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Credit. The New England Journal of Medicine Share Fast Facts This study clears up how big an effect the mutational burden has on outcomes to immune checkpoint inhibitors across many different cancer types. - Click to Tweet The number of mutations in a tumor’s DNA is a good predictor of whether it will respond to a class of cancer immunotherapy drugs known as checkpoint inhibitors. - Click to Tweet The “mutational burden,” or the number of mutations present in a tumor’s DNA, is a good predictor of whether that cancer type will respond to a class of cancer immunotherapy drugs known as checkpoint inhibitors, a new study led by Johns Hopkins Kimmel Cancer Center researchers shows.

The finding, published in the Dec. 21 New England Journal of Medicine, could be used to guide future clinical trials for these drugs. Checkpoint inhibitors are a relatively new class of drug that helps the immune system recognize cancer by interfering with mechanisms cancer cells use to hide from immune cells. As a result, the drugs cause the immune system to fight cancer in the same way that it would fight an .

These medicines have had remarkable success in treating some types of cancers that historically have had poor prognoses, such as advanced melanoma and lung cancer. However, these therapies have had little effect on other deadly cancer types, such as pancreatic cancer and glioblastoma. The mutational burden of certain tumor types has previously been proposed as an explanation for why certain cancers respond better than others to immune checkpoint inhibitors says study leader Mark Yarchoan, M.D., chief medical oncology fellow. Work by Dung Le, M.D., associate professor of oncology, and other researchers at the Johns Hopkins Kimmel Cancer Center and its Bloomberg~Kimmel Cancer Institute for Cancer Immunotherapy showed that colon cancers that carry a high number of mutations are more likely to respond to checkpoint inhibitors than those that have fewer mutations.

However, exactly how big an effect the mutational burden has on outcomes to immune checkpoint inhibitors across many different cancer types was unclear. To investigate this question, Yarchoan and colleagues Alexander Hopkins, Ph.D., research fellow, and Elizabeth Jaffee, M.D., co-director of the Skip Viragh Center for Pancreas Cancer Clinical Research and Patient Care and associate director of the Bloomberg~Kimmel Institute, combed the medical literature for the results of clinical trials using checkpoint inhibitors on various different types of cancer. They combined these findings with data on the mutational burden of thousands of tumor samples from patients with different tumor types. Analyzing 27 different cancer types for which both pieces of information were available, the researchers found a strong correlation.

The higher a cancer type’s mutational burden tends to be, the more likely it is to respond to checkpoint inhibitors. More than half of the differences in how well cancers responded to immune checkpoint inhibitors could be explained by the mutational burden of that cancer. €œThe idea that a tumor type with more mutations might be easier to treat than one with fewer sounds a little counterintuitive. It’s one of those things that doesn’t sound right when you hear it,” says Hopkins.

€œBut with immunotherapy, the more mutations you have, the more chances the immune system has to recognize the tumor.” Although this finding held true for the vast majority of cancer types they studied, there were some outliers in their analysis, says Yarchoan. For example, Merkel cell cancer, a rare and highly aggressive skin cancer, tends to have a moderate number of mutations yet responds extremely well to checkpoint inhibitors. However, he explains, this cancer type is often caused by a cipro, which seems to encourage a strong immune response despite the cancer’s lower mutational burden. In contrast, the most common type of colorectal cancer has moderate mutational burden, yet responds poorly to checkpoint inhibitors for reasons that are still unclear.

Yarchoan notes that these findings could help guide clinical trials to test checkpoint inhibitors on cancer types for which these drugs haven’t yet been tried. Future studies might also focus on finding ways to prompt cancers with low mutational burdens to behave like those with higher mutational burdens so that they will respond better to these therapies. He and his colleagues plan to extend this line of research by investigating whether mutational burden might be a good predictor of whether cancers in individual patients might respond well to this class of immunotherapy drugs. €œThe end goal is precision medicine—moving beyond what’s true for big groups of patients to see whether we can use this information to help any given patient,” he says.

Yarchoan receives funding from the Norman &. Ruth Rales Foundation and the Conquer Cancer Foundation. Through a licensing agreement with Aduro Biotech, Jaffee has the potential to receive royalties in the future..

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As an epidemiologist, I have been asked to respond to this question in one form or another throughout the cipro. This is a very reasonable question to ask, but a challenging one to answer. To calculate the risk of hospitalization or angi cipra floor death after getting infected with antibiotics you need to know the total number of s. The problem is that nobody knows exactly how many people have been infected by the antibiotics.

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If you have enough good data, it would angi cipra floor be possible to calculate the risk of hospitalization or death. You would need to count the number of people who were hospitalized or died and divide that number by the total number of s. It’s also important to take into account time delays between , hospitalization and death. Doing this calculation would give you the true angi cipra floor hospitalization or fatality rate.

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But perhaps a second lesson is that the risks of hospitalization or death are much more complicated to understand and study than you might have thought—and the same goes for deciding how to react to those risks. I look at the numbers and feel confident in the ability of my buy antibiotics vaccination and booster to protect me from severe disease. I also choose to wear a high-quality mask when I’m indoors with lots of people to angi cipra floor lessen my own risk even further and to protect those who may be unable to get vaccinated. There have been many lessons learned from this cipro, and there are many things researchers and the public still need to do better.

It turns out that studying and talking about risk is one of them. This article was originally published on The Conversation.

The following essay is reprinted with permission from cheap cipro online canada The Conversation, an online publication covering the latest research. Thankfully, most people who get buy antibiotics–19 don’t become seriously ill—especially those who are vaccinated. But a small fraction do get hospitalized, and a smaller fraction do die. If you are vaccinated and catch the antibiotics, what are your chances of getting cheap cipro online canada hospitalized or dying?. As an epidemiologist, I have been asked to respond to this question in one form or another throughout the cipro.

This is a very reasonable question to ask, but a challenging one to answer. To calculate cheap cipro online canada the risk of hospitalization or death after getting infected with antibiotics you need to know the total number of s. The problem is that nobody knows exactly how many people have been infected by the antibiotics. So while it is very hard to estimate the true risk of dying if you are vaccinated and come down with buy antibiotics, there are some ways to better understand the risks. Counting s The first thing to consider when thinking about risk is that the cheap cipro online canada data has to be fresh.

Each new variant has its own characteristics that change the risk it poses to those it infects. Omicron came on quickly and seems to be leaving quickly, so there has been little time for researchers or health officials to collect and publish data that can be used to estimate the risk of hospitalization or death. If you have enough good data, it would be possible to calculate the risk of cheap cipro online canada hospitalization or death. You would need to count the number of people who were hospitalized or died and divide that number by the total number of s. It’s also important to take into account time delays between , hospitalization and death.

Doing this calculation would give you cheap cipro online canada the true hospitalization or fatality rate. The trouble is health officials don’t know with certainty how many people have been infected. The omicron variant is incredibly infectious, but the risk of it causing significant illness is much lower compared to previous strains. It’s great that omicron is less severe, but cheap cipro online canada that may lead to fewer people seeking tests if they are infected. Further complicating things is the widespread availability of at-home test kits.

Recent data from New York City suggests that 55% of the population had ordered these and that about a quarter of individuals who tested positive during the omicron surge used a home test. Many people who use home tests report their results, but cheap cipro online canada many do not. Finally, some people who do get symptoms simply may not get tested because they can’t readily access testing resources, or they don’t see a benefit in doing so. When you combine all these factors, the result is that the official, reported count of antibiotics cases in the U.S. Is far lower than the cheap cipro online canada actual number.

Estimating cases Since the beginning of the cipro, epidemiologists have been working on ways to estimate the true number of s. There are a few ways to do this. Researchers have previously cheap cipro online canada used antibody tests results from large populations to estimate the prevalence of the cipro. This type of testing takes time to organize, and as of late February 2022, it doesn’t appear that anyone has done this for omicron. Another way to estimate cases is to rely on mathematical models.

Researchers have used these models to make estimates of total cheap cipro online canada case numbers and also for fatality rates. But the models don’t distinguish between estimated s of vaccinated and unvaccinated individuals. Research has shown time and again that vaccination greatly reduces one’s risk of serious illness or death. This means that calculating the risk of death is only really useful if you can distinguish by vaccination status, cheap cipro online canada and existing models don’t enable this. What’s known and what to do?.

Without a good estimate of total cases by vaccination status, the best data available is known cases, hospitalizations and deaths. While this limited information doesn’t allow researchers to calculate the absolute risk an individual faces, cheap cipro online canada it is possible to compare the risk between vaccinated and unvaccinated people. The most recent data from the Centers for Disease Control and Prevention shows that hospitalization rates are 16 times higher in unvaccinated adults compared to fully vaccinated ones, and rates of death are 14 times higher. What is there to take away from all this?. Most importantly, vaccination greatly reduces the risk of cheap cipro online canada hospitalization and death by many times.

But perhaps a second lesson is that the risks of hospitalization or death are much more complicated to understand and study than you might have thought—and the same goes for deciding how to react to those risks. I look at the numbers and feel confident in the ability of my buy antibiotics vaccination and booster to protect me from severe disease. I also choose to wear a high-quality mask when I’m indoors with lots of cheap cipro online canada people to lessen my own risk even further and to protect those who may be unable to get vaccinated. There have been many lessons learned from this cipro, and there are many things researchers and the public still need to do better. It turns out that studying and talking about risk is one of them.

This article was originally published on The Conversation.

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Cipro can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

Avoid antacids, aluminum, calcium, iron, magnesium, and zinc products for 6 hours before and 2 hours after taking a dose of Cipro.

Proyecto cipres de bella suiza manizales

These effects proyecto cipres de bella suiza manizales are not the result of differences in generosity, but of differences in income and resources. In fact, research routinely finds that Americans with the lowest incomes are the most generous. A recent survey found that nearly 40 percent of those donating to crowdfunding campaigns had household incomes of less than $60,000.

More than a third were without work when proyecto cipres de bella suiza manizales they donated. But without significant income to draw on, these donations are often small, and spread out among a larger number of people in one’s social network who may be asking for help. At the end of 2021, GoFundMe wrote in its annual report, “If 2020 was a year of crisis, 2021 was The Year of Gratitude.” It might be more accurate for GoFundMe to state that in 2021, we were generous, but it wasn’t enough to keep more vulnerable people out of crisis.

