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Missouri Refuses To Renew The License Of Its Only Abortion Clinic

Missouri said Friday it won’t renew a license for the last clinic providing abortions in the state. But a judge ruled the clinic can keep providing abortions while the dispute continues.



ARI SHAPIRO, HOST:

Today, Missouri refused to renew the license of its only abortion clinic, but a judge says the clinic, a Planned Parenthood affiliate in St. Louis, can remain open and can keep performing abortions for now. So where does that leave things? We’re joined by Eli Chen of St. Louis Public Radio. Welcome.

ELI CHEN, BYLINE: Hi. Glad to be here.

SHAPIRO: Why did the state say it would not renew the clinic’s license?

CHEN: So Missouri health officials say that the clinic leaders didn’t want to cooperate and that they found 30 deficiencies in inspection earlier this year and corrected just four of those. Randall Williams is the director of the Missouri department of Health & Senior Services. And he says some doctors refused to be interviewed about some patient cases. And here’s him discussing that very point today in Jefferson City, our state capital.

(SOUNDBITE OF ARCHIVED RECORDING)

RANDALL WILLIAMS: That would be like the FAA having a plane crash in which people got injured and investigating it and when people say, well, what – did you talk to the pilots, say, no, we didn’t talk to the pilots.

SHAPIRO: Now, we know that this standoff had been going on for several weeks and went to a court. How did we get to the judge’s ruling that the clinic could remain open despite not having a license?

CHEN: Yeah. So Planned Parenthood had already filed suit and obtained an injunction to keep going once it became clear that there was a dispute over the license. The judge said today that the injunction is still in effect and abortions are still available at the St. Louis clinic. And he’s going to continue looking at all the legal issues and will issue another decision as soon as he can. But we don’t know when that will be or what exactly he’ll decide.

SHAPIRO: So the status quo continues, at least for the time being. Does Planned Parenthood consider that a win?

CHEN: Their position has been that the state is using the licensing process as a political weapon. M’Evie Mead is the head of Planned Parenthood Advocates of Missouri, and here’s what she had to say this morning to reporters about the state health director, Randall Williams.

(SOUNDBITE OF ARCHIVED RECORDING)

M’EVIE MEAD: He has made a debacle of this process and has dragged Missouri through shameful, shameful attention. And he has harmed many, many, many women.

CHEN: But Mead wanted everyone to know that the judge is still allowing women to get abortions at the clinic.

(SOUNDBITE OF ARCHIVED RECORDING)

MEAD: Today is a victory for women to be able to access the kind of medical care that they and their health professionals need and deserve.

SHAPIRO: OK. So Planned Parenthood is framing it as a win, but it is a temporary win until the judge decides. Do we know how long this will continue and how long this clinic will be under a cloud of uncertainty?

CHEN: It’s unclear how long this really could go on for because the judge could decide the state can’t do this. He might decide that another state body should get involved in the licensing issue or he might decide to hear the full lawsuit himself. It could be any number of things. And, Ari, there is another major development that happened. The state had wanted all abortion clinics to conduct two mandatory pelvic exams before an abortion, but Planned Parenthood pushed back and has been saying that’s been really invasive and traumatic and unnecessary. And today, the Missouri health director conceded a bit on that point. He said he would allow just one pelvic exam on the day of the operation if the doctor gave a medical reason.

SHAPIRO: That’s Eli Chen of St. Louis Public Radio. Thanks very much.

CHEN: Thank you.

Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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1st-Time Homebuyers Are Getting Squeezed Out By Investors

As investors play a growing role in the housing market, many first-time buyers are having a hard time finding a home.

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Marcio Jose Sanchez/AP

It’s gotten a lot harder for first-time homebuyers to nab that dream house. The pool of smaller, affordable starter houses is low. And increasingly, first-time homebuyers are competing with investors who are buying up these homes.

Last year, investors accounted for 1 in 5 starter-priced homes, according to data released by CoreLogic on Thursday. The rate of investor purchases of starter homes has been rising and has nearly doubled since 1999.

Tonya Jones, a Realtor in metro Atlanta, says it is frustrating both for agents and for their first-time homebuying clients when they can’t compete with investors.

