Compounding pharmacies create medication tailored to the specific needs of individual patients. John Oliver explains why this small corner of the drug market can cause big problems.
Compounding pharmacies create medication tailored to the specific needs of individual patients. John Oliver explains why this small corner of the drug market can cause big problems.
Musk spoke in front of a 50-meter, 200-ton Starship prototype, calling it “the most inspiring thing that I’ve ever seen.”
He described unique design features of the vehicle and outlined plans to fast-track production of a Starship fleet. His hope, Musk said, is “to reach orbit in less than six months.”
Since its founding in 2002, SpaceX has been working toward the goal of making space travel cheaper and accessible to would-be space travelers.
The Starship is the company’s next foray: a large vehicle that could theoretically carry people into space, land safely back on Earth and be fit to turn around and fly again. Being able to return to space multiple times with “a rapidly reusable orbital rocket,” Musk explained, is key to the company’s plans.
“The critical breakthrough that’s needed for us to become a space-faring civilization is to make space travel like air travel. With air travel, when you fly a plane, you fly it many times,” he said.
Musk noted that Sept. 28 is the 11th anniversary of the commercial space travel giant’s first big victory, when it reached orbit for the first time with one of its rockets, the Falcon 1. The company hit another milestone in March 2017 when it successfully relaunched its Falcon 9 rocket, after that small rocket had previously launched and relanded in 2016.
The goal now, Musk said, is to get the larger Starship, a vehicle that could carry people, to achieve the same feat.
“This thing is going to take off, fly to about 65,000 feet — that’s about 20 kilometers — and come back and land. In about one to two months,” he said. “It is really gonna be pretty epic to see that thing take off and come back.”
Musk said the company is aggressively working to build the next iterations of the Starship prototype over the next five to six months.
“The rate at which we will be building ships is going to be quite, quite crazy by space standards,” he said.
To do this, he said, the company is ramping up production of the rocket’s engines to reach a production target of building one new engine a day by early next year. If all goes to plan, he said, “we could potentially see people flying next year.”
Musk made a point of thanking one of his investors, Japanese billionaire Yusaku Maezawa, who announced last year that he’d booked a trip as a private passenger with SpaceX for a voyage to the moon.
The reaction from NASA to Saturday’s announcement was to bring attention to another less dramatic goal of SpaceX. The company has a partnership with NASA on the Commercial Crew Program, an enterprise intended to develop safe and affordable transportation of astronauts to and from the International Space Station. NASA Administrator Jim Bridenstine tweeted Friday, in advance of the Starship announcement, that he’d like to see “the same level of enthusiasm focused on the investments of the American taxpayer,” noting that the Commercial Crew Program is years behind schedule.
Musk’s Saturday speech was indeed filled with enthusiasm about space travel. He alluded to his ultimate goal of creating “a self-sustaining city on Mars.” He said that while many problems on Earth need solving, “we also need things that make us excited to be alive and fired up about the future.”
“Becoming a space-faring civilization, being out there among the stars, is one of the things that makes me glad to be alive,” Musk said.
Osaze Osagie, 29, was beloved by his family and community. At his funeral this March, so many people showed up to pay their respects that every seat in the main room was taken and at least 100 more were filled in an overflow area. Person after person told stories of his warmth and kindness. Ten days earlier, his father, Sylvester, made a simple call to local police to perform a mental health “wellness check” on his son. Osagie was shot and killed in his own home by police in State College, Pennsylvania, soon thereafter.
Osagie had been hospitalized at least six times over the years; with a history of autism, paranoid schizophrenia, extreme anxiety, and Asperger’s syndrome, he sometimes struggled to function in society. Last December, his family was proud when he transitioned out of a community residential center to an apartment of his own. As much as they wanted it to work out for him, it was rough. Osagie stopped attending support meetings and cycled on and off his medications. On March 10, after sending texts to family suggesting that he might harm himself, they called 911 for support.
When police got there, they claimed that Osagie had a knife that he refused to put down. When he walked toward the officers, they claimed that a Taser had no impact on him, so they shot and killed him right there on the spot. This past week, the family announced their intention to file a lawsuit against the police department for abandoning multiple protocols when their son was confronted and killed.
Over the past five years, I’ve closely studied thousands of police shootings and seen a trend of black families under duress calling 911 during a mental health emergency, only for their loved one to be killed by police as a result. Of course, when a black family calls 911 for support in a mental health emergency and it goes well, that doesn’t make the news. But the fact remains that in general, black families remain skeptical of calling the police for help under any circumstance — and fatal encounters like the one experienced by the Osagie family confirm those doubts.