Countless campaigns appeal to a crowd that never appears, and which proyecto cipres de bella suiza manizales may not ever see their request for help. Campaigns like Jim’s, and the 90 percent that are unfunded or underfunded provide a haunting record of lives slipping through yawning cracks in our social safety nets. It’s tempting to think that tweaking algorithms or shifting how our attention is directed might help these problems.

But given crowdfunding’s reliance on proyecto cipres de bella suiza manizales enormous social media platforms, it’s naive to expect that technological tweaks could counteract the entrenched effects of income inequalities, social network disparities and social media dynamics. Crowdfunding as a safety net is simply too full of holes, and those who need the most help fall through most often. GoFundMe itself understands that it cannot provide an adequate fix to the unmet basic needs that fill its site.

In February 2021, its CEO, Tim Cadogan, implored Congress to pass further cipro aid, arguing “we can’t do your job for you.” Unless legislators decide to extend and expand essential support programs like the Child Tax Credit, Americans will continue to seek help online, where successes are few and inequalities are more often amplified than ameliorated.In this episode, join freelance journalist and proyecto cipres de bella suiza manizales radio producer Tasha Lemley and podcast host Lydia Chain as they unravel the story of Pervis Payne, a man with an intellectual disability sentenced to death, and the decades-long court battle to remove him from The Row. Below is the full transcript of the podcast, lightly edited for clarity. You can also subscribe to The Undark Podcast at Apple Podcasts, TuneIn, or Spotify.

AMBI. [DRUMBEATS] Andre Johnson. That’s alright, come on!.

Yesterday was a monumental win. And I'm being as serious as I possibly can, what I’m about to say. You literally helped save a person's life yesterday.

We can talk about protest and activism and we can theorize about it all. But this is where the rubber meets the road. Pervis Payne is no longer on death row.

AMBI. [STREET NOISE ROLLS UNDER] Tasha Lemley. Andre Johnson is a professor, pastor, and activist.

And for the past year, he’s led a group of protestors at Union &. McLean in Memphis, Tennessee. It’s a corner that has been used for anti-death penalty actions in years past.

It’s a busy and wide intersection with a Starbucks, a Walgreens, and an upscale Ramen joint. The day before Thanksgiving, about 20 demonstrators spread out for their weekly rally. They’re wearing shirts and they’re holding signs that say “Free Pervis Payne." Johnson’s group believes Pervis Payne is innocent of the crimes that landed him on death row.

Regardless, they also believe he has an intellectual disability — and that, alone, makes it unconstitutional to execute him. So, for 34 years, Payne has lived in this limbo on Tennessee’s Death Row. Until now.

Less than one month before his historical intellectual disability hearing was set to begin, the district attorney made a surprising announcement — that, after they’d conducted expert assessments, they were no longer going to challenge his disability claim and that his sentences should be reduced to life instead of death. This case spans more than three decades, numerous attorneys, and a hard execution date. You’re about to learn how a man with a disability was so hard to diagnose, nearly unconstitutionally killed, and why it took so long to remove him from The Row when he never should have been there in the first place.

Lydia Chain. This is The Undark Podcast. I’m your host, Lydia Chain.

Pervis Payne’s case is complicated — there’s a tangle of critiqued forensics, misplaced evidence, and racism in Shelby County, Tennessee. But it also showcases this convoluted relationship between how scientists and medical professionals understand intellectual disabilities, and then how courts and legislatures interpret and use that science as they make life and death decisions. Tasha Lemley has the story.

Tasha Lemley. In 1988, Pervis Payne was convicted of the brutal murder of Charisse Christopher and her daughter, and the attempted murder of her young son — these are crimes he says he didn’t commit. Heads up.

Their murders were violent and the details are graphic. Payne says he found Christopher with a knife in her neck. He panicked and he tried to help.

Kimkeá Harris. That's what he was raised to do — to be a help. And you and I might not have made that decision because we would have realized that this wasn't something we should touch, but that's where the intellectual disability comes in — inability to make sound judgment ...

This is a man that we believe is wrongfully convicted. Tasha Lemley. That’s attorney Kimkeá Harris.

She’s part of a task force trying to change the legal system in Memphis. She believes Payne’s disability was one of the factors that led to his conviction. But, proving that disability — navigating a tangle of legislative curves — has been a lifelong process for Payne.

Rolanda Holman. I call him Bubba. That's what I call him … Tasha Lemley.

This is Payne’s youngest sister Rolanda Holman. Rolanda Holman. Growing up, we had.

We had fun. We had a loving family … When my parents would go to church on Friday nights, we were so happy that they would leave us here — Bubba home with us. We were like, “Yeah, you know, we're getting ready to party now!.

€ And we would dance and make dance routines and just have a blast. He was always that caring person. If you ever saw one of the pictures that are out there with him holding my sister’s and my hand, that's how he was all the time.

Tasha Lemley. These days, Rolanda and her brother are still close. They talk regularly, and she’s able to help him out with a few things.

Rolanda Holman. So he gets very excited when he gets mail, but when he gets ready to write them back, he'll call me and say, “This is what I wrote.” And he'll read it to me. And some words, he just don't know how to put.

€œWhat do I need to say?. This is what I'm trying to say.” And it could be something as, “I'm happy.” “Oh, I thought I had to put a particular word in there.” “No, ‘happy that you are able to, you know, you're thinking of me. I'm happy that you're supporting me.’ Yeah.

Just simple as that.” “Oh, okay.” You know, something really … he’d say “I knew you’d know!. € Cause he thinks I'm really smart, right?. And he’ll say “I knew, I had to read this, I didn't want to send it out, you know, like crazy or whatever.” And I’ll say, “you know what, Bubba?.

€ I said, “Just write it how you feel.” Tasha Lemley. Rolanda says even though he was seven years older, she knew Bubba couldn’t help with her homework. And, no matter how many times their mother explained, he didn’t remember to separate light and dark clothing for laundry.

Rolanda Holman. As I became an adult, and I look back and, of course, different terms begin to develop over the years about intellectual disabilities and things like that. And so I realized, “Oh, this is what Bubba was experiencing ...” George Woods.

In Mr. Payne's case, we have a rich, rich social history that tells the story of someone who had real problems, who failed a couple of grades, who was never able to pass a Tennessee test to get out of high school. Who was recognized by multiple teachers as being cognitively impaired, who had difficulty reading, who had difficulty spelling, who had difficulty with math.

Tasha Lemley. This is neuropsychiatrist George Woods. He studies co-occurring medical and psychiatric disorders.

This rich social history he’s talking about, well it’s something to remember. It’s one of the pieces needed to decide the constitutionality of executing Payne. [BEAT] Tasha Lemley.

The day Charisse Christopher and one of her children were murdered, Payne went to visit his girlfriend. He testified he followed a noise and he found Christopher and her two young children brutally stabbed in a nearby apartment. Christopher had a knife sticking out of her neck — she and her 2-year-old daughter, Lacie Jo, they died that day.

Payne says he bent down to help her. And he pulled the knife out. He tried to call 911 and he dialed 411 instead — that’s the number for “information.” Then he said that his situation dawned on him.

He was covered in blood. He thought people might think he had committed the crime. And he ran.

George Woods. It was obviously a choice that was made out of ignorance. Right?.

And it's an irrational choice. It’s an irrational choice. And again, can I attribute it just to someone that has intellectual disability?.

Of course not. Would it be consistent with someone who their entire life, under no stress, has difficulty making good choices?. Yes.

Tasha Lemley. Payne’s choices the day of the crime, that’s one place where his disability may have come into play. Woods says … George Woods.

That clinical state of the person makes them vulnerable, makes them “less than” — when we talk about a cognitive state ... We have to figure it out in terms of the crime itself, but we know that we're working with someone whose brain is more vulnerable. And I think that's important.

Tasha Lemley. Payne was 20 years old when he was convicted. He had no criminal record or drug history.

According to court testimony, police responded to a call from a neighbor who heard “blood curdling screams” from the upstairs apartment. They arrived. Found Payne outside the scene.

He said he was afraid he would be mistaken for the murderer — so he panicked and he ran. He was arrested at a friend’s house, tried, and found guilty of two counts of first-degree murder, one count of attempted murder, and he was sentenced to death. In the last three decades, Payne has seen eight appeals denied.

He’s seen science change, and legislatures try to keep up. He’s had an execution date come and go. And, it took all these years for advocates and attorneys to change laws and to confirm his intellectual disability.

To fully understand this case, we need to travel back in time a bit. Through the years, people living with sub-average cognitive functioning have been frequently misunderstood — or even feared. Even the words used to describe their experience can be dehumanizing and cause marginalization.

Here’s a university training video from the 1950s. AMBI. [1950s University of Minnesota training video.] Three grades of deficiency are recognized.

Moderately retarded individuals are referred to as morons. Those who are severely retarded, are classed as imbeciles. And the very severely retarded are termed idiots.

Tasha Lemley. By any name, intellectual disability has long been a part of the human experience. In the recent past, it was popularly referred to as...

Elisabeth Dykens. Mental retardation ... The R word as it's called in the field.

Tasha Lemley. That’s Elisabeth Dykens. She is a professor at Vanderbilt University.

She studies areas of strength in people with intellectual and developmental disabilities. Dykens thinks of disability classification as a series of nesting umbrellas. So the top umbrella, this includes all disabilities.

Elisabeth Dykens. That's a huge umbrella, and that could include people who become disabled as they age because of age-related macular degeneration or blindness or dementia, or you hear about people that go out on disability because they pulled their back while they were at work. Tasha Lemley.

Now, under that umbrella are developmental disabilities, which, Dykens says, as defined by the federal government, are lifelong conditions marked by gaps in several areas of daily functioning. And they begin as the brain is still developing. Under those?.

Intellectual disabilities. And, this is where we get into some pretty muddy territory when it comes to diagnosis. Dykens says that for some of the 7 million Americans living with an intellectual disability disorder we can point to a cause — like an injury or a genetic condition.

But for about half of cases ... It’s not that clear. Elisabeth Dykens.

Unfortunately, there aren't really any biomarkers or blood tests above and beyond, say, a diagnosis of cerebral palsy or genetic syndrome. Even the diagnosis of autism is based on behavioral observations and developmental history. So you're right ...

It is messy. Tasha Lemley. So, for someone like Payne to be diagnosed, Dykens says it’s up to a skilled assessor to take a look at three things.

