Grandmother Di Ayling helps daughter Alison with pre and post school care.

Published December 13, 2017 10:52:44

Teacher Alison Ayling exchanges last-minute information together with her mother Di Ayling, who provides before- after-school take care of grandchildren Max and Alex.

ABC Newcastle: Anthony Scully.

Topics: child-care, children, children—preschoolers, family, newcastle-2300

In the Arizona desert, coal era burns out for Navajo

BLACK MESA, Ariz. — Tradition has it that the spiritual forerunners of the Navajo people picked this spot — the high mesa land of the American Southwest — and assured the Navajo they had reached a kind of promised land.

The Diné, or “children of the Holy People,” as the Navajo call themselves, were taught not to stray from the land bracketed by four sacred mountains, where they would never know the earthquakes, tornadoes and other calamities that beset their neighbors. The Navajo scratched out a living from the sparse scrub country and, for centuries, the teaching seemed true enough.

But the arrival of newcomers — first from Spain, then Mexico and, finally, America — thrust the tribe into new cultures and new economies they did not choose. Over the last century, in particular, American settlers and institutions urged the Navajo into livestock ranching, land development and uranium mining, only to end or curtail those industries, leaving the tribe to manage the disastrous fallout.

Now, history’s pendulum appears to have swung again. A coal business, dropped into the Navajo heartland a half century ago, is staggering. Electric utilities around America are converting to cheaper natural gas. And the world is turning to cleaner power sources, like wind and solar.

Video by Jim Seida, Edited by Aine Pennello

The utility that operates the Navajo Generating Station announced at the start of 2017 that it would turn off the plant by December 2019. The shutdown would almost certainly drag down the power plant’s lone coal supplier, the Kayenta Mine, which has no other customers.

News of those twin blows has rattled hundreds of Navajo workers who would lose their jobs, sent politicians from the Arizona state house to President Trump’s Interior Department scrambling for ways to keep the plant in business, and thrown the far-flung Navajo Nation and the neighboring Hopi Reservation into a tempest. Loved or hated, coal has been a mainstay of life here for decades, even as it has fouled the air and scarred the land that the tribe holds sacred.

On one side, tribal supporters of the power plant and the vast open-pit coal mine that feeds it spent most of the last year fighting furiously to stave off the closure. They hired a top investment banking firm to search for new owners and lobbied in Washington — where coal’s self-proclaimed No. 1 fan occupies the Oval Office — for a political solution.

On the other side, Navajo opponents cheered what they they saw as end times for an industry they say never delivered the economic bounty promised in Indian Country and was blamed for damaging the health and the environment of impoverished residents. The Navajo plant and others in the region laid a persistent haze from the Grand Canyon to Arches National Park in Utah to the Pine Mountain Wilderness in central Arizona. And coal operations siphoned away a vast amount of water in a region that desperately needs more to grow and diversify the economy.

Industry in the Wild West A mine and power plant support two tribes

Navajo

Generating

Station (NGS)

Navajo Nation

Black Mesa &

Lake Powell

Railroad

Kayenta

Mine

Complex

Hopi

Reservation

NEW MEXICO

CALIFORNIA

Navajo

Generating

Station (NGS)

Navajo Nation

Black Mesa &

Lake Powell

Railroad

Kayenta

Mine

Complex

Hopi

Reservation

NEW MEXICO

Navajo Nation

Navajo

Generating

Station (NGS)

Black Mesa &

Lake Powell

Railroad

Kayenta

Mine

Complex

Hopi

Reservation

Coal mined at the Kayenta complex in Northern Arizona flows, by conveyor belt and train, to the Navajo Generating Station. Electricity from the plant helps power the Southwest. Sources: NGS-KMC Project, U.S. Geological Survey, U.S. Census Bureau, OpenStreetMap, Natural Earth

Peabody Energy, the giant multinational company that operates the mine, said it still expects to find a new power plant operator that will continue burning its coal. But the plant operators note that they soon must begin the engineering and planning to take NGS apart and seem to hold little hope the operation can keep going.

The stakes are unusually high. The shutdown of the mine and the power plant — known by its acronym, NGS — would deprive the Navajo reservation of its two largest non-governmental employers. The 43-year-old generating station and its sister coal mine employ more than 700 people, many at salaries of more than $100,000 a year, a small fortune in the depressed economy of Northern Arizona. Another 2,300 jobs in the region are linked to the two major employers.

The financial stimulus also enriches the Navajo Nation, with NGS lease payments and coal royalties contributing roughly one-fifth of the tribe’s general-fund budget. For the government of the Hopi reservation — entirely surrounded by the vast Navajo lands — reliance on coal is even greater. Nearly 87 percent of this year’s Hopi general budget of $14.6 million is expected to come from coal-related royalties and fees.


“How much of that electric line goes to my people?” asked Russell Begaye, the president of the Navajo Nation. “Zero. We don’t get any power from this.”
The loss of those funds is viewed as disruptive to the Navajo government and debilitating for the Hopi. Services ranging from police patrols, to food banks, to health care for the elderly could be slashed if the coal money disappears, tribal members predict. Those services help people already operating on the margins. Half of adult Navajos do not have a job. About 40 percent of the population lives below the poverty line.
“Our leaders in the past saw this as something we would have for 100 years,” Navajo President Russell Begaye said of the coal money. “Now we see that is not the case… At the beginning, this would devastate Navajo.”
‘Not very important country’
The unforgiving land around the Four Corners has repeatedly spawned compromises and odd alliances, none more unlikely than the one that gave birth to the Navajo Generating Station.
In the early 1960s, the modern environmental movement was just coming of age. A signature battle was over construction of a pair of dams on the Colorado River in the Grand Canyon. Environmentalists said that creating lakes in the mile-deep canyon would be like flooding the Sistine Chapel.
Environmentalists succeeded in blocking the dams, so powerful Arizona interests needed an alternative. The influential Udall family — Interior Secretary Stewart Udall and his brother, Rep. Morris Udall — came up with a proposal to build a power plant near Lake Powell, where the river had already been dammed, and use the new electricity to pump Colorado River water south. The scheme would turn 100 square miles of Navajo territory into an open-pit coal mine and subject the surrounding region to the sulphur and carbon emissions that come with burning coal. Desperate to save the Grand Canyon, Sierra Club founder David Brower saw that as an acceptable compromise. “That is not very important country,” he said, “compared to Grand Canyon.”

