Excessive surgeries swell Medicare costs in United States

">
Excessive surgeries swell Medicare costs in United States
December 18th, 2017 by 6FjUhLbu

Wednesday, October 15, 2008

At least 10% of the increase in Medicare expenditures since the mid-1990s is due to increased rates of one type of elective surgery, according to a recent study, and many of the patients may not need it. University of California, San Francisco found that only 44% of patients who undergo an elective cardiac surgery called angioplasty get the recommended test to determine whether the procedure is appropriate.

As a result, patients may be receiving a procedure that they either do not need or for which the risk outweighs the benefit. The operation opens partially clogged arteries in patients with heart disease and the annual rate of elective angioplasties has tripled in the United States during the last decade.

Angioplasties are currently being performed at a rate of over 800,000 per year in the U.S. The average cost was $44,110 per procedure in 2004. Since the operation tends to be performed on older Americans, Medicare covers most patients and compensates US$10,000 to $15,000 for each case.

Reuters reporter Julie Steenhuysen writes that angioplasty is “big business for medical device makers including Boston Scientific Corp, Medtronic Inc, Abbott Laboratories Inc and Johnson & Johnson”. Dr. Raymond Gibbons, a professor of medicine who specializes in cardiology at the Mayo Clinic in Rochester, Minnesota, criticizes the current U.S. health care system for compensating doctors based upon procedures performed rather than for following recommended practices.

We didn’t expect to find 100 percent, but we expected a much higher percentage than 44

A stress test in which the patient walks on a treadmill is recommended to determine whether a partial obstruction impairs heart function. Although not all patients who need angioplasty are strong enough to undergo the stress test, UC San Francisco researchers were surprised that testing preceded so few of the surgeries.

Professor of medicine Dr. Rita F. Redberg told U.S. News and World Report, “We didn’t expect to find 100 percent, but we expected a much higher percentage than 44”. Dr. Redberg co-authored a report on the findings for the Journal of the American Medical Association this month.

Dr. Grace Lin, another co-author of the study, noted: “What really matters is whether or not that blockage is affecting blood flow to the heart. That is why the stress test is important.” Their research analyzed over 23,000 Medicare cases and over 1,600 commercial insurance cases.

American Heart Association president Timothy Gardner called the study “a good wake-up call” to remind medical doctors to make sure they do not perform unnecessary procedures. Dr. Gardner regards the study as evidence that many unnecessary angioplasties are being performed.

You can do a stress test every year to be sure things are normal. That is an important baseline that is being ignored all too frequently.

The study found great variation in the rate of stress testing. Geographic areas ranged from 22% to 76% with the highest rate of testing in the Northeastern and Midwestern states. Testing rates also varied by gender, with men more likely to receive a stress test than women, and by other factors including the age of the physician. Dr. Gibbons points to some of these variances as indications that some physicians may be performing angioplasties indiscriminately.

Not all physicians agree. Although the various types of stress testing usually cost a few hundred dollars instead of tens of thousands, the chief cardiologist at University of Wisconsin Hospital and Clinics Dr. Matthew Wolff notes that stress tests yield false negative results in about 10% of cases. In his opinion, doctors who rely on stress tests “are going to be missing people with severe disease.” Although he agrees that some angioplasties are unnecessary, he contends that the new study does not offer a solution to the dilemma.

The American College of Cardiology plans to release new guidelines soon to help doctors determine when a stress test is appropriate, yet the payment system lacks a financial incentive to abide by testing guidelines. Dr. Eric Topol of Scripps Translational Science Institute in La Jolla, California noted the underuse of stress tests in a study of private insurance records 14 years ago. Dr. Topol agrees that testing guidelines “should be much more clear-cut”, and adds that stress tests ought to be performed annually. “You can do a stress test every year to be sure things are normal. That is an important baseline that is being ignored all too frequently.”

Cardiologist, Dr. Anthony DeFranco of Aurora St. Luke’s Medical Center, considers stress testing to be appropriate in at most 65% of cases, since a substantial minority of patients have other health problems that prevent them from undergoing the test.