First. Deficits in cognitive functioning… Elisabeth Dykens. With an IQ score of less than 70 plus or minus testing error.

Deficits in adaptive behavior ... Tasha Lemley. That one’s number two.

It’s daily life stuff like communication and social skills. Kinda getting around in the world. Elisabeth Dykens.

How do people get along with others?. How do they make use of recreation time?. How do they cope?.

... How do they take care of themselves, their hygiene, where they live, and how do they get about in the community?. Tasha Lemley.

And number three?. All of this has to be identifiable in childhood ... Elisabeth Dykens.

... Age of onset in the developmental years, which is typically defined as before age 18. Tasha Lemley.

Meaning ... A traumatic brain injury, well it could certainly affect cognitive functioning. If that happened under the age of 18, that could be considered an intellectual disability.

But, if the same injury — and same effects — happened at say 30 years old, it wouldn’t qualify as an intellectual disability disorder. So, these three criteria — cognitive functioning, adaptive behavior, and age of onset — they’re the standard for how an intellectual disability disorder is diagnosed. For most people, diagnosis is important because it creates understanding and a path for government services, and it guides a person’s support network in their care.

But the diagnosis is also something to consider in the legal system — especially when it comes to the death penalty. [BEAT] Tasha Lemley. Capital crimes involving perpetrators with intellectual disabilities, they’ve happened, and when Payne was convicted, it was permissible under the 8th amendment to execute someone with an intellectual disability.

But then in 2002, the U.S. Supreme Court decided in Atkins vs. Virginia it’s unconstitutional to execute someone with that diagnosis.

Here’s Justice John Paul Stevens. AMBI. [2002 Atkins Opinion] “We now hold that the Eighth Amendment prohibition against cruel and unusual punishment categorically forbids the execution of the mentally retarded.

[fade under]” Tasha Lemley. There’s a few reasons the Supreme Court decided people with intellectual disabilities “face a special risk of wrongful execution.” One. AMBI.

[2002 Atkins Opinion] “Because of their disabilities in areas of reasoning, judgment, and control of their impulses, however, they do not act with the level of moral culpability that characterizes the most serious adult criminal conduct.” Tasha Lemley. Carol Westlake is the executive director of the Tennessee Disability Coalition. She agrees that intellectually disabled people like Payne, they’re less culpable of a crime they’re involved in — and more likely to be convicted of a crime they weren’t.

First, with the crime itself… Carol Westlake. Somebody befriends them, gets them to do something that they know is probably not in their best interest, but they don't have a clear understanding of the consequences of that and the risks that they're taking. Tasha Lemley.

And whether or not they’re innocent, they’re less likely to be able to navigate the system to defend themselves. AMBI. [2002 Atkins Opinion] “Moreover, their impairments can jeopardize the reliability and fairness of capital proceedings against mentally retarded defendants.” Tasha Lemley.

Westlake says defendants often struggle to be understood by police and lawyers, sometimes even act against their own interests, and… Carol Westlake. Folks with intellectual disabilities — because they lack judgment and because they are so used to being stigmatized — will oftentimes try to “pass.” So they will pretend to understand their rights when they don't really understand their rights. They might want to please authority figures, right?.

Tasha Lemley. Dr. Woods says this is called ...

George Woods. €œThe Cloak of Competence.” You will find that many people with intellectual disability learned how to mask it. You go into a restaurant, right?.

You can't read. You pick up the menu, you say, “Oh, you know, I think I’ll just have what you have”. Tasha Lemley.

So, the Atkins decision was a great move towards reducing the risk of executing someone who may have been manipulated — or for someone like Pervis Payne who may have not been able to help as much in his own defense and innocence claim. One problem with Atkins, though, is the court left it up to each individual state to decide exactly what intellectual disability meant for their capital cases. And states have found ways to evade Atkins.

Each state is able to define the parameters of the legal decision, but that's much different than defining the parameters of what intellectual disability is ... So it's really been the different states attempting to gerrymander intellectual disability that has been confusing, not the standard. Tasha Lemley.

Georgia, Texas, and Florida — they’re really good examples of the less-good ways some states set their parameters. Georgia currently has a “beyond reasonable doubt” standard for proving intellectual disability in capital cases. It’s the harshest in the country — so far making it nearly impossible for a jury to agree someone is guilty, yet disabled and exempt from the death penalty.

And, after Atkins, Texas courts designed their own system of standards to determine someone’s level of disability and if they were eligible for execution. These Briseño factors included the “Lennie standard.” It’s named after Lennie from “Of Mice and Men.” AMBI. [1939 movie clip at 3:21] George.

€œMight as well spend my time telling you things. You forget them and I'll tell you again.” Lennie. €œI've tried and I tried, but it didn't do no good.

I remember about the rabbits, George!. € George. €œThe only thing you can remember is them rabbits.” Tasha Lemley.

Meaning someone, if convicted of murder, had to be at least as disabled as the fictional character “Lennie Small” to be exempt from the death penalty. After the U.S. Supreme Court struck down these standards, Texas now applies contemporary clinical standards to their capital cases.

However, according to the nonprofit Death Penalty Information Center, after Atkins and before this update, Texas executed more than a dozen people who likely had intellectual disabilities. Also, after Atkins, Florida set a standard of a single or “bright line” IQ score. It was kind of a pass-fail.

So if someone was assessed to have an IQ of 70, they were disabled. 71?. Not disabled.

Florida is also now applying more appropriate clinical standards to their capital cases involving people with intellectual disabilities, though their protections are not applied retroactively. Carol Westlake. And it's this business about single IQ score that — and I get — that courts love that sort of thing, right?.

Because ... I’m going it's really messy ... And lawyers and judges don’t want messy, you know?.

It’s like pregnant/not pregnant. Got it. I’m on it, you know?.

Intellectually disabled — or not?. Well … Tasha Lemley. And she says IQ score is not static — it changes for all of us over time.

Scientists’ understanding of the brain developmental period changes over time, too. And because of this, expert definitions get tweaked over time. Like the psychiatric tool, the DSM — the “Diagnostic and Statistical Manual of Mental Disorders.” Carol Westlake.

And you know every 12 or so years it gets updated because the science changes because we know new kinds of things. Tasha Lemley. And the American Association on Intellectual and Developmental Disabilities (or AAIDD) well they also change their definitions.

Carol Westlake:... Their definition, it really comports with the DSM. They have very slight variations.

Tasha Lemley. All of this can be difficult for courts. They prefer clear definitions.

Carol Westlake. There's this changing field ... Not ideal, but it's not distance or volume — not a light switch.

[laughing] Everybody wants a light switch. AMBI. BUZZ/CLICK Tasha Lemley.

Whenever understanding changes and definitions are adjusted, states that still have the death penalty each have a moral responsibility to check themselves — and make sure their laws align with current science. [BEAT] AMBI. Rally singing “Free Pervis Payne!.

€ Tasha Lemley. So what does all of this mean for a case like Pervis Payne’s?. Carol Westlake.

Honestly, as the Pervis Payne issue came up over this last year, and the issue around intellectual disability made us realize that we had missed an opportunity ... To fix this definition. And so we thought that was a really important thing to go back and try to do.

Tasha Lemley. And this takes time. Tasha Lemley.

Tennessee had no ban against executing someone with an intellectual disability when Payne was convicted back in 1988 so ... Kelley Henry. It wasn't really assessed in terms of looking at an exclusion from the death penalty because it didn't exist.

So the testing that was done was not thorough and it was really done more in terms of looking at mitigation ... The jury didn't really get to hear about how his intellectual functioning would have impacted decisions he made. For example, to try to help the victim or to run when he was faced with the police.

Tasha Lemley. Kelley Henry is Payne’s attorney. Her team has been on his case just since 2019.

She says that Payne couldn't raise a claim in 1990 when Tennessee did ban the execution of people with intellectual disabilities because it didn't apply to people who had already been convicted. It also used a single IQ score as the determining factor — and Payne had previously tested too high. At different times and on different tests, his scores have ranged from 68 to 78.

Kelley Henry. The biggest issue 30 years ago was this belief that IQ is like an actuarial score that you had to have this number of 70 that would be spit out on a test. And that became very rigid in our law and our case law — became known as a “bright line rule” ...

Even though science tells us that nobody scores the same on these tests. There's, you know, a standard error of measurement in all science. And in the context of intellectual disability, that standard error of measurement is plus or minus five points...

Tasha Lemley. Dr. Woods says IQ testing is rife with other problems.

He says this one test doesn’t tell us all of what we need to know about neurological function ... There are additional issues of ethnicity and culture ... And then there’s something else wild ...

Kelley Henry. ... The older the test gets the more out of date the norms are.

It’s called “norm obsolescence” ... So if you're giving somebody a test that's particularly old, then their score will be artificially inflated simply because the norming data is out of date. Tasha Lemley.

Basically, IQ tests have to be re-standardized, or kind of calibrated over time, to make up for changes in our culture ... To account for the stuff we’ve picked up along the way — the stuff we just now know. Kelley Henry.

... Some of his test scores appear high because he had a score of 78. So that appears high.

But when you look at the norming data for that score, you realize that he's actually scoring in the intellectually disabled range. And when he was given newer tests that were, you know, normed more contemporaneously, he scored on the lower end. So he definitely meets that definition of intellectual disability.

Tasha Lemley. So, here we have a man convicted of a capital crime a couple of years before his state non-retroactively bans the execution of people with intellectual disabilities and more than a decade before the Atkins decision. And then when the Atkins verdict did pass, Henry says Payne couldn’t file a claim because Tennessee was using a “bright line” score of 70 — and he had an un-normed 78, so he didn’t qualify.

And even when the Tennessee Supreme Court later determined that the standard error of measurement should be considered when looking at someone’s IQ in a capital case, which could have brought Payne’s score into a disability range, his lawyers faced a nightmarish system of bureaucracy. Kelley Henry. He couldn't get into court because there was no procedure for him to get into court.

It really was a procedural technicality. Tasha Lemley. There’s not a piece of paper to file?.

Kelley Henry. Although folks tried. Now, I will say this.

The team before me filed probably six different lawsuits, trying to figure out a way to get him into court. And every single time the court said, “No, there's a procedural reason why you can't use this theory to get into court …” Tasha Lemley. She says the Tennessee Supreme Court took notice in 2016 and told the legislature to fix the procedural problem since they had no interest in executing someone who is intellectually disabled.