In recent years, the Sierra Club has tried to come to terms with the consequences of its decision. The organization’s magazine this year described the acquiescence to a massive polluter as  “shadowy.” It said the organization had learned and would never again treat native people so cavalierly.

With environmental opposition pushed aside, the giant power plant rose in a desolate high desert where man’s previous footprint had consisted of traditional one-room Navajo homes, called hogans, along with truck stops and the occasional tourist oasis. Today, the concrete and steel power factory looms like an alien spacecraft against a backdrop of red sandstone monoliths that date to a time before human history. White steam mushrooms from three smokestacks, visible for miles in every direction.

From the time of its opening in 1974, NGS did not lack for customers. Utilities from as far away as Los Angeles craved cheap power. The environmental costs received fleeting attention.

Coal and homelands in America Native tribes join the ‘extractive’ industries

Coal Power Station

Navajo

Generating

Station

(NGS)

Kayenta

Mine

Complex

Coal Power Station

Navajo

Generating

Station

(NGS)

Kayenta

Mine

Complex

Coal Power Station

Navajo

Generating

Station

(NGS)

Kayenta

Mine

Complex

Coal Power Station

Navajo Generating Station(NGS)

and Kayenta Mining Complex

Sources: U.S. Energy Information Administration, U.S. Environmental Protection Agency,  U.S. Census Bureau

But the new millennium brought new concerns and new competitors.

In 2005, another power plant fueled by Navajo coal — the Mohave Generating Station of Laughlin, Nevada — had to shut down after Southern California utilities balked at paying $1 billion for mandatory air pollution retrofits. The closure marked an early victory in an expanding national campaign to reduce climate-warming greenhouse gases.

As energy companies expanded the use of hydraulic fracturing to free up deep underground deposits, the price of natural gas steadily declined. By 2009, the price cratered, to less than $3 per thousand cubic feet, compared with the previous summer’s high of $13.

The result, from 2010 until the present, is that half of America’s 523 coal-fired electricity plants have either closed or announced they would soon go out of business. The disdain for coal hit the Navajo Generating Station in 2013, when the Los Angeles Department of Water and Power moved to sell its roughly one-fifth stake in the plant. Another stakeholder in NGS, Nevada’s NV Energy, signaled the same year that it planned to phase out coal power.

But in 2016, presidential candidate Donald Trump had a different idea. He insisted coal’s only real problem was excessive government regulation, campaigning on a pledge to end the “war on coal.” Once in office, he canceled the Obama administration’s Clean Power Plan, which supported the economy’s shift away from carbon fuels. And his regulators pushed a rule that would give advantages to power plants, like those that burn coal, that keep large fuel supplies on site. Backers say the policy would make sure that electricity is delivered without interruption.

shutting down.

“Coal is not coming back,” said Bruce Nilles, the senior director of the Sierra Club’s Beyond Coal Campaign. “This promise that it is coming back is doing a great disservice to people like the workers at Navajo Generating Station, keeping them in an unrealistic state of suspense, when they should be planning for the future.”

A river of coal and jobs

Today, a virtual river of coal runs for 17 miles on an elevated conveyor belt from the heart of the Kayenta Mine to the towering silos of a depot on the grassland just north of Black Mesa. Empty trains arrive at the depot three times daily, load up, then ship the shimmering black cargo 78 miles northwest to the Navajo Generating Station, where the fuel piles up in small mountains. It is eventually pounded into dust and burned at 1,000 degrees Fahrenheit, 24 hours a day.

It’s a point of pride with the operators that the power station delivers a continuous supply of electricity. The men and women who work here are quick to contrast that with wind and solar operations, which can wax and wane with the weather.

The Navajo lease with the plant operators runs out on Dec. 23, 2019. But as recently as 2012 that date looked like it would be extended. The tribe and its utility partners (Salt River Project, the Interior Department’s Bureau of Reclamation, Arizona Public Service, NV Energy of Nevada and Tucson Electric Power) agreed to terms to keep NGS open another 25 years, until 2044.

That deal also upped lease payments to the Navajo from $860,000 a year to $32 million annually, according to Begaye, the Navajo president. Importantly, the extension would have given the tribe another 27 years to figure out how to build a post-coal economy.

But with power customers slipping away, the utilities never signed the new lease. The utility that pumps water south said it could have paid $38 million less in 2016 using cheaper alternatives to coal. A crucial blow came when the Salt River Project (SRP), the utility that helped build modern Arizona and the lead operator of the Navajo plant, said it had locked in 10-year contracts for cheap natural gas.

Navajo Nation leaders like Begaye were floored. They said a shutdown would be ruinous — taking 400 jobs at the power plant and another 325 at the coal mine, the vast majority of them held by Navajos, under employment preference agreements. On the smaller Hopi reservation, then-Chairman Herman G. Honanie found the potential gutting of the tribal budget so disturbing he said he could not sleep.

Kayenta mine workload Reduced use of coal, less work for miners

Mine Labor Hours

Mine Production

Mine Employees

short tons

number of employees

Mine Employees

Mine Labor Hours

Mine Production

number of employees

short tons

Mine Employees

number of employees

Mine Labor Hours

Mine Production

short tons

As customers demanded less power from the Navajo Generating Station, the power plant has needed less coal from its sole supplier, the Kayenta Mine. Source: U.S. Energy Information Administration

Peabody Energy does not intend to go quietly. The company commissioned an economic analysis that insisted coal could compete with natural gas. A shutdown of NGS, another study suggested, could lead to power blackouts around the Southwest. (These were countered by a study that found users would have to pay an extra $2.4 billion by 2030 if they continued to rely on coal-fired power.)