First-time buyers typically put down 3% to 5%, Jones said. “Then they’re walking in competing with an all-cash buyer who can close whenever that seller is ready,” she said. “Typically, a first-time homebuyer can’t work under those parameters.”

Investors have always made up a big part of the market for starter homes. But smaller investors are playing a growing role. Last year, these mom and pop investors represented 60% of investor purchases — up from 48% in 2013, CoreLogic said.

As investors snap up more properties, they’re helping drive up prices in many cities nationwide. In May, the median price of existing homes was $277,700, up 4.8% from a year earlier, the National Associations of Realtors reported Friday. For single-family homes, the median price was $280,200, up 4.6%.

Some regions saw a slowdown in home sales at the end of 2018. And last month, sales of existing homes fell 1.1% from a year ago, even as median prices marked the 87th straight month of year-over-year growth, the NAR said.

Jones, who is also a small investor, said rising prices have kept her from buying new properties.

“Investors count on appreciation,” she said. “We’re at a pretty elevated price point right now, so it’s hard to imagine price per square foot getting any higher.”

Investors tend to buy cheap homes with the goal of renovating them and putting them back on the market at a higher price, or renting them out. Lawrence Yun, chief economist at the National Association of Realtors, said investor buying could lead to greater wealth inequality as homeowners and investors profit and nonhomeowners are left behind.

“If first-time buyers are less capable of buying, we’ll have a strange situation where the economy could be good, but the homeownership rate will be underperforming by historical standards,” he said.

In 2018, eight of the top 10 metro areas with the highest investor purchase rates were in the Eastern half of the U.S., CoreLogic said.

The top markets for investors were Detroit, where they accounted for 27% of sales, Philadelphia at 23.3% and Memphis at 19.7%. Some cities with the least investor activity are in Ventura, Calif., and Boise, Idaho, at 4.8% each, and Oakland, Calif., at 5.1%.

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Fashion Statement: Putting Your Mouth Where Your Money Is

Researchers say we often recognize peer pressure in the actions of others — but not in our own choices.

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A while back, Jonah Berger was talking with a lawyer friend from Washington, D.C. The friend was lamenting the impact of social influence on his peers.

He was saying, “‘God, you know, all D.C. lawyers are the same. They make it big, and they go out and they buy a new BMW.’

And I said, ‘Don’t you drive a BMW also?’ He said, ‘oh, yeah, yeah, yeah, but, you know, they all drive gray ones. And I drive a blue one.'”

Our friends may not be independent thinkers, but we are…right? Not quite. Researchers have found that many of our personal preferences are heavily shaped by the whims and wishes of others.

This week, we talk with Jonah Berger about how our choices are influenced by social context. Then, Neeru Paharia takes a closer look at our behavior as consumers. She says the things we purchase send invisible signals – projecting the values we have, and the identities we want.

Additional Resources:

Invisible Influence by Jonah Berger, 2016.

“Sweatshop labor is wrong unless the shoes are cute: Cognition can both help and hurt moral motivated reasoning,” by Neeru Paharia, Kathleen D. Vohs, and Rohit Deshpandé in Organizational Behavior and Human Decision Processes, (2013).

“The Underdog Effect: The Marketing of Disadvantage and Determination through Brand Biography,” by Neeru Paharia, Anat Keinan, Jill Avery, and Juliet B. Schor in Journal of Consumer Research, 2010.

Hidden Brain is hosted by Shankar Vedantam and produced by Jennifer Schmidt, Rhaina Cohen, Parth Shah, Thomas Lu and Laura Kwerel. Our supervising producer is Tara Boyle. You can also follow us on Twitter @hiddenbrain.

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Sweet Win Over Sweden; U.S. Women’s Soccer Team Rolls Through World Cup

United States’ Tobin Heath celebrates after scoring her team’s second goal during the Women’s World Cup in Le Havre, France, Thursday.

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The U.S. got a little redemption at the Women’s World Cup with a 2-0 victory over Sweden. The U.S. powered to the win with a strong defense and relentless attack. It was the hardest game yet for the Americans and shows the team is in top form as it enters the knockout round to defend its World Cup title.

