eHealthInsurance reports that interest in health coverage ginned up by the new federal law has helped new memberships rise 50 percent. Meanwhile, NPR examines the mixed record of the 14 states running their own marketplaces.USA Today: Private Exchange Sees Surge In Health Care EnrollmentThe number of customers on the nation’s largest private health insurance exchange increased by 50 percent in the final three months of 2013, a direct result of demand created by the Affordable Care Act, the company’s CEO said Thursday. Gary Lauer, CEO of eHealth Insurance, said individual memberships rose 50 percent in the fourth quarter of 2013 compared with the same period in 2012, from 113,600 applications in the last three months of 2012 to 169,800 in 2013 (Kennedy, 2/20).NPR: As Deadline Nears, State Insurance Exchanges Still A Mixed BagWith a bit more than a month left for people to sign up for health insurance plans set up under the Affordable Care Act, the federal website known as healthcare.gov finally seems to be working smoothly — in 36 states. But what’s happening in the 14 states that are running their own exchanges? (Rovner, 2/21).Some health law supporters are concerned about mental health benefits –Politico Pro: Mental Health Parity Supporters Worry About Exchange PlansThe long fight to ensure mental health parity is now focusing on Obamacare plans, with advocates fearing that some are already in violation of federal law and regulations. All plans sold on the Affordable Care Act’s new exchanges, plus most other private-market policies, must begin complying in July with final rules to a 2008 law that requires insurers to cover mental health care the same way they cover care for physical ailments. … But ensuring that plans fully follow the law and its final rules will be tricky. In particular, problems are anticipated with the new state-based marketplaces since many have modeled benefits after small-group plans, which are exempt from the law if they were created before March 23, 2010 (Cunningham, 2/20). And in other news from the states –Los Angeles Times: Anthem Blue Cross Widens Enrollment Lead On California’s ExchangeInsurance giant Anthem Blue Cross stretched its lead over rival Blue Shield of California in the state’s health care-coverage exchange, new data show. Anthem signed up 223,630 people through Jan. 31, or 31 percent of California’s exchange market as part of the health care law. Anthem is a unit of Indianapolis-based WellPoint Inc., the nation’s second-largest health insurer (Terhune, 2/20).The Washington Post: More Than 12,000 Congressional Staffers Have Enrolled In Health Plans Through ObamacareThousands of people have purchased health coverage through the District of Columbia’s new small-business insurance marketplace, but only a tiny fraction of them actually own or work for a small business. The rest are members of or work for a single large organization — Congress (Harrison, 2/20).The CT Mirror: Access Health CT Claims An ‘Olympic Bump’Are the Olympics boosting enrollment in Connecticut’s health insurance exchange? Access Health CT, as the exchange is known, has been advertising heavily during broadcasts of the winter games, and Chief Marketing Officer Jason Madrak says it’s experienced something of an “Olympic bump.” In the week after the opening ceremony, Access Health’s website traffic rose 31 percent over the prior week, the number of accounts created rose by 24 percent, and the number of daily enrollments rose by 67 percent (Becker, 2/20).The CT Mirror: Access Health CT Marketing Obamacare ‘Exchange In A Box’Connecticut’s health insurance exchange has run more smoothly than many of its counterparts across the country, and now officials at the state’s insurance marketplace are in discussions about franchising the system to other states. The concept is to market a “turnkey”-type exchange program that other states could use, rather than building their own insurance marketplaces from scratch, said Kevin Counihan, CEO of Access Health CT, the state’s exchange. He refers to it as an “exchange in a box.” Counihan said Access Health officials have met with officials from five states about the idea (Becker, 2/20). The CT Mirror: Access Health CT Spanish-Language Website To Launch FridayAfter months of delays, the Spanish-language website for Connecticut’s health insurance exchange is slated to be available Friday. James Wadleigh, chief information officer of Access Health CT, the state’s exchange, said the Access Health website will undergo maintenance Thursday night. On Friday morning, the Spanish-language site will be up. In addition, there will be some changes to the existing website, he said, including one aimed at making it easier for people to enroll in catastrophic plans (Becker, 2/20). The Wall Street Journal: Nevada’s Health Exchange Director To ResignNevada’s insurance exchange director, Jon Hager, announced his resignation Thursday, days after he had described “a difficult month” for the online insurance portal set up under the federal health care law. The 39-year-old former Navy pilot told the Silver State Health Insurance Exchange board that he would be leaving March 14, the board confirmed (Radnofsky, 2/20). Private Exchange Benefiting From Health Law; Some State-Run Marketplaces Still Struggling This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
Pharmaceutical costs are also in the news — Medicare beneficiaries who live in urban areas may save money on their prescription drugs this year because they have better access to pharmacies in drug plan networks that charge lower copayments or coinsurance, according to the federal Centers for Medicare & Medicaid Services. Such “preferred cost-sharing pharmacies” have been on the rise, adding another layer of calculation — and sometimes confusion — for Medicare beneficiaries who are trying to find the best price for their drugs. (Andrews, 2/19) The Wall Street Journal: Lengthy Hospice Care Boosts Medicare Bills Medicare reimbursement for cardiac imaging isn’t just dramatically higher in a hospital outpatient department, compared to a physician’s office: It’s an entire episode-of-care cost level higher. (Dickson, 2/18) Kaiser Health News: Urban Medicare Beneficiaries May See More Drug Savings This Year For more than a year, top officials from Medicare, the nation’s largest health plans, medical societies and major employer and consumer groups hammered away at a dreadful task: Get everyone to agree to use identical quality measures for the treatment of heart disease, cancer and other common conditions. (Evans, 2/18) Medicare pays hospice agencies to care for patients who are close to death. For some beneficiaries of the taxpayer-funded program, hospice has become a way of life. Between 2005 and 2013, about 107,000 patients received hospice care for an average of nearly 1,000 days spread out over four or more calendar years, according to a Wall Street Journal analysis of Medicare billing records. Medicare’s hospice program, which has been around for 33 years, is supposed to be only for patients who doctors certify are likely to die within six months, or about 180 days. (Weaver, Wilde Mathews and McGinty, 2/18) Modern Healthcare: The Hard Work Ahead On Adopting Uniform Quality Measures Modern Healthcare: Doctors Say Medicare Pays Three Times More For Care In Hospital Outpatient Departments Medicare Costs Rise On Long Hospice Stays Medicare’s hospice program was started for patients likely to die within 180 days, but thousands with dementia and other conditions have spent far more time. In related news, doctors say outpatient care is also boosting Medicare’s bills and the health industry faces challenges meeting quality requirements. This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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The Maruti Suzuki Wagon R EV is expected to launch next year in India, and the car has been spotted road testing. It could be one of the most important vehicle/platforms in the ongoing battle against climate change and pollution in the world’s most air-polluted country. more…The post Indian Road tested Maruti Suzuki Wagon R EV, launching at pollution-fighting $10k appeared first on Electrek. Source: Charge Forward