Posted in Uncategorized | No Comments »

Difference Between Service Dogs, Therapy Dogs, And Emotional Support Animals}

December 18th, 2017 by 6FjUhLbu

Difference between Service Dogs, Therapy Dogs, and Emotional Support Animals

by

Dominic Libatique

There is controversy surrounding the roles of animals in the lives of people with disabilities or chronic illnesses. Being able to keep your animal in a no pets allowed setting many of us have seen the posts online about registering your animal as an emotional support animal with a small fee. This has led people to question the legitimacy of all service animals and their roles. A feeling of distrust among people who do not understand the difference between these animals, and the rights that accompany them, has been emerging as more people utilize these services.

Service Dogs who need Service dog registration are the most protected and trained of the 3 types of dogs. While many people refer to all 3 types as “service animals”, the official names for this type are Service Dog. These dogs are legally considered medical equipment and have a price tag to match, ranging from $10,000- $50,000. They are intensively trained for 1.5-2.5 years, having to pass a variety of tests to be serviceable including, but not limited to, opening cupboards, retrieving dropped objects, staying calm in public, etc.

YouTube Preview Image

Under the Americans with Disabilities Act, Service Dogs are allowed anywhere their handler is, and cannot be turned away from an establishment or refused to go to work with their handler. DOT’s Air Carrier Access Act, and DOJ/HUD Fair Housing Act and Federal Rehabilitation Act cover other circumstances that the ADA doesn’t. While there is a difference between Service Dogs and Emotional Support Animals, there is a gray area for dogs that are used to calm anxiety attacks under ADA rules. Psychiatric Service Dogs are covered under the ADA only if they perform a specific action to avoid or lessen an attack. If they are just there for comfort then they are considered an Emotional Support Animal.

Therapy dogs are kind of the opposite side of the same coin as Service Dogs. Instead of offering physical aid to their handlers, they provide psychological or physiological therapy to others and are accompanied by a handler who doesn’t usually need their service. The best example of a therapy dog would be dogs that go to children’s hospitals to bring comfort, or dogs that work in school systems.

These animals, like the Service Dogs who need service pet registration, require extensive training. Therapy dogs are also encouraged to be very social and interact with a variety of people, unlike Service Dogs who need to focus on their handler. Therapy dogs may be trained by anyone, but they need to meet standards to be certified. Therapy dogs do not have the same rights as service dogs, though many places will allow a therapy dog to accompany their owners, they are not required to by law.

The last types we are discussing are Emotional Support Animals. This one is the most vague and open-ended. An Emotional Support Animal most of the time is registered by its owner because it brings comfort and does not have to have any special training.

We deal with the pet registration of service dogs and the

Emotional Support Animal

serving our customers pet needs in the best way possible. Visit www.usserviceanimalregistry.org for details.

Article Source:

eArticlesOnline.com

}

Posted in Property Management | No Comments »

Blown for Good author discusses life inside international headquarters of Scientology

">
Blown for Good author discusses life inside international headquarters of Scientology
December 18th, 2017 by 6FjUhLbu

Friday, November 13, 2009

Wikinews interviewed author Marc Headley about his new book Blown for Good, and asked him about life inside the international headquarters of Scientology known as “Gold Base“, located in Gilman Hot Springs near Hemet, California. Headley joined the organization at age seven when his mother became a member, and worked at Scientology’s international management headquarters for several years before leaving in 2005.

Posted in Uncategorized | No Comments »

Airborne laser successfully destroys ballistic missile

">
Airborne laser successfully destroys ballistic missile
December 18th, 2017 by 6FjUhLbu

Saturday, February 13, 2010

The United States Missile Defense Agency have announced that their airborne laser system has successfully shot down a ballistic missile for the first time. In a test on Thursday the “Airborne Laser Testbed” (ALTB), a modified Boeing 747-400F, detected a boosting short-range missile and tracked it using a low-energy laser. A second low-energy laser was used to measure and compensate for atmospheric disturbance, before the aircraft’s High Energy Laser was used to destroy the target.

The missile was liquid-fuelled and said to be “threat-representative”, possibly similar to a Scud. It was launched from sea, and shot down by the ALTB within two minutes. In a second test less than an hour later, a solid-fuel missile launched from a ground location was also successfully hit by the High Energy Laser, but deliberately not destroyed. A similar missile was destroyed on February 3.

