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Few too many studs in the stable! Russian PM Vladimir Putin enjoys horse riding, apparently his countrymen enjoy drinking, unhealthy food and emigrating out of Russia. Picture: Alexey Druzhinin
RUSSIA is suffering from a serious shortage of men, with a high male mortality rate fuelled by heart disease and alcoholism, The Moscow Times reported today. Preliminary census results showed that Russia's population dropped by 2.2 million since 2002 to just under 143 million, suggesting the government's efforts to boost the population were not working.
Just 46.3 percent of Russia's population was made up of men, down from 46.6 percent in 2002, the report said.
"Women here live longer," the newspaper quoted demographics researcher Boris Denisov as saying.
Men "do not want to live" in Russia, he added.
Russia has experienced a dramatic drop in population since the fall of the Soviet Union, fueled by alcoholism and unhealthy lifestyles as well as emigration.
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When President Barack Obama addresses the nation Monday evening, nine days after launching airstrikes against Libyan strongman Muammar Qadhafi, his challenge is to convince the public that, congressional nail-biting aside, he acted swiftly and decisively in the national interest.
Congress has cried out in surround sound — with criticism coming from all corners — since U.S. missiles first struck Libyan targets. At best, the public is lukewarm about the mission: According to Gallup, 47 percent approve and 37 percent disapprove. And top Obama administration officials, some of whom have differed over the goals and motivation for the mission, will face tough questioning this week in open hearings and a private, classified briefing for members of Congress.
So when Obama takes the stage at the National Defense University at Fort McNair on Monday evening, there is a sense of urgency that he make an airtight case for his decision to intervene in Libya — and skeptics and supporters alike will also be looking for an endgame.
Here’s the narrative that Obama officials are selling in advance of the address: European and Arab-world allies begged America to get involved to prevent the slaughter of Libyan rebels; ignoring Qadhafi would embolden other despots to quash opponents by force; the United Nations and NATO are on board and the military and intelligence capabilities of the United States were crucial to setting up a “no-fly” zone. On top of that, even though Obama wants Qadhafi ousted, the American role will be wrapped up without an invasion, the officials say.
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Hundreds of thousands gathered to protest major cuts to public spending in the UK and turned violent with more than 200 people arrested 30 injured
Y ALYSSA CARTEE
You're watching multisource world news analysis from Newsy
A protest involving up to half a million people in central London turned violent and resulted in more than 30 minor injuries and the arrests of around 200 people.
The Trade Union Congress, or TUC, organized the march in protest of deep public spending cuts. After what was reported as a “mostly peaceful march,” a break away group began busting in to high end stores and attacking police with light bulbs filled with ammonia. (Video: ITN)
One writer for The Daily Mail says the breakaway group hurt the cause with its violence.
“Yesterday I saw a decent, respectable TUC march hijacked by thugs, vandals and a clueless pack of self-righteous protesters. … They do if, like the TUC protesters, they’re dignified and well controlled. The thugs I saw were shooting themselves in the foot in a mad, counter-productive, wicked way.”
But one writer for The Nation says, the violent protesters are just a product of class warfare.
“It’s easy for us old veterans to heap scorn on the few hundred anarchist punks ... whose appetite for mixing it up with the police threatens to hijack the headlines, and the airtime, earned by the hundreds of thousands of peaceful protesters. But when the political system seems sclerotic and unresponsive dissent will find other avenues.”
“A handful of protesters getting a bit out of hand. The rest of the protest as best we can tell, was not as unruly.” (Video: CNN)
“That was a peaceful demonstration against government spending cuts.” (Video: BBC)
Some believe U.S. coverage of the protests didn’t accurately portray the violence that occurred. A writer for Pajamas Media’s Tatler blog suggests Americans should pay particular attention to the London protest.
“CNN has given powderpuff coverage to the violence. ‘The march was largely peaceful apart from isolated skirmishes between protesters and police, authorities said,’ they falsely report. … Americans should take careful note of events, for the London mob has American cousins who share similar attitudes about budget cuts.”
“As usual, they didn’t even know they were doing it, but the BBC took sides on the TUC protest, even before it had begun. The Corporation and the TUC instinctively recognise each other as allies. Both depend on public money. This helps to explain the Corporation’s spasm of blatant partiality this weekend.”
BBC reports clean-up after the incident could cost “tens of thousands” of pounds.
Associated Press Monday, March 28, 2011
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Congress returns to Washington this week under mounting pressure to strike an agreement with President Barack Obama on a bill to fund the government.
That's proving difficult enough. Then comes the harder part for House Speaker John Boehner: convincing his many tea party-backed GOP freshmen that the sort of split-the-differences measure Obama could sign isn't a sellout.
Time is running short. Staff-level negotiations last week ran aground, and the principals are going to have to pick up the pace to have any chance of making an April 8 deadline to avoid a partial shutdown of the government. Right now it appears that the shutdown that both sides have sworn to avoid is possible _ if not probable.
Republicans complain that the White House and Senate Democrats, after hinting of deep spending cuts, have been slow in officially offering them.
The frustration boiled over on Friday, with Republicans criticizing Democrats for not presenting significant cuts. An offer a few days earlier had ponied up just another $10 billion or so, GOP officials said, which prompted House Majority Leader Eric Cantor to accuse Democrats of "negotiating off of the status quo and refusing to offer any sort of serious plan for how to cut spending."
The tough rhetoric was matched by volleys from Boehner, R-Ohio, and other House GOP leaders. That prompted Sen. Chuck Schumer, D-N.Y., to accuse Republicans of blowing up a near agreement on a "top line" of spending cuts that would have likely given Republicans more than half of their $60 billion-plus in reductions.
