STOP THE BLEED training has saved lives from Sierra Leone to Connecticut

Participants retained knowledge from the course and demonstrated a willingness to help in a bleeding emergency according to two new studies

AMERICAN COLLEGE OF SURGEONS

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VIDEO: STOP THE BLEED TRAINING HAS SAVED LIVES FROM SIERRA LEONE TO CONNECTICUT. view more 

CREDIT: AMERICAN COLLEGE OF SURGEONS

CHICAGO: The STOP THE BLEED® course teaches a skill with lifesaving potential that is easy to learn and globally relevant. Two studies presented at the American College of Surgeons (ACS) Clinical Congress 2020 provide evidence that STOP THE BLEED® training is effective and has made a lifesaving difference around the world.

In one study, an hour-long STOP THE BLEED® course was taught to 121 nursing students at the Kabala Nursing School in rural Sierra Leone. After one year, a survey was administered to the participants to learn whether they encountered bleeding emergencies and whether they were able to administer bleeding control techniques. Seventy-six people responded to the survey, reporting a total of 190 encounters with life-threatening bleeding situations.

The most common injuries requiring a bleeding control intervention were motorcycle collisions (34 percent), knife wounds (19 percent), and car accidents (13 percent). Participants reported they most commonly used wound packing (41 percent), direct pressure (26 percent), and tourniquet application (20 percent). Because they were able to intervene, nearly all of the patients (94 percent) survived, with a majority (82 percent) reporting to the hospital for further medical care.

"People are getting basic medical knowledge, which is essential. With or without a medical background, they can apply this knowledge to save a life," said Samba Jalloh, MB, ChB, of the College of Medicine and Allied Health Sciences, Freetown, Sierra Leone.

In low-to-middle income countries (LMICs), access to health care can be sporadic and the burden of injury can be significant. The findings from this study provide evidence that STOP THE BLEED® training can be implemented in LMICs with sustained success in treating bleeding emergencies before a patient is able to be transported to a hospital.

"Here, there are a lot of risks. Transportation is not very safe, and hospitals can be far away from villages. Knowing how to stop the bleed is very important. People are using the skill to save lives," Dr. Jalloh said.

The researchers stressed that these findings demonstrate enormous lifesaving applicability of STOP THE BLEED® training in Sierra Leone. They noted that future studies should focus on the specifics of adapting bleeding control for use in other LMICs.

"With the efforts of Dr. Jalloh, the course became a mandatory component of house staff training in Freetown. Successful technique usage and course dissemination have encouraged us to think of ways to improve bleeding control training in the United States and abroad. These findings support further emphasis on lifesaving prehospital interventions and represent a great example of sustainable, bidirectional global surgical teamwork," said lead study author Vennila Padmanaban, MD, a surgical resident at Rutgers New Jersey Medical School, Newark.

In another study from researchers in Connecticut, STOP THE BLEED® course attendees demonstrated a strong proficiency of bleeding control knowledge after one year, and course participants, including previously untrained attendees, reported successfully applying hemorrhage control techniques to save lives.

"In our study, we had people as young as 14 and as old as 64 report that they used bleeding control skills. Eight of these people had not undergone any previous training in bleeding control and seven of the people who used the skills did not work as a first responder or in a health care setting," said lead study author Jeremy Fridling, a fourth-year medical student at the Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Conn.

The researchers tracked 1,030 STOP THE BLEED® course attendees, administering surveys before and after the course, as well as six and twelve months later. Of the respondents, 31 participants (8.4 percent) applied bleeding control skills to live victims, with 29 (93.5 percent) reporting a successful outcome.

In the post-course surveys, the average response was between "agree" and "strongly agree" for confidence in knowledge and skills. Notably, the average response (on a 1-5 scale) significantly increased from pre (4.1) to post (4.6), six-month (4.4), and twelve-month (4.5) for willingness to treat a victim with serious bleeding.

"This study is a validation that regular, ordinary people--if you train them and give them a chance and empower them to do a public good and stop bleeding--can stop bleeding with a successful outcome," said study coauthor Lenworth Jacobs, MD, MPH, FACS, professor of surgery, University of Connecticut, and Medical Director, ACS STOP THE BLEED® program.

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Coauthors of the Sierra Leone study are Vennila Padmanaban, MD; Umaru Barrie, BS; Jeremy Badach, MD; Peter Johnston, MD; Wei Wei Zhang, MD; and Ziad C. Sifri, MD, FACS.

Mr. Fridling and Dr. Jacobs' coauthor of the Connecticut study is Richard Feinn, PhD.

"FACS" designates that a surgeon is a Fellow of the American College of Surgeons.

Citation: Bleeding Control Training in West Africa: One Year of Encounters, Interventions and Outcomes. Scientific Forum. American College of Surgeons Clinical Congress 2020.

Citation: Lives Saved and Public Empowerment One Year Following Bleeding Control Training. Scientific Forum. American College of Surgeons Clinical Congress 2020.

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 82,000 members and is the largest organization of surgeons in the world. For more information, visit http://www.facs.org.