And this took time. Meanwhile, Payne got an execution date in 2019. That’s when Henry and her team joined his case and started making some noise.

Thanks in part to buy antibiotics, Payne got a temporary reprieve from execution. Meanwhile, new bills got introduced in the Tennessee Legislature. And then in late April 2021 in the Tennessee General Assembly...

AMBI. [Tennessee General Assembly passing SB1349/HB1062.] Because the U.S. Supreme court and the Tennessee Supreme Court also agree that Tennessee's law must rely on updated medical standards as provided by a manual, such as a DSM-5 and AAIDD-11, and not on outdated and inaccurate measures such as a single IQ score, the requirement for a specific IQ score has been removed from this legislation.

This legislation also provides a procurement, a procedural path, for the very limited number of individuals with an intellectual disability, who are already under the death sentence and who have not had their intellectual disability claims fully adjudicated by the courts on the merits. Tasha Lemley. This bill created clarity and it strengthened the protection of individuals with intellectual disability from execution in Tennessee.

In other words, it fixed the procedural gap Payne’s been in for more than 30 years. There was finally a paper to file. [BEAT] Tasha Lemley.

Henry filed the new claim on Payne’s behalf just 24 hours after the new law passed and courts agreed his claim should be fully heard. Tasha Lemley. Payne’s hearing was set to begin Dec.

13, 2021. And there was a flurry of activity in preparation. The state’s expert conducted an in-person evaluation of Payne.

They also interviewed former teachers and family members ...in part, to make an attempt to accurately place the age of onset of any deficiencies. Again, neuropsychiatrist George Woods. George Woods.

Well, the first thing that you want to do is you want to have a history that tells you something about who he was before 18 … It’s that the social history is so relevant and the data. The medical history, the school history, the testing within the school history, the social history. Who knew him?.

Who knew him in the environment?. What did his friends say about him?. You know, what did his teacher say about him ...

Tasha Lemley. The state filed a motion for their expert to have access to decades of prison records. They also wanted the right to interview prison staff — but they ended up withdrawing that request.

Experts say prison staff aren’t qualified to testify to an intellectual disability. From Woods’s perspective, for testimony to be relevant in a case like Payne’s, you’d want ... George Woods.

Someone with clinical judgment. Clinical judgment is a specialized kind of understanding of the subtleties, of the nuances, of the special needs of the people that have this disorder. ...

Understands that seeing someone that is a cousin that grew up with this person, or seeing someone that's a teacher that taught this person, is much more valuable than seeing someone that is a prison guard that ... Has no technical training that may interact with them for five minutes or 10 minutes a day. Tasha Lemley.

Plus, experts like Woods say adaptive behaviors can actually improve in a structured environment such as death row. George Woods. Both the AAIDD and Social Security ...

Which is also actually involved with this, both say prison settings don’t help ... It's really not a value to evaluate someone in a confined setting because there they have supports...the assessments have to be done with as little support as possible ... Prison life is a very supported life.

You don't have to make your meals. You don't have to do your washing. Your medications are given to you.

You don't have to think about so many things that are structured into your environment and actually make a person look better than they really are. Tasha Lemley. All the while these assessments were happening, and attorneys were debating methods and access, since his temporary reprieve was over, Pervis Payne could have gotten a new execution date from the Tennessee Supreme Court any time.

He wasn’t protected simply because he had an upcoming court date. But as we learned … Andre Johnson. [Echo] Pervis Payne is no longer on death row.

Tasha Lemley. After their investigation, the state’s expert convinced the Shelby County DA that Payne likely has an intellectual disability disorder. And because of that, they stopped pursing the death penalty in his case.

If the hearing had happened, appeals could have lasted for years. AMBI. Weeping and consoling.

[duck under, continue through Skahan] Tasha Lemley. At the short hearing to have his death sentence removed, Payne came into the courtroom and immediately cried and he embraced Kelley Henry. He kind of hung on her.

And Henry says “I’ve got you…” Just two and a half minutes after Payne entered the room Judge Skahan confirmed that his death sentence was formally vacated. These 16 seconds ended decades of wondering when he’d wake up to the date he’d be killed. Judge Paula Skahan.

Alright, well the order has vacated the capital sentences for Mr. Payne. Based on the findings of experts in this matter that he is intellectually disabled.

So, the death sentences are hereby vacated or set aside. Tasha Lemley. Pervis Payne is the first person to avoid execution under the new Tennessee law.

Henry expects about a dozen more inmates on Tennessee’s death row to use this same new pathway to try to prove their intellectual disabilities. [BEAT] Today, more than half of all states have either formally ended the death penalty or have a moratorium on its use. And 10 more states, well they have not executed anyone in a decade or more.

People from marginalized communities are disproportionately more likely to be executed and activists are pushing to make sure people with intellectual disabilities don’t face this irrevocable punishment. Payne’s case shows that even when the science is clear, and it often isn’t, it can take teams of scientists, doctors, lawyers, and legislators decades to update all the manuals, handbooks, policies, laws, and bureaucratic processes. And as they struggle, people die.

Recently, Ernest Johnson was executed in Missouri. He’s a man who many believe had a clear intellectual disability. And Wesley Coonce remains on Indiana’s death row because of one IQ point and a disagreement over age of onset.

The U.S. Supreme court refused to hear the case and Justice Sotomayor published an 11-page dissent on the refusal. [BEAT] So now, Kelley Henry and her team continue moving forward on Payne’s innocence claim.

And supporters for his case are increasing. From The Innocence Project to The Southern Christian Leadership Conference founded by Dr. Martin Luther King, Jr., to a host of online supporters.

Tasha Lemley. And Payne?. He’s grateful.

AMBI. Rally chants of “Free Pervis Payne” Kelley Henry. So Pervis, it's been a year since people have been gathering on street corners in Memphis in support of you.

What has it felt like for you this past year to know these folks are out there bearing witness, hoping to set you free?. Pervis Payne. Wow.

I feel so, so overwhelming during these, during these times...it just gives me a hope and a purpose that I never, never knew before. And I'm so, so grateful, so grateful. And I love all of them.

And I love all of you. And, um, I just thank Jesus for you. And I'd just like to say please keep standing with me.

Lydia Chain. Tasha, thank you so much for bringing us this story and for joining me to talk about it!. Tasha Lemley.

Oh, thank you so much for letting me do it. This has been a story that has been on my mind for, I guess three years now, so to see this finally come together, and especially at such a pivotal time in the case, is just really thrilling and I’m really humbled and grateful to get to be a little part of it. Lydia Chain.

One of the points that we just didn’t have time to really get into in the main story is his ongoing Innocence Project case. Can you tell us a little more about that?. Tasha Lemley.

Right, so one of the biggest things that happened in his innocence claim over the last year is that DNA was finally tested on items that had never been tested before. And that was another court battle, so again we couldn’t have gotten into that in this story. It was another battle, but finally DNA was tested and it was found that especially when it comes to the knife itself, it matches with his testimony that he found, came upon this horrible scene, went down to help the victim, and pulled the knife out by the blade.

And so Pervis’s DNA is on the hilt of the knife and not on the handle. And there is an unidentified male’s DNA on the handle that is not Pervis’s. And it was too degraded to figure out exactly who it was or run it through a database but that evidence alone matches his testimony that he has stuck with for more than 30 years.

And also, you know, it turns out that when Pervis’s team asked for everything that could be tested to be tested, at that point they believed all the evidence was present. Come to find out it’s not. So things like the victim’s fingernail clippings, they’re missing.

Things have gone unaccounted for and that’s a really hard part of this case. Lydia Chain. What’s the next step in Payne’s case?.

Tasha Lemley. So the hope moving forward is the day this podcast comes out, so maybe the day you’re listening to this, Jan. 31, Judge Skahan will determine whether Pervis’s sentences will be served consecutively or concurrently.

And Tennessee is actually favorable to concurrency. That determination should come this week. And if his sentences are determined to be able to be served concurrently, he could be eligible for parole in as early as six years.

And so that’s the hope moving forward, though the largest hope from, from his family and supporters and team is that he will be determined innocent at some point. Lydia Chain.

Before a worthy crowdfunding campaign can receive a donation, it must first get a donor’s attention, typically via a post on a social media platform like Facebook, cheap cipro online canada Instagram or Twitter. But our attention is a limited and valuable commodity, and we simply don’t have the capability to prioritize the enormous volume of content available. So, these platforms choose for us, highlighting via their algorithms a limited selection of campaigns based on factors like popularity, alignment with our interests, geographic or social proximity, when the content was created, or what advertisers pay for.

In this cheap cipro online canada so-called “attention economy,” we often feel overwhelmed by the amount of content we see while also failing to recognize that what we do see is but a tiny, highly curated fraction of the content on the platform. What this means is that only a few crowdfunding campaigns ever reach large audiences, and that audiences are far more likely to see already trending or successful campaigns, like the one for Kasson, than unsuccessful ones, like Jim’s. At the same time, campaigns work moderately well for those who have high-income friend networks.

People tend to have social cheap cipro online canada ties to those who are similar to them in economic, educational and cultural terms. Social scientists call this “homophily.” For example, people who live in wealthier areas are more likely to have rich friends than people who live in poor areas. Those with social networks full of rich friends are able to tap into deep and wide networks of wealth.

We recently found that campaigns started in counties where the median cheap cipro online canada income was in the top 20 percent earned more than twice as much as those started in counties in the bottom 20 percent. When it comes to crowdfunding, social networks amplify income inequalities. These effects are not the result of differences in generosity, but of differences in income and resources.

In fact, research routinely finds that Americans with cheap cipro online canada the lowest incomes are the most generous. A recent survey found that nearly 40 percent of those donating to crowdfunding campaigns had household incomes of less than $60,000. More than a third were without work when they donated.

But without significant income to draw on, these donations are often small, and spread out cheap cipro online canada among a larger number of people in one’s social network who may be asking for help. At the end of 2021, GoFundMe wrote in its annual report, “If 2020 was a year of crisis, 2021 was The Year of Gratitude.” It might be more accurate for GoFundMe to state that in 2021, we were generous, but it wasn’t enough to keep more vulnerable people out of crisis. Countless campaigns appeal to a crowd that never appears, and which may not ever see their request for help.

