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Analysis, background reports and updates from the PBS NewsHour putting today's news in context.

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    Ryan Lochte of USA reacts in Rio de Janeiro, Brazil, on August 11, 2016. Photo by David Gray/Reuters

    Ryan Lochte of USA reacts in Rio de Janeiro, Brazil, on August 11, 2016. Photo by David Gray/Reuters

    Twelve-time Olympic medalist Ryan Lochte and three teammates were robbed at gunpoint early Sunday morning, according to the U.S. Olympic Committee.

    The other swimmers were Gunnar Bentz, Jack Conger, and Jimmy Feigen.

    According to the committee’s statement, the four swimmers were in a taxi headed for the Olympic Village when they were “stopped by individuals posing as armed police officers who demanded the athletes’ money and other personal belongings.”

    The statement conflicted with an initial reaction from the International Olympic Committee, who said reports of the incident were “absolutely not true,” ABC News reported.

    There should be an embedded item here. Please visit the original post to view it.

    Lochte recalled the incident to NBC News:

    “We got pulled over, in the taxi, and these guys came out with a badge, a police badge, no lights, no nothing just a police badge and they pulled us over,” he said. “They pulled out their guns, they told the other swimmers to get down on the ground — they got down on the ground. I refused, I was like we didn’t do anything wrong, so—I’m not getting down on the ground.

    “And then the guy pulled out his gun, he cocked it, put it to my forehead and he said, “Get down,” and I put my hands up, I was like ‘whatever.’ He took our money, he took my wallet — he left my cell phone, he left my credentials.”

    On Thursday, Lochte and three other teammates won gold in the 4×200 meter freestyle relay.

    The post Four American swimmers robbed at gunpoint in Rio, U.S. Olympic Committee says appeared first on PBS NewsHour.

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    The Ocean Cleanup project aims to eliminate millions of tons of plastic from the ocean. Photo by Saskia de Melker/PBS NewsHour

    Watch Video | Listen to the Audio

    By Saskia de Melker and Melanie Saltzman

    SASKIA DE MELKER: 14 miles off the coast of the Netherlands, Boyan Slat is conducting an experiment to rid the world’s waters of plastic trash.

    BOYAN SLAT: It’s a perfect day to install a barrier. We’ve been working on this for quite a few years, and actually having something physical in the ocean that you can see work

    SASKIA DE MELKER: This floating barrier in the North Sea is the first test of this Dutch 22-year-old’s project that he calls “the Ocean Cleanup.”

    BOYAN SLAT: Ultimately, I hope that we can get to a future where the oceans are clean again. I would say that I think within 10 years from now, we would already be really close to getting clean oceans again, and perhaps in 20, 30 years, I think the oceans can be like they were in perhaps the 1950s, before we were using plastic at this scale.

    SASKIA DE MELKER: To call that goal ambitious would be an understatement. About 9 million tons of plastic are dumped into the world’s oceans every year — from littering on beaches, fishing vessels disposing of old nets, and improper waste management.

    That’s enough plastic to fill a football stadium and rise 23 miles in the air.
    Scientists expect the amount of plastic trash in the oceans to double in the next decade as developing countries increasingly use plastic without adequate systems to recycle it. Not only do fish and marine animals get entangled in plastic, they eat it.

    JULIA REISSER: “It’s very likely that that was bites from a fish with a hard beak or it could be even a baby turtle.”

    SASKIA DE MELKER: Julia Reisser is the ocean clean up’s lead oceanographer. She says in water, plastic breaks down into microscopic pieces. So fish ingest plastic particles and may pass the harmful chemicals contained in them along the food chain. That’s why it’s critical to capture the large pieces of plastic before they break down.

    JULIA REISSER: Quantifying the microplastics, the very tiny pieces, you probably are looking at the levels of plastic pollution from a few decades ago. So it’s like climate change: what we’re doing now we might feel in a few decades to come. So we see our operations as a way to intercept the big plastics before it becomes very small, tiny, millimeter-size plastics.

    SASKIA DE MELKER: Rotating ocean currents suck plastic and other trash into concentrated areas– one of the largest is the so-called “Great Pacific Garbage Patch” located between hawaii and california. Scientists estimate that up to 170,000 tons of plastic accumulate here. Ocean garbage patches are vast but dispersed making it difficult to collect or even see the plastic.

    Last year, “the ocean cleanup” deployed 30 vessels to map more than 1 million square miles of the pacific ocean and collect data on plastics. The team discovered more and larger pieces of plastic than expected.

    JULIA REISSER: We got hundreds of times more plastic than marine life on the sea surface of these oceans.

    SASKIA DEMELKER: There’s more plastic than fish?

    JULIA REISSER: Yes, at least at the sea surface of this garbage patch, yes.

    SASKIA DE MELKER: Boyan slat is focused on cleaning up this infamous patch. He was motivated six years ago, when he was on a family vacation.

    BOYAN SLAT: I was 16-years-old, and I was diving in Greece, and then suddenly I realized I came across more plastic bags than fish. So I thought, well, somebody should do something about this. And then one day I realized that these currents between Hawaii and California are rotating, so the plastic doesn’t stay in one spot. I then asked myself, ‘Hey, wait a minute, why would you go through the oceans if the oceans can also move through you?’

    SASKIA DE MELKER: In other words, Slat wondered if the same ocean currents that pushed the plastic deep into the ocean could be harnessed to clean it up. Slat came up with the idea to anchor a structure to the ocean floor similar to an oil rig — a passive barrier that could trap plastics.

    BOYAN SLAT: “The oceanic currents moving around is not an obstacle, it’s a solution.”

    SASKIA DE MELKER: When Slat, as a college freshman majoring in aerospace engineering, , promoted his idea in this “ted talk” four years ago, the video went viral. And with thousands of supporters, he decided to drop out of college to start the Ocean Clean Up.

    SASKIA DE MELKER: What were the reactions to your idea at that time?

    BOYAN SLAT: At first a lot of people told me it was not possible. I thought, well, I don’t know whether it’s possible, but the only way to find out is to actually try and go and do it.

    SASKIA DE MELKER: Through crowdsourcing, he raised 2.2 Million dollars within 100 days and now has attracted a staff that includes dozens of scientists and engineers.Two years ago, Slat co-authored a 528-page report with nearly 100 scientists outlining how his vision could work and then began testing scale model barriers in wave pools. In June, he began testing out at sea.

    The flexible barrier, as shown in this animation will float atop the ocean’s surface, its arms outstretched in a “v” shape. A screen will extend six-and-a-half feet below which the designers claim is deep enough to catch plastics, but shallow enough that marine life can swim underneath it. As plastic accumulates in the center of the barrier, it will be pulled up into a tower and stored until it can be transported back to shore and recycled.

    SASKIA DE MELKER: In the North Sea the waves and currents are actually stronger than those out in the Pacific Ocean. That’s why the Ocean CleanUp team is testing the structural integrity of the floating barrier here first.

    ALLARD VAN HOEKEN: “So we have the big yellow buoys those are the buoys that will hold the barrier.”

    SASKIA DE MELKER: Allard Van Hoeken is an offshore engineer and the project’s chief operating officer. He’s overseeing the year long barrier test.

    SASKIA DE MELKER: What do you expect from this test here?

    ALLARD VAN HOEKEN: So now we’re going to see how the barrier will behave in a real offshore environment, real sea conditions. And also we’re going to do tests. So we’re going to do a capturing test with the fake plastic, it’s not real plastic, it’s made out of corn. And we’re going to release it here in front of the barrier and see how the barrier holds that.

    SASKIA DE MELKER: After this test, van Hoeken’s team of engineers will set their sights on the Pacific Ocean, where they hope to deploy a full scale 62 mile barrier by 2020.

    ALLARD VAN HOEKEN: To put a structure like this in the ocean far away from the coast, thousands of miles away in an area where humans have no control at all. To place it there, make it survive year after year. That’s really a lot of things together that have never been done before.

    SASKIA DE MELKER: The ocean cleanup team has yet to secure funding for the full scale barrier, which it estimates will cost hundreds of millions of dollars. While most of Boyan Slat’s funding has come from private donations the Dutch government recently gave 550-thousand dollars for the prototype test. Sharon Dijksma is the Dutch Minister for the Environment.

    SHARON DIJKSMA: We don’t have a pocket full of money waiting for Boyan after this, but i think the first step getting the prototype out and to be paid for that was probably the hardest step. When this is a success, and he is going to scale up, I think the investors will stand in line to assist him.

    SASKIA DE MELKER: But Nick Mallos, director of the “trash free seas” program at the ocean conservancy in washington d.C. Is among the skeptics.

    SASKIA DE MELKER: From what you know about the ocean cleanup plan, is it a feasible proposition?

    NICK MALLOS: I think there are a lot of factors that are quite concerning. We’re talking about putting the largest manmade object ever known into an ocean in an environment that is one of the most, if not the most, dynamic and, and dangerous ecosystem on the planet. I think at the moment we believe the risk of catastrophe outweighs the potential benefit of plastics extraction.

    SASKIA DE MELKER: Boyan Slat says that that risk can be mitigated. That’s why they’re testing extensively. Mallos says a more cost effective low risk approach is to slow plastic consumption and capture plastics in coastal areas.

    NICK MALLOS: We believe very strongly that we should focus on stopping debris and plastics from entering waterways and the ocean at its source through beach cleanups and waterway and near shore clean ups and redesigning and minimizing the amount of waste that’s available to ever enter the system.

    BOYAN SLAT: I think that prevention and cleanup is highly complementary. Because already there is a massive amount of plastic in the ocean, and it doesn’t go away by itself. It’s a dirty job, but someone’s got to do it, I suppose.

    The post Can this project clean up millions of tons of ocean plastic? appeared first on PBS NewsHour.

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    U.S. Democratic presidential nominee Hillary Clinton smiles as she is introduced at Futuramic Tool & Engineering in Warren, Michigan, on August 11, 2016. Photo by Chris Keane/Reuters

    U.S. Democratic presidential nominee Hillary Clinton smiles as she is introduced at Futuramic Tool & Engineering in Warren, Michigan, on August 11, 2016. Photo by Chris Keane/Reuters

    WASHINGTON — Hillary Clinton’s campaign is launching a new effort to tap into the political power of young, undocumented immigrants, hoping to capitalize on Donald Trump’s promises to make deporting them a top priority of his presidency.

    The 730,000 young people brought to the U.S. as children without legal status are prohibited from voting. Known as Dreamers, they’ve proven themselves to be a powerful organizing force in American politics, mounting a high-profile public campaign that pressured President Barack Obama to grant many of them and their parents reprieves from deportation though two executive orders.

    Clinton’s national voter registration program, called “Mi Sueño, Tu Voto/My Dream, Your Vote,” is being launched on the four-year anniversary of the 2012 order that temporarily shielded from deportation some young immigrants brought to the country illegally as children and allowed them to work legally.

    Organizers will remind voters that a Trump presidency would end that program, according to the campaign, which is already at risk after a June Supreme Court effectively killed Obama’s efforts to give legal status to some of the 11 million immigrants living in the U.S. illegally.

    The program is part of an aggressive effort by Clinton’s campaign to woo the record 27.3 million Latinos eligible to vote in 2016. Polling shows Trump doing worse with Latino voters than any GOP presidential candidate since 1996. Much of the new effort will focus on battleground states including Colorado, Nevada, North Carolina and Florida, where Latinos and other immigrants make up an important part of the voting base.

    [Watch Video]

    Though Obama’s campaign had no formal organization program for Dreamers, door-knocking by those young immigrants, who have lived and attended school in the U.S., helped mobilize many Latino voters who could vote.

    Clinton believes she can harness their power in a more formal way, particularly given her opponent. Trump’s anti-immigrant rhetoric has sparked outrage and fear within the Latino community.

    He’s promised to revoke Obama’s executive orders within the first 100 days of his presidency, calling them the “most unconstitutional actions ever undertaken by a president.”

    Clinton has made revamping the country’s immigration system a key plank of her presidential campaign. She has said she will introduce legislation during her first 100 days in office, vowed to restore and expand Obama’s programs, close private sector detention centers and to “take a very hard look at the deportation policies” now in force.

