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Business December 10, 2018

Unto The Brexit

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British politicians were due to vote today on Prime Minister Theresa May’s plan to take the UK out of the European Union. In a last minute twist however, May announced a postponement of the parliamentary vote.

This reflects the lack of support in Britain for her plan, especially disagreement and worry over what to do about the border between the Republic of Ireland and Northern Ireland. Today on the Indicator, we talk to economist Tim Harford about why the Irish border is such a sticking point, and why it’s so important for the UK to have a comprehensive agreement with Europe in place before it leaves the Union.

Music by Drop Electric. Find us: Twitter/ Facebook.

Subscribe to our show on Apple Podcasts, PocketCasts and NPR One.

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Health December 10, 2018

Research Gaps Leave Doctors Guessing About Treatments For Pregnant Women

For years, pregnant women have been routinely excluded from medical studies, a practice that has left unanswered questions about how best to treat many health conditions during pregnancy.

Maria Fabrizio for NPR

Jenna Neikirk was nearing the end of her first pregnancy when her blood pressure shot up to dangerous levels.

“I started feeling splotchy and hot, just kind of uncomfortable, so I took my blood pressure at work and it was 160 over 120,” she says. Neikirk’s a physical therapist in Atlanta and knew that level was alarmingly high.

She left work and walked over to her obstetrician’s office, which was in the same medical complex.

“They took my blood pressure again and they decided to admit me to the hospital,” Neikirk, 29, says. “So I was actually in the hospital for a night monitoring my blood pressure, monitoring the protein in my urine.”

The doctors were making sure her blood pressure didn’t get so high as to cause a stroke and that she didn’t have symptoms of pre-eclampsia, a condition that can be fatal in pregnant women.

When she was sent home the following day, the doctor put Neikirk on bed rest and told her to stop working. She wasn’t offered any of the dozens of medications on the market that treat high blood pressure.

Jenna Neikirk and her husband, Zach, play with their 5-month-old, Embry, in their apartment in Atlanta.

Jim Burress/WABE


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Jim Burress/WABE

That’s likely because none of those drugs is explicitly approved by the Food and Drug Administration for treatment of pregnant women.

“Gestational hypertension itself is a separate condition, and we actually don’t have any medications that are developed specifically for that,” says Dr. Catherine Spong, chief of maternal-fetal medicine at the University of Texas Southwestern Medical Center in Dallas.

The American College of Obstetricians and Gynecologists recommends women with pre-existing hypertension continue to use some blood pressure medications. And the group says women who develop high blood pressure can receive “emergency treatment” with some drugs.

Still, bed rest isn’t recommended. ACOG cautions against bed rest because there’s no evidence that it helps pregnant women and it may even cause harm.

Neikirk’s doctor’s office didn’t respond to requests for comment.

Neikirk found herself in a situation that many pregnant women do today. They have a medical problem — either that existed before they were pregnant or was caused by being pregnant — and their doctors have to figure out how to deal with it without a strong foundation of medical research to help their decisions.

Historically, pregnant women have been excluded from medical research, because scientists and ethicists were concerned that experimenting on them could hurt them or their fetus.

“Pregnant women are considered a vulnerable population, so, in general, researchers aren’t permitted to experiment on pregnant women,” says Jacqueline Wolf, a professor of the history of medicine in the Department of Social Medicine at Ohio University.

Researchers have to take special precautions to do studies on vulnerable populations, including children, the mentally disabled, incarcerated people and pregnant women. So researchers typically exclude these groups to get their studies approved.

But one result is that doctors caring for pregnant women have fewer tools to care for them when they’re ill, Wolf says.

“That’s where the irony comes in,” she says. “Because researchers are hardly ever permitted to conduct trials on pregnant women, we end up experimenting on pregnant women all the time, because we can’t accumulate a solid fund of evidence. So we just stick with the old standards, or we introduce new things without doing trials on them.”

When a woman gets pregnant, her pre-existing medical conditions don’t disappear, says UT Southwestern’s Spong. She lists a litany of conditions — autoimmune disorders, diabetes, hypertension, infections, asthma, preterm labor, gestational hypertension or hyperemesis — for which there are few therapies that are specifically developed for or tested on pregnant women.

“If someone comes into pregnancy on anti-hypertensive medicines, commonly they will continue on some type of anti-hypertensive medicine during pregnancy,” Spong says. “However, we don’t have information about how that medicine should be dosed in pregnancy.”

She says when women are pregnant, their blood volume doubles and their liver and kidney function change. No one knows how that affects the medication.

So doctors across the country find themselves prescribing medications, or taking patients off them, without strong evidence either way.

By keeping pregnant women out of studies, Spong says, “You are putting them and their fetuses more at risk.”

Spong was chair of a federal task force, mandated in 2016 by the 21st Century Cures Act, that studied the gaps in health care knowledge about pregnant and lactating women. The group issued a 388-page report in September that recommends that pregnant women be routinely included in research studies, that the government devote time and money to studying existing drugs in pregnant women and that the government help develop new drugs to treat problems related to pregnancy and breastfeeding.

Health and Human Services Secretary Alex Azar is supposed to respond to the task force recommendations by the end of December. He didn’t respond to a request made through his spokeswomen for an interview.

Over the years, scientists have accumulated observational research on the safety and efficacy of some existing drugs, including blood pressure medications, says Dr. Alison Cahill, chief of maternal fetal medicine at Washington University in St. Louis.

And for those drugs that have shown themselves to be safe, she says, doctors usually recommend women continue to use them after they become pregnant.

But few studies compare a drug with a placebo in pregnant women, which is considered the gold standard, and few studies show how medications react differently after a woman becomes pregnant. Without that arsenal of well-researched medications, Cahill says she and her patients have to weigh the pros and cons of using a drug, or leaving an ailment untreated.

