Diversity, Equity and Inclusion efforts in the United States military are ineffective, a new Arizona State University study suggests.
The study done by the university's Center for American Institutions argued that there is an emphasis on training new soldiers about social issues like "unconscious bias" and "intersectionality" in a way the center says runs contrary to typical American ideals. The study examined DEI plans in different sectors of the military, including DEI office staffing and education at academies like West Point.
"The massive DEI bureaucracy, its training and its pseudo-scientific assessments are at best distractions that absorb valuable time and resources," the executive summary states. "At worst they communicate the opposite of the military ethos: e.g. that individual demographic differences come before team and mission."
Donald Critchlow, the director of the center, wrote in the studies introduction that it was focused on looking at the influence of Critical Race Theory in the United States Armed Forces training.
"The Commission on Civic Education in the Military began as a project to review civic education in the military. Our research team did not expect to find Critical Race Theory so embedded and pervasive. Diversity, Equity, and Inclusion programs are found throughout the U.S. Armed Forces and our service academies," Critchlow wrote. "This year long study documents just how pervasive these training programs are in our Armed Forces and Service Academies and that DEI extends well beyond just formal training programs in the military and service academies."
"The Founders of our nation understood and feared a politicized military. History had shown them that a politicized army easily became the tool of tyranny. The Armed Forces of the United States has proudly upheld this long tradition of separating mission from politics," he continued.
In terms of recommendations, the study suggests that DEI office's be completely scrapped, but said it may be politically unlikely for the time being.
"The surest way to eliminate the concerning trends we have identified, and the growth of race and sex-based scapegoating and stereotyping in the U.S. military, is to altogether end the DEI bureaucracy there," the study states. "However, until such a time as the executive or legislative branches of the government choose to end the DEI bureaucracy in our federal agencies and military, we are left to advocate the pursuit of alternative avenues that may affect positive change despite existing policies."
They also suggested that the military prioritize civic education with a focus on "America’s commitment to freedom and opportunity."
The study comes as some branches of the military continue to struggle with recruiting new service members.
Update (1830ET): Just as expected, the Democrats - en masse - voted against Speaker Johnson's bill and therefore for 'cheating' in the election.
We would be interested to see who the five Democrats that voted for law and order and election integrity were though.
Co-sponsor of the bill, Congressman Paul A. Gosar, D.D.S. (AZ-09), issued the following statement:
“I find it both laughable and preposterous that the same people who, for the past four years, forced you to carry a vaccine passport to dine in a restaurant, hold a job or get on a flight are the same people now opposing common-sense legislation requiring individuals to show proof of American citizenship to vote in elections.
Voters are overwhelmingly concerned about the integrity of elections and rightfully so. In fact, most states today continue to allow illegal aliens to receive a driver’s license, thus allowing voter registration materials. With 11 million lawbreakers pouring across Joe Biden’s open border, this legislation is a crucial step towards ensuring our elections are fair and honest,” concluded Congressman Gosar.
Hakeem Jeffries labels the SAVE Act as the “Extreme MAGA Republican Voter Suppression Bill."
This wholesale rejection of common sense merely exposes the Democrats' not so cunning plan during the election and into the future.
Jeffries frames the bill as being designed to cover for a Trump loss in the 2024 election, and somehow ties a bill that makes it harder for non-citizens to vote to January 6.
Where do we even start.
Here’s what in the SAVE Act, and what Jeffries is really against:
Require proof of US citizenship to register to vote in federal elections
Prevent non-citizens who receive drivers’ licenses from registering to vote
Require states to acquire documentary proof of US citizenship in person when registering to vote
Require states to establish a process for applicants who do not have documentary proof of US citizenship, but are US citizens
Require states to remove non-citizens from their voter rolls, with free access to federal and state databases with citizenship information
Provide states with resources to remove non-citizens form their voter rolls
There is only one reason to oppose this legislation.
You want to cheat.
* * *
Back in May, House Speaker Mike Johnson unveiled legislation designed to ensure that only American citizens vote.
The unfortunate reality is that Joe Biden has let in millions of illegal immigrants, and the risk that these immigrants could influence our elections is extremely high. Legislation like this is absolutely necessary.
Many on the left oppose this legislation, claiming that it's unnecessary because it is already illegal to vote if you're not a U.S. citizen. However, Johnson addressed this when he introduced the bill earlier this year.
