As the global musical phenomenon turns 50, a hip-hop professor explains what the word ‘dope’ means to him

Hip-hop culture brought graffiti art, breakdancing, emceeing and DJing to prominence. Michael Ochs Archives/Getty Images

A.D. Carson, University of Virginia

After I finished my Ph.D. in 2017, several newspaper reporters wrote about the job I’d accepted at the University of Virginia as an assistant professor of hip-hop.

“A.D. Carson just scored, arguably, the dopest job ever,” one journalist wrote.

The writer may not have meant it the way I read it, but the terminology was significant to me. Hip-hop’s early luminaries transformed the word’s original meanings, using it as a synonym for cool. In the 50 years since, it endures as an expression of respect and praise – and illegal substances.

In that context, dope has everything to do with my work.

In the year I graduated from college, one of my best friends was sent to federal prison for possession of crack cocaine with intent to distribute. He served nearly a decade and has been back in prison several times since.

But before he went to prison, he helped me finish school by paying off my tuition.

‘80’s’ is a song from the author’s dissertation album that describes his conception of ‘dopeness.’

In a very real way, dope has as much to do with me finishing my studies and becoming a professor as it does with him serving time in a federal prison.

Academic dope

For my Ph.D. dissertation in Rhetorics, Communications, and Information Design, I wrote a rap album titled “Owning My Masters: The Rhetorics of Rhymes & Revolutions.” A peer-reviewed, mastered version of the album is due out this summer from University of Michigan Press.

‘The Defense’ describes the composition of the author’s dissertation album and his dissertation defense.

Part of my reasoning for writing it that way involved my ideas about dope. I want to question who gets to determine who and what are dope and whether any university can produce expertise on the people who created hip-hop.

While I was initially met with considerable resistance for my work at Clemson, the university eventually became supportive and touted “a dissertation with a beat.”

Clemson is not the only school to recognize hip-hop as dope.

In the 50 years since its start at a back-to-school party in the South Bronx, hip-hop, the culture and its art forms have come a long way to a place of relative prominence in educational institutions.

Since 2013, Harvard University has housed the Hiphop Archive & Research Institute and the Nasir Jones Hiphop Fellowship that funds scholars and artists who demonstrate “exceptional scholarship and creativity in the arts in connection with Hiphop.”

UCLA announced an ambitious Hip Hop Initiative to kick off the golden anniversary. The initiative includes artist residencies, community engagement programs, a book series and a digital archive project.

Perhaps my receiving tenure and promotion at the University of Virginia is part of the school’s attempt to help codify the existence of hip-hop scholarship.

When I write about “dope,” I’m thinking of Black people like drugs to which the U.S. is addicted.

Dope is a frame to help clarify the attempts, throughout American history, at outlawing and legalizing the presence of Black people and Black culture. As dope, Black people are America’s constant ailment and cure.

To me, dope is an aspiration and a methodology to acknowledge and resist America’s steady surveillance, scrutiny and criminalization of Blackness.

By this definition, dope is not only what we are, it’s also who we want to be and how we demonstrate our being.

Dope is about what we can make with what we are given.

Dope is a product of conditions created by America. It is also a product that helped create America.

Whenever Blackness has been seen as lucrative, businesses like record companies and institutions like colleges and universities have sought to capitalize. To remove the negative stigmas associated with dope, these institutions cast themselves in roles similar to a pharmacy.

Even though I don’t believe academia has the power or authority to bestow hip-hop credibility, a question remains – does having a Ph.D and producing rap music as peer-reviewed publications change my dopeness in some way?

Legalizing dope

Though I earned a Ph.D by rapping, my own relationship to hip-hop in academic institutions remains fraught.

Part of the problem was noted in 2014 by Michelle Alexander, a legal scholar and author of “The New Jim Crow,” when she talked about her concerns about the legalization of marijuana in different U.S. states.

“In many ways the imagery doesn’t sit right,” she said. “Here are white men poised to run big marijuana businesses … after 40 years of impoverished black kids getting prison time for selling weed, and their families and futures destroyed. Now, white men are planning to get rich doing precisely the same thing?”

I feel the same way about dopeness in academia. Since hip-hop has emerged as a global phenomenon largely embraced by many of the “academically trained” music scholars who initially rejected it, how will those scholars and their schools now make way for the people they have historically excluded?

In ‘crack, usa’ the author explores America’s relationship to drugs.

This is why that quote about me “scoring, arguably, the dopest job ever” has stuck with me.

I wonder if it’s fair to call what I do a form of legalized dope.

America’s dope-dealing history

In the late 1990s, I saw how fast hip-hop had become inescapable across the U.S., even in the small Midwestern town of Decatur, Illinois, where I grew up with my friend who is now serving federal prison time.

He and I have remained in contact. Among the things we discuss is how unlikely it is that I would be able to do what I do without his doing what he did.

‘nword gem’ describes the author’s relationships with friends and family.

Given the economic realities faced by people after leaving prison, we both know there are limitations to his opportunities if we choose to see our successes as shared accomplishments.

Depending on how dope is interpreted, prisons and universities serve as probable destinations for people who make their living with it. It has kept him in prison roughly the same amount of time as it has kept me in graduate school and in my profession.

This present reality has historical significance for how I think of dope, and what it means for people to have their existence authorized or legalized, and America’s relationship to Black people.

Many of the buildings at Clemson were built in the late 1880s using “laborers convicted of mostly petty crimes” that the state of South Carolina leased to the university.

Similarly, the University of Virginia was built by renting enslaved laborers. The University also is required by state law to purchase office furniture from a state-owned company that depends on imprisoned people for labor. The people who make the furniture are paid very little to do so.

The people in the federal prison where my friend who helped me pay for college is now housed work for paltry wages making towels and shirts for the U.S. Army.

Even with all of the time and distance between our pasts and present, our paths are still inextricably intertwined – along with all those others on or near the seemingly transient line that divides “legal” and “illegal” dope.

