News for today's 2018

AUSTERITY THREATENS EU COMPETITIVE POSITION

8:29 AM Tukiyooo 0

<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-JojTTXloEpEnpI_rF817GopxMMoCNWk-YvgdL2aJHffz6Yo9cjO6NabqHxwgYZapZSaz8ih2a63jbY339Dm04m45AP__8lq0BuT1OExnYlbH33HbHHIwWEyP-8DtHGmlRDwCLYKc6y8K/s1600/infrastructure-montage.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="170" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-JojTTXloEpEnpI_rF817GopxMMoCNWk-YvgdL2aJHffz6Yo9cjO6NabqHxwgYZapZSaz8ih2a63jbY339Dm04m45AP__8lq0BuT1OExnYlbH33HbHHIwWEyP-8DtHGmlRDwCLYKc6y8K/s400/infrastructure-montage.jpg" width="400" /></a></div><div class="MsoNormal" style="line-height: normal; text-align: center;"> </div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 1;"> </div><div class="MsoNormal" style="line-height: normal; text-align: center;">EUROPE WAS A LEADER IN TERMS OF QUALITY INFRASTRUCTURE</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"> </div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">Austerity is threatening the EU’s competitive edge and the region could fall behind other areas of the world if spending is not kept up on key infrastructure projects including aviation.</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">Company executives, trade groups and even EUROPEAN UNION officials themselves say the region is in danger of falling behind competitors, with possibly irreversible consequences.</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"> </div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">EUROPEAN infrastructure spending rose just 1.5 percent last year to USD$741 billion, compared to global growth of 4.5 percent and a 7.1 percent rise in ASIA-PACIFIC, according to data compiled by Marketline, a business information provider.</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">Spending in EUROPE will increase slightly over the next four years, to 4.3 percent growth by 2016, Marketline said, but will continue to significantly under-perform the world average. Only the UNITED STATES will do worse, with growth of just 1.8 percent seen in 2016.</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">Trade within EUROPE, which has a population of more than 730 million and represents roughly 22 percent of the world's cargo by value, is expected to double in the coming decade.</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">Brussels said in a policy paper released before the recent budget cuts that EUR€550 billion (USD$704 billion) in high-priority projects were needed by 2020 to create a core transport network to meet the increased demand.</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"> </div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">CONCERNS THAT EUROPE RISKS LOSING ITS COMPETITIVE POSITION</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"> </div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">The investment would connect 120 major ports and airports to rail, upgrade 15,000 km (9,300 miles) of rail tracks to high speed and remove 35 key cross-border bottlenecks. The region's railways use seven different gauges and only 20 major airports and 35 major ports are directly connected to the rail network.</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">The upgrades would not only make the distribution of goods faster and cheaper, but also be required to meet EU targets to reduce carbon emissions by 60 percent, halve conventional car use and shift 50 percent of long distance freight onto trains and ships by 2050.</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"> </div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">Airline executives have been among the most outspoken about concerns that EUROPE risks losing its competitive position if it fails to implement these plans.</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">Paris Charles de Gaulle Airport plans to spend EUR€2.1 billion between 2011 and 2015 on new facilities, for example, while Dubai said last year it plans to invest EUR€6 billion in airport expansion by 2018 to boost capacity by 50 percent.</div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;"> </div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto;">"EUROPE was a leader in terms of quality infrastructure," Air France-KLM chief executive Jean-Cyril Spinetta told reporters. "I am very concerned about the future, especially airports. The amount of investment in other regions is incredibly high."</div><div class="MsoNormal">Via Airwise.com </div>

AUSTERITY THREATENS EU COMPETITIVE POSITION

EUROPE WAS A LEADER IN TERMS OF QUALITY INFRASTRUCTURE Austerity is threatening the EU’s competitive edge and the region could fall behind ...

Senior Software Engineer (C++ , OOD, OOP, COM ) (#108980)

5:06 AM Anonymous 0

<div dir="ltr" style="text-align: left;" trbidi="on"> <div style="margin-bottom: 5pt; margin-top: 5pt;">Position : Senior Software Engineer Location: Migdal Ha’emek, Israel Duration: Full time Business Unit The Optical Metrology Division products are used for optical overlay metrology. The portfolio of products includes unique solution packages which are based on hardware and software systems to enhance yield and effectiveness. As a world leader in its field of expertise, the division’s products are the most advanced in performance (measurement accuracy of nanometers and below), reliability, ease of use and compatibility with other KLA-Tencor’s products. KLA-Tencor (Israel) controls over 80% of the world market sales in its field, and its products are used by every major Semiconductor manufacturer around the world. Job Description The senior software engineer for our Optical Metrology Division will join a world-class team of software engineers to conceive, design, develop, optimize, and integrate advanced algorithms and software modules used in Optical metrology. The successful candidate will be working independently to design, develop, and debug complex computer software systems, requiring in-depth evaluation of analysis of various factors, exercising judgment within broadly defined practices and policies in selecting methods, techniques and evaluation criteria for obtaining results. The successful candidate will work independently to design and develop software for current and next generations of Optical Metrology tools and applications.  Required Qualifications: - Good understanding of OOA/OOD/OOP and Design Patterns - Proficiency in C++ programming - Understanding of Windows OS internals (multi-threaded environment, memory management, ...) - Ability to understand and work with existing code base - Must have at least 3-5 years of experience in C# & .Net - Understanding basics of COM - Signal/Image processing and scientific programming background Qualifications/Education Desired -BS degree in Computer Science or Computer Engineering -Must have at least 5 years of experience in C# & .Net -Hands-On knowledge in OOD, OOP, COM, Visual C++ -Experience in SW/HW systems integration -Previous experience in Image processing – an advantage Kindly send your resumes to vicky.palatnik@kla-tencor.com</div> <div style="font-family: Arial; font-size: 12pt;"></div> <div style="font-family: Arial; font-size: 12pt;"></div> </div>

Senior Software Engineer (C++ , OOD, OOP, COM ) (#108980)

Position : Senior Software Engineer Location: Migdal Ha’emek, Israel Duration: Full time Business Unit The Optical Metrology Division prod...

