Mobile internet access? Yeah, that's pretty popular in China, but according to the Ministry of Industry and Information Technology, household access is on the rise, too. The country says it will be expanding FTTH connections by 35 million households in 2013, putting 4M broadband connections (or faster) in over 70 percent of Chinese households. The announcement is part of China's 2013 broadband initiative, which aims to expand connectivity across the nation, including rural areas and schools. By the end of the year, China can expect to have 180,000 new 3G base stations and 1.3 million new WiFi hotspots. Check out the MIIT's full (and machine translated) announcement at the adjacent source link.
A garden at the Apostolic Palace of Castel Gandolfo, the pope's summer residence, on the outskirts of Rome. Pope Benedict XVI officially steps down on Thursday, Feb. 28. Benedict will stay at Castel Gandolfo until renovations on his permanent home are completed. Click the image for more photos.
By M. Alex Johnson, staff writer, NBC News
Even though Pope Benedict XVI is leaving the papacy, he'll remain in sumptuous, familiar surroundings ? at least for a few weeks.
Sometime in April, Benedict will take up permanent residence in Mater Ecclesiae, a modest convent for cloistered nuns at the Vatican. The convent is under renovation, however, so in the meantime, Benedict?will live at Castel Gandolfo, the small town of about 8,000 people a few miles southeast of Rome that has been the summer retreat for popes for almost four centuries.
Vatican records indicate that Benedict has spent an average of five weeks a year at the grand Apostolic Palace at Castel Gandolfo since he assumed the papacy in 2005, so he should feel quite at home.
Alessandro Di Meo / EPA
A light switch bears the Papal seal.
And what a home it is. The complex, which overlooks Lake Albano and what's left of the enormous villa of the first-century Roman Emperor Domitian, actually dwarfs Vatican City by almost 400,000 square feet. It comes complete with landscaped gardens, an arboretum, natural conservatories, museums and fish ponds.
Step inside Pope Benedict's temporary new home
The sculptured gardens, which make up more than half of the estate, are a favorite retreat for popes, who have been known to frequently take long walk along their paths.?
And don't forget the 25 dairy cattle, which are reputed to produce some of the finest milk in Europe.
The town is named for the castle of the Gandolfi family of Genoa, which was built around 1200. It was originally a fortress against marauders, which explains its high walls and other ancient barriers.?
Franco Origlia / Getty Images
The Apostolic Palace and the Pontifical Villas of Castel Gandolfo on Lake Albano will be the Pope Benedict XVI's residence during the next Conclave, in Rome, Italy. The Apostolic Palace of Castel Gandolfo, 10 miles south Rome, is also the summer residence for popes.
Formally speaking, the Vatican assumed control of Castel Gandolfo only in 1929 under the Lateran Treaty, which formalized relations between Italy and the independent state of Vatican City. But in reality, it has been the church's domain since 1596, when Pope Clement VIII seized it from the Savelli family in lieu of unpaid debts, according to the Vatican's official history.
Today, it's home not only to the Apostolic Palace but also the Vatican Observatory (where visitors can see a moon rock collected during the Apollo XVII mission), the Villa Barberini (where many remains of Domitian's palace are still visible), Villa Cybo (which is used by school of the Maestre Pie Filippini religious community), apartments for 21 employees and the Pontifical Church of St. Thomas of Villanova.
Castel Gandolfo, where Pope Benedict XVI will live until his permanent home is completed, has been a quiet sanctuary for 400 years. NBC's Savannah Guthrie reports.
The spectacular view of Lake Albano from the complex has inspired many artists. Landscapes of the scene by Jean-Baptiste Camille Corot, J.M.W. Turner and Claude Lorraine, among others, hang in some of the world's premier museums.
The complex itself is the setting for stunning works of religious art, as well, among them frescoes by Jan Henryk de Rosen and Angelo Righetti's statue "Madonna of the Park."
The Pontifical Church, designed in 1658 by Gian Lorenzo Bernini, the leading sculptor of his age, features interior domes and statues by Antonio Raggi, famous for grand pieces such as the "Virgin and Child" in Paris and the marble "Death of Saint Cecelia" in Rome. One of Bernini's own masterpieces, a fontana, or fountain, adorns the the piazza facing the Apostolic Palace.
At Castel Gandolfo, "I find everything: a mountain, a lake; I even see the sea," Benedict remarked in 2011. Those words are now engraved on a plaque in the town hall.
Benedict will move in to Castel Gandolfo late Thursday afternoon. He'll get there by helicopter ? a tradition started in 1975 by Pope Paul VI, who wanted to avoid traffic on the ancient Appian Way.