The coal mine announced in October that “highly qualified potential investors” had expressed an interest in buying out some of the current power plant operators, with the intention to keep burning coal. Peabody said it intended to have new ownership in place by the end of the first quarter of 2018, though it declined to name the partners willing to buck the nationwide trend.

“There are 195 million tons of coal still left up here,” said Audry Rappleyea, a 30-year veteran of western mining, who oversees operations at Kayenta, “and there’s no reason we shouldn’t mine every last crumb of it.”


“There are 195 million tons of coal still left up here,” says Audry Rappleyea, a 30-year veteran of western mining, who oversees operations at the Kayenta Mine, “and there’s no reason we shouldn’t mine every last crumb of it.”
But at the plant, most workers seem resigned to the end. The Salt River Project already has a program to find its workers jobs at other locations. And some employees have already moved on.
A Salt River Project spokesman said plans must soon be put in place to tear down NGS’s miles of ducts, its mammoth boilers and the signature smokestacks. The important thing, workers here say, is to avoid accidents and to keep the power flowing as long as they can. Stickers on the workers’ hard hats sport a new motto: “Finish Strong.”
A loss of fresh air, abundant water
To some Navajos, the pursuit of extractive industries like coal mining tears at the very core of their traditional teachings. Black Mesa is considered a female deity. Dynamite, tractors and hulking scoopers known as “draglines” effectively rip at the guts of this sacred figure.
“They are destroying the female,” said Percy Deal, an activist with the environmental group Diné Care. “They are interrupting a way of life, a way of religion and harmony and balance between man and nature.”
And there are more practical concerns, which environmental activists detailed one day this fall, in a meeting 25 miles south of the mine. They gathered in a remote niche of the reservation, in a hogan, one of the circular homes in which some Navajo still live. After a lunch of tacos on traditional fry bread, the activists took turns describing the trouble NGS has brought to the reservation. The 2,250-megawatt Navajo Generating Station near Page, Arizona, is the largest coal-fired power plant in the western United States. It has been a mainstay of the Navajo economy for 43 years, but the utilities that operate the plant said they intend to close it in 2019.
Shirley Peaches, a public health worker, read from a yellow legal tablet, recounting the multiple reports of cancer in one rural community downwind from the power plant. A nonsmoker recently came down with lung cancer, another contracted pancreatic cancer and a couple others report malignant growths in their stomachs, Peaches said.
No authoritative long-term health study of the impacts of the power plant’s emissions has been undertaken. A study completed in 2013 found that rates for many cancers, including lung cancer, were substantially lower among Navajos than among whites in New Mexico and Arizona. The report also showed that the Navajo suffered substantially higher rates of stomach, liver and kidney cancers.

A mixed diagnosis Most commonly diagnosed cancers among the Navajo1 compared to non-Hispanic whites, average age-adjusted cancer incidence rates2, 2005 to 2013, males and females combined, all ages

non-Hispanic whites AZ/NM

Pancreatic

Non-Hodgkin

Lymphoma

Colorectal

Female Breast

Cases per 100k people

Pancreatic

non-Hispanic whites

AZ/NM

Non-Hodgkin

Lymphoma

Colorectal

Female

Breast

Cases per 100k people

1American Indian/Alaska cancer incidence data in the six counties that comprise most of the Navajo Nation were used as a proxy for Navajo cancer incidence rates; the counties included: Apache County (AZ), Coconino County (AZ), Navajo County (AZ), McKinely County (NM), San Juan County (NM), San Juan County (UT). 2 Rates are per 100,000 persons and are age-adjusted to the 2000 U.S. standard population. Source: The Navajo Epidemiology Center (NEC) / Arizona Cancer Registry, New Mexico Tumor Registry and Utah Cancer Registry

The Clean Air Task Force, an organization promoting clean energy alternatives, produced a report in 2014 that projected negative health outcomes connected to coal emissions nationwide. It said Navajo Generating Station emissions would cause 12 deaths, 19 heart attacks and 230 asthma episodes annually, above what would be expected without the plant.

A plant spokesman said those projections were not “science-based,” adding that NGS has “some of the most sophisticated pollution control systems in the country.” The spokesman said anecdotes about ill health, tied to the plant, had no basis in science.

“They talk only about how this shutdown is going to impact workers and jobs,” Peaches said. “But they are not looking at the health impacts from the plant, if it keeps going, and how it is really hurting our people.”

Annie Walker, a former academic supervisor for the Bureau of Indian Affairs, said she made home visits to children not able to attend school. She recalled a few with “severe” neurological issues, so debilitating they were bedridden. To Walker, NGS emissions must have caused the illnesses.

By far the most routine complaint about the coal industry is that it consumes a flood of water that the desert reservation can’t afford to lose. The power plant slurps up 32,000 acre-feet of Colorado River water per year for pollution control and cooling, enough to supply about twice that many homes. (An acre-foot is enough water to cover an acre of land with a foot of water, or about 325,000 gallons.)

The Black Mesa Mine, immediately adjacent the Kayenta Mine, once pumped more than 1 billion gallons of groundwater a year, which it used to create a coal and water slurry that was then piped for 273 miles to the now-shuttered Mohave power plant. A couple of years after the mine’s 2005 closure, water levels wells that had been drying out began to increase again, according to the U.S. Geological Survey.

But Navajo and Hopi who live nearby say natural springs in the region have never recovered. Nadine Narindrankura, who farms and raises sheep just north of the isolated community of Hard Rocks, said her extended family has seen paltry harvests from severe drought. And with plants like NGS creating greenhouse gases that warm the earth, the region can only grow warmer, she said.

“The health of our animals is directly tied to the health of the plants and the health of the plants is tied to the health of the air and water,” Narindrankura said. “So we are all in this together.”

The host of the activists’ meeting was Deal, who has lived here all his life. He is agitated about many of the impacts of the coal industry, but particularly disturbed that the 2,250 megawatts of electricity from NGS travel hundreds of miles to big cities, while one third of Navajo reservation homes are still without power. And 40 percent of homes, including Deal’s, don’t have running water, meaning a 34-mile round-trip each week to truck in water.