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Since you’re here… Share on Pinterest Sun 10 Feb 2008 21.59 EST Sport Sport Share on Facebook Support The Guardian Shares00 … we have a small favour to ask. The Guardian will engage with the most critical issues of our time – from the escalating climate catastrophe to widespread inequality to the influence of big tech on our lives. At a time when factual information is a necessity, we believe that each of us, around the world, deserves access to accurate reporting with integrity at its heart.More people are reading and supporting The Guardian’s independent, investigative journalism than ever before. And unlike many news organisations, we have chosen an approach that allows us to keep our journalism accessible to all, regardless of where they live or what they can afford. But we need your ongoing support to keep working as we do.Our editorial independence means we set our own agenda and voice our own opinions. Guardian journalism is free from commercial and political bias and not influenced by billionaire owners or shareholders. This means we can give a voice to those less heard, explore where others turn away, and rigorously challenge those in power.We need your support to keep delivering quality journalism, to maintain our openness and to protect our precious independence. Every reader contribution, big or small, is so valuable. Support The Guardian from as little as $1 – and it only takes a minute. Thank you. Share on Twitter Reuse this content Share on Facebook Topics Share via Email Share via Email Share on Twitter Share on Messenger Eagles soar to open four point lead at topThe Newcastle Eagles went four points clear at the top of the BBL Championship last night with a comfortable 112-82 win at Cheshire Jets. As they had in the BBL Trophy semi-final eight days previously, the Eagles settled the game in the first quarter, leading 34-13 after 10 minutes. The Eagles’ main challengers in the title race may yet turn out to be the Scottish Rocks, who won for the eighth time in their last nine outings when they crushed Sheffield 82-56, with 17 points from Rob Yanders. Elsewhere, Plymouth kept themselves in third place by scoring the last seven points of a 73-70 win over Leicester, with Andrew Lasker scoring 25 points. Rob DugdaleFour-wicket Ishant leaves Australia flounderingA stunning spell of fast bowling from Ishant Sharma set up a five-wicket victory for India against Australia in the Commonwealth Bank Series in Melbourne. Ishant, right, was in destructive form, claiming four wickets as the hosts were dismissed for 159 inside 44 overs. India stuttered in reply but 44 from Sachin Tendulkar and an unbeaten 39 from Rohit Sharma were enough to see them home. Australia’s captain, Ricky Ponting, said: “India bowled well and fielded well but we have some work to do on our batting. We played a few loose shots at the top of the order. When you have a low total to defend you have to find a way of getting wickets. We were not good enough.” ReutersHall takes Masters as home advantage fails WebbEngland’s Lisa Hall claimed the biggest title of her career with a final round of 66 in the ANZ Ladies’ Masters, which was cut to 54 holes because of bad weather at the Royal Pines Resort in Queensland. Hall finished 13 under par on 203 to win by a shot from South Korea’s Shin Hyun-ju, who three-putted the last from 25 feet for a 68. Australia’s Karrie Webb, who won the Australian Open last week and was aiming to extend her record to seven victories in the Masters, finished in fifth place on 10 under after a 70. For Hall, 40, it was a fourth European Tour title and she said: “This really is special. To beat Karrie Webb in her own back yard makes this a great win.” Elspeth BurnsideMurphy punishes Doherty errors to retain Malta CupShaun Murphy retained the Malta Cup in a field featuring all the world top 16 except Ronnie O’Sullivan and Steve Davis by beating Ken Doherty 9-3 in the final at the Hilton Conference Centre, Portomaso. The world No3’s ranking will not be improved by the success, however, because the tournament lost its world ranking status this year. In the final the balls did not run kindly for large breaks, but solid potting and tight safety, with Doherty’s mistakes, saw Murphy home. A day earlier Murphy had seemed to be heading for a semi-final defeat when he trailed China’s Ding Junhui 3-0 but he responded with a 137 clearance – the highest break of the week – before winning 6-5. Clive Everton First published on Sun 10 Feb 2008 21.59 EST Sport in brief Share on WhatsApp Share on LinkedIn
match reports Everton First published on Mon 25 Feb 2008 22.27 EST @DTguardian Share on Messenger Share on Pinterest Daniel Taylor at the City of Manchester Stadium Share on Twitter Share via Email Share on Facebook Shares11 Share on WhatsApp Topics Bill Shankly used to rely on an old saying at Anfield that “first is first and second is nowhere”. These days, finishing fourth is the best Liverpool can hope for and there are even signs that they may have to suffer the indignity of being barged out of the Champions League places by the team from across Stanley Park – a side, lest it be forgotten, whom Rafael Benítez has infamously described as a “small club”.Everton resented that suggestion and they seem to be doing everything in their power to make Benítez rue his words. This victory, courtesy of first-half goals from Yakubu Ayegbeni and Joleon Lescott, propelled David Moyes’s impressive team back above Liverpool into fourth, three points clear of their neighbours, albeit having played a game more.The question of whether they can dig in their heels promises to be almost as intriguing as the title race itself but one certainty is that Manchester City can be discounted with immediate effect. Sven-Goran Eriksson’s team turned down a cul-de-sac last night and, having been thoroughly outplayed, they lie eighth, their lowest position of the Swede’s reign. On this evidence it looks about right.City, it must be said, were poor and occasionally wretched, their frustrations encapsulated in the third minute of stoppage time when Martin Petrov flicked his boot at Leon Osman and was shown a red card for his petulance. Everton were significantly better in all departments. They might conceivably have had three penalties, all for handball, and the score would have been embarrassing had it not been for Joe Hart’s goalkeeping and the referee Rob Styles’s bewildering leniency.Fabio Capello was here and will have been impressed by Hart even if it is bemusing that a 20-year-old who began the season as Eriksson’s third-choice goalkeeper is now being spoken of as a serious contender for the England team. The name of Lescott may also have featured prominently in Capello’s notebook – presumably with a tick rather than a cross – but Micah Richards had a dismal evening in front of the new England manager. All that can be said in his mitigation is that he was not the only one.Moyes’s team were quicker to the ball, stronger in the tackle and played with an urgency that was strangely missing