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Virtual Roundtable: Re-integration or Dis-integration: What Does the Future Hold for Occupied Donbas?

Invitation Only Research Event

28 April 2020 - 4:00pm to 5:30pm

Event participants

Paul D’anieri, Professor of Public Policy and Political Science, University of California, Riverside
Vlad Mykhnenko, Associate Professor of Sustainable Urban Development, St Peter’s College, University of Oxford
Chair: Orysia Lutsevych, Research Fellow and Manager, Ukraine Forum, Chatham House

The armed conflict in Donbas has now entered its seventh year. President Zelenskyy, who came to power in May 2019, promised to end the war with Russia and bring peace to Ukraine.

Since assuming office, Zelenskyy has managed to revive the Normandy Format talks, complete military disengagement at three points along the line of contact and negotiate the release of over a hundred Ukrainians held as prisoners of war in Russia. However, ceasefire violations continue to occur frequently.

Looking at the origins of the armed conflict in Donbas and the region’s economic role in Ukraine’s economy, this event discusses the prospects for conflict resolution. Do the recent events signify an opportunity for peace? Does Zelenskyy have a viable plan for re-integrating Donbas or will the region be cut off from mainland Ukraine for the foreseeable future?

The speakers assess the strategy and track record of the Ukrainian government and its Western allies in bringing parts of the occupied Donbas under Kyiv’s control. They also review possible policy implications of the COVID-19 pandemic for the conflict.

Anna Morgan

Administrator, Ukraine Forum
+44 (0)20 7389 3274




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Nuclear Tensions Must Not Be Sidelined During Coronavirus

1 May 2020

Ana Alecsandru

Research Assistant, International Security Programme
Although the pandemic means the Nuclear Non-Proliferation Treaty (NPT) Review Conference (RevCon) is postponed, the delay could be an opportunity to better the health of the NPT regime.

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Painted stairs in Tehran, Iran symbolizing hope. Photo by Fatemeh Bahrami/Anadolu Agency/Getty Images.

Despite face-to-face diplomatic meetings being increasingly rare during the current disruption, COVID-19 will ultimately force a redefinition of national security and defence spending priorities, and this could provide the possibility of an improved political climate at RevCon when it happens in 2021.

With US presidential elections due in November and a gradual engagement growing between the EU and Iran, there could be a new context for more cooperation between states by 2021. Two key areas of focus over the coming months will be the arms control talks between the United States and Russia, and Iran’s compliance with the 2015 Joint Comprehensive Plan of Action (JCPOA), also known as the Iran Nuclear Deal.

It is too early to discern the medium- and longer-term consequences of COVID-19 for defence ministries, but a greater focus on societal resilience and reinvigorating economic productivity will likely undercut the rationale for expensive nuclear modernization.

Therefore, extending the current New START (Strategic Arms Reduction Treaty) would be the best, most practical option to give both Russia and the United States time to explore more ambitious multilateral arms control measures, while allowing their current focus to remain on the pandemic and economic relief.

Continuing distrust

But with the current treaty — which limits nuclear warheads, missiles, bombers, and launchers — due to expire in February 2021, the continuing distrust between the United States and Russia makes this extension hard to achieve, and a follow-on treaty even less likely.

Prospects for future bilateral negotiations are hindered by President Donald Trump’s vision for a trilateral arms control initiative involving both China and Russia. But China opposes this on the grounds that its nuclear arsenal is far smaller than that of the two others.

While there appears to be agreement that the nuclear arsenals of China, France, and the UK (the NPT nuclear-weapons states) and those of the states outside the treaty (India, Pakistan, North Korea, and Israel) will all have to be taken into account going forward, a practical mechanism for doing so proves elusive.

If Joe Biden wins the US presidency he seems likely to pursue an extension of the New START treaty and could also prevent a withdrawal from the Open Skies treaty, the latest arms control agreement targeted by the Trump administration.

Under a Biden administration, the United States would also probably re-join the JCPOA, provided Tehran returned to strict compliance with the deal. Biden could even use the team that negotiated the Iran deal to advance the goal of denuclearization of the Korean peninsula.