“I actually think that it’s one of the most important responsibilities of a physician,” she says. “There’s always things that we don’t know. And I think part of respecting patients’ autonomy, and their participation in medical decision-making, is to explain what we know but also to explain what we don’t know even if that’s hard.”

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Business December 9, 2018

Exclusive: Ed Department To Erase Debts Of Teachers, Fix Troubled Grant Program

Students and grads cross a rickety bridge.

Lily Padula for NPR

For public school teacher Kaitlyn McCollum, even simple acts like washing dishes or taking a shower can fill her with dread.

“It will just hit me like a ton of bricks,” McCollum says. ” ‘Oh my God, I owe all of that money.’ And it’s, like, a knee-buckling moment of panic all over again.”

She and her family recently moved to a much smaller, older house. One big reason for the downsizing: a $24,000 loan that McCollum has been unfairly saddled with because of a paperwork debacle at the U.S. Department of Education.

But for McCollum and many public school teachers, it appears the nightmare is nearly over.

The Education Department is releasing a plan Sunday to help these teachers who have been wrongly hit with debts, sometimes totaling tens of thousands of dollars, because of a troubled federal grant program.

The move comes after an almost year-long NPR investigation that brought pressure on the department. In May, the Education Department launched a top-to-bottom review of the program. Amid continued reporting, 19 U.S. senators sent a letter, citing NPR, saying the problems should be fixed.

When NPR breaks the news to McCollum that the Department of Education is going to fix this, she is astonished.

“Are you serious?” McCollum says quietly. The teacher from Columbia, Tenn., is in her new home, where the walls are bare but there’s a Christmas tree that she and her her husband, A.J., have just put up. The floor is littered with pine needles as her 19-month-old son, Louther, plays in the next room.

Her eyes well up. She lifts a hand to her mouth and laughs. And then she cries. “That is such good news. Oh, that is such good news.”

Kaitlyn McCollum with her husband, A.J., and son, Louther, after learning of the Department of Education’s decision to help teachers who had lost their TEACH grants because of paperwork problems.

Alexis Marshall for NPR


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Alexis Marshall for NPR

The source of the trouble for these teachers boils down to one word: paperwork.

Since it began in 2008, the goal of the TEACH Grant program has been to entice talented, young teachers to take hard-to-fill jobs at schools in lower-income districts, where they are badly needed.

Grants for aspiring teachers to work at low-income schools

Here’s how it works. Aspiring teachers get grant money to help pay for their own college or graduate school. In exchange, they agree to teach a high-need subject, including math or science, for four years in a school that serves low-income families.

But for many teachers, it has turned into a financial disaster because their grants were converted to loans — with interest. All because of paperwork issues.

“On the phone, honestly, I cried at one point. I was like, ‘This isn’t right. It’s not fair,’ ” says Victoria Libsack, who had her grants involuntarily converted to loans after her first year of teaching in a low-income, South Phoenix, Ariz., school.

Libsack had pleaded with a call center agent to reverse the conversion. “I kept asking [for help], and they’re like, ‘I’m sorry. There’s nothing we can do.’ And I was just crying to them, like, ‘How is this even possible?’ “

Here’s what happened: The program requires teachers to submit paperwork annually, for four years, certifying that they are teaching in a low-income school. But the form itself is notoriously obscure. Even the Department of Education agrees, calling it “too complicated and confusing” in one internal document.

Making matters worse, reminders to complete the paperwork are sometimes sent to outdated addresses, and for many teachers, the form must be completed over the summer when their principals, who have to sign it, are away on vacation.

The most significant issue is the deadline. If teachers submit their paperwork late, or if it’s missing a signature or a date — any little problem — the consequences are catastrophic.

One missed deadline and a $24,000 loan

For three years, McCollum sent in her paperwork on time without incident. But in her fourth year of teaching, the last year she had to submit it, she was told her form had arrived late, and her grants were converted to loans, with interest. That’s why she now owes more than $24,000. At the time, McCollum wrote a formal appeal:

“I now face owing the equivalent of a new car [payment] … because the paperwork was received from me a week after the deadline. I humbly ask that you consider all of the years of my hard work and dedication to inner city education. … My husband and I both have worked so incredibly hard to be anywhere but this situation. … We thank you for your consideration and truly hope that you find favor with us on this issue, as it could truly change our lives.”

McCollum’s appeal was denied.

So were Libsack’s appeals for help. She was told her paperwork was processed one day late. And it has been the department’s policy that even if paperwork is just a day late, that should trigger the conversion of a grant to a loan — a process that is irreversible.

“Teachers who work in Title I schools are passionate and they are giving all of themselves,” Libsack says. “So to take advantage of teachers in this way is … so unjust and something needs to be done about it.”

Internal department documents obtained by Public Citizen, a consumer advocacy group, show that even FedLoan, the company that manages the program for the department, recognized that this paperwork inflexibility was hurting qualified teachers and advised the Education Department to fix it. In one 2015 interaction with the department, FedLoan wrote:

“We believe that [annual] certification is an obstacle for TEACH Grant recipients to completing their service obligation, and doesn’t represent their having no intention to honor the meaning behind the grant: that they serve a low income school in a high need field.”

In the memo, FedLoan even requested the authority to change loans back to grants for teachers who were clearly meeting the spirit of the program — teachers like McCollum and Libsack.

Now, in a tacit acknowledgement that the terms of the program have been too inflexible and punishing, the department is doing something about it.

A second chance

The Department of Education now says it will give teachers who lost their grants because of paperwork problems a second chance to prove they were meeting the program’s teaching requirements. It doesn’t matter if a form arrived late or incomplete in the past. If teachers can now document they were teaching a high-need subject in a low-income school, which was the purpose of the program, they’ll get credit for those years of service and have their loans turned back to grants.