Paul VI was an especially enthusiastic visitor to Castel Gandolfo. In 1972, he described its charms in words that might resonate with Benedict, who said he was abdicating because of his age and declining health:
/
A view of a grotto inside the pope's summer residence.
"We, too, enjoy this God-given gift, by breathing the fresh air, admiring the beauty of our natural surroundings, appreciating the enchantment of its light and silence and seeking here to restore our lack of energy, which is never enough and now even a little scarce."
E-Xpress Interactive have announced some bonuses for people who buy Tomb Raider at launch day from their specialist chain Games The Shop. The game is scheduled to be launched on March 5, and there will be additional exclusive merchandise for people who have pre-ordered the game.
People buying the game on launch day will receive Lara Croft Posters, Lithographs and Two Game DLC?S (Combat Strike Pack and Explorer Pack).?
?The offer is exclusive to all the 10 stores of Games The Shop in Mumbai, Chennai, Pune, and Ahmedabad across India,? the press release reads.
In case you have pre-ordered the game you can receive exclusive steelbook from the distributor, pics of which we have posted below. The game is priced at Rs. 2,499 and will be available online and at retail.
Tomb Raider is developed by Crystal Dynamics and is being published by Square Enix.
Tell us what you think in the comments section below.
WASHINGTON (Reuters) - The father of a 6-year-old boy who was killed in the shooting massacre at a Connecticut school made a dramatic appeal on Wednesday for President Barack Obama's uphill bid to ban sales of military-style assault weapons and high-capacity ammunition magazines.
Testifying before a divided U.S. Senate Judiciary Committee, Neil Heslin, whose son Jesse Lewis was murdered in the December 14 shootings that killed 20 children and six adults, joined an emergency room doctor in recalling the damage done by such a weapon. Heslin held up a picture of his son during his testimony and at times his voice choked with emotion.
"I'm not here for sympathy. I'm here to speak up for my son," Heslin said. Lewis, hit twice in the head, "lost his life ... because of a gun that nobody needs and nobody should have a right to have," Heslin said.
Dr William Begg told the panel that each child who was killed at Sandy Hook Elementary School in Newtown, Connecticut, had three to 11 bullet wounds.
"The gun legislation that you are considering will make a difference," Begg said. "It could prevent future tragedies like Newtown."
The Democrat-led committee is expected to approve, on a party line vote of 10-8, a bill to outlaw military-style semi-automatic rifles and magazines with more than 10 bullets.
But the measure, one of four gun-control bills inspired by Sandy Hook, is likely to face a bipartisan roadblock on the floor of the Democrat-led Senate.
Most Republican lawmakers, along with several Democrats from rural states who strongly support gun rights, have lined up against the bill. They say its restrictions would amount to a violation of their constitutional right to bear arms.
Backers of the bill contend that although Americans have a right to own a gun, the U.S. government has a responsibility to protect citizens from undue risks.
Democrats on the Judiciary Committee have separated Obama's four gun control bills in an effort to get at least some of the less controversial measures, such as expanded background checks for all gun buyers, implemented.
The four bills would require improved background checks, ban assault weapons, crackdown on illegal gun trafficking and improve school safety.
The committee could vote on the measures as early as Thursday, though any member of the panel may ask that consideration of the bills be delayed for a week.
Democratic Senator Dianne Feinstein, who oversaw Wednesday's hearing, is chief sponsor of the bill that would renew a 10-year ban on assault weapons that expired in 2004.
Feinstein said that such firearms have been used in several mass slayings in recent years, including Newtown as well as Aurora, Colorado, Tucson, Arizona, and Blacksburg, Virginia.
"We cannot allow the carnage I have described to continue without taking action," Feinstein said.
Critics of her bill cited studies that found no evidence that the previous decade-long ban had any impact on the U.S. homicide rate.
Senator Charles Grassley, the panel's top Republican, said, "when something has been tried and not found to work, we should try different approaches rather than re-enacting that which failed."
Grassley and other Republicans in Congress have said increased treatment of the mentally ill and improved efforts to prevent such people from getting guns would be a more effective way of curbing gun-related violence.
UCLA study could explain why some people get zits and others don't Public release date: 28-Feb-2013 [ | E-mail | Share ]
Contact: Elaine Schmidt eschmidt@mednet.ucla.edu 310-794-2272 University of California - Los Angeles Health Sciences
2 strains of acne bacteria linked to pimples, another to healthy skin
The bacteria that cause acne live on everyone's skin, yet one in five people is lucky enough to develop only an occasional pimple over a lifetime. What's their secret?
In a boon for teenagers everywhere, a UCLA study conducted with researchers at Washington University in St. Louis and the Los Angeles Biomedical Research Institute has discovered that acne bacteria contain "bad" strains associated with pimples and "good" strains that may protect the skin.