For an NPT regime already confronted by a series of longstanding divergences, it is essential that Iran remains a signatory especially as tensions between Iran and the United States have escalated recently — due to the Qassim Suleimani assassination and the recent claim by Iran’s Revolutionary Guard Corps to have successfully placed the country’s first military satellite into orbit.

This announcement raised red flags among experts about whether Iran is developing intercontinental ballistic missiles due to the dual-use nature of space technology. The satellite launch — deeply troubling for Iran’s neighbours and the EU countries — may strengthen the US argument that it is a cover for the development of ballistic missiles capable of delivering nuclear weapons.

However, as with many other countries, Iran is struggling with a severe coronavirus crisis and will be pouring its scientific expertise and funds into that rather than other efforts — including the nuclear programme.

Those European countries supporting the trading mechanism INSTEX (Instrument in Support of Trade Exchanges) for sending humanitarian goods into Iran could use this crisis to encourage Iran to remain in compliance with the JCPOA and its NPT obligations.

France, Germany and the UK (the E3) have already successfully concluded the first transaction, which was to facilitate the export of medical goods from Europe to Iran. But the recent Iranian escalatory steps will most certainly place a strain on the preservation of this arrangement.

COVID-19 might have delayed Iran’s next breach of the 2015 nuclear agreement but Tehran will inevitably seek to strengthen its hand before any potential negotiations with the United States after the presidential elections.

As frosty US-Iranian relations — exacerbated by the coronavirus pandemic — prevent diplomatic negotiations, this constructive engagement between the E3 and Iran might prove instrumental in reviving the JCPOA and ensuring Iran stays committed to both nuclear non-proliferation and disarmament.

While countries focus their efforts on tackling the coronavirus pandemic, it is understandable resources may be limited for other global challenges, such as the increasing risk of nuclear weapons use across several regions.

But the potential ramifications of the COVID-19 crisis for the NPT regime are profound. Ongoing tensions between the nuclear-armed states must not be ignored while the world’s focus is elsewhere, and the nuclear community should continue to work together to progress nuclear non-proliferation and disarmament, building bridges of cooperation and trust that can long outlast the pandemic.




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Virtual Roundtable: Land Reform in Ukraine: Is Zelenskyy's Government Getting it Right?

Invitation Only Research Event

14 May 2020 - 12:00pm to 1:30pm
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Ihor Petrashko, Minister of Economic Development and Trade, Ukraine
Andriy Dykun, Chair, Ukrainian Agricultural Council
Vadim Tolpeco, Ukrlandfarming Plc
Chair: Orysia Lutsevych, Research Fellow and Manager, Ukraine Forum, Chatham House
Ukraine is known as the ‘breadbasket of Europe’ thanks to its grain exports. On 31 March 2020, the Ukrainian parliament passed a landmark law ending a 19-year ban on the sale of privately owned agricultural land. Due to come into force in July 2021, the law applies to 41.5 million hectares of farmland and economists predict substantial economic gains from this liberalization.
 
This event will discuss the impact of the law on Ukraine’s agricultural sector and food security. How can the government best implement this reform and ensure that small and medium-sized agricultural companies increase their productivity? What does this change mean for Ukraine’s capacity to export grain? Can the country’s food supply withstand crises such as the COVID-19 pandemic? What role could foreign direct investors play in boosting production?
 
This event will be held on the record.

Anna Morgan

Administrator, Ukraine Forum
+44 (0)20 7389 3274




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My first lie

I spoke French for thirteen years I say to him And he smiles. More cheese. Soft night yields to love, Rap is the only hard night sound, The White man is out of his depth, Even in French. He leans forward and whispers in my ear but, The first lie was mine. We’ll count them […]




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Dying is the first race

Never mind Lawyers, Children with no mouths, Never mind Inspiration, Write Now. Photo – ♦Personal♦ -short evocative poetry-




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Graphic showing the role of satellite images in tracking environmental damage

1 June 2012 , Volume 68, Number 4

Eyes in the skies keeping watch on a planet under stress. Click on the PDF link to view the graphic


Graphic




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Mainstreaming the environment into post-war recovery: the case for 'ecological development'

7 September 2012 , Volume 88, Number 5

Richard Milburn




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A Global Response to HFCs through Fair and Effective Ozone and Climate Policies

11 July 2014

Rising HFC use poses a significant threat to intergovernmental efforts to combat climate change. At present, there is a glaring regulatory gap in this area. Although challenging, there is no reason why the international community cannot come together to address this new problem of coordination and ensure that legal regimes support each other.