"After days of positive negotiations, with significant flexibility shown by the speaker, the House Republican leadership is back to agonizing over whether to give in to right-wing demands that they abandon any compromise on their extreme cuts," Schumer said.
Democrats also say that House Republicans insist on using House-passed legislation slashing more than $60 billion from the current-year budget as the starting point for talks, pulling back from an agreement with Boehner's office to work off a baseline essentially set at last year's levels.
Boehner appears to be in a no-win situation. Any agreement with Obama is sure to incite a revolt among hard-line tea partiers who want the full roster of cuts and an end to funding for Obama's signature health care law. And social conservatives are adamant that the measure cut off money for Planned Parenthood clinics that provide abortions in addition to the family planning services the government funds. Any attempts to outmuscle Obama with legislation that pleases tea partiers, however, would surely incite a shutdown.
"The speaker knows that when it comes to avoiding a shutdown, his problem is with the tea party, not Democrats," Schumer said.
Republicans promised last year that they would ratchet spending down to 2008 levels and force Obama to backtrack on generous budget increases made on his watch. To meet the promise, GOP leaders initially pressed for about $35 billion in cuts in a proposal that took account of the fact that the budget year is almost halfway over.
That idea didn't sell with tea party activists, and Boehner was forced to almost double the size of the cuts, driving away any potential Democratic support. But that means that the halfway point between the House-passed measure and a proposal advanced by Democrats controlling the Senate is roughly where Boehner started out in the first place.
Democrats are also pressing to use savings from nonappropriated accounts like farm subsidies to replace cuts made from agency operating budgets, a move that Republicans are resisting.
Perhaps even more difficult than a solution on spending is the question of numerous policy provisions, known as "riders," that lace the GOP budget proposal. Democrats adamantly oppose GOP provisions that seek to block implementation of Obama's health care law and cut Planned Parenthood from federal funding.
The not-so-subtle tradeoff would be for Republicans to drop their most controversial riders in exchange for more give from Democrats on spending cuts. Getting to that point promises to be political torture for Boehner, and his aides insist that any final agreement will have to include some riders or it can't pass the House.
"I think if Boehner and Obama could sit down, they could probably cut a deal pretty quickly, but I think Boehner's got too many cats to herd in order to go where he has to go," said Democratic budget expert Scott Lilly of the liberal-leaning Center for American Progress. "There's a lot of turmoil that needs to take place before this straightens itself out."
The vehicle for the debate is must-do legislation to fund the day-to-day operating budgets of federal agencies _ including military operations in Iraq and Afghanistan _ through the Sept. 30 end of the budget year.
Last month, House Republicans passed a measure cutting more than $60 billion from the $1.1 trillion budgeted for such programs last year. All the savings was taken from domestic programs and foreign aid, which make up about half of the pot. Democrats in the Senate killed the measure as too extreme, citing cuts to education, health research, food inspection and other programs and services.
The legislation was supposed to have been approved last year, but the Democratic-controlled Congress failed to pass a budget. After the elections that swept Republicans into control of the House, Republicans blocked a last-ditch effort to pass a catchall spending bill in December's lame-duck session.
Other controversial policy prescriptions would block the Environmental Protection Agency from carrying out regulations on greenhouse gases and implementing a plan to clean up the Chesapeake Bay, and bar the government from shutting down mountaintop mines it believes will cause too much water pollution.
Robert Gibbs, the former White House Press Secretary for President Obama may soon have a new boss in Facebook CEO Mark Zuckerberg. Reports are circulating that the social network would like Gibbs to head up their most important company communications.
The move, planned ahead of the company’s expected 2012 initial public offering (IPO) is still in the early stages and no formal offer has been made.
According to political insiders, Gibbs was getting ready to work on President Obama’s re-election campaign but recently decided to seek private sector work.
If Gibbs does accept the job, it could mean millions of dollars in his pockets as the company is said to be rushing along with negotiations since talks between him and the company were meant to be kept confidential. Apparently Gibbs has been stewing over the decision, even consulting with former White House colleagues, including David Axelrod.
The move could not only help Facebook garner a solid focused voice, but Gibbs’ experience in Washington could prove invaluable as Facebook comes under more intense scrutiny by Washington lawmakers and regulators who fear the company has not done enough to protect the privacy of their users.
JEFFERSON CITY, Mo. -- Frustrated by a perceived lack of success at a Missouri Capitol that professes job-creation as its top goal, more than a dozen representatives from businesses began meeting last summer to develop a winning strategy for 2011. Over the next several months, they winnowed their shared goals to six initiatives that were among the least likely to immediately harm the state's feeble finances.
But as every good retailer knows, even the best plans can fail without a catchy marketing campaign.
It was Dan Shaul, the director of the Missouri Grocers Association, who hit upon the slogan that has since enchanted Missouri's Republican-led Legislature.
"I said, ‘We're just trying to fix things that are broken that aren't going to cost money, let's keep it simple - ‘Fix the Six,'" Shaul recalled.
"I looked across the table at him and I said, ‘That's brilliant!'" said Dan Mehan, president of the Missouri Chamber of Commerce and Industry. "It just kind of had a little song to it."
At of the midpoint of Missouri's annual legislative session, the business community's "Fix the Six" agenda has fared remarkably well. Five of its six priorities already have passed the House; half have cleared the more deliberative Senate. And Republican legislative leaders in both chambers cited their progress on the business agenda as their top accomplishments so far. Lawmakers are to return from their spring break Monday for the second half of their session that ends May 13.