The findings, published in the Feb. 28 edition of the Journal of Investigative Dermatology, could lead to a myriad of new therapies to prevent and treat the disfiguring skin disorder.
"We learned that not all acne bacteria trigger pimples one strain may help keep skin healthy," said principal investigator Huiying Li, an assistant professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA. "We hope to apply our findings to develop new strategies that stop blemishes before they start, and enable dermatologists to customize treatment to each patient's unique cocktail of skin bacteria."
The scientists looked at a tiny microbe with a big name: Propionibacterium acnes, bacteria that thrive in the oily depths of our pores. When the bacteria aggravate the immune system, they cause the swollen, red bumps associated with acne.
Using over-the-counter pore-cleansing strips, LA BioMed and UCLA researchers lifted P. acnes bacteria from the noses of 49 pimply and 52 clear-skinned volunteers. After extracting the microbial DNA from the strips, Li's laboratory tracked a genetic marker to identify the
bacterial strains in each volunteer's pores and recorded whether the person suffered from acne.
Next, Li's lab cultured the bacteria from the strips to isolate more than 1,000 strains. Washington University scientists sequenced the genomes of 66 of the P. acnes strains, enabling UCLA co-first author Shuta Tomida to zero in on genes unique to each strain.
"We were interested to learn that the bacterial strains looked very different when taken from diseased skin, compared to healthy skin," said co-author Dr. Noah Craft, a dermatologist and director of the Center for Immunotherapeutics Research at LA BioMed at HarborUCLA Medical Center. "Two unique strains of P. acnes appeared in one out of five volunteers with acne but rarely occurred in clear-skinned people."
The biggest discovery was still to come.
"We were extremely excited to uncover a third strain of P. acnes that's common in healthy skin yet rarely found when acne is present," said Li, who is also a member of UCLA's Crump Institute for Molecular Imaging. "We suspect that this strain contains a natural defense mechanism that enables it to recognize attackers and destroy them before they infect the bacterial cell."
Offering new hope to acne sufferers, the researchers believe that increasing the body's friendly strain of P. acnes through the use of a simple cream or lotion may help calm spotty complexions.
"This P. acnes strain may protect the skin, much like yogurt's live bacteria help defend the gut from harmful bugs," Li said. "Our next step will be to investigate whether a probiotic cream can block bad bacteria from invading the skin and prevent pimples before they start."
Additional studies will focus on exploring new drugs that kill bad strains of P. acnes while preserving the good ones; the use of viruses to kill acne-related bacteria; and a simple skin test to predict whether a person will develop aggressive acne in the future.
"Our research underscores the importance of strain-level analysis of the world of human microbes to define the role of bacteria in health and disease," said George Weinstock, associate director of the Genome Institute and professor of genetics at Washington University in St. Louis. "This type of analysis has a much higher resolution than prior studies that relied on bacterial cultures or only made distinctions between bacterial species."
Acne affects 80 percent of Americans at some point in their lives, yet scientists know little about what causes the disorder and have made limited progress in developing new strategies for treating it. Dermatologists' arsenal of anti-acne tools benzoyl peroxide, antibiotics and Accutane (isotretinoin) hasn't expanded in decades. Most severe cases of acne don't respond to antibiotics, and Accutane can produce serious side effects.
###
The research was supported by a grant (UH2AR057503) from the National Institutes of Health's Human Microbiome Project through the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Co-authors include co-first author Sorel Fitz-Gibbon, Bor-Han Chiu, Lin Nguyen, Christine Du, Dr. Minghsun Liu, David Elashoff, Dr. Jenny Kim, Anya Loncaric, Dr. Robert Modlin and Jeff F. Miller of UCLA; Erica Sodergren of Washington University; and Dr. Marie Erfe of LA BioMed.
Washington University: Caroline Arbanas, arbanasc@wustl.edu
314-286-0109
LA BioMed: Laura Mecoy, lmecoy@labiomed.org
310-546-5860
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
UCLA study could explain why some people get zits and others don't Public release date: 28-Feb-2013 [ | E-mail | Share ]
Contact: Elaine Schmidt eschmidt@mednet.ucla.edu 310-794-2272 University of California - Los Angeles Health Sciences
2 strains of acne bacteria linked to pimples, another to healthy skin
The bacteria that cause acne live on everyone's skin, yet one in five people is lucky enough to develop only an occasional pimple over a lifetime. What's their secret?
In a boon for teenagers everywhere, a UCLA study conducted with researchers at Washington University in St. Louis and the Los Angeles Biomedical Research Institute has discovered that acne bacteria contain "bad" strains associated with pimples and "good" strains that may protect the skin.