McCollum teaches at Columbia Central High School in Tennessee. After she was told her TEACH Grant paperwork was late, her grants were converted to loans.

Stacy Kranitz for NPR


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Stacy Kranitz for NPR

“We get focused on, you know, budgets and legislative requirements and things like this, and frankly, I think sometimes we forget who we ultimately work for,” says Chris Greene, the chief customer experience officer for the Education Department’s Federal Student Aid office. “We know these folks made career-defining decisions to do very noble work. We are absolutely supportive of it. We know we can do better, and that’s what we’re trying to do today.”

Here’s how this fix will work. For teachers who can prove they have fulfilled all four years of service, their debts will be erased. If they have been paying back these loans, the department says those balances will be erased and teachers will be refunded whatever they have paid into the system.

For teachers who have not yet taught the full four years, they too can now get credit for all years served in a qualifying school, regardless of any past paperwork problems. Their loans will be converted back to grant status, and they will have the opportunity to get back on track and complete their service. One caveat: the original terms of the program require that teachers complete four years of service within an eight-year window, and that’s still the case.

Also, none of this will be automatic. As part of this change, the department will reach out to teachers it thinks might qualify for the fix, which it is calling a “reconsideration process.”

But Federal Student Aid Communications Director April Jordan says the burden is still on teachers to speak up. To get their money back, “they need to raise their hand and tell us that they want us to take a look at their certification again,” she says.

If they do that, thousands of teachers around the country who have been hurt by the program would likely be eligible for help.

The scale of the problem

An internal Department of Education survey that was first obtained by NPR found that 1 in 3 participants whose grants had been converted to loans said that he or she was nevertheless likely to meet TEACH’s service requirements or had already met them. The report estimated that was upwards of 12,000 teachers.

Another internal document, obtained by Public Citizen, shows that more than 4,000 formal disputes have been filed by teachers who lost their grants because of late paperwork. And those disputes very likely understate the scale of the problem.

Many teachers have told NPR that call center workers actually advised them not to bother disputing the loss of their grants if they missed a deadline.

“I’m like, ‘Let me talk to your supervisor,’ ” David West told NPR earlier this year. The Lexington, S.C., teacher called FedLoan when his grants were involuntarily converted because of late paperwork. West says the representative on the phone told him, “You can talk to who you want and … you can try to appeal this if you want. But nobody ever wins.”

David West, an art teacher in South Carolina, is a recipient of a TEACH Grant that was converted to a loan after he sent in a form with a mistake.

Sean Rayford for NPR


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Sean Rayford for NPR

As part of its fix, the department says it will also review the older cases of an additional 10,000 teachers whose grants appear to have been converted to loans completely by mistake.

The department is also making changes to protect future teachers. It is extending deadlines and redesigning the certification process to make it much less likely that teachers run into paperwork problems in the first place.

Not all good news

Some teachers who lost their grants say they chose, as a result, to change schools or quit teaching altogether. For these teachers, completing their service within the program’s 8 year window may be a challenge.

They include teachers like Libsack. She says she taught for three years in a qualified South Phoenix school but moved to another state and now teaches in a school that doesn’t qualify. Six years have passed in Libsack’s eight-year window. So to erase her debts under the new fix, the clock is ticking. She would need to quit her current job and teach another year in a low-income school within the next two years.

“I’m very happy that I at least have a chance to not have to pay back all this money,” Libsack says. “But it also puts me in a bad situation because this school where I’m working now, I’ve established relationships with kiddos and families and staff. And so now I’m going to have to rethink next year because I don’t have a very big window.”

Libsack says she wishes the department would give teachers like her more time. Julie Murray agrees. An attorney with Public Citizen Litigation Group, Murray has been fighting the department to release documents related to the TEACH Grant program.

In fact, Murray says, “the department already has a policy where it suspends the eight-year period in some circumstances. So this is not a case in which Congress hasn’t given the department authority.”

Murray points to one more challenge that, she says, the department may have to contend with: The paperwork form the program provides teachers to certify that they taught in a given year doesn’t appear to have gone through a required government review, though it’s not clear what, if anything, that might mean moving forward.

Murray says the department should further overhaul the program over the coming months in a process that’s already underway, known as negotiated rule-making.

“I am ecstatic”

One thing is clear. For teachers who have been hurt by this program, the fix the department is announcing Sunday could help many of them get their grant money back and move on with their lives.

While McCollum still has to go through the official reconsideration process, which could take several months, she says she is going into the holidays with a $24,000 weight off her shoulders.

“I feel very much freed,” she says. “I am ecstatic.”

The department is working to finalize the details of its fix by the end of January.

Teachers are encouraged to go to www.studentaid.gov/teach-reconsideration to find out what they need to do.

NPR wants to hear from teachers as they go through the reconsideration process. Please share your stories with us here. You can find all of NPR’s reporting on the troubled TEACH Grant program here.

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Health December 9, 2018

For One Rural Community, Fighting Addiction Started With Recruiting The Right Doctor

Located in Northern Wisconsin along the shores of Lake Superior, Ashland, Wis. has had enough of substance abuse issue. NorthLakes Community Clinic brought in Dr. Mark Lim to start a team providing substance abuse and mental health services.

Derek Montgomery for NPR


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Derek Montgomery for NPR

Lindsay Bunker woke up from a nightmare.

The 32-year-old lives with her sixth-month-old daughter on the Lac Courte Oreilles Indian Reservation in northern Wisconsin. She’s struggled with addiction for over 10 years, mostly to heroin. Then came the nightmare: She dreamt two men were attacking her baby while she could think only about drugs.

“In my mind I was thinking, ‘If I can just get one hit, if I can get one line, I can save her,'” she recalls, pausing before continuing, “I woke up and I was panicking. How can a mother think like that?”