Campaigns like Jim’s, and the 90 percent that are unfunded or underfunded provide a haunting record cheap cipro online canada of lives slipping through yawning cracks in our social safety nets. It’s tempting to think that tweaking algorithms or shifting how our attention is directed might help these problems. But given crowdfunding’s reliance on enormous social media platforms, it’s naive to expect that technological tweaks could counteract the entrenched effects of income inequalities, social network disparities and social media dynamics.

Crowdfunding as a safety net is simply too full of holes, and those who need the most help cheap cipro online canada fall through most often. GoFundMe itself understands that it cannot provide an adequate fix to the unmet basic needs that fill its site. In February 2021, its CEO, Tim Cadogan, implored Congress to pass further cipro aid, arguing “we can’t do your job for you.” Unless legislators decide to extend and expand essential support programs like the Child Tax Credit, Americans will continue to seek help online, where successes are few and inequalities are more often amplified than ameliorated.In this episode, join freelance journalist and radio producer Tasha Lemley and podcast host Lydia Chain as they unravel the story of Pervis Payne, a man with an intellectual disability sentenced to death, and the decades-long court battle to remove him from The Row.

Below is cheap cipro online canada the full transcript of the podcast, lightly edited for clarity. You can also subscribe to The Undark Podcast at Apple Podcasts, TuneIn, or Spotify. AMBI.

[DRUMBEATS] Andre Johnson cheap cipro online canada. That’s alright, come on!. Yesterday was a monumental win.

And I'm being as cheap cipro online canada serious as I possibly can, what I’m about to say. You literally helped save a person's life yesterday. We can talk about protest and activism and we can theorize about it all.

But this is where the cheap cipro online canada rubber meets the road. Pervis Payne is no longer on death row. AMBI.

[STREET NOISE cheap cipro online canada ROLLS UNDER] Tasha Lemley. Andre Johnson is a professor, pastor, and activist. And for the past year, he’s led a group of protestors at Union &.

McLean in Memphis, Tennessee cheap cipro online canada. It’s a corner that has been used for anti-death penalty actions in years past. It’s a busy and wide intersection with a Starbucks, a Walgreens, and an upscale Ramen joint.

The day before Thanksgiving, cheap cipro online canada about 20 demonstrators spread out for their weekly rally. They’re wearing shirts and they’re holding signs that say “Free Pervis Payne." Johnson’s group believes Pervis Payne is innocent of the crimes that landed him on death row. Regardless, they also believe he has an intellectual disability — and that, alone, makes it unconstitutional to execute him.

So, for 34 cheap cipro online canada years, Payne has lived in this limbo on Tennessee’s Death Row. Until now. Less than one month before his historical intellectual disability hearing was set to begin, the district attorney made a surprising announcement — that, after they’d conducted expert assessments, they were no longer going to challenge his disability claim and that his sentences should be reduced to life instead of death.

This case spans cheap cipro online canada more than three decades, numerous attorneys, and a hard execution date. You’re about to learn how a man with a disability was so hard to diagnose, nearly unconstitutionally killed, and why it took so long to remove him from The Row when he never should have been there in the first place. Lydia Chain.

This is The cheap cipro online canada Undark Podcast. I’m your host, Lydia Chain. Pervis Payne’s case is complicated — there’s a tangle of critiqued forensics, misplaced evidence, and racism in Shelby County, Tennessee.

But it also showcases this convoluted relationship between how scientists and medical professionals understand intellectual disabilities, cheap cipro online canada and then how courts and legislatures interpret and use that science as they make life and death decisions. Tasha Lemley has the story. Tasha Lemley.

In 1988, Pervis Payne was convicted of the brutal murder of Charisse Christopher and her daughter, and the attempted murder of her young son — these are crimes he says he didn’t cheap cipro online canada commit. Heads up. Their murders were violent and the details are graphic.

Payne says he found Christopher cheap cipro online canada with a knife in her neck. He panicked and he tried to help. Kimkeá Harris.

That's what he was raised cheap cipro online canada to do — to be a help. And you and I might not have made that decision because we would have realized that this wasn't something we should touch, but that's where the intellectual disability comes in — inability to make sound judgment ... This is a man that we believe is wrongfully convicted.

Tasha Lemley cheap cipro online canada. That’s attorney Kimkeá Harris. She’s part of a task force trying to change the legal system in Memphis.

She believes Payne’s disability was cheap cipro online canada one of the factors that led to his conviction. But, proving that disability — navigating a tangle of legislative curves — has been a lifelong process for Payne. Rolanda Holman.

I call him cheap cipro online canada Bubba. That's what I call him … Tasha Lemley. This is Payne’s youngest sister Rolanda Holman.

Rolanda Holman cheap cipro online canada. Growing up, we had. We had fun.

We had a loving family … cheap cipro online canada When my parents would go to church on Friday nights, we were so happy that they would leave us here — Bubba home with us. We were like, “Yeah, you know, we're getting ready to party now!. € And we would dance and make dance routines and just have a blast.

He was always cheap cipro online canada that caring person. If you ever saw one of the pictures that are out there with him holding my sister’s and my hand, that's how he was all the time. Tasha Lemley.

These days, Rolanda cheap cipro online canada and her brother are still close. They talk regularly, and she’s able to help him out with a few things. Rolanda Holman.

So he gets very excited when he gets mail, but when he gets ready to write them back, he'll call me and say, “This is what I wrote.” And he'll cheap cipro online canada read it to me. And some words, he just don't know how to put. €œWhat do I need to say?.

This is what I'm trying to say.” And it could be something as, “I'm happy.” “Oh, I thought I had to put a particular word in there.” “No, ‘happy that you are able to, you know, you're thinking of cheap cipro online canada me. I'm happy that you're supporting me.’ Yeah. Just simple as that.” “Oh, okay.” You know, something really … he’d say “I knew you’d know!.

€ Cause he cheap cipro online canada thinks I'm really smart, right?. And he’ll say “I knew, I had to read this, I didn't want to send it out, you know, like crazy or whatever.” And I’ll say, “you know what, Bubba?. € I said, “Just write it how you feel.” Tasha Lemley.

Rolanda says cheap cipro online canada even though he was seven years older, she knew Bubba couldn’t help with her homework. And, no matter how many times their mother explained, he didn’t remember to separate light and dark clothing for laundry. Rolanda Holman.

As I became an adult, and I look back and, of course, different terms begin to develop over the years about intellectual disabilities and things like that cheap cipro online canada. And so I realized, “Oh, this is what Bubba was experiencing ...” George Woods. In Mr.

Payne's case, we have a rich, rich social cheap cipro online canada history that tells the story of someone who had real problems, who failed a couple of grades, who was never able to pass a Tennessee test to get out of high school. Who was recognized by multiple teachers as being cognitively impaired, who had difficulty reading, who had difficulty spelling, who had difficulty with math. Tasha Lemley.

This is cheap cipro online canada neuropsychiatrist George Woods. He studies co-occurring medical and psychiatric disorders. This rich social history he’s talking about, well it’s something to remember.

It’s one of the pieces needed to decide the cheap cipro online canada constitutionality of executing Payne. [BEAT] Tasha Lemley. The day Charisse Christopher and one of her children were murdered, Payne went to visit his girlfriend.

He testified he followed a noise and he found Christopher and her two young children brutally stabbed in a nearby apartment cheap cipro online canada. Christopher had a knife sticking out of her neck — she and her 2-year-old daughter, Lacie Jo, they died that day. Payne says he bent down to help her.

And he cheap cipro online canada pulled the knife out. He tried to call 911 and he dialed 411 instead — that’s the number for “information.” Then he said that his situation dawned on him. He was covered in blood.

He thought people might think he had cheap cipro online canada committed the crime. And he ran. George Woods.

It was obviously a choice that was made out of ignorance cheap cipro online canada. Right?. And it's an irrational choice.

It’s an cheap cipro online canada irrational choice. And again, can I attribute it just to someone that has intellectual disability?. Of course not.

Would it be consistent with someone who their entire life, under cheap cipro online canada no stress, has difficulty making good choices?. Yes. Tasha Lemley.

Payne’s choices the cheap cipro online canada day of the crime, that’s one place where his disability may have come into play. Woods says … George Woods. That clinical state of the person makes them vulnerable, makes them “less than” — when we talk about a cognitive state ...

We have to figure it out in terms of the crime itself, cheap cipro online canada but we know that we're working with someone whose brain is more vulnerable. And I think that's important. Tasha Lemley.

Payne was 20 years old when he was cheap cipro online canada convicted. He had no criminal record or drug history. According to court testimony, police responded to a call from a neighbor who heard “blood curdling screams” from the upstairs apartment.

They arrived cheap cipro online canada. Found Payne outside the scene. He said he was afraid he would be mistaken for the murderer — so he panicked and he ran.

He was arrested at a friend’s house, tried, and found guilty of two counts of first-degree cheap cipro online canada murder, one count of attempted murder, and he was sentenced to death. In the last three decades, Payne has seen eight appeals denied. He’s seen science change, and legislatures try to keep up.

He’s had an cheap cipro online canada execution date come and go. And, it took all these years for advocates and attorneys to change laws and to confirm his intellectual disability. To fully understand this case, we need to travel back in time a bit.

Through the years, people living with sub-average cognitive functioning cheap cipro online canada have been frequently misunderstood — or even feared. Even the words used to describe their experience can be dehumanizing and cause marginalization. Here’s a university training video from the 1950s.

AMBI. [1950s University of Minnesota training video.] Three grades of deficiency are recognized. Moderately retarded individuals are referred to as morons.

Those who are severely retarded, are classed as imbeciles. And the very severely retarded are termed idiots. Tasha Lemley.

By any name, intellectual disability has long been a part of the human experience. In the recent past, it was popularly referred to as... Elisabeth Dykens.

Mental retardation ... The R word as it's called in the field. Tasha Lemley.

That’s Elisabeth Dykens. She is a professor at Vanderbilt University. She studies areas of strength in people with intellectual and developmental disabilities.

Dykens thinks of disability classification as a series of nesting umbrellas. So the top umbrella, this includes all disabilities. Elisabeth Dykens.