A.D. Carson, Assistant Professor of Hip-Hop, University of Virginia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How the James Webb Space Telescope has revealed a surprisingly bright, complex and element-filled early universe – podcast

The James Webb Space Telescope is providing astronomers with images and data that reveal secrets from the earliest era of the universe. NASA/STScI

Daniel Merino, The Conversation and Nehal El-Hadi, The Conversation

If you want to know what happened in the earliest years of the universe, you are going to need a very big, very specialized telescope. Much to the joy of astronomers and space fans everywhere, the world has one – the James Webb Space Telescope.

In this episode of “The Conversation Weekly,” we talk to three experts about what astronomers have learned about the first galaxies in the universe and how just six months of data from James Webb is already changing astronomy.

The James Webb Space Telescope successfully launched into space on Dec. 25, 2021. After about six months of travel, setup and calibration, the telescope began collecting data and NASA published the first stunning images.

One of Webb’s nicknames is the “first light telescope.” This is because Webb was specifically designed to be able to see as far back as possible into the earliest days of the universe and detect some of the first visible light.

You can see these galaxies in the images NASA has released. Jonathan Trump, an astronomer at the University of Connecticut, is on one of the teams working on some of the early James Webb data. He was watching the release of the first images live and noticed some things many nonastronomers might have missed. “In the background, behind these beautiful arcs and spirals and massive elliptical galaxies are these tiny, itty-bitty red smudges. That’s what I was most interested in, because those are some of the first galaxies in the universe.”

This compound image shows some of the earliest galaxies ever seen, highlighted by the small boxes in the images on the left and right, and shown up close in the images in the center. NASA, ESA, CSA, Tommaso Treu (UCLA), CC BY-SA

To see any of these galaxies from the earliest days of the universe would be exciting, but right off the bat, Jeyhan Kartaltepe, an astronomer at the Rochester Institute of Technology, found something exciting when she started digging into the data.

“One of the things we’ve learned is that there are more of these galaxies than we expected to see.” In addition to working on identifying these early galaxies, Kartaltepe has been using Webb’s incredible resolution to study their structure and shape. “We expect there to be discs because discs form pretty naturally in the universe whenever you have something that’s rotating. But we’ve been seeing a lot of them, which has been a bit of a surprise.”

In addition to noting the shape of the galaxies in the early universe, astronomers like Trump are starting to be able to assess the chemical composition of these galaxies. He does this by looking at the spectrum of light James Webb is collecting. “We look at these distant galaxies and we look for particular patterns of emission lines. We often call them a chemical fingerprint because it really is like a particular fingerprint of particular elements in the gas in a galaxy.”

The universe started with just hydrogen and helium, but as stars formed and fused elements together, bigger, heavier elements started to emerge and fill in the periodic table as it is today. And just like Kartaltepe, Trump is finding evidence that things were happening faster in the early universe than astronomers expected. “I would’ve guessed that the universe would have struggled to make the periodic table and build up things. But that’s not what we found. Instead, the universe seems to have proceeded pretty rapidly.”

This photo shows Webb’s first deep-field image, a long exposure of a small part of the sky revealing thousands of galaxies, many of which are too faint for even Hubble to detect. NASA/STScI

The discoveries coming out of James Webb are already changing how astronomers think of the early universe and challenging much of the existing theory. But the truly exciting part is that we are just beginning to see what this telescope is capable of, as Michael Brown, an astronomer at Monash University, explains.

“I’ve been on science papers that have used literally just a couple of minutes of data,” Brown says. “The image quality is just so good that a couple of minutes can do amazing things.” But soon Webb will begin to do follow-up surveys, take deep-field images and stare at parts of the sky for days and even weeks. Over the coming months, years and decades, Webb is going to keep giving astronomers plenty to work on, and astronomers like Brown are excited. “There is just all this complexity there, and we are barely scratching the surface. This will be the stuff that people who are students now are going to devote their careers to. And it’s going to be marvelous.”

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This episode was produced by Katie Flood and Daniel Merino, with sound design by Eloise Stevens. It was written by Katie Flood and Daniel Merino. Mend Mariwany is the show’s executive producer. Our theme music is by Neeta Sarl.

You can find us on Twitter @TC_Audio, on Instagram at theconversationdotcom or via email. You can also sign up to The Conversation’s free daily email here. A transcript of this episode will be available soon.

Listen to “The Conversation Weekly” via any of the apps listed above, download it directly via our RSS feed, or find out how else to listen here.

Daniel Merino, Associate Science Editor & Co-Host of The Conversation Weekly Podcast, The Conversation and Nehal El-Hadi, Science + Technology Editor & Co-Host of The Conversation Weekly Podcast, The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Brains also have supply chain issues – blood flows where it can, and neurons must make do with what they get

Blood carries oxygen and vital nutrients to the brain. Mr. Suphachai Praserdumrongchai/iStock via Getty Images

Suzana Herculano-Houzel, Vanderbilt University

Neuroscientists have long assumed that neurons are greedy, hungry units that demand more energy when they become more active, and the circulatory system complies by providing as much blood as they require to fuel their activity. Indeed, as neuronal activity increases in response to a task, blood flow to that part of the brain increases even more than its rate of energy use, leading to a surplus. This increase is the basis of common functional imaging technology that generates colored maps of brain activity.

Scientists used to interpret this apparent mismatch in blood flow and energy demand as evidence that there is no shortage of blood supply to the brain. The idea of a nonlimited supply was based on the observation that only about 40% of the oxygen delivered to each part of the brain is used – and this percentage actually drops as parts of the brain become more active. It seemed to make evolutionary sense: The brain would have evolved this faster-than-needed increase in blood flow as a safety feature that guarantees sufficient oxygen delivery at all times.

Functional magnetic resonance imaging is one of several ways to measure the brain.

But does blood distribution in the brain actually support a demand-based system? As a neuroscientist myself, I had previously examined a number of other assumptions about the most basic facts about brains and found that they didn’t pan out. To name a few: Human brains don’t have 100 billion neurons, though they do have the most cortical neurons of any species; the degree of folding of the cerebral cortex does not indicate how many neurons are present; and it’s not larger animals that live longer, but those with more neurons in their cortex.

I believe that figuring out what determines blood supply to the brain is essential to understanding how brains work in health and disease. It’s like how cities need to figure out whether the current electrical grid will be enough to support a future population increase. Brains, like cities, only work if they have enough energy supplied.