    Last month, she called on Latino voters to help stop what she called GOP rival Donald Trump’s efforts to “fan the flames of racial division.”

    “Donald Trump is running the most divisive campaign our lifetime. His message is that you should be afraid,” she told a gathering of Latino activists In Washington. “We’ve got to come back twice as strong and twice as clear. We have got to say with one voice that Latinos are vital part of the American community.”

    The post New Clinton effort aims to tap the power of ‘Dreamers’ appeared first on PBS NewsHour.

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    Wisconsin Gov. Scott Walker on Sunday said the state’s National Guard is on standby after a night of protests in a low-income, predominately black neighborhood in Milwaukee, triggered by the police shooting of a black man there.

    Local police on Sunday said Sylville Smith, 23, had been pulled over on Saturday for running a traffic stop in Sherman Park. When Smith and another person in the car started running, an officer shot Smith in pursuit. Police say he was armed with a stolen handgun.

    Even though his identity wasn’t officially released until Sunday afternoon, people in the neighborhood knew who had been shot. And Smith’s death came as officer killings of black men and women have been met with backlash across the nation. Milwaukee is also one of the country’s most segregated cities.

    After the shooting, Smith’s family had gathered with neighbors and friends at the scene. As night fell, the crowd got bigger, and anger escalated, said Reggie Moore, who heads the office of violence prevention at the city’s health department.

    “Instead of engaging, [police] decided to disperse. The crowd did not disperse. They took over an intersection,” Moore said. “[Police] definitely took a restrained approach.”

    Then people started throwing stones and bricks, smashing windows of police cars and setting four businesses, including a gas station, ablaze.

    One police officer was hit in the head with a brick that was thrown through the window of his car, according to The New York Times. Moore said it was the “most violent” he’s seen a protest get in Milwaukee.

    At least a few police officers and community members were injured, while about a dozen people were arrested, he said.

    After the flames died down and people left, police tweeted around 3:30 a.m. that police were “restoring order.”

    On Sunday morning, several faith-based institutions and neighbors came to clean up the aftermath, Moore said.

    “When people are seeing these regular occurrences, it has an impact. It’s not just incidents taken in isolation,” he said.

    Walker issued a statement saying that in case of more violent protests, the National Guard will help “upon request.”

    “This act of selfless caring sets a powerful example for Milwaukee’s youth and the entire community,” he said. “I join Milwaukee’s leaders and citizens in calling for continued peace and prayer.”

    Mildred Haynes, Smith’s mother, told the local newspaper the Milwaukee Journal Sentinel that Smith was the father of a 2-year-old boy.

    “My son is gone due to the police killing my son,” she said Sunday. “I am lost.”

    The post Wisconsin governor activates National Guard after police shooting sparks protests appeared first on PBS NewsHour.

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    A worker takes off U.S and Puerto Rican flag after rally of U.S. Democratic presidential candidate Bernie Sanders in San Juan, Puerto Rico, May 16, 2016. REUTERS/Alvin Baez

    A worker takes off U.S and Puerto Rican flag after rally of U.S. Democratic presidential candidate Bernie Sanders in San Juan, Puerto Rico, May 16, 2016. REUTERS/Alvin Baez – RTSEL4U

    PHILADELPHIA — Residents of Puerto Rico can’t vote in presidential elections. But with the island’s economy in shambles, many are fleeing to the U.S. mainland, potentially shifting demographic norms in some of the most closely contested states.

    The impact of Puerto Rican migrants on the election hinges on how successful voting advocates are in getting them to the polls, with many focused more on finding jobs, homes and schools.

    Together, Pennsylvania, Florida and Ohio — three pivotal states in the fall — absorbed more than 22,500 Puerto Rican migrants in 2013 alone. Many more Puerto Ricans already living on the mainland have relocated to these states from traditional hubs such as New York.

    Recent polls suggest that for now, Democrat Hillary Clinton leads in Pennsylvania and has the edge in Ohio, while Clinton and Republican Donald Trump are in a close race in Florida.

    “Think about what happened in 2000” with the presidential recount in Florida, said Sandra Suarez, a professor of political science at Philadelphia’s Temple University. “The difference was a few hundred votes.”

    Puerto Ricans living on the island can only vote in presidential primaries. As U.S. citizens, they are immediately eligible to vote in national elections upon residency and registration on the mainland. Even if only one-quarter of eligible recent Puerto Rican migrants vote in Pennsylvania and Florida, that could be enough to tilt a close race.

    Dozens of new grassroots organizations have emerged in recent years to encourage Puerto Ricans to vote, said Justin Velez-Hagan, founder of the National Puerto Rican Chamber of Commerce.

    The Rev. Roberto Luis Lugo of Philadelphia, who has been organizing activists to get Puerto Ricans to vote, said it doesn’t really matter for whom they vote, as long as they exercise their right as citizens. “If they vote, we can make a big difference in whatever election we have,” he said.

    Puerto Rico’s economy has been on the decline since the 1990s, when tax incentives for U.S. companies to operate in Puerto Rico were repealed. Stagnation turned into a free-fall in the 2007 housing market crash. The island has failed to bounce back ever since, with unemployment topping 12 percent earlier this year —more than double the national average.

    New York has been a traditional hub for Puerto Rican migrants, but they are increasingly settling elsewhere, due mainly to New York’s high cost of living. Puerto Ricans typically have a high turnout at home; voter participation often exceeds 70 percent. Organizers have in the past faced hurdles encouraging Puerto Ricans on the mainland to get to the polls.

    Jonathan Lewis, a recent migrant to Philadelphia, left his hometown of Arecibo, Puerto Rico, in search of opportunity when his biomedical science degree would only land him a job at McDonald’s. His girlfriend, a student at New York University at the time, invited him to the mainland. It was an easy decision, and he quickly found a job at FedEx.

    But voting wasn’t a priority for Lewis until he encountered an organizer on the street who registered him within minutes.

    “People will always be more concerned about finding a job,” Lewis said. “Once they already have a job, they will start probably having interest in some other things like voting, getting registered, that kind of thing.”

    In the 2014 elections, only about one-quarter of eligible Puerto Ricans on the mainland voted, whereas nationally, voter turnout reached about 42 percent that year, and 27 percent among Latinos as a whole, according to the Pew Center.

    High turnout would likely favor Clinton. Polls show she leads by large margins among Latinos nationally, though those samples are not large enough to give a breakdown of her performance among Puerto Ricans specifically.

    Clinton won Puerto Rico during the primaries and has made prominent campaign hires to appeal to Latino voters. The Trump campaign has been less successful at reaching out to Latino voters and lost Puerto Rico to Florida’s Cuban-American Sen. Marco Rubio in a landslide during the primaries.

    The post How much influence do Puerto Rican voters hold in 2016? appeared first on PBS NewsHour.

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    Nearly half of the counties in the U.S. don't have a single obstetrician/gyncologist and 56 percent are without a nurse midwife, according to the American College of Nurse-Midwives, Stateline reported. Photo by Geoff Manasse/Getty Images

    Nearly half of the counties in the U.S. don’t have a single obstetrician/gyncologist and 56 percent are without a nurse midwife, according to the American College of Nurse-Midwives, Stateline reported. Photo by Geoff Manasse/Getty Images

    Faced with a shortage of obstetricians and gynecologists and nurse midwives, several states are considering proposals that advocates say would improve health care for women.

    But with the female population of the United States and number of babies born here projected to increase sharply over the next decade and beyond, scholars and medical organizations say more dramatic changes are needed to ensure that the medical needs of American women are met.

    One possibility: easing restrictions on nurse midwives, who attend to labor and delivery and also provide routine primary and gynecological care for women of all ages. Other steps under consideration include offering financial incentives to encourage more medical professionals to specialize in maternal health care and to encourage them to locate in regions with extreme shortages, particularly in rural areas.

    “It’s very simple,” said William Rayburn, a professor of obstetrics and gynecology at the University of New Mexico who has written on maternal health issues. “Our population is continuing to grow faster than we are producing ob-gyns.”

    Nearly half the counties in the U.S. don’t have a single obstetrician/gynecologist and 56 percent are without a nurse midwife, according to the American College of Nurse-Midwives (ACNM).

    “There are women in California who have to drive hours in order to see an ob-gyn.” California Assemblywoman Autumn Burke

    “There are women in California who have to drive hours in order to see an ob-gyn,” said California Assemblywoman Autumn Burke, a Democrat.

    The workforce shortage can have dangerous consequences, and may help explain why a relatively high percentage of American women die as a result of pregnancy, said Eugene Declercq, a professor of community health sciences at Boston University who has studied the ob-gyn workforce.

    Burke is author of a bill in the California Legislature that would remove the requirement that nurse midwives practice under the supervision of doctors, a change that supporters say would boost maternal health services in underserved areas. There is a similar effort in North Carolina, and many other states have adopted those reforms over the last decade.

    As restrictions have been lifted, the numbers of nurse midwives has risen. The number of nurse midwives has grown by 30 percent since 2012, according to the Bureau of Labor Statistics. But their overall numbers remain low, with about 11,200 in the whole country. There are about 20,000 ob-gyns.

    Meanwhile, the American Congress of Obstetricians and Gynecologists (ACOG) is pushing measures in the U.S. Congress that would provide financial incentives to encourage medical school graduates to go into the field.

    But even that may not be enough. By ACOG’s estimate, the U.S. will have between 6,000 and 8,800 fewer ob-gyns than needed by the year 2020 and a shortage of possibly 22,000 by the year 2050.

    Demographic Shifts
    The number of women in the United States is expected to climb by nearly 18 percent between 2010 and 2030, and, with it, the number of births. The Centers for Disease Control and Prevention recorded 3.9 million births in 2014 and projects that number will rise steadily in the years to come, reaching about 4.2 million births a year by the year 2030.

    The number of medical school graduates going into obstetrics and gynecology residency programs has remained steady since 1980, with about 1,205 residents entering the specialty each year, according to Thomas Gellhaus, ACOG’s president.

    Most ob-gyns over age 55 are men. But women are almost equal in number in the 45-54 age group and outnumber men at the younger end of the profession. In 2013, more than four out of five first-year ob-gyns were women.

    That’s important, Gellhaus said, because female ob-gyns retire about 10 years earlier than their male counterparts and often prefer part-time schedules.

    At the same time, Gellhaus and others familiar with workforce issues say, both women and men entering the field are less inclined to make themselves available around-the-clock in the way older practitioners did.

    “The traditional model was that ob-gyns made this extraordinary commitment,” said Boston University’s Declercq. “I’ll be there for you, pre-natal, delivery and post-delivery. Women patients loved it, but today’s obs are looking for a better balance in their lives and don’t want to make that kind of sacrifice in their lives and their families’ lives.”

    “The traditional model was that ob-gyns made this extraordinary commitment. “I’ll be there for you, pre-natal, delivery and post-delivery. Women patients loved it, but today’s obs are looking for a better balance in their lives and don’t want to make that kind of sacrifice in their lives and their families’ lives.”

    Those shifting attitudes have given rise to the growing use of “laborists” — ob-gyns or nurse midwives who do nothing but attend labor and deliveries in the hospital. That model leaves ob-gyns with time to concentrate on other maternal health issues. More than 250 hospitals now have a laborist on staff.

    Another factor is the growing number of doctors entering obstetrics and gynecology who are choosing subspecialties such as gynecologic oncology, reproductive endocrinology and infertility, and female pelvic medicine and reconstructive surgery, further reducing the number available for routine maternal preventive care and normal deliveries. According to ACNM, 7 percent of ob-gyns residents entered a subspecialty in 2000. By 2012, the percentage had grown to 19.5 percent.

    To help address the shortage, ACOG and other physicians’ groups are supporting congressional proposals to increase the number of medical residencies by 15,000 positions over a five-year period, with half of those designated for medical specialties in short supply, including ob-gyns.

    The federal government spends about $15 billion a year on medical residency education, most of it by way of Medicare, the health plan for the elderly, and Medicaid, the state-federal partnership health plan for lower income Americans. It now funds about 30,000 residency positions a year.