“Some have noted that it's already a crime for noncitizens to vote in a federal election, and that is true. But here are four things that are also true,” Speaker Johnson said back in May.
“(1) It is true that there is no mechanism to ensure only those registering or voting are actually citizens…
(2) It is true that Biden has welcomed millions and millions of illegal aliens, including sophisticated criminal syndicates and agents of adversarial governments, into our borders and even on humanitarian parole…
(3) It is true that a growing number of localities are blurring the lines for noncitizens by allowing them to vote in municipal elections…
(4) It is true that Democrats have expressed a desire to turn non-citizens into voters.”
So, what does the bill do?
Johnson explained in a thread on X/Twitter that the legislation requires state election officials to verify citizenship before providing voter registration forms, mandates proof of citizenship to register for federal elections, and accepts various documents to ease the registration process for citizens. It also gives states access to federal databases to remove noncitizens from voter rolls and confirms citizenship for those lacking proof.
Additionally, it directs DHS to consider removal proceedings for noncitizens registered to vote and ensures naturalized citizens are notified of their voting rights.
Who could oppose such commonsense legislation to protect our elections?
[ZH: House Democratic leadership is bringing out the big guns against a Republican bill set to be voted on next week that would require proof of U.S. citizenship to vote in federal elections, Axios has learned.
In a whip question - a roundup of the coming week's votes with instructions for how leadership wants rank-and-file members to vote - House Minority Whip Katherine Clark's (D-Mass.) office told House Democrats they are "urged to VOTE NO" on the bill.
That means that Democratic leadership will send its whip team to cajole colleagues into not supporting the legislation.
The bill, Clark's office said, would create an "extreme burden for countless Americans" and "further intimidate election officials and overburden states' abilities to enroll new voters."]
Elon Musk weighed in on the proposed legislation by reposting Johnson's thread on X.
He dubbed those who oppose it "TRAITORS," and then rhetorically asked what the punishment for treason is.
The punishment for treason in the United States, as laid out in 18 U.S. Code § 2381, is the death penalty, or a minimum of five years in prison.
Also, they are to be fined no less than $10,000 and rendered constitutionally ineligible to hold office in the United States.
I'm perfectly okay with Democrats who oppose election integrity being barred from holding office. How about you?
In preclinical studies, a team of researchers from Mount Sinai Health System in New York City and City of Hope in Los Angeles report new findings on a therapeutic combination that regenerated human insulin-producing beta cells, providing a possible new treatment for diabetes. The findings werepublishedinScience Translational Medicine.
This work, led by Andrew F. Stewart, MD, Irene and Dr. Arthur M. Fishberg Professor of Medicine and Director of the Mount Sinai Diabetes, Obesity and Metabolism Institute, began at the Icahn School of Medicine at Mount Sinai in 2015. The studies were a team effort.
Adolfo Garcia-Ocaña, Ph.D., formerly a professor at Mount Sinai and who is now at City of Hope, a leading research center for diabetes and one of the largest cancer research and treatment organizations in the United States, and is the Ruth B. and Robert K. Lanman Chair in Gene Regulation and Drug Discovery Research and chair of the Department of Molecular & Cellular Endocrinology, and his research team designed the studies and performed the novel, extensive and detailed animal transplant and drug treatment models using beta cells from donors.
Final studies took place at City of Hope in 2023.
For the study, the natural product harmine, which is found in some plants, was combined with a widely used class of type 2 diabetes therapy called GLP1 receptor agonists.
Researchers transplanted a small number of human beta cells into mice that had no immune system and that also served as a standard model of type 1 and type 2 diabetes; these mice were treated with the combination therapy and their diabetes was rapidly reversed. Strikingly, human beta cell numbers increased by 700% over three months with this drug combination.
"This is the first time scientists have developed a drug treatment that is proven to increase adult human beta cell numbers in vivo. This research brings hope for the use of future regenerative therapies to potentially treat the hundreds of millions of people with diabetes," said Dr. Garcia-Ocaña, the paper's corresponding author.
"It has been remarkable to watch this story unfold over the past 15 years," said Dr. Stewart, who, along with Peng Wang, Ph.D., Professor of Medicine (Endocrinology, Diabetes and Bone Disease) at Icahn Mount Sinai, conceived of and performed the initial high-throughput drug screen that led to the discovery of harmine described in Nature Medicine in 2015.