The findings, published in the Feb. 28 edition of the Journal of Investigative Dermatology, could lead to a myriad of new therapies to prevent and treat the disfiguring skin disorder.
"We learned that not all acne bacteria trigger pimples one strain may help keep skin healthy," said principal investigator Huiying Li, an assistant professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA. "We hope to apply our findings to develop new strategies that stop blemishes before they start, and enable dermatologists to customize treatment to each patient's unique cocktail of skin bacteria."
The scientists looked at a tiny microbe with a big name: Propionibacterium acnes, bacteria that thrive in the oily depths of our pores. When the bacteria aggravate the immune system, they cause the swollen, red bumps associated with acne.
Using over-the-counter pore-cleansing strips, LA BioMed and UCLA researchers lifted P. acnes bacteria from the noses of 49 pimply and 52 clear-skinned volunteers. After extracting the microbial DNA from the strips, Li's laboratory tracked a genetic marker to identify the
bacterial strains in each volunteer's pores and recorded whether the person suffered from acne.
Next, Li's lab cultured the bacteria from the strips to isolate more than 1,000 strains. Washington University scientists sequenced the genomes of 66 of the P. acnes strains, enabling UCLA co-first author Shuta Tomida to zero in on genes unique to each strain.
"We were interested to learn that the bacterial strains looked very different when taken from diseased skin, compared to healthy skin," said co-author Dr. Noah Craft, a dermatologist and director of the Center for Immunotherapeutics Research at LA BioMed at HarborUCLA Medical Center. "Two unique strains of P. acnes appeared in one out of five volunteers with acne but rarely occurred in clear-skinned people."
The biggest discovery was still to come.
"We were extremely excited to uncover a third strain of P. acnes that's common in healthy skin yet rarely found when acne is present," said Li, who is also a member of UCLA's Crump Institute for Molecular Imaging. "We suspect that this strain contains a natural defense mechanism that enables it to recognize attackers and destroy them before they infect the bacterial cell."
Offering new hope to acne sufferers, the researchers believe that increasing the body's friendly strain of P. acnes through the use of a simple cream or lotion may help calm spotty complexions.
"This P. acnes strain may protect the skin, much like yogurt's live bacteria help defend the gut from harmful bugs," Li said. "Our next step will be to investigate whether a probiotic cream can block bad bacteria from invading the skin and prevent pimples before they start."
Additional studies will focus on exploring new drugs that kill bad strains of P. acnes while preserving the good ones; the use of viruses to kill acne-related bacteria; and a simple skin test to predict whether a person will develop aggressive acne in the future.
"Our research underscores the importance of strain-level analysis of the world of human microbes to define the role of bacteria in health and disease," said George Weinstock, associate director of the Genome Institute and professor of genetics at Washington University in St. Louis. "This type of analysis has a much higher resolution than prior studies that relied on bacterial cultures or only made distinctions between bacterial species."
Acne affects 80 percent of Americans at some point in their lives, yet scientists know little about what causes the disorder and have made limited progress in developing new strategies for treating it. Dermatologists' arsenal of anti-acne tools benzoyl peroxide, antibiotics and Accutane (isotretinoin) hasn't expanded in decades. Most severe cases of acne don't respond to antibiotics, and Accutane can produce serious side effects.
###
The research was supported by a grant (UH2AR057503) from the National Institutes of Health's Human Microbiome Project through the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Co-authors include co-first author Sorel Fitz-Gibbon, Bor-Han Chiu, Lin Nguyen, Christine Du, Dr. Minghsun Liu, David Elashoff, Dr. Jenny Kim, Anya Loncaric, Dr. Robert Modlin and Jeff F. Miller of UCLA; Erica Sodergren of Washington University; and Dr. Marie Erfe of LA BioMed.
Washington University: Caroline Arbanas, arbanasc@wustl.edu
314-286-0109
LA BioMed: Laura Mecoy, lmecoy@labiomed.org
310-546-5860
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Soon after Joseph Francis learned that his levels of ?bad? LDL cholesterol sat at twice the norm, he discovered the short?comings of cholesterol-lowering drugs ? and of the clinical advice guiding their use. Francis, the director of clinical analysis and reporting at the Veterans Health Administration (VA) in Washington DC, started taking Lipitor (atorvastatin), a cholesterol-lowering statin and the best-selling drug in pharmaceutical history. His LDL plummeted, but still hovered just above a target mandated by clinical guidelines. Adding other medications had no effect, and upping the dose of Lipitor made his muscles hurt ? a rare side effect of statins, which can cause muscle breakdown.