    Another proposal backed by ACOG would have the federal government designate obstetrical shortage areas in the country as it currently does with primary care, mental health and dental services. That would make ob-gyns and nurse midwives eligible for financial help with their education debts from the National Health Service Corps.

    At least one state, Wisconsin, has begun an initiative to address the shortage. Starting next year, the University of Wisconsin School of Medicine will designate one resident in obstetrics and gynecology who will do at least a quarter of his or her training in rural areas with too few maternal health providers.

    “The goal is to give them experience in these underserved areas because residents who train in certain settings are likely to locate their practices in similar settings,” said Ellen Hartenbach, an ob-gyn professor and residency program director at the Wisconsin medical school.

    The program is the first to train ob-gyns in underserved areas, she said, and it has already attracted interest from medical schools elsewhere in the country.

    Bigger Role for Midwives?
    Nurse midwives see themselves as part of the solution to the shortage of maternal health services, but they face some legislative hurdles if they are going to play a greater role.

    Nurse midwives are registered nurses who also complete an accredited graduate school course of study in midwifery. Licensed (or its equivalent) in all 50 states, nurse midwives are trained in all areas of maternal health, usually can prescribe and administer medications, and they deliver babies, almost exclusively in hospitals or birthing centers. (Another class of midwives, called “certified professional midwives,” perform home births in the U.S., but they are licensed or statutorily authorized in only 29 states.)

    In half the states, nurse midwives are permitted to practice independently.

    But 25 states require them to practice under the supervision of a doctor or in collaborative arrangements with doctors. But the ACNM and its state affiliates have complained for years that many doctors are unwilling to take on midwives, denying women access to these maternal health care providers.

    While ACOG opposes the restrictions on nurse midwives, other physician organizations, including the American Medical Association and many of its state affiliates, have continued to insist that doctor supervision of nurse midwives is essential to patient health.

    In North Carolina, where 31 of 100 counties do not have an ob-gyn, nurse midwives must have signed supervisory agreements with a doctor in order to practice. Nurse midwives are fighting a legislative battle to remove the restrictions.

    Suzanne Wertman, president of the state chapter of the ACNM, said few doctors are willing to enter into such arrangements because they regard the nurse midwives as competition or can’t afford the steep increases in their medical malpractice premiums such agreements would require.

    John Thorp, Jr., a professor of obstetrics and gynecology at the University of North Carolina, agreed that malpractice concerns discourage doctors from entering into those supervisory agreements with nurse midwives.

    The ACNM says state Medicaid programs should pay nurse midwives at the same rate they pay doctors for performing the same services, and states should require hospitals to offer nurse midwives the same clinical and staff privileges, including hospital admitting privileges that they extend to physicians.

    There is precedent for nurse midwives to play a larger role. In the U.S., physicians deliver 90 percent of the babies. But in other countries, midwives attend the majority of births. In England, for example, over half of deliveries are performed by midwives while ob-gyns concentrate on patients with higher risk pregnancies.

    “That model has proven to work,” Declercq said, “and it just makes sense.”

    The post How are states meeting health care shortages for pregnant women? appeared first on PBS NewsHour.

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    Medical marijuana is displayed in Los Angeles, California, U.S. August 6, 2007.  REUTERS/Mario Anzuoni/File Photo

    Medical marijuana is displayed in Los Angeles, California, U.S. August 6, 2007. REUTERS/Mario Anzuoni/File Photo

    Medical marijuana has been legal in Maine for almost 20 years. But Farmington physician Jean Antonucci says she continues to feel unprepared when counseling sick patients about whether the drug could benefit them.

    Will it help my glaucoma? Or my chronic pain? My chemotherapy’s making me nauseous, and nothing’s helped. Is cannabis the solution? Patients hope Antonucci, 62, can answer those questions. But she said she is still “completely in the dark.”

    Antonucci doesn’t know whether marijuana is the right way to treat an ailment, what amount is an appropriate dose, or whether a patient should smoke it, eat it, rub it through an oil or vaporize it. Like most doctors, she was never trained to have these discussions. And, because the topic still is not usually covered in medical school, seasoned doctors, as well as younger ones, often consider themselves ill-equipped.

    Even though she tries to keep up with the scientific literature, Antonucci said, “it’s very difficult to support patients but not know what you’re saying.”

    As the number of states allowing medical marijuana grows — the total has reached 25 plus the District of Columbia — some are working to address this knowledge gap with physician training programs. States are beginning to require doctors to take continuing medical education courses that detail how marijuana interacts with the nervous system and other medications, as well as its side effects.

    Though laws vary, they have common themes. They usually set up a process by which states establish marijuana dispensaries, where patients with qualifying medical conditions can obtain the drug. The conditions are specified on a state-approved list. And the role of doctors is often to certify that patients have one of those ailments. But many say that, without knowing cannabis’ health effects, even writing a certification makes them uncomfortable.

    “We just don’t know what we don’t know. And that’s a concern.” Wanda Filer, American Academy of Family Physicians

    “We just don’t know what we don’t know. And that’s a concern,” said Wanda Filer, president of the American Academy of Family Physicians and a practicing doctor in Pennsylvania.

    This medical uncertainty is complicated by confusion over how to navigate often contradictory laws. While states generally involve physicians in the process by which patients obtain marijuana, national drug policies have traditionally had a chilling effect on these conversations.

    The Federation of State Medical Boards has tried to add clarity. In an Aug. 9 JAMA editorial, leaders noted that federal law technically prohibits prescribing marijuana, and tasks states that allow it for medical use to “implement strong and effective … enforcement systems to address any threat those laws could pose to public safety, public health, and other interests.” If state regulation is deemed insufficient, the federal government can step in.

    That’s why many doctors say they feel caught in the middle, not completely sure of where the line is now drawn between legal medical practice and what could get them in trouble.

    In New York, which legalized marijuana for medicinal purposes in 2014, the state health department rolled out a certification program last October. (The state’s medical marijuana program itself launched in January 2016.) The course, which lasts about four hours and costs $249, is part of a larger physician registration process. So far, the state estimates 656 physicians have completed the required steps. Other states have contacted New York’s Department of Health to learn how the training works.

    Pennsylvania and Ohio are also developing similar programs. Meanwhile in Massachusetts, doctors who wish to participate in the state medical marijuana program are required to take courses approved by the American Medical Association. Maryland doesn’t require training but encourages it through its Medical Cannabis Commission website, a policy also followed in some other states.

    Physicians appear to welcome such direction. A 2013 study in Colorado, for instance, found more than 80 percent of family doctors thought physicians needed medical training before recommending marijuana.

    But some advocates worry that doctors may find these requirements onerous and opt out, which would in turn thwart patients’ access to the now-legal therapy, said Ellen Smith, a board member of the U.S. Pain Foundation, which favors expanded access to medical cannabis.

    Education is essential, given the complexity of how marijuana interacts with the body and how little physicians know, said Stephen Corn, an associate professor of anesthesiology, perioperative and pain medicine at Harvard Medical School. Corn also co-founded The Answer Page, a medical information website that provides educational content to the New York program, as well as a similar Florida initiative. The company, one of a few groups to offer teachings on medical marijuana, is also bidding to supply information for the Pennsylvania program, Corn said.

    “You need a multi-hour course to learn where the medical cannabis works within the body,” Corn said. “As a patient, would you want a doctor blindly recommending something without knowing how it’s going to interact with your other medications? What to expect from it? What not to expect?”

    But many say the science is too weak to answer these questions.

    One reason: the federal Drug Enforcement Agency classifies marijuana as a schedule I drug, the same level as heroin. This classification makes it more difficult for researchers to gain access to the drug and to gain approval for human subjects to participate in studies. The White House rejected a petition this past week to reclassify the drug in a less strict category, though federal authorities say they will start letting more facilities grow marijuana for the purpose of research. (Currently, only the University of Mississippi can produce it, which advocates say limits study.)

    From a medical standpoint, the lack of information is troubling, Filer said.

    “Typically, when we’re going to prescribe something, you’ve got data that shows safety and efficacy,” she said. With marijuana, the body of research doesn’t match what many doctors are used to for prescription drugs.

    Still, Corn said, doctors appear pleased with the state training sessions. More than 80 percent of New York doctors who have taken his course said they changed their practice in response to what they learned.

    But even now, whenever Corn speaks with doctors about medical marijuana, people ask him how they can learn more about the drug’s medical properties and about legal risks. Those two concerns, he said, likely reduce the number of doctors comfortable with and willing to discuss marijuana’s place in medicine, even if it’s allowed in their states.

    Though others say this circumstance is starting to ease, doctors like Jean Antonucci in Maine continue to struggle to figure out how marijuana can fit into safe and compassionate medicine. “You just try and be careful — and learn as much as you can about a patient, and try to do no harm,” she said.

    The post Why some doctors feel ‘completely in the dark’ about medical marijuana appeared first on PBS NewsHour.

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    Republican presidential nominee Donald Trump speaks to the Trask Coliseum at University of North Carolina in Wilmington, North Carolina. Photo by Eric Thayer/Reuters

    Republican presidential nominee Donald Trump speaks to the Trask Coliseum at University of North Carolina in Wilmington, North Carolina. Photo by Eric Thayer/Reuters

    Donald Trump will declare an end to nation building if elected president, replacing it with what aides described as “foreign policy realism” focused on destroying the Islamic State group and other extremist organizations.

    In a speech Monday in Ohio, Trump will argue that the United States needs to work with anyone who shares that mission, regardless of other ideological and strategic disagreements. Any country that wants to work with the U.S. to defeat “radical Islamic terrorism” will be a U.S. ally, he is expected to say.

    “Mr. Trump’s speech will explain that while we can’t choose our friends, we must always recognize our enemies,” Trump senior policy adviser Stephen Miller said Sunday.

    On the eve of the speech, the Clinton campaign slammed Trump’s campaign manager for ties to Russia and pro-Kremlin interests, an apparent reference to a New York Times story published Sunday night. The story alleges Paul Manafort received $12.7 million from Ukraine’s former pro-Russia president and his political party for consultant work over a five-year period. The newspaper says Manafort’s lawyer denied his client received any such payments.

    Trump on Monday is also expected to outline a new immigration policy proposal under which the U.S. would stop issuing visas in any case where it cannot perform adequate screenings.

    It will be the latest version of a policy that began with Trump’s unprecedented call to temporarily bar foreign Muslims from entering the country — a religious test that was criticized across party lines as un-American. Following a massacre at a gay nightclub in Orlando, Florida, in June, Trump introduced a new standard.

    “As he laid out in his Orlando remarks, Mr. Trump will describe the need to temporarily suspend visa issuances to geographic regions with a history of exporting terrorism and where adequate checks and background vetting cannot occur,” Miller said.

    Trump is also expected to propose creating a new, ideological test for admission to the country that would assess an applicant’s stances on issues like religious freedom, gender equality and gay rights. Through questionnaires, searching social media, interviewing friends and family or other means, applicants would be vetted to see whether they support American values like tolerance and pluralism.

    The candidate is also expected to call in the speech for declaring in explicit terms that, like during the Cold War, the nation is in an ideological conflict with radical Islam.

    Trump’s Democratic rival Hillary Clinton and top U.S. government officials have warned of the dangers of using that kind of language to describe the conflict, arguing that it plays into militants’ hands.

    While Trump has been criticized in the past for failing to lay out specific policy solutions, aides say that Monday’s speech will again focus on his broader vision. Additional speeches with more details are expected in the weeks ahead, they said.

    Trump is also expected to spend significant time going after President Barack Obama and Clinton, the former secretary of state, blaming them for enacting policies he argues allowed the Islamic State group to spread. Obama has made ending nation building a central part of his foreign policy argument for years.

    “Mr. Trump will outline his vision for defeating radical Islamic terrorism, and explain how the policies of Obama-Clinton are responsible for the rise of ISIS and the spread of barbarism that has taken the lives of so many,” Miller said Sunday in an email, using an alternative acronym for the Islamic State group.

    The speech comes as Trump has struggled to stay on message. Last week, an economic policy speech he delivered calling for lower corporate taxes and rolling back federal regulations was overshadowed by a series of provocative statements, including falsely declaring that Obama was the “founder” of the Islamic State group.