That's a huge umbrella, and that could include people who become disabled as they age because of age-related macular degeneration or blindness or dementia, or you hear about people that go out on disability because they pulled their back while they were at work. Tasha Lemley. Now, under that umbrella are developmental disabilities, which, Dykens says, as defined by the federal government, are lifelong conditions marked by gaps in several areas of daily functioning.

And they begin as the brain is still developing. Under those?. Intellectual disabilities.

And, this is where we get into some pretty muddy territory when it comes to diagnosis. Dykens says that for some of the 7 million Americans living with an intellectual disability disorder we can point to a cause — like an injury or a genetic condition. But for about half of cases ...

It’s not that clear. Elisabeth Dykens. Unfortunately, there aren't really any biomarkers or blood tests above and beyond, say, a diagnosis of cerebral palsy or genetic syndrome.

Even the diagnosis of autism is based on behavioral observations and developmental history. So you're right ... It is messy.

Tasha Lemley. So, for someone like Payne to be diagnosed, Dykens says it’s up to a skilled assessor to take a look at three things. First.

Deficits in cognitive functioning… Elisabeth Dykens. With an IQ score of less than 70 plus or minus testing error. Deficits in adaptive behavior ...

Tasha Lemley. That one’s number two. It’s daily life stuff like communication and social skills.

Kinda getting around in the world. Elisabeth Dykens. How do people get along with others?.

How do they make use of recreation time?. How do they cope?. ...

How do they take care of themselves, their hygiene, where they live, and how do they get about in the community?. Tasha Lemley. And number three?.

All of this has to be identifiable in childhood ... Elisabeth Dykens. ...

Age of onset in the developmental years, which is typically defined as before age 18. Tasha Lemley. Meaning ...

A traumatic brain injury, well it could certainly affect cognitive functioning. If that happened under the age of 18, that could be considered an intellectual disability. But, if the same injury — and same effects — happened at say 30 years old, it wouldn’t qualify as an intellectual disability disorder.

So, these three criteria — cognitive functioning, adaptive behavior, and age of onset — they’re the standard for how an intellectual disability disorder is diagnosed. For most people, diagnosis is important because it creates understanding and a path for government services, and it guides a person’s support network in their care. But the diagnosis is also something to consider in the legal system — especially when it comes to the death penalty.

[BEAT] Tasha Lemley. Capital crimes involving perpetrators with intellectual disabilities, they’ve happened, and when Payne was convicted, it was permissible under the 8th amendment to execute someone with an intellectual disability. But then in 2002, the U.S.

Supreme Court decided in Atkins vs. Virginia it’s unconstitutional to execute someone with that diagnosis. Here’s Justice John Paul Stevens.

AMBI. [2002 Atkins Opinion] “We now hold that the Eighth Amendment prohibition against cruel and unusual punishment categorically forbids the execution of the mentally retarded. [fade under]” Tasha Lemley.

There’s a few reasons the Supreme Court decided people with intellectual disabilities “face a special risk of wrongful execution.” One. AMBI. [2002 Atkins Opinion] “Because of their disabilities in areas of reasoning, judgment, and control of their impulses, however, they do not act with the level of moral culpability that characterizes the most serious adult criminal conduct.” Tasha Lemley.

Carol Westlake is the executive director of the Tennessee Disability Coalition. She agrees that intellectually disabled people like Payne, they’re less culpable of a crime they’re involved in — and more likely to be convicted of a crime they weren’t. First, with the crime itself… Carol Westlake.

Somebody befriends them, gets them to do something that they know is probably not in their best interest, but they don't have a clear understanding of the consequences of that and the risks that they're taking. Tasha Lemley. And whether or not they’re innocent, they’re less likely to be able to navigate the system to defend themselves.

AMBI. [2002 Atkins Opinion] “Moreover, their impairments can jeopardize the reliability and fairness of capital proceedings against mentally retarded defendants.” Tasha Lemley. Westlake says defendants often struggle to be understood by police and lawyers, sometimes even act against their own interests, and… Carol Westlake.

Folks with intellectual disabilities — because they lack judgment and because they are so used to being stigmatized — will oftentimes try to “pass.” So they will pretend to understand their rights when they don't really understand their rights. They might want to please authority figures, right?. Tasha Lemley.

Dr. Woods says this is called ... George Woods.

€œThe Cloak of Competence.” You will find that many people with intellectual disability learned how to mask it. You go into a restaurant, right?. You can't read.

You pick up the menu, you say, “Oh, you know, I think I’ll just have what you have”. Tasha Lemley. So, the Atkins decision was a great move towards reducing the risk of executing someone who may have been manipulated — or for someone like Pervis Payne who may have not been able to help as much in his own defense and innocence claim.

One problem with Atkins, though, is the court left it up to each individual state to decide exactly what intellectual disability meant for their capital cases. And states have found ways to evade Atkins. Dr.

Woods. George Woods. Each state is able to define the parameters of the legal decision, but that's much different than defining the parameters of what intellectual disability is ...

So it's really been the different states attempting to gerrymander intellectual disability that has been confusing, not the standard. Tasha Lemley. Georgia, Texas, and Florida — they’re really good examples of the less-good ways some states set their parameters.

Georgia currently has a “beyond reasonable doubt” standard for proving intellectual disability in capital cases. It’s the harshest in the country — so far making it nearly impossible for a jury to agree someone is guilty, yet disabled and exempt from the death penalty. And, after Atkins, Texas courts designed their own system of standards to determine someone’s level of disability and if they were eligible for execution.

These Briseño factors included the “Lennie standard.” It’s named after Lennie from “Of Mice and Men.” AMBI. [1939 movie clip at 3:21] George. €œMight as well spend my time telling you things.

You forget them and I'll tell you again.” Lennie. €œI've tried and I tried, but it didn't do no good. I remember about the rabbits, George!.

€ George. €œThe only thing you can remember is them rabbits.” Tasha Lemley. Meaning someone, if convicted of murder, had to be at least as disabled as the fictional character “Lennie Small” to be exempt from the death penalty.

After the U.S. Supreme Court struck down these standards, Texas now applies contemporary clinical standards to their capital cases. However, according to the nonprofit Death Penalty Information Center, after Atkins and before this update, Texas executed more than a dozen people who likely had intellectual disabilities.

Also, after Atkins, Florida set a standard of a single or “bright line” IQ score. It was kind of a pass-fail. So if someone was assessed to have an IQ of 70, they were disabled.

71?. Not disabled. Florida is also now applying more appropriate clinical standards to their capital cases involving people with intellectual disabilities, though their protections are not applied retroactively.

Carol Westlake. And it's this business about single IQ score that — and I get — that courts love that sort of thing, right?. Because ...

I’m going it's really messy ... And lawyers and judges don’t want messy, you know?. It’s like pregnant/not pregnant.

Got it. I’m on it, you know?. Intellectually disabled — or not?.

Well … Tasha Lemley. And she says IQ score is not static — it changes for all of us over time. Scientists’ understanding of the brain developmental period changes over time, too.

And because of this, expert definitions get tweaked over time. Like the psychiatric tool, the DSM — the “Diagnostic and Statistical Manual of Mental Disorders.” Carol Westlake. And you know every 12 or so years it gets updated because the science changes because we know new kinds of things.

Tasha Lemley. And the American Association on Intellectual and Developmental Disabilities (or AAIDD) well they also change their definitions. Carol Westlake:...

Their definition, it really comports with the DSM. They have very slight variations. Tasha Lemley.

All of this can be difficult for courts. They prefer clear definitions. Carol Westlake.

There's this changing field ... Not ideal, but it's not distance or volume — not a light switch. [laughing] Everybody wants a light switch.

AMBI. BUZZ/CLICK Tasha Lemley. Whenever understanding changes and definitions are adjusted, states that still have the death penalty each have a moral responsibility to check themselves — and make sure their laws align with current science.

[BEAT] AMBI. Rally singing “Free Pervis Payne!. € Tasha Lemley.

So what does all of this mean for a case like Pervis Payne’s?. Carol Westlake. Honestly, as the Pervis Payne issue came up over this last year, and the issue around intellectual disability made us realize that we had missed an opportunity ...

To fix this definition. And so we thought that was a really important thing to go back and try to do. Tasha Lemley.

And this takes time. Tasha Lemley. Tennessee had no ban against executing someone with an intellectual disability when Payne was convicted back in 1988 so ...

Kelley Henry. It wasn't really assessed in terms of looking at an exclusion from the death penalty because it didn't exist. So the testing that was done was not thorough and it was really done more in terms of looking at mitigation ...

The jury didn't really get to hear about how his intellectual functioning would have impacted decisions he made. For example, to try to help the victim or to run when he was faced with the police. Tasha Lemley.

Kelley Henry is Payne’s attorney. Her team has been on his case just since 2019. She says that Payne couldn't raise a claim in 1990 when Tennessee did ban the execution of people with intellectual disabilities because it didn't apply to people who had already been convicted.

It also used a single IQ score as the determining factor — and Payne had previously tested too high. At different times and on different tests, his scores have ranged from 68 to 78. Kelley Henry.

The biggest issue 30 years ago was this belief that IQ is like an actuarial score that you had to have this number of 70 that would be spit out on a test. And that became very rigid in our law and our case law — became known as a “bright line rule” ... Even though science tells us that nobody scores the same on these tests.

There's, you know, a standard error of measurement in all science. And in the context of intellectual disability, that standard error of measurement is plus or minus five points... Tasha Lemley.

Dr. Woods says IQ testing is rife with other problems. He says this one test doesn’t tell us all of what we need to know about neurological function ...

There are additional issues of ethnicity and culture ... And then there’s something else wild ... Kelley Henry.

... The older the test gets the more out of date the norms are. It’s called “norm obsolescence” ...

So if you're giving somebody a test that's particularly old, then their score will be artificially inflated simply because the norming data is out of date. Tasha Lemley. Basically, IQ tests have to be re-standardized, or kind of calibrated over time, to make up for changes in our culture ...

To account for the stuff we’ve picked up along the way — the stuff we just now know. Kelley Henry. ...

Some of his test scores appear high because he had a score of 78. So that appears high. But when you look at the norming data for that score, you realize that he's actually scoring in the intellectually disabled range.

And when he was given newer tests that were, you know, normed more contemporaneously, he scored on the lower end. So he definitely meets that definition of intellectual disability. Tasha Lemley.