Disclaimer: AAAS and EurekAlert! are not responsible for

 

AI predicts patients at highest risk for severe pain, increased opioid use post-surgery

Model helps guide anesthesia approaches to limit opioid exposure

AMERICAN SOCIETY OF ANESTHESIOLOGISTS

Research News

CHICAGO - Artificial intelligence (AI) used in machine learning models can predict which patients are at highest risk for severe pain after surgery, and help determine who would most benefit from personalized pain management plans that use non-opioid alternatives, suggests new research being presented at the ANESTHESIOLOGY® 2020 annual meeting.

Some patients experience more severe pain after surgery and need higher doses of opioids for longer periods of time, which increases their risk for opioid abuse disorder. By knowing which patients are at higher risk for severe post-surgical pain, physician anesthesiologists can create an anesthesia plan using non-opioid alternatives - such as nerve blocks, epidurals and other medications - to more effectively address pain and reduce the need for opioids.

Currently physicians use time-consuming questionnaires to identify patients at higher risk for severe post-surgical pain, asking about their history of anxiety, sleep quality and depression. In this study, researchers sought a faster, more effective method using machine learning, where a system learns and evolves based on data it is provided. They created three machine learning models that analyzed patients' electronic medical records, which identified that younger age, higher body mass index, female gender, pre-existing pain and prior opioid use were the most predictive factors of post-surgical pain.

"We plan to integrate the models with our electronic medical records to provide a prediction of post-surgical pain for each patient," said Mieke A. Soens, M.D., lead author of the study and an anesthesiologist at Brigham and Women's Hospital and anesthesiology instructor at Harvard Medical School, Boston. "If the patient is determined to be at high risk for severe post-surgical pain, the physician anesthesiologist can then adjust the patient's anesthesia plan to maximize non-opioid pain management strategies that would reduce the need for opioids after surgery."

In the two-part study, researchers looked at data from 5,944 patients who had a wide variety of surgeries, including gallbladder removal, hysterectomy, hip replacement and prostate surgery. Of those, 1,287 (22%) had consumed 90 morphine milligram equivalent (MME) in the first 24 hours after surgery, which is considered a high dose. In the first part of the study, they used 163 potential factors to predict high pain post-surgery, based on a literature search and consultation with experts. From there they created three machine learning algorithm models (logistical regression, random forest and artificial neural networks) that mined the patients' medical records and whittled the 163 predictor factors down to those which most accurately predicted patients' pain severity and potential opioid needs after surgery.

In the second part, they compared what the models predicted to actual opioid use in those same patients. They determined all three models had similar predictive accuracy overall: 81% for logistical regression and random forest methods and 80% for artificial neural networks. That means the models accurately identified which people were more likely to have severe pain and need higher doses of opioids about 80% of the time.

"Electronic medical records are a valuable and underused source of patient data and can be employed effectively to enhance patients' lives," said Dr. Soens. "Selectively identifying patients who typically need high doses of opioids after surgery is important to help reduce opioid misuse."

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THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS

Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 54,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Join the ANESTHESIOLOGY® 2020 social conversation today. Like ASA on Facebook, follow ASALifeline on Twitter and use the hashtag #ANES20.

 

How the brain helps us navigate social differences

Our brain responds differently if we talk to a person of a different socioeconomic background from our own compared to when we speak to someone whose background is similar, according to a new imaging study by UCL and Yale researchers.

UNIVERSITY COLLEGE LONDON

Research News

 

Our brain responds differently if we talk to a person of a different socioeconomic background from our own compared to when we speak to someone whose background is similar, according to a new imaging study by UCL and Yale researchers.

In the study, published in the journal Social Cognitive and Affective Neuroscience, 39 pairs of participants had a conversation with each other while wearing headsets that tracked brain activity.

Researchers found that, among pairs of people who had very different socioeconomic backgrounds - calculated according to education level and family income - there was a higher level of activity in an area of the frontal lobe called the left dorsolateral prefrontal cortex. The area is associated with speech production and rule-based language as well as cognitive and attentional control.

The findings support previous research suggesting that frontal lobe systems play a role in detecting bias and helping us to regulate our behaviour to avoid bias expression. The increased activity in the left frontal lobe was observed in both participants and was more alike than the brain responses of participants talking to someone of a similar background.

In a questionnaire following their task, participants paired with people of different backgrounds reported a slightly higher level of anxiety and effort during their conversation than those in similar-background pairs.

Professor Joy Hirsch (UCL Medical Physics & Biomedical Engineering and Yale) said: "For the first time, we have identified the neural mechanisms involved in social interactions between people of different backgrounds.

"I believe our findings offer a hopeful message. We know that humans can have positive social encounters with others who are different. Now we have the neurobiological basis - our brains have apparently developed a frontal lobe system that helps us deal with diversity."

Participants' brain activity was tracked using a new technique called functional near-infrared spectroscopy (fNIRS), which monitors blood flow and blood oxygenation by measuring changes in near-infrared light and involves wearing only a light headset. Previous studies have involved using MRI scans, which require patients to lie down and keep still, making conversation difficult.

The conversation task lasted for 12 minutes and involved participants being randomly assigned four subjects on themes such as "What did you do last summer?" and "How do you bake a cake?"

After their conversation task, participants were asked about the level of education they had completed and their parents' annual income and given a score based on these details. Pairs of participants were classified as either "high-disparity" or "low-disparity" depending on how different their scores were.