Resources as highways or rivers

But how could I test whether blood flow to the brain is truly demand-based? My freezers were stocked with preserved, dead brains. How do you study energy use in a brain that is not using energy anymore?

Luckily, the brain leaves behind evidence of its energy use through the pattern of the vessels that distribute blood throughout it. I figured I could look at the density of capillaries – the thin, one-cell-wide vessels that transfer gases, glucose and metabolites between brain and blood. These capillary networks would be preserved in the brains in my freezers.

A demand-based brain should be comparable to a road system. If arteries and veins are the major highways that carry goods to the town of specific parts of the brain, capillaries are akin to the neighborhood streets that actually deliver goods to their final users: individual neurons and the cells that work with them. Streets and highways are built on demand, and a road map shows what a demand-based system looks like: Roads are often concentrated in parts of the country where there are more people – the energy-guzzling units of society.

In contrast, a supply-limited brain should look like the river beds of a country, which couldn’t care less about where people are located. Water will flow where it can, and cities just have to adjust and make do with what they can get. Chances are, cities will form in the vicinity of the main arteries – but absent major, purposeful remodeling, their growth and activities are limited by how much water is available.

This image shows astrocytes, a type of brain cell, contacting a ravinelike capillary. Ed Reschke/Stone via Getty Images

Would I find that capillaries are concentrated in parts of the brain with more neurons and supposedly require more energy, like streets and highways built in a demand-based manner? Or would I find that they are more like creeks and streams that permeate the land where they can, oblivious to where the most people are, in a supply-driven manner?

What I found was clear evidence for the latter. For both mice and rats, capillary density makes up a meager 2% to 4% of brain volume, regardless of how many neurons or synapses are present. Blood flows in the brain like water down rivers: where it can, not where it is needed.

If blood flows regardless of need, this implies that the brain actually uses blood as it is supplied. We found that the tiny variations in capillary density across different parts of dead rat brains matched perfectly with the rates of blood flow and energy use in the same parts of other living rat brains that researchers measured 15 years prior.

Resolving blood flow and energy demand

Could the specific density of capillaries in each part of the brain be so limiting that it dictates how much energy that part uses? And would that apply to the brain as a whole?

I partnered with my colleague Doug Rothman to answer these questions. Together, we discovered that not only do both human and rat brains do what they can with what blood they get and typically work at about 85% capacity, but overall brain activity is indeed dictated by capillary density, all else being equal.

The reason why only 40% of the oxygen supplied to the brain actually gets used is because this is the maximum amount that can be exchanged as blood flows by – like workers trying to pick up items on an assembly line going too fast. Local arteries can deliver more blood to neurons if they start using slightly more oxygen, but this comes at the cost of diverting blood away from other parts of the brain. Since gas exchange was already near full capacity to begin with, the fraction of oxygen extraction seems to even drop with a slight increase in delivery.

From afar, energy use in the brain may look demand-based – but it really is supply-limited.

Blood supply influences brain activity

So why does any of this matter?

Our findings offer a possible explanation for why the brain can’t truly multitask – only quickly alternate between focuses. Because blood flow to the entire brain is tightly regulated and remains essentially constant throughout the day as you alternate between activities, our research suggests that any part of the brain that experiences an increase in activity – because you start doing math or playing a song, for example – can only get slightly more blood flow at the expense of diverting blood flow from other parts of the brain. Thus, the inability to do two things at the same time might have its origins in blood flow to the brain being supply-limited, not demand-based.

A better understanding of how the brain works could offer insights into human behavior and disease. Peter Dazeley/The Image Bank via Getty Images

Our findings also offer insight into aging. If neurons must make do with what energy they can get from a mostly constant blood supply, then the parts of the brain with the highest densities of neurons will be the first to be affected when there is a shortage – just like the largest cities feel the pain of a drought before smaller ones.

In the cortex, the parts with the highest neuron densities are the hippocampus and entorhinal cortex. These areas are involved in short-term memory and the first to suffer in aging. More research is needed to test whether the parts of the brain most vulnerable to aging and disease are the ones with the greatest number of neurons packed together and competing for a limited blood supply.

If it’s true that capillaries, like neurons, last a lifetime in humans as they do in lab mice, then they may play a bigger role in brain health than expected. To make sure your brain neurons remain healthy in old age, taking care of the capillaries that keep them supplied with blood may be a good bet. The good news is that there are two proven ways to do this: a healthy diet and exercise, which are never too late to begin.

Suzana Herculano-Houzel, Associate Professor of Psychology, Vanderbilt University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why the growing number of foreign agent laws around the world is bad for democracy

Georgians protest a foreign agent bill that mirrored a Russian law used to crack down on dissent. Vano Shlamov/AFP via Getty Images

Maxim Krupskiy, Tufts University

After several days of mass protests and clashes between protesters and police in early March, the ruling party of Georgia, a former Soviet state located in the Caucasus, succumbed to pressure and abandoned its proposed laws on foreign agents.

But the uproar and media focus surrounding the Georgian initiative and its demise should not mask a greater trend when it comes to such laws, which target foreign-funded media and nongovernmental organizations, or NGOs. Over the past decade they have sprung up in countries across the world. China, India, Cambodia, Australia and Uganda are among the dozens of countries that have “foreign agent” laws on their books.

And a few days after the withdrawal of the Georgian draft laws, Politico reported that the European Union was going to develop its own register of foreign agents.

Overly broad, prone to abuse

The impetus for the adoption of these laws in recent years has come from growing international tensions and concerns of national authorities about foreign influence on domestic affairs and public opinion.

The interpretation and application of “foreign agent” laws varies from jurisdiction to jurisdiction. But they all tend to require the registration and singling out of organizations with foreign funding or “influence.” In many cases, their activities are also curtailed unreasonably.

From my experience representing NGOs classified as foreign agents, such laws have the potential to be used as a tool against groups providing human rights and social assistance or monitoring the transparency of government agencies. Any organization involved in any way in international activities and deemed by a state to be influencing domestic policy or public opinion runs the risk of being recognized as a foreign agent.

The legislation in Georgia would have required nongovernmental organizations and media outlets that receive more than 20% of their funding from abroad to be included in a special register of “agents of foreign influence.” They would also need to file an annual financial declaration or face a US$9,500 fine.