A capacity crowd of 25,000 at Stade Océane in Le Havre, France got to see a gem of a match. The U.S. was sharp and precise from the beginning. It didn’t take long for the Americans to score. In the third minute, Megan Rapinoe punched a corner kick into the penalty area. It skipped low through the box and Lindsey Horan poked it into the back of the net for the fastest goal scored in this tournament.

That didn’t take long. Lindsey Horan with a goal just two minutes in! #USASWE pic.twitter.com/TkOYTWYrLR

— Laurel Wamsley (@laurelwamsley) June 20, 2019

The second goal came in the second half at the 50th minute. Tobin Heath did some very Tobin Heath things with her footwork. Faced with a crazy angle, she blistered the ball off a Swedish defender into the goal.

.@TobinHeath: the reason ‘don’t believe me just watch’ exists https://t.co/KKQbpFxeRY

— U.S. Soccer WNT (@USWNT) June 20, 2019

This was the toughest opponent the U.S. has faced so far. At the last two games there was an assumption that the U.S. would win, this time around the only known was that some very good soccer would be played. And indeed, it was. Sweden pressured the U.S. but it was never enough.

The U.S. team was well-rested. Seven of its starters did not play in the last match against Chile. The biggest surprise was the absence of midfielder Julie Ertz. She is the anchor of the U.S. backfield and held out of competition today for precautionary reasons. U.S. Soccer said Ertz had a “minor hip contusion.” Star forward Alex Morgan played the first half but went down late and was replaced by Carli Lloyd at halftime.

Both the U.S. and Sweden had already advanced to the knockout round regardless of what happened on the field today. But this match was about bragging rights. There’s a long history between the U.S. and Sweden.

The teams have played each other 38 times going back to 1987, and they’ve faced off at five previous World Cups. The U.S.’s record in those matches is three wins, one loss and one tie.

In fact, it was at the 2015 Women’s World Cup when these two teams also squared off in the final game of group play like today. The Swedish coach then was Pia Sundhage who had led the U.S. until 2012 including Olympic gold medals in 2008 and 2012. It was also her Sweden team that knocked the U.S. out of the 2016 Olympics in the quarterfinals.

That loss still stings the U.S. Soccer program. It was the earliest the Americans got bounced from a major tournament and forced the team to change to a more attacking style of play that was both more technical and more tactical. U.S. forward Christen Press says the loss sticks with her to this day. “You don’t forget the taste in your mouth when you fail and when you lose in a world championship,” she said. “There’s a little bit of that that will definitely act as motivation. And you always play to win and to never have that feeling again.”

With the win, the U.S. will take on Spain in the Round of 16. Spain has struggled offensively and squeaked into the knockout round of the Women’s World Cup for the first-time ever. The Spaniards defeated South Africa 3-1 in the opener, then lost to Germany 1-0 and played to a scoreless draw against China. The U.S.-Spain match is Monday at noon (ET) at Stade Auguste-Delaune in Reims.

Laurel Wamsley contributed to this report.

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World Cafe Latin Roots: 7 Femme-Fronted Andean Electro-Alternative Acts

Caro Arroba describes her music as “tech house Andino.”

Isabel Dávila/Courtesy of the artist


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There is such a superb and expanding community of musicians and producers creating Andean electro and alternative soun we’ve decided to highlight some of the womxn producers and femme-fronted projects stimulating this empowering movement. Ranging in soundscapes that feature ethno bass, dance floor field recordings and techno, these exceptional musicians are giving new life to often forgotten roots music.

These one-of-a-kind sound artisans are producing material as legacies of their countries ancestral music while also generously providing a musical platform for its regeneration.


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Caro Arroba

Currently making music in Chicago, Quito, Ecuador-hailing producer Caro Arroba describes her music as “tech house Andino — exploring the relation between mind, nature and machines” and presents this as exhilarating sound tributes to the indigenous peoples of Ecuador. She samples traditional Pre-Colombian rhythms with the use of Andean instruments like tollos, quenachos and ocarinas. She then loops these, randomly or in sequence, into techno and house, in effect creating musical time travel.