It was a wake-up call. Bunker says she realized in that moment that heroin was “evil” and she resolved to get into treatment. In a lot of rural America, that’s where the story could have ended.

Many rural communities lack basic resources for substance abuse. There are fewer services available than in urban areas—as many as 82 percent of rural Americans may live in counties that lack detoxification services, for example.

Life And Health In Rural America

You can find the other stories in our series about life in rural America here.

But Bunker was lucky. She found a community health center only about an hour from her home that recently expanded its addiction treatment services.

The clinic, NorthLakes Community Clinic,serves Medicaid and Medicare patients, and offers sliding scale payments for those with low-income. It expanded its addiction recovery program with the help of state and federal grants targeting opioid use. Though rural communities across the country struggle with addiction, community health centers like this one are modeling an approach to managing — and funding — treatment programs.

“We were seeing substance use disorders killing our community and we felt it was our job to step up,” says Reba Rice, the clinic’s CEO. “We feel that all of our patients and community members deserve a life worth living.”

Not just opioids

Rice says addiction has torn apart rural communities in Northern Wisconsin in the last five years or so, with an increase in crime, problems in schools, trauma in families.

“It was amazing how many things we were seeing changed,” she says. “The way people looked at each other, the level people were willing to trust each other, and it was all about the changes that this disease makes on its victims”

Lindsay Bunker (left) talks to her counselor Regina Fox (right) at the NorthLakes Community Clinic in Ashland, Wisconsin. Bunker is in treatment for heroin addiction. She says the clinic’s approach is helping: “I love being here. I feel safe. I feel strong. I feel supported.”

Derek Montgomery for NPR


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Derek Montgomery for NPR

A recent poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health shows that opioid and other drug abuse is the top health concern for rural Americans.

NorthLakes has long provided primary care, dental and behavioral health services for low-income residents in Ashland, Wisconsin, and in several nearby towns. But as the opioid addiction problem worsened, Rice says she felt a responsibility as a health care provider to do something about it.

“We contributed to the problem so we needed to contribute to the solution,” she says.Rice says opioids were just part of the puzzle: meth and alcohol were huge problems too. In fact, meth use in Wisconsin it has grown by 250 percent in recent years, according to the FBI. But new funds were becoming available for opioid treatment so the clinic applied for those — and is using them to build a comprehensive addiction treatment program that addresses all the substances people there struggle with.

To fund its expanded addiction treatment services, NorthLakes applied for and won a grant from the state of Wisconsin three years ago. It also got other federal grants intended for mental health and addiction. Central to their plan was hiring a physician who could lead the new program, and could prescribe the addiction treatment buprenorphine, known by the trade-name Suboxone.

Suboxone treatment is one of the most effective ways to treat opioid addiction. But it is hard to find in rural areas, because only providers who’ve received special training are allowed to prescribe it. One 2015 study found that more than 80 percent of rural counties in the U.S. do not have a single physician able to prescribe it.

NorthLakes found a physician who could prescribe it and more than that, who had a vision for a comprehensive addiction program.

Building treatment capacity

Dr. Mark Lim says he is surprised he’s here in this 8,000 person port-town on Lake Superior. He’d dreamed of living in a big city since he moved to the U.S. from the Philippines. When he got the call about the job, he was hesitant at first. “I didn’t know where that was on a map,” he recalls.

But he saw this part of Wisconsin, where the death rate from drug and alcohol abuse is nearly twice as high as the state average, as a place where he could make a difference.

Lim’s been board certified in addiction medicine since it was officially recognized as a subspecialty in 2016, but he’s been working in the field since about 10 years ago when he started working in an addiction practice in Maine.

Dr. Mark Lim moved from Maine to become the recovery program medical director at NorthLakes Community Clinic in Ashland, Wisconsin. He wanted to set up a comprehensive practice to treat a range of addictions.

Derek Montgomery for NPR


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Derek Montgomery for NPR

He took the Wisconsin job, with one stipulation: He would start a program to address addiction as a whole. His expertise would be just one part of the treatment approach.

“If I’m just going to be the Suboxone doctor I’m not doing the full practice of addiction,” Lim says.

Because while the medication can be effective for treating opioid use disorder, Lim says addiction is not just about opioids.

“Opioids are big right now,” Lim says. “But you have to work with alcohol too. You have to work with marijuana too. You have to work with methamphetamine, cocaine.”

Rice says she and Lim developed the program together with community partners including educators, law enforcement and tribal leadership. “We were successful because we had a vision for creating a program and so did he,” Rice says.

While it’s rare to have a doctor who can prescribe Suboxone in a rural area like this one, Lim says only about 40 of his more than 200 patients take it. For the rest, his program relies on a combination of counseling, group therapy for addiction and underlying mental health issues, and case management. Staff help to remove barriers to being successful in recovery, helping patients with things like, transportation to the clinic, daycare for parents during therapy, and even job placements.

This kind of recovery program that combines clinical and counseling services is exactly what rural communities need, says John Gale of the Maine Rural Health Research Center.

“That’s exactly the way it should be done. Because most people with a substance use disorder have co-occurring mental health and substance use problems,” Gale says. “If we take care of [a patient’s] heroin problems and we don’t treat the underlying mental health and substance abuse problems, they’re going to go to go to alcohol, they’re going to do something else.”

And while most of the attention and dollars are focused on opioid abuse right now, he says rural communities struggling to address addiction can use those resources to build a larger treatment capacity.

“They can use [those resources] to say, ‘Wait a minute, let’s build a treatment capacity for other people,’ ” Gale says. “And they begin to create a community where you can treat all sorts of substance use disorders.”

Lindsay Bunker gets a ride to and from the NorthLakes clinic from a medical transportation company — it’s about an hour’s drive each way from the reservation. The clinic has a baby sitter who looks after her daughter when Bunker is in appointments. She makes the trip nearly every day.