Black families remain skeptical of calling the police for help under any circumstance — and fatal encounters like the one experienced by the Osagie family confirm those doubts.
Police killings of people with mental illnesses are a huge problem for those of all races. Studies show that as many as 50 percent of people killed by American police had registered disabilities and that a huge percentage of those were people with mental illnesses. One study states that people with untreated mental illnesses are a staggering 16 times more likely to be shot and killed by police.
But African Americans are at even higher risk due to the racism in our country and in our police forces. Right now, outside of Atlanta, a trial is underway for the officer who shot and killed Anthony Hill, an Afghanistan war veteran who had a mental illness. Hill was not only unarmed, but he was also completely nude. He needed immediate medical attention. Instead, he was fatally shot by an officer who claimed what officers often claim: that he feared for his life.
This past December, the city of New York paid the family of Deborah Danner — a 66-year-old black woman with a long history of mental illness, who was also completely nude and in her own home — $2 million after an New York Police Department officer shot and killed her. She, too, needed medical help, but got bullets instead.
It is interesting how many times American police routinely find a way to push past such fears to peacefully arrest white mass shooters who were heavily armed and just slaughtered scores of people. For years, I used to advocate for police to receive more training to prevent the shooting deaths of people like Hill and Danner. Cut after seeing police from coast to coast routinely exercise so much restraint and patience when arresting armed white shooters, I’m no longer confident that training is the problem. Police seem fully capable of exercising restraint when they feel like it.
The list of black deaths is so long. This past May, Pamela Turner, a 44-year-old black woman experiencing a mental health crisis was shot and killed by police in Texas. In Oklahoma this past April, 17-year-old Isaiah Lewis, also naked and in a mental health crisis, was shot and killed by police. This past June, Taun Hall called 911 for support with her 23-year-old-son, Miles, who had a mental illness. Police shot and killed him. The latest research suggests that no single group of people is more likely to be killed by police than young black boys and men — registering even higher than white people with mental illnesses. Consequently, young black men with mental illnesses are in the single most at-risk category in the nation for fatal police violence.
Every day brings more evidence of the United States’ profound political polarization. Partisan intransigence, vitriol, and divisiveness now contaminate most government institutions. What is more, these sentiments have steadily infiltrated every nook and cranny of American life. The 2020 presidential campaign will only further intensify the country’s partisan tribalism. And despite the lofty praise that news media and civil society heap on politicians who work across party lines, the divisive trend continues with no end in sight.
The more than 35 books published on this subject in the past decade have shed much light on partisan dynamics. Yet almost without exception, they examine U.S. polarization as an isolated phenomenon, separate from the experiences of other countries. In our research and advocacy work, we have taken a different tack.
Collaborating with scholars from around the world, we have examined the striking rise of severe polarization in numerous other democracies, including Bangladesh, Colombia, Poland, and Turkey. In each case we took a close look at the roots of polarization and then traced its trajectory over time, analyzing the main drivers as well as the negative consequences and attempted remedies.
Although polarization in the United States shares some basic features with political divisions elsewhere, we found that it stood out in many crucial respects. American polarization has deep roots that have taken decades to grow and strengthen. The United States may look much like many other angry, divided countries, but its brand of polarization raises specific concerns about the future and functioning of its democracy.
In most highly polarized states, the fundamental divisions arose first among elite political actors. They then spread throughout society when politicians made calculated efforts to solidify or expand their bases. U.S. polarization has altogether different sources. Partisan sentiment bubbled up from the belly of American society, not the head.
The cultural transformations that swept the United States in the 1960s and 1970s first set the trend in motion. During this period, the civil rights movement, the women’s rights movement, the anti–Vietnam War movement, and the sexual revolution all upended established traditions and hierarchies. Two contending visions of America emerged from the maelstrom: a progressive vision that embraced far-reaching sociopolitical change and a conservative vision that sought to block or limit it. Politicians and political parties were slow to use the emerging rift to their advantage. Instead, social activists, evangelists, and public intellectuals drove the rise of polarization within American society.
Only later did polarization worm its way into the formal political realm. As the progressive and conservative social movements gained force and coherence, their ideologues vied for influence within the Democratic and Republican parties, seeking to transform what had for several decades been two catchall, ideologically heterogeneous parties into more defined, programmatic organizations.