The "Fix the Six" slogan refers to six legislative proposals. The top item would restrict people's ability to bring workplace discrimination claims. The second would modify a 2005 business-backed law that made it more difficult for employees to win workers' compensation claims. Both are touted as ways to reverse court decisions that business leaders contend have eroded the original intent of state laws.
Other prongs of the business agenda would phase out Missouri's corporate franchise tax, eliminate an annual inflationary adjustment to Missouri's minimum wage that was approved by voters in 2006, reduce the potential liability to businesses in personal injury lawsuits and tweak the state's bonding ability in order to repay $825 million borrowed from the federal government for unemployment benefits.
The changes are backed by a coalition that - in addition to the state chamber and grocers' group - includes the National Federation of Independent Business, Associated Industries of Missouri, the Missouri Merchants and Manufacturers Association, groups representing general contractors and restaurants, and regional business groups from St. Louis, Kansas City and Springfield.
"All the business groups came together," said House Speaker Steven Tilley, R-Perryville. "They basically said to us that if you can fix these six problems that we think we can create jobs."
Jobs continue to be a concern in Missouri, because the unemployment rate remains around 9.5 percent. From January 2010 to January 2011, Missouri gained about 1,000 nonfarm jobs on a seasonally adjusted basis. But since employment peaked in February 2008, Missouri has lost 168,000 jobs, according to figures from the federal Bureau of Labor Statistics.
Whether the business agenda actually will create jobs is debatable.
House Minority Leader Mike Talboy says the "Fix the Six" agenda is designed to cut costs for businesses, but he says that doesn't necessarily translate to additional jobs.
"It's very interesting that you would call ‘job creation' squeezing workers, reversing civil rights standards, going after wages, making it harder for those that are hurt at work to actually have some recourse to take care of themselves after they can no longer can work," said Talboy, D-Kansas City. "That's not exactly what I would call a job-creator."
Talboy notes that bills providing tax breaks to computer data centers and science and technology companies have yet to receive debate in either the House or Senate. Both of those proposals also are backed by the state Chamber of Commerce, although they are not part of the "Fix the Six" campaign. The chamber also is backing a newly proposed tax break to help make Lambert-St. Louis International Airport a cargo hub for foreign countries such as China.
Efforts to expand state tax credits have seen limited success in the state Senate, where some lawmakers instead want to scale back the state's tax credits and subject them to greater legislative control.
Mehan said the proposed tax breaks weren't included in the "Fix the Six" package because their potential to affect the state's budget made them more controversial. He contends the items in the package are still substantial changes.
But there isn't consensus on that description.
"We're not trying to change anything, we're just trying to fix them," Shaul reiterates.
Shaul's slogan may help that happen in the Legislature. But if the business bills reach Gov. Jay Nixon's desk, it most likely will be because the various businesses groups forged a common agenda.
CHICAGO -- That nonstop crying of a baby with colic has some parents turning to popular folk remedies. Unfortunately, there's no good evidence they work, according to a review of 15 studies.
The results don't surprise New York City mom Leni Calas, 32. She tried many treatments studied, including fennel extract, sugar drops and massage, and says nothing worked for baby Roxy, who cried almost nonstop for six months.
"Our daughter would wake up and cry literally morning to night without napping," Calas said. "She would just literally scream herself purple, and then throw up because she had been screaming so much."
Calas said she and her husband couldn't accept what doctors told them - that there was nothing wrong with their baby and that she'd outgrow the crying spells. But that's exactly what happened.
And that's what most doctors believe about colic, which affects up to roughly 20 percent of U.S. babies, usually in the first few months of life.
If a physical problem can be found, the condition is usually not considered colic. Gastric reflux and protein allergies are among conditions that can cause digestive upsets and crying spells in babies, and are often mistakenly called colic.
That may explain why some remedies thought to ease digestive problems may not work in babies with true colic, including alternative treatments containing fennel, herbal teas and probiotics, which all were included in the medical review.
Alternative remedies are not tested and approved by the federal government, and the purity and amounts of their ingredients are not always verified. Parents should always check with their pediatricians if they plan to give their children an alternative treatment, said Dr. Jatinder Bhatia, head of the American Academy of Pediatrics nutrition committee.
The study by researchers at the University of Exeter in England was published online Monday in Pediatrics. The researchers analyzed results from 15 studies on various alternative remedies, massage and chiropractic methods advertised as effective against colic. Overall, almost 1,000 infants were involved.
Few of the studies were rigorously conducted and all had "major limitations," the researchers said.
"Thus, the notion that any form of complementary and alternative medicine is effective for infantile colic is currently not supported from the evidence" studied, they said.
None of the studies reported side effects, but one involving an herbal remedy listed vomiting, constipation and other symptoms possibly related to the treatment.
Although there were promising signs with a few treatments, including fennel extract, herbal teas and sugar solutions, better research is needed to provide conclusive evidence, said researcher Rachel Perry, the review's lead author.
Her own two children had colic, but it disappeared around the time she tried giving them an over-the-counter herbal liquid promoted as effective against colic.
Because colic does go away on its own, it's hard to determine whether specific treatments might work, she said.
"As a desperate mother, I can understand the sort of desire to try anything," Perry said.
She urged parents not to give up, since it's possible better designed studies on alternative remedies will show more definitive results.
