first_img“I’m not ashamed or embarrassed, even as old as I am, to deliver sandwiches,” he said, pulling on his retail chain polo shirt before rushing to a Saturday morning shift.He continued: “I know people, they’d rather get food stamps and feel sorry for themselves. But I’m a fighter. I will not give up. … If I can bring in an extra $400 a week or $800 a month, she can get what she needs for the baby.”Often getting home after midnight, he keeps shampoo and shaving cream in his car and naps in parking lots between jobs, relying on Red Bull and aspirin to stay alert.That means on many nights, when Tiffany picks up Brody from day care after her 90-minute commute, she handles most of the chores at home.”Sometimes I feel like a single mom because my husband is never around,” she said.She carefully tracks the family’s medical expenses, trying to juggle them with ordinary outlays that can’t wait — like $500 for the brakes that went out on her car this month.At the rate they’re going, the bills won’t be paid until Brody is 3, Tiffany said. The Canos are getting older and they’d like to have another baby before it’s too late, but, for now, that seems impossible.For 2019, the couple have decided to switch to a different plan offered through the regional bank where Tiffany works. The premium is higher — $650 a month — but the deductible is $1,500 with just 10 percent coinsurance.”It is going to be a lot more per paycheck, which is going to hurt us,” Tiffany said. “But after what just happened, I want to make sure we are prepared in case anything does occur.”How to fix a health care system that burdens middle-class families so heavily is beyond her, she said.“The only thing we can do is just keep working,” Tiffany said. “I always wonder: How does everybody else do it?”KHN’s coverage of children’s health care issues is supported in part by the Heising-Simons Foundation. This article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. Robert Cano, also 37, had family health insurance for 2018 through his job as a manager at a large-chain retail store, for which he pays nearly $500 per month. The plan’s $3,000 annual deductible and 40 percent coinsurance fees have added up faster than the Canos anticipated.First came the nearly $4,000 bill from the in-network hospital where Brody was born Jan. 2, followed by separate fees from the anesthesiologist and the doctor who performed the routine delivery. Then, at 2 months, Brody was hospitalized with breathing problems doctors said could be related to allergies or asthma. In May, Tiffany came down with a stomach virus that sent her to the emergency room for drugs to treat nausea and dehydration. In October, the baby developed a bad case of bacterial conjunctivitis, or pinkeye.”It’s been, like, $300 here, $700 there,” said Tiffany. “We had a hospital bill for him being sick of, like, $1,800.” Unable initially to find a pediatrician she liked, Tiffany has agonized over whether to use the ER when Brody gets sick. When he had pinkeye, she debated whether to take him in, hoping it would get better on its own.Then he got worse, she said, pulling up a photo on her phone of her son with half-moons of red, puffy flesh under his dark eyes.”I let him suffer for a day like that,” she said.The Canos lost their first child, a girl, midway through her pregnancy in 2016. Tiffany acknowledges that experience has left her more anxious than the average first-time mom.”It gave me so much fear that something would happen to him,” she said.As for their own health care needs, the couple put themselves lower on the priority list. Tiffany has used a prosthetic limb since childhood, when her lower left leg was amputated because of a birth defect.She needs a new prosthesis because her body changed during pregnancy, but she can’t see how to afford it.A model suitable for the busy life of a working mom would easily cost $10,000 to $15,000, according to Tom Fise, executive director of the American Orthotic & Prosthetic Association.”I try to push through,” Tiffany said. “I put on that brave face of just walking, but it’s so painful to walk. I have bruises all over my leg. I get blisters all the time.” Lately, she’s been wearing an old prosthesis, one she used in high school, because it’s more comfortable.The Canos don’t know how exactly they fell into such debt, since they tried hard to make responsible decisions. After meeting three years ago, they knew quickly that they wanted to marry and have a family.”I waited until I found the right guy,” said Tiffany, who was thrilled when, in 2016, they were able to afford a 2,500-square-foot, two-story home in one of the stucco-and-tile neighborhoods an hour outside Phoenix.But, taken together, the medical payment plans and premiums are almost as much as their $1,300 monthly mortgage. All told, the Canos spend about 15 percent of their annual income on health care, almost three times the average for non-Medicare households in the U.S.Related StoriesResearch reveals genetic cause of deadly digestive disease in childrenGuidelines to help children develop healthy habits early in lifeStudy analyzes high capacity of A. baumannii to persist on various surfacesThat leaves too little for day care, car payments, gas, food and dozens of other domestic expenses, Tiffany said.For 17 years, Robert Cano had comprehensive health insurance through his job as a soldier in the Army Reserve and paid little or nothing for medical care. He left the Army in 2017, however, after he learned he would be deployed for an extended time away from his wife and new son.”I told them, ‘I have to be at home,'” he recalled. The Army insurance ended on Dec. 31, 2017, two days before Brody was born.That meant moving to his employer’s insurance plan. Like more than 40 percent of 152 million Americans who get health insurance through work, the Canos are enrolled in a plan that demands thousands of dollars before any coverage kicks in.The couple discovered that they earn too much to qualify for financial assistance from medical providers, or for subsidies if they shifted their insurance to a plan under the federal health insurance exchange. She is a full-time bank compliance officer. He is a full-time store manager.Tiffany wrote to KHN after seeing stories about sky-high medical bills on TV. Dr. Merrit Quarum, the chief executive of WellRithms, a health care consulting firm, reviewed the family’s medical bills and the responses from their health care providers.Though Quarum had questions about some of the fees in the itemized bills — $4 for a 600-milligram ibuprofen tablet? $3,125 to place an epidural? — he found the charges were legitimate under the terms of the contract between the hospital and the Canos’ insurer. Tiffany’s only recourse was to set up the five payment plans she navigates each month.”I wish I could say it wasn’t so, but it is,” Quarum said.Mostly to pay off that health care debt, Robert has taken several part-time gigs this year — he works as a substitute teacher and a nighttime security guard and delivers sandwiches for a fast-food chain in Scottsdale, 40 miles away, where tips are better. He said he sometimes works up to 120 hours in a week.center_img Reviewed by James Ives, M.Psych. (Editor)Dec 28 2018Robert and Tiffany Cano of San Tan Valley, Ariz., have a new marriage, a new house and a 10-month-old son, Brody, who is delighted by his ability to blow raspberries.They also have a stack of medical bills that threatens to undermine it all.In the months since their sturdy, brown-eyed boy was born, the Canos have acquired more than $12,000 in medical debt — so much that they need a spreadsheet to track what they owe to hospitals and doctors.”I’m on these payment arrangements that are killing us,” said Tiffany Cano, 37, who has spent her lunch hours on the phone negotiating payoff plans that now total $700 a month. “My husband is working four jobs. I work full time. We’re a hardworking family doing our best and not getting anywhere.”The pair, who earn nearly $100,000 a year, are insured and have had no major illnesses or injuries. Still, the Canos are among the 1 in 4 Americans who report in multiple polls that the high cost of health care is the biggest concern facing their families. And they’re at risk of joining the 62 percent of people who file for bankruptcy tied to medical bills.”Oh, yes, that worry is always in the back of my mind,” Tiffany said.The family is part of a struggling group: middle-class folks who have followed the rules and paid for employer-based medical insurance, only to find that soaring health care costs — combined with high deductibles, high copayments and surprise medical bills — leave them vulnerable.”I thought we’d be covered, and it’s just not enough coverage at all,” she said.last_img read more