Unfit for Work: The startling rise of disability in America | Planet Money - NPR

4:39 AM Tukiyooo 0

In the past three decades, the number of Americans who are on disability has skyrocketed. The rise has come even as medical advances have allowed many more people to remain on the job, and new laws have banned workplace discrimination against the disabled. Every month, 14 million people now get a disability check from the government. The federal government spends more money each year on cash payments for disabled former workers than it spends on food stamps and welfare combined. Yet people relying on disability payments are often overlooked in discussions of the social safety net. People on federal disability do not work. Yet because they are not technically part of the labor force, they are not counted among the unemployed. In other words, people on disability don't show up in any of the places we usually look to see how the economy is doing. But the story of these programs -- who goes on them, and why, and what happens after that -- is, to a large extent, the story of the U.S. economy. It's the story not only of an aging workforce, but also of a hidden, increasingly expensive safety net. For the past six months, I've been reporting on the growth of federal disability programs. I've been trying to understand what disability means for American workers, and, more broadly, what it means for poor people in America nearly 20 years after we ended welfare as we knew it. Here's what I found. More ... <a href="http://apps.npr.org/unfit-for-work/">http://apps.npr.org/unfit-for-work/</a>

Unfit for Work: The startling rise of disability in America | Planet Money - NPR

In the past three decades, the number of Americans who are on disability has skyrocketed. The rise has come even as medical advances have al...

Google #20: Six useful ‘Google in the classroom’ posts

4:02 AM Tukiyooo 0

<div dir="ltr" style="text-align: left;" trbidi="on">There are just so many posts about how to use Google in the classroom that it is quite mind-blowing. Today I thought I would list a few of them that I have found helpful. Four excerpts come from come from one of my favourite blogs, the TeachThought blog. . 1) 5 Simple Ways To Use Google Docs In The Classroom (from the TeachThought blog) <div class="separator" style="clear: both; text-align: center;"><img alt="image" border="0" height="308" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjcIH5NBojq3KxevlO8DheFK5B24tIsdpOlFqdqbCshyF9KZHOAgB2uzYAY2EEm0cDOAYL6UUaZECPoFQSAPLTa_UZb-TmhD2xrlSuuhHHtGg0fKEiKdiknP0RtSWkKA_MUxPOhJ6D13iA/?imgmax=800" style="background-image: none; border-width: 0px; display: inline; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="400" /></div> from <a href="http://www.teachthought.com/technology/5-simple-ways-to-use-google-docs-in-the-classroom/" title="http://www.teachthought.com/technology/5-simple-ways-to-use-google-docs-in-the-classroom/">http://www.teachthought.com/technology/5-simple-ways-to-use-google-docs-in-the-classroom/</a> This is a great post that you must read. It outlines: <div style="text-align: left;"></div><ul style="text-align: left;"><li>how to introduce collaborative writing using the integrated reference tools and smart spell checker </li><li>how to use Google Forms as an inbox for collecting assignments from students, </li><li>how to use Google for online, collaborative brainstorming  sessions that provide students with opportunities to work together to develop ideas.how to provide students with immediate feedback and increase motivation by creating a simple self-grading quiz with a Google Form.</li><li>How to use and create Google Doc templates as a virtual copy machine to save time.</li></ul> 2) 25 ways Google can help you to become a better teacher (from the TeachThought blog) <div class="separator" style="clear: both; text-align: center;"><img alt="image" border="0" height="272" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgM1h_fu7YzIWQhC_VFCtLdV84QJ9XTZ6wJdWQNp1L3ZFjCu-0giN9Ga7jSMWyV6_8OGeNk41KRB7oHFG79GYlgnj4-oLtdZcPu1U8e8jVRF479ER7wfZ-NWjMVWSwDS5Ocx1IO3CfqMiQ/?imgmax=800" style="background-image: none; border-width: 0px; display: inline; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="400" /></div> from <a href="http://www.teachthought.com/featured/25-ways-google-can-help-you-become-a-better-teacher/" title="http://www.teachthought.com/featured/25-ways-google-can-help-you-become-a-better-teacher/">http://www.teachthought.com/featured/25-ways-google-can-help-you-become-a-better-teacher/</a> This post has 25 very useful tips on using Google in your daily teaching. It is definitely worth a read. 3) 21 Google Chrome Extensions For Increased Productivity (from the TeachThought blog) Google Chrome is an amazing browser for both teacher and students for many reasons. One big plus is that you can sign into your profile from any compyter and have all your bookmarks, history, settings come up immediately. You’ll see all your extensions appear in a  shot and these make browsing an absolute breeze because everything is right there saving hours of time. This post highlights 21 really useful extensions for encouraging productivityin the classroom.   You need to take a read of  <a href="http://www.teachthought.com/technology/21-google-chrome-extensions-for-increased-productivity/" style="font-family: Arial, Helvetica, sans-serif;">21 Google Chrome Extensions For Increased Productivity</a> 4) 20 Useful Google Search Tips You Probably Don’t Know (from the TeachThought blog) Searching the Internet is such a vital skill these days. There is a lovely embedded plugin that shows the 20 useful lovely tips. (Would love to know which application was used to create this!) <div class="separator" style="clear: both; text-align: center;"><img alt="image" border="0" height="301" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhrhLeZwynat0Xb-ckANkpz1FFy_D4x3gJvoyDJxPK_ToV_uclxGtb1gX-9DF11cmwwUu2SaiYAjUXNuRpn5v_LjmlPaCJA8IEN1q8yEQDQxLe4laO84F6bmcZ91Nn4yGG4sfvyMWai_HM/?imgmax=800" style="background-image: none; border-width: 0px; display: inline; margin: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="400" /></div> from http://www.teachthought.com/technology/20-useful-google-search-tips-you-probably-dont-know/ 5) 52 Tips And Tricks For Google Docs In The Classroom  (from the TeachThought blog) <div class="separator" style="clear: both; text-align: center;"><img alt="image" border="0" height="256" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiskZUpZX5dmUhfAXyi0DZvpBp-Uh-_eh5A5vtjGIVivFew7l-ZBcxDhOtXMMhzNx3evFZlFWrXuQCulbehqNCXxeqqPPN94Gv9JvHVKhOvWBzq3R9FM5PEezJSpZm_kkmBEaOa6JhbPQc/?imgmax=800" style="background-image: none; border: 0px; display: inline; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="400" /></div> This post raises the question ‘Are you using Google to its fullest potential?'  It outlines 52 great ideas for getting the most out of Google Docs including awesome ideas and tricks for collaboration, sharing, and staying productive. This post is definitely worth a read….<a href="http://www.teachthought.com/technology/52-tips-and-tricks-for-google-docs-in-the-classroom/" style="font-family: Arial, Helvetica, sans-serif;">52 Tips And Tricks For Google Docs In The Classroom</a>  6) Paperless Classroom Series: Google Drive Andy Marsinek shows how he moved from being a teacher who collected everything on paper, to introducing the paperless classroom. This is made possible with Google Drive. He says “students and teachers can access, edit, and work on assignments almost anywhere. And I am certain these mobile device features for Google Docs will only get better.” Take a read….<a href="http://www.bpsedtech.org/2012/11/27/the-paperless-options-series-google-drive/" style="font-family: Arial, Helvetica, sans-serif;">Paperless Classroom Series: Google Drive</a></div>

30 Days of Google Google #20: Six useful ‘Google in the classroom’ posts

There are just so many posts about how to use Google in the classroom that it is quite mind-blowing. Today I thought I would list a few of t...