“We feel it’s our water,” Deal said. “We want it back.”

Government officials at the national, state and tribal level say they would like to expand water and electric service across the reservation. But with 180,000 people spread over an area the size of West Virginia, many of the homes are so isolated that laying pipe or electric lines would be prohibitively expensive, they say.

One of the biggest looming fights, if the power plant closes, will be over the 50,000 acre-feet of water that had been set aside for its operation. The Navajo believe they should get the water. But under the byzantine Colorado Compact, which divides the river’s water among seven states, the allocation is promised to the state of Arizona. The tribe will have to fight for a share.

The anti-coal group gathered around Deal’s table nodded in assent as Ron Milford, a public health worker on the reservation, summed up. “Water is more important than anything,” he said. “It’s the bottom line for health. It’s the bottom line for the economy. It’s the bottom line for life.”

The miners who keep the lights on

In May, the U.S. Interior Department — which holds a 24-percent stake in the power plant through the Bureau of Reclamation, in order to pump water across Arizona — held hearings on the future of the Navajo Generating Station.

Filing much of the room at the first “listening session” were rows of workers in matching blue and white “Kayenta Mine” T-shirts. Men, and a few women, took turns talking about how the mine had changed their lives. Many had been itinerant workers, following construction jobs all over the West. But once they landed jobs at Kayenta they could stay home, help raise their kids and become part of the community.

Their fear is not of the unemployment line, but of joining the long parade of Navajos who have had to leave the tribe’s homeland. Workers at the power plant expressed the same fears of loss of culture and community.

One tribal member, Lelandolph Watson, has managed to afford a ranch house and three acres in Page, Arizona, thanks to his seven years working at the power plant. He can ride his horse out back and even rope a calf — at least the mechanical kind, towed behind his all-terrain vehicle.

If NGS closes, Watson expects to move to San Diego, where he served in the Navy, or to Phoenix, far away from the outdoor life and rodeos that his ranching family raised him to love. “Everything I ever wanted, I have now,” said Watson, a 36-year-old father of three. “For my life, my wife’s life and the kids, it’s going to be a really big disruption.”

No one should underestimate how much their labor spreads benefits well beyond their families, the workers said.

“I tell these guys they contribute every day,” said Jarvison Littlesunday, a supervisor at NGS. “They provide the power, the power that makes monitors run in hospitals and lights go on in schools and air conditioning everywhere. That is is the stuff that we make.”

Mine workers said that even some people who oppose coal mining seem to forget their opposition when the weather turns cold. They see the naysayers lining up in Kayenta’s public “load out” area, where tribal members are welcome to fill their pickup trucks with loads of free coal to burn in their homes.

Marie Justice, a Navajo truck driver at the coal mine and president of the United Mine Workers local, encapsulated the miners’ sense of abandonment at one of the Interior Department hearings.

“We have given our land all that time for them to make money … and provided all the water here to turn on their faucets,” Justice said. “Now you want to walk away from all of this? I don’t think that is right.”

Like hundreds of other Navajo miners at Kayenta, truck driver Lawrence Gilmore, 57, could use at least a few more years on the job to get himself to a proper retirement age. With his kids mostly on their own, he would like to spend some of his money to build a retirement home in the hills near Pinon.

Gilmore was as happy as any of his colleagues when he heard the report from Peabody that new owners might be coming to rescue the power plant. “Everything’s not gloom and doom,” he told a visitor. But in the next moment, he recalled a conversation in which he told his 28-year-old son, Quanah, that he could see the mine closing some day.

“It’s probably a good idea,” he said, “to just let it heal.”

On some mornings, Gilmore will pull his pickup to a stop high on Black Mesa. He has been to this scrubby hillside enough that, even in the pre-dawn dark, he can find a familiar pinon pine tree that’s become something like an altar. Facing the tree, not much taller than he is, Gilmore will sprinkle a little white corn meal, an offering for the coming day.

In his native Navajo, he’ll address the mountain underneath his feet. “I thank you for providing for me and my family,” Gilmore will say. “I want safety for everyone. I am not here to harm you.”

Final countdown to Hats on 4 CPC

The Worldwide Children’s Palliative Care Network (ICPCN) is counting lower the days until their annual Hats on 4 CPC campaign. The campaign, that is presently in the third year of running will occur on Friday 14 October 2016. Hats on 4 CPC is a terrific raise awareness and money for children’s palliative care worldwide. Regardless if you are a college, business, NGO, children’s palliative care service or simply an over-all man in the pub, it’s increasingly simple to obtain involved.

The ICPCN is impressed with the amount of organisations and people from around the world which have adopted the campaign making it their very own. Exciting occasions happen to be planned within the U . s . States, Hong Kong, Portugal and Nigeria simply to mention a couple of countries. When requested concerning the campaign, Joan Marston, ICPCN’s Leader stated, “We put on a hat to safeguard us in the sun in order to make us look great. With children’s palliative care our goal would be to safeguard children whenever possible in the results of their illness while getting just as much pleasure and sweetness to their lives as possible. By putting on a hat on Friday 14 October you’ll be a part of an international movement to lessen children’s suffering and also to bring beauty and compassionate care to their short lives.”

With simply a couple of days left until Hats on 4 CPC, make certain you do not lose out on this chance to behave for that over 21 million children worldwide which are dying in discomfort and suffering, with no necessary palliative care.

How will you become involved?

You will get involved with ICPCN’s annual Hats on 4 CPC at various levels, you will get involved as:

  • A person
  • School or company
  • Children’s palliative care service or NGO

The ICPCN is promoting stickers, posters, flyers as well as other materials to help you to promote this very day. Click the link, to download this stuff. If you’re motivated to complete more, you are able to encourage your number of buddies, workplace, school or business to obtain involved by hosting your own ‘Mad Hatter’s Tea Party’ or lunch.

Click the link for more information about Hats on 4 CPC or else contact the ICPCN at [email protected] to join up your event or more information. 