So Francis pulled back to moderate Lipitor doses and decided that he could live with his high cholesterol. Later, he learned that other patients were being aggressively treated by doctors chasing stringent LDL targets. But Francis found the science behind the target guidelines to be surprisingly ambiguous. ?You couldn?t necessarily say lowering LDL further was going to benefit the patient,? he says.
The standard advice may soon change. For the first time in more than a decade, the US National Heart, Lung and Blood Institute is revising the clinical guidelines that shaped Francis?s treatment (see ?How low can you go??). Expected to be released later this year, the fourth set of guidelines, called ATP IV, has been drawn up by an expert panel of 15 cardiologists appointed by the institute. The guidelines will set the tone for clinical practice in the United States and beyond, and will profoundly influence pharmaceutical markets. They will also reflect the growing debate over cholesterol targets, which have never been directly tested in clinical trials.
Since 2002, when ATP III called on doctors to push LDL levels below set targets, the concept of low cholesterol has become synonymous with heart health. Patients brag about their cholesterol scores, physicians joke about adding statins to drinking water, and some hospitals reward doctors when patients hit cholesterol targets.
In 2011, US doctors wrote nearly 250 million prescriptions for cholesterol-lowering drugs, creating a US$18.5-billion market, according to IMS Health, a health-care technology and information company based in Danbury, Connecticut. ?The drug industry in particular is very much in favour of target-based measures,? says Joseph Drozda, a cardiologist and director of outcomes research at Mercy Health in Chesterfield, Missouri. ?It drives the use of products.?
ATP III reflected a growing consensus among physicians that sharply lowering cholesterol would lessen the likelihood of heart attacks and strokes, says Richard Cooper, an epidemiologist at the Loyola University of Chicago Stritch School of Medicine in Illinois, who served on the committee that compiled the guidelines. The committee drew heavily on clinical data, but also took extrapolations from basic research and post hoc analyses of clinical trials. LDL targets were set to be ?less than? specific values to send a message, Cooper says. ?We didn?t want to explicitly say ?the lower the better? because there wasn?t evidence for that,? he says. ?But everybody had the strong feeling that was the correct answer.?
By contrast, the ATP IV committee has pledged to hew strictly to the science and to focus on data from randomized clinical trials, says committee chairman Neil Stone, a cardiologist at Northwestern University School of Medicine in Chicago. If so, Krumholz argues, LDL targets will be cast aside because they have never been explicitly tested. Clinical trials have shown repeatedly that statins reduce the risk of heart attack and stroke, but lowering LDL with other medications does not work as well. The benefits of statins may reflect their other effects on the body, including fighting inflammation, another risk factor for heart disease.
Krumholz?s scepticism is rooted in experience. In 2008 and 2010, the Action to Control Cardiovascular Risk in Diabetes (ACCORD) clinical trial challenged dogma when it reported that lowering blood pressure or blood sugar to prespecified targets did not reduce the risk of heart attack or stroke. In the case of blood sugar, the risks were worsened. The trial demonstrated the folly of assuming that risk factors must have a causal role in disease, says Robert Vogel, a cardiologist at the University of Colorado, Denver. ?Short people have a higher risk of heart disease,? he says. ?But wearing high heels does not lower your risk.?
Jay Cohn, a cardiologist at the University of Minnesota Medical School in Minneapolis, also worries that the focus on LDL levels offers up the wrong patients for statin therapy. Most of those who have a heart attack do not have high LDL, he notes. Cohn advocates treating patients with statins based on the state of health of their arteries, as revealed by noninvasive tests such as ultrasound. ?If your arteries and heart are healthy, I don?t care what your LDL or blood pressure is,? he says.
?We can?t just assume that modifying the risk factor is modifying risk.? Not all cardiologists want to abolish LDL targets. Indeed, Seth Martin, a fellow in cardiology at Johns Hopkins University School of Medicine in Baltimore, Maryland, believes that ATP IV should reduce LDL targets further. The simplicity of targets has helped to deliver an important public-health message, he says, and motivated many patients to get the statin therapy that he believes they need. ?Just to throw that out the window doesn?t seem like the ideal scenario.?
Whatever the decision, the pharmaceutical industry will be watching closely, says Donny Wong, an analyst at Decision Resources, a market-research company based in Watertown, Massachusetts. Although most statins are off patent, the big pharmaceutical companies are racing to bring the next LDL-lowering drug to market. In particular, millions of dollars have been poured into drugs that inhibit a protein called PCSK9, an enzyme involved in cholesterol synthesis. This approach lowers LDL but has not yet been shown to reduce heart attacks or strokes.