first_imgReviewed by James Ives, M.Psych. (Editor)Feb 26 2019Scientists at the University of Virginia School of Medicine have discovered a defect in immune cells known as “killer T cells” that explains their inability to destroy cancer tumors. The researchers believe that repairing this defect could make the cells much better cancer killers. Further, they predict their discovery could be used within three to five years to help identify patients who will best respond to cancer therapies.The finding could be a significant boost to the burgeoning field of immunotherapy, which aims to harness the body’s immune defenses to defeat cancer. The discovery could also let doctors better predict and assess how well a patient responds to treatment.”For a long time, the presence of immune cells in cancer has been associated with a better outcome in patients, but it’s not really been clear why the immune cells haven’t been able to control the cancer. What is the cancer doing?” said researcher Timothy Bullock, PhD, of the UVA Cancer Center. “This [finding] gives us plenty of opportunity to come in with interventions to invigorate these T cells and level the playing field substantially so they’re much more competitive.”Building Better Cancer KillersDespite their fearsome moniker, “killer” T cells often become inactive in solid tumors. UVA’s new research sheds light on why. Bullock and his team determined that these sluggish soldiers suffer from a dysfunctional enzyme, enolase 1. Without it, they cannot use a vital nutrient, glucose.”There is a functional defect in this enzyme that is preventing the cells from breaking down glucose and using it in such a way that they can proliferate and become functional,” explained researcher Lelisa F. Gemta. “They don’t process it well, and that’s what we’ve been digging into: to find out why do these cells take up glucose but fail to break it down.”Related StoriesSugary drinks linked to cancer finds studyLiving with advanced breast cancerTrends in colonoscopy rates not aligned with increase in early onset colorectal cancerBy amping up the effectiveness of the enzyme, the researchers believe they can make the killer T cells much better at killing cancer. The sluggish soldiers would become much more formidable fighters.The researchers also believe that doctors will be able to examine the enzyme to predict how well a patient will respond to treatment. “I think that there is an opportunity to actually use this enzyme as a read-out for the quality of the T cells that are in the tumor, so that when a physician comes in with a clinical trial we can theoretically analyze how the T cells metabolically compare within the tumor,” said Bullock, of UVA’s Department of Pathology. “It’s almost a biomarker of immune function and fitness within the tumors.”The research is part of UVA’s aggressive efforts to advance the field of immunotherapy. For example, it is conducting a leading-edge clinical trial of an experimental immunotherapy for pediatric acute lymphoblastic leukemia that has resisted other forms of treatment. The approach, known as chimeric antigen receptor T-cell therapy, takes a child’s own immune cells and genetically modifies them to make them better at killing cancer.By confronting the defect they have discovered and making these T cells fitter, Bullock hopes that his new discovery will complement such emerging treatments and make them more effective. The finding, he notes, also might be put to use one day to dampen excessive immune responses, such as are seen in autoimmune disorders. Source: read more

first_imgReviewed by James Ives, M.Psych. (Editor)Mar 11 2019The extension of working life is a hot topic in many European Countries and will have numerous implications on individuals and society at large.On Wednesday 6 March 2019, COST Action IS1409: Gender and Health Implications of Policies to Extend Working Lives in Western Countries, held a Policy Event at the European Parliament in Brussels, Belgium. The event aimed to highlight policy messages representing 4 years of collaborative research by a network of 140 individuals from 34 countries.The event was opened by Director of the COST Association, Ronald de Bruin before welcome addresses were given by Lambert van Nistelrooij MEP, Chair of Intergroup on Active Ageing and Mairead McGuinness, Vice President of the European Parliament.McGuinness highlighted the importance of the Action and expressed the need for more experts to understand the challenges faced in view of gender and health implications in extended working lives in Western countries.6 policy briefs were presented during the event – Age Management, Health, Employment and Care, Inclusion and Gender, Pensions and Pension Planning.The work of the ActionCOST Action IS1409, which commenced activity in 2015, has been working to advance scientific knowledge about the gendered impacts of extended working life on the health and economic well-being of older workers in Europe. The Action has also been working to support informed gender-sensitive future policy, explicitly considering the differential needs of women and men.”On inclusion and gender, in the context of pension spending in Europe which is one of the biggest spending areas of government, the income gap between men and women still exists and it is most critical. To reduce the gap, we do not have enough policies implemented. This is because we have paid little attention to changes in the labor market to understand gender inequality and its outcomes for women.” Dr Nata Duvvury, Working Group Leader for COST Action IS1409 and Senior Lecturer and Director of the Centre for Global Woman’s studies and Leader of Gender and Public Policy Cluster in the Whitaker Institute at National University of Ireland.Related StoriesResearch sheds light on sun-induced DNA damage and repairComplement system shown to remove dead cells in retinitis pigmentosa, contradicting previous researchNew findings may help kick-start aging immune system”There is still room to reduce age stereotypes and improve diversity in the work environment. Innovative approaches and trainings to managers can be organized to train their staff to be aware of the different need workers have according to gender and age. It has been proven to be very effective to allow aging workers to maintain a work life balance.”Jonas Radl, COST Action Management Committee for IS1409 and Associate professor of Sociology and at the Department of Social Sciences of Universidad Carlos III of Madrid”I must insist on the achievement early career investigators have gained by being involved in this network. This is the next generation of researchers with new approaches and creativity setting a solid base for future collaborations.”Dr. áine Ní Léime, COST Action IS1409 Chair and Deputy Director of the Irish Centre for Social Gerontology, National University of Ireland, GalwayThe event was organized by the Subgroup on Active Aging in the Intergroup on Active Aging, Intergenerational Solidarity and Family Issues, with support from the COST Association.Source: read more

first_img Source: Reviewed by Alina Shrourou, B.Sc. (Editor)Mar 30 2019It’s gory, sticky and undoubtedly on the nose, but a blend of icing sugar, chicken stock and flexible resin is proving to be the just the right recipe for creating realistic foot ulcers as part of a world-first podiatric training initiative at the University of South Australia.Concocted by UniSA’s Dr Helen Banwell and Dr Ryan Causby the gooey mixture is being added to newly printed 3-dimensional feet and is designed to mimic infected and non-infected diabetic foot wounds.The 3D printed feet are created with wound-like cavities in place. Made from thermoplastic polyurethane (a plastic with many properties, including elasticity, transparency, and resistance to oil, grease and abrasion), each takes a week to print, and costs less than $4 to produce. The addition of life-like ulcers and effects is added by the creative hands of UniSA’s podiatry team and can encompass anything from dry gangrene to oozing pus.Dr Banwell says the 3D foot models will play an important part in teaching fourth-year podiatry students about how treat and manage high-risk foot conditions.”Managing and adeptly treating severe foot conditions is an essential podiatric skill, particularly given the consistent rise in type 2 diabetes within our population,” Dr Banwell says.”Foot care is incredibly important for people with diabetes, as even one small cut can potentially lead to catastrophic consequences, including foot ulcers, lower limb wounds or amputations.”Diabetic foot disease is one of the leading causes of disability across the world with a mortality rate worse than many cancers. Diabetic Foot Australia estimates that on any given day 300,000 people are at risk of developing diabetic foot disease.In Australia, diabetes causes more than 4400 amputations, and 10,000 hospital admissions for diabetes-related foot ulcers, many of which end with a limb or part of a limb amputated.Related StoriesBordeaux University Hospital uses 3D printing to improve kidney tumor removal surgery’Traffic light’ food labels associated with reduction in calories purchased by hospital employeesIt is okay for women with lupus to get pregnant with proper care, says new study”Over the past two decades we’ve seen a 30 per cent increase in lower limbs amputation rates,” Dr Banwell says.”About 85 per cent of these are preceded by a foot ulcer and could be prevented with appropriate care.”The most effective way to manage these conditions is to medically remove dead or damaged skin to expose the healthy skin underneath and encourage healing. But learning the necessary scalpel skills to do this is challenging due to the risks of ‘practicing’ on a such a high-risk population.”The 3D foot models – and the mock injuries with which we enhance them- enable us to provide a realistic but safe learning tool for students to practice their scalpel skills, before they begin clinical placements, and all without the stress or anxiety of treating a real patient.”To support the training, ulcer debridement and management videos are being developed in partnership with the via the NADC accredited high-risk foot clinic at the Royal Adelaide Hospital.”New technologies are opening doors every day,” Dr Banwell says. “Our 3D injury-enhanced foot models are a meeting of creative minds and new technologies, and we’re very pleased with the result.”When the students encounter the models, we know they’ll be pleasantly (or perhaps unpleasantly) surprised. Either way, we’re sure they’ll be gaining the confidence, techniques and critical skills that will place them steps ahead of the competition.”The new training with 3D foot models officially kicks off on Monday 1 April (no joke).last_img read more