The two groups - different-background pairs and similar-background pairs - were matched in terms of age, race and gender, minimising the impact of these variables on the results. The participants were recruited from Yale's home city of New Haven in Connecticut, both from within the campus and beyond. They ranged in age from 19 to 44 and had a wide variety of socioeconomic backgrounds.

Lead author Olivia Descorbeth, a Yale University graduate who came up with the research proposal while still at school, said: "We wanted to know if the brain responded differently when we talked to others of a different socioeconomic background. Now we know that it does and that humans have a neurobiology that helps us navigate social differences."

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Senior author Professor Hirsch's joint appointment between UCL and Yale is made possible by the Yale-UCL Collaborative, an agreement that promotes joint research and enables teaching to be shared between the two institutions.

The study received funding from the National Institute of Mental Health, of the US National Institutes of Health.

 

A tale of two cesspits: DNA reveals intestinal health in Medieval Europe and Middle East

New research proves the feasibility of retrieving bacterial DNA from ancient latrines

MAX PLANCK INSTITUTE FOR THE SCIENCE OF HUMAN HISTORY

Research News

 

IMAGE: THE MEDIEVAL LATRINE AT RIGA DURING EXCAVATION view more 

CREDIT: ULDIS KAL?JIS

A new study published this week demonstrates a first attempt at using the methods of ancient bacterial detection, pioneered in studies of past epidemics, to characterize the microbial diversity of ancient gut contents from two medieval latrines. The findings provide insights into the microbiomes of pre-industrial agricultural populations, which may provide much-needed context for interpreting the health of modern microbiomes.

Over the years, scientists have noted that those living in industrialized societies have a notably different microbiome compared to hunter-gatherer communities around the world. From this, a growing body of evidence has linked changes in our microbiome to many of the diseases of the modern industrialized world, such as inflammatory bowel disease, allergies, and obesity. The current study helps to characterize the change in gut microbiomes and highlights the value of ancient latrines as sources of bio-molecular information.

Ancient Gut Microbiomes: Exploring the Bowels of History

Piers Mitchell of Cambridge University specializes in the gut contents of past people through analysis of unusual substrates. By looking at the contents of archaeological latrines and desiccated faeces under the microscope, he and his team have learned volumes about the intestinal parasites that plagued our ancestors.

"Microscopic analysis can show the eggs of parasitic worms that lived in the intestines, but many microbes in the gut are simply too small to see," comments Mitchell. "If we are to determine what constitutes a healthy microbiome for modern people, we should start looking at the microbiomes of our ancestors who lived before antibiotic use, fast food, and the other trappings of industrialization."

Kirsten Bos, a specialist in ancient bacterial DNA from the Max Planck Institute for the Science of Human History and co-leader the study, was first skeptical about the feasibility of investigating the contents of latrines that had long been out of order.

"At the outset we weren't sure if molecular signatures of gut contents would survive in the latrines over hundreds of years. Many of our successes in ancient bacterial retrieval thus far have come from calcified tissues like bones and dental calculus, which offer very different preservation conditions. Nevertheless," says Bos, "I was really hoping the data here would change my perspective."

The team analyzed sediment from medieval latrines in Jerusalem and Riga, Latvia dating from the 14th-15th century CE. The first challenge was distinguishing bacteria that once formed the ancient gut from those that were introduced by the environment, an unavoidable consequence of working with archaeological material.

The researchers identified a wide range of bacteria, archaea, protozoa, parasitic worms, fungi and other organisms, including many taxa known to inhabit the intestines of modern humans.

"It seems latrines are indeed valuable sources for both microscopic and molecular information," concludes Bos.

No Modern Matches for Ancient Microbiomes

Susanna Sabin, a doctoral alumna of the MPI-SHH who co-led the study, compared the latrine DNA to those from other sources, including microbiomes from industrial and foraging populations, as well as waste water and soil.

"We found that the microbiome at Jerusalem and Riga had some common characteristics - they did show similarity to modern hunter gatherer microbiomes and modern industrial microbiomes, but were different enough that they formed their own unique group. We don't know of a modern source that harbors the microbial content we see here."

The use of latrines, where the faeces of many people are mixed together, allowed the researchers unprecedented insight into the microbiomes of entire communities.

"These latrines gave us much more representative information about the wider pre-industrial population of these regions than an individual faecal sample would have," explains Mitchell. "Combining evidence from light microscopy and ancient DNA analysis allows us to identify the amazing variety of organisms present in the intestines of our ancestors who lived centuries ago."

Despite the promise of this new approach for investigating the microbiome, challenges remain.

"We'll need many more studies at other archaeological sites and time periods to fully understand how the microbiome changed in human groups over time," says Bos. "However, we have taken a key step in showing that DNA recovery of ancient intestinal contents from past latrines can work."

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Parents less aware when their kids vape than when they smoke

UCSF study says strict household rules are best way to prevent tobacco use

UNIVERSITY OF CALIFORNIA - SAN FRANCISCO

Research News

 

Most parents know or suspect when their child smokes, but they are much more likely to be in the dark if the child vapes or uses other tobacco products, according to a large national study by researchers at UC San Francisco.