In a press release announcing the successful tests the Missile Defense Agency said: “The revolutionary use of directed energy is very attractive for missile defense, with the potential to attack multiple targets at the speed of light, at a range of hundreds of kilometers, and at a low cost per intercept attempt compared to current technologies.”

The ALTB is described as a “pathfinder” for the use of directed energy in missile defense. It is designed to operate at high altitudes above the clouds, and to detect and destroy ballistic missiles soon after launch whilst they are still in their boosting phase. The aircraft is provided by Boeing, the main laser by Northrop Grumman, and the control systems by Lockheed Martin.

“Through its hard work and technical ingenuity, the government-industry team has produced a breakthrough with incredible potential,” stated Greg Hyslop, vice president of Boeing Missile Defense Systems. He said that the experiment had “made history”.

The US has been working on the program since 1996, and has faced numerous problems in that time. The megawatt-class High Energy Laser is known as the chemical oxygen iodine laser (COIL), and consists of six modules, each as large as an SUV. The sheer weight of chemicals needed was almost too much for the 747 jet. The laser also had problems with accuracy due to atmospheric conditions.

February’s tests were originally scheduled to be carried out in 2002. The amount spent getting the project to this stage has also risen from a planned US$1 billion to $7.3 billion. Last year, Secretary of Defense Robert Gates cut the program back to a single jet for research, suggesting it would not see actual deployment.

“The reality is that you would need a laser something like 20 to 30 times more powerful than the chemical laser in the plane right now to be able to get any distance from the launch site to fire,” Gates told Congress. “So, right now the [jet] would have to orbit inside the borders of Iran in order to be able to try and use its laser to shoot down that missile in the boost phase.”

Gates also raised concerns at the large number of planes that would be required, and the ensuing cost. However, he said that directed energy weapons still had potential for missile defense.

Posted in Uncategorized | No Comments »

Britons seized from finance ministry in Iraq

">
Britons seized from finance ministry in Iraq
December 18th, 2017 by 6FjUhLbu

Tuesday, May 29, 2007

Five British citizens have been seized in the Iraqi capital, Baghdad. The group, comprising a finance expert and four bodyguards, were captured from the finance ministry by kidnappers wearing police uniforms and driving police vehicles. The BBC is reporting that over 40 police vehicles were involved in the incident.

In separate incidents, at least 22 people were killed and 55 injured in a bus explosion elsewhere in the city, and at least 15 people were killed in a car bomb which injured a further 36, possibly more.

It is believed the four bodyguards are employed by Canadian GardaWord, a subsidiary of Garda.

Posted in Uncategorized | No Comments »

Scenario for impeachment of Lula raised in Brazil

">
Scenario for impeachment of Lula raised in Brazil
December 17th, 2017 by 6FjUhLbu

Tuesday, June 28, 2005

São Paulo, Brazil — The government of the Brazilian President Luiz Inácio Lula da Silva and his party, the Workers’ Party are the target of several serious accusations of corruption.

This is the most severe political crisis since Brazilians first attained their right to vote for a President in 1989, the former President Fernando Collor de Mello was elected.

The ruling Workers’ Party has not succeeded in its defense against the accusations. The Brazilian deputy Roberto Jefferson said that the ruling party bought the support of some Brazilian deputies, paying 30 thousand Brazilian Reals (US$ 12 thousand) each, every month. Although Jefferson said that he had no proof of this, he gave a very detailed description of the alleged corruption scheme.

The testimonies of other witnesses and the investigation that is being made by police gave support for some of the Jefferson’s claims. Independent investigation being made by newspapers and magazines, and the publication of documents and other evidences, expose the government and Workers’ Party more and more.

Popular support for the President is deteriorating. Except for the Workers’ Party and the Communist Party of Brazil (PCdoB) which are part of the government, there is not another political party in Brazil denying the accusations. All newspapers and magazines publish stories every day related to the scandal. The Workers’ Party itself is divided: some members believe that the accusations are true and that something went wrong, others prefer to deny the evidences and they argue that the party is innocent.