Hospital still the most typical host to dying for kids with cancer in England

The research, funded by Marie Curie, checked out the way the host to dying in youngsters and youthful individuals with cancer in England has altered within the period 1993-2014, following numerous national initiatives to enhance finish of existence care because the late 1990s.

The paper, printed now in BMC Cancer, examined data in the dying registration database from the Office for National Statistics, covering 12,774 children and youthful people (to the chronilogical age of 24) whose deaths were recorded to be because of or associated with cancer.

Within the period 1993 to 2014, hospital deaths dropped slightly from 50 plusPercent to 45%, as the proportion of home deaths fluctuated around 40%. Deaths in hospices greater than bending from 6% in 1993-2000 to 13% in 2005-2014.

Individuals aged as much as 19 years were more prone to die in your own home than youthful adults. Youthful patients with haematological cancer for example leukaemia or individuals with a mix of conditions were built with a greater possibility of hospital dying.

Residing in a deprived area was connected having a reduced possibility of dying in your own home but didn’t affect rates of hospice deaths.

The research didn’t consider the preferences from the patient and family people, or indicators for clinical suitability from the host to dying. However, as previous research has proven that the patient and/or their carer’s preference for where you can die is extremely determined by the amount of care and support available, the authors conclude more initiatives are have to enhance finish of existence support and capacities both at home and in hospices.

Have to enable greater option for children and youthful people in the finish of existence

“Our findings reveal that further work is required to enhance finish of existence care support to allow more children and youthful individuals to die both at home and inside a hospice, whenever they express a desire to do this,” stated lead author, Dr Wei Gao, in the Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation at King’s College London.

“We all know that youngsters and youthful individuals with cancer as well as their carers are particularly worried about having the ability to alleviate discomfort along with other signs and symptoms to be comfortable within their last days however, if these needs can’t be met in various care settings this leads to nearly all deaths happening in hospital.

“Using hospices, although increasing, continues to be rather lower in most British regions, despite their potential like a appropriate option to hospital in assisting to handle the signs and symptoms of cancer.

“More scientific studies are needed about how better to expand using hospice services. Considering that home and hospices are often preferred for youthful cancer patients to invest their last moments of existence, the healthcare system must be better outfitted to satisfy such needs.”

The research was welcomed by Barbara Gelb OBE, Chief executive officer at Together for brief Lives, who highlighted the requirement for comprehensive children’s palliative care to be able to better offer people choice over where they spend their final days, but additionally noticed that for many hospital is how they would like to be:

“These children frequently possess a different care journey to individuals with non-malignant conditions, with lots of developing close contacts with hospital teams, for instance, that could influence selected host to dying. The key factor is the fact that professionals encourage these families and youthful individuals to explore, discuss and arrange for their finish of existence choices – and discover what suits them.

“There are lots of things to consider, including how discomfort and potentially distressing signs and symptoms can best be managed, if the location can hold equipment and medical supplies, and just what change up the situation may have around the wider family. We want an adaptable approach and families have to know they are able to change their brains, of course this happens near to the finish of the lives.

“Real choice also depends upon comprehensive children’s palliative care finding yourself in place which could support families night and day, including at nights and weekends. What this means is became a member of up services working over the statutory, voluntary and sectors and across different settings.”

‘Place of dying in youngsters and youthful individuals with cancer and implications for finish of existence care: a population-based study in England, 1993–2014’ by Gao et al is printed in BMC Cancer.

New Expect Youngsters with Multiple Food Allergic reactions

HealthDay news image

TUESDAY, 12 ,. 12, 2017 (HealthDay News) — Cure for children using more than one harmful food hypersensitivity shows promise at the begining of trials, researchers say.

Almost one-third of individuals having a food hypersensitivity have reactions to several kind of food. This could increase the chance of accidental exposure and existence-threatening anaphylaxis, based on researchers at Stanford College Med school.

No treatment are available for multiple food allergic reactions. Usually, people are told to prevent the meals triggers, however this requires constant focus on their diet program.

“Patients think it is very difficult to accept multiple food allergic reactions,” stated study senior author Dr. Sharon Chinthrajah. “It puts an enormous social and economic burden on families.”

Within this new study, scientists combined the bronchial asthma drug omalizumab (Xolair) with immunotherapy for 48 children using more than one food hypersensitivity.

Immunotherapy exposes patients to small levels of the meals that create their allergy symptoms. Progressively, the allergen dose is elevated before the patient can tolerate normal levels of the meals.

Taking omalizumab made an appearance to hurry in the desensitization process without having to sacrifice safety, they stated.

“This may be an extremely promising method to reduce the burden of just living with food allergic reactions,” stated Chinthrajah, director of clinical translational research at Stanford’s Center for Allergy and Bronchial asthma Research.

Even though the answers are preliminary, they claim that youngsters with multiple food allergic reactions “might eventually be securely desensitized for their trigger-foods by using this treatment combination,” she stated. Still, further research is required to read the findings prior to the treatment opens up.

The research participants were at random allotted to get the combined allergy treatment or perhaps a placebo. These were 4 to fifteen years of age and were allergic to a number of foods, including almonds, cashews, eggs, hazelnuts, milk, peanuts, sesame, soy, walnuts and wheat.

The kids received omalizumab or perhaps a placebo for eight days before beginning immunotherapy as well as for eight days during combination treatment with immunotherapy for 2 to 5 trigger-foods. The participants then ongoing immunotherapy with no drug for the next 20 days.

They discovered that 83 percent from the treatment group could tolerate a little dose of two food allergens versus 33 percent who required the placebo.

The research demonstrated significant enhancements in complete safety and effectiveness in multi-allergic patients given omalizumab and food immunotherapy, stated study co-author Dr. Kari Nadeau.

“Omalizumab might help change the path of therapy by looking into making it safer and faster,” stated Nadeau, a professor of drugs as well as pediatrics.

The kids who received the double treatment were desensitized for their food allergic reactions quicker than individuals using the placebo coupled with less digestive and breathing issues, based on the researchers.

“Patients and families say they are so grateful. They are able to broaden their food variety and take part in more social activities without anxiety about a poor allergic attack,” Chinthrajah stated.