Francis expects the new guidelines to relax the targets. He and his colleagues decided last autumn to change the VA?s own clinical standards, so that they no longer rely solely on an LDL target but instead encourage doctors to prescribe a moderate dose of statin when otherwise healthy patients have high LDL cholesterol. The ATP IV guidelines will take a similar approach, he speculates, noting that the VA consulted several outside experts who are also serving on the ATP committee.
Despite an increasingly vegetarian diet, Francis?s cholesterol has not budged. ?Sometimes I want to call my physician and say, ?Don?t worry about that target,?? he says. ?It?s going to be changing very soon.? ?
This story is reprinted with permission from Nature. It was first published on February 26, 2013.
By?Matt Mumber, Heather Reed, and foreward by Andrew Weil New Page Books, $15.99,?235 pages
Are you stressed? Who isn?t stressed these days? If you (or someone you know) is battling the stresses of daily life, Sustainable Wellness: An Integrative Approach to Transform Your Mind, Body, and Spirit?may provide the handy plan. Dr. Andrew Weil wrote the preface because he also practices integrative medicine. Dr. Matt Mumber and Heather Reed, a yoga instructor, take time in the beginning section to start building a basic knowledge for the reader. Mumber and Reed stress that a sustainable, integrative approach ?should be practical and should fit into everyday situations.? The authors meld together a balanced way?like the image of a three-legged stool of health?for someone looking to make lifestyle changes.
Mumber and Reed depict a program with eight steps to finding lasting health: mindfulness, know thyself, life review and planning, nutrition, physical activity, stress management, spirituality then bringing them all together. Throughout the steps, there are ?Yoga Bits? for the reader, which is useful for taking breaks and starting slowly in this lifestyle shift. Frequent examples and self-administered quizzes also help the reader through. This is a strong book to check out if interested in a less stressful and more balanced life.
WASHINGTON (AP) ? White House-backed legislation in the Senate to replace $85 billion in across-the-board spending cuts would result in very modest deficit savings through the end of the budget year, officials said Wednesday, most if not of all of them through higher taxes on millionaires.
Instead, the bill drafted by Senate Democrats would spread one year's worth of anticipated savings over a decade, a move sponsors say is designed to prevent damage to a shaky economic recovery.
The Democrats' approach to the latest episode of budget brinkmanship comes as the two political parties vie for public support in advance of across-the-board cuts due to kick in on Friday.
The replacement measure, which has yet to be distributed publicly, proposes cuts in defense spending and elimination of a program of payments to certain farmers as well as a tax on millionaires as the main elements of an alternative.
Yet it also specifies that no defense reductions would take place for 18 months, and officials added that the elimination of the farm program would have virtually no impact on the deficit until a new budget year begins on Oct. 1.
The tax on millionaires would raise government revenues through the end of the budget year by an estimated $1 billion ? a figure that pales in comparison to the $85 billion in spending cuts due to take effect. White House spokesman Jay Carney recently told reporters at the White House the administration supports the measure.
The Senate is expected to vote on Thursday on rival Democratic and Republican plans to replace the spending cuts, known in Washington-speak as a sequester. Both bills are expected to fail.
In an indication that across-the-board cuts are inevitable, President Barack Obama has set a meeting with congressional leaders for the day they take effect. While the administration has warned of severe cuts in government services as a result of the reductions, few, if any, are likely to be felt for several weeks.
That could give the administration and lawmakers breathing room to negotiate a replacement, although Senate Republican Leader Mitch McConnell said during the day there were limits to what could be negotiated.
"We can either secure those reductions more intelligently, or we can do it the president's way with across-the board cuts. But one thing Americans simply will not accept is another tax increase to replace spending reductions we already agreed to," he said.
Democrats said their proposal to replace across-the-board cuts was designed with the economy in mind.
It "seeks the same amount of savings in a more responsible way" as the $85 billion in cuts that will otherwise take effect, said Adam Jentleson, a spokesman for Senate Majority Leader Harry Reid.
"The impact on the economy is much better. Sequestration as constituted would hurt economic growth and destroy jobs," he added.
Over a decade, the bill would cut deficits by an estimated $110 billion, half from higher taxes and half from the defense and farm program cuts.
That is in keeping with Obama's call for a balanced approach that combines selected spending cuts with closing tax loopholes.
Senate Democrats have been reluctant to spell out the details of their measure, although it is not clear if that results from its relatively small impact on the deficits through the end of the current budget year.
Across the Capitol, though, the party's leaders have talked openly of their desire to spread the cuts in their replacement measure over a longer period.
"It is entirely intentional," said Rep. Chris Van Hollen, D-Md., and the party's senior member on the House Budget Committee. "The whole idea is to achieve the equivalent deficit reduction without hurting jobs and having disruption in the economy. You do that by having targeted cuts and eliminating tax loopholes over a longer period of time," he added.
