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| ? | + | extremely helpful thank you!<p style="text-align:right">[[User:Aakash95|Aakash95]] 04:43, 20 February 2013 (EET)</p> | |
Aakash95 04:43, 20 February 2013 (EET)
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The medical interventions ? including early caesarean deliveries, CT scans for head injuries in children and annual Pap tests for middle-aged women ? may be necessary in some cases, the physician groups said. But often they are not beneficial and may even cause harm.
"We are very concerned about the rapidly escalating cost of healthcare," said Dr. Bruce Sigsbee, president of the American Academy of Neurology, which was among the 17 medical groups contributing to the list of procedures. "This is not healthy for the country, and something has to be done."
Development of the list, which was organized by the American Board of Internal Medicine's ABIM Foundation, is a minor milestone in efforts to enlist physicians to rein in unnecessary services, a leading cause of the skyrocketing healthcare tab.
In 2011, the ABIM Foundation published a similar list of procedures submitted by nine other medical societies as part of its Choosing Wisely campaign.
The United States spends more than $2.5 trillion a year on healthcare, or more than $8,000 per person. That is 21/2 times as much as the average spent by other industrialized nations, according to data collected by the Organization for Economic Cooperation and Development, whose members include the richest nations.
Studies show that the high cost of U.S. healthcare is driven in large part by prices. American hospitals and doctors charge much more than their international counterparts.
But U.S. physicians also perform many more tests and elective procedures. For example, American doctors order nearly twice as many CT and MRI exams as doctors in other industrialized countries do. They perform more knee replacements and deliver more babies by caesarean section.
Some of this extra care may result in better outcomes. The U.S. has some of the highest cancer survival rates in the world, for instance.
But America lags far behind other industrialized countries in caring for children with asthma and adults with chronic bronchitis and emphysema, among other illnesses.
A growing number of experts have concluded that much medical care in the U.S. is wasteful and even dangerous for patients. A 2012 report from the independent Institute of Medicine estimated total waste in the system at 30%, or $750 billion a year.
"Millions of Americans are increasingly realizing that when it comes to healthcare, more is not necessarily better," said Dr. Christine K. Cassel, president of the ABIM Foundation.
For example, despite the popularity of early caesareans, there is growing evidence that babies born before 39 weeks' gestation have higher risks of learning disabilities and even death.
Whether, or how quickly, the initiative to curb unnecessary procedures will yield results remains unclear.
Persuading doctors to be more conservative can be difficult, said Dr. Lowell E. Schnipper, an oncologist at Boston's Beth Israel Deaconess Medical Center and chairman of a national task force on controlling the cost of cancer care. "These diseases can be fatal," Schnipper said. "The stakes are high. And families very often push the doctor, who wants to take care of the patient as best he or she can."
Recent warnings from the U.S. Preventive Services Task Force that screenings for breast and prostate cancers often do more harm than good drew huge backlashes from patient advocates. Similarly, the Obama administration's efforts to raise awareness about unnecessary medical care and to improve data on best medical practices as part of the 2010 healthcare law prompted many Republicans to characterize the ideas as rationing.
But Dr. Manoj Jain, a leading health quality advocate in Memphis, Tenn., said more aggressive efforts may be needed to reduce wasteful and dangerous medical practices.
Like many experts, Jain advocates more evaluation of physicians and new ways to pay for healthcare that reward better outcomes and higher efficiency instead of the current fee-for-service system, which pays doctors for every procedure they do.
"If we really are going to bend the cost curve, we have to get really serious," Jain said.
Among the medical societies that identified overused procedures prescribed by their members were the American Academy of Pediatrics, the American Academy of Ophthalmology, the American College of Obstetricians and Gynecologists, and the Society of Thoracic Surgeons.
The ABIM Foundation effort also drew support from leading consumer and business groups, including Consumer Reports, the AARP and the National Business Group on Health.
noam.levey@latimes.com
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Visiting Google today you will see a special Google logo, aka Doodle, for Nicolaus Copernicus's 540th birthday. The logo is of planets revolved around the sun, as opposed to other views of the day. As you can see, the Google name is etched into the logo, as all Google Doodles are.