    Trump’s allies said Sunday they’re confident that this time, the billionaire developer will stay on track.

    “Stay tuned, it’s very early in this campaign. This coming Monday, you’re going to see a vision for confronting radical Islamic terrorism,” his vice presidential running mate, Mike Pence, said on Fox News Sunday.

    “If the disgusting and corrupt media covered me honestly and didn’t put false meaning into the words I say, I would be beating Hillary by 20 percent.” — Donald Trump

    Trump and his top advisers, meanwhile, have blamed the media for failing to focus on his proposals.

    “If the disgusting and corrupt media covered me honestly and didn’t put false meaning into the words I say, I would be beating Hillary by 20 percent,” he tweeted Sunday.

    The post Trump to declare end to nation building, if elected president appeared first on PBS NewsHour.

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    Republican U.S. presidential nominee Donald Trump speaks at Youngstown State University in Youngstown, Ohio August 15, 2016. REUTERS/Eric Thayer - RTX2L10D

    Republican U.S. presidential nominee Donald Trump speaks at Youngstown State University in Youngstown, Ohio on Aug. 15, 2016. Photo by Eric Thayer/Reuters

    WASHINGTON — Donald Trump on Monday painted the Middle East as an oasis of stability before Hillary Clinton’s tenure as secretary of state, arguing that she and President Barack Obama “launched” the Islamic State group onto the world.

    In trying to outline how he would defeat the threat, Trump himself launched several other false claims.

    He said Clinton and Obama sought to install a democracy in Libya and pushed for immediate change in leadership in Syria, accusing the pair of embarking on a “nation-building” strategy that few Republicans would ascribe to Obama’s intervention-averse administration.

    READ MORE: Trump to declare end to nation building, if elected president

    In contrast, he advocated his own vision for U.S. foreign policy that included the suggestion of a U.S. takeover of Iraq’s oil reserves.

    A look at some of Trump’s comments and how they adhered to the facts:

    TRUMP: “President Obama and Hillary Clinton should have never attempted to build a democracy in Libya, to push for immediate regime change in Syria or to support the overthrow of Mubarak in Egypt.”

    THE FACTS: Trump seems to be confusing Obama and Clinton’s limited interventions, and sometimes non-interventions, with President George W. Bush’s post-9/11 regime-change efforts.

    When the U.S. led a coalition to bomb Libya in March 2011, it was sold as a humanitarian intervention. Obama vowed not to deploy U.S. troops on the ground and focused primarily on protecting Libyan civilians from dictator Moammar Gadhafi’s military forces. He didn’t promise a stable democracy there, like Bush did.

    Five months into Syria’s conflict, Obama urged President Bashar Assad to step aside. But Obama did very little to realize such a result, to the great dismay of his GOP critics and even some in his own administration.

    To this day, the United States maintains its call for a Syria without Assad, even as it works with the Syrian leader’s closest partners to try to engineer a unity government that would keep Assad in power, perhaps indefinitely.

    While Trump is right that Libya, Syria and Egypt appeared more stable seven years ago, his analysis leaves out the simmering resentment for autocratic governments that would bubble over during the 2011 Arab Spring. That cannot be ascribed to Obama and Clinton.

    TRUMP on Clinton’s role in the Libya campaign: “With one episode of bad judgment after another, Hillary Clinton’s policies launched ISIS onto the world stage.”

    THE FACTS: The U.S.-led military campaign in Libya created a security vacuum and political chaos. But it took three years before IS emerged in Iraq and Syria, and there is no connection between those developments.

    The group has its roots in a militant organization known as al-Qaida in Iraq, which found haven in Syria after being nearly decimated in Iraq in 2007-2009.

    Some experts say the instability in Libya opened a door for the Islamic State to spread to North Africa, particularly after it suffered heavy losses in Syria and Iraq in 2015-16. But the group is facing severe setbacks there, too.

    TRUMP on the Iraq war: “I have been clear for a long time that we should not have gone in. But I have been just as clear in saying what a catastrophic mistake Hillary Clinton and President Obama made with the reckless way in which they pulled out.”

    THE FACTS: Trump did publicly say he wanted U.S. troops out years earlier than Obama pulled them out.

    He said in March 2007 the U.S. should declare victory and withdraw troops because Iraq was going to get further bogged down in civil strife.

    He said the U.S. was “keeping a lid” on the situation by being there, but that when the U.S. leaves, “it’s all going to blow up” so the U.S. might as well leave “because you just are wasting time.”

    TRUMP: “I have long said that we should have kept the oil in Iraq … In the old days, when we won a war, to the victor belonged the spoils.”

    THE FACTS: While Trump argues against nation-building, he seems to be suggesting the U.S. should have seized Iraq and its natural resources as an American colony. He ignores the fact that Iraq is a sovereign country and the U.S. at no point threatened to take possession of the country.

    Trump says he would have used the money from oil sales to pay for the care of wounded soldiers. But the mission would require a permanent occupation, or at least until the oil runs out, and a large presence of American soldiers to guard sometimes isolated oil fields and infrastructure.

    Trump’s claim that the U.S. has taken “spoils” in previous wars also raises questions.

    After major wars, the 240-year-old United States has tended to pour money and aid back into countries it has fought to help re-establish governments and services.

    The U.S. still has troops in Germany and Japan, with the permission of those nations, but it did not take possession of their oil or other natural resources.

    To achieve Trump’s stated goal of destroying Islamic State militants’ revenue stream, the U.S. has bombed oil facilities in Iraq. The bombing was designed to render the oil facilities inoperable, but not destroy them, with the notion that Iraq could rebuild its own economy with their oil when the conflict ended.

    TRUMP: “Anyone who cannot name our enemy is not fit to lead our country. Anyone who cannot condemn the hatred, oppression and violence of radical Islam lacks the moral clarity to serve as our president.”

    THE FACTS: Obama doesn’t use the phrase “radical Islamic terrorism,” but he condemns the group harshly and regularly. He has characterized IS fighters as “thugs,” ”thieves” and terrorists.

    Obama says he doesn’t want to connect the group to the religion of Islam. Doing so, he says, would unnecessarily anger Arab allies fighting the group, alienate Muslims at home and validate the claims of the enemy. “ISIL is not ‘Islamic.’ he has said, using his preferred acronym for the group.

    Trump’s actual opponent in the presidential race, Clinton, is more comfortable with such terminology.

    She has used the terms “radical jihadism” and “radical Islamism.”

    TRUMP: The Islamic State “has a new base of operations” in Libya.

    THE FACTS: Islamic State militants have tried to establish such a base in the city of Sirte. But a U.S.-supported military offensive in Libya this year has all but driven the group out of its former headquarters there.

    U.S. officials estimated at one point as many as 6,000 extremists in the North African country. Latest estimates put only a “couple hundred” IS militants left in Sirte. Libyan officials say the city is 70 percent liberated and IS militants are cornered in a few locations.

    TRUMP on Iran: “The world’s largest state sponsor of terrorism is now flush with $150 billion in cash released by the United States.”

    THE FACTS: Trump got closer to the truth by holding back from his oft-repeated claim that the U.S. “gave” Iran the money. He still doesn’t get it right.

    When Iran lived up to its part of the nuclear deal in January, it regained access to some $100 billion in Iranian assets that were frozen in overseas banks. And as one of seven parties to the agreement, the United States scrapped sanctions to allow that to happen.

    But Iran is hardly flush with cash.

    Much of the money has gone to paying off debts accrued while suffering from U.S. and global economic restrictions. Tens of billions more are going into infrastructure projects. And Iran has kept much of the remaining money overseas to avoid inflationary pressures on its economy.

    U.S. officials say Iran has brought home less than $20 billion.

    The post AP fact check: Donald Trump on U.S. intervention in the Middle East appeared first on PBS NewsHour.

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    JUDY WOODRUFF: A photography museum is reopening in a sleek new home in New York City, with an exhibition to make you think twice about all the cameras that surround us.

    Jeffrey Brown has the story.

    JEFFREY BROWN: A stark message stops visitors in their tracks at the threshold of the International Center of Photography’s new home: “By entering this area, you consent to being photographed, filmed and/or otherwise recorded, and surrender the right to the use of such material throughout the universe in perpetuity.”

    And that’s what the museum’s first exhibition in its brand-new space in Lower Manhattan explores, the changing role of privacy in a world inundated with surveillance and oversharing.

    PAULINE VERMARE, Associate Curator, “Public, Private, Secret”: What is your secret life? How can you keep it secret? I think that’s one of the keys of this exhibition is really that, keeping your privacy, but also making sure that your secret life remains your secret life.

    JEFFREY BROWN: Pauline Vermare is the associate curator of Public, Private, Secret, a mix of visual media, modern and historical.

    There’s this 1946 Yale Joel photograph of a couple through a two-way mirror for a series in “LIFE” magazine, and more contemporary surveillance art by Jill Magid, who captured herself on surveillance cameras, and Merry Alpern, who secretly shot through the bathroom window of a seedy sex club for her “Dirty Windows” series.

    The museum itself has come a long way from its 1974 beginnings in a Manhattan mansion under the direction of famed Hungarian photographer Cornell Capa.

    Since then, the world of photography has changed.

    MARK LUBELL, Executive Director, International Center of Photography: It is the most Democratic format. It is in the hands of all of us. We all are now visually communicating.

    JEFFREY BROWN: Mark Lubell is the current director of the museum, known as the ICP. He’s overseen an institutional shift, from photojournalism and art photography to an embrace of today’s digital media landscape, where cell phone cameras are ubiquitous.

    MARK LUBELL: The big difference is, it used to be a few people taking images that went out to millions. And now it’s millions and millions of people going out to millions and millions of people. I think that’s a seismic shift in the medium, and it’s something that we should be looking at and exploring.

    JEFFREY BROWN: In the inaugural exhibition, that means a sometimes jarring juxtaposition of images.

    PAULINE VERMARE: We start with historical precedents, and everything is thrown together. It’s not like there’s a hierarchy. Everything is at the same level.

    JEFFREY BROWN: A lineup of mid-20th century mug shots taken by unknown photographers sits just beneath portraits of four Muslim women, prisoners in a concentration camp during the Algerian War. They were forced to pose without their veils.

    In our own time, people expose themselves.

    WOMAN: I’m not gay.

    MAN: I am gay.

    WOMAN: I am so gay.

    JEFFREY BROWN: Offering up private thoughts online, in the form of video diaries available to anyone. Artist Natalie Bookchin sifted through hundreds of those and created an installation titled “Testament.”

    NATALIE BOOKCHIN, Artist, “Testament”: I’m choreographing these moments and organizing them to try to make some sense out of them.

    I think that there’s a sense, first of all, that this stuff is junk, right, that it’s throwaway, that we shouldn’t watch it, that it’s all just narcissistic, and that it’s kids that are doing silly things with their phone.

    And what I’m trying to show in this work, that it’s not just kids, that it’s like — it’s sort of people. You know, people are doing this, old people, young people, men, women.

    JEFFREY BROWN: We see and hear some subjects alone, others in a kind of chorus focused on a particular theme. One of her pieces examined people who had lost their jobs in the recession.

    NATALIE BOOKCHIN: I wanted in the work to both show the way that sort of people were alone, in some way trying to engage in a political discussion or a social discussion, something that just happened that’s really bad, because the economy is crashing and people are losing their jobs.

    But then, at the same time, people are isolated and alone, and they’re speaking to themselves.

    JEFFREY BROWN: The culture of celebrity is also on display in many different forms.

    Patrick McMullan’s Facebook collage from this year’s New York Fashion Week. A series of Andy Warhol Polaroids framed on mirrors, so you’re part of the subject’s 15 minutes of fame too.

    And then there’s the placement of this untitled self-portrait by famed art photographer Cindy Sherman.

    This is art. She’s shown in every museum in the world.


    JEFFREY BROWN: And then you have Kim Kardashian selfies, a book about selfies. Somehow, they belong together, you’re saying, in our world?

    PAULINE VERMARE: Well, specifically, this image, in fact, by Cindy Sherman, because she’s pretending to be a star, you know, hunted by the paparazzo, this is what we’re talking about, that tension and the resistance.