“I love being here. I feel safe. I feel strong. I feel supported,” Bunker says.

But she only sees Dr. Lim about once a week. Instead, like all of the patients here, she spends most of her time in one-on-one and group counseling sessions. There’s the early relapse prevention group (from which Bunker recently graduated), then there’s the relapse recovery group, the family group, the engaged-in-recovery group. There’ll be a trauma group soon as well.

Bunker says those group sessions are really important in helping her stay in recovery.

“I get cravings and the cravings are being taken away with that medicine [suboxone]. But being here with my peers, I love it. I really do,” Bunker says.

And she says, recovery agrees with her.

“I look good, I feel good, I’m taking care of my kid,” she says. “I’m doing very well.”

Bram Sable-Smith (@besables) is a health reporter based in Madison, Wis.

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Sports December 8, 2018

Cargo Ship Saves 29-Year-Old Sailor In South Pacific After Her Boat Flips

Susie Goodall on her boat DHL Starlight on July 1 at the start of the solo around-the-world Golden Globe Race.

JEAN-FRANCOIS MONIER/AFP/Getty Images


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JEAN-FRANCOIS MONIER/AFP/Getty Images

The challenge: Sail 30,000 miles around the globe, non-stop, alone.

What could go wrong?

This week, Susie Goodall found out. The 29-year-old British woman was the youngest participant in the annual Golden Globe Race which sends sailors from the coast of France around the earth and back to the same port. Or at least that’s the plan.

On Wednesday morning, Goodall was 2,000 miles west of South America when her boat flipped in heavy wind, broke its mast and knocked her temporarily unconscious. She activated her emergency beacon and a series of troubling updates were posted to her Twitter account:

73-DISMASTED.HULL https://t.co/jj0fKZ29HZ FORM OF JURY RIG,TOTAL LOSS

— SusieGoodallRacing (@susieBgoodall) December 5, 2018

73-INTERIOR TOTAL WRECK,LIFERAFTOK

— SusieGoodallRacing (@susieBgoodall) December 5, 2018

73-NASTY HEAD BANG AS BOAT PITCHPOLED.UNBELIEVABLY ROLY NOW

— SusieGoodallRacing (@susieBgoodall) December 5, 2018

Chile’s Maritime Coordination Center received her distress signal and ordered the Tian Fu, a cargo ship on its way from China to Argentina, to divert from its course and rescue Goodall.

Meanwhile, all Goodall could do was wait — trying to keep her boat steady in the choppy South Pacific and pumping out water that was leaking into the damaged cabin.

When the 600-foot rescue vessel finally reached Goodall, deploying a small boat to retrieve her was deemed impossible because of 10-13 foot waves rocking both ships. Instead, crew members on board the Tian Fu executed a kind of high-stakes version of Candy Crane, lowered a cable from one of the ship’s massive cargo hoists, and plucked Goodall from her deck, hauling her to safety.

After 3 intensive days of co-ordinations from MRCC Chile, today at 15:35 UTC the motor vessel “TIAN FU” was able to recue the British yachtswoman Susie Goodall.
BZ. pic.twitter.com/20bOEendr2

— MRCC Chile (@MRCCChile) December 7, 2018

The good news was posted to her Facebook page: “From Susie, at 15:14 UTC: ON THE SHIP!!!” Goodall is expected to arrive at the Chilean port of Punta Arenas on Wednesday.

She is not the first sailor to run into trouble in this year’s race. As NPR reported, an accident in the Indian Ocean in September forced the evacuation of a naval commander; skippers from France and Ireland have also had to be rescued.

In a post from Nov. 30 titled “Half way round the world,” Goodall wrote about how challenging the experience had been at that point as she faced fierce seas.

“To say I’d had enough by this point is an understatement. They were the hardest and loneliest days I’ve ever had. All I wanted was a break from it. But being under Australia, half the world from home I might as well sail home again instead of taking a break.”

Her family thanked rescuers and race organizers Friday, and said farewell to her ship, the DHL Starlight.

“It was with a heavy heart Susie left DHL Starlight to fend for herself, before she fills with water and rests on the Pacific Ocean floor. DHL Starlight has been her home for the past few years; a faithful friend who stood up valiantly to all the elements, a guardian until their last moments together.”

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Health December 7, 2018

Facing Critical Labor Shortage, Japan Opens Door Wider To Foreign Workers

In front of Japan’s parliament on Friday, people stage a rally against the bill to allow more foreign workers into the country.

Kazuhiro Nogi/AFP/Getty Images


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Kazuhiro Nogi/AFP/Getty Images

Japanese lawmakers have passed controversial legislation expanding the number of semi-skilled foreign workers who can live and work in the notably insular nation for up to five years.

Japan has been pressed to make the change because of a critical labor shortage that results from its rapidly aging society and low birth rate.

Japan’s upper house of parliament passed the law 161 to 76 just after 4 a.m. Saturday local time, after a day when the opposition parties tried to unsuccessfully to block the measure.

The law will go into effect in April 2019.

The legislation has been viewed as a last-resort measure by Prime Minister Shinzo Abe’s ultra-conservative government to address a severe shortage of workers in 14 industries, including restaurants, nursing, construction and agriculture.

According to the Associated Press, two categories of workers will be accepted, with conditions that will discourage them from trying to immigrate permanently.

The law will apply to as many as 345,000 less-skilled workers who will be allowed to stay for up to five years, but not bring in family members. It will also permit higher-skilled workers to enter with their families for 10 years and will provide them a path to Japanese citizenship. Both categories will have requirements for Japanese language competency.

Japan’s population is expected to decline from about 127 million to about 88 million by 2065, according to the National Institute of Population and Social Security. In September, Japan’s Internal Affairs and Communications Ministry released data showing that for the first time, one in five people in the nation is older than 70.