from the home side. All of which spares Styles another inquest into his officiating, given that there were two occasions when Richards inexplicably jabbed out his right arm to handle the ball inside the penalty area and a less obvious one when Nedum Onuoha did the same.The sense of injustice seemed to spur on the visiting players. Their passing was crisp, they played with width and penetration and looked particularly incisive when attacking down the left. City, in stark contrast, looked unrecognisable from the side who had beaten Manchester United in their last game – which was strange and, for Eriksson, deeply irritating given that he had chosen the same team.Perhaps, in hindsight, Eriksson will regret not starting with Elano and Vedran Corluka, both of whom had been suspended at Old Trafford. His team did not manage a noteworthy attempt on goal in the opening half and, once the first goal went in, Everton were so utterly in command they could conceivably have put the result beyond doubt by half-time.As it was, their superiority was rewarded with only one more goal, Lee Carsley’s deep cross picking out Lescott in a congested penalty area and the defender jumping highest to loop a well directed header beyond Hart. It summed up City’s performance that Richard Dunne, their usually imperious captain, was outjumped in the process, but it was totally in keeping with the way the game had gone since the first few minutes when Hart had to rush from his goal-line to save adroitly at Yakubu’s feet. After 29 minutes Steven Pienaar’s curling effort flicked off the crossbar and, within 60 seconds, Everton took the lead when Yakubu touched the ball to Tim Cahill, set off for the six-yard area and arrived just in time to turn in the return pass.Equally disappointing for Eriksson must have been the lukewarm response from his team after the interval. True, there was an improvement but this owed much to Everton sitting back on their lead and the away side rarely looking troubled. Eriksson introduced Elano and his new striker, Felipe Caicedo, but their increased possession seldom amounted to anything and at the other end they continued to look vulnerable.Everton might, indeed, have scored a third when Yakubu surged down the left and cut the ball back for Cahill, who was denied by Michael Ball’s saving tackle and Dunne’s clearance. Hart’s one-handed save thwarted Carsley late on and, soon afterwards, the City supporters began to drift away, a few of them wondering perhaps how early next season’s Intertoto Cup will interrupt summer. Share on LinkedIn Soccer Reuse this content Manchester City Share on Twitter Soccer Lescott sinks City as Everton climb back into fourth Mon 25 Feb 2008 22.27 EST Share on Facebook Share via Email
I hope the usual suspects don’t muddy up the conversation again by calling this one a “declination.” (See here for the recent post).As highlighted in this August 2015 post, Houston-based Vantage Drilling disclosed:“In July 2015, we became aware of media reports that our agent utilized in the contracting of the Titanium Explorer drillship has entered into a plea arrangement with the Brazilian authorities in connection with the agent’s role in obtaining bribes on behalf of former Petrobras executives. We have since confirmed that our agent, who has represented multiple international companies in their contracts with Petrobras, has entered into such discussions and provided evidence to the Brazilian authorities of an alleged bribery scheme between the former Petrobras executives and a former director of Vantage.The former director, Mr. Su, was the sole owner of the company that owned the Titanium Explorer at the time the alleged bribe was paid. We have not been contacted by any governmental authority in connection with these allegations. However, we voluntarily contacted the SEC and the Department of Justice (the “DOJ”) to advise them of these recent developments. We continue to investigate the matter, but as of now, our internal and independent investigations have found no evidence of wrongdoing by our employees or participation in any manner with the inappropriate acts alleged to have been conducted by the agent.We cannot predict whether any governmental authority will seek to investigate this matter, or if a proceeding were opened, the scope or ultimate outcome of any such investigation. If the SEC or DOJ determines that we have violated the U.S. Foreign Corrupt Practices Act of 1977 (the “FCPA”), or if any governmental authority determines that we have violated applicable anti-bribery laws, they could seek civil and criminal sanctions, including monetary penalties, against us, as well as changes to our business practices and compliance programs, any of which could have a material adverse effect on our business and financial condition.On August 21, 2012, we filed a lawsuit against Mr. Su, a former member of our Board of Directors and the owner of F3 Capital, our largest shareholder, asserting breach of fiduciary duties, fraud, fraudulent inducement and negligent misrepresentation, and unjust enrichment based on Mr. Su’s conduct in his dealings with the Company both immediately prior to, and during his tenure as one of our directors. On June 20, 2014, we received notice that Mr. Su had filed a countersuit against the Company and certain of the Company’s current and former officers and directors. The countersuit alleges fraud, breach of fiduciary duty, negligent misrepresentation, tortious interference with contract, and unjust enrichment and seeks indemnification from us with respect to the matters that are the basis of our lawsuit.”As highlighted in this May 2016 post, the company disclosed in pertinent part:“In connection with our cooperation with the DOJ and SEC, we recently advised both agencies that in early 2010, we engaged outside counsel to investigate a report of allegations of improper payments to customs and immigration officials in Asia. That investigation was concluded in 2011, and we determined at that time that no disclosure was warranted; however, in an abundance of caution, we are reviewing the matter again in light of the allegations in the Petrobras matter.”Yesterday, the company issued this release which states:“[The company] has received a letter from the United States Department of Justice (the “DOJ”) acknowledging Vantage’s full cooperation in the DOJ’s investigation concerning possible violations by Vantage of the Foreign Corrupt Practices Act (the “FCPA”), and indicating that the DOJ has closed its investigation without any action.The investigation arose in 2015 from allegations of improper payments to former officials of Petróleo Brasileiro S.A (“Petrobras”) in connection with the contracting of the Titanium Explorer drillship to Petrobras. From the outset of the investigation, the Company has provided its full cooperation to the DOJ and the United States Securities and Exchange Commission (the “SEC”).Mr. Ihab Toma, Vantage’s Chief Executive Officer, stated, “We are very pleased with the closure of the DOJ’s investigation. Vantage has been, and remains, firmly committed to conducting its operations in compliance with all applicable laws and regulations, including the FCPA.”It is the Company’s understanding that the parallel investigation by the SEC remains open at this time, and Vantage continues to cooperate with the SEC with regard to that investigation.” Learn More & Register FCPA Institute – Boston (Oct. 3-4) A unique two-day learning experience ideal for a diverse group of professionals seeking to elevate their FCPA knowledge and practical skills through active learning. Learn more, spend less. CLE credit is available.