“Kids say such things as, ‘I no more spend time at the allergen-free table at lunch I’m able to sit with my usual buddies,’ ” Chinthrajah added. “These small stuff that others ignore can open their social world.”

The research was printed online 12 ,. 11 in The Lancet Gastroenterology & Hepatology.

SOURCE: Stanford College, news release, 12 ,. 11, 2017

News tales are written and supplied by HealthDay and don’t reflect federal policy, the views of MedlinePlus, the nation’s Library of drugs, the nation’s Institutes of Health, or even the U.S. Department of Health insurance and Human Services.

Strengthening palliative care services for him or her of Malawi

Malawi is among the African countries that are moving fast within the developing and strengthening of palliative care services for kids. This past year, with the assistance of ICPCN, the Palliative Care Association of Malawi (PACAM) received a grant in the Open Society Institute of Southern Africa to upscale palliative care services for kids. 

Training
The grant enabled Malawi to coach 20 health care professionals in children’s palliative care from the district hospitals. Formerly palliative care services entered tertiary hospitals which made ease of access difficult. It had been also hard to make follow-up of individuals children who was simply discharged home through the tertiary hospitals once they been stabilised. Training was conducted by ICPCN, PACAM and also the Malawi Secretary of state for Health.

Following the training, nine districts from the Central Region of Malawi have nurses and clinical officials who’ve began palliative care services for kids. With educational funding in the True Colours Trust, a donor in the United kingdom, each hospital has refurbished surroundings which are particularly focused on children’s palliative care.  

Hospitals which was without rooms to spare used the funds to purchase large multipurpose containers that they will convert into clinics. A house service continues to be began by among the district hospitals located in Lilongwe, the main city town of Malawi. The Secretary of state for Health has hired co-ordinators in every hospital to guarantee the smooth running of services.

Impact report
Before the keeping trained nurses and clinicians in district hospitals, set up a baseline assessment from the services ended and it’ll be interesting to determine its impact in the finish of the season. The Secretary of state for Health is planning to integrate palliative care, including those of children, in to the primary health system of care in the united states. 

ICPCN, PACAM and also the government of Malawi are grateful to OSISA for awarding the grant which chose to make this project possible.  

Key options that come with the Republicans’ final goverment tax bill

House and Senate Republicans unveiled their joint goverment tax bill on Friday mid-day, which dramatically cuts corporate tax rates and overhauls the person tax code. Released just days before expected votes on Tuesday and Wednesday, the balance looks on the right track to get law within days.

Here are the noticably features.

Individual taxes

The balance keeps the present seven brackets for tax, but lowers the rates and changes the earnings thresholds. The very best rate could be 37 percent versus 39.6 % under current law, that is less than the debts that formerly passed the home and Senate. The person tax cuts expire after 2025.

The conventional deduction is nearly bending to $12,000 for people, $18,000 for mind of household, and $24,000 for couples, meaning less people will probably itemize their taxes. The balance eliminates the $4,050 personal exemption that taxpayers can presently claim on their own and dependents.

Prior analyses of the home and Senate bills discovered that the biggest benefits accrue towards the wealthiest Americans and absolutely nothing within the new bill “significantly changes that takeaway,” based on Ernie Tedeschi, an economist and former Treasury official.

Tax rates for single filers:

  • 10%: as much as $9,525
  • 12%: $9,525 to $38,700
  • 22%: $38,700 to $82,500
  • 24%: $82,500 to $157,500
  • 32%: $157,5000 to $200,000
  • 35%: $200,000 to $500,000
  • 37%: $500,000 & up

Tax rates for joint filers:

  • 10%: as much as $19,050
  • 12%: $19,050 to $77,400
  • 22%: $77,400 to $165,000
  • 24%: $165,000 to $315,000
  • 32%: $315,000 to $400,000
  • 35%: $400,000 to $600,000
  • 37%: $600,000 and above

Child tax credit

Among the big reasons analyses of the home and Senate bill found couple of gains for lower earnings taxpayers was that lots of don’t make enough money to pay for earnings taxes and take advantage of the rate cuts. However, many low-earnings families with children often see slightly bigger gains underneath the conference bill because of an expanded child tax credit pressed for by Senators Marco Rubio, R-Fla. and Mike Lee, R-Utah.

The brand new child tax credit is going to be $2,000, just like within the Senate bill, but no more than $1,400 is going to be refundable against payroll taxes versus $1,100 earlier. Although not everybody is titled fully $1,400, which scales track of earnings.

“Tens of millions of children in low-earnings working families can get nothing in the last-minute changes towards the Republicans tax bill’s child tax credit increase — and for that reason can get only a token increase of $75 or fewer per family,” Chye-Ching Huang, director of federal tax policy in the left-leaning Focus on Budget and Policy Priorities, stated within an e-mail. “Another 14 million continuously get under the bill’s full CTC increase.”

Estate tax

The beginning point for that estate tax could be bending underneath the bill in the current $5.5 million for single filers.

This benefits wealthy heirs, but goes less far compared to House bill, which may have eliminated the estate tax entirely. President Jesse Trump’s family may have saved over $1 billion by themselves in the event that change choose to go into effect.

Deductions

The balance will get eliminate a number of deductions while placing limits on others. The balance caps the mortgage interest deduction at $750,000 of principal. The condition and native tax break is limited to $10,000 but enables taxpayers to count a mixture of purchase, earnings, and property taxes.

Some deductions eliminated in the past versions of House and Senate bills are preserved. The balance keeps a current deduction for top medical expenses and lowers its earnings threshold for 2 years. The balance keeps a tax break on education loan charges as well as an adoption tax credit.

Graduated pupils keep an essential benefit that enables these to avoid having to pay tax on tuition waivers. The Home bill might have eliminated it.

Corporate tax cuts

The brand new goverment tax bill cuts the organization tax rate from 35 % to 21 percent while taxing foreign earnings at lower rates of 15.five percent on liquid assets and eight percent on illiquid assets. This can be a vary from the present system by which companies can defer taxation on profits they keep abroad.