The authors of the Georgia bill compared it to the American Foreign Agents Registration Act, or FARA, which applies to any “agent of a foreign principal.”

But critics argued that it was a copy of Russia’s more repressive foreign agents law. Human rights groups say the Russian law allows the Kremlin to obstruct the work of NGOs and independent media, as well as to harass dissenting citizens.

Ever since Russia enacted its foreign agents law in 2012, I have seen how authorities use vague legal concepts like “political activity,” “foreign funding” and “foreign influence” to determine whether an NGO is a foreign agent. These vague legal concepts allow executive authorities and courts to interpret the law as broadly as they like and arbitrarily decide who is or isn’t a foreign agent.

And this broad and arbitrary classification of foreign agents is not unique to Russia. It also applies to foreign agent legislation in more democratic countries. However, the more authoritarian a regime is, the more negative consequences these laws have on civil society.

How foreign agent laws began

The first foreign agent law, FARA, was enacted in the U.S. in 1938 to counter Nazi propaganda. This law is still in force today but has undergone significant changes. The concept of propaganda has disappeared from it, and its stated purpose is to identify foreign influence in the U.S. and address threats to national security.

While FARA does not create repressive restrictions on civil society, it can be interpreted extremely broadly if desired. The large number of advisory opinions that the FARA unit has issued on individual requests indicates how difficult it can be to determine who should register as a foreign agent.

In drafting their own foreign agent legislation, Russia and Georgia both referred to FARA. However, there is a key difference between their legislation and FARA: In the Russian and now-abandoned Georgian versions, “foreign agents” do not need to carry out activities on behalf of a foreign government, political party, business or individual.

As such, the use of the terms “foreign agent” and “agent of foreign influence” is incorrect from a legal point of view – agency activity does not even need to be proved.

Nonetheless, the legal consequences are very real for those who are labeled “foreign agents.” In Russia, these organizations cannot engage in educational activities in state schools, organize public events or produce or distribute materials for children. And their programs and activities can be canceled by state authorities even if they do not violate the law.

Protesters in Tbilisi, the capital of Georgia, face police in riot gear as they rally against the government’s planned foreign agent legislation. Zurab Tsertsvadze/AFP via Getty Images)

Civil rights violations

Similar legislation in other countries also violates civil rights and freedoms. Chinese law requires NGOs to obtain government permission to conduct their activities and to register with the security authorities, along with a number of other serious restrictions that essentially make it impossible for them to operate. As The Guardian newspaper has pointed out, “foreign NGOs must refrain from engaging in political or religious activities or acting in a way that damages ‘China’s national interests’ or ‘ethnic unity.’”

In Uganda, NGOs cannot operate in any part of the country unless they receive permission from the District NGO Monitoring Committee and the local government. They must also sign a memorandum of understanding with government representatives.

In 2022, international human rights organizations including Amnesty International and Human Rights Watch called on the Indian government to stop applying the Foreign Contribution Regulation Act to civil society. They argued that the law was being used to persecute the Centre for Promotion of Social Concerns, a prominent local NGO that monitors human rights abuses. Indian authorities accused the group of “portraying India’s human rights record in negative light … to the detriment of India’s image,” and searched its office and seized documents.

Beyond these legal consequences for NGOs, state rhetoric against foreign agents can lead citizens to distrust important NGOs and other organizations that protect human rights and provide public services. And unfairly applying the foreign agents law to individuals leads to a return to the Soviet rhetoric of “enemies of the nation.” Vladimir Putin’s railing against unspecified “scum and national traitors” and the “fifth column” wishing to destroy Russia in the interests of the West is an extreme manifestation of this rhetoric.

International courts have recognized how foreign agents laws have violated citizens’ rights and freedoms. In June 2022, the European Court of Human Rights ruled that Russia had violated the right to freedom of assembly and association with regard to NGOs deemed foreign agents. Two years earlier, the European Court of Justice determined that the Hungarian law on foreign agents unduly violates individual rights and freedoms and contradicts the European Union Charter of Human Rights. However, neither decision brought practical results, as the legislation in Russia and Hungary remains intact.

Growing movement

In the wake of Russia’s invasion of Ukraine in 2022, and foreign interference in elections in the U.S. and Canada, measures to protect state sovereignty have grown more popular.

Countries need to ensure transparency in financial transactions in order to curb corruption, money laundering, terrorism funding and other crimes. However, creating unnecessarily broad foreign agents laws that stigmatize and restrict law-abiding NGOs, independent media and individuals is a threat to democratic values.

Maxim Krupskiy, Visiting scholar, Russia and Eurasia Program, Tufts University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

FDA approval of over-the-counter Narcan is an important step in the effort to combat the US opioid crisis

The use of naloxone administered by nasal spray can be a lifesaving drug with minimal side effects. TG23/iStock via Getty Images Plus

Lucas Berenbrok, University of Pittsburgh; Janice L. Pringle, University of Pittsburgh, and Joni Carroll, University of Pittsburgh

On March 29, 2023, the U.S. Food and Drug Administration approved Narcan for over-the-counter sale. Narcan is the 4-milligram nasal spray version of naloxone, a medication that can quickly counteract an opioid overdose.

The FDA’s greenlighting of over-the-counter naloxone means that it will be available for purchase without a prescription at more than 60,000 pharmacies nationwide. That means that, for 90% of Americans, naloxone nasal spray will be accessible at a pharmacy within 5 miles from home. It will also likely be available at gas stations, supermarkets and convenience stores. The transition from prescription to over-the-counter status is expected to take a few months.

We are pharmacists and public health experts who seek to increase public acceptance of and access to naloxone.

We think that making naloxone available over the counter is an essential step in reducing deaths due to overdose and destigmatizing opioid use disorder. Over-the-counter access to naloxone will permit more people to carry and administer it to help others who are overdosing. Moreover, increasing naloxone’s over-the-counter availability will convey the message that risks associated with substance use disorder warrant a pervasive intervention much as with other illnesses.

Deaths from opioid overdoses across the U.S. have increased nearly threefold since 2015. Between October 2021 and October 2022, approximately 77,000 people died from opioid overdoses in the U.S. Since 2016, the synthetic opioid fentanyl has been responsible for most of the drug-involved overdose deaths in America.