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Lara Nuh

The dynamic visuals, folk-storytelling and heart-pounding musical sensations in the video for “Tierra que suena by producer Lara Nuh, are instantly, incredibly mystifying. It’s a gutsy synergy of hip-hop, chant and electronica. The musician and spoken word artist from Lima, Peru digs creatively into the sounds of the past while not shying away from making use of current technology. In her most recent live electronic dance track “Colibrí, for example, she makes magic with an array of MIDI controllers, hardware sequencers and samples.


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ShuShupe

Inspired by the sounds of the Peruvian jungle, plus cumbia and a close encounter with a venomous viper known as a shushupe, producer Ursula Talavera created ShuShupe, a purveyor of “folkloric music with beats.” Her latest recording, “Ayahuasca Love,” is included in the New Latam Beats From Perú compilation.


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Barda

Cecilia Gebhard, known artistically as Barda, is an Argentine producer who composes complex down tempo electronica, nurtured by the micro-region of Alto Valle as well as Patagonia. She is considered part of the new South American wave. Her EP Lembrança debuted as a limited release 12″ vinyl via Shika Shika Records in Berlin. It’s a synthy, experimental mix of acoustic instruments, ethno bass and charango. Barda, together with MicaTower, form part of the Plantasía music series in Buenos Aires.


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Maribel Tafur

From Lima, Peru, Maribel Tafur is an accomplished multi-instrumentalist and composer. Incorporating field recordings, her aural designs are a moody amalgam of warm, inviting ambient and down tempo sounds that create the ultimate sensory experience. Tafur has been commissioned to create soundtracks for all the restaurants run by Peruvian chefs Pia Leon and Virgilio Martinez, and has collaborated on music soundtracks and backdrops for fashion designers and their brands. In the music video for Summer Dreams, she uses Cymatics which show water patterns triggered by music playing through a speaker.


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Swing Original Monks

Swing Original Monks, formed in Quito, are an invigorating, multicultural frenzy of musical energy with Colombian artist Juana Monk belting out electrifying vocals and Steph Viteri on bass. The seven-piece ensemble traverses the borderless world of music highlighting familial Ecuadorian sounds with the unconventional, like Balkan merengue or Western chicha. In addition, they combine elements of nu-cumbia, folk, rock, jazz and gypsy swing. Their album SOMOS is actually a reissue of their debut album, La Santa Fanesca. The original album caught the interest of producer Eduardo Cabra of Calle 13 who they eventually worked with, recording the new edition in Puerto Rico.


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Daniela Alban

This young graphic designer and electronic producer focuses on underground music communities sharing dance floor deliriums of techno, dub, psychedelic and low frequency sounds. In addition to her electronic skills, she’s an avid musician who plays guitar, drums, bass and piano, which she uses in her programming. Her music can be found on the release Insert Content, on the Miaw label along with artists Gianni and Nicolas Ricalde.

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Putting A Price On Chat: Slack Is Going Public At $16 Billion Value

Slack Technologies is going public Thursday. In the fiscal year that ended Jan. 31, the company nearly doubled its revenues, to about $400 million. But it had a net loss of nearly $139 million.

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In just five years, Slack has grown to have more than 10 million users and has become a verb in the process. “I’ll Slack you” is shorthand for sending a message via the workplace chat platform.

On Thursday, the company will take that popularity to the New York Stock Exchange, where its shares will be publicly listed for the first time.

At a starting price of $26 per share set Wednesday, Slack Technologies would be worth about $16 billion.

Instead of having a conventional initial public offering, Slack will enter into the market as a direct listing, which means the shares will simply be listed on the New York Stock Exchange. Most firms that pass on an IPO are widely known companies that are in good financial shape.

As Fortune explains:

“Unlike an ordinary IPO, a direct listing means the company doesn’t issue any new shares and doesn’t raise additional capital. It’s primarily a way for company insiders to sell some of their holdings to investors, while bypassing the formidable fees and requirements of using an underwriter.”

Spotify, the music-streaming company, went public as a direct listing last year.

In the fiscal year that ended Jan. 31, Slack nearly doubled its revenues, to about $400 million. But it had a net loss of nearly $139 million.