The logo is animated showing that pattern of the planets, as per Nicolaus Copernicus's own writings. Here is a picture of the logo with the planets, without them and just the planets themselves:
Nicolaus Copernicus was born in Poland on February 19, 1473 and died at the age of 70 on May 24, 1543.
The logo is a representation of what he is most well known for, Heliocentrism. Heliocentrism is the astronomical model in which the Earth and planets revolve around a relatively stationary Sun at the center of the Solar System.
For more about Nicolaus Copernicus and why Google felt he deserves a logo 540 years later, see his Wikipedia page.
Forum discussion at Google Web Search Help.
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ROUND ROCK, Texas (AP) ? Dell Inc. on Tuesday posted another quarter of declining sales and profits, the type of results that have disenchanted shareholders and prompted a buyout agreement.
Two weeks ago, Dell's founder and CEO Michael Dell and a group of investors agreed to buy the company for $24.4 billion with a plan to turn it around. If the deal goes through, it will take the PC maker off the stock market after 25 years.
The company's two largest shareholders after Michael Dell don't think the offer is high enough, and plan to vote against the deal. The company's conference call to discuss the quarterly earnings will mark Michael Dell's first public remarks since the terms of the sale were announced.
Dell's slump stems from weakening demand for PCs as more technology spending shifts toward smartphones and tablet computers.
The Round Rock, Texas company posted net income of $530 million, or 30 cents per share, for its fiscal fourth quarter, which ended Feb. 1. That was down from $764 million, or 43 cents per share, in the quarter a year ago.
Excluding acquisition- and severance-related charges, earnings were 40 cents per share, beating by 1 cent the average forecast of analysts polled by FactSet.
Revenue was $14.3 billion, down 11 percent from a year ago. It beat analyst expectations at $14.1 billion.
Dell's stock gained 5 cents to $13.85 in extended trading after the financial results were released. That's 20 cents above the buyout offer, indicating that investors believe there's some chance of an improved bid.
Source: http://news.yahoo.com/dell-earnings-down-31-percent-4q-213005100--finance.html
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Currently 21 states and Washington, D.C., use automated cameras at traffic intersections to catch violations such as running through red lights and stopping over white lines. While the cameras bring in thousands of extra dollars, drivers and some government officials argue they are inaccurate and rip people off. NBC's Tom Costello reports.
By Lisa Riordan Seville and Hannah RappleyeNBC News
Drivers dread it -- that flash as they try to speed through a yellow traffic light. It?s a red light camera, and a signal that a ticket is on the way.
A rarity 15 years ago, red light cameras have become ubiquitous in many U.S. cities. Communities in 24 states and Washington, D.C., now use the cameras to try to decrease illegal -- and sometimes deadly -- traffic violations. Supporters say it?s worked.
"In the last five years we went from 54 traffic fatalities to 19,? said Cathy Lanier, police chief in Washington, D.C., which began using the cameras in 1999. ?I mean, that's dramatic!?
Red light cameras are one piece of a growing network of automated traffic enforcement. Cameras now monitor speed, bus and high-occupancy-vehicle lanes and intersections with stop signs. Proponents like Lanier say they help to deter accidents, nab violators and allow states and municipalities to keep an eye on the roads for less.
But critics of red light programs worry about the Big Brother aspect of using cameras instead of cops. Many also say cameras, which are generally run by private companies, have spread not because they make streets safer, but because they mean profit for cities and companies.
?What the issue really comes down to is these companies are ripping people off by hundreds of millions of dollars, in the name of caring about our safety and our health and our kids,? said New Jersey Assemblyman Declan O?Scanlon, who has introduced anti-red light camera legislation to the state Legislature.
Recent news stories have fueled opposition. In Chicago, an alleged pay-to-play scandal led the mayor to ban one company from bidding for future contracts. Millions were spent on pro-camera lobbying in Florida and other states. In Iowa, doubts about the constitutionality of using cameras as traffic enforcers led a state senator to introduce a bill to ban red-light cameras ? a move already taken by at least nine other states.
What does science say?
Red light violations were associated with some 700 deaths and nearly 90,000 injuries in 2009, according to a study based on data reported to the National Highway Traffic Safety Administration. Fatalities and injuries have decreased in recent years, the study shows.