    And this is — our show — this show is generally about the resistance, or the opposite of resistance, which is what Kim Kardashian does.

    JEFFREY BROWN: Which is, take my picture.

    PAULINE VERMARE: Just take it, and here it is for you.

    JEFFREY BROWN: The museum also wants us to question the very definition of photography and who’s a photographer.

    MARK LUBELL: What I do on my phone is not photography. I am creating images.

    JEFFREY BROWN: We’re not taking photos on our phones? What are we doing?

    MARK LUBELL: Well, we’re communicating. We’re communicating. But we’re communicating using the image.

    I want to look at where society is today. The thematic of sort of understanding the world that we are today, and looking at it, and examining it, and debating it is central to ICP’s DNA. And I think that’s why the show makes a lot of sense.

    JEFFREY BROWN: The exhibition Public, Private, Secret is on view through early January 2017.

    From New York, I’m Jeffrey Brown for the “PBS NewsHour.”

    The post How one exhibit is rethinking privacy in a world that’s always watching appeared first on PBS NewsHour.

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    JUDY WOODRUFF: And now a look at the current state of security inside the U.S.

    As we approach the 15th anniversary of 9/11, journalist Steven Brill spent the past year looking into how the country has changed since that terrible day, what’s been spent and what gaps still exist. His article, “Are We Any Safer?”, appears in the latest issue of “The Atlantic.”

    And I recently sat down with him and asked him what he learned.

    STEVEN BRILL, Contributor, The Atlantic: In a nutshell, what I concluded was, the way we have responded to the terrorist attacks, to 9/11, which, you know, changed everything, is sort of a microcosm of what we are as a country today.

    A lot of it was heroic, ingenious, people going beyond the cause of duty, doing really great things. And then a lot of it was actually quite the opposite, a lot of Beltway boondoggles, billions of dollars wasted because government contractors promised technology and solutions that they couldn’t produce.

    And we have struggled as a country with dealing with the notion of this new kind of risk. The idea, as President Bush explained, after 9/11, of never again, we’re never going to have a terrorist attack again, that’s just unrealistic in today’s world.

    JUDY WOODRUFF: You clearly give the government — and it spans several administrations, two administrations — credit for getting some things right, as you just said, but…

    STEVEN BRILL: A lot of things right, and a lot of unsung people, tens of thousands of people going to work every day at the Department of Homeland Security, the FBI, places like TSA, the Border Patrol, really obsessed with the job of keeping us safe.

    And the only time we notice them is when something goes wrong. And that makes it a tough job. On the other hand, a lot of it went back to politics as usual. Every small town that you can think of made a request for government grants for homeland security, for everything ranging from routine fire trucks to fish tanks in a police station.

    So, there are a lot of abuses.

    JUDY WOODRUFF: I was struck because, early on in the piece, you say, yes, we are safer than we were on 9/11, safer against the kind of threat we faced on 9/11.

    STEVEN BRILL: Right.

    JUDY WOODRUFF: But the threat has changed.

    STEVEN BRILL: Right.

    JUDY WOODRUFF: And that’s what the government is — all of us are grappling with right now.

    STEVEN BRILL: We have done a lot to batten down the hatches, to make us safer, at the airports, at the ports, all over the place.

    But the threats have multiplied, the threats around the world. Our defenses are much stronger. The offense has multiplied and is much stronger. And it’s more difficult because, unlike the kind of coordinated, orchestrated attack that we faced on 9/11, where people were communicating, money was exchanging hands, that kind of stuff which we can now track, if some lone wolf in his basement is online…


    STEVEN BRILL: and he can go into a gun store in this country and buy an assault weapon, and he shoots up a shopping mall and yells out, you know, something in Arabic, that makes him a terrorist, and it scares us mightily.

    And that’s not something we can really prevent, other than doing something about assault weapons.

    JUDY WOODRUFF: So, how — that’s what interested me so much in this piece was you look at one thing after another that the government did, some of it successfully.

    But, still, you have this undefined threat out there, some of which, as you say, it’s a lone wolf. It’s somebody who may be just mentally unstable who decides to adopt the terrorism…


    STEVEN BRILL: Exactly.

    And there are some non-lone wolf threats, some kind of more orchestrated threats, that were in the headlines right after 9/11 that basically fell out of the headlines, and therefore fell off our radar, and, frankly, that the government hasn’t paid enough attention to.

    The best example is the bioterror attack.

    JUDY WOODRUFF: Bioterrorism.

    STEVEN BRILL: Right after 9/11, with the anthrax attacks, that’s all we thought of.

    The technology that we tried to develop 15 years ago still hasn’t been developed that would warn us in the right way of a bio attack. We have not done enough to protect ourselves from dirty bombs. You can still go to hospitals and other industrial sites all over this country, and maybe have to break a tiny little padlock, if that, to get ahold of radiological material that you can mix with an easily available explosive and create a dirty bomb.

    JUDY WOODRUFF: But why hasn’t something like that been addressed?

    STEVEN BRILL: Because we tend to go after yesterday’s headline. Our attention shifts. And we don’t — when you say that everything’s a priority, if you have 10 or 12 high priorities, none of them becomes a priority, except if it’s in the news, if it’s in the headlines, if it’s part of a congressional hearing, maybe.

    So, we haven’t done the job we need to do of really assessing all the threats rationally and having a discussion with the American people that says, we can’t deal with everything, we have to have priorities, and some things are going to slip through the cracks, and, by the way, there are going to be terrorist attacks, not of the kind we had on 9/11.

    People are never going to be able to hijack a plane because of the TSA, because we have fortified cockpit doors in airlines. We have done a lot of things to deal with that, but we haven’t done much to deal with trains or ferry boats, for example.

    JUDY WOODRUFF: Because of our political system, as you say, it’s hard for our leaders to — political leaders to say candidly to the American people that there will always be a threat out there, that you cannot completely…

    STEVEN BRILL: President Obama has tried to do that. And every time he’s even in a subtle way tried to do that, where he has said — and, indeed, his Department of Homeland Security has implemented really important mitigation measures, really important, you know, recovery measures if there’s an attack.

    There was a drill in Boston just a few months before the bombing there. And when they did a report about that drill and how that had really helped to save lives after the marathon bombing, he was attacked by Senator Coburn for putting too much emphasis on mitigation, and not enough on prevention.

    Now, that, to me, is the equivalent of saying, why do you have ambulances on call? Why don’t you do something about crime and traffic safety?

    Well, you try to prevent crime and you try to prevent car accidents, but you have emergency rooms, you have ambulances. You acknowledge the fact that you’re not going to prevent all traffic accidents.

    We are not going to prevent all terrorism, especially if you define it as someone being able to get an assault weapon, which you can do in this country, and claim to be loyal to ISIS or some organization like that.

    JUDY WOODRUFF: What would you say to the next leader of this country, the next president about what most needs to be done to make this country…


    STEVEN BRILL: Well, the first thing that needs not to be done is to declare war on Muslims or Islam, because that’s exactly what those terrorists want.

    They want this to be the apocalyptic, end-of-all-worlds war between them and us. And President Bush didn’t take the bait, and President Obama has resisted taking that bait.

    Donald Trump campaigns on that. And it almost makes you think — in fact, it makes me think that ISIS would love to have someone like Trump be president, because they would get the fulfillment of their dream, which is to have the great confrontation with Western civilization.

    The second thing is to keep educating the country. While doing everything we can to prevent terrorism, keep educating the country to the reality that there are going to be some attacks, and that doesn’t mean it’s the apocalypse. It doesn’t mean we’re weak.

    Saying there are going to be attacks doesn’t mean you’re throwing in the towel, but it means we have to be realistic.

    JUDY WOODRUFF: Well, it’s certainly a provocative piece. It’s one that reminds us of how complex the challenges are, and they don’t get any simpler as time goes by.

    STEVEN BRILL: Thanks.

    JUDY WOODRUFF: Steven Brill. Are we any safer than we were on 9/11?

    Thank you very much.

    STEVEN BRILL: You’re welcome.

    The post 15 years after 9/11, national security is stronger — but so are the threats appeared first on PBS NewsHour.

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    JUDY WOODRUFF: But, first: The years-long fight to control Syria’s largest city, Aleppo, grinds on, with civilians stuck between rebel and government forces.

    Last week, more than two dozen Syrian physicians there wrote a letter to President Obama urging him to take action to end the carnage. Only 35 physicians remain to serve more than 300,000 people. They wrote, in part, because they themselves are under attack, the people whose mission it is to help the civilians caught in the crossfire. And they are hit in the places that should be safest, hospitals and other medical facilities.

    Special correspondent Marcia Biggs reports now from Southern Turkey near the Syrian border.

    And a warning: This story contains images that may upset some viewers.

    MARCIA BIGGS: It is a war crime to target medical facilities, but, in Syria, bombs rain down on hospitals, doctors and patients.

    Just in the last few weeks, pro-government forces bombed a maternity hospital in Idlib, supported by Save the Children. And airstrikes hit six hospitals around Aleppo. Nurses gathered babies from their incubators, the strike narrowly missing their ward.

    Rami Kalazi is no stranger to airstrikes like these.

    DR. RAMI KALAZI, Aleppo Neurosurgeon: I was sleeping here, and my colleague is here. And the attack happened. We came out alive. I don’t know how.

    MARCIA BIGGS: Kalazi was one of Aleppo’s last remaining doctors. We caught up with him in Turkey. He said he believes these hospitals were targeted.

    DR. RAMI KALAZI: They are the artery of life in the city. Can you imagine a life in city without hospitals? Who will treat your kids? Who will make the surgeries for the injured people? So, they are targeting these hospitals because they know, if these hospitals were completely destroyed, the life will be completely destroyed.

    MARCIA BIGGS: Eastern Aleppo had already suffered a massive blow in April, when Al Quds Hospital, supported by Doctors Without Borders, and the city’s main pediatric hospital, was destroyed by two consecutive airstrikes.

    DR. RAMI KALAZI: It was a very hard night. Every one or two hour, we had an airstrike, and we had to treat some injured people.

    MARCIA BIGGS: Soon he realized the full extent of the damage, more than 50 people dead, including six members of hospital staff.

    DR. RAMI KALAZI: They were all friends. So, it was emotionally so hard, because you are treating your friend. You know how hard is that. And you see that he is in danger, he may not live, he may not survive. It was a horrible night.

    MARCIA BIGGS: One of them, 35-year-old Waseem Maaz, seen here on that fateful night, was a beloved pediatrician, one of only two in the entire city. He was just beginning his shift. Moments later, disaster.

    What has Syria lost there?

    DR. RAMI KALAZI: Can you imagine, when you have more than 300,000 people in your city, and you have only two pediatricians, and you have lost one? Can you imagine how much the loss is big?

    MARCIA BIGGS: According to Physicians for Human Rights, there have been over 375 strikes against medical facilities and doctors in Syria since the revolution began.

    Their report stipulates that over 90 percent of those came at the hands of the Syrian regime and its allies.

    See larger version of this map here.

    WIDNEY BROWN, Director of Programs, Physicians for Human Rights: Syria had a very sophisticated health care infrastructure, hospitals that are multistoried, very well-equipped, very large, very well-marked. You don’t make a mistake of just hitting that hospital, and you certainly don’t do it multiple times. This is absolutely a deliberate strategy by the Syrian government.

    MARCIA BIGGS: Widney Brown is director of programs for the Physicians for Human Rights, which maintains that the destruction of hospitals by President Assad is being used as a weapon of war.

    WIDNEY BROWN: When you target a hospital, you don’t just destroy that brick-and-mortar structure. You destroy actually a safe place that people can go for lifesaving aid.

    When you kill a doctor, you don’t just kill that one individual. You actually kill all the people he or she would have saved.

    MARCIA BIGGS: Brown says medical professionals are specifically targeted for detention, torture, and even murder by the Syrian regime; 750 have been killed in the last five years, like 46-year-old cardiologist Hasan al-Araj, whose car was hit by an airstrike.

    WIDNEY BROWN: We believe that they are being persecuted because they can actually give eyewitness testimony about all of the crimes being committed by the Syrian government. When they say a chemical weapon was used, they are incredibly credible.