Duncan Brack

Associate Fellow, Energy, Environment and Resources Programme

Stephen O. Andersen

Director of Research, the Institute for Governance & Sustainable Development (IGSD)

Joanna Depledge

Affiliated Lecturer, Department of Politics and International Studies, University of Cambridge

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In this aerial image, icebergs are seen as a glacier is flown into the sea on July 30, 2012 near Qaanaaq, Greenland. Photo by The Asahi Shimbun via Getty Images.

Hydrofluorocarbons (HFCs) are replacements for many of the chlorofluorocarbons (CFCs) and hydrochlorofluorocarbons (HCFCs) currently being phased out under the Montreal Protocol on Substances that Deplete the Ozone Layer. Unlike those ozone-depleting substances (ODS), HFCs do not destroy the ozone layer, but they are very powerful greenhouse gases (GHGs) – up to thousands of times more damaging to the climate than carbon dioxide – and their use is currently growing faster than any other category of GHGs. Projections show HFC use increasing as much as 30-fold by 2050, adding up to 0.1°C of global average temperature rise by mid-century, and increasing up to five-fold, to 0.5°C, by 2100. This clearly makes it more difficult to limit the rise in global temperature to the internationally agreed ceiling of 2°C – and thereby avoid dangerous climate change – by the end of the 21st century.

As GHGs, HFCs fall under the purview of the 1992 United Nations Framework Convention on Climate Change (UNFCCC) and are explicitly listed under the UNFCCC’s 1997 Kyoto Protocol, which controls emissions of HFCs and other GHGs. They are not, however, subject to any specific measures under the climate agreements, and this is unlikely to change in the near future. Accordingly, the last five years have seen proposals to amend the Montreal Protocol to phase down the production and consumption of HFCs.

Such a step would have a number of advantages. Since substitutes already exist for almost all uses of HFCs, the consumption and production phase-out model of the Montreal Protocol is better suited to controlling HFCs than the emissions limits controls of the climate regime; and the individuals and organizations involved in implementing the Montreal Protocol have accumulated substantial experience and expertise in dealing with precisely those industrial sectors in which HFCs are used, including refrigeration and air-conditioning, foams, solvents and aerosols.

This paper, which draws on the discussions at a workshop held at Chatham House in April 2014, outlines the main issues around the question of how best to craft a fair and effective global response to the growth in HFC use. A number of key issues are central to the debate: the principle of equity between developed and developing countries; the availability of alternatives to HFCs; the need for financial support for developing countries; the legal relationship between the climate and ozone regimes; and, underlying all these, the need for political will to resolve these challenges.




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Accelerating Innovation for a Circular Economy

Invitation Only Research Event

12 July 2016 - 9:30am to 5:30pm

Chatham House, London

Over the next two decades, a combination of ‘circular economy’ approaches and distributed manufacturing methods such as 3D printing raise the prospect of fundamental changes to the nature of production, the reconfiguration of supply chains and changes to patterns of resource consumption – with profound implications for sustainability. This roundtable will bring together expert participants from companies, government, civil society and academia to discuss the state of innovation in the ‘circular economy,’ with a particular focus on the approaches and activities of entrepreneurs and investors, what is needed to scale up and accelerate innovation, how to track and measure progress, and how to ensure that innovation in the ‘circular economy’ makes a significant contribution to the meeting of short and medium term climate and sustainability goals.

Attendance at this event is by invitation only. 

Johanna Lehne

Research Associate, Energy, Environment and Resources
+44 (0)20 7314 3629




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Inner Circle gives thanks for Jacob Miller on his birthday - Singer would have caused ‘problem’ at King’s House, says ­former bandmate

Long before the existence of the Internet and going viral was a thing, reggae singer Jacob Miller, back in the ‘70s, coined a term that went viral – under heavy manners. Ian Lewis of Inner Circle band, the Bad Boys of Reggae, recalled that his...