Researchers, however, are divided on how much red light cameras increase safety.
Charlie Neibergall / AP file
Traffic passes a red light camera at an intersection in Clive, Iowa.
In 2011, the Insurance Institute for Highway Safety, a nonprofit research group funded by the insurance industry, released a study that found red light cameras decreased fatal accidents by an estimated 24 percent in large cities that use them.
But a 2005 Federal Highway Administration study painted a more nuanced picture. Data from seven jurisdictions showed a decrease in front-into-side crashes at intersections with cameras. But it also showed an increase in rear-end crashes. The researchers said that apparently was the result of drivers hitting the brakes to avoid a ticket. Overall, however, the research showed the cameras saved money by both decreasing the most serious accidents, and generating revenue.
However, the FHA says that red light cameras shouldn?t be a knee-jerk traffic enforcement option. The agency issued a number of recommendations regarding the implementation of red light cameras, saying cameras should be considered only after engineering solutions have failed in problem intersections. Among the possible solutions, it says: Give drivers more cushion. Increasing yellow time by one second, it found, can result in a 40 percent decrease in crashes in stoplight-controlled intersections.
?It all hinges on proper yellow light time,? said John Bowman, communications director of the National Motorists Association, a drivers advocacy group. ?If yellow lights are set properly, based on established traffic engineering, red light cameras are unnecessary because you almost automatically have low numbers of violations and low numbers of accidents. If you shorten those yellow light times beyond bare minimums, that?s when you start to generate more accidents and more violations.?
Problematic cameras
A yellow light in Cary, N.C., had Howard Bond seeing red.
Last year Bond?s son was issued two different tickets for turning left on a red light at an intersection. But when Bond watched videotape of the alleged traffic offenses, he saw that in both instances his son had legally turned left on a flashing yellow light. The town had recently switched to a flashing yellow at the intersection, but Redflex, the private company running the cameras, kept treating it as a red, Bond said.
Each time, Bond, who lives in nearby Chatham County, went to the office that issued the tickets to complain. Each time, he said, his tickets were dismissed but the larger issue was ignored.
"I just basically stood there and said, ?No sir, you?re going to look at the video,?? Bond told NBC News. But law enforcement officials told him he would have to attend a hearing to contest it.
"I said 'We?re not going through all that,'? Bond said. ?He started hee-hawing around. Then he looked at the video and said, ?This is wrong.?"
After a local television news station approached town officials with Bond?s tickets, details emerged about tens of other tickets wrongfully issued in Cary by faulty red light cameras last year. A review of its red light cameras found that cameras in one intersection had generated at least 31 false violations, many of which led to $50 tickets.
Town officials told the Raleigh News and Observer that Redflex had failed to report the error to the town.?
But Jody Ryan, spokesperson for Redflex, said the company took action as soon as it discovered the wrongful tickets.
?In this situation, changes were made by the Town of Cary to the traffic light phases without Redflex Traffic Systems, Inc. knowledge,? Ryan said. ?Because we were unaware of these changes, our systems triggered a set of false positives. ?Once we were notified of the issue Redflex either dismissed or refunded all the affected citations on behalf of the Town of Cary.?
While major cities can make millions off red light cameras, in some contracts red light camera companies keep the majority of funds paid by violators. Redflex?s contract with Cary, for instance, allowed the company to keep 88 percent of the money generated by red-light camera tickets in Cary. Between April 2004 and July 2012, ticketed drivers paid $5.7 million to the company, and $646,000 to the Wake County Public School System, which received the city?s proceeds.
The controversy led town officials to abandon its red-light camera program altogether.
Cary is one of a number of communities, including large cities such as Houston, that have recently abandoned their camera programs amid opposition from residents.
Dollars and cents
About 700 municipalities in the country have cameras. One of the most prominent companies, Redflex, had about 2,000 cameras in operation around the nation in 2011, bringing in over $92 million in revenue, according to its annual report. American Traffic Solutions, another big player in the industry, reports more than 3,000 road safety systems installed in the U.S. and Canada, which include red light cameras.