He said the Democrats' approach is the same as Federal Reserve Chairman Ben Bernanke's recommendation, which is to help the recovery gain strength before beginning to make cuts.
In the Senate, Republicans have yet to disclose their own sequester replacement measure. Most of the rank and file favors an alternative that lets Obama adjust the cuts to minimize any impact on the public, but that approach has its critics among lawmakers who fear giving the White House that much authority.
____
Eds: AP White House Correspondent Julie Pace contributed to this story
MOSCOW/ BERLIN (Reuters) - Russia called on the United States on Tuesday to press the Syrian opposition to hold direct talks with Damascus, saying President Bashar al-Assad's opponents must appoint negotiators.
The crisis in Syria made up "the bulk of the conversation" between Russian Foreign Minister Sergei Lavrov and U.S. Secretary of State John Kerry at talks in Berlin on Tuesday, U.S. State Department spokeswoman Victoria Nuland said.
After talks she characterized as "really serious and hard-working", Moscow and Washington sounded a rare note of accord over efforts to launch talks to end the nearly two-year-old conflict, in which 70,000 people have been killed.
Lavrov said the new U.S. top diplomat seemed to grasp the gravity of the crisis in Syria and that the former Cold War foes had agreed to do everything in their power "to create the best conditions to facilitate the soonest possible start of a dialogue between the government and the opposition."
He said Russia wanted to see the Syrian opposition name its representatives for talks with the government at a meeting in Rome this week between the Syrian opposition, and Western and regional powers favorable to their cause.
Moscow and Washington have been at loggerheads over whether the Syrian opposition's calls for Assad to step down should be a pre-condition for talks.
Lavrov, ahead of the meeting with Kerry, said he would urge Washington to lean on the Syrian opposition to drop requests for Assad to go, a demand he characterized as "unrealistic".
Russia has been one of Assad's staunchest ally and, with China, has blocked three U.N. Security Council resolutions aimed at mounting pressure on him to end the violence that began with a crackdown on street protests against his rule.
Washington has sided with the Syrian opposition in seeking Assad's removal from power.
Syrian Foreign Minister Walid al-Moualem said in Moscow on Monday that the government was ready for talks, but opposition leaders and rebel commanders insist Assad must go first.
Kerry responded dismissively to Moualem's offer, saying it was hard to understand how people having Scud missiles fired at them would take an offer of dialogue seriously. Syria denies using ballistic missiles in the fighting.
He also appeared to promise more concrete support to Assad's opponents, without saying whether the United States might rethink its earlier aversion to arming or training them.
"We are determined that the Syrian opposition is not going to be dangling in the wind," Kerry said in London on Monday.
Lavrov also signaled on Tuesday that the prospects for direct talks in Syria had receded in the past few days, voicing fears "extremists" now have the upper hand among Assad's foes.
"A few days ago it seemed that conditions for the sides to sit down for talks ... were getting clearer," he said.
"But then came denials of such an approach. It seems extremists, who bet on a military solution to Syria's problems and block initiatives to start dialogue, have for now come to dominate in the ranks of the Syrian opposition, including in the so-called (Syrian) National Coalition."
Western countries and some Arab states have accused Russia, a long-standing arms supplier to Damascus, of shielding Assad.
Moscow has hit back by saying it has worked hard to try to persuade the two sides in Syria to start talks and accusing its Western allies of failing to do enough to support those efforts.
It also says support for the rebels plays into the hands of militant Islamists, a theme Assad himself often evokes.
(Additional reporting and writing by Alissa de Carbonnel; Editing by Jon Hemming)
Whenever you decide to begin a bodybuilding program you will need a workout schedule. This will help you stay focused and is a necessary part of muscle growth. The schedule is what will get your muscles used to the rigors of strength training and help you gain muscle mass.
A workout schedule for bodybuilding will consist of two components: exercise and rest. You will need to strength train on a regular basis. Usually, trying to do this every day at the same time is a good idea as it helps your body get used to it and keeps you from not putting it off for later. Once you establish a schedule you will get into the rhythm of things and can begin transforming your body.
Rest is another important factor in your bodybuilding schedule. Your muscles need rest in order to recover from the training. When you strength train, your muscle tissues are broken down. They need time to repair themselves so they may grow. This part is just as important as the exercise itself.
If you are looking to gain muscle mass in a very short period of time, you will need to follow an intense exercise program. Begin each workout with a short warm up. This should be five to ten minutes of light cardio. Walking on a treadmill or riding a stationary bike will work well for this. You should also be sure to stretch your muscles after warming up so they will be ready for the workout.