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Inner Circle to create song from winning poem - Close to 100 entries for Circle of Light contest

IT IS said that every cloud has a silver lining, and that could still hold true, even in the midst of a terrifying global pandemic. Despite COVID-19, the cycle of life continues, and out of it has sprung forth an inspiring poetry competition,...




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5 Questions With … Walshy Fire

Event producers and entertainers still have a while to figure out how to right themselves after the threat of COVID-19 has passed. But that doesn’t mean they should wait until a vaccine is developed or until people begin to brave skies and crowds...




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Norris McDonald | Coronavirus, faith-based medicine and quackery

Four companies involved in one of America’s “largest price-fixing cases” are now behind the anti-malaria drug touted by Donald ‘The Great Impeached’ Trump as a snake-oil, cure-all treatment for COVID-19, caused by the novel coronavirus. Several...




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Flair Fashionary

We’re back! Hope you’re as excited as we are to do some learning! Let’s ease into things though, no one wants to learn about hems every week. So this week we’re gonna look at collection based words that describe how fashion is compiled! Dweek! Say...




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Sir, it is not PMS - Endometriosis can cause depression in your partner

Women with endometriosis have significantly higher rates of depression than women in the general population. That’s according to psychiatrist Dr Kristen Robinson-Barrett. It’s the end of endometriosis month, so Flair spoke to the expert to explore...




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HB-EGF Signaling Is Required for Glucose-Induced Pancreatic {beta}-Cell Proliferation in Rats

The molecular mechanisms of β-cell compensation to metabolic stress are poorly understood. We previously observed that nutrient-induced β-cell proliferation in rats is dependent on epidermal growth factor receptor (EGFR) signaling. The aim of this study was to determine the role of the EGFR ligand heparin-binding EGF-like growth factor (HB-EGF) in the β-cell proliferative response to glucose, a β-cell mitogen and key regulator of β-cell mass in response to increased insulin demand. We show that exposure of isolated rat and human islets to HB-EGF stimulates β-cell proliferation. In rat islets, inhibition of EGFR or HB-EGF blocks the proliferative response not only to HB-EGF but also to glucose. Furthermore, knockdown of HB-EGF in rat islets blocks β-cell proliferation in response to glucose ex vivo and in vivo in transplanted glucose-infused rats. Mechanistically, we demonstrate that HB-EGF mRNA levels are increased in β-cells in response to glucose in a carbohydrate-response element–binding protein (ChREBP)–dependent manner. In addition, chromatin immunoprecipitation studies identified ChREBP binding sites in proximity to the HB-EGF gene. Finally, inhibition of Src family kinases, known to be involved in HB-EGF processing, abrogated glucose-induced β-cell proliferation. Our findings identify a novel glucose/HB-EGF/EGFR axis implicated in β-cell compensation to increased metabolic demand.




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PRMT1 Is Required for the Maintenance of Mature {beta}-Cell Identity

Loss of functional β-cell mass is an essential feature of type 2 diabetes, and maintaining mature β-cell identity is important for preserving a functional β-cell mass. However, it is unclear how β-cells achieve and maintain their mature identity. Here we demonstrate a novel function of protein arginine methyltransferase 1 (PRMT1) in maintaining mature β-cell identity. Prmt1 knockout in fetal and adult β-cells induced diabetes, which was aggravated by high-fat diet–induced metabolic stress. Deletion of Prmt1 in adult β-cells resulted in the immediate loss of histone H4 arginine 3 asymmetric dimethylation (H4R3me2a) and the subsequent loss of β-cell identity. The expression levels of genes involved in mature β-cell function and identity were robustly downregulated as soon as Prmt1 deletion was induced in adult β-cells. Chromatin immunoprecipitation sequencing and assay for transposase-accessible chromatin sequencing analyses revealed that PRMT1-dependent H4R3me2a increases chromatin accessibility at the binding sites for CCCTC-binding factor (CTCF) and β-cell transcription factors. In addition, PRMT1-dependent open chromatin regions may show an association with the risk of diabetes in humans. Together, our results indicate that PRMT1 plays an essential role in maintaining β-cell identity by regulating chromatin accessibility.




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Aaron's 85th birthday a celebration of a great life

Henry "Hank" Aaron was born in Alabama three years after Willie Mays, 85 years ago Tuesday. Now, all this time later, Aaron is as much the conscience and the soul of baseball as any man alive. But we don't just celebrate a great baseball life today. We celebrate a great American life.