As it continues to grow, Slack’s biggest hurdle will be proving to its users that it’s more than just a chat application.

Forrester analyst Michael Facemire says it’s hard for people to understand why the platform is more useful than other chat applications without trying it for themselves. With Microsoft Teams as a major competitor, Slack is facing pressure to distinguish itself in the market.

“If the world were only composed of technologists and developers and Silicon Valley illuminati, then Slack would be far, far ahead,” Facemire says. “There is a large percentage of the population that isn’t that. This is where tools like Microsoft Teams do just as well.”

Slack’s decision to begin trading as a direct listing follows a wobbly start for Uber, which has had one of the most anticipated initial public offerings in the tech sector. Last month, the ride-hailing company reported a $1 billion loss in its first public financial report, just weeks after its IPO.

Slack, which was publicly released in 2014, stemmed from an internal chat platform created by CEO Stewart Butterfield during a failed video game development. The software was created to avoid the confusion of email and, per its acronym, provide a “Searchable Log of All Conversation and Knowledge” for the team, which had people working all over North America.

Butterfield co-founded Flickr, which he sold to Yahoo for around $25 million in 2005. But despite interest from Amazon, Google and Microsoft in 2017, he held on to Slack, which continued to compete with emerging chat platforms.

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U.S. Women To Take On Their Biggest Opponent Yet With Game Against Sweden

The biggest test for the U.S. Women’s National Team at the Women’s World Cup comes Thursday when the U.S. takes on Sweden. It’s been a busy week with many notable performances.



MARY LOUISE KELLY, HOST:

The U.S. women’s soccer team is back in action tomorrow at the Women’s World Cup in France. The team is taking on its biggest opponent yet, Sweden – a key match for the U.S. And there’s plenty else going on at the tournament.

Here to catch us up is NPR’s Laurel Wamsley. She’s been following the U.S. team in France, and she joins us on the line from there now. Hey there.

LAUREL WAMSLEY, BYLINE: Hi there.

KELLY: Hi. So I want to get to the U.S. women in just a second, but I gather it’s a player from Brazil who’s got everybody buzzing today.

WAMSLEY: Absolutely. That’s Marta. She’s the Brazilian superstar. You probably heard about her. And she scored on a penalty last night in their game – in Brazil’s game against Italy. And with that goal, she set the all-time scoring record for most World Cup goals, men or women, with 17.

And in a press conference after the match, Marta talked about how she’s dedicating that goal to all the girls who believe in their dreams. And she said that the Brazilian team can be an example in their country and also to South America that women can do every kind of role. But she also pointed out that given the huge audience for this event, that in a way, each team is doing that in their own home country. And because of Marta’s goal, Brazil will now go through to the knockout round, which had been in question.

KELLY: OK, all right, so the U.S. team – we said they take on Sweden. That’s going to be tomorrow. What are the stakes here?

WAMSLEY: Well, this is a matchup with a lot of history. So the U.S. used to have a Swedish coach, Pia Sundhage, and she led them to Olympic gold in both 2008 and 2012. And then right after the 2012 Olympics, she left the U.S. squad and went to coach Sweden. And then in the 2016 Olympics, Sundhage was the coach of Sweden that knocked out the U.S. team in the quarterfinals. And no U.S. women’s soccer team had ever left a major tournament that early, so it was a huge blow.

And it’s been said that the coach who took over after Sundhage, Jill Ellis, who’s the coach now, has spent a lot of time watching the tape and spending time with that and figuring out, how does this U.S. team face off against teams like Sweden that just bunker down defensively and won’t let them through?

KELLY: Wow – so quite a rivalry and, it sounds like, quite a game potentially tomorrow. This is not going to be like the opening match, where we saw the U.S. just dominate against Thailand. It was 13-nil, I think.

WAMSLEY: Yes, it was. And, no, this will be nothing like that. So people are predicting maybe 2-0, 2-1 against Sweden. This is going to be the first real test for the U.S. at this tournament, especially for the defense and for goalkeeper – new goalkeeper Alyssa Naeher. They just haven’t had much come their way so far. Here’s what coach Jill Ellis said earlier today about this game.