The study, which tracked more than 23,000 participants aged 12 to 17 years old, found that parents or guardians were substantially less likely to report knowing or suspecting that their child had used tobacco if the child used only e-cigarettes, non-cigarette combustible products or smokeless tobacco, compared to smoking cigarettes or using multiple tobacco products.

The researchers also found that when parents set strong household rules about not using tobacco - applying to all residents - their children were less likely to start tobacco use. Just talking to kids about not smoking was far less effective. The study publishes at 9:01 p.m. PT, Oct. 4, 2020, in Pediatrics.

"We know that tobacco-free homes are a key tool to help prevent smoking by kids," said corresponding and senior author Benjamin Chaffee, DDS, MPH, PhD, an associate professor at the UCSF School of Dentistry. "What studies haven't examined is how tobacco-free homes stack up against other approaches and how much tobacco-free home rules might help with other tobacco products beyond smoking.

"Tobacco use by children is troubling, and dentists, like all healthcare providers, should be concerned about preventing youth tobacco use," Chaffee said.

Over the last decade, the smoking landscape has dramatically changed, especially among youth, for whom cigarette smoking has declined while use of electronic cigarettes soared. Last year, the Centers for Disease Control and Prevention reported that more than 1 in 4 high school students was vaping.

The new study used data from the Population Assessment of Tobacco and Health (PATH) Study to investigate parental awareness of youth tobacco use and the role of household tobacco rules in preventing smoking. In addition to cigarettes and e-cigarettes, the study looked at non-cigarette combustible products (including cigars, pipes, hookahs, and bidis), and smokeless tobacco (including snuff, chewing tobacco, snus, and dissolvable tobacco).

It found that parents were more likely to know or suspect that their child was using a tobacco or nicotine product if the child was older, male, identified as white, and lived with a tobacco user, as well as if the parents were less educated. Mothers were singled out as more aware than fathers.

The researchers also found that teens and tweens living in homes with the strictest rules prohibiting tobacco use were 20-26 percent less likely to start using tobacco, compared to youth living in the most permissive homes.

The investigators suggest that parents:

• Don't smoke;
• Create tobacco-free home environments that include all parts of the home;
• Establish strict rules against all tobacco use that apply to all members of the household;
• Have high-quality, clear communication with youth about not using tobacco.

"Low parental awareness of e-cigarette use belies rising public attention to youth vaping," said co-author Tsu-Shuan Wu, a student at the UCSF School of Dentistry. "Youth tobacco use is a considerable public health concern, regardless of the tobacco product used, and parents play a very important role in tobacco prevention.

"Creating tobacco-free home environments is one approach parents can use to set norms and expectations about tobacco use," she said. "And for healthcare providers, raising parental awareness should be part of overall guidance and tobacco-prevention support."

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Funding: Support was provided by the National Institutes of Health grant number U54HL147127 and the Delta Dental Community Care Foundation.

About UCSF: The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF's primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. Learn more at ucsf.edu, or see our Fact Sheet.

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Body size of the extinct Megalodon indeed off the charts in the shark world

TAYLOR & FRANCIS GROUP

Research News

 

IMAGE: SCHEMATIC DRAWING SHOWING THE DISTRIBUTION OF MAXIMUM POSSIBLE SIZES OF ALL KNOWN 70 NON-PLANKTIVOROUS GENERA (GROUPS) IN THE SHARK ORDER LAMNIFORMES, COMPRISING MODERN (IN GRAY) AND EXTINCT (IN BLACK; WITH... view more 

CREDIT: KENSHU SHIMADA

A new study shows that the body size of the iconic gigantic or megatooth shark, about 15 meters (50 feet) in length, is indeed anomalously large compared to body sizes of its relatives.

Formally called Otodus megalodon, the fossil shark that lived nearly worldwide roughly 15-3.6 million years ago is receiving a renewed look at the significance of its body size in the shark world, based on a new study appearing in the international journal Historical Biology.

Otodus megalodon is commonly portrayed as a super-sized, monstrous shark, in novels and films such as the 2018 sci-fi thriller "The Meg," but it is known that the scientifically justifiable maximum possible body size for the species is about 15 meters (50 feet). Nonetheless, it is still an impressively large shark, and the new study illuminates exactly how uniquely gigantic the shark was, according to Kenshu Shimada, a paleobiologist at DePaul University in Chicago and lead author of the study.

Otodus megalodon belongs to the shark group called lamniforms with a rich fossil record, but the biology of extinct forms is poorly understood because these cartilaginous fishes are mostly known only from their teeth. Based on measurements taken from present-day non-planktivorous lamniforms, the study presents an equation that would allow estimations about the body length of extinct forms from their teeth. The study demonstrates that O. megalodon that reached about 15 meters (50 feet) is truly an outlier because practically all other non-planktivorous sharks have a general size limit of 7 meters (23 feet), and only a few plankton-eating sharks, such as the whale shark and basking shark, were equivalent or came close to the size. The study also reveals that the Cenozoic Era (after the age of dinosaurs, including today) saw more lamniform lineages attaining larger sizes than the Mesozoic (age of dinosaurs) Era.

Warm-bloodedness has previously been proposed to have led to the gigantism (over 6 meters, or 20 feet) in multiple lamniform lineages. The new study proposes their live-bearing reproductive strategy with a unique cannibalistic egg-eating behavior to nourish early-hatched embryos to large sizes inside their mother to be another possible cause for the frequent evolution of gigantism achieved by lamniform sharks.