"The steady progression from the most basic human beta cell biology, through robotic drug screening and now moving to human studies, illustrates the essential role for physician-scientists in academia and pharma."
Growing new beta cells
More than 10% of the world's adult population has diabetes, a disease defined by high blood sugar levels. In both type 1 and type 2 diabetes, a reduction in both the quantity and quality of insulin-producing beta cells causes high blood sugar. Unfortunately, none of the many commonly used diabetes therapies are able to increase human beta cell numbers, and therefore cannot completely reverse diabetes.
Fortunately, most people with diabetes have some residual beta cells, which is what inspired the research team to search for ways to restore their numbers.
The team had previously shown that several different inhibitors of an enzyme in beta cells called DYRK1A can induce the proliferation of adult human beta cells in a tissue culture dish for a few days. But prior to this study, no one had shown the ability to expand human beta cells numbers in vivo in human islet grafts used in an animal model over many months.
To accurately measure the mass of human beta cells in the islet grafts, the team turned to Sarah A. Stanley, MBBCh, Ph.D., Associate Professor of Medicine (Endocrinology, Diabetes and Bone Disease), and Neuroscience, at Icahn Mount Sinai.
Using an advanced laser microscopy tool called iDISCO+ that effectively makes biological tissue transparent, Dr. Stanley saw that beta cell mass was dramatically increased through mechanisms that included enhanced proliferation, function, and survival of the human beta cells. The technology allowed for accurate and rigorous quantitative assessment of engrafted human beta cells for the first time.
Mount Sinai is conducting studies to test these in humans for potential toxicity risks and estimate dosing for clinical trials, and is planning to initiate first-in-human trials with independent research teams next year. Mount Sinai owns an extensive patent portfolio covering these technologies.
Researchers also want to address the fact that in patients with type 1 diabetes, the immune system will continue to kill new beta cells. At City of Hope, Dr. Garcia-Ocaña and colleague Alberto Pugliese, MD, Samuel Rahbar Chair in Diabetes & Drug Discovery, chair of the Department of Diabetes Immunology, and director of The Wanek Family Project for Type 1 Diabetes within the Arthur Riggs Diabetes & Metabolism Research Institute, plan to test inducers of beta cell regeneration together with immunomodulators that regulate the immune system.
Their goal is for the combination to allow new beta cells to thrive and improve insulin levels.
"Our studies pave the way for moving DYRK1A inhibitors into human clinical trials and it's very exciting to be close to seeing this novel treatment used in patients," Dr. Garcia-Ocaña said. "There is nothing like this available to patients right now."
Drs. Stewart and DeVita are named co-inventors on patent applications for DYRK1A inhibitors, such as harmine, for the treatment of diabetes. These patent applications are filed through the Icahn School of Medicine at Mount Sinai and are currently unlicensed.
Using genetic engineering techniques, investigators at the Johns Hopkins Kimmel Cancer Center and its Ludwig Center, the Lustgarten Laboratory and Bloomberg~Kimmel Institute for Cancer Immunotherapy have designed a novel type of cell to recognize and fight cancer.
To produce the cells, called Co-STAR (Co-stimulatory Synthetic T-cell receptor and Antigen Receptor) cells, the researchers combined genetic components of four types of cells that the body normally uses to defend against invaders to make a powerful new cell type: T-cell receptors (TCRs) from T cells, antibodies from B cells, MyD88 from white blood cells called monocytes, and CD40 from dendritic and other cells.
The TCR and antibody components served as an "invader-detecting device," recognizing cancer cells as foreign, and the "alarm" triggered by this hybrid detector was boosted by the MyD88 and C40 components.
In laboratory studies, Co-STARs led to a sustained anti-tumor response against human cancer cells growing in test tubes and in mice. A description of the work was published July 10 in Science Translational Medicine.
T cell-based therapies are among the most promising approaches to treat advanced cancer and are the subject of intense research, explains lead study author Brian Mog, M.D., Ph.D., an internal medicine resident at Brigham and Women's Hospital in Boston. He was a medical and graduate student at the Johns Hopkins University School of Medicine when the research was conducted.
However, TCR and CAR (chimeric antigen receptor, usually using an antibody as the detector), which are aimed at stimulating an immune response by activating T cells, each have limits. The combination of the two can overcome these limitations.
"We needed to make a new type of cell, because we were trying to target specific antigens called peptide-HLA (human leukocyte antigen) antigens, which are peptide fragments from mutant proteins inside the cancer cell that are displayed on the cell surface by peptide-holding proteins called HLAs," Mog explains.