Take out the trash: get rid of the apps, to do's and activities that clutter your life.

4:00 AM Tukiyooo 0

Prom will be here tomorrow. It is a circus. No, literally, the theme is “A Night Under the Big Top,” a vintage circus theme that has turned out quite nicel even if I say so myself. <div class="separator" style="clear: both; text-align: center;"></div> But as I read the Psalms this morning, I was so taken by this phrase in Psalm 110:3a <blockquote class="tr_bq">“Your troops will be willing…”</blockquote> <div class="separator" style="clear: both; text-align: center;"></div><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiD9RcRzWk_y5b1G6PYXzTUPI7lm6kerQHxT-rWi6pfgSF3DPgnMBrTh_caWQFGU4ZslQdLU_b83Qa2hkmPQbyTnWMR1h4ILWLAzyF0-xLsh-lfSPQQBdal75qWQN0k_ese3sXSNqnyjOAu/s1600/Photo+Mar+26,+12+31+52+PM.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiD9RcRzWk_y5b1G6PYXzTUPI7lm6kerQHxT-rWi6pfgSF3DPgnMBrTh_caWQFGU4ZslQdLU_b83Qa2hkmPQbyTnWMR1h4ILWLAzyF0-xLsh-lfSPQQBdal75qWQN0k_ese3sXSNqnyjOAu/s320/Photo+Mar+26,+12+31+52+PM.jpg" width="240" /></a>Well, sometimes, I've noticed that there is one job that when I ask for it to be done that no one wants to. The troops aren't willing. Since I've asked, only one student in the six times I've asked it, has been willing to take out the trash. I've seen them toy with the trash and move it around a bit in the auditorium, but only one picked up the bags and actually hauled it out. Why is that? Is it because it is beneath them? Is it because it isn't as fun as putting Christmas lights on the stage or as neat as suspending acrobats from the ceiling? Little do they realize that if the trash wasn't out, they wouldn't be able to see those acrobats, lights, or the billowing tent that has consumed the auditorium. The trash would cover it all. <h2></h2><h3></h3><h3>Get rid of the apps that clutter and don't add beauty or function to your life</h3>Everyone wants a new tool, but who wants to get rid of one that doesn't work? I've been intentionally deleting apps off my ipad and iphone screen of late. If I don't use it, I'll send it into the ether of things that I own but aren't installed on my devices. Like a prom filled with trash, the trash fills up the space that you want to use for something beautiful and useful. So, take out the trash. It isn't glamorous, but it is necessary. <h3>Mistaken identity</h3>There are times that you might delete something that is functional. Take a look at <a class="zem_slink" href="http://google.com/" rel="homepage" target="_blank" title="Google">Google</a>, they are spring cleaning right now. They've tossed <a class="zem_slink" href="http://www.google.com/reader" rel="homepage" target="_blank" title="Google Reader">Google reader</a> into the dustbin and now, it is rumored, <a class="zem_slink" href="http://www.google.com/alerts" rel="homepage" target="_blank" title="Google Alerts">Google Alerts</a> will go the same way. They are “taking out their trash.” Sadly, sometimes people don't recognize the trash from the treasure. Like the person who throws away fine jewelry with the constume, mistakes happen. (In my opinion, <a href="http://coolcatteacher.blogspot.com/2013/03/google-reader-fans-transition-to-feedly.html">Google has put the treasure</a> in the trash.) Gladly, if you delete an app off your phone or ipad, it isn't permanent. It is still there in uninstalled apps and it can return quickly. <h3>What is your excuse?</h3>When installing a new app, challenge yourself to always delete one you haven't used lately. Cut the clutter and clear your mind. I always keep one empty spot on the homescreen of my iphone. It makes me feel like I have room for more and it is a signal to myself that I will have margin and leave room for new things in my life. There are times, my friends, we have to take out the trash. Not just to have room for more, but to have room to breathe and think. Do we really want our glass full all of the time or do we want to enjoy finishing the glass and being done for a while. Our to do lists, our phones, our computers are all full of more trash than we care to admit. Let's make a commitment today to remove the trash so we can enjoy the circus. <div class="zemanta-pixie" style="height: 15px; margin-top: 10px;"><a class="zemanta-pixie-a" href="http://www.zemanta.com/?px" title="Enhanced by Zemanta"><img alt="Enhanced by Zemanta" class="zemanta-pixie-img" src="http://img.zemanta.com/zemified_c.png?x-id=63dc5ada-6507-44f5-9afc-5f9f52252213" style="border: none; float: right;" /></a></div>

Take out the trash: get rid of the apps, to do's and activities that clutter your life.

Prom will be here tomorrow. It is a circus. No, literally, the theme is “A Night Under the Big Top,” a vintage circus theme that has turned ...