So, here we have a man convicted of a capital crime a couple of years before his state non-retroactively bans the execution of people with intellectual disabilities and more than a decade before the Atkins decision. And then when the Atkins verdict did pass, Henry says Payne couldn’t file a claim because Tennessee was using a “bright line” score of 70 — and he had an un-normed 78, so he didn’t qualify. And even when the Tennessee Supreme Court later determined that the standard error of measurement should be considered when looking at someone’s IQ in a capital case, which could have brought Payne’s score into a disability range, his lawyers faced a nightmarish system of bureaucracy.

Kelley Henry. He couldn't get into court because there was no procedure for him to get into court. It really was a procedural technicality.

Tasha Lemley. There’s not a piece of paper to file?. Kelley Henry.

Although folks tried. Now, I will say this. The team before me filed probably six different lawsuits, trying to figure out a way to get him into court.

And every single time the court said, “No, there's a procedural reason why you can't use this theory to get into court …” Tasha Lemley. She says the Tennessee Supreme Court took notice in 2016 and told the legislature to fix the procedural problem since they had no interest in executing someone who is intellectually disabled. And this took time.

Meanwhile, Payne got an execution date in 2019. That’s when Henry and her team joined his case and started making some noise. Thanks in part to buy antibiotics, Payne got a temporary reprieve from execution.

Meanwhile, new bills got introduced in the Tennessee Legislature. And then in late April 2021 in the Tennessee General Assembly... AMBI.

[Tennessee General Assembly passing SB1349/HB1062.] Because the U.S. Supreme court and the Tennessee Supreme Court also agree that Tennessee's law must rely on updated medical standards as provided by a manual, such as a DSM-5 and AAIDD-11, and not on outdated and inaccurate measures such as a single IQ score, the requirement for a specific IQ score has been removed from this legislation. This legislation also provides a procurement, a procedural path, for the very limited number of individuals with an intellectual disability, who are already under the death sentence and who have not had their intellectual disability claims fully adjudicated by the courts on the merits.

Tasha Lemley. This bill created clarity and it strengthened the protection of individuals with intellectual disability from execution in Tennessee. In other words, it fixed the procedural gap Payne’s been in for more than 30 years.

There was finally a paper to file. [BEAT] Tasha Lemley. Henry filed the new claim on Payne’s behalf just 24 hours after the new law passed and courts agreed his claim should be fully heard.

Tasha Lemley. Payne’s hearing was set to begin Dec. 13, 2021.

And there was a flurry of activity in preparation. The state’s expert conducted an in-person evaluation of Payne. They also interviewed former teachers and family members ...in part, to make an attempt to accurately place the age of onset of any deficiencies.

Again, neuropsychiatrist George Woods. George Woods. Well, the first thing that you want to do is you want to have a history that tells you something about who he was before 18 … It’s that the social history is so relevant and the data.

The medical history, the school history, the testing within the school history, the social history. Who knew him?. Who knew him in the environment?.

What did his friends say about him?. You know, what did his teacher say about him ... Tasha Lemley.

The state filed a motion for their expert to have access to decades of prison records. They also wanted the right to interview prison staff — but they ended up withdrawing that request. Experts say prison staff aren’t qualified to testify to an intellectual disability.

From Woods’s perspective, for testimony to be relevant in a case like Payne’s, you’d want ... George Woods. Someone with clinical judgment.

Clinical judgment is a specialized kind of understanding of the subtleties, of the nuances, of the special needs of the people that have this disorder. ... Understands that seeing someone that is a cousin that grew up with this person, or seeing someone that's a teacher that taught this person, is much more valuable than seeing someone that is a prison guard that ...

Has no technical training that may interact with them for five minutes or 10 minutes a day. Tasha Lemley. Plus, experts like Woods say adaptive behaviors can actually improve in a structured environment such as death row.

George Woods. Both the AAIDD and Social Security ... Which is also actually involved with this, both say prison settings don’t help ...

It's really not a value to evaluate someone in a confined setting because there they have supports...the assessments have to be done with as little support as possible ... Prison life is a very supported life. You don't have to make your meals.

You don't have to do your washing. Your medications are given to you. You don't have to think about so many things that are structured into your environment and actually make a person look better than they really are.

Tasha Lemley. All the while these assessments were happening, and attorneys were debating methods and access, since his temporary reprieve was over, Pervis Payne could have gotten a new execution date from the Tennessee Supreme Court any time. He wasn’t protected simply because he had an upcoming court date.

But as we learned … Andre Johnson. [Echo] Pervis Payne is no longer on death row. Tasha Lemley.

After their investigation, the state’s expert convinced the Shelby County DA that Payne likely has an intellectual disability disorder. And because of that, they stopped pursing the death penalty in his case. If the hearing had happened, appeals could have lasted for years.

AMBI. Weeping and consoling. [duck under, continue through Skahan] Tasha Lemley.

At the short hearing to have his death sentence removed, Payne came into the courtroom and immediately cried and he embraced Kelley Henry. He kind of hung on her. And Henry says “I’ve got you…” Just two and a half minutes after Payne entered the room Judge Skahan confirmed that his death sentence was formally vacated.

These 16 seconds ended decades of wondering when he’d wake up to the date he’d be killed. Judge Paula Skahan. Alright, well the order has vacated the capital sentences for Mr.

Payne. Based on the findings of experts in this matter that he is intellectually disabled. So, the death sentences are hereby vacated or set aside.

Tasha Lemley. Pervis Payne is the first person to avoid execution under the new Tennessee law. Henry expects about a dozen more inmates on Tennessee’s death row to use this same new pathway to try to prove their intellectual disabilities.

[BEAT] Today, more than half of all states have either formally ended the death penalty or have a moratorium on its use. And 10 more states, well they have not executed anyone in a decade or more. People from marginalized communities are disproportionately more likely to be executed and activists are pushing to make sure people with intellectual disabilities don’t face this irrevocable punishment.

Payne’s case shows that even when the science is clear, and it often isn’t, it can take teams of scientists, doctors, lawyers, and legislators decades to update all the manuals, handbooks, policies, laws, and bureaucratic processes. And as they struggle, people die. Recently, Ernest Johnson was executed in Missouri.

He’s a man who many believe had a clear intellectual disability. And Wesley Coonce remains on Indiana’s death row because of one IQ point and a disagreement over age of onset. The U.S.

Supreme court refused to hear the case and Justice Sotomayor published an 11-page dissent on the refusal. [BEAT] So now, Kelley Henry and her team continue moving forward on Payne’s innocence claim. And supporters for his case are increasing.

From The Innocence Project to The Southern Christian Leadership Conference founded by Dr. Martin Luther King, Jr., to a host of online supporters. Tasha Lemley.

Rally chants of “Free Pervis Payne” Kelley Henry. So Pervis, it's been a year since people have been gathering on street corners in Memphis in support of you. What has it felt like for you this past year to know these folks are out there bearing witness, hoping to set you free?.

Pervis Payne. Wow. I feel so, so overwhelming during these, during these times...it just gives me a hope and a purpose that I never, never knew before.

And I'm so, so grateful, so grateful. And I love all of them. And I love all of you.

And, um, I just thank Jesus for you. And I'd just like to say please keep standing with me. Lydia Chain.

Tasha, thank you so much for bringing us this story and for joining me to talk about it!. Tasha Lemley. Oh, thank you so much for letting me do it.

This has been a story that has been on my mind for, I guess three years now, so to see this finally come together, and especially at such a pivotal time in the case, is just really thrilling and I’m really humbled and grateful to get to be a little part of it. Lydia Chain. One of the points that we just didn’t have time to really get into in the main story is his ongoing Innocence Project case.

Can you tell us a little more about that?. Tasha Lemley. Right, so one of the biggest things that happened in his innocence claim over the last year is that DNA was finally tested on items that had never been tested before.

And that was another court battle, so again we couldn’t have gotten into that in this story. It was another battle, but finally DNA was tested and it was found that especially when it comes to the knife itself, it matches with his testimony that he found, came upon this horrible scene, went down to help the victim, and pulled the knife out by the blade. And so Pervis’s DNA is on the hilt of the knife and not on the handle.

And there is an unidentified male’s DNA on the handle that is not Pervis’s. And it was too degraded to figure out exactly who it was or run it through a database but that evidence alone matches his testimony that he has stuck with for more than 30 years. And also, you know, it turns out that when Pervis’s team asked for everything that could be tested to be tested, at that point they believed all the evidence was present.

Come to find out it’s not. So things like the victim’s fingernail clippings, they’re missing.

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Evidence suggests that the smallpox treatment can help prevent monkeypox s and decrease the severity of the symptoms. One treatment known as Imvamune or Imvanex is licensed in the U.S. To prevent monkeypox and smallpox cheap cipro online canada. Vaccination after exposure to the cipro may also help decrease chances of severe illness.

The CDC currently recommends smallpox vaccination only in people who have been or are likely to be exposed to monkeypox. Immunocompromised people cheap cipro online canada are at high risk. This article was originally published on The Conversation. Read the original article.CLIMATEWIRE | When California suffers a heat wave, it leans heavily on hydropower from the Pacific Northwest to keep the cheap cipro online canada lights on.

But that hydropower may not always be available when it’s most needed, as climate change is shifting the ground on which the West’s dams sit. Higher temperatures means snowmelt occurs earlier in the year and leaves less water available for power generation during the depths of summer. The result is a heightened risk of blackouts during extreme heat waves as a result of less hydro availability, according to a report out this week from the North American Electric Reliability cheap cipro online canada Corp. (NERC).

The report highlights a paradox of running the region’s electric grid in a warming world. As energy demand rises with temperatures, there may cheap cipro online canada be less hydro available to supply power, increasing the need for fossil fuels. €œIn general, hydro is a low-carbon source of electricity that is needed to address climate change,” said Steve Clemmer, director of energy research at the Union of Concerned Scientists. €œAt the same time, it is an electricity resource being affected by climate change.” According to NERC, the greatest threat to cheap cipro online canada the West is a heat wave like the one that boiled cities from Seattle to Tucson in 2020 (Energywire, May 19).

Hotter temperatures strain the grid because soaring demand means there is less spare power to ship from one part of the region to another. The risk of power outages is especially acute during the early evening hours, when solar output begins to fall but electricity demand remains elevated. It’s against that backdrop cheap cipro online canada that hydropower becomes particularly important. A recent study published in the journal Earth’s Future found that hydro availability and summer air temperatures are likely the biggest determinants in Western electricity prices in the coming decades.