    MARCIA BIGGS: Hospitals are often hit multiple times as part of what is called a double-tap strategy. Planes will circle back after hitting a target, once first-responders have arrived on scene, as shown on this video, to target those delivering aid to the wounded.

    Despite the risks, hospitals still continue to run.

    Here, Dr. Kalazi sweeps up after one of the more than 20 strikes his hospital suffered, creating a new normal for an already ravaged community.

    DR. RAMI KALAZI: All the hospitals in Aleppo City have been bombed, all of them. There’s no exceptions.

    The first thing you will think in is looking for your colleagues. Are they still alive or dead? Will I see, for example, of an arm for my colleague or a leg, or I will see a body, or half of a body, or will I see him alive? You don’t know.

    We announce among the patients that it’s now risky to stay in the hospital, so please find safe places or go as fast as you can to your homes.

    MARCIA BIGGS: What about the critical patients?

    DR. RAMI KALAZI: They stay in the hospital. And some of them died during these attacks.

    MARCIA BIGGS: So there’s just really nowhere to go?


    MARCIA BIGGS: You would think that the hospital would be the safe place, the safe zone.

    DR. RAMI KALAZI: But, in Syria, there is nothing safe.

    MARCIA BIGGS: Kalazi told us the memory that haunts him the most is of a family of seven pulled from under the rubble.

    WIDNEY BROWN: Only one survived, only one child. He was 3 years old. I was completely freezed. I just cried. When I see a child, it’s so hard, because he’s a child. He’s innocent. He’s made nothing to be punished for.

    MARCIA BIGGS: Amidst so much despair, Dr. Kalazi’s wife gave birth to a baby boy just over a year ago.

    DR. RAMI KALAZI: We decided to have a baby, because it’s like a new hope, you know? But we decided to stay in Aleppo, because we have a mission to complete. We are physicians. We are humans. And this is our city.

    MARCIA BIGGS: A few months ago, his hospital and his home were hit on the same day. Here he is in this video with his wife and infant son surveying the damage.

    Kalazi was on R&R outside the city last month when government forces blocked the last road to Aleppo, making it not only impossible for him to return, but for the people to get desperately needed food and medical aid.

    WIDNEY BROWN: What we have in Syria are two stories. It’s quick deaths by being bombed when you’re a civilian, and it’s the slow death of starvation.

    And they are facing this as the U.N. Security Council does nothing.

    MARCIA BIGGS: Do you ever feel abandoned?

    DR. RAMI KALAZI: From the world, yes. From the international community, yes, because they can do, but they don’t want to. No one wants to help us from the governments. We don’t know why.

    MARCIA BIGGS: But halfway around the world, these American doctors do want to help.

    DR. ZAHER SAHLOUL, Critical Care Specialist, Syrian American Medical Society: So, you have doctors who send, for example, X-rays.

    MARCIA BIGGS: Drs. Zaher Sahloul and Samer Attar represent the Syrian American Medical Society, which connects doctors in the U.S. with Kalazi’s hospital and others all over Syria.

    DR. ZAHER SAHLOUL: They can move the camera from a patient to patient, and describe the patient to me. They can look at — put the camera on the monitor, so I can see the vital signs. I can communicate with the doctor also, and they will tell me what’s happening.

    So, that way, you are there, but through this very simple technology.

    DR. RAMI KALAZI: You are not alone in treating your person — your patients. And you have this emotional support.

    MARCIA BIGGS: Sahloul and Attar traveled last month to Aleppo to show solidarity with their Syrian colleagues.

    DR. SAMER ATTAR, Orthopedic Surgeon, Syrian American Medical Society: You definitely feel targeted. Everyone feels targeted. A missile lands somewhere within the vicinity of the hospital, and you feel the foundations of the hospital shake.

    There was one moment I was knocked off my feet, and your ears are ringing, but people just get back up and go back to work. They’re staying out of a sense of obligation and duty to help the helpless. They are heroically and selflessly risking their lives.

    MARCIA BIGGS: They say some hospitals have even moved their emergency rooms underground to protect the patients, who come in droves.

    DR. SAMER ATTAR: There were just so many people. It was just child after child after child after child. And you just keep saying to yourself, just, please, God, when will this trail of injured end?

    MARCIA BIGGS: Are you angry by the lack of response?

    DR. SAMER ATTAR: Well, of course you’re angry. It’s five years on, close to half-a-million killed and 12 million displaced. And those numbers are still rising. And now we have a city of 300,000 people that are being sieged and starved and bombed to death, with the international community sitting idly by.

    And you have children who are burning tires to create their own no-fly zone. That’s embarrassing. That’s shameful.

    MARCIA BIGGS: The doctors testified last week at a U.N. special session on Aleppo, where they conveyed messages from their Syrian colleagues, treating babies exposed to chlorine gas and toddlers with spines shredded decimated by shrapnel, wrapping tiny bodies in white shrouds.

    After five long years, one 21-year-old nurse knows now not to ask for too much.

    DR. SAMER ATTAR: I expected her to talk about no-fly zone, or peace, or all of these things.

    And she said: I have a patient. Her name is Shahed. She is 10 years old. Is there any way that they can intervene to evacuate the patient, so her life can be saved? Because her mom comes every day, and she tells her, and she tells her, I would like to take you home, so you can ride your bicycle.

    And this is what she wanted from the Security Council.

    MARCIA BIGGS: While the siege on Aleppo was partially broken by rebel soldiers just over a week ago, the last road in and out of the city is still far too dangerous to travel.

    So, Rami Kalazi remains on the outside looking in, desperate to get back to his beloved hometown.

    DR. RAMI KALAZI: And any time Aleppo is not besieged, I will go back to Aleppo, even for a visit. It’s my lovely place.

    MARCIA BIGGS: It’s still your lovely place.

    DR. RAMI KALAZI: Yes, it’s my lovely place, because I feel that I’m born to be here to help these people.

    MARCIA BIGGS: A place where no one is safe and saving lives can get you killed.

    For the “PBS NewsHour,” I’m Marcia Biggs in Gaziantep, southern Turkey.

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    JUDY WOODRUFF: And now for much more on the twists and turns of this presidential race, we turn to Politics Monday with Tamara Keith of NPR and Susan Page of USA Today.

    And welcome to you both.

    Tam Keith, we have been listening to this report. How significant is this?

    TAMARA KEITH, NPR: It’s unclear that this is going to dramatically change anything for the Trump campaign.

    In some ways, the idea of some connection to Russia or something has long existed, especially around Paul Manafort, who has a relatively long career of working for not just Yanukovych, but other, you would say, unsavory characters or people who have fallen out of political favor with the U.S. government over the decades.

    JUDY WOODRUFF: And, Susan Page, I mean, we heard some pretty strong language there from The New York Times reporters speaking about venal corruption. It’s not a pretty picture.

    SUSAN PAGE, USA Today: You got 84 days until the campaign, and every day you spend talking about anything except Hillary Clinton’s record or what your own vision of the country is, is a day that’s lost.

    In addition, I think this opens the doors to more queries about Donald Trump’s own financial arrangements with interests in Russia. That’s something that we have heard something about. We don’t have a lot of details. We may learn more about that in the next couple of months.

    JUDY WOODRUFF: Well, there was another newspaper today writing about Donald Trump, Tamara Keith, The Wall Street Journal editorial page.

    This is a consistently conservative newspaper, usually very strong language in support of conservative causes. Today, they laid it on the line. They said, Donald Trump, you either get your act together, in so many words, by Labor Day, which is three weeks from now, or turn it over to Mike Pence.

    TAMARA KEITH: There is a lot of frustration that is expressed in this editorial that I hear a lot talking to Republicans.

    I talked to a Republican pollster today. Now, he worked for Marco Rubio, but he told me that expecting Donald Trump to change is like marrying someone and then hoping they will change later. And, generally, he said, that doesn’t work out very well.

    I talked to another Republican today who said, well, that teleprompter speech he gave about foreign policy, that was solid.

    JUDY WOODRUFF: Which he gave today in Ohio.

    TAMARA KEITH: Exactly.

    He’s done several of these teleprompter speeches. And what this Republican said was, let’s see how long it lasts. Let’s see if he can stay on message a day, two days, seven days, two weeks.

    And this person was calling for cutting him loose, for moving millions of dollars to focus on congressional races, and not spend that money on a presidential race.

    JUDY WOODRUFF: Susan, is there particular weight, though, that this come from The Wall Street Journal editorial page?

    SUSAN PAGE: It’s one more sign of the fracturing of the traditional Republican coalition.

    It’s the media side, the editorial page side that’s been the strongest voice for Republicanism and especially conservatism in the United States. And, in addition, you see the foreign policy establishment associated with Republican presidents breaking away. You see senator after senator, a half-dozen Republican sitting senators, saying they may not vote for Donald Trump.

    This is a party that is imploding. And it’s a sign of a civil war that we’re going to see when this election is over.

    JUDY WOODRUFF: Tamara, one of the things that the Journal editorial said was, they basically called the Trump campaign incompetent. How do the experts see the campaign compared to Hillary Clinton’s effort?

    TAMARA KEITH: Well, experts I have spoken to say that this is basically campaign malpractice.

    It’s not a fully functioning campaign, like you would expect a campaign to function, like a campaign that would win would function. But Donald Trump doesn’t want that. It’s not like he necessarily can’t put it together. He doesn’t want to put it together. He over the weekend tweeted repeatedly that he’s not changing, there is no pivot.

    People just want him to change, but he’s not changing. So, in some ways, it’s kind of like, you have to listen to him. He doesn’t want to run ads. He thinks he can do free media. He’s doing — he’s running this the way he wants it.

    JUDY WOODRUFF: And, Susan, the Trump campaign, you ask them, and they say, yes, we do have an effort under way, we have a plan, we have a strategy.

    SUSAN PAGE: So, they don’t have the historic vision of a campaign that we’re all accustomed to, but I will tell you one number that I think is of great concern to Republicans. And that is, since we started with polling in 1952, the candidate who is ahead at this point two weeks after the conventions are over, has invariably won the popular vote.

    So, you’re getting to a point where the election starts to get cooked. It’s not quite baked yet, but it is like concrete getting set, getting harder and harder. And it takes — it takes more and more power to change what’s been laid as you go forward.

    This is really — even though we’re still in the summer, we’re still in August, this is a pretty critical period if you look at elections historically.

    JUDY WOODRUFF: And I do want to get to Hillary Clinton.

    But the polls, Tamara Keith, are showing that it’s not just in the battleground states where Hillary Clinton is ahead, but it’s in states that Mitt Romney and John McCain won where Donald Trump is having difficulty right now.

    TAMARA KEITH: Or where the demographics have changed a little bit since Mitt Romney and John McCain ran.

    In a state like Georgia, where it’s suddenly looking a little bit more competitive, it — I think that to say that Hillary Clinton can compete in Georgia at this point still seems like a bridge farther than a lot of people are willing to go.

    But North Carolina, for instance, is a state certainly where the Clinton campaign believes that they have a chance to win this. And if they can, that would be a huge problem for Donald Trump.

    JUDY WOODRUFF: And, Susan, just quickly, your newspaper had a poll today looking at millennials that vote, young voters under 35.

    SUSAN PAGE: And the historic weakness by Donald Trump among these younger voters.

    He’s only getting 20 percent of the vote of millennials. Now, they are the least reliable voters by age. Older people are more likely to turn out to the polls. But we have never seen a candidate in modern times have that poor a showing of millennials.

    And if that trend continues, it will be the third consecutive election where Democrats will have beaten the Republican by double digits among younger voters. And if you look at the long-term future of this party, that starts to set partisan preferences in a way that’s really dangerous for the GOP.

    JUDY WOODRUFF: So, Hillary Clinton, Tamara Keith, was out on the trail today with Vice President Biden, working-class Scranton, Pennsylvania, on a day when Donald Trump is out hammering away on national security, on ISIS.

    Is she as vulnerable as Donald Trump makes her out to be? He at one point said, she’s not capable of handling ISIS.