Bhatia, a professor at Georgia Health Sciences University, said the study results don't mean that none of the treatments will work for any baby. Some parents do report success with alternative remedies. Sometimes that might be because parents think it will work and they feel calmer, which can in turn calm the baby - a placebo effect. But even if there's only a placebo effect, there's no reason not to continue, as long as doctors have been consulted and the treatment is safe, Bhatia said.
Parents should always check with their pediatricians if they plan to give their children an alternative treatment, said Bhatia, For Leni Calas' baby Roxy, now almost 2, the incessant crying spells tapered down and by 9 months disappeared.
Calas said she's convinced of one thing "that no one wants to hear - that the only thing that really does cure it is time."
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Online:
American Academy of Pediatrics: http://www.aap.org
KANSAS CITY, Mo. -- Missouri is proposing sweeping accreditation changes for its public schools that would add new statewide tests, including an end-of-high-school exam, and require districts to better monitor how their graduates fare in college.
The newest version of the Missouri School Improvement Program would focus solely on how students perform academically. The state would no longer take into account such things as the ratios of students to teachers, administrators and counselors, and whether districts offer certain courses such as art and physical education.
Districts also would be reviewed annually instead of once every five years and would be required to report a host of new details on everything from their early childhood programs to the percentage of students completing federal financial aid forms.
Michele Clark, a spokeswoman for the Department of Elementary and Secondary Education, said the direction the state is heading is "really exciting." The State Board of Education gave initial approval this month to the plan, which is revised every five years. The latest changes are part of an effort to move Missouri toward being ranked among the top 10 states in educational performance. The state now ranks closer to the middle.
But the changes have raised a range of concerns. Some fear that ratios of students to staff would rise and that art and music would be overlooked because meeting certain staffing ratios and teaching certain classes would only be guidelines. New fine arts tests are included under the latest accreditation changes - but those tests would be taken just twice between kindergarten and high school graduation.
"I think there is going to be an all-out effort to voice opposition to what the state board is doing," said Mike Wood, a lobbyist with the Missouri State Teachers Association.
The Missouri Association of School Administrators has voted to ask the State Board of Education to delay finalizing the changes until educators could voice their concerns. The Missouri Association of Secondary School Principals discussed the plan this weekend, but members didn't vote.
"Our folks are extremely dissatisfied by the process with which it was developed," said Roger Kurtz, the administrators association's executive director. He said part of the problem is that educators don't feel that their questions are being answered.
Responding to the concerns Sunday, State Education Commissioner Chris Nicastro said the education department will make a renewed effort to gather input on the changes.
"There is a very wise Japanese proverb: 'None of us is as smart as all of us,' and we need to hear from everyone," Nicastro said in a statement. "It has become clear that we must redouble our efforts to receive this valuable input."
Hundreds of comments about the proposed changes have already been submitted to the state, and more are expected. The Board of Education will accept comments for 30 days starting April 15 before making a final decision in May. Nicastro said the state also is offering to meet with the educational organizations.
The standards are used to evaluate schools and spur improvement. Currently, St. Louis and nearby Riverview Gardens are the state's only two districts deemed unaccredited - a designation that can ultimately lead to a state takeover.
Ten other districts, including Kansas City, are provisionally accredited, meaning they're subject to extra scrutiny.
The plan includes new year-end tests for physics, chemistry, world history and 11th grade English. But it's the proposed end-of-high-school exams, which some states use to gauge whether students can graduate, that have some educators most spooked.
"The fear is that at some point in time these tests would become a requirement for high school graduation," said Jim L. King, executive director of the Missouri Association of Secondary School Principals.
Clark, the education department spokeswoman, said any conversation about student graduation requirements would be separate from the accreditation changes.
The proposed standards also would require districts to monitor the percentage of their graduates taking remedial coursework in college and how many of them earn either an associate's degree within three years or a bachelor's degree within six years. Previously, districts just had to document how many students were enrolled in college within six months of graduation.
Of the 21,440 first-time freshmen enrolled in Missouri's public colleges and universities in fall 2003, 2,462 had received a two-year degree and 6,555 had received a four-year degree in six years, according to the latest statistics available on the Missouri Department of Higher Education's website.
The department said that in fall 2009, 38.1 percent of first-time freshmen took at least one remedial course - most commonly in math.
Educators said they don't have control over students once they graduate and colleges have varying requirements for placing students in remedial courses.
Missouri community colleges are working to change that and have set a standard for placing students in remedial courses that takes effect this fall. But the four-year institutions don't have a consistent standard.
Clark said the education department is collaborating with the state Department of Higher Education to develop a consistent way to identify need for freshman remediation in college. She said remediation rates will not be considered for accreditation decisions under the proposed changes, but educators fear that could change.
Telemedicine connects big-city specialists and rural patients
BY JIM DOYLE post-dispatch.com Monday, March 28, 2011
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On the top floor of St. John's Mercy Medical Center, doctors and nurses watch banks of video feeds, peering in on intensive care patients at rural hospitals across the Midwest.
Two critical care doctors and nine nurses in the St. Louis area oversee more than 400 patients at St. John's Mercy and a dozen other hospitals in four states. In round-the-clock shifts, they scan patients' vital signs and review their medications, lab work, X-rays and medical records. They conduct real-time quality control audits to ensure best practices are being followed.
From this control room, they can operate high-resolution cameras mounted in doorways of patients' rooms — and even zoom in to examine a patient's eyes or wounds. With two-way cameras, they talk directly with rookie nurses at the bedside of patients — or consult with patients themselves — at far-flung hospitals in places like Independence, Kan.