€œIf we have heat waves that increase demand, that is when that loss of hydro becomes really important,” said Adrienne Marshall, a computational hydrologist at the Colorado School of Mines. The challenges vary cheap cipro online canada in different parts of the West, she said. Scientists generally expect temperate regions of the world to become wetter and arid regions drier as temperatures rise. The issue in the Northwest is seasonal.

Many dams in the region are cheap cipro online canada subject to regulations that require them to manage water levels for flood protection, agricultural use and endangered species habitat, meaning there are limits to how much water can be stored behind impoundments if runoff occurs earlier in the year, Marshall said. That presents challenges during summer heat waves, when demand for electricity soars. The Southwest is less reliant on dams to produce electricity than its northern cheap cipro online canada neighbors, but faces decreased hydro output as the region becomes drier. That has important implications for the region’s decarbonization efforts.

€œAs we think about what it takes to decarbonize our grid, hydro becomes especially important and useful because it is a renewable energy source that can be turned on and off relatively rapidly in response to wind and solar availability,” Marshall said. €˜Energy emergencies’ cheap cipro online canada expected this summer The climate impact of hydro availability is most apparent in California, where power plant emissions rise and fall depending on in-state hydro output. In 2021, EPA data shows that California greenhouse gas emissions were 37 million tons, their highest level since 2016. That coincided with hydro generation that was the state’s lowest since 2015, at 14.5 terawatt-hours of electricity, according to U.S.

Energy Information Administration figures cheap cipro online canada. Natural gas generation picked up much of the slack, churning out 96.5 TWh of electricity, the highest such figure since 2016. The Golden State is also highly reliant on hydropower imports to steady the grid during high demand events, according to NERC. In an extreme peak cheap cipro online canada event, total California imports would rise to an estimated 17.4 gigawatts, up from 13 GW during a normal peak.

In its report, NERC pointed to “an elevated risk of energy emergencies” this summer as dry conditions threaten the availability of hydropower. €œPeriods of high demand over a wide area will result in reduced supplies of energy for transfer, causing operators to rely primarily on alternative resources for system balancing, including natural-gas-fired generators cheap cipro online canada and battery systems,” NERC warned. Low hydro availability leaves California particularly vulnerable to the recent rise in natural gas prices, said Fred Heutte, senior policy associate at the NW Energy Coalition. It also points to the need for further measures to reduce demand and coordinate delivery of electricity supplies, which will allow the region to maximize the hydro resources available.

Other analysts said improved forecasting and snow pack monitoring will also enable the region to better predict how much hydro it will have cheap cipro online canada in a given year. The good news, Heutte said, is that the challenge has prompted grid planners in the region to think through how to keep the system running during extreme heat events. €œYou have to be ready for the unexpected,” he said. €œIt’s the unexpected issues cheap cipro online canada that we are trying to focus on more now.” Reprinted from E&E News with permission from POLITICO, LLC.

Copyright 2022. E&E News provides essential news for energy and environment professionals..

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ATLANTA – Many Black communities in Metro cipro heartburn Atlanta face high levels of environmental exposures that can negatively impact the health of Black children, and scientists are faced with the challenge of effectively communicating the dangers of environmental exposures to diverse communities. To address these issues, the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health (NIH), has awarded a $4 million, five-year grant to support research related to addressing health disparities through cipro heartburn transformative communication strategies. With this grant, an Emory-led team of environmental health scientists and health communication experts from the University of Georgia will join forces to translate important environmental health research findings to key stakeholders in the community, academia and health care systems through the newly created Center for Children’s Health Assessment, Research Translation and Combating Racism. The Center will develop high-impact messaging strategies that can cipro heartburn be used to improve children’s health by focusing on health literacy and best practices in prevention communication and dissemination. Faculty from the Rollins School of Public Health and Spelman College, one of the nation’s most prestigious historically black colleges for women, will also play a critical role in advancing the science generated by the Center and ensuring meaningful discussions and rapid feedback between a community advisory board and all members of the Center.

Linda cipro heartburn McCauley, dean, and professor at Emory University’s Nell Hodgson Woodruff School of Nursing will direct the new Center.“This Center is uniquely positioned to foster excellence in research on children’s environmental health that will nurture the next generation of scientists and provide information that can benefit the Atlanta community, which has suffered from decades of environmental racism and has many of the highest levels of health disparities in the nation,” says McCauley. €œOur goal is to improve the health of children, and we know better communications will lead to prevention and early detection of environmental health exposures.” “We hope to expand the public health impact of children’s cipro heartburn environmental health science by synthesizing existing research into innovative health communication interventions, curricula and policies,” says Center co-director Sun Joo (Grace) Ahn, associate professor at UGA’s Grady College of Journalism and Mass Communication. €œTogether, we will identify target audiences among marginalized and under-resourced populations and design innovative health messages that can help us better communicate with audiences that have traditionally been challenging to reach.” The Center will also partner with Sharecare, the digital health company whose comprehensive and data-driven virtual health platform helps people, providers, employers, health plans, government organizations and communities optimize individual and population-wide well-being by driving positive behavior change.Donna Hill Howes, RN, MS, chief nursing officer and SVP, corporate partnerships of Sharecare, commented, “Increasing access to information about children’s environmental health is critical to building strong, healthy communities. Working closely with our partners at Emory, UGA and the Center, we believe that, together, we can effectively support the translation of health science to action-oriented information by leveraging our content and products, connecting stakeholders across fields and utilizing our cipro heartburn national reach to augment children’s environmental health.” Emory is one of six academic institutions in a network of Children’s Environmental Health Research Translation Centers in the U.S., and it will serve as the National Coordinating Center for the network. The Coordinating Center will be led by Nsedu Obot Witherspoon, executive director of the Washington, D.C.-based Children’s Environmental Health Network.

Other Centers were awarded to Johns Hopkins University, Oregon State University, the University of Pennsylvania, New York University and cipro heartburn the University of Southern California. Research reported in this publication was supported by the National Institute of Environmental Health Sciences of the National Institutes of Health under Award Number P2CES033430. The content cipro heartburn is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. About the National Institute of Environmental Health Sciences (NIEHS)NIEHS supports research to cipro heartburn understand the effects of the environment on human health and is part of the National Institutes of Health. For more information on NIEHS or environmental health topics, visit www.niehs.nih.gov or subscribe to a news list.

About the National Institutes of Health (NIH)NIH, the nation’s medical research agency, includes 27 cipro heartburn Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical and translational medical research, and is investigating cipro heartburn the causes, treatments and cures for both common and rare diseases. More information about NIH and its programs is available online..

ATLANTA – Many Black communities in Metro Atlanta click reference face high levels of environmental exposures that can negatively impact the health of Black children, and scientists are faced with the challenge cheap cipro online canada of effectively communicating the dangers of environmental exposures to diverse communities. To address these issues, the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of cheap cipro online canada Health (NIH), has awarded a $4 million, five-year grant to support research related to addressing health disparities through transformative communication strategies. With this grant, an Emory-led team of environmental health scientists and health communication experts from the University of Georgia will join forces to translate important environmental health research findings to key stakeholders in the community, academia and health care systems through the newly created Center for Children’s Health Assessment, Research Translation and Combating Racism.

The Center will develop high-impact messaging strategies that can be used to improve children’s health by focusing on health cheap cipro online canada literacy and best practices in prevention communication and dissemination. Faculty from the Rollins School of Public Health and Spelman College, one of the nation’s most prestigious historically black colleges for women, will also play a critical role in advancing the science generated by the Center and ensuring meaningful discussions and rapid feedback between a community advisory board and all members of the Center. Linda McCauley, dean, and professor at Emory University’s Nell Hodgson Woodruff School of Nursing will direct the new Center.“This Center is uniquely positioned to foster excellence in research on children’s environmental health that will nurture the next generation of scientists and provide information that can benefit the Atlanta community, which has suffered from decades of environmental racism and has many cheap cipro online canada of the highest levels of health disparities in the nation,” says McCauley.

€œOur goal is to improve the health of children, and we know better communications will lead to prevention and early detection of environmental health exposures.” “We cheap cipro online canada hope to expand the public health impact of children’s environmental health science by synthesizing existing research into innovative health communication interventions, curricula and policies,” says Center co-director Sun Joo (Grace) Ahn, associate professor at UGA’s Grady College of Journalism and Mass Communication. €œTogether, we will identify target audiences among marginalized and under-resourced populations and design innovative health messages that can help us better communicate with audiences that have traditionally been challenging to reach.” The Center will also partner with Sharecare, the digital health company whose comprehensive and data-driven virtual health platform helps people, providers, employers, health plans, government organizations and communities optimize individual and population-wide well-being by driving positive behavior change.Donna Hill Howes, RN, MS, chief nursing officer and SVP, corporate partnerships of Sharecare, commented, “Increasing access to information about children’s environmental health is critical to building strong, healthy communities. Working closely with our partners at Emory, UGA and the Center, we believe that, together, we cheap cipro online canada can effectively support the translation of health science to action-oriented information by leveraging our content and products, connecting stakeholders across fields and utilizing our national reach to augment children’s environmental health.” Emory is one of six academic institutions in a network of Children’s Environmental Health Research Translation Centers in the U.S., and it will serve as the National Coordinating Center for the network.

The Coordinating Center will be led by Nsedu Obot Witherspoon, executive director of the Washington, D.C.-based Children’s Environmental Health Network. Other Centers were awarded to Johns Hopkins University, cheap cipro online canada Oregon State University, the University of Pennsylvania, New York University and the University of Southern California. Research reported in this publication was supported by the National Institute of Environmental Health Sciences of the National Institutes of Health under Award Number P2CES033430.

The content is solely the responsibility of the authors and does not necessarily represent the official cheap cipro online canada views of the National Institutes of Health. About the National Institute of Environmental Health Sciences (NIEHS)NIEHS supports research to understand the effects of the environment on human health and is part of the National cheap cipro online canada Institutes of Health. For more information on NIEHS or environmental health topics, visit www.niehs.nih.gov or subscribe to a news list.

About the cheap cipro online canada National Institutes of Health (NIH)NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical and translational medical research, and is cheap cipro online canada investigating the causes, treatments and cures for both common and rare diseases.

More information about NIH and its programs is available online..

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