentucky.

When he received the top award from the East Kentucky Leadership Foundation in 2017, Jones said, "We have a viable culture here. We have a lot of problems, but we have a lot of people with great values."

Jones, a native of western North Carolina, held degrees from the University of North Carolina and Kentucky's Berea College, where he ran its Appalachian center in 1970-93. It is named for him. Jones "had been diagnosed with cancer, and earlier this year had decided that he didn’t wish to continue treatment," center Director Chris Green, who is editing Jones's memoirs, said on Appalnet, the list-serve for Appalachian academics, whose discipline Jones helped create. "Despite this, he kept up correspondence, worked on his memoir, and was only occasionally down with his afflictions."

The Rev. Kent Gilbert, pastor of Union Church in Berea, wrote, "He loved good dry and wry humor, music of all kinds, a lively conversation, and was a craftsman, musician, and an appreciator of the arts in every form. Truly a man of many talents! A fierce champion for those whom the world had handed a bad hand, he worked hard against the causes of poverty and injustice. If he had impatience with anything it was the too-evident arrogant hypocrisy of politicians who said much but did little to improve other’s lives."

George Brosi, another Appalachian academic who lived in the same retirement community as Jones, wrote on Appalnet, "Nobody devoted more of their life to Appalachia than Loyal Jones, and he contributed as much as anyone to Appalachian studies. He set the tone for our field with humor, grace, integrity, erudition, and wisdom."