"We help save lives," said Lisa Manion, who worked as an intensive care unit nurse for more than a dozen years before joining the Mercy SafeWatch Center, one of the nation's largest teleICU units. "We do catch some things that the (bedside) staff, who are overworked, may not catch in time."
St. Louis area hospitals and health care systems based in the region are increasingly taking advantage of "telemedicine" — the use of computers and telecommunications to connect big-city hospitals to often underserved rural areas, where specialty doctors are scarce. Besides electronically monitoring the intensive care units of remote hospitals, such technologies are also being used to link specialists with patients, including stroke victims and women with high-risk pregnancies.
Telemedicine is hardly new. Major hospitals on the East and West coasts have capitalized on these communications devices in recent years, and specialists practicing in rural areas of Missouri and Illinois have relied on telemedicine for more than a decade for their consultations with remote patients. But it's a relatively new phenomenon in the St. Louis area, where specialists affiliated with the Sisters of Mercy Health System, SSM Health Care, BJC HealthCare, and Washington University have begun using these communications technologies to reach out to outlying areas.
joystick medicine
At Parkland Health Center in Farmington, Mo., a robotic device on wheels helps on-call specialists in St. Louis quickly interview patients who have suffered a stroke.
The stroke specialist uses a computer with a joystick to drive the robotic two-way video system down the hallway to the patient's room in the emergency department. Talking directly with the patient through the video monitor, the specialist performs a neurological exam to determine whether blood-clot busting drugs need to be administered and whether the patient should be transferred to Barnes-Jewish Hospital, also part of the BJC HealthCare system.
The patient is asked a series of questions to assess brain function and ability to speak and also asked to describe a series of still images on the video monitor. The patient's physical abilities and reflexes are also assessed with a nurse's help.
"The technology has gotten so much better and so much cheaper over time," said Dr. Karen Edison, director of the Center for Health Policy at the University of Missouri. "We really see this as the future: taking health care to patients wherever they are."
Edison, a dermatologist and medical school professor, began using video teleconferencing to serve remote patients in 1995. Many of her colleagues — including specialists in cardiology, psychiatry, neurology and those who attend to children with special needs — are also using these methods to consult with patients.
In recent years, the financial barriers for telemedicine have crumbled. Medicare and Medicaid reimburse doctors the same basic rate for in-person patient care as a video conference with a remote patient. Private payers, including health insurance companies, large employers and health maintenance organizations, also pay for many telemedicine services.
"It's a much more patient-centered way of bringing health care to people in rural areas, patients where they live," Edison said. "People can't always leave their homes. A lot of people work in low-wage jobs. ... If we can use technology to keep people in their homes and healthier longer, we should do it."
black boxes
Edison and other health experts say telemedicine helps deliver a valuable form of preventative care that, although it requires an investment in new technologies, could save the U.S. health system huge sums of money by preventing hospitalizations.
"It's our opinion that it will save money by providing more quality care. And by improving quality, you reduce cost," said Dr. Tim Smith, vice president of research for Mercy's Center for Innovative Care. "We have to be better at being innovative and trying to find better ways to deliver care."
He said that although health care providers may spend more money up front on telemedicine equipment and nurses' time, the costs are minuscule compared with emergency room admissions, intensive care visits, prolonged hospitalizations and nursing home care.
He said that many of those served in rural areas are Medicare and Medicaid patients, and a lot of federal and state dollars go toward long-term hospitalizations.
The Mercy system recently won a $495,926 federal grant that will enable the hospital chain to begin installing medical monitoring devices as well as "tele-home" converters in 900 patients' homes in small towns in southwest Missouri and northwest Arkansas.
The monitoring devices can record the daily readings — such as blood sugar, breathing levels, body weight and physical activity — of patients with chronic illnesses or conditions such as asthma, diabetes, emphysema and congestive heart failure.
The converter boxes transmit these daily readings to a doctor's office. If, for instance, a patient's readings are subpar three days in a row, it might warrant a call from the doctor's office. If no readings are recorded, it might also prompt a call from the doctor.
"It's a way for us to reach out to a patient in their homes in a less obtrusive way than calling a patient every day or sending a nurse there," Smith said. "And the more engaged a patient is in their own health care, the more likely they are to be adherent to good health priorities like diet, health and exercise."
improved images
Dr. Jim Bartelsmeyer, director of maternal fetal medicine at St. John's Mercy, began using video teleconferencing two years ago for his consultations with women who have high-risk pregnancies.
SSM's "teletouch" program, which began last year, uses video streaming to enable maternal fetal specialists at a control center at St. Mary's Health Center in Richmond Heights to examine patients and review their "Level 2" ultrasounds at community hospitals in Rolla, Mo., Breese and Maryville.
"The moms appreciate not having to come into the city," said Susan Staub, executive director of SSM's maternal and pediatric services. "Telemedicine is becoming much more acceptable because the images are so much better than they used to be."
Surgeons also have used video technologies to consult with rural patients about their post-operative recoveries and examine their wounds.
Meanwhile, some health providers are using "telemobile" services to send messages to the computers and cell phones of diabetic teenagers about the benefits of good diet and exercise.
By offering specialists' services remotely, telemedicine also is saving the state money by decreasing the transportation costs of inmates sent to off-site medical clinics.
Two days after using Flickr to display photos of police officers from Egypt’s feared state security force, Hossam el-Hamalawy watched in disbelief as they vanished from the popular social networking site.
“I thought I was being hacked,” said el-Hamalawy, a prominent Egyptian blogger and human rights activist who had uploaded the headshots of the police from CDs found by activists early this month at the State Security Police headquarters in Nasr City. He later learned in an email from Flickr that the photos were removed because he had not taken the images himself, a violation of the site’s community rules.