A great part of the work of the Brazilian parliamentarians is related to the investigation of the scandals. Besides the Votes-for-cash scandal dennounced by Jefferson, there are the Bingo’s scandal, the Post Office scandal and the Brazilian Reinsurance Institute (IRB) scandal. All of these scandals are being submited to investigation by Brazilian parliamentarians.

One important question is whether President Lula knew about the alleged scandals in his government or not. If he knew and he did nothing he was conniving or he participated, it is the worst. If he didn’t know, someone can say that he was very incompetent because he didn’t see something so big under his nose.

Today, the authority and the efficiency of the President is being questioned. Some people say that it was the former Minister José Dirceu who actually took great part of the decisions in Lula’s government. The politicians say that President Lula must take control of his government, that he should do a major reform of his government and that he should get away from the people who are involved in the scandals.

Besides the corruption dennounciations, the government of President Lula is being criticized by his weak social agenda. The programme called “Zero Hunger” has showed little results and many people accuse it of being just a marketing strategy.

The management of the economy has being praised by some analysts. However, critics, even inside the government like the Vice-President José Alencar have already criticized it, because of the high interest rates. There is not severe inflation, but unemployment is high, and salaries are low.

The next days or the next month may be decisive to the future of Lula. He must show that he is not involved in the corruption scandals, he must reform the government and he must prove that he is competent. The positive factor are that the Brazilian economy is not seriously contaminated by the political crisis until now, the population is perplexed but calm and the politicians are not envolving the President in the denunciations, although they demand the investigation of all corruption allegations. However, nobody knows how much this situation will remain or if it will remain until the end of the government of President Lula in 2006.

This article features first-hand journalism by Wikinews members. See the collaboration page for more details.
This article features first-hand journalism by Wikinews members. See the collaboration page for more details.

Posted in Uncategorized | No Comments »

Australian refugee contractor accused of breaching its duty of care

">
Australian refugee contractor accused of breaching its duty of care
December 17th, 2017 by 6FjUhLbu

Friday, December 30, 2005

Contents

  • 1 Richard Niyonsaba
  • 2 Denial of food
  • 3 Background and Criticisms
  • 4 Sources

The Australian Centre for Languages, a company which has a multi-million dollar contract with the Australian government to provide refugee services, has been accused of breaching its duty of care following the death of a chronically ill child and allegations of failing to provide three women in their care with food.

Posted in Uncategorized | No Comments »

Tom Cruise orders €14,500 takeaway meal

">
Tom Cruise orders €14,500 takeaway meal
December 17th, 2017 by 6FjUhLbu

Tuesday, August 2, 2005

Tom Cruise this week took the delivery service to a whole new level. Celebrating his 43rd birthday with numerous guests at a party in the USA, Cruise decided to call up his three favorite chefs, all living in Italy, to prepare a meal.

Cruise decided to fly all three chefs out to the United States at a cost of €14,500. According to the Daily Mail the chefs cooked the celebrity tagliatelle ragu, veal, and chocolate tiramisu.

Posted in Uncategorized | No Comments »

Exclusive interview with prominent blogger, David Farrar

">
Exclusive interview with prominent blogger, David Farrar
December 16th, 2017 by 6FjUhLbu

Thursday, May 10, 2007

Freelance journalist writing for Wikinews, Gabriel Pollard, with help from Brian Anderton, has interviewed New Zealand-based blogger, David Farrar on blogging, web 2.0, and the Internet in general.

David Farrar is most known for his “fairly popular” blog, Kiwiblog, where he posts on various topics, including politics and technology. He is the vice-president of the Internet Society of New Zealand, and has been involved in helping to split Telecom New Zealand up and in anti-spam legislation.

David Farrar first started using the “best invention ever,” Internet, in February 1996 after having owned a BBC Micro microcomputer since 1982. On the Internet he debated various issues using Usenet newsgroups. Kiwiblog now serves for this purpose. He then got his own personal Internet account with ihug in August of that year.

Farrar also has political ties, which can be seen in some of his blog posts. For eight years, Farrar worked for various Prime Ministers (PM) and Opposition leaders for the National Party, working with the likes of former PM Jim Bolger and former PM Jenny Shipley in the Media Services Unit of Ministerial Services.