Partisan sentiment bubbled up from the belly of American society, not the head.
In most other seriously polarized countries, charismatic leaders were the main contributors to the schism. Not so in the United States. Until recently, there was no American equivalent to President Recep Tayyip Erdogan in Turkey or President Hugo Chávez in Venezuela. In fact, most U.S. presidents in the past four decades have tried to appeal at least somewhat to the center—whether it was Richard Nixon pursuing a raft of relatively moderate socioeconomic policies, Bill Clinton adopting a strategy of “triangulation” after 1994, or George W. Bush trying to advance some elements of “compassionate conservatism.”
Donald Trump is a startling exception in this regard. He is the first U.S. president within living memory to wield polarization as a core political strategy, deliberately seeking to intensify partisan emotions around the most divisive issues facing the country. But his administration is as much a symptom as it is a cause of polarization. In this, Trump is unlike his counterparts in Ankara or Caracas.
To the extent that polarization in the United States comes from the bottom rather than the top, political elites cannot easily reverse or moderate it, even if they genuinely wish to do so. Countries that manage to ease polarization are typically ones where a sharply divisive figure has left the scene and his or her successors are able to walk back the corrosive partisanship. In Ecuador, for instance, President Lenín Moreno has moved away from the antidemocratic tactics of his predecessor, even though the two men come from the same party. In the United States, by contrast, partisanship has continually deepened over the last five decades, regardless of who has occupied the White House. The lesson is clear: Trump’s eventual departure may temper America’s polarization fever, but it will not cure the malady.
A triumphant Papy Faty spoke with glee about how he had beaten the system. Two months later, he was dead after collapsing on the football pitch.
His death could have been avoided had the Burundian midfielder not defied doctors’ orders, twice, by signing professional contracts with first division side Real Kings in Durban and eSwatini’s Malanti Chiefs after being told while at Bidvest Wits to quit playing football because of his heart condition.
“I decided not to go to the operation because it wasn’t a good idea,” Faty toldKick Off magazine. “I’m using a normal muti, African muti. That’s why I have [played] three games [and] nothing happened.”
Two months after he said this, tragedy struck. Faty’s fragile heart gave in and he died during Chiefs’ match against Green Eagles at Killarney Stadium in Pigg’s Peak, Eswatini. The signs were there. He collapsed during the Kings’ match against University of Pretoria in September 2018. He spent just six months, featuring in only three games, in Durban in his first act of defiance against the doctors who had picked up his heart condition.
“I am sorry to say this, and may his soul rest in peace, but it was irresponsibility from his part because he was told that he can’t play and it wasn’t only one doctor who told him that,” said Bafana Bafana team doctor Thulani Ngwenya.
“It was two doctors who told him to quit football, firstly a sports physician and then a cardiologist. I know those people personally. The South African teams wouldn’t accept him because they knew that it was a risk, but he decided to go to Swaziland and I don’t think that they did a thorough pre-competition and pre-season medical assessment in Swaziland. “That is why I say that in Africa we are lacking behind in sports science. They didn’t do an echocardiogram [a thorough assessment of the functioning of the heart, which can determine the presence of many types of heart disease] or an ECG [electrocardiogram, which checks signs of heart disease], because if they did they were going to pick up these things and they were going to save someone,” said Ngwenya.
Faty’s case brought into sharp focus the different challenges the continent faces in the fight against heart problems, with African players more susceptible to cardiac arrest. If a player with a well-documented heart condition can get a professional contract, how thorough is the assessment to check the players whose heart problems aren’t known?
The biggest issue with cardiac arrest is detection. Many players go for years without being properly diagnosed because their issues aren’t picked up under the microscope of even the best medical help. Nigerian footballer Nwankwo Kanu’s heart problems were only detected after the Olympics. He was receiving some of the best medical treatment at Ajax Amsterdam, who also didn’t pick up the problem that Inter Milan’s medical team found.
Affordability is another issue. An echocardiogram costs between R5 000 and R8 000, and an ECG will set you back somewhere from R1 000 to R1 500.
Then there is the issue of belief. Faty genuinely believed muti would cure him, going as far as to say that there was nothing wrong with him but that he was bewitched because some doctors said there was nothing wrong with him.
“For some time, we as Africans have been lacking behind in terms of sports medicine,” Ngwenya said. “That is why right now we have something that we call a pre-competition medical assessment, where we do thorough assessments. We will do blood, musculoskeletal exam [a physical assessment] and then we will do heart examinations.