Strategies For Minimizing Risk Under The FCPA A compliance guide with issue-spotting scenarios, skills exercises and model answers. “This book is a prime example of why corporate compliance professionals and practitioners alike continue to listen to Professor Koehler.” Order Your Copy Interested in elevating your Foreign Corrupt Practices Act knowledge and practical skills?For professionals in the FCPA space – or wishing to join the FCPA space – this is what the FCPA Institute is all about and the next FCPA Institute will be in Phoenix on January 17-18, 2019.The FCPA Institute is different than a typical FCPA conference.At the FCPA Institute, information is presented in an integrated and cohesive manner by an expert instructor with FCPA practice and teaching experience. Moreover, the FCPA Institute promotes active learning by participants through issue-spotting videos, skills exercises, small-group discussions and the sharing of real-world practices and experiences.To best facilitate the unique learning experience that the FCPA Institute represents, attendance at each FCPA Institute is capped at 25 participants.In short, the FCPA Institute elevates the FCPA learning experience for a diverse group of professionals and is offered as a refreshing and cost-effective alternative to a typical FCPA conference. The goal of the FCPA Institute is simple: to develop and enhance fundamental skills relevant to the FCPA, FCPA enforcement, and FCPA compliance best practices in a stimulating and professional environment with a focus on learning.The FCPA Institute presents the FCPA not merely as a legal issue, but also as a business and accounting issue. The FCPA Institute is thus ideal for a diverse group of professionals such as in-house and outside counsel; business executives; finance, accounting and auditing professionals; and other compliance professionals seeking sophisticated FCPA knowledge and practical skills.Set forth below is a sampling of what FCPA Institute “graduates” have said about their experience.“Unlike other FCPA conferences where one leaves with a spinning head and unanswered questions, I left the FCPA Institute with a firm understanding of the nuts and bolts of the FCPA, the ability to spot issues, and knowledge of where resources can be found that offer guidance in resolving an issue. The limited class size of the FCPA Institute ensured that all questions were answered and the interactive discussion among other compliance professionals was fantastic.” (Rob Foster, In-House Counsel, Oil and Gas Company)“The FCPA Institute was one of the best professional development investments of time and money that I have made since law school. The combination of black letter law and practical insight was invaluable. I would highly recommend the FCPA Institute to any professional who has compliance, ethics, legal or international business responsibilities.” (Norm Keith, Partner, Fasken Martineau, Toronto).“The FCPA Institute is very different than other FCPA conferences I have attended. It was interactive, engaging, thought-provoking and at the completion of the Institute I left feeling like I had really learned something new and useful for my job. The FCPA Institute is a must-attend for all compliance folks (in-house or external).” (Robert Wieck, CPA, CIA, CFE, Forensic Audit Senior Manager, Oracle Corporation)The FCPA Institute is a top-flight conference that offers an insightful, comprehensive review of the FCPA enforcement landscape. Professor Koehler’s focus on developing practical skills in an intimate setting really sets it apart from other FCPA conferences. One of the best features of the FCPA Institute is its diversity of participants and the ability to learn alongside in-house counsel, company executives and finance professionals. (Blair Albom, Associate, Debevoise & Plimpton)“The FCPA Institute was a professionally enriching experience and substantially increased my understanding of the FCPA and its enforcement. Professor Koehler’s extensive insight and practical experience lends a unique view to analyzing enforcement actions and learning compliance best practices. I highly recommend the FCPA Institute to practitioners from all career stages.” (Sherbir Panag, MZM Legal, Mumbia, India)“The FCPA Institute provided an in-depth look into the various forces that have shaped, and that are shaping, FCPA enforcement. The diverse group of participants provided unique insight into how, at a practical level, various professionals evaluate risk and deal with FCPA issues on a day-to-day basis. The small group setting, the interactive nature of the event, and the skills assessment test all set the FCPA Institute apart from other FCPA conferences or panel-based events.” (John Turlais, Senior Counsel, Foley & Lardner)FCPA Institute participants not only gain knowledge, practical skills and peer insight, but can also elect to have their knowledge assessed and earn a certificate of completion upon passing a written assessment tool. In this way, successful completion of the FCPA Institute represents a value-added credential for professional development. Attorneys who complete the FCPA Institute may also be eligible to receive Continuing Legal Education (“CLE”) credits. In addition, previous FCPA Institute participants have successfully obtained continuing education units from the Society of Corporate Compliance and Ethics for attending the FCPA Institute.To learn more about the FCPA Institute and to register, click here.