Employers Adding Incentives to Health Programs - NYTimes.com

3:09 AM Tukiyooo 0

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Employers are increasingly trying to lower health care costs by using incentives to persuade workers to make better lifestyle choices, a new survey shows, but what remains less clear is whether a reward is better than a punishment — or whether the programs work at all.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><a title="The survey." href="http://aon.mediaroom.com/2013-03-25-Aon-Hewitt-Survey-Highlights-Important-Role-of-Incentives-in-U-S-Employers-Efforts-to-Improve-Workforce-Health-and-Performance" style="color: rgb(102, 102, 153); text-decoration: none; ">The survey</a>, of 800 large and midsize employers conducted by the human-resources consulting firm Aon Hewitt, found that the vast majority of companies, or 79 percent, use rewards like lower insurance premiums to try to nudge employees to improve their health. But increasingly, the survey found, employers are taking the programs a step further, by penalizing employees who do not make healthy choices and linking incentives to measurable results.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">"Employers are feeling the need to intensify their efforts to create an environment where people feel they are responsible for their own health," said Jim Winkler, chief innovation officer for health care at Aon Hewitt.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">While a little more than half, or 56 percent, of the companies using incentives required employees to sign up for programs like health coaching or completing a questionnaire, 24 percent tied their incentives to progress on measures like a person's blood pressure or body mass index. And the survey found that more than two-thirds of companies said they were considering taking similar steps in the future.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Programs that seek to impose consequences on workers by charging them higher premiums or requiring them to pay a surcharge for failing to take steps to lose weight or quit smoking <a title="Times article." href="http://www.nytimes.com/2011/11/17/health/policy/smokers-penalized-with-health-insurance-premiums.html?pagewanted=all" style="color: rgb(102, 102, 153); text-decoration: none; ">have come under criticism</a> by those who have argued that the policies are invasive and can punish people for health problems that not are always easy to fix.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Although some employees have sought to challenge such policies in federal court, arguing that they are a violation of privacy or of the Americans with Disabilities Act, <a title="Reuters article on recent legal action." href="http://newsandinsight.thomsonreuters.com/Legal/News/2013/03_-_March/A_new_CVS_wellness_program_raises_privacy_concerns/" style="color: rgb(102, 102, 153); text-decoration: none; ">the cases</a> have so far failed to gain traction.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The programs are likely to increase in popularity in the years ahead, in part because, as part of the new <a href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/health_care_reform/index.html?inline=nyt-classifier" title="Recent and archival news about healthcare reform." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">health care law</a>, beginning in 2014 employers will be able to use as much as 30 percent of a worker's health care premiums on incentives programs, from 20 percent previously.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><a href="http://topics.nytimes.com/top/news/business/companies/cvscaremark_corporation/index.html?inline=nyt-org" title="More information about CVS Caremark Corporation" class="meta-org" style="color: rgb(102, 102, 153); text-decoration: none; ">CVS Caremark</a>, the large drugstore chain and pharmacy benefit manager, <a title="Boston Herald article." href="http://bostonherald.com/business/healthcare/2013/03/cvs_presses_workers_for_medical_information" style="color: rgb(102, 102, 153); text-decoration: none; ">recently said</a> it would require its 200,000 employees to report their weight, blood sugar and cholesterol or be forced to pay an annual penalty of $600. It also will require that smokers try to quit. Several other major employers, including PepsiCo and Wal-Mart, have also adopted such policies.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">While the popularity of workplace wellness programs appears to be on the rise, <a title="Article in The New England Journal of Medicine." href="http://www.nejm.org/doi/full/10.1056/NEJMp1105966" style="color: rgb(102, 102, 153); text-decoration: none; ">there is less evidence</a> about whether they actually lower health care costs or make employees healthier. Programs that reward people for good behavior may be singling out those who were already practicing healthy habits, while those that penalize workers for bad behavior may be unfairly singling out the very people who need lower health care costs.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">"These are really hard behaviors and decisions to move the needle on," said Michelle Mello, a professor of law and public health at Harvard. She cautioned against drawing too many conclusions from the Aon Hewitt survey, because the companies that participated may have been more likely to offer workplace wellness programs than those that did not. Aon Hewitt said the survey's 20 percent response rate was typical for the industry and the companies who completed the survey were a representative sample.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><a title="Abstract of an article in the journal Health Affairs." href="http://content.healthaffairs.org/content/32/3/477.abstract" style="color: rgb(102, 102, 153); text-decoration: none; ">One recent study</a> of a workplace wellness program, at a hospital system in St. Louis, found that the program decreased hospitalization of its employees for some conditions, but did not actually save the system any money.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Dr. Troy Brennan, the chief medical officer at CVS Caremark, agreed that the research into whether incentive programs worked was not yet conclusive, but said his company had already seen positive results. CVS is in the third year of an ongoing incentive program: in the first year, employees were asked to answer questions about their health, and in the second they were encouraged to undergo basic tests, like blood sugar and cholesterol, or face a $180 penalty. This year, the penalty was increased to $600.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Since the program began, Dr. Brennan said, employees' overall blood sugar has decreased, as have their cholesterol levels, while their so-called good cholesterol has increased. So far, employees do not receive rewards or penalties based on their improvements on these measures, but Dr. Brennan said it was possible.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">He said he understood that these policies created some discomfort, and said patients' individual data was kept private from the company. CVS contributes millions of dollars toward workers' health insurance, like most other employers, Dr. Brennan said, and thus has a stake in its employees' health. "Like it or not, in this country, employment and health insurance and health care are all intimately related," he said.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Several health groups, including the American Heart Association, have expressed concern over the growing popularity of incentive programs, saying they could be used by employers to transfer the higher costs of health care to sicker individuals.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Laurie Whitsel, director of policy research for the American Heart Association, said she was encouraged by a proposed rule by the Obama administration that would require employers to accommodate workers whose doctors concluded that certain goals, like losing weight in a short period, would be unhealthy.<p itemprop="articleBody" style="color: black; font-size: 1.2em; margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); position: static; z-index: auto; ">Still, she said, many questions remained unanswered. "Ultimately it's really going to be a national experiment," she said.</div><a href="http://www.nytimes.com/2013/03/26/business/companies-offer-workers-more-incentives-for-health-changes.html?&pagewanted=print">http://www.nytimes.com/2013/03/26/business/companies-offer-workers-more-incentives-for-health-changes.html?&pagewanted=print</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "> </div>

Employers Adding Incentives to Health Programs - NYTimes.com

Employers are increasingly trying to lower health care costs by using incentives to persuade workers to make better lifestyle choices, a new...