“That is totally ludicrous,” he said. “Flickr is full of accounts with photos that people did not take themselves.”
Flickr is among the social media networks, like Facebook, Twitter and YouTube, that are increasingly being used by activists and pro-democracy forces especially in the Middle East and North Africa. That new role for social media has put these companies in a difficult position: how to accommodate the growing use for political purposes while appearing neutral and maintaining the practices and policies that made these services popular.
YouTube was one of the first social media networks to wrestle with content posted by a human rights advocate that conflicted with its terms of service. In November 2007, it removed videos flagged as “inappropriate” by a community member that showed a victim being tortured by police in Egypt. They were uploaded by Wael Abbas, another Egyptian blogger. After a public outcry, YouTube staff members reviewed the videos and restored them. The company, owned by Google, now has as process in place to deal with such questions.
Facebook has remained mostly quiet about its increasing role among activists in the Middle East who use the site to connect dissident groups, spread information about government activities and mobilize protests. But Facebook is being drawn into the Israeli-Palestinian conflict and has been pushed to defend its neutral approach and terms of service to some supporters of Israel, including an Israeli government official.
March 22, 2011 www.kpho.com
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PHOENIX -- Sheriff Joe Arpaio rolled out the tanks to take down a man suspected of cockfighting.
West Valley residents in the neighborhood are crying foul after armored vehicles, including a tank, rolled into their neighborhood to make the bust.
Neighbor Debra Ross was so worried she called 911 and went outside where a nearby home had its windows blown out, was crawling with dozens of SWAT members in full gear, armored vehicles and a bomb robot. “When the tank came in and pushed the wall over and you see what's in there, and all it is, is a bunch of chickens,” Ross said.
In a massive show of force on Monday, the Maricopa County Sheriff’s Office executed a search warrant and arrested the homeowner, Jesus Llovera, on charges of suspected cockfighting. Llovera was alone in the house at the time of the arrest, and he was unarmed. “I think taxpayers should be shocked,” said Robert Campus, Llovera’s attorney. Campus said he believes the operation costs tens of thousands of dollars. Deputies had no probable cause to believe Llovera was armed or dangerous, according to Campus.
Campus said he believes the entire scene was basically a stage, to help actor Steven Seagal’s TV show, “Lawman.” Seagal was riding in the tank. The Sheriff’s Department has entered into a contract with Seagal and part of that contract gives Seagal carte blanche to go along with the sheriff as he arrests people. Thousands of dollars in damages were made to the property and 115 birds were euthanized on the spot. Llovera was convicted of a misdemeanor last year of attending a cockfight and has no history of owning weapons.
Yet the sheriff’s office said they had reasons to believe Llovera might be armed.
Banks pouring money into technology funds, wealthy clients and institutions clamoring to get pieces of startups, expectations of stock market debuts building — as Wall Street’s machinery kicks into second gear, some investors with memories of the Internet bust a decade earlier are wondering whether this sudden burst of activity spells danger for the industry once again.
With all this exuberance, valuations are soaring. Investments in Facebook and Zynga have more than quintupled the implied worth of each company in the last two years. The social shopping site Groupon is said to be considering an initial public offering that would value the company at $25 billion. Less than a year ago, the company was valued at $1.4 billion.
“I worry that investors think every social company will be as good as Facebook,” said Roger McNamee, a managing director of Elevation Partners and an investor in Facebook, who co-founded the multibillion-dollar private equity fund Silver Lake Partners at the height of the boom. “You have an attractive set of companies right now, but it would be surprising if the next wave of social companies had as much impact as the first.”
Funds set up by Goldman and JPMorgan Chase have invested in Internet startups like Facebook and Twitter or in funds with stakes in those startups. Even the mutual fund giants Fidelity Investments and T. Rowe Price have stepped up their efforts, placing large bets on companies like Groupon and Zynga.
Thomas Weisel, founder of an investment bank called the Thomas Weisel Partners Group that prospered in the first Internet boom, says he is “astounded” by the amount of money now flooding the markets.
“I think it’s much greater today,” he said. “The pools of capital that are looking at these Internet companies are far greater today than what you had in 2000.”
Yet there are notable differences between the turn-of-the-century dot-com boom and now. For one, the stock market is not glutted with offerings. In 1999, there were 308 technology IPOs, making up about half of that year’s offerings, according to data from Morgan Stanley. In 2010, there were just 20 technology IPOs, based on Thomson Reuters data.
More important, the tech startups that have attracted so much interest from investors have real businesses — not just eyeballs and clicks. Companies like Facebook have fast-growing revenue. Groupon, which has been profitable since June 2009, is on track to take in billions in revenue this year. And since 1999, when 248 million people were online (less than 5 percent of the world’s population), broadband Internet and personal computing have become mainstream. About one in three people are online, or roughly 2 billion users, according to data from Internet World Stats, a website that compiles such numbers.
“In those days, you had tiny, little companies going public that hardly had a business plan,” Stefan Nagel, associate finance professor at Stanford University, said. “And now you’re talking about only a few companies — companies that are already global and with revenue.”
With such a small, elite group, the potential fallout if things go badly would be limited, some investors say. “Yes, we have a frenzy again,” said Lise Buyer, a principal of the Class V Group, an advisory firm for companies considering initial public offerings. “But the frenzy is on a very select group of companies. Facebook is clearly Secretariat, but there are a few other championship horses they are looking to bet on.”