QUESTION: Good afternoon Martin,Do you gander that President Trump is aware that a higher dollar will cream the economy and is doing all he can to fight that trend?Maybe he is reading AE but like other politicians still thinks he can manipulate the economy?Trump is battling the Fed over interest rates. What does it mean for your money?MDCANSWER: Trump does realize that there has been a flight to the dollar. I believe his bashing the Fed to lower rates is inspired by the hope of keeping a lower dollar for trade. I do not believe higher rates are on his radar with respect to the markets. He is probably seeing briefings of the rise in rates and what is taking place with the national debt.As far as what does it mean for your money: the trend from public debt to private will be accelerated by this trend. I believe that the Fed will try pegging rates with caps rather than engaging in QE as Europe has done. Categories: Interest Rates Tags: Federal Reserve, Interest Rates « When Will Interest Rates Rise? Public v Private Interest Rates & Sovereign Debt Crisis »
by, Margit Novack, GuestBloggerTweetShareShareEmail0 SharesMrs Jones, this chicken is the freezer is from 2002. Do you want us to throw it away?” I asked. “Oh no,” said Mrs. Jones. “ I just sautee it with some butter and seasoning and it tastes fine.” “But it’s ten years old, It can’t possibly be good for you. “I’m 92, it can’t be that bad.”And that’s when I began to think about surplus safety.Culture changing expert Dr. Bill Thomas argues that when dealing with elders, we focus almost exclusively on the down side of risk, and in doing so, inadvertently remove the possibility of upside of risk — the opportunity for growth and new experiences. As a result we create environments with a “surplus of safety.”This concept has caused me to rethink my job as a Senior Move Manager — someone who specializes in creating safe physical environments for elders.Part of my job is advising against throw rugs and for chairs with arms, for placing things needed every day on shelves where they can be reached without a stool, and more. Ever mindful of the devastating impact of a fall, I urge clients to downsize sufficiently so their belongings will fit in their new surroundings, and ask them not to be present while we unpack so they can avoid the stress of move day. I want to protect them, because they haven’t moved in 40 years and I help people move every day, so I know what is best for them.But do I?Relocation Stress Syndrome (RSS) is the name given to the physiologic and psychosocial disturbances that result from transferring from one environment to another. At first, psychologists believed that this occurred primarily in involuntary transfers to long term care settings, but today scientists agree that RSS can occur in moves to many settings and even when moves are voluntary and planned.The symptoms of RSS are loneliness, depression, anger, apprehension, dependency, confusion, anxiety and withdrawal and can affect anybody who moves to a new home. Minor characteristics include changes in sleeping and eating habits, insecurity, lack of trust and need for excessive reassurance.When experiencing relocation stress, the process depends on a number of variables, such as age and stage of life, personality, number of losses, amount of preparation and the degree and type of support before, during and after the move. RSS is experienced until a sense of control is regained.Given the support we provide before, during and after the move, involvement by Senior Move Managers and family members must decrease the likelihood of RSS, right?But here’s the rub. When we take excessive control of the move to maximize the outcome, are we taking control away from our clients and parents?Another culture change advocate, Kort Nygard, tells the story of a man in a long term care setting who asked for something meaningful to do. How did he define “meaningful?”“Where if I screw up, something bad happens.”Are we so focused on helping clients and parents achieve “good moves” that we reduce their opportunity for risk and control? If control over one’s move is so important in minimizing RSS, are we inadvertently contributing to the very thing we want to avoid?I agree that being in an over cluttered home, with potential physical hazards, can decrease one’s sense of control. But you and I have that choice — the opportunity to make bad decisions. Shouldn’t our clients and our parents have it too? Are we patronizing them by urging them to do what we want because we know best, even when it conflicts with what they want? The fact that things don’t fit in a new home does not mean that clients didn’t part with a great deal. Instead of helping them feel good about what they did accomplish, are we making them feel bad about what they didn’t?The desire to help clients and parents have a good move while maximizing their sense of acheivement and control is a conflict that seems inherent in what Senior Move Managers do. Let’s remind ourselves to not “over-protect” our clients.As expressed succinctly by Kort’s friend, part of what makes life meaningful is knowing that what you do matters and has consequences. Retaining the right to make decisions, even bad decisions, is a key ingredient of being in control.Related PostsSurplus Safety….More Than Meets the EyeI had the privilege recently of attending a symposium about “surplus safety,” put together by the Erickson School at the University of Maryland at Baltimore and funded by the Maurice Rothschild Foundation. Many thanks to these organizations for convening a group of more than 30 of the best and brightest…Myrtle Beach-The Joys of Upside Risk!A few months ago, I had the opportunity to hear Dr. Bill Thomas discuss “Surplus Safety” at the Eden Alternative Conference. I sat there at the time in complete agreement with him but not really taking to heart all that … Continue reading →Surplus Safety SymposiumOn Wednesday and Thursday this week I will be taking part in a groundbreaking symposium sponsored by The Erickson School at UMBC focused on the concept of Surplus Safety I’ve been developing with Dean Judah Ronch. The goals of this two-day symposium are huge. GIGANTIC. We have brought together a…TweetShareShareEmail0 Shares
Source:http://www.eneuro.org/content/early/2018/05/14/ENEURO.0038-18.2018 By Dr. Ananya Mandal, MDMay 16 2018UCLA neuroscience researchers have successfully transferred the memory of one animal to another via injections of RNA. This futuristic study has made possible hopes for similar transfers among higher animals too including humans. The study also provides understanding about the ways in which the brain stores memories and could be the next big thing in memory loss, dementia and related diseases. The study was published in the online journal eNeuro that is the online publication of Society for Neurosciences.The study led by scientist David Glanzman works with RNA transfers and provides understanding of these genetic materials in memory and learning. Experts are sceptical about the research though because the brains of the slugs are much simpler in comparison to higher animals and humans and it could be a distant possibility to imagine same could be done for humans. This new study was funded by the National Institutes of Health and the National Science Foundation.For the experiment the team gave mild electric shocks to marine snail Aplysia californica. These snails quickly learned to withdraw their siphons and gills when they were shocked. This lasted for up to a minute and was clearly a defence manoeuvre. The manoeuvre was repeated when the snail was mildly touched as well. Snails that were not shocked earlier withdrew their siphons and gills briefly when touched. This indicated that the shocked snails had memories of the shocks.Related StoriesWearing a hearing aid may mitigate dementia riskLiving a healthy lifestyle may help offset genetic risk of dementiaWhy women who work are less likely to develop dementiaNext the researchers extracted RNA from the nervous systems of these snails