first_imgReviewed by James Ives, M.Psych. (Editor)Apr 10 2019The MDI Biological Laboratory and the University of New England (UNE) are bringing Maine researchers together to discuss how they can collaborate to identify solutions to the opioid epidemic in Maine.In a first step toward this goal, the institution will hold a panel discussion on the opioid crisis at the upcoming 46th Maine Biological and Medical Sciences Symposium (MBMSS), an annual statewide gathering at which students and scientists have the opportunity to network, collaborate, exchange ideas and share research results.The panel discussion, entitled “The Science Behind the Opioid Crisis,” will be led by Karen L. Houseknecht, Ph.D., associate provost for research and scholarship at UNE. As a professor of pharmacology, Houseknecht leads a National Institutes of Health (NIH)-funded research program that studies the pharmacology of psychiatric medications and emerging drugs of abuse. She is part of a multi-investigator, NIH-funded project to develop safer medications for the treatment of chronic pain.An audience discussion on the scientific resources that are being devoted to the opioid crisis will follow the panel discussion.The rate of opioid-related overdose deaths in Maine is nearly double the national rate and the state ranks among the top 10 in the rate of opioid-related overdose deaths, according to the National Institute on Drug Abuse.The panelists will be Ian D. Meng, Ph.D., and Leslie Ochs, Pharm.D., Ph.D., M.S.P.H., of UNE, and Elissa J. Chesler, Ph.D., and Vivek Kumar, Ph.D., of The Jackson Laboratory in Bar Harbor. The topics will include the roles played by genetics, pain and prescribing practices in the development of substance abuse, and the use of the mouse as a platform for addiction studies.Maine is one of many states with federal IDeA (Institutional Development Award) funding that are prioritizing research focused on reducing the burden of opioid addiction, according to the National Institute of General Medical Sciences, which administers the IDeA program. The program was established to enhance biomedical research in the 23 states and Puerto Rico that have historically had low success rates for grant funding.Related StoriesIT Faces the Digital Pathology Data TsunamiOmron donates cutting-edge laboratory to help UH engineering students gain real-world skillsEggshells can enhance growth of new, strong bonesMany of the IDeA states include rural regions that have been hard hit by the opioid crisis.”The National Institutes of Health encourages those who receive IDeA funding to share research results widely across institutions and states,” said Jane E. Disney, Ph.D., director of education at the MDI Biological Laboratory. “Including this session on opioid research in our annual symposium is an example of our commitment to increasing knowledge about this important topic in Maine.”The panel discussion is expected to serve as a platform for a future symposium on the science behind the opioid crisis, she added.”We know we have the scientific resources here in Maine to make real progress in addressing the opioid crisis,” Houseknecht said. “Our goal is to bring researchers and health care professionals from across the state together to build collaborative partnerships to address the multi-faceted problem of substance abuse in an inter-disciplinary, intra-professional way.”Approximately 200 people are registered for the April 26-27 symposium, which was established in 1975 as a forum for scientists from a range of biological and biomedical sciences disciplines. Traditionally, it has also focused on supporting student research at the undergraduate and graduate levels and growing Maine’s research capacity. Source: read more

first_imgBy Dr. Ananya Mandal, MDMay 8 2019The Centres for Disease Prevention and Control (CDC) has released a Vital Signs report that says that at least three in five pregnancy related deaths are preventable. Pregnancy related deaths include deaths cause before, during or up to one year after delivery. Pregnancy related deaths are those that are caused by reasons which are linked to or result from complications directly associated with pregnancy. It could be a chain of events that are triggered or activated by the pregnancy, its physiological effects and its complications.The report says that around 700 pregnancy related deaths are recorded in the United States. Of these 31 percent occur during pregnancy, 36 percent occur during delivery or childbirth and within a week after delivery. A further 33 percent of the deaths can occur within the period of one week after delivery and up to one year post-delivery.The CDC looked at pregnancy related mortality and morbidity data between 2011 and 2015. They also analysed details of pregnancy related deaths from maternal mortality review committees across 13 states between 2013 and 2017.The results revealed that among a heterogenic population, the risk of dying due to pregnancy related complications is around three times more likely among the Black and American Indian/Alaska Native women compared to Caucasian women. The key point that was noted by the researchers was that most of these deaths were preventable irrespective of the race and ethnicity.According to a statement from Robert R. Redfield, M.D., CDC Director, “Ensuring quality care for mothers throughout their pregnancies and postpartum should be among our Nation’s highest priorities. Though most pregnancies progress safely, I urge the public health community to increase awareness with all expectant and new mothers about the signs of serious pregnancy complications and the need for preventative care that can and does save lives.”This Vital Signs report remains the latest data on CDC’s Pregnancy Mortality Surveillance System and also summarized the recommendations in prevention of deaths of the mothers due to pregnancy related causes. Maternal mortality review committees or MMRCs from 13 states involve specialists from different disciplines and the recommendations in preventing or reducing mortality rates among mothers is provided by these experts. The experts have said that several factors are associated with the maternal deaths. Some of these include lack of access to adequate health care facilities, delayed or missed diagnosis of pregnancy related emergencies, lack of knowledge among the patients as well as health care providers. The MMRCs say that most of these deaths could have been prevented.The report says that the commonest causes of pregnancy related deaths in the nation are due to heart attack, heart disease or stroke causing around 34 percent of all deaths. Severe bleeding and infections are also a major cause of deaths during and after pregnancy and childbirth. At delivery the commonest causes of death include severe bleeding and amniotic fluid embolism. Amniotic fluid embolism is caused when amniotic fluid from the womb enters the mother’s blood stream during child birth. Commonest causes of deaths during the week after delivery include bleeding, high blood pressure and infections. Deaths during the period up to 1 year after delivery include cardiomyopathy or weakening of the heart muscles.Related StoriesOpioids are major cause of pregnancy-related deaths in UtahPre-pregnancy maternal obesity may affect growth of breastfeeding infantsWomen’s pre-pregnancy obesity changes breast milk contents which can affect infant growthWanda Barfield, director of the Division of Reproductive Health in CDC’s National Center for Chronic Disease Prevention and Health Promotion in her statement said, “Our new analysis underscores the need for access to quality services, risk awareness, and early diagnosis, but it also highlights opportunities for preventing future pregnancy-related deaths. By identifying and promptly responding to warning signs not just during pregnancy, but even up to a year after delivery, we can save lives.”According to the recommendations the MMRC data suggests awareness regarding warning signs and ongoing conversations on the part of the providers. The recommendations state that hospitals and healthcare systems can encourage communication between healthcare providers and improve quality of care before, during and after delivery.  Communities and state can contribute in providing adequate housing and transportation especially for high risk pregnancies. Above all, prevention rests on awareness and knowledge of the warning signs, says the report.The actions taken by the CDC with regards to prevention of maternal deaths include – Tracking of all maternal deaths related to pregnancy and associated complications Support to around 25 MMRCs around the nation via funding from the “Preventing Maternal Deaths: Supporting Maternal Mortality Review Committees” stating fall 2019 Supporting 13 state perinatal quality collaboratives for improvement of health of the newly delivered mothers and their babies Development of the CDC Levels of Care Assessment Tool to assess the level of maternal and new born care provided by the health care setups and providing technical assistance. Public awareness programmes regarding warning signs of high risk pregnancies The three key recommendations from the report include, “During Pregnancy: Improve access to and delivery of quality prenatal care, which includes managing chronic conditions and educating about warning signs. At Delivery: Standardize patient care, including delivering high-risk women at hospitals with specialized providers and equipment and Postpartum: Provide high-quality care for mothers up to one year after birth, which includes communicating with patients about warning signs and connecting to prompt follow-up care.”Public Health Grand Rounds is yet another effort on the part of the CDC to reduce pregnancy related deaths by raising awareness. It is a monthly webcast that discusses major health issues. The CDC along with collaborators also started “Review to Action”, a website that had resources to support MMRCs. It contains a Maternal Mortality Review Information Application (MMRIA), which is a data entry system that can provide detailed data on maternal mortality.last_img read more

first_imgRelated StoriesSchwann cells capable of generating protective myelin over nerves finds researchAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapyTAU’s new Translational Medical Research Center acquires MILabs’ VECTor PET/SPECT/CTThe researchers used VHA data from fiscal year 2017 to identify 965 VDC enrollees, 21,117 veterans receiving other purchased-care services at VHA medical centers that offered VDC, and 15,325 veterans receiving other purchased-care services at VHA medical centers that did not yet offer VDC but were interested in implementing the program. The researchers then looked at VHA hospitalizations and related costs for all of these veterans in 2016 and in 2018. When the researchers controlled for demographics, levels of care needed, duration of care, the biases of the data, and other factors, they found similar changes in hospitalization rates and costs from before and after enrollment in VDC or another program.Source:Boston University School of MedicineJournal reference:Garrido, M. et al. (2019) Users Of Veteran-Directed Care And Other Purchased Care Have Similar Hospital Use And Costs Over Time. Health Affairs. Given the popularity of this program, and our findings that enrollees have similar outcomes as enrollees in other programs, further expansion of Veteran-Directed Care may be justified.”Dr. Melissa Garrido, associate director of the Partnered Evidence-Based Policy Resource Center (PEPReC) at the VA Boston Healthcare System and research associate professor of health law, policy & management at BUSPH Reviewed by Kate Anderton, B.Sc. (Editor)Jun 11 2019A new study led by Boston University School of Public Health (BUSPH) and Veterans Affairs Boston Healthcare System researchers finds that a program that gives veterans flexible budgets for at-home caregivers is at least as effective as other veteran purchased-care services. Published in the June issue of Health Affairs, the study shows that, although the average enrollee in the Veterans Health Administration (VHA)’s Veteran-Directed Care (VDC) program has more complex health burdens than veterans in other purchased-care programs, enrollees in both groups had similar hospitalization and cost trajectories.VDC provides monthly budgets and counseling to veterans who need significant assistance with daily living, allowing them to hire personal care workers or family and friends as paid caregivers to help them continue living at home. The VDC program launched in 2009, and has proven very popular with veterans and their family caregivers, but is not yet operational nationwide.last_img read more