Naloxone can be a lifesaving intervention from opioids and other drugs that are laced with the synthetic opioid fentanyl.

What is naloxone?

Naloxone reverses overdose from prescription opioids like fentanyl, oxycodone and hydrocodone and recreational opioids like heroin. Naloxone works by competitively binding to the same receptors in the central nervous system that opioids bind to for euphoric effects. When naloxone is administered and reaches these receptors, it can block the euphoric effects of opioids and reverse respiratory depression when opioid overdose occurs.

There are two common ways to administer naloxone. One is through the prepackaged nasal sprays, such as Narcan and Kloxxado or generic versions of the drug. The other method is via auto-injectors, like ZIMHI, which deliver naloxone through injection, similar to the way epinephrine is delivered by an EpiPen as an emergency treatment for life-threatening allergic reactions.

The FDA will review a second over-the-counter application for naloxone auto-injectors at a later date. Although no interaction with a health care provider will be needed to purchase over-the-counter naloxone, when naloxone is purchased at a pharmacy, a knowledgeable pharmacist will be able to help people choose a product and explain instructions for use.

Research shows that when people who are likely to witness or respond to opioid overdoses have naloxone, they can save patients’ lives. This also includes bystanders as well as first responders like police officers and paramedics.

But until now, people in those situations could intervene only if they were carrying prescription naloxone or knew where to retrieve it quickly. Friends and family of people who use opioids are often given prescriptions for naloxone for emergency use. Over-the-counter naloxone will help make the drug more accessible to members of the general public.

Naloxone works on a variety of opioids, including fentanyl.

Reducing stigma and saving lives

Naloxone is a safe medication with minimal side effects. It works only for those with opioids in their system, and it’s unlikely to cause harm if given by mistake to someone who’s not actively overdosing on opioids.

Since approximately 40% of overdoses occur in the presence of someone else, we believe public access to naloxone is extremely important. People may wish to have naloxone on hand if someone they know is at an increased risk for opioid overdose, including people who have opioid use disorder or people who take high amounts of prescribed opioid medications.

Community centers and recreational facilities may also keep naloxone on hand, similar to the placement of automated external defibrillators in public spaces for emergency use when someone has a heart attack.

There’s a long-held public stigma that suggests addiction is a moral failing rather than a chronic yet treatable health condition. Those who request naloxone or who have an opioid use disorder experience stigma and often aren’t comfortable disclosing their drug use to others, or seeking medical treatment. Removing naloxone’s prescription requirements by making it over the counter could decrease the stigma experienced by individuals since they no longer must request it from a health care provider or behind the pharmacy counter.

In addition, we encourage health care providers and members of the general public to use less stigmatizing language when discussing addiction.

Questionable accessibility

Often, medications switched from prescription to over the counter are not covered by insurance. It remains unclear if this will be the case with Narcan. If so, the costs will shift to the patient, highlighting the reason continued support of programs that offer naloxone free of charge remains important.

What’s more, over-the-counter access could paradoxically cause a decrease in the drug’s availability. A rise in purchases could make it harder to buy naloxone if manufacturer supply does not keep up with increased consumer demand. The U.S. experienced such shortages of over-the-counter drugs in late 2022 during the nationwide surges in flu, respiratory syncytial virus and COVID-19.

Federal and state governments could lessen these potential barriers by subsidizing the cost of over-the-counter naloxone and working with drug manufacturers to provide production incentives to meet public demand.

The effects of nationwide access to over-the-counter naloxone on opioid-related deaths remain to be seen, but making this medication more widely available is an important next step in our nation’s response to the opioid crisis.

Lucas Berenbrok, Associate Professor of Pharmacy and Therapeutics, University of Pittsburgh; Janice L. Pringle, Professor of Pharmacy and Therapeutics, University of Pittsburgh, and Joni Carroll, Assistant Professor of Pharmacy and Therapeutics, University of Pittsburgh

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A Mission for Nutrition

Accomplish health goals with better-for-you family meals

Setting out on a mission to eat healthier starts with creating goals and working to achieve them with those you love. To help make nutritious eating more manageable, call together your family and work with one another to create a menu everyone can enjoy while staying on track.

Connecting an array of recipes that all can agree on starts with versatile ingredients like dairy. Gathering at the table with your loved ones while enjoying delicious, nutritious recipes featuring yogurt, cheese and milk can nourish both body and soul.

For example, the key dairy ingredients in these recipes from Milk Means More provide essential nutrients for a healthy diet. The cheese varieties in Feta Roasted Salmon and Tomatoes and 15-Minute Weeknight Pasta provide vitamin B12 for healthy brain and nerve cell development and are a good source of calcium and protein, which are important for building and maintaining healthy bones. Meanwhile, the homemade yogurt sauce served alongside these Grilled Chicken Gyros provides protein and zinc.

To find more nutritious meal ideas to fuel your family’s health goals, visit MilkMeansMore.org.

Feta Roasted Salmon and Tomatoes

Recipe courtesy of Marcia Stanley, MS, RDN, Culinary Dietitian, on behalf of Milk Means More
Prep time: 15 minutes
Cook time: 15 minutes
Servings: 4

• Nonstick cooking spray
• 3 cups halved cherry tomatoes
• 2 teaspoons olive oil
• 1 teaspoon minced garlic
• 1/2 teaspoon dried oregano or dried dill weed
• 1/4 teaspoon salt
• 1/2 teaspoon coarsely ground black pepper, divided
• 1 1/2 pounds salmon or halibut fillets, cut into four serving-size pieces
• 1 cup (4 ounces) crumbled feta cheese

1. Preheat oven to 425 F. Line 18-by-13-by-1-inch baking pan with foil. Lightly spray foil with nonstick cooking spray. Set aside.
2. In medium bowl, toss tomatoes, olive oil, garlic, oregano or dill weed, salt and 1/4 teaspoon pepper.
3. Place fish pieces, skin side down, on one side of prepared pan. Sprinkle with remaining pepper. Lightly press feta cheese on top of fish. Pour tomato mixture on other side of prepared pan. Bake, uncovered, 12-15 minutes, or until fish flakes easily with fork.
4. Place salmon on serving plates. Spoon tomato mixture over top.