Understanding body sizes of extinct organisms is important in the context of ecology and evolution. "Lamniform sharks have represented major carnivores in oceans since the age of dinosaurs, so it is reasonable to assert that they must have played an important role in shaping the marine ecosystems we know today," said Shimada.

"This is compelling evidence for the truly exceptional size of megalodon," noted co-author Michael Griffiths, a professor of environmental science at William Paterson University in Wayne, New Jersey. Co-author Martin Becker, also a professor of environmental science at William Paterson University, added, "this work represents a critical advancement in our understanding of the evolution of this ocean giant."

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American people facing 'choiceless’ democracy

TEHRAN, Oct. 04 (MNA) – Stating that the US elections are not fully democratic, Richard Falk said that it does not matter for American people who wins as either way the problems of their lives will not be solved.

To know more about the US Presidential Election, we reached out to Richard Anderson Falk, professor emeritus of international law at Princeton University.

Here is the full text of the interview:

Why is turnout so low in US elections?

Electoral turnout has been low in recent years because the perceptions of living in a ‘choiceless’ democracy give many US citizens the impression that it does not matter who wins as either way the problems of their lives will not be solved. Perhaps, more than choiceless, a better existential explanation of this devaluing of the right to vote is the sense of what I would call irrelevant democracy. This means that political outcomes of elections are felt to be irrelevant to conditions of poverty or discrimination, or economic unfairness, an interpretation that gains credibility that it is ‘the losers’ in American society that make up the bulk of those who fail to vote. It reflects deep alienation in middle class and underclass America, which has been somewhat lessened at this time due to a fear that Trump’s reelection could produce a fascist America. This fear will undoubtedly increase voter turnout in November, but not necessarily in a post-Trump future.

Although it is the disadvantaged who disproportionately refrain from voting (and partly also for reasons connected with voter suppression discussed previously), there are sophisticated citizens who refuse to vote on principle or vote under the banner of ‘the lesser of evils.’ Progressive anti-Trumpists are faced with this dilemma in the forthcoming elections.

Can the US election be considered a fully democratic election?

No, the American elections as currently administered on national level are not fully democratic for three principal reasons: (1) most obviously, due to various forms of voter suppression and distortion encroaching especially on the rights of persons of color and the impoverished to cast their votes either as a result of difficult registration rules or by making polling sites feel hostile or requiring especially long waits in neighborhoods where minorities and the poor live; (2) by presidential opposition to voting by mail and by alleging fraud and rigging without any evidence imperiling his willing to transfer political power if he loses, undermining confidence in the integrity of elections and causing the public great anxiety; (3) by not acknowledging and challenging ‘systemic racism’ inherent in American society that produces discrimination against African-Americans, Muslims, and other victimized minorities.

What is the difference between Trump and Biden? Could we describe Biden as a pacifist candidate?

Biden’s record, especially on international issues and the Middle East, is of a consistently war-mongering character that includes strong support for the disastrous 2003 war and subsequent occupation of Iraq and mindless indifference to Israel’s criminal disregard of Palestinian rights. Besides, as suggested, Biden seems as readier for a new cold war than Trump. His version of the foreign policy bipartisan consensus is more coherent and deferential to the considered views of the political elite and militarized American bureaucracy while Trump is an impulsive leader that thinks he can by himself engineer a revival of American preeminence by bullying, bluster, and bluff.

My own reluctant support of Biden is rooted in my greater apprehensions about Trump, which also explains why I equally reluctantly supported Hillary Clinton in 2016 when she opposed Trump. I regard his demagogic style, racist affinities, ultra-nationalism, ecological denialism as a vehicle for a fascist future for the United States, which would mean the total abandonment of democratic procedures of governance, accompanied by repressive policies and practices. Such an abandonment would almost certainly produce harsh exclusionary hostility to immigration except from majority white countries, punishment of dissent and protest activity, and an economic and political order even more slanted in favor of the most wealthy. My reluctance about the electoral choice posed by Biden or Trump is also colored by uncertainty in the form of an obscure future. I fear a belligerent future in which Biden’s approach leads to interventions and even war, whereas I grant the possibility that a reelected Trump could opt for isolationism, which resulted in more moderation in the Middle East and elsewhere.

Interview by Amir Muhammad Esmaeili

News Code 164294

Whoever wins US election, JCPOA must be restored: Finaud


TEHRAN, Sep. 28 (MNA) – Commenting on the fate of the JCPOA and lawfulness of Trump moves against Iran at UNSC head of arms proliferation at GCSP says, "whoever wins the US 2020 Presidential Election, JCPOA must be restored."

Due to the US position in the economic, political, security, and military spheres, the country has taken many unilateral steps in the international arena in recent decades, which has led to the formation of a trend in its foreign and economic policy.

Although this unilateral foreign and economic policy emerged with the post-World War II, ups and downs during the presidency of most US presidents, it seems to have become even more during Donald Trump's term.

Trump's unilateralist policies not only created tensions between the country and other world powers such as Russia and China but have even raised tensions between the United States and its European and NATO allies.

Now that the first term of Trump's presidency is coming to an end, many in the world are waiting for the results of the US presidential election.