first_imgThe Center for Applied Biomechanics is crash-testing an industry-standard dummy that is designed to represent a 5th percentile female (5 feet tall, weighing 110 pounds). These tests will help evaluate how realistic the dummy is in representing a real female automobile occupant. Image Credit: UVA Center for Applied Biomechanics By Dr. Ananya Mandal, MDJul 10 2019Research has shown that over the last decade, cars have been rendered safer compared to older models. They are more resilient to frontal collisions say experts than before. Frontal collisions remain one of the commonest types of car crashes.Now the researchers at the University of Virginia’s Center for Applied Biomechanics have shown that despite these safety measures, women – even while they are wearing seat belts, are more prone to injuries due to the car crashes compared to the men. The results of the study were published this week in the latest issue of the Traffic Injury Prevention. The study was titled, “Automobile injury trends in the contemporary fleet: Belted occupants in frontal collisions.” Jason Forman, a principal scientist with the Center for Applied Biomechanics in a statement said, “Until we understand the fundamental biomechanical factors that contribute to increased risk for females, we’ll be limited in our ability to close the risk gap. This will take substantial effort, and in my view the National Highway Traffic Safety Administration does not have the resources needed to address this issue.”For this study the team collected crash and injury data from the National Automotive Sampling System Crashworthiness Data System between 1998 and 2015. All the police-recorded cases during this period were in the database and were used for the analysis. The team included the impact of frontal collisions in all victims over the age of 13 years. There were nearly 23,000 frontal crashes and over 31000 victims have been recorded. The numbers of females and males among the injury victims are similar, the team wrote. Pregnant women beyond their first trimester of pregnancy were excluded from the analysis. Frontal collisions were defined as those between “10 o’clock to 2 o’clock”.The team explains that belted women travellers in the new cars that are generally safer than their older counterparts are at a 73 percent greater risk of being injured seriously in the frontal collisions of the cars compared to men who are belted. The team took into consideration all the other factors such as age of the occupant, severity of the collision, stature and body mass index of the occupant as well as a vehicle model and year. Despite controlling for all these factors, the risk among women remain high the researchers wrote.Related StoriesScientists develop universal FACS-based approach to heterogenous cell sorting, propelling organoid researchResearch sheds light on sun-induced DNA damage and repairTrump administration cracks down on fetal tissue researchThe risk of injuries to the women is commonly highest in the lower limbs they add. Injuries to those over 66 years are commonly those to the rib cage and chest the team wrote. There is a lowered risk of skull fractures, cervical spine injuries and injuries to the abdomen with the new car models wrote the researchers. There has also been a reduction in injuries to the hips, thighs and knees, they add. This has been a welcome change. What needs to reduce is the risk of rib fractures and fractures to the breast bone or sternum, they wrote. Injuries to the hands, arms and wrists are also unchanged over the years with change and modification of car models, the team wrote.Forman explained, “For belted occupants in frontal collisions, substantial reductions in injury risk have been realized in many body regions in recent years. These results provide insight into where advances in the field have made gains in occupant protection, and what injury types and risk factors remain to be addressed.”Authors concluded in their study, “For belted occupants in frontal collisions, substantial reductions in injury risk have been realized in many body regions in recent years. Risk reduction in the thorax has lagged other body regions, resulting in increasing prevalence among skeletal injuries in newer model year vehicles (especially in the elderly).” They sign off, “These results provide insight into where advances in the field have made gains in occupant protection and what injury types remain to be addressed.”The study was supported and funded by the Autoliv Research.Related studyAuthors Classen and colleagues from University of Florida in April this year came up with a review titled, “Smart In-Vehicle Technologies and Older Drivers: A Scoping Review” in the journal OTJR (Thorofare N J).The team wrote that advent of “in-vehicle information systems (IVIS)” or “advanced driving assistance systems (ADAS)”, have decreased the crash risk of the car among drivers. They examined the effects of IVIS and ADAS on older drivers in terms of comfort, safety and convenience. For this they gathered data from 28 studies that has used simulators or on-road experiments.The team noted that these technologies have improved the safety of the cars and has also countered the decline in safety as the age of the drivers rose. The team wrote that with age drivers tended to experience a decline in their cognitive abilities. This was countered by the technologies. They wrote, “The ADAS enhanced safety and comfort by increasing speed control, lane maintenance, and braking responses.” They called for more real-life situation studies to prove their hypothesis. Source: references: Jason Forman, Gerald S. Poplin, C. Greg Shaw, Timothy L. McMurry, Kristin Schmidt, Joseph Ash & Cecilia Sunnevang (2019) Automobile injury trends in the contemporary fleet: Belted occupants in frontal collisions, Traffic Injury Prevention, DOI: 10.1080/15389588.2019.1630825, Classen, S., Jeghers, M., Morgan-Daniel, J., Winter, S., King, L., & Struckmeyer, L. (2019). Smart In-Vehicle Technologies and Older Drivers: A Scoping Review. OTJR: Occupation, Participation and Health, 39(2), 97–107. read more

first_imgReviewed by Kate Anderton, B.Sc. (Editor)Jun 29 2019A recent study, partially supported by the INC and published in the journal Nutrients, observed a significant increase in erectile function after the consumption of 60 g/day of nuts.Lifestyle risk factors such as smoking or stress may influence erectile dysfunction through the vascular and nervous system. This study explored the effects of nut supplementation on erectile function.Forty-three healthy males, aged 18-35, were assigned to a “nut group” and consumed the usual Western-style diet supplemented with 60 g/day of raw mixed nuts (30 g of walnuts, 15 g of almonds, and 15 g of hazelnuts); and forty participants were assigned to a “control group” and they followed the usual Western-style diet but avoided nut consumption during the 14-week follow-up. Levels of nitric oxide and E-selectin (two biomarkers of erectile endothelial function) were measured. Participants also completed the International Index of Erectile Function (IIEF) questionnaire, which evaluated the influence of nuts on erectile function through 15 questions.The results of the questionnaire observed a significant increase in some of the erectile function parameters in the nut-supplemented group. The study, conducted by Dr. Albert Salas-Huetos and led by Dr. Mònica Bulló from Rovira i Virgili University in Spain, concluded that a Western-style diet supplemented with mixed nuts may help to improve erectile function. This is the largest randomized clinical trial to date analyzing the effect of nut supplementation on erectile and sexual function in subjects without erectile dysfunction.”Dr. Mònica Bulló Source:INC International Nut and Dried Fruit Councillast_img read more

first_img Source:ISPOR The findings were disappointing. Unfortunately, in these 3 CED implementations, uncertainties were neither systematically nor completely identified. Furthermore, the analyzed dossiers did not justify why specific outcomes were not included in the CED research plan. Reviewed by James Ives, M.Psych. (Editor)Jul 15 2019Value in Health, the official journal of ISPOR- the professional society for health economics and outcomes research, announced today the publication of new research from The Netherlands showing important gaps in the deployment of “coverage with evidence development,” a type of pharmaceutical managed entry agreement that gives patients access to treatments while additional evidence is being collected. The report, “Uncertainty and Coverage With Evidence Development: Does Practice Meet Theory?” was published in the July 2019 issue of Value in Health.Reimbursement decisions concerning pharmaceuticals are subject to uncertainty. Over the years, decision makers have employed a variety of policy measures, called managed entry agreements, to regulate the reimbursement of new, often expensive, healthcare innovations. “Coverage with evidence development” (CED) is one type of managed entry agreement that aims to reduce the uncertainty surrounding the (cost) effectiveness of treatments by granting access to these treatments to patients while additional evidence is being collected.The Dutch have been leaders in implementing managed entry agreements of various types, including CED. In The Netherlands, CED has been used to regulate the reimbursement of expensive medicines since 2006 and of specific outpatient pharmaceuticals since 2012. Despite the widespread use of CED, evaluation of the value of specific CED arrangements has been lacking.In order to determine whether the practical implementation of CED in The Netherlands has included all the crucial steps for successful implementation, the authors examined the first 3 CED schemes that were completed in The Netherlands. The initial and final assessment dossiers for these cases have been published on the Dutch Health Care Institute (Zorginstituut Nederland) website:Related StoriesSleep disorders in patients with low back pain linked to increased healthcare visits, costsAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapyApplication of machine learning methods to healthcare outcomes research Alglucosidase Alfa (Myozyme®) for the treatment of Pompe’s disease Rituximab (MabThera®) for the treatment of rheumatoid arthritis Trastuzumab (Herceptin®) for the treatment of human epidermal growth factor receptor 2 positive early breast cancercenter_img These findings support the need for a more systematic approach to identify uncertainties in assessments and to explore the impact of these uncertainties on the results and decision making. Such an approach should rest on a clear definition of uncertainty and its sources. A framework would help to systematically identify uncertainty, and this process should involve all stakeholders. Value of information analysis, and the uncertainties that are not included in this analysis, should inform CED research design.”Xavier G.L.V. Pouwels, MSc, Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, The Netherlandslast_img read more