Salesmen in the Surgical Suite - NYTimes.com

3:08 AM Tukiyooo 0

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><nyt_text style="color: rgb(51, 51, 51); font-family: Georgia, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; "><div id="articleBody">When Fred E. Taylor arrived at Harrison Medical Center in Silverdale, Wash., for a routine <a href="http://health.nytimes.com/health/guides/surgery/prostate-removal/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Prostate removal ." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">prostatectomy</a>, he expected the best medical care new technology had to offer: robotic surgery, billed as safer, less painful and easier on the body than traditional surgery.The operation, on Sept. 9, 2008, was supposed to take five hours. But it was marred by a remarkable cascade of complications and dragged on for more than 13 hours, leaving Mr. Taylor, who had been an active 67-year-old retiree, incontinent and with a <a href="http://health.nytimes.com/health/guides/surgery/colostomy/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Colostomy." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">colostomy</a> bag, and leading to kidney and lung damage, <a href="http://health.nytimes.com/health/guides/disease/sepsis/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Sepsis." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">sepsis</a> and a stroke.Mr. Taylor survived his injuries but died last year. Now, his wife, Josette, is suing <a href="http://www.intuitivesurgical.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">Intuitive Surgical Inc.</a>, the company that makes the equipment and trained the surgeon to use it. As it turned out, the surgeon, Dr. Scott Bildsten, had never before used the robotic equipment without supervision."We are the old school, where you trust the doctor," said Mrs. Taylor, who noted that her husband's life was so limited after the operation that he used to cry about being "trapped in this body."It is not the first time patients have claimed they were harmed by Intuitive's robotic surgical equipment, called the da Vinci Surgical System. But the Taylor case, set for trial in April, is unusual. Internal company e-mails, provided to The New York Times by lawyers for the Taylor estate, offer a glimpse into the aggressive tactics used to market high-tech medical devices and raise questions about the quality of training provided to doctors before they use new equipment on patients.Intuitive, based in Sunnyvale, Calif., declined to comment on the lawsuit but said studies showed that its robotic equipment results in better outcomes than conventional open surgery. "The most objective and therefore best measure of efficacy for all of those involved in training — from Intuitive Surgical, the hospitals, the proctors and the surgeons themselves — is represented in the comparative clinical outcomes of da Vinci surgery," said Angela Wonson, the company's vice president for communications.According to Intuitive, 1,371 hospitals in the United States have purchased a da Vinci system, and many have purchased two. Nearly half a million procedures worldwide were performed robotically last year, including prostatectomies and <a href="http://health.nytimes.com/health/guides/surgery/hysterectomy/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Hysterectomy." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">hysterectomies</a>, among other operations.A surgeon using the da Vinci system sits at a console with a camera that provides a high-definition, three-dimensional image of the surgical site. He or she manipulates miniaturized instruments; computer and robotic technology translates and scales the surgeon's hand movements.Hospitals are responsible for setting the credentialing standards, or training requirements, for physicians who will use the equipment on patients. But internal company e-mails suggest that Intuitive's sales representatives were intimately involved in the process, presenting themselves as experts and pressing for lower standards in order to ease the training path for busy surgeons, to increase use of the equipment and to drive sales.In an e-mail dated May 31, 2011, a Western regional sales manager for Intuitive noted that area surgeons had used robotic equipment only five times, although the company's goal was to see 36 robotic operations performed by the end of June. He urged sales staff to persuade surgeons to switch upcoming cases to robotic ones."Don't let proctoring or credentialing" — shorthand for supervised surgery and hospital certification — "get in our way," the e-mail said.In December 2009, a sales representative urged a hospital in Billings, Mont., to ease up on its credentialing requirement, saying in an e-mail that requiring surgeons to do five supervised operations using the robot before going solo was "on the high side" and could have "unintended consequences." Hospital officials replied, saying, "We will review and most likely will decrease the 5 down to 3."Ms. Wonson, the Intuitive spokeswoman, said the company does not get involved in determining who is qualified to operate its robotic equipment, which is the responsibility of the hospitals. "We do not make recommendations," she said in an e-mail.Dr. Bildsten was one of six doctors given free training by Intuitive, including one day of hands-on training at the company's facility in California. He also had done two practice runs on the equipment with a more experienced surgeon before operating on Mr. Taylor, he said in a legal deposition. Still, he said, no one warned him that a patient like Mr. Taylor, who weighed nearly 300 pounds, was not a good candidate for robotic surgery.He did not respond to telephone messages requesting comment.Company e-mails submitted in the Taylor case also suggest that members of the sales staff at Intuitive worked diligently to persuade surgeons to choose the da Vinci procedure for patients even when they were planning to use a different method.In one e-mail on June 28, 2010, a clinical sales director urged the sales team — whose compensation was linked to filling a quarterly quota of operations — to "scrub" doctors' schedules and get procedures moved up by a few days in order to make the quarterly goal. "Let's bring it home!" she wrote. "Be sure you scrub all schedules, identify cases on Thursday and Friday that can be moved up."On Aug. 9, 2010, a clinical sales director wrote to his team: "Be proactive in finding cases to convert. Be prepared to challenge each trained surgeon every time you see a lap or open case. Be unsatisfied with the thought of ending a day without a converted case." ("Lap" refers to laparoscopic procedures, an alternate form of minimally invasive surgery.)The sales representatives were often in the operating rooms, where they offered advice to newly trained surgeons who were having technical difficulties with the robot, according to legal depositions in the Taylor case. The representatives also appear to have had access to the operating room schedules and were urged to "partner" with surgical teams "to review and select appropriate cases," according to court documents.On March 3, 2011, a sales representative wrote in an e-mail to his team that he had met with a gynecologic surgeon in Utah who was trained a year earlier but had stopped doing robotic cases. The surgeon subsequently "agreed to convert the next two to da Vinci."In depositions, some Intuitive sales representatives defended their involvement, saying that it was important for surgeons to use the robotic system frequently in order to maintain and improve their skills.The Food and Drug Administration allowed the sale of the da Vinci system in 2000 under a controversial process called "premarket notification," often used to bring medical devices to market without the rigorous trials of safety and efficacy typically required of new drugs. Manufacturers are able to exempt devices from the rigorous trials by claiming they are similar to existing devices already on the market.When devices are brought to market this way, the F.D.A. "cannot require training programs as a condition of clearance," said Synim Rivers, an agency spokeswoman.Before allowing this type of market clearance, the agency twice asked Intuitive for more information about how doctors would be trained to use company equipment. Intuitive provided details of a 70-item exam for surgeons and a three-day hands-on training protocol.By 2002, however, the company had revamped its training program, replacing the 70-item exam with a 10-question online quiz and reducing the time spent in hands-on training at Intuitive's facility to one day.The largest study to date of robotic hysterectomies has <a title="Times article about robotic hysterectomies. " href="http://well.blogs.nytimes.com/2013/02/25/questions-about-a-robotic-surgery/" style="color: rgb(102, 102, 153); text-decoration: none; ">questioned the use of robot-assisted surgery</a> over more conventional forms of minimally invasive surgery. A study published in February in The Journal of the American Medical Association evaluated outcomes in 264,758 women who had laparoscopic or robotically assisted hysterectomy and found <a href="http://www.ncbi.nlm.nih.gov/pubmed/23423414" style="color: rgb(102, 102, 153); text-decoration: none; ">no overall difference in complication rates between the two groups</a>.But the researchers did find that robotically assisted surgery for hysterectomy costs on average about one-third more than laparoscopic surgery.Last week, Dr. James T. Breeden, the president of the American Congress of Obstetricians and Gynecologists, <a href="http://www.cnbc.com/id/100554849" style="color: rgb(102, 102, 153); text-decoration: none; ">publicly urged</a> patients "to separate the marketing hype from the reality" when considering a surgical method for hysterectomy. "Just because it's newer and higher technology," he said, "doesn't mean it's better."<nyt_correction_bottom><div class="articleCorrection" style="margin-bottom: 2.8em; "></div></nyt_correction_bottom><nyt_update_bottom></nyt_update_bottom></div></nyt_text><span style="color: rgb(51, 51, 51); font-family: Georgia, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); display: inline !important; float: none; "></div><a href="http://www.nytimes.com/2013/03/26/health/salesmen-in-the-surgical-suite.html?nl=todaysheadlines&emc=edit_th_20130326&pagewanted=print">http://www.nytimes.com/2013/03/26/health/salesmen-in-the-surgical-suite.html?nl=todaysheadlines&emc=edit_th_20130326&pagewanted=print</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "> </div>

Salesmen in the Surgical Suite - NYTimes.com

When Fred E. Taylor arrived at Harrison Medical Center in Silverdale, Wash., for a routine prostatectomy , he expected the best medical car...