Japan has felt the pressure of an aging population and declining birthrates for decades. The government has tried to meet labor shortages by encouraging more employment of women and older workers, and using more robots and other automation.

And it does have foreign workers. Their number has more than doubled since 2000 to nearly 1.3 million last year, out of a working-age population of 67 million, according to the AP.

“Workers from developing Asian countries used to stay mostly behind the scenes, but not anymore. Almost all convenience stores are partly staffed by Asian workers and so are many restaurant chains.”

Many foreigners are working in Japan on training visas “that don’t allow them to switch jobs even if they are abused or underpaid,” says The Wall Street Journal editorial board. Thousands of student visa holders also work in Japan, often for longer than the 28 hours a week legally allowed.

But until now the government has resisted opening the door to a legal influx of semi-skilled foreign laborers, as many Japanese, particularly Abe’s right-wing supporters, fear a loss of cultural distinctiveness and homogeneity. It’s one reason the government has been careful not to characterize the new visa program as immigration.

But, as The Washington Post reports, Abe’s government is “closely entwined with the business community, and the message it hears from every quarter — shipbuilding and construction, agriculture and fishing, elder-care establishments and convenience-store owners — is ever more insistent: We need more workers.”

A report by Tokyo Shoko Research showed the number of bankruptcies in Japan caused by staff shortages doubled between 2016 and 2017, according to The Wall Street Journal.

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Business December 7, 2018

Facing Critical Labor Shortage, Japan Opens Door Wider To Foreign Workers

In front of Japan’s parliament on Friday, people stage a rally against the bill to allow more foreign workers into the country.

Kazuhiro Nogi/AFP/Getty Images


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Kazuhiro Nogi/AFP/Getty Images

Japanese lawmakers have passed controversial legislation expanding the number of semi-skilled foreign workers who can live and work in the notably insular nation for up to five years.

Japan has been pressed to make the change because of a critical labor shortage that results from its rapidly aging society and low birth rate.

Japan’s upper house of parliament passed the law 161 to 76 just after 4 a.m. Saturday local time, after a day when the opposition parties tried to unsuccessfully to block the measure.

The law will go into effect in April 2019.

The legislation has been viewed as a last-resort measure by Prime Minister Shinzo Abe’s ultra-conservative government to address a severe shortage of workers in 14 industries, including restaurants, nursing, construction and agriculture.

According to the Associated Press, two categories of workers will be accepted, with conditions that will discourage them from trying to immigrate permanently.

The law will apply to as many as 345,000 less-skilled workers who will be allowed to stay for up to five years, but not bring in family members. It will also permit higher-skilled workers to enter with their families for 10 years and will provide them a path to Japanese citizenship. Both categories will have requirements for Japanese language competency.

Japan’s population is expected to decline from about 127 million to about 88 million by 2065, according to the National Institute of Population and Social Security. In September, Japan’s Internal Affairs and Communications Ministry released data showing that for the first time, one in five people in the nation is older than 70.

Japan has felt the pressure of an aging population and declining birthrates for decades. The government has tried to meet labor shortages by encouraging more employment of women and older workers, and using more robots and other automation.

And it does have foreign workers. Their number has more than doubled since 2000 to nearly 1.3 million last year, out of a working-age population of 67 million, according to the AP.

“Workers from developing Asian countries used to stay mostly behind the scenes, but not anymore. Almost all convenience stores are partly staffed by Asian workers and so are many restaurant chains.”

Many foreigners are working in Japan on training visas “that don’t allow them to switch jobs even if they are abused or underpaid,” says The Wall Street Journal editorial board. Thousands of student visa holders also work in Japan, often for longer than the 28 hours a week legally allowed.

But until now the government has resisted opening the door to a legal influx of semi-skilled foreign laborers, as many Japanese, particularly Abe’s right-wing supporters, fear a loss of cultural distinctiveness and homogeneity. It’s one reason the government has been careful not to characterize the new visa program as immigration.

But, as The Washington Post reports, Abe’s government is “closely entwined with the business community, and the message it hears from every quarter — shipbuilding and construction, agriculture and fishing, elder-care establishments and convenience-store owners — is ever more insistent: We need more workers.”

A report by Tokyo Shoko Research showed the number of bankruptcies in Japan caused by staff shortages doubled between 2016 and 2017, according to The Wall Street Journal.

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Sports December 7, 2018

How Atlanta Became A Soccer Town

Atlanta and Portland face on in Major League Soccer’s championship on Saturday. Atlanta’s team is only two years old and its success is due, in part, to massive fan support and a hometown strategy.



AILSA CHANG, HOST:

When you think about sports in the South, you probably think football, not soccer. Well, think again. Tomorrow’s Major League Soccer championship is between the Portland Timbers and Atlanta United. The Georgia team is only in its second season, but it’s already setting a new standard for professional soccer attendance. As Emma Hurt from member station WABE reports, that success is no accident.

EMMA HURT, BYLINE: On a Saturday in June, the world’s most-attended soccer game wasn’t at the World Cup. It was in Atlanta. That might sound surprising but not to those who go to Atlanta United games and often fill a 72,000-seat stadium. Last week, thousands showed up at a watch party to cheer the team playing a semifinal game in New York.

UNIDENTIFIED SPORTS FANS: (Chanting) We are the A from way down South, and we are here, rowdy and proud. Sha-la-la-la (ph), sha-la-la-la.

HURT: The fan energy was electric.

UNIDENTIFIED SPORTS FAN: I actually believe in this team. I think we’re going to go all the way. It’s going to be awesome.

HURT: And before the team even left the field that night, the championship game happening in Atlanta tomorrow sold out. Again, that’s about 72,000 people. Keep in mind the average attendance of an American pro soccer game is more like 22,000. Atlanta United’s numbers are better than some pro football crowds.