Grilled Chicken Gyros

Recipe courtesy of Kirsten Kubert of "Comfortably Domestic" on behalf of Milk Means More
Prep time: 30 minutes, plus 30 minutes chill time
Cook time: 20 minutes
Servings: 8

Chicken:

• 3 tablespoons unsalted butter, melted
• 2 tablespoons chopped fresh dill
• 1 tablespoon chopped fresh oregano
• 2 cloves garlic, peeled and minced
• 3 tablespoons freshly squeezed lemon juice
• 1 teaspoon kosher salt
• 1/2 teaspoon black pepper
• 2 pounds boneless, skinless chicken breasts

Yogurt Sauce:

• 1 1/2 cups plain, whole-milk yogurt
• 1 1/2 tablespoons freshly squeezed lemon juice
• 1/2 cup diced cucumber
• 2 tablespoons chopped fresh dill
• 1 clove garlic, peeled and minced
• 1/4 teaspoon kosher salt
• 1/8 teaspoon black pepper

• 3-4 small loaves whole-wheat pita bread, halved lengthwise
• 1 cup thinly sliced tomatoes
• 1/2 cup thinly sliced red onion

1. To make chicken: Place melted butter, dill, oregano, garlic, lemon juice, salt and pepper in gallon-size zip-top freezer bag. Seal bag and shake contents to combine. Add chicken. Seal bag, pressing air out of bag. Shake chicken to coat with marinade. Refrigerate chicken in marinade 30 minutes.
2. To make yogurt sauce: Stir yogurt, lemon juice, diced cucumber, dill, garlic, salt and pepper. Cover sauce and refrigerate.
3. Heat grill to medium heat.
4. Grill chicken over direct heat, about 10 minutes per side, until cooked through. Transfer chicken to cutting board and rest 10 minutes. Thinly slice chicken across grain.
5. Serve chicken on pita bread with tomatoes, red onion and yogurt sauce.

15-Minute Weeknight Pasta

Recipe courtesy of Kirsten Kubert of "Comfortably Domestic" on behalf of Milk Means More
Prep time: 5 minutes
Cook time: 10 minutes
Servings: 6

• 6 quarts water
• 16 ounces linguine or penne pasta
• 2 tablespoons unsalted butter
• 1/2 cup thinly sliced onion
• 1 cup thinly sliced carrots
• 1 cup thinly sliced sweet bell pepper
• 1/2 cup grape tomatoes, halved
• 1 teaspoon kosher salt
• 1/4 teaspoon black pepper
• 2 cloves garlic, peeled and minced
• 1 cup reserved pasta water
• 1 teaspoon finely grated lemon zest
• 1/2 cup smoked provolone cheese, shredded
• 1/4 cup chopped fresh parsley (optional)
• Parmesan cheese (optional)

1. Bring water to rolling boil and prepare pasta according to package directions for al dente texture, reserving 1 cup pasta water.
2. In large skillet over medium heat, melt butter. Stir in onions, carrots and sweet bell peppers. Saute vegetables about 5 minutes, or until they brighten in color and begin to soften. Add tomatoes, salt, pepper and garlic. Cook and stir 1 minute to allow tomatoes to release juices.
3. Pour reserved pasta water into skillet, stirring well. Bring sauce to boil. Reduce heat to medium-low and simmer 3 minutes. Taste sauce and adjust seasonings, as desired.
4. Transfer drained pasta to skillet along with lemon zest and smoked provolone cheese, tossing well to coat. Serve immediately with fresh parsley and Parmesan cheese, if desired.

 

SOURCE:
United Dairy Industry of Michigan

How the bottled water industry is masking the global water crisis

Bottled water corporations exploit surface water and aquifers, buy water at a very low cost and sell it for 150 to 1,000 times more than the same unit of municipal tap water. (Shutterstock)

Zeineb Bouhlel, United Nations University and Vladimir Smakhtin, United Nations University

Bottled water is one of the world’s most popular beverages, and its industry is making the most of it. Since the millennium, the world has advanced significantly towards the goal of safe water for all. In 2020, 74 per cent of humanity had access to safe water. This is 10 per cent more than two decades ago. But that still leaves two billion people without access to safe drinking water.

Meanwhile, bottled water corporations exploit surface water and aquifers — typically at very low cost — and sell it for 150 to 1,000 times more than the same unit of municipal tap water. The price is often justified by offering the product as an absolute safe alternative to tap water. But bottled water is not immune to all contamination, considering that it rarely faces the rigorous public health and environmental regulations that public utility tap water does.

In our recently published study, which studied 109 countries, it was concluded that the highly profitable and fast-growing bottled water industry is masking the failure of public systems to supply reliable drinking water for all.

The industry can undermine progress of safe-water projects, mostly in low- and middle-income countries, by distracting development efforts and redirecting attention to a less reliable, less affordable option.

Bottled water industry can disrupt SDGs

The fast-growing bottled water industry also impacts the UN’s Sustainable Development Goals (SDG) in many ways.

The rising sales of global bottled water is contributing to plastic pollution on land and in the oceans. (Shutterstock)

The latest UN University report revealed that the annual sales of the global bottled water market is expected to double to US$500 billion worldwide this decade. This can increase stress in water-depleted areas while contributing to plastic pollution on land and in the oceans.

Growing faster than any other in the food category worldwide, the bottled water market is biggest in the Global South, with the Asia-Pacific, Africa and Latin American and Caribbean regions accounting for 60 per cent of all sales.

But no region is on track to achieve universal access to safe water services, which is one of the SDG 2030 targets. In fact, the industry’s greatest impact seems to be its potential to stunt the progress of nations’ goals to provide its residents with equitable access to affordable drinking water.

Impact on vulnerable nations

In the Global North, bottled water is often perceived to be healthier and tastier than tap water. It is, therefore, more a luxury good than a necessity. Meanwhile, in the Global South, it is the lack or absence of reliable public water supply and water management infrastructure that drives bottled water markets.

Therefore, in many low- and middle-income countries, particularly in the Asia Pacific, rising consumption of bottled water can be seen as a proxy indicator of decades of governments’ failure to deliver on commitments to safe public water systems.