New Prostate Cancer Tests May Supplement P.S.A. Testing - NYTimes.com

3:02 AM Tukiyooo 0

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><nyt_text style="color: rgb(51, 51, 51); font-family: Georgia, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; "><div id="articleBody">Sophisticated new <a href="http://health.nytimes.com/health/guides/disease/prostate-cancer/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Prostate Cancer." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">prostate cancer</a> tests are coming to market that might supplement the unreliable <a href="http://health.nytimes.com/health/guides/test/psa/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about PSA." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">P.S.A.</a> test, potentially saving tens of thousands of men each year from unnecessary biopsies, operations and radiation treatments.Some of the tests are aimed at reducing the false alarms, and accompanying anxiety, caused by elevated P.S.A. readings. Others, intended for use after a definitive diagnosis, examine the genetic workings of the <a href="http://health.nytimes.com/health/guides/disease/cancer/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Cancer." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">cancer</a> to distinguish dangerous tumors that need treatment from slow-growing ones that might be left alone.The tests could provide a way out of the bitter debate over whether healthy men should be screened for prostate cancer.The problem with the P.S.A. blood test is that many of the cancers it detects are unlikely to cause harm. But there is no reliable way to identify them. So a large majority of men with positive tests undergo surgery or radiation treatment, and many suffer for years, needlessly, from complications like incontinence and <a href="http://health.nytimes.com/health/guides/symptoms/erection-problems/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Erection problems." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">erectile dysfunction</a>.In late 2011, the United States Preventive Services Task Force, a government advisory body, provoked a furor by <a title="An article about the recommendation." href="http://www.nytimes.com/2011/10/07/health/07prostate.html" style="color: rgb(102, 102, 153); text-decoration: none; ">recommending against screening</a>, saying that far more men were harmed by unnecessary biopsies and treatments than were saved from dying of cancer.But if new tests can better determine risk, screening could become more useful."It's not that screening doesn't work; it's that we haven't done a great job of targeting treatments for the tumors that need it," said Dr. Matthew R. Cooperberg, an <a title="More about Dr. Cooperberg." href="http://www.urology.ucsf.edu/faculty/cooperberg" style="color: rgb(102, 102, 153); text-decoration: none; ">assistant professor of urology</a> at the University of California, San Francisco who has been a consultant to some of the testing companies.Reducing unnecessary treatments could also reduce the $12 billion in estimated annual spending related to prostate cancer. Test developers hope that such savings will make their tests cost-effective, even at prices that will exceed $3,000 in some cases.More than a dozen companies have introduced tests recently or are planning to do so in the near future. Rather than looking at a single protein like P.S.A., which stands for prostate-specific antigen, many of these tests use advanced techniques to measure multiple genes or other so-called molecular markers."It's the cancer for the next 18 to 24 months that will be transformed by molecular markers," said Dr. Doug Dolginow, chief executive of <a title="The company's Web site." href="http://www.genomedx.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">GenomeDx Biosciences</a>, a start-up planning to introduce a test later this year.Experts caution that it is too early to tell how well most of the tests will perform and whether they will make a difference. Although the tests are intended to help men make treatment decisions, the onslaught of so many could cause more confusion."It's a little tricky to find out which one applies to you and whether it will be paid for by insurance," said Jan Manarite, who runs the telephone help line for the <a title="The institute's Web site." href="http://prostate-cancer.org/" style="color: rgb(102, 102, 153); text-decoration: none; ">Prostate Cancer Research Institute</a>, a patient education organization.Prostate cancer specialists say screening has declined since the task force recommended against it, but millions of men in the United States still get regular blood tests to measure P.S.A. As many as a million have biopsies each year, with about 240,000 prostate cancer cases diagnosed and 28,000 deaths from the disease.The biggest battle among test developers could be between <a title="The company's Web site." href="http://www.genomichealth.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">Genomic Health</a> and <a title="The company's Web site." href="http://www.myriad.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">Myriad Genetics</a>, which are moving into the prostate cancer field after successes in <a href="http://health.nytimes.com/health/guides/disease/breast-cancer/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Breast cancer." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">breast cancer</a> testing.Myriad is known for its test for genetic mutations that raise a woman's risk of getting breast cancer. Genomic Health's Oncotype DX test helps determine if a woman should receive <a href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/chemotherapy/index.html?inline=nyt-classifier" title="Recent and archival health news about chemotherapy." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">chemotherapy</a>.Both companies have developed prostate tests analogous to Oncotype DX. They analyze gene activity levels in the tumor sample obtained by <a href="http://health.nytimes.com/health/guides/test/biopsy/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Biopsy." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">biopsy</a> to gauge how aggressive the cancer is, helping doctors and patients decide whether to treat it. The companies say their tests provide better information than the Gleason score, the main tool now used to assess tumor aggressiveness, which is based on how cells look under a microscope.One study of Myriad's test looked at stored biopsy samples from 349 British men who were found to have prostate cancer from 1990 to 1996 and did not receive immediate treatment.About 19 percent of the men with the lowest risk scores on Myriad's test died from prostate cancer within 10 years, compared with 75 percent of the men with the highest risk scores, according to results <a title="The study results." href="http://www.nature.com/bjc/journal/v106/n6/full/bjc201239a.html" style="color: rgb(102, 102, 153); text-decoration: none; ">published last year</a> in the British Journal of Cancer.Still, some prostate cancer specialists say the test, which is called Prolaris and went on sale last year, has not been adequately validated, and sales have been very low. Noridian, the <a href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medicare/index.html?inline=nyt-classifier" title="Recent and archival health news about Medicare." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">Medicare</a>contractor for Utah, where Myriad is based, said it would not pay for the $3,400 test.Genomic Health says it plans to start selling its test, the Genomic Prostate Score, after releasing supporting data at the American Urological Association's annual meeting in May.Insurers might be reluctant to pay for the new tests without evidence that men will trust the results enough to forgo treatment if so indicated. The tests still leave some uncertainty, and many men do not want to live with cancer, no matter how slight some test says the risk is."We already know from conventional information that there are a group of men who are very unlikely to have progression, but they still get treated," said Dr. Lee N. Newcomer, senior vice president for oncology at UnitedHealthcare.Angel Vasquez, for example, resisted when his urologist told him that he could forgo treatment based on his low Gleason score and P.S.A. levels."I said, 'No, my philosophy is if there is something in my body that is not supposed to be there, I want it to come out,' " said Mr. Vasquez, 67, of Matthews, N.C.The doctor ordered Myriad's Prolaris test. Rather than justifying a decision to watch and wait, the test showed the tumor to be more aggressive than thought, a finding later confirmed after Mr. Vasquez had surgery."Had I left it alone, it would have really progressed," he said.Some experts say that even if the new tests are not perfect, they are better than what is available now."Even if we can only convince 15 to 20 percent of men that we have enough confidence that they don't need to be treated, that will be a big step forward," said Dr. Eric A. Klein of the Cleveland Clinic, who has worked with Genomic Health.Another company, <a title="The company's Web site." href="http://www.bostwicklaboratories.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">Bostwick Laboratories</a>, already sells a tumor aggressiveness test called ProstaVysion, and <a title="The company's Web site." href="http://www.metamarkgenetics.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">Metamark Genetics</a> is developing its own.GenomeDx is focusing on a test that would be used after surgery to help determine whether additional treatment with radiation or drugs would be useful. Danaher already sells such a test.<a title="The company's Web site." href="http://www.hologic.com/en/" style="color: rgb(102, 102, 153); text-decoration: none; ">Hologic</a>, <a title="The company's Web site." href="http://www.mdxhealth.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">MDxHealth</a> and <a title="The company's Web site." href="http://www.mitomicsinc.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">Mitomics</a> sell tests that they say can reduce the number of unnecessary second biopsies, which are often done when a first biopsy is negative but P.S.A. levels remain high.<a title="The company's Web site." href="http://www.opko.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">Opko Health</a>, <a title="The company's Web site." href="https://www.beckmancoulter.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">Beckman Coulter</a> and <a title="The company's Web site." href="http://www.metabolon.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">Metabolon</a> are developing tests that would be used in conjunction with P.S.A. screening. Because P.S.A. levels can be elevated for reasons other than cancer, as many as three-quarters of biopsies do not find cancer — and the biopsies can cause pain and infections.<a title="The study." href="http://jco.ascopubs.org/content/28/15/2493.full" style="color: rgb(102, 102, 153); text-decoration: none; ">One published study</a> showed that Opko's test could have reduced unnecessary biopsies by about 50 percent, though it would have missed 12 percent of high-grade cancers.Yet another test could come from the discovery by researchers at the University of Michigan that a particular fusion of two genes is found in half of prostate cancers, and only in prostate cancer."You'd still miss 50 percent of the disease, but at least you know if you have it you have prostate cancer," said Dr. Arul M. Chinnaiyan, a <a title="More about Dr. Chinnaiyan." href="https://www.umms.med.umich.edu/pibsfacsearch/facultyPage.do?facUniqname=arul" style="color: rgb(102, 102, 153); text-decoration: none; ">professor of urology and pathology</a>. He said a urine test was being developed that combines the gene fusion with PCA3, another marker.Some experts say unnecessary procedures can be reduced simply by using the P.S.A. test less frequently, and also by improving imaging. The new tests are "singles and doubles at best," said Dr. William J. Catalona, director of the prostate program at Northwestern University, who helped bring the P.S.A. test to market in the 1990s. But, Dr. Catalona said, this is only the start. "This field is moving kind of like cellphones," he said.<nyt_correction_bottom><div class="articleCorrection" style="margin-bottom: 2.8em; "></div></nyt_correction_bottom><nyt_update_bottom></nyt_update_bottom></div></nyt_text><span style="color: rgb(51, 51, 51); font-family: Georgia, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); display: inline !important; float: none; "></div><a href="http://www.nytimes.com/2013/03/27/business/new-prostate-cancer-tests-may-supplement-psa-testing.html?&pagewanted=print">http://www.nytimes.com/2013/03/27/business/new-prostate-cancer-tests-may-supplement-psa-testing.html?&pagewanted=print</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "> </div>