To shed more light on President Trump's unilateralism and anti-Iran moves and the reasons behind them, we reached out to Marc Finaud head of arms proliferation at Geneva Center for Security Policy (GCSP).

Here is the full text of our interview with him:

How lawful do you assess the US move?

As this was confirmed by the UN Secretary-General and most other members of the UN Security Council, this decision cannot have any legal effects because the US withdrew from the JCPOA and has no legal ground to activate a mechanism provided for in that agreement.

After opposition from other UNSC members to the US unilateral action, the White House has imposed some other unilateral sanctions on Iran and has threatened other states to obey the US sanctions. Will the US be able to get what it wants with respect to Iran through bullying others?

Unfortunately, the US has been accompanying its unilateral sanctions with extra-territorial jurisdiction, meaning that it can impose secondary sanctions on states or entities that continue to trade with Iran. This is a powerful deterrent that has already discouraged major companies to trade with or invest in Iran, especially if they fear losing the American market. Even the EU mechanism to shield EU companies is not sufficient to give them assurances that they will not be affected by US secondary sanctions.

Why does Trump focus on Iran in the UNSC despite failures? Do you see any relation between his moves and the US 2020 Presidential Election?

Of course, appearing tough on Iran is popular among Trumps’ electoral base and is encouraged by anti-Iranian lobbies. And because this electorate is unmoved by facts, it does not realize that this policy is ineffective if not counter-productive.

How do you assess the US unilateralism’s effect on the efficiency of the UNSC?

This unilateralist policy has led to complete isolation of the US not only within the Security Council but globally. It contributed to further deterioration of the ability of the UNSC to fulfill its role in preserving international peace and security.

Some say the world orders and the UN structure does not meet the US interest anymore and some circles in the US believe in changes to the UN structures and are eager to show UNSC as an ineffective body that doesn’t meet the US needs. They believe focusing on Iran at the body prepares a good opportunity for some groups that have problems with the body to put pressure on the UN for reforms. What do you think of this?

Certainly, the UN as a whole, and the UNSC in particular, need reform for better performance, including enlargement. But exerting pressure on other members, including the US closest allies, is not the best way to achieve this goal. It is no secret that the Trump administration and its advisers are deeply opposed to multilateralism and any cooperative approach to security as demonstrated in the US withdrawal from major international agreements.

How do you see the future of the JCPOA and also the future of the transatlantic relation if Trump wins the election and if Biden wins?

Trump has said that, if re-elected, he would negotiate a new deal with Iran while Biden promised to reintegrate the JCPOA and re-establish dialogue with Tehran. Whoever wins, the JCPOA must be restored as the minimum common denominator on the basis of which further negotiations can take place. This means that the reciprocal nature of the JCPOA must be recognized and a win-win agreement can be the only basis for further relations.

News Code 164087

Bahrain’s normalization deal: mission of godfather’s pawns

By: Mehdi Azizi

TEHRAN, Sep. 12 (MNA) – Saudi Arabia, the godfather, has sent off its insignificant pawns to play the chess game of "normalization of relations with Israel" first to test the waters for its own normalization of relations with the regime.

Of course, Bahrain had already stepped onto this path ahead of other Arab countries, at a time when the first step was taken to implement the so-called “Deal of the Century” in this country. The holding of the economic summit of the Deal of the Century in Bahrain, which took place months ago, showed that Bahrain is certainly acting no differently from its other Arab friends in the Persian Gulf while walking on this path.The “train of normalization”, or more precisely, the recognition of the process of normalization of relations with the Zionist regime, has finally arrived at the Bahraini station, as was already expected.

The important point here is to interpret the reason for choosing the UAE and Bahrain as the first countries to normalize relations with the Zionist regime within the framework of the constituent structure of these countries and the Arab dictators’ dependency on the Zionist regime; dictatorial regimes that see their stability and the survival of their political life in giving concessions to the Zionist regime, and some of them have been formed on the basis of a British or American agreement. Some of these dictatorial regimes also lack political independence and popular support.

Bahrain, meanwhile, can be described as a degrading political model and dependent on Saudi Arabia, lacking national independence and popular support, and aptly fit for the term "Saudi Arabia’s errand boy".

Most countries, which are called small or microscopic countries in international relations, are either formed on the basis of political agreements and seek an opportunity to maintain their power or even eliminate political rivals at home, or in the absence of these elements, they seek to side with and support the policies of the United States and the Zionist regime in the regional and global arenas.

As noted earlier, the power and influence of these countries to sway the public opinion of the Arab nations are not enough for them to play a prominent role for the Palestinian cause, and that is exactly why Israel and Trump have chosen them to act as the first stops for the train of the normalization of relations with the regime. On the one hand, due to the lack of national capacity and commonalities, and home to a heterogeneous population, they are not worried about popular reactions in these countries, and on the other hand, it can be a good benchmark for measuring the reaction of other Islamic and Arab nations to this dangerous and threatening move.

Foreigners make up a large part of the UAE population. On the other hand, these countries are not of special strategic importance in terms of historical and cultural impact on the Palestinian cause. Instead, these countries pick up and carry out missions that the US has pre-defined for them.