    TAMARA KEITH: He also implied that she may not be healthy enough to handle ISIS. There was a little bit of that in there.

    This is an area where sometimes she doesn’t talk about it with the urgency that he talks about it, and that might give him a little bit of space. But many polls are now showing that people believe Hillary Clinton does have the temperament on foreign policy in a way that some voters have concerns about Donald Trump.

    JUDY WOODRUFF: But he does come back to that language, Susan, time and again, suggesting that she just — she wouldn’t be capable, she wouldn’t be strong enough to stand up to something like ISIS.

    SUSAN PAGE: And if you want to look at the biggest problem Hillary Clinton has, it’s that this is an electorate that wants change, wants change in terms of the battle against terrorism, wants change in terms of the growing equality in the U.S. system.

    And so there is an argument to be made against Hillary Clinton, who is, as Donald Trump would say, a third term of Barack Obama. The question is, is Donald Trump the person who can prosecute the case against Hillary Clinton?

    JUDY WOODRUFF: And, Tamara, what do we think about that?

    Is — because if he does — say he gives a speech about ISIS every other day between now and the election. Can that — is that the kind of thing that can move voters?

    TAMARA KEITH: Well, I mean, he would have to do just those.

    JUDY WOODRUFF: Speeches.

    TAMARA KEITH: He would have to do just the teleprompter, and not the big raucous rallies where he gets — that, really, they fuel him and they give him a ton of energy.

    But at those raucous rallies, a more nuanced argument about whether the Iraq pullout should have happened at the pace that it did becomes Barack Obama founded ISIS, and then becomes, you know, a day of doubling down, and then a day of tweeting about sarcasm.

    JUDY WOODRUFF: And, just quickly, Susan, it’s not just that. It’s — he will keep coming back to the e-mails, the 30,000 e-mails. He brings it up every chance he gets.

    SUSAN PAGE: That’s right.

    And that is a vulnerability for Hillary Clinton. But her attack on him is that he doesn’t have the temperament or the disposition to handle the job of president. And especially when it comes to the issue of commander in chief, that is an argument that has gotten some traction with American voters.

    JUDY WOODRUFF: Susan Page, Tamara Keith, thank you both very much, 85 days to go.


    TAMARA KEITH: Countdown clock.

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    Paul Manafort, senior advisor to Republican U.S. presidential candidate Donald Trump, exits following a meeting of Donald Trump's national finance team at the Four Seasons Hotel in New York City, U.S., June 9, 2016.  REUTERS/Brendan McDermid - RTSGTBH

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    JUDY WOODRUFF: And how political unrest in Ukraine has made its way into the race for president of the United States.

    Before becoming Donald Trump’s campaign manager, Paul Manafort consulted for Viktor Yanukovych, the former Ukrainian president who fled to Russia in 2014 and later faced charges in the deaths of civilian protesters. Yanukovych’s removal exposed a political system in Kiev rife with corruption.

    Today, The New York Times reports of a — quote — “black ledger” that allegedly links Manafort to millions of dollars in secret cash payments.

    John Yang has the story.

    JOHN YANG: The papers were discovered by Ukraine’s newly formed National Anti-Corruption Bureau.

    In some 400 pages of handwritten notes, Paul Manafort’s name appears 22 times over the course of five years, totaling $12.7 million.

    The New York Times’ Moscow correspondent, Andrew Kramer, is one of the reporters who wrote the story, and he joins us now from Moscow.

    Andrew, thanks for being with us.

    Andrew, first of all, tell us exactly what it was that they found. What were these ledgers? Where was the money coming from? What were the payments for?

    ANDREW KRAMER, The New York Times: Those are all very good questions.

    Thank you.

    The ledger is called in Ukraine the black ledger, and it’s a collection of papers, perhaps 400 pages, as you mentioned, with handwritten notes describing payments from the Party of Regions, which is a pro-Russian political party that Paul Manafort worked for before becoming manager of the Republican campaign this year in the United States.

    The outlays described in this ledger included legitimate campaign expenses, such as advertising, travel for candidates, and also illegal activities under any definition, such as payments to the electoral commission of Ukraine, members of the electoral commission receiving money from this same fund.

    According to the ledger, there is also mention of Paul Manafort. So, at the same time, you have a payment for a campaign consultant, there are outlays to potentially illegal activities like bribing.

    Where the money came from, also a very good question. I spoke with a senior member of the Party of Regions who described using the system before he left the party. And he said that the money was, in part, undocumented campaign contributions to the Party of Regions and also money extorted from business owners in Ukraine by the party.

    JOHN YANG: Why is this significant? Why is the fact that Manafort’s name is on this ledger at this sum of $12.7 million, why is this significant?

    ANDREW KRAMER: Well, I think it’s significant because the Trump campaign has made Russia an issue this year.

    Mr. Trump has spoken favorably of President Vladimir Putin. There was a hack of the Democratic National Committee e-mail system, which has been blamed by the U.S. security services on Russia.

    And many members of his campaign staff have experience in this part of the world, most notably Mr. Manafort. This is why we spent time to look into Mr. Manafort’s business dealings and political activities in Ukraine over the past decade.

    JOHN YANG: And remind us of Viktor Yanukovych, the former president of Ukraine, who was one of Manafort’s clients, as well as the party. Remind us of who he is, what he did and his relationship with Vladimir Putin.

    ANDREW KRAMER: Certainly.

    Mr. Yanukovych was prime minister and then president of Ukraine with a generally pro-Russian line to his politics, although he did also negotiate with the European Union to join a trade agreement, eventually, instead of choosing that agreement, choosing the alternative trade agreement with Russia, which was the cause of a large popular uprising in Ukraine in 2014 that led to his ouster.

    Mr. Yanukovych fled to Russia, where he’s still living.

    JOHN YANG: And we should point out that Mr. Manafort said — quote — “The suggestion that I accepted cash payments is unfounded, silly and nonsensical.”

    He also included in his statement that all of his political payments are all-inclusive. They go for paying for staff, for polling, for research and advertising.

    How does that jibe — what he said in his statement, how does that jibe with what the anti-corruption unit found?

    ANDREW KRAMER: The anti-corruption found his name mentioned in this ledger, according to a statement from the Anti-Corruption Bureau.

    They could not prove that he actually received the money, because they don’t know the signatures beside these line items in the ledger. It’s conceivable that somebody else may have taken this money, for example, and deposited it into a company that sent the money to Mr. Manafort.

    This is clearly an under-the-table payment in any case. And from what I understand of his statement, he doesn’t dispute the sum involved or that he was paid for his work in Ukraine, but, rather, the nature of the payment, that it was an under-the-table payment.

    JOHN YANG: And your story also talked about some of the other business dealings that Paul Manafort had in Ukraine and their connections with people connected to Yanukovych.

    ANDREW KRAMER: That’s right.

    Sometimes, it’s said you can do good while doing well. And while he was doing what was said to be a good deed of promoting democracy in Ukraine, he was also doing well.

    The — there — several opportunities open for lucrative side deals during his period in Ukraine. We examined one of them in particular involving the purchase of a cable television station in Southern Ukraine, in Odessa, that was orchestrated through a series of offshore shell companies.

    These same companies were used by members of the inner circle of the Yanukovych government to launder money obtained through corrupt means from Ukraine. The indication is that Mr. Manafort was doing business with or intended to do business with this venal and corrupt group of people who led that country for about a decade.

    JOHN YANG: Andrew Kramer of The New York Times, thanks for joining us to talk about your reporting.

    ANDREW KRAMER: Thank you very much.

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    Police advance toward protesters during disturbances following the police shooting of a man in Milwaukee, Wisconsin, U.S. August 14, 2016. REUTERS/Aaron P. Bernstein   - RTX2KVTN

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    JUDY WOODRUFF: In the day’s other news: An 18-year-old was shot and seriously injured after a second night of protests in a Milwaukee neighborhood. It followed the fatal police shooting of Sylville Smith, a black man authorities say was carrying a stolen handgun.

    Dozens of officers clashed with protesters overnight, and four sheriff’s deputies were wounded. Milwaukee’s mayor blamed outsiders for the unrest, and called for calm.

    MAYOR TOM BARRETT, Milwaukee: We have issues in this city. We know there are issues. There’s too much poverty, there are housing issues, there are public safety issues, there are education issues. None of those issues get addressed if your intent is to inflict property or personal damage in this great neighborhood.

    JUDY WOODRUFF: No major property damage was reported last night, unlike the previous night, when six businesses were torched.

    Officials also said they will now strictly enforce the city’s 10:00 p.m. curfew for teenagers. In Nepal, 33 people are dead after their bus plunged off a mountain road, careening almost a hundred feet down a hillside.

    The bus had departed from Kathmandu, and crashed about 50 miles east of the capital city. At least 28 more people were injured, some critically. Victims were airlifted back to hospitals in Kathmandu.

    An airstrike sent a Doctors Without Borders hospital in Northern Yemen today — the exact death toll wasn’t immediately clear, but Yemeni officials said there were some 20 casualties among hospital patients and staff. A Saudi Arabian-led coalition has been bombing rebel targets in the country for more than a year.

    Back in the U.S., a wildfire spanning more than six square miles is burning out of control north of San Francisco. More than 4,000 people in and around the rural town of Lower Lake have been forced to evacuate. The fire first broke out Saturday, and has since destroyed at least 175 structures. It’s one of 11 major fires burning across California right now.

    Major hotel chains in 10 states and the District of Columbia have been hit by hackers. Malware was installed on the payment processing systems of 20 different Hyatt, Sheraton, Marriott, and Westin properties as far back as March of 2015. The company that manages the hotels insists the security breach has been contained. There’s no immediate word how many customers were affected.

    A banner day on Wall Street: All three major stock indexes closed at record highs, driven in part by gains in the chemical and the mining sectors. The Dow Jones industrial average climbed more than 59 points to close at 18636. The Nasdaq rose 29 points, and the S&P 500 added six.

    And at the Summer Olympic Games, U.S. gymnast Laurie Hernandez won silver in the balance beam finals. Her teammate Simone Biles added a bronze medal to her collection of golds, after a rare stumble on the beam.

    Meanwhile, on the track, Emma Coburn became the first American woman to ever medal in the 3,000-meter steeplechase, taking the bronze.

    Still to come on the “NewsHour”: new revelations tying Donald Trump’s campaign chair to Ukraine’s pro-Russian party; on Politics Monday, Hillary Clinton’s edge in key swing states; doctors desperately trying to save lives amid Syrian airstrikes; and much more.

    And how political unrest in Ukraine has made its way into the race for president of the United States.

    Before becoming Donald Trump’s campaign manager, Paul Manafort consulted for Viktor Yanukovych, the former Ukrainian president who fled to Russia in 2014 and later faced charges in the deaths of civilian protesters. Yanukovych’s removal exposed a political system in Kiev rife with corruption.

    Today, The New York Times reports of a — quote — “black ledger” that allegedly links Manafort to millions of dollars in secret cash payments.

    John Yang has the story.

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    Republican U.S. presidential nominee Donald Trump speaks at Youngstown State University in Youngstown, Ohio August 15, 2016. REUTERS/Eric Thayer - RTX2L1B2

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    JUDY WOODRUFF: Turning to the campaign for the White house, the candidates showed up in hard-fought states, where the race is closest, focusing on national security, while slamming each other.

    Lisa Desjardins reports.

    LISA DESJARDINS: To the campaign battleground of Youngstown, Ohio, Donald Trump brought his outline of a more protective America, generally less involved overseas, but more focused on fighting the Islamic State.

    DONALD TRUMP (R), Presidential Nominee: If I become president, the era of nation-building will be brought to a very swift and decisive end.


    LISA DESJARDINS: The Republican nominee outlined three broad points. He would hold joint military operations with any country fighting ISIS. The campaign confirmed that could include current U.S. adversary and Syrian leader Bashar al-Assad. He would ask law enforcement here to find new ways to I.D. radicals. And he would freeze immigration from regions where background checks are too difficult, while adding a new test.

    DONALD TRUMP: The time is overdue to develop new screening test for the threats we face today. I call it extreme vetting. I call it extreme, extreme vetting. Our country has enough problems. We don’t need more. And these are problems like we have never had before.