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Hyde comes prepared to first Spring Training

For Brandon Hyde, the days and weeks leading up to Tuesday were filled with phone calls to friends, to former colleagues, to mentors he's made across more than two decades in the game. A constant theme emerged from the ensuing chats: What, exactly, should Hyde expect from his first Spring Training as a big league manager?




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Wave him bye bye: O's voice Angel retires

Wave him bye bye. A legendary voice of Orioles baseball is calling it a career. Joe Angel, beloved play-by-plan man and voice of the Orioles' radio broadcasts for nearly two decades, announced his retirement this week. The decision caps a 41-year career in the booth for Angel, 71, a fixture for 19 seasons across two stints in Baltimore.




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Impaired Metabolic Flexibility to High-Fat Overfeeding Predicts Future Weight Gain in Healthy Adults

The ability to switch fuels for oxidation in response to changes in macronutrient composition of diet (metabolic flexibility) may be informative of individuals’ susceptibility to weight gain. Seventy-nine healthy, weight-stable participants underwent 24-h assessments of energy expenditure and respiratory quotient (RQ) in a whole-room calorimeter during energy balance (EBL) (50% carbohydrate, 30% fat) and then during 24-h fasting and three 200% overfeeding diets in a crossover design. Metabolic flexibility was defined as the change in 24-h RQ from EBL during fasting and standard overfeeding (STOF) (50% carbohydrate, 30% fat), high-fat overfeeding (HFOF) (60% fat, 20% carbohydrate), and high-carbohydrate overfeeding (HCOF) (75% carbohydrate, 5% fat) diets. Free-living weight change was assessed after 6 and 12 months. Compared with EBL, RQ decreased on average by 9% during fasting and by 4% during HFOF but increased by 4% during STOF and by 8% during HCOF. A smaller decrease in RQ, reflecting a smaller increase in lipid oxidation rate, during HFOF but not during the other diets predicted greater weight gain at both 6 and 12 months. An impaired metabolic flexibility to acute HFOF can identify individuals prone to weight gain, indicating that an individual’s capacity to oxidize dietary fat is a metabolic determinant of weight change.




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Inhibition of Mitochondrial Calcium Overload by SIRT3 Prevents Obesity- or Age-Related Whitening of Brown Adipose Tissue

The whitening and loss of brown adipose tissue (BAT) during obesity and aging promote metabolic disorders and related diseases. The imbalance of Ca2+ homeostasis accounts for the dysfunction and clearance of mitochondria during BAT whitening. Capsaicin, a dietary factor activating TRPV1, can inhibit obesity induced by high-fat diet (HFD), but whether capsaicin inhibits BAT loss and the underlying mechanism remain unclear. In this study, we determined that the inhibitory effects of capsaicin on HFD-induced obesity and BAT whitening were dependent on the participation of SIRT3, a critical mitochondrial deacetylase. SIRT3 also mediated all of the beneficial effects of capsaicin on alleviating reactive oxygen species generation, elevating mitochondrial activity, and restricting mitochondrial calcium overload induced by HFD. Mechanistically, SIRT3 inhibits mitochondrial calcium uniporter (MCU)-mediated mitochondrial calcium overload by reducing the H3K27ac level on the MCU promoter in an AMPK-dependent manner. In addition, HFD also inhibits AMPK activity to reduce SIRT3 expression, which could be reversed by capsaicin. Capsaicin intervention also inhibited aging-induced BAT whitening through this mechanism. In conclusion, this study emphasizes a critical role of the AMPK/SIRT3 pathway in the maintenance of BAT morphology and function and suggests that intervention in this pathway may be an effective target for preventing obesity- or age-related metabolic diseases.




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Whitley throws first bullpen session of spring

All eyes were on right-hander Forrest Whitley, MLB Pipeline's top pitching prospect, when he threw in the bullpen for the first time Friday in Major League camp. Astros manager AJ Hinch, assistant general manager Brandon Taubman and director of player development Pete Putila were all watching intently as Whitley threw 21 pitches -- fastballs, changeups and cutters.