However, it should be emphasized that Trump, in addition to using the normalization of relations with the Zionist regime for his own electoral campaign, feels that if he succeeds with the UAE and the islands, then the way to normalize relations with Israel would be paved for other countries, or at least the costs of such a measure would be reduced.

Of course, they are still waiting for the reaction of the Arab and Islamic nations. This is where the support of Egyptian President Abdel Fattah al-Sisi and some Arab kings come into the picture. It is clear that the next stop - if their evaluations get the desired results - will be some key Arab countries that play an important role in the Palestinian political arena.

In general, it can be said that Saudi Arabia has sent off its insignificant pawns and errand boys to play in this game of chess, in order to, if the conditions are right, make public its own normalization of relations with Israel. This issue has been raised even with the Egyptians.

Undoubtedly, this American political show is only for electoral purposes and can be evaluated in line with the implementation of projects such as the deal of the century, the annexation of the West Bank and parts of the occupied Golan, the relocation of the US embassy from Tel Aviv to Jerusalem al-Quds, and now the Arab countries’ normalization of relations with the Zionist regime.

In any case, what happened in actuality was that all Palestinian factions, with all their various suffixes, methods of resistance, approaches, and different tastes, achieved a common ground, with results that may not have been so easy to obtain over the years.

It should be noted that Arab ethnicity or mere Arabism, without invoking Islamic teachings and the option of resistance, not only cannot bring the Palestinian people closer to its aspirations but rather putting trust in the camp over the years, i.e. the process of reconciliation, has reduced the level of demands of the Palestinian people from the formation of an independent Palestinian state to the withdrawal of settlements in the Palestinian territories.

MNA/5021452

China is on the verge of an end to absolute poverty. Now for the really hard part


Poverty alleviation was given new prominence in 2015 when President Xi Jinping pledged to lift those in the greatest hardship by 2020

Despite the expense and resources spent on improving the lives of poor rural Chinese, there is more to be done to help them adjust and keep them in work


Zhuang Pinghui in Beijing Published:  2 Oct, 2020

Jifu Jifuzi and his wife Li Youling watch TV in their new home. Photo: Simon Song


Jifu Jifuzi was living in an isolated village on a mountain cliff in southwestern China just as other members of the Yi ethnic minority had done for generations.


The remote location in Sichuan province originally helped the community to avoid conflicts but ultimately it meant they were left behind as China modernised.

The family – Jifu, his wife and three adult children – were living in a mud house with a fire in the centre of the room and their chickens and pigs next to their home. When it rained, the roof leaked and mountain roads were too muddy to go anywhere.
But things started to improve rapidly in 2018, after Chinese President
Xi Jinping visited the Liangshan Yi autonomous prefecture – one of the poorest parts of the country – and called on cadres to speed up
poverty alleviation efforts.

Villagers in Xujiashan moved into their new houses built by the government in 2019. 

Photo: Simon Song

Roads were built to connect the mountain villages and houses were constructed to ensure each person had the standard 35 square metres of living space. Villagers finally had access to relatively modern amenities: a flush toilet, running water, television and, for better hygiene, their animals were raised away from the living quarters.

“I am very grateful for all this. I didn’t pay for anything,” said Jifu Jifuzi, 50, who moved to a five-bedroom house with his family in October last year.

He and his two sons headed to Zhejiang to work on construction sites in the far eastern province now that new roads made the journey easier. Together they could bring home about 60,000 yuan (US$8,800) a year.

Jifu was the face the Chinese government proudly showed to the outside world, representing the 10 million rural residents across the country resettled from remote or hazardous areas as part of Beijing’s poverty alleviation campaign.

In a three-day government-organised tour, large areas featuring new blocks of flats, houses and public squares were decorated with slogans thanking the Communist Party in Yi-dominant counties. The media was also shown the former mud hut homes to underscore the achievements of the campaign.

China is set to announce that its poverty alleviation programme is a success, having spent a lot of money and labour, but there appears to be a long way to go if people helped by the campaign are to stay employed, adjust to their new lifestyle and stay out of dire poverty.

Xi tries to reassure ethnic minorities they won’t be ‘left behind’
11 Jun 2020



China’s anti-poverty campaign began decades ago but picked up pace in 2015 when Xi made an ambitious pledge to end absolute poverty – measured in 2011 as equal to an annual income of 2,300 yuan in 2011 – by 2020. The timer was set to ensure China became a “moderately prosperous society”, a founding mission for the ruling party by 2021 when it celebrates its centenary.

The Chengbei Ganen Community is the largest relocation settlement from inhospitable areas of the poverty alleviation initiative of Yuexi county, Sichuan province. Photo: Simon Song


To reach the goal the unprecedented campaign was carried out with no consideration of cost – either labour costs or funds – in spite of the country’s slowing economy.

Each household deemed to be in poverty was identified with a clear sign by their entrance and the name and telephone number of a public servant or staff of a state-owned enterprise paired up to help the household. More than 2.9 million party cadres were sent to villages to help poor villages rise above the poverty line. In higher-level arrangements, affluent eastern provinces have been paired with poor provinces and offered financial support, jobs and business opportunities.