Explore further Sales of smart speakers are expected to nearly double in the US, to $3.8 billion, from last year according to Lesley Rohrbaugh and Steve Koenig, researchers with the Consumer Technology Association, which organizes the annual CES trade event.”That market is not just heating up, it is a wildfire,” Koenig said while discussing industry trends expected to play out at CES and globally in the coming year.”Compatibility with digital assistants has become table stakes (in the consumer electronics industry).”Being able to order items, select music, get information, and more by speaking to digital assistants such as Amazon’s Alexa, Google Assistant, and Microsoft’s Cortana has been such a hit that pressure will be on for more ways to interact with machines using voice, the researchers predicted.At the same time, artificial intelligence will improve, with machines getting better at thinking like people, anticipating desires, and holding conversations instead of simply taking orders, according to Rohrbaugh.The CES show-floor was expected to be rife with appliances, televisions, vehicles, speakers, robots, and more augmented with virtual assistant software such as Alexa, Cortana, Google Assistant or Samsung’s Bixby.”We will truly be able to converse with our AI devices,” Rohrbaugh said while envisioning where smart speaker technology was heading.”AI is going to know you and you will be able to trust the device.”Behind the scenes, telecommunications service providers around the world will continue to roll-out fifth-generation, or 5G, networks capable of moving seemingly limitless amounts of data blazingly fast, according to the researchers.Such 5G networks will be key to enabling machines such as self-driving cars to process sensor data quickly enough to make real time decisions, they said.”Clearly, we don’t want self-driving vehicles to hesitate for even a millisecond, so we are going to need 5G,” Koenig said.Those higher speeds will also be necessary to “make virtual reality really wireless,” handle data used to manage “smart cities,” power augmented reality, and even to channel the flood of high-definition video streamed online.”5G and AI are heralds for the coming data age,” Koenig said.Spending on consumer electronics devices and streaming services in the US alone was expected to climb slightly more than 3 percent this year to $351 billion, with the number of “connected” devices in the country rising to 715 million from 671 million last year. Citation: Virtual aide market a “wildfire” at CES gadget show (2018, January 8) retrieved 18 July 2019 from This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. What’s on center stage at the CES tech show? Your voice © 2018 AFP Voice-commanded virtual assistants packed into speakers and other devices will be a “game-changing” trend this year, Consumer Electronics Show researchers said Sunday. read more

Wanda originally specialised in real estate, but later diversified into cinema, amusement parks and sports Troubled Chinese conglomerate Wanda announced Monday that e-commerce giant Alibaba has agreed to buy a stake in its cinema division for around $750 million, the latest sell-off by the heavily-indebted group. Wanda stock skyrockets after $5.4bn Tencent tie-up Explore further Wanda Film said in a regulatory filing that Alibaba will buy a 7.66 percent stake for 4.68 billion yuan, and a holding company controlled by the Beijing government will take 5.11 percent for 3.12 billion yuan (around $500 million), generating over $1.2 billion for the conglomerate.Following rapid diversification, Wanda ended up mired in debt and under the scrutiny of Chinese regulators, forcing its head Wang Jianlin—once China’s richest man—to sell off parts of his empire.Last month, it raised $5.4 billion through a stake sale and retail link-up with several investors, including Chinese internet giant Tencent.Wanda Film owns 1,352 cinemas around the world with more than 14,000 screens—around 12 percent of the global box office, according to the Wanda Group website.Alibaba will now become the second-largest shareholder in the division, strengthening its position in China’s massive entertainment market.The e-commerce behemoth already has a foothold in Hollywood, with its 2016 purchase of a minority stake in Steven Spielberg’s Amblin Partners, which owns DreamWorks Pictures.Wanda originally specialised in real estate, but later diversified into cinema, amusement parks and sports—including the 2015 acquisition of a 20-percent stake in Spanish top-flight football club Atletico Madrid.But Beijing, which has been trying to control the surge in Chinese corporate debt, was alarmed by Wanda’s “irrational” purchases, which were largely financed through borrowing. © 2018 AFP This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. Citation: Alibaba buys stake in Wanda Film for $750 million (2018, February 5) retrieved 18 July 2019 from read more

“It is not a market driven victory because it is CPD, which is a government owned agency, which tilted the vote in the favor of an American hedge fund instead of an industrial long-term shareholder, so that’s surprising,” Gillham said. Telecom Italia’s shares rose 1 percent percent to 1.15 euros after the vote.Despite earlier calling for a breakup of Telecom Italia, Elliott said Friday that it was aligned with Genish’s plans, which call for keeping the company together.The first indication of the board’s strategy and Genish’s future with the company could come Monday, during the board’s first meeting.The Italian government has been drawn into the long-running fray, activating the rarely invoked “golden power” to protect strategic assets. It took a 5 percent stake earlier this year, giving it a board seat.Vivendi said that the vote of the government’s investment arm, known as CPD, appeared to be the determining one but stopped short of calling it government interference. Cheers went up among small stakeholders when Elliott Advisors’ narrow 49.8 percent victory over Vivendi’s 47.2 percent was announced. Elliott claims 10 seats, which it says it will fill with a cadre of well-known Italian businessmen, to Vivendi’s five.Despite losing the vote, Vivendi said they will fight any moves to separate the network infrastructure from Telecom Italia’s services, as Elliott had previously advocated.”We are here for the long-term and we are still the biggest shareholder. And we will be very sure there is no dismantling of the group. We will be very vigilant about that,” said Vivendi spokesman Simon Gillham.The stage for the shareholders’ battle was set when Elliott revealed its stake, currently at around 9 percent, earlier this year, and said it wanted to shake up the board to increase shareholder value. Telecom Italia has lost a third of its value since Vivendi became the controlling shareholder in 2015.Elliott expressed full support for CEO Amos Genish, who was brought in by Vivendi, but called the vote that marginalized the controlling shareholder a “positive step forward for corporate governance at Telecom Italia.” French media group Vivendi lost de facto control of Telecom Italia on Friday when a U.S. activist hedge fund won a majority of seats on the former state monopoly’s board in a dramatic shareholders’ showdown that also raised questions about the government’s role. Tim Vice President Franco Bernabe’, right, talks with Tim CEO Amos Genish prior to the start of the shareholders meeting, in Rozzano, near Milan, Italy, Friday, May 4, 2018. Telecom Italia shareholders are to decide whether the activist hedge fund Elliott Management has the power to revamp the board against the controlling stakeholder, French entertainment group Vivendi. (AP Photo/Antonio Calanni) © 2018 The Associated Press. All rights reserved. This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. The Italian government last year moved to protect Telecom Italia amid concerns over the French company’s control of Telecom Italia’s Sparkle undersea cable division and Telsy, which provides encrypted communications technology to the Italian military and government. The government decree requires a board member who is Italian and holds a security clearance to handle matters significant to national security.Elliott’s earlier proposal to separate Telecom Italia from the network infrastructure could allow an independent company controlled only by Italian investors, which the Italian government would favor. Vivendi, which controls just under the 25 percent threshold that would trigger a takeover, is reluctant to spin off the network, which is the money-generator at the heavily indebted company.Vivendi took a controlling stake of Telecom Italia with the aim of taking over also Silvio Berlusconi’s Mediaset to create a big media holding. That Mediaset deal has fallen in dispute, and analyst Carlo Carnevale Maffe said Vivendi’s major error was not courting officials with their strategy.”They penetrated at nighttime, and they occupied. This is perfectly legal and perfectly justified,” said Maffe, a management professor at Milan’s Bocconi University. “But if you want to buy a major telco and the biggest private media company, you need to knock on the door and at least ask permission.” Citation: US hedge fund wrests Telecom Italia control from Vivendi (2018, May 4) retrieved 18 July 2019 from A view of the Tim’s shareholders meeting, in Rozzano, near Milan, Italy, Friday, May 4, 2018. Telecom Italia shareholders are to decide whether the activist hedge fund Elliott Management has the power to revamp the board against the controlling stakeholder, French entertainment group Vivendi. (AP Photo/Antonio Calanni) Telecom Italia CEO to step down if hedge fund breaks up board: report From left, Telecom’s Roberto Capone, Tim CEO Amos Genish, Tim Vice President Franco Bernabe’ and Tim’s Notary Carlo Marchetti sit prior to the start of the Tim’s shareholders meeting, in Rozzano, near Milan, Italy, Friday, May 4, 2018. Telecom Italia shareholders are to decide whether the activist hedge fund Elliott Management has the power to revamp the board against the controlling stakeholder, French entertainment group Vivendi. (AP Photo/Antonio Calanni) Explore further read more