JILL ELLIS: This is going to be great for us because we do need to sharpen that in terms of, you know, the first two games. We haven’t had a lot of balls to deal with in behind. And Alyssa hasn’t had a lot to deal with. But, you know, I’d also sort of remind the players that we’ve played one of the most competitive schedules and for that very purpose – to have as many of those moments before we came to this big stage.

WAMSLEY: And so the thing about this game is that both U.S. and Sweden are already through. And if the U.S. were to lose to Sweden tomorrow, they would actually maybe have an easier path in this tournament because they may have to play France if they win in the quarterfinals. But that’s just not how this team plays. This team plays to win, and that’s what they’re going to go out there to do tomorrow.

KELLY: Yeah. And before I let you go, just a quick sense of the scene, because you’ve been all over – you’ve been in Paris. You’ve been in Reims. Where are you exactly today?

WAMSLEY: Right now I’m in Le Havre a couple miles from where the team is going to play tomorrow. And…

KELLY: And is everybody just totally caught up in this?

WAMSLEY: Yes and no. In Paris, you almost wouldn’t know it’s happening. There’s almost no signage, no indication that it’s happening. You see – still see more signs for the men’s football games than the women’s. But here in these smaller towns where the U.S. has been playing in Reims and in Le Havre, you do see them a lot more, and there is a palpable excitement here. And of course wherever the U.S. plays, the U.S. fans go. So there’s a lot of excitement.

KELLY: All righty, thank you, Laurel.

WAMSLEY: Thank you.

KELLY: NPR’s Laurel Wamsley reporting.

Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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The Thistle & Shamrock: New Releases And Debuts

Dàimh is featured in this week’s episode of The Thistle & Shamrock.

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Step into summer by tuning into some of the fresh new music recently arrived at The Thistle & Shamrock offices in the U.S. and Scotland. Fiona Ritchie handpicks newly-hatched releases from debuting artists that have caught her ear as well as the latest from musicians who frequent her playlists. Be among the first to hear what’s sprouting from Fiona’s music inbox.

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Canada’s Trudeau Approves Controversial Pipeline Expansion

A tugboat operator secures a floating razor wire security fence during an emergency response exercise at the Kinder Morgan Inc. Westridge Marine Terminal in Burnaby, British Columbia, Canada, last September. A new expansion of the Trans Mountain pipeline would significantly expand tanker traffic in the region.

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Canada’s Prime Minister Justin Trudeau has given the green light for a second time to a $5.5 billion pipeline expansion that has attracted strong opposition from environmentalists and some indigenous groups.

Trudeau, an ardent supporter of green energy, has found himself defending the 620-mile Trans Mountain pipeline expansion since his government first approved it in 2016. The project is meant to bring petroleum from oil sands near Edmonton, Alberta, to tanks in Burnaby near Vancouver on Canada’s Pacific Coast.

Last year, opponents won a suit in Canada’s Federal Court of Appeals to temporarily halt the expansion, but Trudeau’s government subsequently purchased the existing 715-mile pipeline from the Canadian division of Kinder Morgan Energy Partners LP for about $3.5 billion in an effort to move the project ahead.

At Tuesday’s news conference in Ottawa announcing that the project was back on, Trudeau justified the move by saying the money reaped from the pipeline would be channeled back into green projects.

“We need to create wealth today so we can invest in the future,” he said. “We need resources to invest in Canadians so they can take advantage of the opportunities generated by a rapidly changing economy, here at home and around the world.”

Trudeau said the pipeline would deliver oil to the Pacific Coast for shipment to Asia, reducing Canada’s dependency on selling its petroleum to the United States.

Green Party Leader Elizabeth May was quoted by the CBC as calling Trudeau’s promise to funnel profits from pipeline into clean energy technology a “cynical bait-and-switch that would fool no one.”

“If you’re serious about fighting climate change, you invest public funds in renewable energy,” May said. “And there’s no guarantee that this pipeline will ever turn a profit anyway.”

The majority of First Nations communities have signed off on the expansion, but some still oppose it.