But how? Well, the games are fun. Atlanta United’s owner, Arthur Blank, also owns the Falcons and opened a brand-new stadium for the two teams last year. But United games don’t feel like they’re in a football stadium. All the signage is digital. There’s barely a trace of the Falcons on a soccer day. Catie Griggs, who runs business operations for United, says that was a deliberate business decision.

CATIE GRIGGS: We have the ability to truly shift the physical infrastructure of the stadium to accommodate a different sport in a way that is meaningful and authentic and not simply an afterthought.

HURT: It showed fans that soccer was a priority. Another business decision that’s building goodwill – cheap concessions. Hotdogs are $2. At the baseball stadium across town, they’re $6.50. And then there’s the mechanics of the team. Blank hired management with global soccer pedigrees who in turn attracted talented, young players. But OK, a fun stadium and good players who are winning games – still, where are all these southern fans coming from? Matt Stigall started a petition back in 2011 to bring pro soccer to Atlanta, and even he is surprised.

MATT STIGALL: I was never expecting 70,000 people selling out every game, breaking records upon records and really setting a new standard for the league and having all eyes of the world look and be like, holy crap, Atlanta’s a soccer town.

HURT: One reason, he says, is Atlanta United has a clean soccer slate to take advantage of.

STIGALL: There’s a lot of people that I know that moved to Atlanta recently, brought all their original teams in the other sports, whether it’s NFL, NBA, Major League Baseball, the team that their families have been fans of for generations. They don’t have a soccer team.

HURT: Plus there’s the general rise in American soccer popularity. Soccer TV viewership is up while football’s is shrinking. Soccer games don’t stop for commercial breaks, and the games are simply shorter. These are all reasons for the trend to continue, says Matt Doyle, a columnist for MLS.

MATT DOYLE: Thirty-five years ago when I was growing up, Major League Baseball was the undisputed number-one sport among all age groups.

HURT: But today, baseball is number three behind basketball and football. And soccer is soon expected to move into third place ahead of baseball. Here’s Griggs again with the team.

GRIGGS: It’s a serendipitous collision of time, opportunity, market where fundamentally our role is to not screw it up.

HURT: But Atlanta sports fans have a reputation to disprove – that they only support teams when they’re winning. The city’s basketball, baseball and even football teams are well-aware of that. No one knows if the stereotype will hold true here until Atlanta United starts losing. For NPR News, I’m Emma Hurt in Atlanta.

(SOUNDBITE OF SONG, “SEVEN NATION ARMY”)

THE WHITE STRIPES: (Singing) I’m going to fight them all. A seven-nation army…

Copyright © 2018 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

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Entertainment December 7, 2018

First 'Avengers: Endgame' Trailer Arrives as Release Date Moves Up; Here's Everything We Know

Avengers: Endgame

Ever since the devastating ending of Avengers: Infinity War, moviegoers have been dying to see what happens next and find out just what’s become of not only half of Earth’s Mightiest Heroes, but the whole Marvel Cinematic Universe. The fourth crossover tentpole of the franchise, Avengers: Endgame, will see theatrical release just under a year later, hopefully with all our questions answered.

The first trailer for Endgame has now arrived to give fans hope that the surviving members of The Avengers will defeat Thanos and fix the galactic genocide he caused with his attainment of all the Infinity Stones and a snap of his fingers. Some familiar faces not seen in Infinity War now join the remaining original MCU heroes as the movie also just revealed a release date that’s a little sooner than expected.

Watch the trailer below after learning everything we know so far about the highly anticipated sequel.

Obviously there are SPOILERS for Infinity War from here on.

Who is left from Infinity War to star in Avengers: Endgame?

The survivors of the snap, as we’re reminded with the first trailer, include Tony Stark (Robert Downey Jr.), who is drifting alone in space, and Captain America (Chris Evans) and Black Widow (Scarlett Johansson), who are working together to figure out how to deal with Thanos’ wiping out of 50% of all living creatures.

As we learned after the release of Infinity War, much of the follow-up movie will revolve around Captain America and Natasha (Black Widow). According to screenwriter Stephen McFeely (per BuzzFeed):

We had so many characters in movie 1, and we knew it was a two-movie conversation. Some characters were better served in movie 2 after this event. We were making some choices based on some characters we knew were going to leave us at the end of the first movie, so they got highlighted in the first movie. And some who were going to be in the second movie more maybe got less attention or less screentime [in Infinity War] — I’m thinking of Cap and Natasha, specifically. It’s about the story we wanted to tell in movie 2, mostly.

Briefly appearing in the trailer, Thor, Hulk, and Nebula are also still around. Not shown, War Machine, Rocket, Okoye and M’Baku were all last seen alive in Wakanda (see the full list of who lived and who died here), so presumably, they’ll all be back for Endgame in some capacity, as well.

Will Hawkeye and Ant-Man finally join in the fight?

Joining this round after sitting Infinity War out will indeed be Hawkeye (Jeremy Renner), whose return is confirmed in reveals in the first Endgame trailer. The character has a new look, a new weapon of choice, and a new identity — as “Ronin.” And he seems to be out for blood — did he lose his family in the snap?

There’s also Scott Lang, aka Ant-Man (Paul Rudd), who shows up at the Avengers’ front door with a hint that he knows how to help. And he’s got the van we saw at the very end of Ant-Man and the Wasp, when he seemed to be trapped in the Quantum Realm.

So the Quantum Realm is the key to reversing Thanos’ damage?

That’s not confirmed but very logically assumed by Ant-Man’s eager appearance in the first footage we’ve seen from the movie. Perhaps there will be some time travel involved, courtesy of that mysterious part of the MCU.

Do we know yet the whereabouts of other heroes whose status was never made clear?