For Wall Street, the initial attraction to Internet startups in the 1990s was the opportunity to earn fees from taking the companies to market. At its peak in 1999, the industry made $1.3 billion in underwriting fees, according to data from Thomson Reuters.
But as enthusiasm surged, many firms also rushed to make investments for their clients and themselves through special-purpose funds and direct investments. And in many cases the banks got burned just as ordinary investors did.
“The investment pools that we did back in 2000 did extremely poorly, because many of those companies went from filing an IPO to bankruptcy courts in a matter of months,” said Weisel, whose firm was acquired by Stifel Financial last year.
In 1998, Goldman Sachs Capital Partners, the bank’s private equity arm, began a new, $2.8 billion fund largely geared toward Internet stocks. Before that fund, the group had made fewer than three dozen investments in the technology and communications sectors from 1992 to mid-1998, according to Goldman Sachs documents about the fund.
But between 1999 and 2000, the new fund made 56 technology-related investments, of about $27 million on average. In aggregate, the fund made $1.7 billion in technology investments — and lost about 40 percent of that after the bubble burst. (The group, which manages the money of pensions, sovereign wealth funds and other prominent clients, declined the opportunity to invest in Facebook early this year.)
Philip A. Cooper, who in 1999 was head of a separate Goldman Sachs group that managed fund of funds and other investments, recalled that investors were clamoring, “We want more tech, we want more.”
Bowing to pressure, he created a $900 million technology-centric fund in 1999, and within eight weeks he had nearly $2 billion in orders. Despite the frenzy, he kept the cap at $900 million.
“There was a lot of demand, but we couldn’t see any way we could prudently put that much capital to work,” said Cooper, who has since left Goldman.
Other Wall Street firms, including JPMorgan Chase and Morgan Stanley, also made a number of small to midsize investments during the period. In 1999, for instance, Morgan Stanley joined Goldman Sachs and others in a $280 million investment in CarsDirect.com, which scrapped its initial plans to go public when the market deteriorated.
“We thought we were going to double our money in just a couple of weeks,” said Howard Lindzon, a hedge fund manager of Lindzon Capital Partners and former CarsDirect.com investor. “No one did any due diligence.” Lindzon lost more than $200,000 on his investment.
Also in 1999, Chase Capital Partners (which would later become part of JPMorgan Chase) invested in Kozmo.com — an online delivery service that raised hundreds of millions in venture funding. JPMorgan Chase, which just recently raised $1.2 billion for a new technology fund, at the time called Kozmo.com “an essential resource to consumers.” At its height, the company’s sprawling network of orange bike messengers employed more than a thousand people. Less than two years later, it ceased operations.
An online grocer, Webvan, was one of the most highly anticipated IPOs of the dot-com era. The business had raised nearly $1 billion in startup capital from institutions like Softbank of Japan, Sequoia Capital and Goldman Sachs. Goldman, its lead underwriter, invested about $100 million.
On its first day, investors cheered as Webvan’s market value soared, rising 65 percent to about $8 billion at the close. Less than two years later, Webvan was bankrupt.
About the same time, Internet-centric mutual funds burst onto the scene. From just a handful in early 1999, there were more than 40 by the following year. One fund, the Merrill Lynch Internet Strategies fund, made its debut in late March 2000 — near the market’s peak — with $1.1 billion in assets. About one year later, the fund, with returns down about 70 percent, was closed and folded into another fund.
“We all piled into things that were considered hot and sexy,” said Paul Meeks, who was the fund’s portfolio manager. Meeks started six tech funds for Merrill Lynch from 1998 to 2000.
Today, the collective amount of money that Wall Street banks are pumping into Internet startups, on top of the surging cash piles from venture capital groups, hedge funds and private equity, is a major concern for some investors.
Over the last five months, many venture capital players have raised giant chunks of capital. One Facebook investor, Accel Partners, is about to raise $2 billion for investments in China and the United States, while Bessemer Venture Partners is said to be closing in on $1.5 billion for a new fund. Greylock Partners, Sequoia Capital, Andreessen Horowitz and Kleiner Perkins Caufield & Byers have collectively raised more than $3 billion in the last six months.
Weisel, who has also been tracking hedge fund activity, finds the numbers dizzying. Countless hedge funds are investing in private placements — “dozens and dozens of hedge funds are doing the same thing,” he said.
As cash continues to pile up, the fear is that all this money cannot be put to work responsibly. With only a few perceived “winners,” some investors must be choosing losers or paying too much, Meeks said.
“When you see the valuations being bandied about — I do think, boy, these better be really special companies.”
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Read the complete story on The New York Times website.
TOKYO -- The auto industry disruptions triggered by Japan's earthquake and tsunami are about to get worse.
In the weeks ahead, car buyers will have difficulty finding the model they want in certain colors, thousands of auto plant workers will likely be told to stay home, and companies such as Toyota, Honda and others will lose billions of dollars in revenue. More than two weeks since the natural disaster, inventories of crucial car supplies - from computer chips to paint pigments - are dwindling fast as Japanese factories that make them struggle to restart.
Because parts and supplies are shipped by slow-moving boats, the real drop-off has yet to be felt by factories in the U.S., Europe and Asia. That will come by the middle of April.
"This is the biggest impact ever in the history of the automobile industry," said Koji Endo, managing director at Advanced Research Japan in Tokyo.
Much of Japan's auto industry - the second largest supplier of cars in the world - remains idle. Few plants were seriously damaged by the quake, but with supplies of water and electricity fleeting, no one can say when factories will crank up. Some auto analysts said it could be as late as this summer.