first_img In this Wednesday, May 16, 2018 photo, operator Andrew Reisinger drives a personnel shuttle along a small gauge rail line inside a 2.5-mile bypass tunnel being dug for the Delaware Aqueduct, in Marlboro, N.Y. Hard-hat workers are toiling deep underground, 55 stories beneath the Hudson River, to eliminate gushing leaks in an aging tunnel that carries half the city’s water supply over 85 miles from Catskill Mountain reservoirs. (AP Photo/Julie Jacobson) About 18 million gallons—3 percent of the aqueduct’s flow, or enough to fill about 27 Olympic-size swimming pools—escapes from the pipeline every day. The loss is too big to ignore, but the tunnel is too vital to simply drain for a multi-year repair. City officials eventually settled on the parallel bypass tunnel, which allows for a shutdown measured in months instead of years. In this Wednesday, May 16, 2018 photo, a tunnel worker uses a flashlight to signal the driver of an underground train engine, in Marlboro, N.Y. Hard-hat workers are toiling deep underground, 55 stories beneath the Hudson River, to eliminate gushing leaks in an aging tunnel that carries half the city’s water supply over 85 miles from Catskill Mountain reservoirs. (AP Photo/Julie Jacobson) A long, cylindrical machine nicknamed “Nora” presses into the rock face with a spinning 21.6-foot diameter “cutter head” embedded with 41 spinning, steel blades. The tunnel boring machine, the sort used worldwide for major water and transportation projects, is named for civil engineer Nora Stanton Blatch Deforest Barney. The pulverized rock comes out the back via conveyor belt to be loaded onto rail cars and hauled topside.Dozens of workers are deep down at a time. They work Nora’s controls, bolt together pieces of the ever-lengthening concrete tunnel, operate rail cars and tend to material going up and down the 900-foot shaft.It’s a construction site in a cave—and a wet one. Miners are constantly sloshing through puddles from the seeping groundwater. Explore further In this Wednesday, May 16, 2018 photo, an excavator loads a dump truck with shale from a 2.5-mile bypass tunnel being dug for the Delaware Aqueduct, in Marlboro, N.Y. Hard-hat workers are toiling deep underground, 55 stories beneath the Hudson River, to eliminate gushing leaks in an aging tunnel that carries half the city’s water supply over 85 miles from Catskill Mountain reservoirs. (AP Photo/Julie Jacobson) By 2023, water will flow through a bypass built to last. A layer of steel will be fitted inside this tunnel and then another layer of concrete added for a final 14-foot-diameter tunnel, all the way through the limestone formation.Said Rush: “We don’t plan to come down again anytime soon.” In this Wednesday, May 16, 2018 photo, Mike Schmitt, project manager for the New York State Department of Environmental Protection explains the design and construction of a 2.5-mile bypass tunnel for the Delaware Aqueduct, in Marlboro, N.Y. Hard-hat workers are toiling deep underground, 55 stories beneath the Hudson River, to eliminate gushing leaks in an aging tunnel that carries half the city’s water supply over 85 miles from Catskill Mountain reservoirs. (AP Photo/Julie Jacobson) Draining the aqueduct in 2022 will give crews time to reroute the water under the Hudson and to seal other leaks some 25 miles up the aqueduct. Those losses in Wawarsing, New York, are far smaller, but they did contribute to a local plague of flooded basements and sodden lawns that resulted in the government buying some homes.Cutting off half the city’s water supply for up to eight months sounds like a recipe for disaster, but the environmental agency has been preparing for years. Conservation efforts, like the installation of low-flow toilets, have contributed to dropping water usage rates even as the city grew.The city will rely on water from reservoirs in suburban Westchester County and the Catskill Aqueduct, which should have a higher capacity by then. That aqueduct will be shut down for several 10-week increments so crews can scrub out microorganisms that have created a layer of “biofilm,” which inhibits the flow through the century-old tunnel. Along with the complementary Catskill Aqueduct, the two help connect a complex system that serves 9.6 million people in New York City and upstate municipalities. Engineers and politicians compare the network of 19 reservoirs, three lakes and connecting tunnels to the grand aqueducts of ancient Rome.But the Delaware Aqueduct is showing its age at a weak point where it crosses through limestone beneath the Hudson River near Newburgh, New York. Limestone is less dense and has more “give” than the neighboring shale, so crews protected that length of the concrete tunnel with a steel sleeve. But for an unknown reason—lack of foresight, lack of steel during wartime—they did not extend it through the entire limestone formation.Leaks formed in that gap, with some of the water burbling up into the river. Hard-hat workers are toiling deep underground, 55 stories beneath the Hudson River, to eliminate gushing leaks in an aging tunnel that carries half the city’s water supply over 85 miles from Catskill Mountain reservoirs. Using a cylindrical, space-rocket-size borer, they are carving through solid rock to create a 2.5-mile bypass tunnel around the worst of the leaks.When they finish the $1 billion tunnel in 2022, the entire Delaware Aqueduct will be shut down for months to prepare for the diversion. And if they do it right, New Yorkers turning on their faucets will never even notice.”It’s really the largest and most complex water tunnel repair that the city of New York has ever done,” said Vincent Sapienza, commissioner of the city Department of Environmental Protection. “There’s a lot of moving parts that we’ve been wrestling with for several years now.”The Delaware Aqueduct is to the city what the aorta is to our circulatory systems: a necessary channel to keep everything running. It was drilled and blasted out mostly during World War II and carries about 600 million gallons a day, entirely by gravity, from four Catskill region reservoirs to a holding reservoir just north of the city line.center_img In this Wednesday, May 16, 2018 photo, a figure of Saint Barbara, patron saint of miners, sits mounted on a wall inside a 2.5-mile bypass tunnel being dug for the Delaware Aqueduct, in Marlboro, N.Y. Hard-hat workers are toiling deep underground, 55 stories beneath the Hudson River, to eliminate gushing leaks in an aging tunnel that carries half the city’s water supply over 85 miles from Catskill Mountain reservoirs. (AP Photo/Julie Jacobson) “We couldn’t fathom shutting down the tunnel,” said Paul Rush, deputy commissioner of the environmental department.Workers began digging two giant access holes on either side of the river in 2013, and actual tunneling started last summer. Travertine reveals ancient Roman aqueduct supply In this Wednesday, May 16, 2018 photo, tunnel workers push equipment up a rail track to a machine boring a 2.5-mile bypass tunnel for the Delaware Aqueduct, in Marlboro, N.Y. Hard-hat workers are toiling deep underground, 55 stories beneath the Hudson River, to eliminate gushing leaks in an aging tunnel that carries half the city’s water supply over 85 miles from Catskill Mountain reservoirs. (AP Photo/Julie Jacobson) Citation: Fixing a massive NYC plumbing leak, 55 stories underground (2018, June 20) retrieved 18 July 2019 from New York City is in the midst of a plumbing repair job of monumental proportions. In this Wednesday, May 16, 2018 photo, a tunnel worker fixes “bumps” in the rail of a 2.5-mile bypass tunnel being dug for the Delaware Aqueduct, in Marlboro, N.Y. Hard-hat workers are toiling deep underground, 55 stories beneath the Hudson River, to eliminate gushing leaks in an aging tunnel that carries half the city’s water supply over 85 miles from Catskill Mountain reservoirs. (AP Photo/Julie Jacobson) © 2018 The Associated Press. All rights reserved. This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.last_img read more