The balance also eliminates the organization alternative minimum tax, which presently limits the quantity of deductions an organization may take.

Pass-through companies

Certain business organized as pass-through may take a 20 % deduction, with a few additional rules for companies that earn earnings over $157,500 for people and $315,000 for joint filers.

Whether you are qualified could rely on what sort of business you have: An architecture firm within the earnings threshold might take the deduction, for instance, after being overlooked within the Senate bill. But an attorney would be ineligible.

Generally, tax experts have elevated concerns that the pass-through deduction creates a motivation for people to prevent earnings taxes. The conference report notes the limitations on bigger companies are made to discourage wealthy Americans from rejiggering their finances to qualify.

“The positive view is ‘Wow, this makes many people to begin a small company,'” Don Susswein, a principal at RSM’s Washington National Tax, told NBC News. “The pessimistic view could it be may cause many people to transform their salary into business earnings by filing certificates.”

Healthcare

The balance eliminates the person mandate, a vital area of the Affordable Care Act that penalizes Americans that do not maintain coverage of health.

The Congressional Budget Office estimates 13 million less individuals will have medical health insurance following a decade when the mandate is eliminated and premiums will rise by 10 % around the individual market.

Nonprofits

The balance doesn’t incorporate a repeal from the Manley Amendment, which prohibits non profit organizations and places of worship from participating in partisan politics. The Home might have eliminated that amendment, which may have potentially given people the opportunity to anonymously put money into political ads using tax-deductible donations.

First children’s hospice enables children to reside and also to die without discomfort in Kyrgyzstan

By 2014, very little individuals Kyrgyzstan understood about palliative care. Familiar with the discomfort of others and daily deaths, doctors just shrugged their shoulders: “So what can we all do if there’s no medication?”

Work within Children’s Oncology solved the problem to determine problems that could ‘t be solved over years. So when a young boy by having an inoperable tumor from the larynx, who couldn’t eat and breathe, was discharged home, this tragedy was the beginning point in my decision to produce a children’s hospice. 

Exactly twelve months later, this plan of action was implemented. Later, I came across there are greater than 500 diagnoses relevant to children’s palliative and hospice care, where youngsters are likely not live to their adult years. To be able to separate those activities from Children’s Oncology, the kids Hospice continues to be formally registered and grew to become referred to as Charitable organization Public Foundation “The very first children’s hospice “.

Your building
The hospice building is a comfortable two-story house having a small courtyard. And nowadays we must pay not a tiny bit of money for rental and heating, but it’s possible with the aid of supportive Maecenas. Getting our very own building could be presents!

The home has everything to create a live there comfortable. Individual rooms for kids as well as their families, a children’s playroom, a kitchen area, along with a room for workers and volunteers.

Homecare service
The House care service started employed in The month of january, 2016.  During your day we’d a period to go to only three families, many addresses have been in new suburbs, without roads and figures. Red carpet several weeks of effort their email list of kids nobody need assistance progressively grew to become better, but other parts of work still lie ahead, making the forthcoming work appear endless.

Parallel for this daily work – we assistance to get medicines, we organise transportation, we offer financial aid to children identified as having cancer- it’s impossible to list out everything. An anaesthetic machine continues to be bought for that Children’s Department of Oncology Center, using the generous assistance of sponsors, so they cover purchasing needles for daily painless bloodstream tests and also the provision of anesthetic cream. 

Incorporated within our jobs are the registration of the most basic medicine, dental morphine for kids, an opioid painkiller, without which existence for the youthful patients could be real torture. The Building Blocks has elevated $800 for purchasing dental morphine, however it may be bought just once it’s registered and introduced in to the country. However, we’ve celebrated a current victory, along with like-minded people – the registration of fentanyl patches for patients with digestive system problems, and individuals to whom it’s difficult to swallow a discomfort reliever.

Memorandum signed
On September 21, 2016 the Charitable organization public foundation “First Children’s Hospice” and also the Secretary of state for Social Development and Work signed a Memorandum on development of places for palliative take care of children in specialised boarding houses. Later on these can become regional centres of palliative take care of kids with Homecare service. During these boarding houses there are approximately 100 bedridden children, careful objectors and individuals whose parents arrived at visit their kids every so often. And frequently it takes place that employees don’t know the youngsters diagnosis, or their therapy needs. The CPF “First Children’s Hospice” with the Public Foundation “Children’s palliative” (Moscow, Russia) has held a couple-day seminar for that employees of orphanages.

Domestic palliative care services only have just started to develop, for instance death care as part of a mental support services are completely undeveloped. I recall the situation when, following the dying of the baby, instead of giving support towards the child’s mother, she was accused by her husband’s relatives who stated it had become her fault the child was ill. The lady was near suicide, and merely over time we could stop her, support her, and direct her ideas inside a existence-affirming direction.

Requirements of the building blocks
The Building Blocks constantly requires not just finances along with other material assistance, but additionally free hands, or someone prepared to just talk or provide a hug and bond with individuals whose health isn’t as good as our very own.  Any river includes tiny droplets, and excellent achievements can occur with lots of small donations. Visit drop from each, a river can look, after which end up being the ocean!

Family Meals Offer Better Socialized Kids

HealthDay news image

THURSDAY, 12 ,. 14, 2017 (HealthDay News) — Children whose families regularly eat meals together generally have better social skills and fitness levels, researchers report.

Family meals yield multiple mental and physical health advantages, based on the lengthy-term Canadian study.

“The existence of parents during mealtimes likely provides youthful kids with firsthand social interaction, discussions of social issues and day-to-day concerns,” described study author Linda Pagani.

In the family table, children are learning prosocial interactions inside a familiar and emotionally secure setting, added Pagani, a professor of pyschoeducation in the College of Montreal.

“Experiencing positive types of communication may very well assist the child participate in better communication skills with individuals outdoors from the family,” she stated inside a college news release.

They used data in the Quebec Longitudinal Study of kid Development, which adopted children from age 5 several weeks. The children were born in 1997 and 1998, and fogeys began reporting on family meals at 6. At 10, info on the kids lifestyle habits as well as their well-being was supplied by parents, teachers and also the youngsters themselves.