Hitachi Automotive Systems, which makes parts such as airflow sensors and drive control systems, is waiting for its suppliers to restart while dealing with its own problems. Its plants are without water and gas, and have rolling electricity blackouts. Workers are repairing crumpled ceilings, fallen walls and cleaning up shattered glass. A spokesman said he doesn't know when its plants will reopen.
The uncertainly has suppliers, automakers and dealers scrambling. And it exposes the vulnerability of the world's most complex supply chain, where 3,000 parts go into single car or truck. Each one of those parts is made up of hundreds of other pieces supplied by multiple companies. All it takes is for one part to go missing or arrive late, and a vehicle can't be built.
When General Motors briefly shut a pickup plant in Shreveport, Louisiana, due to a lack of parts, it caused the partial closing of a New York factory that supplies engines for those trucks. Sweden's Volvo has warned that its production could be disrupted because it is down to a week's worth of some parts.
Car buyers will soon see higher prices and fewer choices. Some car colors will be harder to get because a paint pigment factory in Japan was damaged and shut production. As a result, Ford is telling dealers to stop ordering "tuxedo black" models of its F-150 pickup and Expedition and Navigator SUVs. It's also shifting away from some reds. The moves are precautionary, Ford said. Chrysler told dealers it was temporarily restricting orders of vehicles in 10 colors.
That worries some dealers, especially when popular colors like black could be in short supply
"It's hard enough to sell a $60,000 Navigator in this economy," said Fortunes O'Neal, general manager at Park Cities Ford in Dallas. "We don't want to have to tell customers, ‘You've got to pick another color.'"
Customers also face rising prices for models like Toyota's Prius, which is made only in Japan. Fears of falling supply have some dealers driving a hard bargain with customers who want the fuel-efficient hybrid as gasoline prices rise. Recent discounts of 5 to 10 percent on that car are disappearing.
Japanese carmakers, who have shut most of their domestic plants, are warning that some of their overseas factories will stop running, too, in an effort to conserve supplies. Toyota and Honda expect shutdowns at North American plants. Honda said production could be interrupted after April 1. Even though most of its parts are sourced in the region, a few critical ones still come from Japan.
Goldman Sachs estimates the shutdowns are costing the Japan automakers $200 million a day, which adds up to $2.8 billion for just the past two weeks. Each week of continued shutdowns costs $1.4 billion. By comparison, Toyota made $2.3 billion in all of 2010, and its sudden acceleration recalls cost $2 billion. The cost of damage from Japan's natural disaster could dwarf that recall, which was considered Toyota's biggest crisis ever.
Much depends on how many spare components automakers have in stock - which is probably very few. Japan's automakers spearheaded lean manufacturing, under which parts are delivered to plants the same day they are used. Automakers are still receiving parts that were put on ships weeks ago, but those supplies will dwindle.
After the earthquake hit, car companies began the long process of figuring out which parts are in danger of running out. That means figuring out where every piece in every part comes from.
"Everyone is putting on the brakes a little bit and taking a look to see where they are affected," said Paul Newton, an analyst with IHS Automotive.
Companies will shut down plants as soon as some parts start running out, which could start happening in the next four to six weeks, he said. "You will see it happen almost daily."
IHS Automotive predicts that one-third of daily global automotive production will be cut because of supply chain disruptions. That means about 5 million vehicles worldwide won't be built, out of the 72 million vehicles planned for production in 2011.
To get a feel for the supply chain, consider a car radio. It's made up of hundreds of pieces from all over the world. The display may come from a supplier in Japan, while the wiring and circuitry originate in Korea. The plastic knobs could come from a company in China, and the metal structure that holds it all together is shipped from India.
All those parts come together at different times: The wiring and electronic components are installed into the metal frame. Then that piece is shipped to another supplier, who snaps on the plastic face and knobs. The radio could pass through three or four suppliers before being put on a ship, where it will spend weeks at sea heading to its final destination: The assembly plant.
"This isn't just as straightforward as assembling the iPad 2," said Brian Johnson, an autos analyst with Barclays Capital.
An example of Japan's importance in auto parts: its suppliers make many of the electronic components that control music systems and the sensors that monitor fuel levels and airbags.
Although most Japanese auto parts makers are not located in the areas that were inundated by the tsunami, between quake damage, electricity outages and water cutoffs, many factories in the region have remained paralyzed ever since.
Suppliers could be up and running again in April, but it could take until May or June for the entire supply base to be back.
Some car manufacturers, meanwhile, are considering shifting operations to deal with the crisis. Nissan, for example, is thinking of moving some of its engine production to Tennessee from Japan.
But those shifts won't be easy. First, lean inventories make it hard for automakers to suddenly change sources of supply. And plants that build car electronics, for example, have stringent safety requirements and exacting high-tech specifications that limit a company's flexibility, said Christopher Richter, an industry analyst at CLSA Asia Capital Markets. A supplier for the computer chip that triggers an air bag, for example, can't be switched quickly.
But car executives can keep this from becoming a total disaster: They can allocate scarce parts to their more popular or profitable vehicles, keeping those assembly lines running while slowing down the less profitable ones.
That's what many people believe GM did when it decided to close the Shreveport plant, because dealers have ample inventory of both trucks made there, more than two months' worth.
Newton said car companies will do their best to keep producing the cars people want.
"It's quite a lot to prioritize, but they'll do it," he said.
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Kurtenbach reported from Tokyo and Carty reported from Detroit. David Koenig in Dallas and Malcolm Foster in Tokyo contributed to this report.