Their specific target was a peptide containing the R175H mutation of p53 (the 175th amino acid of p53 is mutated from arginine to histidine), displayed on the HLA-A2 allele (gene variation). This is the most common mutation in the tumor suppressor protein p53, which is in turn the most commonly mutated gene in human cancers.
However, these antigens are present in very low numbers (just one to 10) in a cancer cell, and the classic CAR format would not be able to react to such a small amount.
"Our goal was to combine some of the advantages of the CAR format with those of the natural T cell receptor on T cells, supplemented with additional signaling boosters, so that they could fight cancers more effectively," Mog says.
The team went through multiple rounds of engineering to come up with the final design, testing their receptors in model cancer cell lines in test tubes and then in mouse models of cancer. The final Co-STAR T cells were able to continuously kill human cancer cells in test tubes.
When tested in mouse models of cancer, Co-STARs induced a robust, long-lasting proliferation of T cells that were able to induce profound remissions and often cure human cancer cells growing in mice. By contrast, more conventional T cells or CAR T cells were not able to eradicate the cancer cells in vitro and only brought about temporary tumor control in mice, with the cancers re-emerging days later.
"Brian's results demonstrated that Co-STAR T cells combine the advantages of many features of immune cells that normally fight infection in a way that allowed them to effectively kill cancer cells in mouse models," says co-senior investigator Bert Vogelstein, M.D., Clayton Professor of Oncology, Howard Hughes Medical Institute investigator and co-director of the Ludwig Center. "Co-STARs address some, but certainly not all, challenges confronting T cell-based therapeutics but are certainly worthy of continued investigation."
"I was, honestly, incredibly surprised that the Co-STARs worked so well in mice, given that I had generated so many different types of T cells over four years that could only slow the growth of cancers in mice," adds Mog. "Witnessing those cures was a very exciting moment."
Study co-authors were Nikita Marcou, Sarah DiNapoli, Alexander Pearlman, Tushar Nichakawade, Michael Hwang, Jacqueline Douglass, Emily Han-Chung Hsiue, Stephanie Glavaris, Katharine Wright, Maximilian Konig, Suman Paul, Nicolas Wyhs, Jiaxin Ge, Michelle Miller, P. Aitana Azurmendi, Evangeline Watson, Drew Pardoll, Sandra Gabelli, Chetan Bettegowda, Nickolas Papadopoulos, Kenneth Kinzler and Shibin Zhou of Johns Hopkins.
A major clinical trial, led by researchers at the University of Nottingham, has shown the Lee Silverman Voice Treatment (LSVT LOUD) is more effective than the current speech and language therapy provided by the NHS, when treating patients with Parkinson's disease (PD).
The results of the trial, which are published today inThe BMJ,showed that LSVT LOUD was more effective at reducing the participant's reported impact of voice problems than no speech andlanguagetherapy, as well as the NHS delivered speech and language therapy.
The trial was led by experts from the Universities of Nottingham and Birmingham, along with colleagues at Sandwell and Dudley Hospital Trust, University College London, King's College London, the University of Bangor, Canterbury Christ Church University and Glasgow Caledonian University.
It was carried out by NHS Speech and Language Therapy services across the UK and coordinated and analyzed by the team at the Birmingham Clinical Trials Unit (BCTU) at the University of Birmingham.
Professor Catherine Sackley, from the School of Health Sciences and the NIHR Nottingham Biomedical Research Centre, led the study. She says, "The impact of speech and communication problems in people with PD can cause them to feel stigmatized. It can stop them going out, stop them socializing, and stop them doing day-to-day tasks such as shopping, which can have a detrimental impact on their quality of life.
"This is the first study of its kind to look at the most effective treatment options. The results clearly show that delivered in this way, the LSVT LOUD method is both effective and it can be cost effective. The NHS method as it is currently delivered is not effective. Now we have this data, we need to look at other factors and whether if different therapies are delivered in different ways, this would further impact the results."
Building on a pilot study, participants were recruited from 40 NHS sites across the UK and were randomized into three groups. One group received the LSVT LOUD, one received the current NHS speech and language treatment, and the third didn't receive any therapy.
LSVT LOUD is an effective speech treatment for people with PD and other neurological conditions. The treatment trains people with PD to use their voice at a more normal level while speaking at home, at work, or in the community. Patients are given voice exercises to do this.