Until Farrar landed himself a job in parliament, he had been using mainly Apple computers, “[I] finally converted to Microsoft in 1997 after being the only person in Parliament to have a Mac!”

Farrar was involved with introducing public e-mail for ministers, and the first Prime Minister website.

In 2004, after leaving politics, Farrar set up his polling and research company.

Kiwiblog, sparked by now defunct blog NZ Pundit by Gordon King, currently receives over 300,000 visitors a month. He suspects that Russell Brown, and the Spareroom blogs get well over 100,000 visitors. “There’s then probably a dozen or so other bloggers who get into the tens of thousands.”

“Gordon [King] would post wonderful polemics challenging the conventional thinking and reporting, and after a few months of reading him I realized that I also had views and could try sharing them with the world. So in July 2003 I made my first post, and enjoyed it ever since.”

Farrar admits to not having a deliberate strategy for promoting himself and his blog, he just found that doing more posts in a day and posting what he was interested in got the visitors that were interested in the same things. “Oh and most important of all is to have a sense of humour and enjoy doing it.”

If Farrar wasn’t blogging, he says he would be “Earning money! I spend far too long blogging when I should be working on more business. However it is doing well enough that I can divide my time up between my business, InternetNZ and blogging and not starve.”

Farrar has a few tips for those politicians who have started a blog, or are looking at starting one up, “Very few are successful because [they] treat it as a one way communication tool where they just post press releases or travel diaries. Rodney Hide is the best example of doing it the right way. John Key is video blogging and responding to comments through future videos, which is a different way to interact.” But still warns that most readers of blog prefer “honest opinion” instead of reading what the politicians want them to read.

Farrar is a huge supporter of Wikipedia and says that he uses it multiples times a day. He says that he was “very proud” when the Wikipedia community regarded him as notable enough to have his own entry.

“I wish I had more time to edit Wikipedia. There’s lots more NZ content to get onto there.”

Sites like YouTube, which Farrar uses daily, show that they can leave big brand names like Google Video for dead if they show strong innovation, Farrar says.

Farrar says the success to websites such as Wikipedia and YouTube is because of multiple user generated content, “…rather than tightly controlled content from one source.” The focus on the community at large is also a major factor of their success.

When asked where he sees the Internet in decades from now, his simple response was, “I wish I knew.” But he does predict every house in New Zealand will be connected to the Internet via fibre optics.

One scenario Farrar drew was, “…being able to see a map of your local area on your phone, and not just get told where the nearest toilets or bookstore is, but also if any of your friends are nearby.”

David Farrar would just like to say thanks for the opportunity of being interviewed on Wikinews.

Posted in Uncategorized | No Comments »

MS Explorer cruise ship passengers are safe

">
MS Explorer cruise ship passengers are safe
December 16th, 2017 by 6FjUhLbu

Friday, November 23, 2007

All passengers and crew from the stricken Canadian cruise ship MS Explorer are safe. Since broadcasting a call for help at approximately 05:24 UTC, a number of vessels in the area have raced to rescue her 156 passengers and crew. Four vessels led by the cruise ship the Endeavour were the first to arrive and pick up the evacuees from lifeboats and RIBs, later being transferred to the Norwegian ship, MS Nordnorge.

In less than one hour all passengers and crew, said to be cold but in good health, were safely transferred to the Nordnorge, and that vessel is now heading towards King George Island, three or four hours steaming away. Speaking on the BBC’s News 24, the captain of the Nordnorge said that he was heading for the Chilean research station, from where it is expected that all can be flown back to the South American mainland.

Off the South Shetland Islands the ship struck an underwater object (believed to be a submerged iceberg ) the Explorer developed a fist sized crack and began taking on water. Initially said to be listing to starboard at 25° the Argentine Coast Guard reports that the list has since increased to 45° and the vessel is expected to sink soon. Concerns now turn to possible environmental concerns and damage.

The rescue effort was an international affair involving the coast guards of Argentina, USA, Chile and the UK. The UK’s Maritime and Coastguard Agency received notification from the US Coast Guard between 5.30-6.00 asking for the Explorer’s emergency data plans.

Posted in Uncategorized | No Comments »

« Previous Entries