Red light cameras can also pull in big revenues for cities. An investigation by NBC 4 in Washington, D.C., found the Capitol region drivers received tickets with at least $18 million dollars in fines in one year attributable to the cameras. NBC 5 in Dallas found a single camera in Arlington, Texas, generated $2.5 million over four years.
NBCDFW.com: Red light cameras make millions
Communities continue to adopt the technology. In 2011, East Cleveland residents voted to keep red light cameras. Last year, New Jersey?s Pohatcong Township voted to extend its contract with Arizona-based American Traffic Solutions.
?The bottom line is that those who oppose cameras are the minority,? said Charles Territo, spokesperson for American Traffic Solutions. He added that American Traffic Solutions doesn?t issue tickets: a police officer reviews each image before issuing a violation. According to ATS, about 50 percent of traffic ?events? each year are rejected before a violation is issued.
?The majority of voters around the country know the dangers of red light running,? Territo said. ?Nobody likes to get a ticket, but cameras are used in a number of places around the country and the world. They?re used to help police officers do their job.?
But cameras have faced increasing opposition from drivers who object to the automated systems for many reasons, including the inability to confront their accuser in court. Facing pressure from constituents, local and state politicians in Iowa, Florida, New Jersey and other states have recently introduced measures to change or end the camera programs.
Other controversies have raised questions about red light?cameras. Problems with short yellow lights, which may increase the number of tickets issued, have surfaced in cities from California to Tennessee. Judges in Baltimore have castigated the city and thrown out tickets after finding the city had shortened yellow lights below recommended limits. Last summer, the New Jersey?Transportation?Department ordered 21 red light programs suspended after finding yellow-light timing issues. Meanwhile, camera companies have sued, or threatened to sue, cities who back out of contracts. And they?ve been?investigated for possible?pay-to-play schemes with local governments.?
?They?re very aggressive in terms of lobbying for favorable legislation or favorable court cases,? said Bowman of the National Motorists Association. ?It?s big business, and there?s a lot of money at stake.?
Last October, Chicago Mayor Rahm Emanuel barred Redflex from re-bidding on the city?s red-light camera contract after a Chicago Tribune investigation found that Redflex company executives and lobbyists had paid for hotel rooms and spent thousands on entertainment for the city official overseeing the red light program.
Chicago?s red light cameras raised big revenues for the city. Redflex has operated a red-light program in the city since 2003, generating about $300 million in fines for the city and $97 million in revenue for itself. Redflex. Residents in the city have long complained about discrepancies between yellow light times in the city and its suburbs.
?We authorized an internal investigation and, though the inquiry is not complete, have learned that some Redflex employees did not meet our own code of conduct and the standards that the people of the City of Chicago deserve,? said Ryan, Redflex spokesperson, of the Chicago case. ?We will take corrective action and make additional information public.?
Automated traffic enforcement companies spend millions persuading local and state lawmakers to expand programs, using lobbyists, municipal partners and nonprofits to advance the cause. After spending $1.5 million lobbying Florida lawmakers over four years, American Traffic Solutions became the main-red light camera supplier in the state, winning contracts in more than 65 cities.
Territo, the spokesperson for American Traffic Solutions, defended efforts to expand red light camera programs, which he emphasized are above all about safety. ?Just as opponents of red-light safety cameras fund efforts to remove cameras, we expend resources on efforts to defend them,? he said.
Recognizing growing opposition to red light enforcement technologies, companies are looking to new markets. Both Redflex and American Traffic Solutions have active speed cameras in various markets, though 12 states have banned the technology. Both companies have also started programs to enforce rules prohibiting drivers from going around stopped school buses.
Redflex recently became the nation?s largest provider of school bus arm cameras, which catch drivers who speed past the stop signs that swing out from the side of school buses. The company has launched 10 pilot programs in six states.?
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Sebastian Holst makes yoga mobile applications with his wife, a yoga instructor.
The Mobile Yogi is sold in all the major mobile app stores. But when someone buys his app in the Google Play store, Holst automatically gets something he says he didn't ask for: the buyer's full name, location and e-mail address.
He says people are not aware that Google is sharing their personal information with third parties. No other app store transmits users' personal information to third-party developers when they buy apps, he said.