The NHS treatment is a personalized program delivered by a therapist and is less intensive. It is delivered over six to eight sessions rather than the LSVT LOUD, which is delivered in 16 sessions over four weeks.
Between September 2016 and March 2020, 388 people with PD and dysarthria (difficulty speaking) took part in the trial. Of these, 130 were allocated to the LSVT LOUD group, 129 to the NHS therapy group and 129 to neither.
LSVT LOUD consisted of four face-to-face or remote 50-minute sessions, each week delivered over four weeks, with additional home-based practice. The NHS speech and language therapy was determined by the local therapist in response to a participant's individual needs, and an average of one session every other week was delivered over 11 weeks.
The findings of the trial showed that LSVT LOUD was more effective at reducing the impact of dysarthria than no speech and language therapy and the NHS version. The NHS therapy showed no evidence of benefit compared to no speech and language therapy.
Adrian Wrigley, who has Parkinson's said, "Speech and language therapy research is very important to me personally, as I've seen firsthand how the loss or reduction of our main communication tool leads to higher levels of frustration and anxiety not only for those of us with Parkinson's but our partners and friends. So the development of a treatment that works is very important for the Parkinson's community."
More information: What is the clinical effectiveness of Lee Silverman Voice Treatment (LSVT LOUD), NHS speech and language therapy (SLT), versus no speech and language therapy for dysarthria in people with Parkinson's disease?, The BMJ (2024). DOI: 10.1136/bmj-2023-078341
Just under a month before the Olympic Games in Paris, the National Academy of Medicine devoted an entire day to a series of conferences on medicine and the Olympic and Paralympic Games. Topics included "high-level sports and cardiac function," athletes' mental health, and the life expectancy and "healthy aging" of high-level athletes. The conference was moderated by Dr Jean-Philippe Hager, a sports physician in Lyon, France. "The subject is complex," he asserted at the outset.
Defining Terms
"First, we must define the terms." What is an athlete? An athlete practices high-level sports, sometimes outside of competition. Aging is the set of changes that occur with advancing age aside from any illness. What is healthy aging? There is no physiologic definition. For the World Health Organization, "healthy aging involves improving the quality of life of aging individuals."
Based on these definitions, the next question to address is the life expectancy of high-level athletes. To answer this question, Hager relied on a systematic review of the literature on the subject from 2015 onward. The review included 57 articles. "High-level sports lengthen the lifespan, but the physiologic mechanism at play remains uncertain. These athletes live on average 5 years longer and have a lower risk of cardiovascular or cancer pathologies. However, they exhibit the same risks as the general population regarding neurologic or psychiatric pathologies," said Hager.
Better Aging?
Do these exceptional athletes have a higher chance of aging well? To answer this challenging question, Hager relied on, among other sources, a systematic review conducted by Filippo Migliorini. "There are arthrogenic sports, like soccer and American football, contrasting with endurance sports that are not arthrogenic. Contact sports (like boxing, rugby, and martial arts) are traumatogenic, but it must be added that prevention and early medical management related to intensive sports should allow for normal joint aging. Nevertheless, continuing high-level sports despite nonhealed injuries reinforces the arthrogenic risk."
Quality of Life
Sports, regardless of whether they are arthrogenic or traumatogenic, do not seem to affect these athletes' quality of life. "According to a study on professional cricket, professional players experience more pain during and after their careers but report a very satisfactory quality of life. In rugby, it is known that front-line players present cervical arthritis but have little functional impact other than neck stiffness. Rugby is traumatogenic, but former rugby players report having a good quality of life," said Hager.
Addiction Issues
Nevertheless, he added, many retired athletes face addiction problems, particularly with alcohol. "I also add that even when the athlete practices traumatogenic or arthrogenic sports, their participation is valued by society. Sports create social connections that contribute to good quality of life." In conclusion, Hager suggested that "we must teach our athletes to take care of themselves. We must also improve medical support, prevent traumatic injuries, screen for psychologic disorders... Athletes must also play an active role in sports health."
In late June, the Ontario Government announced that it is consulting with the College of Nurses of Ontario, Toronto, Ontario, Canada, on expanding the scope of practice for nurse practitioners. The changes are being considered as one measure to help address the critical shortage of primary care in the province.