that had been shocked. They injected this RNA into snails that had not been shocked. They also injected some unshocked snails with RNA from other unshocked snails. The results showed that the unshocked snails that received RNA from the shocked snails were ones that withdrew for longer durations when confronted with a soft touch compared to those that were unshocked and received RNA from unshocked snails. This meant that the memory of the electric shocks were transmitted from the shocked snails to the unshocked and un-exposed snails.RNA works as messenger and a template for protein formation. Till date synapses and connection between neurons have been the basis for memory and learning. This is a new concept in memory and learning that is being explored say researchers. Glanzman said about the results, “It’s as if we transferred a memory”.As a next step the team took the sensory neurons of the snails in petri dishes. They found that neurons of the snails that have been shocked are more excitable compared to the neurons of the snails that have not been shocked. Glanzman said that the memories seem to be stored within the nucleus of these neurons where these RNA can stimulate or block the actions of the genes by turning them off or on. He explained that the changes within the neurons is mediated by the RNA as seen by this experiment. He said that although several researchers would disagree, he is convinced that memories may remain even if the synapses come and go. This has to mean that the memories are stored in some form within the nucleus. Image Credit: Lisa S. / Shutterstock
Source:https://www.uji.es/com/investigacio/arxiu/noticies/2018/6/monitoratge/ Jun 12 2018Research staff from the Universitat Jaume I in the fields of information technology, psychology and business have developed a monitoring system based on indoor location using mobile devices. The purpose of this system is to improve the observation of the positioning of elderly people, in their own homes and in a non-intrusive way, from Wi-Fi signals.This new system detects, in the quickest possible way, changes in the behavior of elderly people, which allows the intervention of caregivers or their relatives with all the available information. The procedure does not need any additional infrastructure; it is able to issue warnings before an unusual behavior of the people monitored and allows the caregivers to check this behavior through a web interface.The study was directed by the lecturer Óscar Belmonte from the GIANT Research Group (Machine Learning for Smart Environments) with the participation of Raúl Montoliu, from the same group; Antonio Caballer, from the Intervention and Evaluation in Socio-educational Contexts Research Group, and Merche Segarra from the Department of Business Administration and Marketing.According to data from the Spanish Institute of Statistics, referring to the year 2016, 41.7% of people who live alone in Spain are over 65 and 70.7% of them are women. Most of them prefer to live in their own home and not in residences. There are even studies that indicate that, in economic terms, it is better to live in your own home, but this implies that care and attention, in terms of time and economic organization, fall mostly on the family.”We start from the concept of health and active aging established by the WHO”, explains the researcher Antonio Caballer. “In this sense, we talk about the use of new technologies to improve the feeling of loneliness, participation, the level of safety and to keep older people in their homes the maximum possible time, without having to go to senior centers”.Teleassistance has allowed providing care and assistance services to the elderly remotely, in a minimally intrusive way, and in their own homes. This service has been used to detect anomalies that pose an imminent risk to the person’s health, such as a fall. With the new system proposed by the UJI team, it will be possible to detect possible risky situations, such as if a person stays in bed more than usual or has not gone to the kitchen to cook.Related StoriesTAU’s new Translational Medical Research Center acquires MILabs’ VECTor PET/SPECT/CTTrump administration cracks down on fetal tissue researchAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapy”Our purpose is to study the evolution in a person’s long-term health. If there is a continuous deterioration in their cognitive or physical functions, we should realize as soon as possible and try to determine the moment in which this deterioration began”, explains Óscar Belmonte, main researcher of the study.The system uses objective parameters to determine the usual behavior of the elderly people within their own home, so that it establishes behavior patterns and warns when a deviation occurs. From the signal emitted by Wi-Fi access points, it is possible to build algorithms that, once trained, estimate the user’s position according to the intensities measured by a device carried by the user (a mobile phone, laptop, smart watch or any other device with a wireless connection chip). “Once the model of a person’s data is constructed, we have to check each day if their behavior coincides with the learned behavior or if there are behavioral changes”, says Belmonte.The behavior pattern is extracted from the data provided by indoor location algorithms. Thus, once the behavior of the person is known, it can be monitored to detect possible deviations from the known pattern. In this way, it will be possible to evaluate if either the deviations are occasional, or they indicate a progressive change in the behavior or a possible risky situation.The Universitat Jaume I has granted an aid to validate this new system with people over 55 within the StartUJI program for the Valorization of Research Results of the Research Promotion Plan 2017. The project will last 15 months.
Jun 14 2018Researchers at Houston Methodist Research Institute and The University of Texas MD Anderson Cancer Center have found a prescription drug, Calcitriol, approved by the Food and Drug Administration for the treatment of calcium deficiency and kidney diseases, may increase the likelihood of surviving ovarian cancer.Their preclinical research, reported in the Journal of the National Cancer Institute, integrated computational modeling and biology experiments in cell lines and mouse models to pinpoint a molecular pathway between malignant cells and supportive cells, called fibroblasts, associated with poor prognosis for patients with high-grade serous ovarian cancer, the most common and difficult form of the disease.A review of potential drugs by Houston Methodist researchers indicated that a synthetic and active form of a vitamin D analog called Calcitriol might break up molecular communication between cancer cells and fibroblasts, a finding confirmed in mouse models by MD Anderson researchers.This study opens a new potential avenue for treating ovarian cancer. Since Calcitriol is an FDA-approved drug, no additional research is needed before the drug can advance to human clinical trials for ovarian cancer. The researchers are working to address regulatory procedures, planning and funding required to open a clinical trial.”Targeting cancer cells might not be the only solution to treating cancer. Other cells in the tumor and surrounding microenvironment, such as fibroblasts, immune cells, fat cells and other supportive cells make up the very complex ecosystem of tumors that we need to understand,” said Samuel Mok, Ph.D., professor of Gynecologic Oncology and Reproductive Medicine and co-senior author of the study.Using a computer modeling technique pioneered by co-senior author Stephen Wong, Ph.D., the Houston Methodist team processed and analyzed genomic big data to identify crosstalk targets and screen FDA-approved drugs. Their approach allowed them to look at the complexity of the interactions among tumor cells and different types of supporting cells to see a full map of their intricacies.”In this era of big data, we can systematically identify pathways and therapies, as