As we noted in our list of who lived and who died, there are some characters whose status was never made clear by the movies nor the filmmakers. One of those is Black Panther’s sister, Shuri, whose face is seen in the first Endgame trailer with a caption that she is missing.

Also, Captain Marvel has to show up, right?

We can assume based on the symbol on Nick Fury’s pager in the Infinity War post-credits scene that Captain Marvel will definitely be flying into Avengers: Endgame ready to help save the day/universe. McFeely also promised in the BuzzFeed interview that Captain Marvel, which opens in February and is set in the 1990s, will also connect to the events of the Avengers sequel:

Put yourself in our positions two years ago. We’re looking at a blank wall, and it says Avengers 3, Ant-Man and [the] Wasp, Captain Marvel, Avengers 4. So there are four big shoeboxes, and we’re responsible for the bookends. As we’re going through deciding what we want to do, we have these two shoeboxes in the middle that you can either look at as burdens or opportunities.

Will the characters who died in Infinity War be resurrected?

The only thing that has kept Marvel fans from being totally devastated by the deaths in Infinity War is the assumption that most will be reversed in Endgame. After all, nobody is truly dead for long in comic books — or comic book movies. And in the comic series Infinity War is based on, the characters wiped out by Thanos’s powers are revived by another character, Nebula, after she takes possession of the Gauntlet.

Sadly, screenwriters Christopher Markus and Stephen McFreely said early on that’s not the direction the next movie would go in. Markus told BuzzFeed:

[Avengers 4] doesn’t do what you think it does. It is a different movie than you think it is. Also…[the deaths are] real. I just want to tell you it’s real, and the sooner you accept that, the sooner you will be able to move on to the next stage of grief.

What about the characters who have more movies on the way?

Among those who disappeared at the end of Infinity War are Spider-Man, Black Panther, Doctor Strange, Star-Lord and most of the other Guardians of the Galaxy. All of them either have definite sequels in the works or, especially in the case of the massive hit Black Panther, are expected to. McFeely addressed T’Challa’s death in the BuzzFeed interview specifically:

Remember, when we’re writing [Infinity War], and even shooting, there is no Black Panther movie. We don’t know it’s going to be so good, so effective, so resonant. And we had to treat all these characters the same. People who leave us [in Infinity War] are the leads of their own franchises. And Black Panther’s no different.

Also, Marvel Studios head Kevin Feige continues to claim that Avengers 4 is a certain ending to the Marvel Cinematic Universe as we know it, though that has often just seemed like a conclusion to a certain storyline. Last fall, though, Feige hinted to Vanity Fair that movies such as the next Spider-Man and Guardians of the Galaxy films, and anything after Avengers 4, will be a new era of canon:

There will be two distinct periods. Everything before Avengers 4 and everything after. I know it will not be in ways people are expecting.

Will any more characters die in Endgame?

Oh yeah. For a long time, fans have anxiously expected that Iron Man and Captain America will die at some point because actors Robert Downey Jr. and Chris Evans are leaving the franchise. They survived Infinity War‘s brutal ending but they could be next. Co-director Joe Russo told Variety:

For us, there will always be stakes and the stakes have been progressing from film to film. And I think you can extrapolate that they will continue to deepen in Avengers 4.

And specifically when asked about the fates of Iron Man and Captain America, Joe Russo answered “with a sly smile”:

Just you wait.

Will Endgame be even longer than Infinity War?

This is very likely. And considering Infinity War has a running time of two hours and 36 minutes, that means Avengers 4 is going to be really, really long, as Joe Russo admitted to Collider, though this could change:

It could easily be a three-hour film but I think that we’re very hard on the material, we like it to play at a certain pace, so I’m sure we’ll squeeze it. We have a whole year of work left on that movie. I do think it’ll be longer than Avengers 3.

When can we see the movie?

April 26, 2019.

Watch the first Avengers: Endgame trailer:

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Entertainment December 6, 2018

Today in Movie Culture: All of Christian Bale's Physical Transformations, a History of Italian Horror and More

Here are a bunch of little bites to satisfy your hunger for movie culture:


Music Video of the Day:

Footage from Return of the Jedi merges with retro ’80s-influenced graphics in this music video for “Sunrise on Endor” by Gemini Sunset (via Geekologie):

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Video Essay of the Day:

For Fandor, Leigh Singer examines Dogtooth, the breakout movie of The Favourite director Yorgos Lanthimos:

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Movie History of the Day:

One Hundred Years of Cinema chronicles the history of Italian horror movies, including the original Suspiria:

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Movie Comparison of the Day:

Couch Tomato shows us 24 reasons that Pixar’s Incredibles 2 is basically the same movie as Ghostbusters II:

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Vintage Image of the Day:

JoBeth Williams, who turns 70 today, in a promo shot with Craig T. Nelson, Oliver Robins and Heather O’Rourke on the set of Poltergeist in 1981:

Actor in the Spotlight:

In honor of Christian Bale’s transformation for Vice, Vulture chronicles his weight change over 12 roles:

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Screenwriting Lesson of the Day:

The latest video from Lessons from a Screenplay looks at the script for Good Will Hunting and how it puts the psychology of its main character on the surface:

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Cosplay of the Day:

Now all Captain Marvel cosplay is apparently required to include a cat, as per the one in the new trailer:

Update: Milo was NOT ready to cosplay with me. He was quite mad. #CaptainMarvel #MiloContent pic.twitter.com/tCq4j4TGBh

— Lee (@leiladaisyj) December 5, 2018

Easter Eggs of the Day:

Speaking of Captain Marvel, here’s another video highlighting the new trailer’s Easter eggs via ScrenCrush:

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Classic Movie Trailer of the Day:

Today is the 45th anniversary of the release of The Wicker Man. Watch the original trailer for the classic horror movie below.

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and

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