The rising consumption of bottled water in some countries can be seen as a proxy indicator of decades of governments’ failure to deliver on commitments to safe public water systems. (Shutterstock)

This further widens the global disparity between the billions of people who lack access to reliable water services and the others that enjoy water as a luxury.

In 2016, the annual financing required to achieve a safe drinking water supply throughout the world was estimated to cost US$114 billion, which amounts to less than half of today’s roughly US$270 billion global annual bottled water sales.

Regulating the bottled-water industry

Last year, the World Health Organization estimated that the current rate of progress needs to quadruple to meet the SDGs 2030 target. But this is a colossal challenge considering the competing financial priorities and the prevailing business-as-usual attitude in the water sector.

As the bottled water market grows, it is more important than ever to strengthen legislation that regulates the industry and its water quality standards. Such legislation can impact bottled water quality control, groundwater exploitation, land use, plastic waste management, carbon emissions, finance and transparency obligations, to mention a few.

Our report argues that, with global progress toward this target so far off-track, expansion of the bottled water market essentially works against making headway, or at least slows it down, adversely affecting investments and long-term public water infrastructure.

Some high-level initiatives, like an alliance of Global Investors for Sustainable Development, aim to scale up finance for the SDGs, including water-related ones.

Such initiatives offer the bottled water sector an opportunity to become an active player in this process and help accelerate progress toward reliable water supply, particularly in the Global South.

Zeineb Bouhlel, Research Associate, Institute for Water, Environment and Health (UNU-INWEH), United Nations University and Vladimir Smakhtin, Former Director of the Institute for Water, Environment and Health (UNU-INWEH), United Nations University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Public school enrollment dropped by 1.2M during the pandemic – an expert discusses where the students went and why it matters

Some parents decided to continue home-schooling their kids even after public schools resumed in-person classes. AP Photo/Sarah Blake Morgan

Thomas Dee, Stanford University

Student learning took a big hit during the COVID-19 pandemic. Just how much is only becoming clear nearly three years after the World Health Organization declared the pandemic and nearly all U.S. public schools pivoted to online instruction for at least several months in March 2020.

However, the data guiding the nation’s efforts to help kids catch up does not generally include the students who experienced the most dramatic learning disruptions.

Nationwide testing results released in the fall of 2022 revealed that the reading and math performance on standardized tests of students who were in fourth and eighth grades in the U.S. in the 2021-2022 school year declined by historic amounts.

This dramatic evidence of learning loss has mobilized federal, state and local education leaders. The federal government has allocated US$122 billion to support state and local efforts to help students “catch up in the classroom.”

Public school districts are using these resources to fund tutoring and extended learning time. And researchers are assessing the effects of these investments on standardized test scores.

However, these efforts do little to identify or target support to the children whose learning environments were most disrupted by the pandemic. This is especially so for the youngest students, who aren’t yet old enough for most standardized testing.

Enrollment decline and the ‘streetlight effect’

During the pandemic, public school enrollment in grades K through 12 fell by 1.2 million students. These declines were concentrated among kindergarten students and in schools that offered only remote instruction.

Similarly dramatic enrollment losses among even younger learners erased a decade of progress in boosting preschool education enrollment.

These declines indicate that the pandemic caused students to miss instructional time or undertake disruptive school switches, often in their developmentally critical early years.

However, school officials list early-childhood programs among the least popular use of available federal funds and provide no indication of targeted academic-recovery efforts for younger or truant students.

This is an example of what scholars call the “streetlight effect,” in which people focus their attention on easily visible evidence – such as the test scores available for older, currently enrolled students – rather than other relevant data that are more obscured and harder to identify.

And long lags in national data reporting mean little is yet known about the learning environments of the disproportionately young children whose families avoided public schools during the pandemic. Currently, official federal statistics do not even provide basic data on private school or home-school enrollment beyond 2019.

In most schools, standardized tests don’t start until well beyond kindergarten. FatCamera/E+ via Getty Images

Where the kids went

My research, done collaboratively with The Associated Press and data journalists at Stanford University’s Big Local News, addresses this issue.

For our analysis, we gathered state-level data on public, private and home-school enrollment for the school years from 2019-20 through 2021-22. We also used U.S. Census Bureau estimates to identify the school-age population in each state over this time period. These combined data provide insights into where the students who avoided public schools went and what it means for the nation’s academic-recovery efforts.

Complete data aren’t available in every state, but we have good data on more than half of the school-age population in the U.S. at the onset of the pandemic. These states also experienced public school enrollment declines that are representative of the national trend.

Some students, particularly the youngest, clearly turned to private schools during the pandemic. In the 34 jurisdictions with available data, private school enrollment grew by over 140,000 students between the 2019-20 and 2021-22 school years. However, this increase only explains a modest amount – roughly 14% – of the corresponding decline in public school enrollment.

A more surprising finding is the robust growth of home-schooling during this period. An early Census Bureau survey reported that home-schooling increased soon after the pandemic began. Our data show this initial increase endured into the 2021-22 school year when most public schools returned to in-person instruction.

In the 22 jurisdictions with data, home-school enrollment increased by over 184,000 students between the 2019-20 and 2021-22 school years – a 30% increase. For every additional student enrolled in private school over this period, nearly two entered home-schooling. This sustained growth in home-schooling explains 26% of the corresponding losses in public school enrollment.

Roughly a quarter of the public school enrollment loss simply reflects the pandemic decline in the number of school-age children in the U.S. However, people moving to new homes during the pandemic means this demographic impact varied considerably by state. In states like California and New York, which saw their overall populations fall dramatically, the percentage declines in public school enrollment were at least six times those in states like Texas and Florida, where populations grew.

New questions for academic recovery

These findings raise several new questions about what help American students will need to get their education back on track. For instance, researchers know little about the learning opportunities available to children who switched to home-schooling, or the effects of this choice on families.

Our data is also unable to locate more than one-third of the students who left public schools. That could mean that some children are not going to school at all – or that even more families started home-schooling but did so without notifying their state.