The expansion is designed to move nearly a million barrels of oil each day — triple the flow from the existing pipeline. That is expected also to significantly boost tanker traffic on Canada’s Pacific Coast from just 60 vessels a year to more than 400, according to The Associated Press.

However, opponents of the Trans Mountain expansion warn that the risks of spills will rise dramatically.

Trudeau said he expects “shovels will be in the ground” this year.

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In Rural Wyoming, This Program Is Designed To Help Patients Manage Medical Needs

Managing chronic pain can be particularly difficult for people in rural areas because of the necessity of frequent doctor visits. Volunteers in rural Wyoming are trying to help.



AUDIE CORNISH, HOST:

When you live in a rural place, the doctor’s office or emergency room can be hard to get to. For people living with chronic conditions, that makes life complicated. Wyoming Public Radio’s Maggie Mullen reports on one program designed to help rural patients manage their medical needs.

MAGGIE MULLEN, BYLINE: Gary and Celeste Havener live 40 miles outside of Laramie in southeast Wyoming. They spend a lot of their time growing vegetables and riding horses across the prairie.

GARY HAVENER: And any time you get on a horse, anything can happen.

MULLEN: A few weeks ago, Celeste fell off her horse.

CELESTE HAVENER: Had a very ungraceful dismount and tweaked my knee pretty good.

MULLEN: Afterwards, she laid on the ground for a while, trying to figure out how hurt she was, but also wondering if a visit to the doctor was worth it.

C. HAVENER: After it didn’t get better, I did go to town.

MULLEN: This kind of decision-making is something she and her husband do often since they both have other health issues. Gary deals with pain from injuries working as a carpenter, and Celeste just recently wrapped up radiation treatment for breast cancer.

C. HAVENER: I think most rural people choose Dr. Denial as their first choice. Dr. Google is their second choice.

MULLEN: In a recent poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, 26% of rural Americans say there’s been a time the past few years when they needed health care, but did not get it. A majority of them say it was because financial barriers kept them from seeing a doctor, but almost a quarter of them say it was because health care was too far or difficult to get to. That’s where Janet Korpela comes in.

JANET KORPELA: In a rural area, if someone can manage their own health better and go to the doctor less often, then that’s a win for everybody.

MULLEN: Today, she’s running a leader training with eight volunteers for a program called Healthy U.

(SOUNDBITE OF TABLES BEING MOVED)

MULLEN: They arrange tables in a circle so participants can all face one another. The people from this training will go back into their communities to teach patients living with chronic conditions how to better manage their health. These leaders don’t need a medical background. Korpela says, they just need to be willing to do the 40 hours of free training.

KORPELA: This curriculum is really designed to be led by pure leaders, which means that the leaders should be equivalent or equal to the people who will eventually be taking the workshops.

MULLEN: One of the things volunteers do in the training is role-play. Korpela is in the role of patient.

KORPELA: My action plan was to take my prescribed medication daily, on time, as prescribed. And I did not do that. And actually…

MULLEN: Volunteers learn to brainstorm solutions. Melanie Pearce and Dawn Garrison have a few ideas.

MELANIE PEARCE: Take your medicine with a regular activity.

DAWN GARRISON: I said, put it by the toothpaste so when you brush your teeth in the morning, you take it first thing in the morning. I’m assuming that you brush your teeth every morning.

(LAUGHTER)

MULLEN: This is called action planning, and studies show it’s effective at improving quality of life and reducing the number of doctor visits or hospitalization.

ANNA D’HOOGE: I mean, I think we tend to think of it as a medical issue in the sense of disease management – like, you just need to go to the doctor or take your medication.

MULLEN: That’s Anna D’Hooge. She’s one of 62 people in Wyoming to complete the leader training. She’s a nutritionist at a hospital in Cheyenne, and the majority of her patients deal with a chronic condition.

D’HOOGE: Hopefully, people will realize, oh, well, I’m not a health care doctor. I’m not a nurse, but I do have these skills, so I can help my friend with chronic disease by doing this.

MULLEN: For D’Hooge, she decided to do the training as a way to make her community a healthier place to live. For NPR News, I’m Maggie Mullen in Laramie.

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