"Google is not taking reasonable steps to ensure that this data is used correctly," said Holst, whose app has 120,000 users.
Google is coming under fire just as regulators in the U.S. and overseas are stepping up their scrutiny of how all the players in the industry - mobile apps, stores, advertising networks and others - handle consumers' private information. Regulators are pushing for greater transparency of what information is collected by apps and how it's shared.
Google Play has worked differently from Apple's iTunes since it launched in October 2008. App developers set up accounts through the mobile payment system Google Wallet, which makes them merchants in the store. When someone buys an app from Google Play, that transaction - and the customer's information - is sent to the developer. The developer has to comply with rules about what to do with the information.
But at Apple, iTunes is the merchant. App developers say they never receive customer information.
In an e-mailed statement, Google defended how Google Play operates.
"Google Wallet shares the information necessary to process a transaction, which is clearly spelled out in the Google Wallet Privacy Notice," the statement said.
Barry Schwartz, news editor of website Search Engine Land, said he prefers it that way.
"I want to be able to service my customers, and yes, they are my customers, not Google's and not Apple's customers. They download our products. They call the developer with questions. We provide them the tools and the content. They are our customers," Schwartz wrote in a blog post. "Apple doesn't tell us who our customers are, and when we need that information to verify ownership or to give refunds, we are left with blindfolds on. Google, in my opinion, does it right by making the user who downloads the app our customer."
But Danny Sullivan, founding editor of Search Engine Land, said Google should make it clear to consumers that their information is being shared with third-party developers.
"Google's privacy policies don't make clear this is happening, something Google probably needs to correct," Sullivan said. "I sure had no idea that Google Play did this."
Nor did Dan Nolan, an Australian app developer. He said he was astonished when he found out that Google was sending him users' names, e-mail addresses, cities and ZIP codes. He wrote a blog post last week condemning Google for doing it.
Nolan runs a popular app in Australia called "Paul Keating Insult Generator" that throws out quips worthy of the former prime minister there.
"Under no circumstances should I be able to get the information of the people who are buying my apps unless they opt into it and it's made crystal clear to them that I'm getting this information," Nolan said.
Privacy watchdogs say consumers are largely in the dark that Google is sending their information to outside developers, despite assurances from Google that it tells them when they sign up for Google Wallet. That, they say, is "troublesome."
"The question is: What constitutes meaningful consent?" said Marc Rotenberg, executive director of the Electronic Privacy Information Center. "The bottom line is that users are not able to control how their data is being gathered and disclosed."
Apple may have started the mobile app boom in 2008, but Google is catching up. As of October, Google Play had the same number of apps - 700,000 - as Apple.
Google is trying to gain an advantage by making it easier for developers to build apps and easier for users to buy them. Apps help fuel the growing popularity of phones that run Google's Android software. Apple's app sales still generate several times the revenue of Google's.
Google does not run its app store with the same ironclad control that Apple does, and that has occasionally led to problems.
It's also had run-ins with federal regulators over privacy. Google agreed in 2011 that it would ask users before sharing their data with outsiders to settle government claims that it violated its users' privacy with its social network Buzz.
The Federal Trade Commission settlement also required the search giant to submit to independent privacy audits every two years for 20 years. Last year Google had to pay $22.5 million to settle charges for bypassing the privacy settings of millions of Apple users. It was the largest penalty ever levied on a company by the FTC.
Google is not the only company to come under fire for how it shares information with app developers. In 2011, Facebook Inc. agreed to a 20-year privacy settlement with the FTC that required the company to get users' permission before changing the way it treats personal information. The FTC alleged that Facebook engaged in deceptive behavior when it promised that third-party apps would only have access to user information they needed when in fact many apps had unrestricted access to users' personal data.
Source: http://feeds.sfgate.com/click.phdo?i=b38765f60d3b66833e0a129cc214523e
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A Texas couple trying to give their son a little sibling gave him four brothers instead, beating the odds to deliver quadruplets ? two sets of identical twin boys conceived at the same time. Tressa Montalvo, 36, gave birth to quadruplets Ace, Blaine, Cash and...
Source: http://news.yahoo.com/michelle-obama-jokes-bangs-mid-life-crisis-215224180--abc-news-politics.html
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