Ontario currently has more than 5000 nurse practitioners. While nurses' scope of practice varies across provinces, nurse practitioners can already diagnose, refer patients to specialists, and prescribe medication in Ontario and several other provinces.
The proposed changes include allowing nurse practitioners to apply a defibrillator and cardiac pacemaker therapy, perform electrocoagulation to remove skin tags and treat lesions, and sign blood testing forms for specific infectious diseases. The government is also considering making changes to end-of-life care by allowing nurse practitioners to certify death in all circumstances or any registered nurse to certify an expected death (such as in during palliative care).
"By leveraging the full extent of our training and expertise, nurse practitioners can play a crucial role in ensuring a more integrated health system. These proposed changes will lead to faster care, better outcomes, and a more efficient healthcare system," Michelle Acorn, DNP, NP, CEO of the Nurse Practitioners' Association of Ontario, told Medscape Medical News.
Michelle Acorn, DNP, NP
Expanding the Scope
The proposed measures could help provide more timely care, said Acorn, who has been a practicing nurse for more than 25 years. Throughout her career, regulatory changes have enabled nurses to apply their training better in practice.
Nurse practitioners gained the authority to prescribe controlled substances in 2017 and to order CT and MRI scans in 2022. The ability to prescribe certain medications was also expanded to all registered nurses in 2023. Yet, "nurse practitioners still represent an untapped resource right now," Acorn added.
Now that nurses can perform these key tasks, the new changes "are just a few gaps that need to be closed right now to ensure that they're fully optimized and integrating into the Ontario healthcare system," said Acorn. Beyond the proposed changes, Acorn believes that allowing nurses to certify mental health forms is particularly important. "We absolutely have the knowledge, skills, and judgment to do this."
Some doctors, however, are hesitant about expanding nurses' scope of practice, without properly ensuring patient safety. "Doctors value the vital contribution that other healthcare professionals bring to the team, but we need a plan in place to ensure that there is an integrated system of primary care. If there is no integration plan or quality framework put in place when expanding the scope of healthcare professionals, it will be detrimental for patient safety and for the future of family medicine," the Ontario Medical Association (OMA) told Medscape Medical News in a statement.
"Our goal is to ensure that patients get the care they need in a system that is integrated and ensures they do not fall through the cracks. That happens when there is a strong family medicine foundation to the primary care and larger healthcare systems," the OMA continued.
Nurse-Led Clinics
Allowing nurses to certify death could be particularly beneficial, according to Tammy O'Rourke, NP, PhD, assistant professor at Athabasca University, Athabasca, Alberta, Canada, who supports the proposed changes. Currently, physicians are brought in to sign the death certificate, which can be distressing to families during their loss. "There's no legal requirement that death be pronounced by a physician, only that the paperwork be done by a physician," said O'Rourke. "And they bill the Ontario Health Insurance Plan about $70 for that."
Tammy O'Rourke, NP, PhD
While nurse practitioners now perform many of the same services as physicians, they cannot bill in the same fee-for-service model and are typically paid less than doctors, O'Rourke noted. This discrepancy has caused some nurses to begin private clinics where patients pay out of pocket for primary care services — a practice that has generated controversy. O'Rourke worked in one nurse-led private clinic in Belleville, Ontario, from 2010 to 2014. Alternative reimbursement models are the best option, she said, but all providers should be paid the same for providing the same services.
Whether private clinics are a viable solution, changing the remuneration system may help improve access to care, Patrick O'Byrne, RN-EC, PhD, a professor of nursing at the University of Ottawa, Ottawa, Ontario, Canada, told Medscape Medical News. O'Byrne does not support private clinics as a system-level intervention, though he does not criticize the nurses who work in them. But he does believe that nurse practitioners would benefit from direct access to fee schedules and billing.
'Low-Hanging Fruit'
Regarding the proposed changes to scope of practice, "they took some very easy, low-hanging fruit," said O'Byrne. Although the changes will be important for a small number of people, he believes that they are not "a rate-limiting step" in Ontarians' access to care.
"Any movement is good movement forward, but I don't think it's going to have a huge, profound effect." Instead, he believes bureaucratic barriers such as billing regulation must be changed to reduce the bottleneck in primary care.
"The longer the bottleneck persists, the more the public is going to say, 'Give us the nurse practitioners. We want access to good, quality care'," said O’Byrne. "It becomes a bit of a turf war when you're in the health professions, between medicine and nursing, but the patients don't care about a turf war. They want access."