we’re using an unbiased approach to look at all possibilities,” said Wong, chair of systems medicine and bioengineering and John S. Dunn Sr. Presidential Distinguished Chair in Biomedical Engineering at Houston Methodist. “Our computational modeling can tell you which pathway is important for a particular disease. It allows for the heterogeneous tumor data to be fed in to the model to precisely identify these pathways, giving us a comprehensive view and allowing us to see specifically which malfunctioning cells to target.”Fibroblasts make and maintain connective tissue that provides a scaffolding for organs. To better understand their role, Mok, co-lead author Tsz-Lun Yeung, Ph.D., and colleagues carved out fibroblasts from tumor samples to study separately, using a precise process called laser microdissection.They studied gene expression by these cancer-associated fibroblasts (CAFs) and found the fibroblasts had two distinct expression, or signatures that they named CAF-C and CAF-N.Related StoriesUsing machine learning algorithm to accurately diagnose breast cancerStudy: Nearly a quarter of low-risk thyroid cancer patients receive more treatment than necessarySugary drinks linked to cancer finds study”A survival analysis of these two CAF types in 46 ovarian cancer patients showed that patients with CAF-C fibroblasts had a poor prognosis, with median overall survival of 16 months compared to 33 months for the other type,” Mok said.Smad signaling between cancer cell, fibroblastsThe next step was to sort out what, specifically, makes the CAF-C group promote aggressive disease. Using a multi-cellular crosstalk modeling tool developed by Wong, called CCCExplorer (Cell-Cell Communication Explorer), co-lead author Jianting Sheng, Ph.D., and colleagues of the Houston Methodist team input gene-expression profiles from micro-dissected fibroblasts and neighboring ovarian cancer cells provided by Mok to compute, predict and prioritize crosstalk pathways and cell-to-cell interactions in the tumor microenvironment.”We identified a signaling pathway, called Smad, as the culprit of poor ovarian cancer outcomes,” Wong said. “Reprogramming these cells by targeting their communication networks presents an opportunity for the development of new cancer treatment strategies. If we focus on targeting these supportive cells in the tumor microenvironment instead of the tumor, itself, it could lead to less toxic, more effective treatments.”Experiments by Mok and colleagues confirmed the primacy of Smad signaling. Gene expression analysis again clustered patients into two groups; those with high expression of Smad-regulated genes had median overall survival of 15 months compared to 26 months for those with low expression.Wong and colleagues at Houston Methodist applied another computational module in their CCCExplorer tool to predict known drugs that have passed phase I safety trials that might target Smad signaling. Calcitriol was selected for further studies in part because previous research shows it can inhibit the binding of Smad proteins to their target genes.MD Anderson cell line experiments showed Calcitriol blocks Smad signaling. Treating ovarian-tumor bearing mice with Calcitriol reduced cancer cell proliferation and tumor volume while lengthening median overall survival from 36 to 48 weeks.”We know that cells in the tumor microenvironment actually support the cancer and may contribute to its aggressiveness. This study opens up a new potential avenue for developing ovarian cancer treatments,” said co-author Karen Lu, M.D., chair of Gynecologic Oncology and Reproductive Medicine at MD Anderson and J. Taylor Wharton, M.D., Distinguished Chair in Gynecologic Oncology.”These researchers have developed a unique and powerful concept to decode crosstalk and interactions among different cell components in the complex tumor microenvironment,” said Jenny C. Chang, M.D., director of Houston Methodist Cancer Center and Emily Herrmann Chair in Cancer Research. “Instead of testing one hypothesis at a time, the modeling tool now allows the cancer researchers and drug designers to comprehensively evaluate major intercellular crosstalk pathways simultaneously to find novel targets for ovarian and other cancers.” Source:https://www.mdanderson.org/newsroom/2018/06/md-anderson-houston-methodist-scientists-detect-new-ovarian-cancer-target.html
Aug 10 2018Immunologists at Friedrich-Alexander-Universität Erlangen-Nürnberg have demonstrated that ILC2, a group of rare lymphoid cells, play a key role in the development of inflammatory arthritis. ILCs have several functional similarities to T-cells and are important agents of our congenital immune system. The FAU researchers’ findings could form the basis for new approaches for treating rheumatoid arthritis. The findings have now been published in the renowned journal Cell Reports.Rheumatoid arthritis is the most common form of inflammatory joint conditions. In contrast to osteoarthritis, where patients’ joints degenerate, the symptoms of arthritis such as overheating, swelling and redness, occur in flare-ups and are frequently caused by disturbances in the immune system. The disease mainly affects the fingers and toes, but also knees, shoulders and hip joints. Around one percent of the population suffer from the condition and women are three times more likely to suffer from it than men. Treatment usually focuses on easing pain and slowing down the progression of the disease as there is no cure for rheumatoid arthritis.Rare immune cell regulates arthritisImmunologists at FAU have now proven that ILC2, a rare form of lymphocyte, plays a key role in the development of rheumatoid arthritis. Although ILCs, so-called ‘innate lymphoid cells’, do not have the T cell and B cell receptors nor cell type markers that are otherwise typical for lymphocytes, they are pivotal in defending the human body from pathogens. They are often the ‘first aiders’ who alarm the immune system before the actual immunisation begins. ‘From earlier research, we know that ILC2 can initiate the suppression of chronic inflammation by producing the cell signal molecule IL-9’, says project manager Dr. Mario Zaiss from the Department of Medicine 3 – Rheumatology and Immunology at Universitätsklinikum Erlangen. ‘In our current study, we specifically examined the role of ILC2s in the early stage of rheumatoid arthritis’.Related StoriesStill-to-be-approved drug proves to be new option for treating active rheumatoid arthritisResearchers identify new clues on tissue damage in rheumatoid arthritis and lupusMultiple breaches of injection safety practices identified in New Jersey septic arthritis outbreakILC2 only helps before the onset of the diseaseFirstly, Zaiss and his colleagues were able to demonstrate that the number of ILC2 in the peripheral blood and in the joints of patients with rheumatoid arthritis is significantly higher than in healthy people. Laboratory tests confirmed the regulatory function of ILC2. When the researchers reduced the number of these immune cells genetically, this exacerbated the progression of the disease later on, while increasing the number of ILC2 during therapy significantly reduced the arthritis. The researchers, however, cannot hold out any hope that they will be able to cure patients who already have inflammatory arthritis through targeted enrichment of ILC2. ‘There is no doubt that ILC2 has a regulatory effect during the early stage of arthritis,’ explains Mario Zaiss. ‘However, any treatment must start before the onset of the disease – transferring ILC2 later on does not improve symptoms.’Further research is set to find safe methods of increasing the number of ILC2 in the body in a targeted manner. Researchers must also find new and reliable methods of detecting signs of arthritis before the onset of the disease as this is the only time when these rare lymphocytes can be used as a treatment. Source:https://www.fau.eu/2018/08/06/news/research/can-rare-lymphocytes-combat-rheumatoid-arthritis/