When compared with children who was without regular family meals at 6, individuals who did had greater amounts of fitness, lower soft-drink consumption and much more social abilities at age 10, they found.

Additionally they were less inclined to have behavior problems.

“Our findings claim that family your meals are not exclusively markers of home atmosphere quality, but they are very simple targets for parent education about improving children’s well-being,” Pagani stated.

The research was printed 12 ,. 14 within the Journal of Developmental & Behavior Pediatrics.

SOURCE: College of Montreal, news release, 12 ,. 14, 2017

News tales are written and supplied by HealthDay and don’t reflect federal policy, the views of MedlinePlus, the nation’s Library of drugs, the nation’s Institutes of Health, or even the U.S. Department of Health insurance and Human Services.

First consumption of students to new Masters/Postgraduate Diploma in Health Sciences (Children’s Palliative/ Complex Care Nursing) in Ireland

This dynamic programme is made for rns dealing with children and adolescents with complex or existence restricting conditions. This primary of the kind Irish programme aims to equip nurses using the necessary in-depth evidence based understanding, skills and competencies to supply safe, quality choose to highly dependent children and youthful people because they accept complex and existence restricting illness.

Concerning the programme
The programme continues to be established in response to the quickly growing figures of Irish children coping with existence restricting and palliative care needs presently believed at 4,000 children (Ling et al 2015) and also the subsequent requirement for nursing staff to achieve the understanding and skills to look after this population. Although dying in early childhood is comparatively uncommon, the particular care requirements of the kid and family need a reflective, family centred and evidence-based method of practice (Goldman, Hain and Liben, 2012). The current recommendations inside the Irish Insurance policy for Kids with Existence Restricting conditions (DoH&C 2010) encourages further professional development for nurses taking care of these children and adolescents and families. This latest programme aims to help nurses look around the methods to palliative and sophisticated care practice. The programme and suite of modules intends to assistance with the transformation from the nursing workforce or more skilling of practitioners who would like to expand and boost their nursing practice around palliative and sophisticated take care of children, youthful people as well as their families.

Palliative and sophisticated take care of children is different from take care of adults for the reason that many children requiring palliative/complex care have existence-restricting conditions, instead of advanced terminal conditions. Children may survive a long time using these conditions. The requirements of these children vary from the requirements of adults along with a significant proportion have lengthy term needs, and lots of accept severe disability. The requirements of their own families can also be more complicated. Respite care is a vital aspect in the proper care of kids with existence-restricting conditions. However, if youngsters  reach the finish of existence, care must be provided inside a compassionate, holistic  and competent manner. We simply acquire one chance to have it suitable for children and families.

Considerable growth and development of services
The introduction of Irish palliative care services during the last 25 years or so continues to be considerable. The Government’s dedication to palliative care was initially reflected within the National Health Strategy in 1994, which recognised the key role of palliative care services in improving quality of existence. It gave dedication towards the ongoing growth and development of these types of services inside a structured manner, to have the greatest possible quality of existence for patients as well as their families. The Minister for Health insurance and Children subsequently established the nation’s Advisory Committee on Palliative Care who’d the duty for analyzing palliative care services in Ireland, outcomes of that are based in the 2001 Report from the National Advisory Committee on Palliative Care. Using the publication of the national policy Palliative Take care of Kids with Existence-restricting Conditions (2010), Palliative Care Competence Framework (2014), worldwide and national reports and guidelines on palliative care provision like the World Health Organisation (2008) ‘The Global Burden of Disease’, National Institute for Health insurance and Clinical Excellence (NICE) guidelines (2013), Report from the Irish Advisory Committee on Palliative Care (2001) and also the Irish Hospice Foundation (2008) ‘Palliative Take care of all’ documents supports the necessity to give a programme that is evidence based and encompassing the growing demands of kids and adolescents who are required palliative and sophisticated care.

Palliative Take care of All
The Irish Hospice Foundation (2008) printed a paper “Palliative Take care of All” analyzing the necessity to expand palliative choose to a broader population group, with particular focus on children. In addition, ethnic and cultural diversity has become a demographic reality within modern Irish society and can’t be overlooked by paediatric or palliative care services. All cultures and religions have particular beliefs associated with dying, dying and death such as the Irish traveller community who also provide different traditions. In figuring out the requirement for paediatric palliative/complex care services, other population groups with particular needs ought to be considered. Included in this are kids with intellectual, physical and physical disabilities.

Prevalence
Within Ireland, prevalence of existence-restricting conditions has become believed at 3,840 children (Ling et al 2015). Palliative and sophisticated care is supplied in all sorts of settings aligned to family and child preference and could include home, hospital, school, hospice and respite centres (IHF/HSE 2013). The paediatric palliative care nurse or nurse for kids with complex care needs plays a vital role as part of the multidisciplinary team. Paediatric palliative/complex care nurses need a extensive understanding from the experience and philosophy of palliative, complex care from neonates to adolescents as well as their families.

To meet up with the requirements of a number of children requiring palliative and sophisticated care, this latest programme aims to equip nurses using the broad skills essential to meet the requirements of kids across a multitude of settings. The brand new programme has both theoretical and clinical components and also the unique curriculum continues to be developed having a team containing Ms Louise Neary, RCN, RNID, RNT, MSC , Ms Deidre Fitzgerald RCN, MSc and Ms Laura Dempsey MSc, RNT, RGN and includes valuable contributions from medical colleagues within the field. A blended learning approach is adopted within the delivery of the programme that is a flexible method of learning, to be able to combine working full-time with studying. This program continues to be authorized by the Nursing and Midwifery Board of eire. Included in the programme, every student may have the help of the Programme Director and mentors across the country to produce a unique professional development portfolio for college students to attain defined learning priorities for that speciality.

Please Visit:  http://world wide web.nuigalway.ie/courses/trained-postgraduate-courses/childrens-palliative-care-complex-care/

Open for applications in MARCH 2017.

Please contact Programme Director [email protected]