“In terms of the heart, we will start by examining it physically by using a stethoscope. After that, we will do an electrocardiogram that will check the conduction of your heart. And from there, we will go over and above to do an echocardiogram that checks the heart muscle itself, its activity, how big it is, heart valves and will detect any abnormality of a heart, heart muscle or a valve. When we have detected a problem with the heart, it will help us manage it.” Ngwenya continued: “Most of the time, [sports] people who die because of sudden cardiac arrest are Africans, mostly West Africans. Africans’ hearts are designed in a way that they are bigger than normal, so when we play sports or do something that will make us exert ourselves so much that our heart muscles work harder, the heart becomes bigger. By working harder, you are enlarging your heart muscles because it means when the demand increases, the power of your muscles increases. It’s just like lifting weights. When you lift weights, your muscles bulk up.”
Congressional antitrust investigators are scrutinizing plans by Google to use a new internet protocol because of concerns that it could give the company a competitive advantage by making it harder for others to access consumer data.
In a letter this month, investigators for the House Judiciary Committee asked Google for information about its “decision regarding whether to adopt or promote the adoption” of the protocol, which the Alphabet Inc. company said is aimed at improving internet security.
House investigators are also asking whether data collected or processed through the new protocol will be used by Google for any commercial purposes, according to the Sept. 13 letter.
The Justice Department is aware of concerns over the protocol change and has recently received complaints, according to a person familiar with the matter.
The new standard would encrypt internet traffic to improve security, which could help prevent hackers from snooping on websites, and from spoofing—faking an internet website to obtain a consumer’s credit-card information or other data.
But the new standard could alter the internet’s competitive landscape, cable and wireless companies said. They fear being shut out from much of user data if browser users move wholesale to this new standard, which many internet service providers don’t currently support. Service providers also worry that Google may compel its Chrome browser users to switch to Google services that support the protocol, something Google said it has no intention of doing.
“Right now, each internet service provider has insight into the traffic of their users, and that’s going to shift” as a result of the change, said Andy Ellis, chief security officer at Akamai Technologies Inc., which provides internet services to corporations but doesn’t support the new standard.
Google, which has vast troves of consumer data because of its domination of search, plans to begin testing the navigation protocol with about 1% of its Chrome browser users next month, a first step toward more widespread adoption of the new technology.
Google said that it is supporting the new technology to improve users’ security and privacy and that its browser changes will leave consumers in charge of who shares their internet surfing data.
The new standard modernizes a fundamental building block of the internet known as the domain name system, or DNS. This software takes a user’s electronic request for a website name such as wsj.com and, much like a telephone book, provides the series of internet protocol address numbers used by computers.
“Google has no plans to centralize or change people’s DNS providers to Google by default. Any claim that we are trying to become the centralized encrypted DNS provider is inaccurate,” the company said in an emailed statement.
In a blog post earlier this month, the Electronic Frontier Foundation, a digital-rights watchdog group, said it was “very excited” by the new standard’s potential to improve internet privacy.
Nevertheless, the EFF is worried that the new standard could chip away at the decentralized nature of the internet. The solution, the EFF said, is for more service providers to support the new DNS standard so consumers have more choice.
Google and another browser maker, Mozilla Corp., want to encrypt DNS. Doing so could help prevent hackers from spoofing or snooping on the websites that users visit, for example. Such a move could complicate government agencies’ efforts to spy on internet traffic. But it could prevent service providers who don’t support the new standard from observing user behavior in gathering data.
Like Google, Mozilla’s Firefox is planning a small-scale rollout of the protocol, expected to start in the coming weeks. Firefox is planning eventually to move most U.S. consumer users to the new standard, perhaps as early as year’s end.
Mozilla is taking a more aggressive approach than Google. It will move most consumers—but not corporate users who use providers such as Akamai—to the new standard automatically, even if the change involves switching their DNS service providers.
Mozilla sees the antitrust concerns raised about Google as “fundamentally misleading,” according to Marshall Erwin, Mozilla’s senior director of trust and safety.
Service providers are raising these concerns to undermine the new standard and ensure that they have continued access to DNS data, he said.
While Google is taking a less-aggressive approach than Mozilla, the long-term impact of the change could be enormous. Google’s Chrome has about 64% of the world-wide browser market, according to StatCounter, the internet data tool.