first_img Citation: $16 per month streaming service Philo expands to Amazon Fire and Apple TV (2018, July 11) retrieved 18 July 2019 from One of the newest broadband TV services, Philo, is expanding its reach. New internet TV service has $16 monthly tab and no sports ©2018 USA Today Distributed by Tribune Content Agency, LLC. The $16 monthly streaming subscription service, which launched in November 2017 on Roku devices, desktop and web browsers and iPhones, is now available on Amazon TV and Apple TV, the video service said Tuesday.Philo is also getting a boost of more than $40 million in investment funding, led by AMC Networks, Discovery and Viacom. Those three major programmers along with A+E and Scripps provided the initial investment of $25 million to help launch the service. (Discovery acquired Scripps in July 2017 for $11.9 billion.)The dual-pronged initiative will likely raise the awareness of Philo, which includes A&E, AMC, BET, Comedy Central, Discovery Channel, HGTV, OWN and another 30-plus channels.”Nobody knows Philo exists,” said Rich Greenfield, a media and technology analyst with financial services firm BTIG in New York. “The device partnerships are going to provide a good amount of visibility from a marketing standpoint in terms of how Amazon markets around Prime Day and how Apple promotes this.”It’s no accident that Philo’s arrival on Amazon’s Fire TV happens just days before the online retailing giant’s Amazon Prime Day on July 16. And the funding will help raise awareness of the streaming service long after Amazon’s event.”I hear a lot of people online who say they love Philo and they’re surprised they don’t see advertisements for the company in more places,” said Philo’s CEO Andrew McCollum. “That’s one thing we will be changing with the funding.”McCollum declined to reveal the size of Philo’s current subscriber base, but said “we’re really happy with the growth.”Want to check out Philo? It has a seven-day free trial and you can sign up with just your phone number. Features include an unlimited 30-day DVR, on-demand programs, and the ability to watch shows that have aired in the past three days.Wondering what is up with the name? Philo T. Farnsworth invented television in 1930. Explore further This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.last_img read more

first_img The decision to divorce comes after a trial separation, according to a statement posted Wednesday on Jeff Bezos’ Twitter account. He and his wife both signed the announcement, which ended with a vow to remain “cherished friends.”Left unanswered was one of the biggest sticking points in any divorce: How the assets amassed during the marriage will be divided.And there may never have been more money than in this case.Jeff Bezos is ranked at the top of most lists of the world’s wealthiest people, and his fortune currently hovers around $137 billion, according to estimates by both Forbes and Bloomberg. Virtually all of that is tied up in the nearly 79 million shares of Amazon stock (currently worth about $130 billion) that Bezos owns in the Seattle company, translating into a 16 percent stake. Bezos, 54, also owns rocket ship maker Blue Origin and The Washington Post, which he bought for $250 million in 2013.Because the pair were married before Amazon was founded, it’s likely that MacKenzie Bezos holds a large claim to that fortune, though details hinge on where the couple files for divorce and if they had a prenuptial agreement.King County, where their home is located, confirmed on Twitter Wednesday that the Bezoses had not filed for divorce in court. The couple own a home in a wealthy Seattle suburb within the county. The Bezoses have four children.”The property acquired during the marriage is common property,” said Jennifer Payseno, a family lawyer at the firm McKinley Irvin in Seattle. That includes stock ownership, although Amazon has not filed any regulatory documents to suggest Bezos’ stake in the company has changed.All that power and wealth has magnified the focus on Jeff Bezos, although his divorce seems unlikely to enthrall the public like high-profile breakups among movie stars such as Brad Pitt and Angelina Jolie. Or even those of other billionaires, such as Donald Trump’s tabloid-fodder split with his former wife Ivana in the early 1990s, long before he was elected president.But the Bezos divorce seems likely to attract more attention than when Google co-founder Sergey Brin—currently worth $49 billion—divorced his former wife Anne in 2015.The amicable tenor of the Bezoses’ divorce announcement makes it highly likely that the couple already has reached an agreement on how to divide their assets, Payseno said.Amazon’s origins trace back to a road trip that the Bezoses took together not long after they met in New York while working at hedge fund D.E. Shaw. They got married just six months after they began dating, according to Bezos.Not long after that, Jeff Bezos quit his job at Shaw and started an online bookstore. While his wife did the cross-country driving, Bezos wrote a business plan on the way to Seattle—chosen for its abundance of tech talent. By July 1995, Amazon was operating out of a garage, with MacKenzie Bezos lending a hand, according to a review she posted on Amazon in 2013 panning “The Everything Store,” a book about Bezos and the company written by Brad Stone.”I was there when he wrote the business plan, and I worked with him and many others represented in the converted garage, the basement warehouse closet, the barbecue-scented offices, the Christmas-rush distribution centers, and the door-desk filled conference rooms in the early years of Amazon’s history,” she recalled.Amazon has since evolved from an upstart website selling books to an e-commerce goliath that sells virtually all imaginable merchandise and runs data centers that power many other digital services such as Netflix. It also has become a leader in intelligent voice-activated speakers with its Echo products, which are emerging as command centers for internet-connected homes—and a gateway to buying more stuff from Amazon. Citation: Amazon founder Jeff Bezos and wife divorcing after 25 years (2019, January 9) retrieved 17 July 2019 from As Amazon slashes prices, Bezos sees jump in wealth Explore further In this March 4, 2018 file photo, Jeff Bezos and wife MacKenzie Bezos arrive at the Vanity Fair Oscar Party in Beverly Hills, Calif. Bezos says he and his wife, MacKenzie, have decided to divorce after 25 years of marriage. Bezos, one of the world’s richest men, made the announcement on Twitter Wednesday, Jan. 9, 2019. (Photo by Evan Agostini/Invision/AP, File)center_img Amazon CEO and founder Jeff Bezos and his wife, MacKenzie, are divorcing, ending a 25-year marriage that played a role in the creation of an e-commerce company that made Bezos one of the world’s wealthiest people. This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. © 2019 The Associated Press. All rights reserved.last_img read more

first_imgWould you ever go on vacation to the North Pole? Unless you like subzero temperatures and Nordic-ski treks, probably not. But if you lived 56 million years ago, you might answer differently. Back then, you would have enjoyed balmy temperatures and a lush green landscape (although you would have had to watch out for crocodiles). That’s because the world was in the middle of an extreme period of global warming called the Paleo-Eocene Thermal Maximum, when the Earth was so hot that even the poles reached nearly tropical temperatures. But was the planet ever as hot as it is today, when every month the globe seems to be breaking one high-temperature record after another? It turns out that the Earth has gone through periods of extreme warming more than once. The poles have frozen and thawed and frozen again. Now, the Earth is heating up again. Even so, today’s climate change is a different beast, and it’s clearly not just part of some larger natural cycle, Stuart Sutherland, a paleontologist at the University of British Columbia, told Live Science. [How Often Do Ice Ages Happen?]  AdvertisementIs It OK to Throw House Spiders Outside?Some gentle souls will trap spiders in a jar and release them outside, waiting for them to scurry away. But is this outdoor relocation an act of compassion, or a death sentence for the spider?Your Recommended PlaylistVolume 0%Press shift question mark to access a list of keyboard shortcutsKeyboard Shortcutsplay/pauseincrease volumedecrease volumeseek forwardsseek backwardstoggle captionstoggle fullscreenmute/unmuteseek to %SPACE↑↓→←cfm0-9接下来播放Why Do Leaves Change Colors in the Fall?01:39关闭选项Automated Captions – en-US facebook twitter 发邮件 reddit 链接已复制直播00:0001:2701:27  Earth’s climate does naturally oscillate — over tens of thousands of years, its rotations around the sun slowly change, leading to variations in everything from seasons to sunlight. Partially as a result of these oscillations, Earth goes through glacial periods (better known as ice ages) and warmer interglacial periods. But to create a massive warming event, like the Paleo-Eocene Thermal Maximum, it takes more than a change in the tilt of Earth’s axis, or the shape of its path around the sun. Extreme warming events always involve the same invisible culprit, one we’re all too familiar with today: a massive dose of carbon dioxide, or CO2. This greenhouse gas was almost certainly responsible for the Paleo-Eocene Thermal Maximum. But how did CO2 concentrations get so high without humans around? Scientists aren’t absolutely sure, said Sébastien Castelltort, a geologist at the University of Geneva. Their best guess is that volcanoes spewed carbon dioxide into the atmosphere, trapping heat, and perhaps melting frozen pockets of methane, a greenhouse gas more potent than CO2 that had been long sequestered under the ocean. Just because extreme warming events spurred by greenhouse gases have happened before, doesn’t mean these events are harmless. Take, for instance, the Permian-Triassic extinction event, which struck a few million years before dinosaurs arose on the planet. If the word “extinction” isn’t enough of a clue, here’s a spoiler: it was an absolute disaster for Earth and everything on it. This warming event, which occurred 252 million years ago, was so extreme that Sutherland calls it the “poster child for the runaway greenhouse effect.” This warming event, which was also caused by volcanic activity (in this case, the eruption of a volcanic region called the Siberian Traps), triggered climate chaos and widespread death. “Imagine extreme drought, plants dying, the Saharah spreading throughout the continent,” Sutherland told Live Science. Temperatures rose 18 degrees Fahrenheit (10 degrees Celsius). (This is compared with the 2.1 F (1.2 C) rise in temperature we’ve seen since humans began burning fossil fuels). Around 95% of marine life and 70% of terrestrial life went extinct. “It was just too hot and unpleasant for creatures to live,” Sutherland said. It’s uncertain how high greenhouse gas concentrations were during the Permian-Triassic extinction event, but they likely were far higher than they are today. Some models suggest they grew as high as 3,500 parts per million (ppm). (For perspective, today’s carbon dioxide concentrations hover a little over 400 ppm — but that’s still considered high). But it’s the rate of change in CO2 concentrations that makes today’s situation so unprecedented. During the Permian Triassic extinction event, it took thousands of years for temperatures to rise as high as they did — according to some studies, as many as 150,000 years. During the Paleo-Eocene Thermal Maximum, considered an extremely rapid case of warming, temperatures took 10,000 to 20,000 years to reach their height. Today’s warming has taken only 150 years. That is the biggest difference between today’s climate change and past climatic highs. It’s also what makes the consequences of current climate change so difficult to predict, Castelltort said. The concern isn’t just “but the planet is warming.” The concern is that we don’t know how rapid is too rapid for life to adjust, he said. Based on past warming events, no experts could possibly say that the current rate of warming won’t have dramatic consequences, he said. “We just don’t know how dramatic,” he added. What is a Carbon Sink? Why Weather Affects Climate Change Beliefcenter_img What If a Giant Asteroid Had Not Wiped Out the Dinosaurs? Originally published on Live Science.last_img read more