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UN leader says one billion people with disabilities hard hit by virus

UNITED NATIONS (AP) — The United Nation’s leader said Wednesday the world’s one billion people living with disabilities are among the hardest hit by the coronavirus and called for them to have equal access to prevention and...




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Airbnb laying off 1,900 employees due to travel decline

Airbnb says it is laying off 25% of its workforce as it confronts a steep decline in global travel due to the new coronavirus pandemic. It’s a serious setback for the 12-year-old home-sharing company, which just a few months ago was...




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US firms return virus loans as Treasury threatens penalties

  WASHINGTON (AP) — More than 40 public companies are pledging to return money to the government’s small business coronavirus fund now that Treasury Secretary Steven Mnuchin is threatening criminal prosecutions for...




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Rogue tourists arrested as Hawaii tries to curb virus spread

HONOLULU (AP) — Hawaii authorities are cracking down on rogue tourists who are visiting beaches, riding personal watercraft, shopping and generally flouting strict requirements that they quarantine for 14 days after arriving. A newlywed...




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Putin-Trump call focuses on coronavirus, arms control, oil

MOSCOW (AP): United States (US) President Donald Trump and Russian President Vladimir Putin discussed progress in combating the coronavirus pandemic, along with arms-control issues and oil prices, in a phone call Thursday, the White House and the...




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Venerable but vulnerable: Centenarians hit hard by virus

BOSTON (AP) — Centenarians have always been a rare breed. Now they’re an endangered species. The 100-plus crowd — those most venerable of human beings — is succumbing rapidly and heartbreakingly to the coronavirus...




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Umpires suffering ‘dislocation’ but looking to alternatives – Johnson

ROSEAU, Dominica (CMC): A top West Indies Cricket Umpires Association (WICUA) official says regional umpires have also been heavily impacted by the cessation of cricket, stemming from the outbreak of the COVID-19 pandemic. Vivian Johnson, who...




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MoBay City Run going virtual

Western Bureau: THE MOBAY City Run organisers have reconsidered the event’s cancellation. Organising committee chair­person Janet Silvera said on Sunday, the day the event was to have taken place, that the seventh staging of the 5K/10K Walk and Run...




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International donations to the Ebola virus outbreak: too little, too late?

Karen Grépin, assistant professor of global health policy at New York University, has been examining the pledges made by the international community to help fight the ebola virus outbreak - was it really too little, too late? Read her full analysis: http://www.bmj.com/content/350/bmj.h376




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Michelle Sinclair GP - surgery buildings are not up to scratch

Michelle Sinclar, a GP in Hampshire who is concerned that GP premises aren't fit for purpose and limit her ability to provide fully rounded patient care. BMJ Voices is a collection of readers’ experiences of working in the NHS. For this, The BMJ is seeking short audio submissions from UK listeners. These submissions will be published on...




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The BMJ requires data sharing on request for all trials

The movement to make data from clinical trials widely accessible has achieved enormous success, and it is now time for medical journals to play their part. From 1 July The BMJ will extend its requirements for data sharing to apply to all submitted clinical trials, not just those that test drugs or devices. The BMJ's Elizabeth Loder explains what...




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Zika virus - "it really felt like having bad sunburn, all over your body"

“Juliet”, a woman living in London, was diagnosed with a mysterious illness in November 2015, Ian Cropley, a consultant in infectious disease from The Royal Free London NHS Foundation Trust, was there to investigate. In this podcast, we find out how Zika, once a little known virus causing a rash and fever, has subsequently become a global health...




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Médecins Sans Frontières's Dunkirk spirit

As France has moved in recent weeks to clear camps where migrants stay while trying to cross illegally into Britain, Médecins Sans Frontières has just opened a new one. Sophie Arie talks to Caroline Gollé, medical coordinator at the Médecins Sans Frontières​ La Linière camp​. Read more about the camp: http://www.bmj.com/content/352/bmj.i1696




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The pattern of damage caused by Zika virus in the brains of 23 foetuses

In February World Health Organization (WHO) declared the microcephaly epidemic in South America an international public health emergency. Today, the US Centers for Disease Control and Prevention, the CDC, has confirmed that it’s is Zika virus which is causing that microcephaly.  The outbreak was originally spotted in Recife, in Brazil, and it’s...