A third possibility is that the pandemic led more families to have their kids skip kindergarten. Our data indirectly supports this conjecture. The unexplained declines in public school enrollment are concentrated in states that do not require kindergarten attendance, like California and Colorado.

What we do know is the pandemic’s learning disruptions occurred disproportionately among the nation’s youngest learners.

Our work to understand and respond to this situation is just beginning. One possible response is to refocus some federal funding on the broad use of early screening tools to reliably identify – and address – learning setbacks years before students are old enough to take the current battery of standardized tests, which often begins in the third grade. Policymakers can also do more to locate students who are missing and to understand the educational needs of those outside the light of conventional data systems.

Thomas Dee, Barnett Family Professor, Stanford University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The World Bank used to cause untold harm - but 30 years ago it started reforming. What went right

Photo by Celal Gunes/Anadolu Agency via Getty Images

Danny Bradlow, University of Pretoria

Development projects can have profound impacts on their societies. There are many benefits that flow from building new roads and power plants, and from modernising agricultural practices. But they can also have permanent negative consequences.

For example, communities may be involuntarily relocated to make way for roads or power plants. These projects can change the way natural resources are used in a particular area, making it difficult or impossible for communities to continue their traditional agricultural practices. The job opportunities that they create can challenge traditional values and ways of living.

Historically, many of these projects have been owned or sponsored by governments, eager to bring the benefits of modernisation to their citizens. They have often been funded by multilateral institutions like the World Bank, which was established in 1944 to fund the reconstruction and development of its member states.

These institutions were not unaware of the environmental and social impacts of the projects they funded. However, they maintained that each state had to decide for itself how it wished to manage these impacts. They would argue that they were merely the funders, and so should defer to the government on how to manage them. It would be an affront to the state’s sovereignty for them to interfere with the government’s decisions on these aspects of the project.

The World Bank’s confidence in its ability to avoid responsibility for its project related decisions and actions was bolstered by the fact that it was immune from being sued in any national court.

The result was that the bank supported some projects that were environmentally and socially damaging. As a result, during the 1980s the World Bank was the target of sustained protests by affected communities and their allies around the world.

To its credit, 30 years ago the bank, following an international campaign in which this author participated, recognised that its position was untenable. In 1993 it established the world’s first citizen driven independent accountability mechanism, the World Bank Inspection Panel.

This article argues that the panel’s 30th anniversary is a moment to celebrate its accomplishments. The panel has significant limitations. Nevertheless, its impact on development and the international development financing institutions has been profound.

Accomplishments

The three-member panel is independent of the World Bank’s management. It receives and investigates complaints from communities who allege that they have been harmed or threatened with harm because of the World Bank’s failure to comply with its own policies and procedures in funding a particular project. In other words, the panel’s focus is exclusively on the conduct and decisions of the Bank’s staff and management.

It sends its findings to the bank’s board. In cases of noncompliance, the bank’s management is expected to submit an action plan to the board that explains how it will correct the noncompliance and its consequences. Both the report and the action plan are made public.

Since it was established, the panel’s investigations have resulted in some relief for affected communities. For example, 70,000 people, previously ignored by the World Bank, received compensation for their losses in a bridge project in Bangladesh. In the Democratic Republic of Congo, a forestry project was revised to provide greater protection to indigenous communities who had not been adequately consulted about the project.

The panel has also succeeded in establishing the principle that international financial organisations must be accountable for their own actions to the communities whose lives are affected by the projects and policies they finance.

Since its establishment, over 25 multilateral and national development banks and institutions have established their own independent accountability mechanisms. In total, these mechanisms have received 1,634 complaints, of which about 330 have been from 27 countries in Africa. Forty-five of the African cases have resulted in findings on compliance or noncompliance.

All findings of noncompliance have led to management action plans intended to correct the noncompliance.

The reports of these mechanisms are used both by their own institutions to improve their performance in development projects and to reduce the risk that they repeat old mistakes. They can also help ensure that they are held accountable when they do repeat these mistakes.

Many of these mechanisms now offer dispute resolution services in addition to compliance reviews. Many of them now also publish reports documenting the lessons they have learned about specific aspects of development projects.

It is important to note that many of the issues that arise in these cases also arise in private sector projects. This means that the reports provide guidance and help develop good practice standards for all development projects. They are also used to develop best practice in regard to the human rights and environmental responsibilities of business.

Challenges

To be sure, independent accountability mechanisms face significant challenges.

The first is that bringing cases to the mechanisms is not simple. Many of the successful cases have required communities to obtain the assistance of technical experts. This means that the cases that are brought come from communities that have access to sophisticated NGOs and advisers rather than because they are the most urgent cases.

Second, they cannot make binding decisions or determine that the communities should be given a remedy. There have been cases in which those who have been harmed by the action of the banks have been compensated. But this is not the norm. In fact, there is only one case in Africa in which a panel investigation led to victims receiving monetary compensation. The panel’s report in a case in Uganda resulted in the World Bank developing a new policy on gender-based violence and establishing a trust fund to compensate, and support the girls and women who were the victims of this violence.

Designing and funding remedies that can be used in all similarly situated cases is politically and technically complicated. But it is not acceptable that those who have been harmed by the Bank’s own failures do not receive an effective remedy that compensates them for their loss.

Third, the bravery required to bring complaints to these mechanisms must be noted. They require the complainants to go to an international forum in opposition to their own governments or powerful interests in their own countries who support the projects the banks are funding. It is therefore inevitable that in some cases, the supporters of the project will retaliate against the complainants. This suggests that the mechanisms and the banks have a responsibility to take action to protect the complainants.

To their credit, the banks and the mechanisms have foreseen this problem and do allow for confidential complaints. But the procedures that seek to protect the complainants from reprisals have not always been fully effective.

It is now standard practice for multilateral financing institutions like the World Bank to have an independent citizen driven accountability mechanism that focuses exclusively on the responsibilities of the institution. The only exception to this general rule is the International Monetary Fund.

The mechanisms have also demonstrated that they can evolve and adapt to new challenges. While their limitations have also become clear, we should celebrate the Inspection Panel’s 30th anniversary.

Danny Bradlow, SARCHI Professor of International Development Law and African Economic Relations, University of Pretoria

This article is republished from The Conversation under a Creative Commons license. Read the original article.