first_imgAugust 17, 2018 SHARE SHARE EMAIL Union Minister Arun Jaitley today remembered former Prime Minister Atal Bihari Vajpayee as a “quintessential gentleman” who accepted criticism and valued consensus as he was a “product” of parliamentary democracy. Vajpayee, 93, passed away at the All India Institute of Medical Sciences (AIIMS) here last evening after a prolonged illness. Jaitley, who was a minister in the Vajpayee government, said, “Atal-ji’s demise is referred to by many as end of an era. I, however, consider it as a continuation of the era of which he was one who laid the foundation.” In a blog post titled ‘Atalji, the Quintessential Gentleman—How he made a difference?’, the minister said the essential aspect of Vajpayee’s political journey, true to his name ‘Atal’ was determination. “In the world’s largest democracy only the Congress Party dominated in the first few decades. Atalji created an alternative, which in the last two decades became larger and bigger than the Congress. Along with (L K) Advaniji, he created a second line leaders both in the Centre and the states,” he said. Vajpayee, Jaitley said, was always open to ideas and gave priority to national interest. “…(he) was always at ease in dealing with both friends and opponents and never allowed himself to get into any petty controversy,” said the minister, who is recuperating after a kidney transplant surgery.‘Liberaliser’The Pokhran Nuclear Test in 1998 was a defining moment of the Vajpayee’s government and he also went out of the way to work for peace with Pakistan. “But when the need arose, he inflicted a severe blow to it in Kargil. Both Pokhran and Kargil were his high points. On the economic front, he was a liberaliser. National Highway, rural roads, better infrastructure, a new telecom policy which was pragmatic, a new electricity law are evidence of this,” Jaitley said. Jaitley further wrote that the poet in Vajpayee also created a dreamer. “Atalji was a democrat. His political style was liberal. He accepted criticism. He was a product of parliamentary democracy and, therefore, valued consensus. He bore no malice. He communicated even with those who disagreed. Whether in opposition or the government, his attitude never changed. He was an iconic communicator unparalleled in recent history,” the blog said. Jaitley also recalled that in Parliament, Vajpayee was heard in pin drop silence and in public meetings audiences waited for hours before he could arrive. “His oration was always blended with humour. His ability for an instant response was unmatched. His choice of words, his turn of phrases, the poetry that he injected in his expression, gave him the ability to even explain the most complicated issue in a simple language,” the minister said. death COMMENTcenter_img SHARE Published on COMMENTSlast_img read more

first_imgSHARE SHARE EMAIL politics Published on The only way to let the sufferings of violence go is forgiveness, Congress President Rahul Gandhi said citing his personal experience. “And for forgiveness, you need to understand where it is coming from. My father was killed by a terrorist in 1991. When the terrorist died a few years later, I was not happy. I saw myself in his children,” Rahul Gandhi said in Germany on what he felt when LTTE chief Velupillai Prabhakaran — a key accused in the murder of his father and former prime minister Rajiv Gandhi — was shot dead by Sri Lankan troops in 2009.He said he was not happy when the news reached him. “I called up my sister. I said to her that it is strange, but I am not happy. I should be celebrating that the person who killed my father is dead,” he said. While addressing a gathering at the Bucerius Summer School, Gandhi said he lost two members of his family due to violence. “My grandmother (Indira Gandhi) and my father (Rajiv Gandhi) were both killed. So, I have suffered violence. I am talking actually from experience. The only way you can move forward after violence is forgiveness. There is no other way. And to forgive you have to understand what exactly happened and why it happened.”He added that the reason he was not happy was because he saw himself in Prabhakaran’s children. “Him lying there actually means there are kids like me who are crying. You might call him a bad, evil person, but violence against him was impacting others like it impacted me,” he said. “The only way you move away from violence is through forgiveness.” SHAREcenter_img COMMENTS August 23, 2018 COMMENTlast_img read more

first_imgKerala Chief Minister Pinarayi Vijayan (file photo)   –  PTI SHARE SHARE EMAIL natural disasters COMMENT COMMENTS Published oncenter_img Kerala Chief Minister Pinarayi Vijayan has dismissed as baseless the Opposition charges that the devastating floods witnessed by the State were “a man-made disaster’’. The Chief Minister’s statement came in as response to a blistering attack by the Leader of Opposition, Ramesh Chennithala, on the ‘faulty management’ of dams even as a crunch situation had built up. Residents warned“Dams are never opened without an alert. In July second week, reservoirs were full. In the third week, dams were opened. It was announced that the dams will be opened in a phased manner,” Vijayan said. After the rivers overflowed, residents along the rivers were warned and asked to move out. Care was taken not to open the gates at Idukki and Idamalayar together since it would cause major flooding. In the case of the Idamalayar dam, a blue alert was given on July 25, orange alert on August 1, and red alert on August 8. These are official records, and was publicised in the media, Vijayan said. The Chief Minister countered Chennithala’s allegation saying that the dams were opened not during night when people were asleep, as he had alleged, but only in the morning. Neither were 44 of them opened together, with the Chief Minister stating that they had to open a few at the same time due to the unexpected intensity of the rains. When a reservoir is full, there is no option but to release excess water. Still, authorities had also avoided opening the Idukki and Idamalayar dams together since it would have worsened the situation. Effectively managedDrawing parallels to the 2013 monsoon, the Opposition Leader had argued that the floods were effectively managed by the then government which had foreseen the rains and opened the smaller dams instead of the Idukki dam to reduce the extent risk of flooding. To this, Pinarayi Vijayan said that the 2013 rains were normal in comparison to what the State witnessed this year. Despite some dams reaching full reservoir level in 2013, there was no requirement to open the sluice gates as the State had received much lesser rainfall at the time. Whenever alerts were issued this time, officials responsible were prompt in updating the media and immediate action was also taken to alert and evacuate people living near the dam. Responding to Chennithala’s accusation that there was a delay in opening the Idukki dam shutters despite water levels reaching 2,397 ft against a full reservoir level of 2,403 ft, Vijayan said that all arrangements had been made to open the shutters on a trial run basis. However, due to excessive rainfall, the Idamalayar dam had to opened before Idukki dam, he said. SHARE August 23, 2018 Keralalast_img read more