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Medical error—the third leading cause of death in the US

Medical error is not included on death certificates or in rankings of cause of death. Martin Makary, professor of surgery at Johns Hopkins University School of Medicine, joins us to explain why we don't measure medical error, and why it is so important that we start. Read the full analysis: http://www.bmj.com/content/353/bmj.i2139




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Women and the Zika Virus

Interviews from the Women deliver conference in Copenhagen. Donna McCarraher, director of reproductive, maternal, newborn and child health at FHI 360, explains why women should be at the centre of efforts to mitigate the effect of Zika Virus in Brazil.




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Caring for patients with delirium at the end of their life

Delirium is common in the last weeks or days of life. It can be distressing for patients and those around them. A clinical update explains why successful management involves excluding reversible causes of delirium and balancing drugs that may provoke or maintain delirium while appreciating that most patients want to retain clear cognition at the...




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Middle East respiratory syndrome

Middle East respiratory syndrome (MERS) is an acute viral respiratory tract infection caused by the novel betacoronavirus. Cases have been limited to the Arabian Peninsula and its surrounding countries, and to travellers from the Middle East or their contacts. The clinical spectrum of infection varies from no symptoms or mild respiratory...




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Identifying a viral rash in pregnancy

Viral exanthema can cause rash in a pregnant woman and should be considered even in countries that have comprehensive vaccination programmes. Measles and rubella can cause intrauterine death. Intrauterine infection with rubella can lead to congenital rubella syndrome in the liveborn baby. In this podcast, Jack Carruthers, honorary clinical...




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Future Earth - linking health and environmental research

The rapid changes in the global environment have led many scientists to conclude that we are living in a new geological epoch—the Anthropocene—in which human activities have become the dominant driving force transforming the Earth’s natural systems. A recent joint publication by the World Health Organization and Convention on Biological Diversity...




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"The interest of diesel drivers over the interest of the public" - tackling air pollution

Air pollution is a truly damaging environmental insult to the human body. The numbers of premature deaths, in the UK alone, that can be attributed to it are calculated to be 40,000 a year. Yet despite this, action to tackle the problem - as with the other huge environmental issue of our time, climate change - is distinctly lacking. Robin...




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Biomarkers - miracle or marketing?

The BMJ has been campaigning for an end to “too much medicine” - the pernicious effect of marketing on the range of tests and treatments that doctors offer patients - tests and treatments which are motivated by the financial reward to the system, than the health of the individual. A new analysis on BMJ.com takes a look at what’s happening in the...




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"For the first time in 15 years the quitting rate has gone up" - ecigarettes smoking cessation

It’s been 10 years since electronic cigarettes hit the shelves in a big way - and since there controversy has reigned about their health effects - are they less unhealthy than smoking traditional tobacco cigarettes, and will they increase nicotine dependence? Its to that last point that new research, published on BMJ.com is looking into -...




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Suspect, investigate, and diagnose acute respiratory distress syndrome

Acute respiratory distress syndrome was first described in 1967 and has become a defining condition in critical care. Around 40% of patients with ARDS will die, and survivors experience long term sequelae. No drug treatments exist for ARDS, however good supportive management reduces harm and improves outcome. In this podcast, John Laffey,...




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Virginia Murray - the science of disaster risk reduction

Virginia Murray, public health consultant in global disaster risk reduction at Public Health England, was instrumental in putting together the Sendai Framework for Disaster Risk Reduction - an international agreement which aims to move the world from reacting to disasters, to proactively preventing them. In this podcast, she explains what they...




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New antivirals for Hepatitis C - what does the evidence prove?

There’s been a lot of attention given to the new antirviral drugs which target Hepatitis C - partly because of the burden of infection of the disease, and the lack of a treatment that can be made easily accessible to around the world, and partly because of the incredible cost of a course of treatment. But a new article on BMJ talks about the...




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Terence Stephenson - looking back at chairing the GMC

Terence Stephenson is a consultant paediatrician who became been chair of the General Medical Council in 2015. His 4 year tenure has now come to an end, but during his time with the regulator the medical profession faced a number of challenges - the case of Hadiza Bawa Garba and a growing recruitment crisis in the NHS - the GMC is the...