My application was ambitious because Fight for Sight are not afraid to fund ideas that break new ground. I feel very fortunate to receive this early career researcher funding to grow my existing research skills, develop new ones, and gain experience as a Chief Investigator managing and developing my own research project.I am working hard to make sure I deliver a successful project that will, in the future, benefit people living with dementia and those who are caring for them. If you’re an early career researcher and thinking of applying, do – the benefits are huge!” We’re delighted to open the call for our latest funding round. Both funding streams will provide an opportunity for clinicians, scientists and allied health professionals to deliver impactful research. We encourage researchers to apply and take this opportunity to carry out their pioneering research.” Related StoriesTrump administration cracks down on fetal tissue researchAXT enhances cellular research product portfolio with solutions from StemBioSysResearch on cannabis use in women limited, finds new studyAdditionally, the charity is also calling for applications for their annual Project Grants Award which offers up to £170,000 for three years for clinical and non-clinical research scientists to undertake research in all fields of ophthalmic and vision research.Fight for Sight is partnering with Alzheimer’s Research UK to co-fund research addressing dementia and visual impairment. The Fight for Sight / Birdshot Uveitis Society Project Grant particularly encourages projects investigating disease activity and biomarkers.Dr Neil Ebenezer, Director of Research, Policy and Innovation at Fight for Sight, said: Aug 17 2018Fight for Sight, the UK’s leading sight loss charity, has announced that the Project Grants Awards and the recently established Primer Fellowship call is now open for applications.The charity will provide funding of up to £60,000 for two individuals to undertake vision related research for one year. One of the Fellowships is funded in collaboration with The Royal College of Ophthalmologists.The Fellowships were established in order to fund trainee ophthalmologists at an early stage in their career. The charity is calling upon the brightest minds among eye health professionals to undertake ophthalmic and vision research. The aim of the Fellowship is to help equip those who wish to embark on research fellowships in the future, leading to better and more impactful research.Dr Marianne Coleman, a previous Primer Fellowship recipient from The University of Surrey who is using the funding to determine whether binocular vision and pupil response testing should be included in dementia-friendly eye-testing guidelines said: Source:http://www.fightforsight.org.uk/news-and-views/articles/news/charity-invites-applications-from-brightest-minds-in-vision-research/
Source:http://www.cbs.mpg.de/presse/depression-hypothalamus Reviewed by Kate Anderton, B.Sc. (Editor)Sep 20 2018According to the World Health Organization (WHO) 322 million people worldwide were affected by depression in 2015–4.4 percent of the world’s population. In the search for the underlying causes of this widespread disorder, researchers have concluded that it could arise from predisposition combined with an individual’s environmental stress factors.So far, it is known that people more predisposed to depression show a dysregulation of the endogenous stress response system, otherwise known as the hypothalamic-pituitary-adrenal axis (HPA axis), which is normally triggered when we are faced with a stressful situation. This response increases the amount of cortisol, providing the body with more energy when faced with a potential threat or challenge. Once the challenging situation has passed, several control mechanisms in the HPA axis normally ensure the system returns to a balanced state.Related StoriesStudy reveals long-term benefits of stress urinary incontinence surgeryTransobturator sling surgery shows promise for stress urinary incontinenceDon’t Miss the Blood-Brain Barrier Drug Delivery (B3DD) Summit this AugustIn people who suffer with depressive disorder or who are more predisposed, this is not the case. Instead, a malfunction of the feedback mechanism results in a stress response operating at full throttle, even when there is no apparent stressful situation. Until now, the underlying reason for this hyperactive stress response system and the role of the hypothalamus as its overall control unit has remained unclear.In a recent study with 84 participants, scientists at the Max Planck Institute for Human Cognitive and Brain Sciences (MPI CBS) in Leipzig and the Department of Psychiatry and Psychotherapy of the University Clinic in Leipzig have revealed that in people with an affective disorder, the left hypothalamus was on average five per cent larger than that of their healthy counterparts. ‘We observed that this brain region is enlarged in people with depression as well as in those with bipolar disorder, two types of affective disorders’, says Stephanie Schindler, a PhD student at both research institutes involved in the study and first author of the underlying publication just published in the scientific journal Acta Psychiatrica Scandinavica. Furthermore, in one of the groups of participants with depression it was also revealed that the more severe the depression, the larger the hypothalamus was. Medication did not have any effect on the size of the hypothalamus.These relations were found out using a high-resolution 7-Tesla MRI scanner. The severity of disorders was measured using standardized questionnaires and interviews.Although studies have shown this brain structure to be more active in people with depression or bipolar disorder, it is not yet known what role a larger hypothalamus plays. ‘Higher activity could lead to structural changes and thus to a larger volume of the hypothalamus normally the size of a one cent coin’, says Stefan Geyer, one of the study’s principal investigators and head of the research group Anatomical Analysis of the Organization of the Human and Non-Human Primate Brain at MPI CBS.
ShareTweetSharePinSam Raphael speaking at the reopening of Jungle Bay five-star resortJungle Bay Resort and Spa has reopened its doors as a 5-star hotel at Morne Acouma in Soufriere.The resort was destroyed by landslides caused by Tropical Storm Erika on August 27th 2015, leaving 65 persons jobless as a result. Forty farmers farmers also relied on purchases from Jungle Bay for their livelihood. There was no loss of life or injuries at the time of disaster as guests were relocated to the Delices Primary School.Developer of Jungle Bay Resort, Sam Raphael encourages Dominicans here and abroad to see this reopening as an opportunity to open more businesses on island.He spoke at the opening ceremony and official vine cutting on Sunday, June 30th 2019 in Soufriere.“I encourage Dominicans at home and abroad to see this as an improvement in an enabling environment for business and to seize the opportunity like I encourage the people from Soufriere and the surrounding environment,” Raphael said“We are going to need additional hotel rooms…there will be spin off businesses for accommodation of guest houses and so on,” Raphael stated. “Certainly, we need a lot of activity because we don’t want our people to be bored. We don’t want them to say we’re tired of eating that hotel food; we want them to get that local food. We want activities, things for them to do, specialty niche activities that they can enjoy.”He said hotels that are being built all over Dominica can also be used as business opportunities for Dominicans. Jungle Bay will have 85 rooms, two restaurants, swimming pools, fourteen studio spas, two yoga studios and many other amenities on completion. The first 30 rooms were opened on Sunday (phase one) and the remaining rooms should be completed by next year.Close to 60 permanent staff members are currently employed at the resort along with a little over 100 construction workers. Overtime the hotel staffing is expected to increase to 160 workers.