New Prostate Cancer Tests May Supplement P.S.A. Testing - NYTimes.com

Sophisticated new prostate cancer tests are coming to market that might supplement the unreliable P.S.A. test, potentially saving tens o...

Doctor for N.F.L. Says Study Overstates Effects of C.T.E. - NYTimes.com

3:01 AM Tukiyooo 0

When a government agency prepared a workplace safety fact sheet based on a study of degenerative brain disease in retired N.F.L.players, the organization invited several people to comment on a draft. According to a memorandum obtained by The New York Times, most of the reviewers suggested simplifying the fact sheet so that players without a scientific background could better understand the findings. But one response stood out: a doctor on the N.F.L.'s head, neck and spine committee asked that a mention of chronic traumaticencephalopathy, or C.T.E., be removed. C.T.E. is a degenerative brain disease that is closely related to Alzheimer's disease and is believed to be caused by repeated head trauma. It has been found posthumously in dozens of football players, provoking widespread concern about the sport's potential long-term cognitive effects. Against this backdrop of public awareness, the N.F.L. has drastically shifted its position on head injuries in recent years, introducing rule changes and promoting education. But the league has expressed skepticism about the possibility of a link between on-field head injuries and C.T.E., a sentiment captured in the league doctor's request to the federal safety agency. The doctor, who was not named in the internal memo, said references to C.T.E. should be removed because it was "not fully understood" and because it was not listed on the death certificates of the retired players in the study and thus lacked "epidemiological validity." He suggested that traumatic brain injury, or T.B.I., be used instead because it "may accomplish what you want to say in more established medical terms." Researchers from the National Institute for Occupational Safety and Health, which wrote the fact sheet, rejected the league doctor's proposed change. Independent medical experts said such a request was inappropriate and not in line with prevailing research. "That's what bugged me the most," said Jeffrey Kutcher, a neurologist and the director of Michigan NeuroSport at the University of Michigan, referring to the request to use traumatic brain injury instead of C.T.E. "It's a huge jump and it goes completely away from what the Niosh study showed." Richard Ellenbogen, the chairman of the University of Washington's neurological surgery department and a co-chairman of the N.F.L.'s head, neck and spine committee, said he did not know which doctor suggested changing the text of the fact sheet. But he said the doctor was correct in wanting to include a reference to traumatic brain injury. T.B.I. is a clinical diagnosis that can be identified in living patients, Ellenbogen said, while C.T.E. is a pathological diagnosis that so far can be found only through autopsies. "Whoever said that is right," Ellenbogen said. "We've got to be careful because C.T.E. is a pathological diagnosis. We know that exists. That's been proven forever. What's important about this study is, if I played sports and had concussions, what's my chance of getting these?" Ellenbogen said there was not enough research to answer that question. "Right now, people are on the razor's edge cutting the words," he said. "The problem is, the science isn't there yet. But we have to be clear. I'm agreeing with the Niosh study, but we just have to be more careful to make clear that C.T.E. is a pathological diagnosis and T.B.I. is a clinical diagnosis." Like Ellenbogen, independent medical experts said they agreed with the agency when it wrote that there was no known "cause-effect relationship between football-related concussions and death from these neurodegenerative disorders," as well as the agency's statement that "professional football players are at increased risk of death" fromamyotrophic lateral sclerosis, Alzheimer's disease and Parkinson's disease. The medical experts also expressed dismay that an N.F.L. doctor would point to the death certificates of former players in the study. C.T.E. is often diagnosed months after death, when brain samples are examined. "This is an epidemiological entity, and at this point it definitely garners this title because of the number of players we have diagnosed with it," said Alexander K. Powers, an assistant professor of neurosurgery who specializes in sports-related brain and spine injuries at Wake Forest Baptist Medical Center. "There's plenty of research that is active. It's a robust field. It's not some orphan ambition." The fact sheet, sent to retired N.F.L. players in January, summarized research published in September in the journal Neurology that found that players "may be at a higher risk of death associated with Alzheimer's and other impairments of the brain and nervous system than the general U.S. population." Before publishing its fact sheet, Niosh asked three former players, a representative from the N.F.L. Players Association and a representative from the N.F.L. Player Care Foundation, an independent organization that assists retired players, to review and comment on a draft. The foundation asked for advice from the doctor on the head, neck and spine committee. Niosh researchers rejected the proposed change because C.T.E. "resonated with the players who reviewed the draft and provided feedback" and was widely acknowledged. Using T.B.I. was also inappropriate because it described an injury that might result in a disorder like C.T.E. and was therefore not equivalent, said Ann Mobley, the health communications specialist at Niosh who wrote the fact sheet. The debate over the long-term effects of head injuries in football has engaged neurosurgeons, neurologists, neuropsychologists and other researchers and clinicians. It has also led to lawsuits. Several thousand retired players have accused the N.F.L. of deliberating playing down the dangers of head injuries. Everett Lehman, an epidemiologist at Niosh and the principal author of the original mortality study of more than 3,400 retired players, said his department must balance accuracy and clarity in its research. He said the N.F.L. doctor's request was misguided. "I just think they are different things, and we didn't think it was important to include T.B.I.," he said. "Maybe whoever looked at it didn't carefully look at our paper." <a href="http://www.nytimes.com/2013/03/28/sports/football/doctor-for-nfl-says-study-overstates-effects-of-cte.html">http://www.nytimes.com/2013/03/28/sports/football/doctor-for-nfl-says-study-overstates-effects-of-cte.html</a>?

Doctor for N.F.L. Says Study Overstates Effects of C.T.E. - NYTimes.com

When a government agency prepared a workplace safety fact sheet based on a study of degenerative brain disease in retired N.F.L.players, the...

Daily Education and Technology News for Schools 03/28/2013

2:30 AM Tukiyooo 0

<ul class="diigo-linkroll"> <li> <a href="https://en.mention.net">mention | Your Media Monitoring Application</a> Mention gives you 3 alerts for free. Everyone should be following mention of their name and brand names (or school name) it is important. If you want more than 3, you'll have to pay. I use Google Alerts to track flat classroom and cool cat teacher - sad Google Alerts is gone, but here's an alternative. tags: <a href="https://www.diigo.com/user/coolcatteacher/education">education</a> <a href="https://www.diigo.com/user/coolcatteacher/Google">Google</a> <a href="https://www.diigo.com/user/coolcatteacher/tumblr">tumblr</a> <a href="https://www.diigo.com/user/coolcatteacher/news">news</a> <a href="https://www.diigo.com/user/coolcatteacher/social">social</a> <a href="https://www.diigo.com/user/coolcatteacher/media">media</a> <a href="https://www.diigo.com/user/coolcatteacher/brand">brand</a> <a href="https://www.diigo.com/user/coolcatteacher/management">management</a> </li> <li> <a href="http://mashable.com/2013/03/23/google-alerts/">Looking for a Google Alerts Alternative? Try This</a> Aurgghh! So Google alerts is dead too. I thought it was just misbehaving. It might have gone on spring break never to unbreak. Oh dear. Here are some alternatives from mashable. tags: <a href="https://www.diigo.com/user/coolcatteacher/education">education</a> <a href="https://www.diigo.com/user/coolcatteacher/news">news</a> <a href="https://www.diigo.com/user/coolcatteacher/google">google</a> <a href="https://www.diigo.com/user/coolcatteacher/tumblr">tumblr</a> </li> <li> <a href="http://www.edweek.org/ew/toc/2013/03/14/index.html?intc=EW-TC13-TWT">Education Week: March 14, 2013</a> Building a digital district. There are some great resources from Edweek on this topic. There is also a PDF or print version of the technology counts 2013 version. tags: <a href="https://www.diigo.com/user/coolcatteacher/education">education</a> <a href="https://www.diigo.com/user/coolcatteacher/news">news</a> </li> <li> <a href="https://twitter.com/edutopia/finland-hangout-panelists">@edutopia/Finland Hangout Panelists on Twitter</a> This is an example of how you can share lists. Edutopia created a list of the panelists who "hung out" today with the edutopia panel from Finland and the University of Pennsylvania. Excellent group today. tags: <a href="https://www.diigo.com/user/coolcatteacher/education">education</a> <a href="https://www.diigo.com/user/coolcatteacher/news">news</a> <a href="https://www.diigo.com/user/coolcatteacher/twitter">twitter</a> </li> </ul>Posted from <a href='https://www.diigo.com'>Diigo</a>. The rest of my favorite links are <a href='https://www.diigo.com/user/coolcatteacher'>here</a>.

Daily Education and Technology News for Schools 03/28/2013

mention | Your Media Monitoring Application Mention gives you 3 alerts for free. Everyone should be ...