A Tibetan woman plants vegetable next to her village home. In Qingshui village, in Liaoping township of Ganluo county, Liangshan prefecture, there is a population of 721 in 212 households, and the registered poor population is 319. Villagers were resettled in new houses in 2019. Photo: Simon Song


It is difficult to calculate how much money has been poured into the cause – the campaign has depended on resources from enterprises as well as government funding – to build infrastructure such as roads and businesses, relocate people away from extremely poor areas and pay for education and public health. In Liangshan alone, 115.7 billion yuan (US$17 billion) has been spent since 2016.

Poverty alleviation efforts were redoubled in 2018 for the final three years of “rough battle” to help areas deeply mired in poverty, especially the “three regions and three prefectures”, involving 19 groups of ethnic minority people who lived on the Tibet plateau, in Xinjiang, in Linxia in Gansu province, in Liangshan in Sichuan province and in Nujiang in Yunnan province.

Because of the campaign, about 13 million rural residents have been lifted out of poverty each year since 2013, according to official government figures. The staggering number of 98 million impoverished rural residents in 2013 was cut to 5.5 million by last year.

Officials predicted that China would reach its target as scheduled – no pandemic, economic slowdown or closed factories would stand in the way when China was so close to reaching its crowning social accomplishment.

“The epidemic and floods in summer have been big challenges but we are very confident that we can reach the poverty alleviation target this year,” said Hong Tianyun, deputy head of the State Council’s Leading Group Office of Poverty Alleviation and Development.

Ethnic Yi women learn to do traditional Yi embroidery as a vocational training at Chengbei Ganen Community in Yuexi county. Photo: Simon Song

Peng Qinghua, party secretary of Sichuan province, conceded that the coronavirus pandemic had made the poverty alleviation work more difficult, especially because the province was known as a major source of migrant workers for other areas but many of those workers had not been able to leave while much of the country was under lockdown.

“That would affect their annual income but the impact would not be severe,” Peng said. Work on poverty alleviation programme construction projects that had been suspended because of lockdowns had since resumed and would be finished on schedule, according to Peng.

However, high living costs and limited job opportunities are new obstacles for rural families who must give up farming after moving to new homes.

Local governments are under huge pressure to help these families, including providing them with job training or organising business opportunities, but it is not always an easy task.

In the Ganen residential area of Yuexi county near Liangshan where 6,600 people have been moved from their mountain homes to flats, the local government pays women 30 yuan a day to train to work as nannies or domestic helpers.

Hailai Budumu, whose husband works on construction sites in the Sichuan capital Chengdu, said through a translator that she was happy to move into a 75-square metre flat last year after paying 20,000 yuan “because it is a much better house than the old one”. She took part in the 23-day nanny training with little expectation that she would become one earning as much as 1,000 yuan a month.

“A job as a cleaner near my home with a few hundred yuan a month would be fine,” she said.

Her trainer Li Fang added that the challenge was not just to meet work skill sets but that people moving from the high mountains had to adapt to modern urban living and learn hygienic habits to appear “employable” for local families.

“Moving meant a drastic change [of life] and sometimes higher living costs. The tap water is cleaner than spring water but also comes at a price,” said Lin Shucheng, party secretary of Liangshan prefecture.

He said the prefecture government’s preferred strategy was to relocate families closer to where they were living instead of sending them away to distant cities and towns if they did not have family members to support them.

There are also doubts over the effectiveness of the poverty alleviation work because the huge amount of resources involved means the programme may not be sustainable.

Local governments are also trying to set up businesses, such as vegetable farms and collectively owned apple orchards, and promote local tourism to help create job opportunities and generate sustainable income.

“New businesses may fail and rural residents who have been lifted out of poverty may fall back [into the poverty trap again],” said Li Guoxiang, a rural affairs researcher with the Chinese Academy of Social Sciences. “Such risks are always present and [we need] at least three years to observe and monitor to ensure the efforts are successful, and we may even extend the period if necessary.”

Wang Yonggui, head of the poverty alleviation and development bureau in Liangshan, said establishing better and more efficient transport links was crucial to success of the programme.

“I was born here and I know what [life] was like when all the counties here – 11 of them – were inaccessible because we were not linked to any highways and it took five hours just to travel 10km,” Wang said. “We need to build more roads in the next five years so that our crops and harvests can be sold outside and we may even be able to make some money by selling our spring water.”

But even if the 2020 goal is achieved, it does not mean China has eliminated poverty once and for all. Premier Li Keqiang said in May that 600 million people in China still lived on about 1,000 yuan a month.

It signals that the party has a long way to go to reach its second centenary goal: to build China into a modern socialist country that is prosperous, strong, democratic, culturally advanced and has reach the level of moderately developed countries by 2049 – 100 years after the founding of
the People’s Republic of China.

Li, of the Chinese Academy of Social Sciences, indicated that in future China may not set a “poverty line” like it did in battling absolute poverty.

“The next stage of poverty alleviation is about narrowing the gap between cities and rural areas, and between affluent and poor regions. It is not going to be about individuals but groups of people,” Li said.

“That goal is possible to reach because of what China has achieved in dealing with absolute poverty – to provide individuals with necessary conditions to survive and let them develop the capability for self-development.”

This article appeared in the South China Morning Post print edition as: victory Declared in first part of anti-poverty drive


Zhuang Pinghui
Based in Beijing, Zhuang Pinghui joined the Post in 2004 to report on China. She covers a range of issues including policy, healthcare, culture and society