    LISA DESJARDINS: Hillary Clinton’s campaign responded before the speech with this ad attacking Trump’s national security credentials with his own words.

    DONALD TRUMP: Putin did call me a genius.

    GEN. BARRY MCCAFFREY (RET.), U.S. Army: His comments are impulsive. They’re unsettling.

    LISA DESJARDINS: The anti-Trump theme dominated, as Clinton took the stage in Scranton, Pennsylvania, with native son and Vice President Joe Biden.

    VICE PRESIDENT JOSEPH BIDEN: I was proud. My son Beau served for a year in Iraq, came back highly decorated soldier.


    VICE PRESIDENT JOSEPH BIDEN: I must tell you, I must tell you, had Donald Trump been president, I would have thrown my body in front of him. No, I really mean it, to keep him from going, if the judgment was based on Trump’s decision.

    LISA DESJARDINS: Clinton repeated her attack on Trump’s preparedness.

    HILLARY CLINTON (D), Presidential Nominee: Sometimes, he says won’t tell anyone what he will do because he wants to keep his plan — quote — “secret.”


    HILLARY CLINTON: And then it turns out secret is, he has no plan.


    HILLARY CLINTON: And that was very clear when he said, “I know more about ISIS than the generals.”

    No, no, Donald, you don’t.

    LISA DESJARDINS: For weeks, both candidates have insisted the other is not fit to be president. With 85 days until the Election Day, that question is dominating the campaign trail.

    For the “PBS NewsHour,” I’m Lisa Desjardins.

    The post Trump reveals his national security plan — while Clinton says he doesn’t have one appeared first on PBS NewsHour.

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    Richard Rossi and his 4 year old great grandson Justice wade through water in search of higher ground after their home took in water in St. Amant, Louisiana, U.S., August 15, 2016.  REUTERS/Jonathan Bachman   - RTX2L08B

    Watch Video | Listen to the Audio

    JUDY WOODRUFF: Swathes of southern Louisiana are still underwater after a weekend of historic flooding. At least six people died and thousands have had to leave their homes.

    As far as the eye could see, there was water. The rising floodwaters took many in Louisiana by surprise. Whole neighborhoods were submerged, and more than 20,000 people were forced to evacuate. By today, many had managed to make it to makeshift shelters on higher ground.

    TORINA HEBERT, Flood Victim: My house was underwater. I have three children. My sister lives in the Sherwood Forest area, and she was on top of her roof. And she has five children.

    KATHRYN SAPPE, Flood Victim: It was pretty scary because we didn’t know how high the waters were going to rise or how fast they were going to rise. We just got out of there before it was too late.

    JUDY WOODRUFF: Since Friday, the state has been battered by an onslaught of torrential rain. In Baton Rouge and the surrounding area, the Amite River surged to more than 40s feet. Lafayette and its suburbs were inundated as well.

    Louisiana Governor John Bel Edwards visited Lafayette Parish today.

    GOV. JOHN BEL EDWARDS (D-La): We’re going to transition into a recovery phase as we can here. We’re going to make every bit of assistance available to you as soon as we possibly can. That’s my commitment as governor.

    JUDY WOODRUFF: Rescue operations are still under way, and crews worked all weekend to pull stranded victims from their homes.

    Others rescued trapped drivers as water surged into their cars. It’s unclear when evacuees will be allowed to go home. More than 10,000 people are being housed in local shelters. Others are relying on the kindness of their neighbors.

    WOMAN: They are the most kind, amazing people ever. I owe them so much.

    JUDY WOODRUFF: Louisiana’s insurance commissioner estimates 75 percent of those affected by the flooding do not have flood insurance. 

    The post Severe flooding in Louisiana kills at least 6, forces 20,000 to evacuate appeared first on PBS NewsHour.

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  • 08/16/16--04:30: Does food make the Olympian?
  • Members of the Olympic team from Chinese Taipei eat fast food in the athletes village of the Rio 2016 Olympic Games on August 1, 2016. (Photo credit: ED JONES/AFP/Getty Images)

    Members of the Olympic team from Chinese Taipei eat fast food in the athletes village of the Rio 2016 Olympic Games on August 1, 2016. Photo by Ed Jones/AFP/Getty Images

    Olympic athletes burn thousands of calories as they strive for gold medals, making food essential for their training. Swimmer Michael Phelps claimed during the 2008 Beijing Games to eat 12,000 calories per day, though this Washington Post article suggests that he’s since downsized his caloric intake.

    Phelps aside, we were fascinated by how professional athletes fuel themselves for Olympic events, so we reached out to the Olympians themselves. Here’s what they had to say:


    Carli Lloyd (volleyball): Before a match, Lloyd eats a banana with nut butter. Vitamin B6 in bananas helps the body make new red blood cells, and the nut butter is packed with protein. Or sometimes, she opts for a fruit smoothie with protein powder. “Kind of depends on where I am in the world and what is available,” she said.

    Cammile Adams (swimming): Protein is essential to Adams’ diet. She drinks chocolate milk and eats Blue Diamond almonds post-race, both protein sources for a quick recovery. But it’s the caffeine in coffee that she turns to for energy before climbing onto the starting block.

    Kelsey Robinson (volleyball): “Matcha green tea latte with coconut milk before games for a little energy,” Robinson said. Matcha is a caffeine source with catechins — antioxidants which have been found to reduce cell damage and control body weight. Coconut milk has several vitamins and minerals, including iron, vitamin C, and calcium.

    Nathan Keith Schrimsher (modern pentathlon): Schrimsher aims for lean proteins — key for muscle rebuilding — and healthy fats, like certain oils or nuts, that lower cholesterol. And after the competition? “Doesn’t matter if it’s winning or losing…I am a sushi fan any day of the week,” he said.

    We also reached out to Ron Maughan, chair of the International Olympics Committee Medical Commission’s Nutrition Working Group, about the ideal diet for Olympic athletes and how that varies from sport to sport. Here’s an excerpt from our interview with Maghan.

    How important is nutrition to an Olympic athlete?

    Ron Maughan: Nutrition isn’t one of the big factors that makes someone an Olympic athlete. Talent, genetics, motivation, training, tactics, resistance to injury, response to training…these are the key components. But when an athlete is at that starting line, and everyone has these same traits, nutrition can make the big difference. Good nutrition won’t make you into an Olympian, but without it you won’t be as good as you could have been.

    Team USA suggests this Ginger Molasses Granola as a great breakfast option. (Credit: Leigh Anne Tiffany / PBS NewsHour)

    Team USA suggests this Ginger Molasses Granola as a great breakfast option. (Photo by Leigh Anne Tiffany/PBS NewsHour)

    What are you looking for when you design an Olympian’s diet?

    Maughan: Different nutritionists have different ways of doing things, but there are some general principles. You look at what an athlete is currently doing, and if it’s sensible and works, keep doing what you’re doing. If there leaves room for improvement, you suggest changes. Most diets are set in terms of nutrition goals for carbs, proteins, vitamin C, and so on. You need to make sure the athlete stays healthy, has a good immune system to fight off infections. Plus you need to take into account the athlete’s age, size, sex, sporting event, whether they’re a vegetarian or a meat eater. You’ll have a different plan for a Chinese athlete than a South American one, since different ethnic groups have different food cultures and food practices. You get to know their background, their likes and dislikes, go through trial and error over the years…you don’t just become an Olympic athlete overnight.

    Are there different diets for different sports?

    Maughan: “Yes, food affects athletes in specific ways. Like if you’re dealing with a marathon runner, gastrointestinal discomfort is a big problem, so we’ll aim for low residue, high fiber diets or specific energy gels and alternative carbs to keep the GI tract clean. At the elite level, it’s highly individualized from athlete to athlete, even within a given sport.”

    Team USA suggests this Watermelon Juice as a power boost training beverage. (Credit: Leigh Anne Tiffany / PBS NewsHour)

    Team USA suggests this Watermelon Juice as a power boost training beverage. (Photo by Leigh Anne Tiffany/PBS NewsHour)

    How do athletes’ diets differ between training and competition days?

    Maughan: After a workout, the muscles will reconfigure for hours or days after training. So we want to keep the proteins we do want and remove the proteins we don’t, and that comes from selecting specific protein food sources for different sports and athletes. They also need sufficient carbs for liver health, a good water/salt balance, and so on. Most athletes will train twice a day, so a quick recovery after a training session is needed in order to train again. Now for the day of an event, everything is about the performance, you can forgo the larger health factors. And once you have your gold medal, recovery is not as important, so you can just relax.

    How is it working with these Olympic athletes?

    Maughan: One of the things that is hard to remember is there isn’t a strong nutrition component to most curriculums. We don’t teach kids much about nutrition. So many athletes have a lack of understanding. Open any sports magazine, and you’ll see health advertisements for wonder solutions. There are risks in using dietary supplements. They can be bad in health, bad for performance, can contain drugs that could cause an athlete to fail doping tests.

    Team USA suggests this Curried Sweet Potato Quinoa as a great lunch choice. (Credit: Leigh Anne Tiffany / PBS NewsHour)

    Team USA suggests this Curried Sweet Potato Quinoa as a great lunch choice. (Photo by Leigh Anne Tiffany/PBS NewsHour)

    Vitamins and other supplements can cause athletes to fail doping tests?

    Maughan: Oh definitely. There have been a number of tested positives that almost certainly came from dietary supplements. Foods can cause false positives too, meat in particular. At the Under-17 World Cup in Mexico, dozens of players tested positive for clenbuterol [a banned drug known for increasing lean muscle growth, but found in some meat products]. You see the headlines in the newspaper seeing an athlete failed a drug test — some high-profile cases where the athlete was just ignorant or careless — and people think they are a liar. It’s not made clear to the public who cheated and who made a mistake. And proving 100 percent definitively what caused the positive result is difficult. There are a lot of things out there for the athlete to worry about. They have races to run, implements to throw, games to play.

    What’s the hardest thing about working with Olympians?

    Maughan: Sometimes the enjoyment is taken out of eating. A lot of times an athlete needs to eat when they are not hungry, or not eat when they are hungry in order to meet nutrition and body competition goals. Athletes in weight category sports, like boxing and judo, may need to restrict their eating in order to meet weight, even when they are training a hard amount. A rower needs to eat a ton since their training includes weight lifting, running and three hours on the water, so they eat a lot to keep going even when they aren’t hungry. If you’re a gymnast training five hours a day with mainly technical exercises, you may not be able to eat as much as you want.

    Team USA has a 30-minute Spaghetti and Meatballs recipe that is a perfect quick dinner option. (Credit: Leigh Anne Tiffany / PBS NewsHour)

    Team USA has a 30-minute Spaghetti and Meatballs recipe that is a perfect quick dinner option. (Photo by Leigh Anne Tiffany/PBS NewsHour)

    What about nutrition for the everyday athlete?

    Maughan: Nutrition is important for everybody. What we eat affects how we feel, how we perform. Eating plays a role in our daily lives. We eat several times a day, it brings people together, friends, family. And for an athlete, it doesn’t make sense to train hard and then throw away the benefits of proper nutrition. Though athletes at the Olympic level train hard, so they have room to eat a lot of different things. A marathon runner who needs 5,000 calories a day can eat a couple of chocolate bars or a glass of wine and still be able to eat the food that give them the nutrition they need. For someone not training so hard, there might not be that room. But while we should give thought to the food we eat, we should not be too fixated with food.

    What do you wish people knew about Olympic athletes?

    Maughan: Olympians eat the same food as normal people, they just need to be a bit more careful. They represent the extremes of body shape, body size, body performance, but they don’t live the life of an extremist. They’ll still go out to burger chains, they just won’t do it twice a day every day.

    Team USA offers this Vegan Peanut Butter Mousse as a sweet dessert that also aids performance. (Credit: Leigh Anne Tiffany / PBS NewsHour)

    Team USA offers this Vegan Peanut Butter Mousse as a sweet dessert that also aids performance. (Photo by Leigh Anne Tiffany/PBS NewsHour)

    Responses have been edited for clarity purposes.

    The post Does food make the Olympian? appeared first on PBS NewsHour.


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