Warm up before each exercise using approximately half the weight you will use during your working sets. Perform around four to six repetitions with the lighter weight. This will prepare your muscles to work under heavier loads.
Exercise each muscle group, doing two to three sets of each with eight to 12 reps. As time goes by, you will decrease the number of reps while increasing the amount of weight. This is what makes it an intense workout. You are pushing your muscles to the max by using heavier weights. More reps here won?t do you more good, in fact, they may wind up doing less. You don?t want to over train your muscles, you simply want to stimulate them, not annihilate them. More weight is what will do this for you in a short amount of time.
Move through all your exercises and cool down afterwards. Post-workout stretching will help you relax the muscles and begin the repair process. You muscles need to stay flexible, with msucle flowing nutrients to them in order to grow. Work out three to four days a week hitting different muscle groups on different days. Splitting it up like this also keeps you from over training. Rest the remaining days. Your muscles will thank you for it by beginning to grow stronger and before you know it you?ll gain more muscle mass in a short period of time than you ever thought possible.
All good plans start with a solid groundwork especially with weight loss. Include vital lifestyle changes that will help you eat better, get more exercise and improve your health. When you have the right information, you become unstoppable. The tips you learn here will give you a good start, and get you in the right mindset to implement smart changes in your lifestyle.
When beginning a new weight loss program, seek the advice of a dietician for the best results. Our bodies are all different, so you may not get the same results from one diet that someone else did. Seek outside help when trying to lose weight.
You can shed extra weight simply by walking up and down the stairs. As simple as it may seem, you are still burning calories that you would not have had you taken the elevator.
There are a number of popular diets that simply do not work alone. Therefore, it is important to join a gym to have a backup plan. Although a decrease in overall calories will help you lose weight or slow your weight gain, exercise will help you burn calories and increase your weight loss. Your ultimate goal should be to change your lifestyle so that you consume less calories than you burn.
Eating distracted is an open door to more pounds. If you ignore what you're putting in your mouth, you won't lose any weight. Be aware of the quantity that you are consuming at each sitting, and you are sure to find that you do not eat as much.
If you're going to eat nuts, eat nuts that come with the shell on. The reason for this is because it takes longer to consume shelled nuts, which will cause you to eat less.
Never take diet drugs without first consulting with a health care professional. Anyone with a heart condition, or taking other medicines, should not take most of the available diet pills. Consult your physician before taking any unproven product designed to help you lose weight, especially pills.
Reducing your intake of red meat can help with your weight loss efforts. Red meat contains a lot of cholesterol and saturated fat which is harmful to your heart. Switch out red meat for leaner cuts of meat such as turkey, tuna, chicken or other types of fish.
When you must choose between salad and soup at a restaurant, choose clear soup or a salad. Eating either, however, will have you eating less of your calorie-laden entree.
Do not become obsessed with the scale. If you're checking your weight on the scale every day to track the progress of your weight loss program, there's a chance that you won't see the results you were expecting and it can be upsetting. Exercising builds muscle, which is heavier than fat. The best way to judge whether or not your weight loss plan is working is to examine how well your clothing is now fitting.
Keeping a healthy weight is the key to your future health. The style of life that you have determines the success you will have. Change your habits and use all resources to keep on track to a healthier you. Instead of wondering what will happen, know what you want to do and do it.
About the Author
Losing weight can be challenging, especially when you have tried seemingly everything and have given up hope. At weightlossgeeks.com, we understand what you are going through and it is our goal to provide you with the Weight Loss Tips, information, resources and support through a virtual community to help you succeed with your weight loss goals.
An Illinois grocer was sentenced to two-and-a-half years in federal prison Monday for defrauding government and nutrition programs.
Khaled Saleh, 48, the owner of Sunset Food Market in Waukegan was charged with illegally exchanging cash with customers using food stamp cards and nutrition coupons during an undercover investigation.
Saleh was sentenced to 30 months in prison by U.S. District Judge Charles Norgle.
Saleh, along with his wife, Fatima Saleh, 37, acquired more than $844,000 by paying customers approximately half the value in cash for goods purchased at other stores using their benefits.
They then re-sold the same items in their store at a substantially higher price.
During the investigation, an agent with the U.S. Department of Agriculture, Office of Inspector General, exchanged food stamp benefits for cash and used benefits to purchase formula at a discount store, which he then re-sold for half the price in cash to the Salehs on several occasions.
Read more from NBCChicago.com
The couple was arrested in May 2011 and both pleaded guilty last August to conspiracy to defraud government programs.
The government forfeited $391,616 in cash and bank account funds that were seized from the Salehs, and Khaled Saleh was ordered to pay $453,013 in restitution for the remaining balance.
Sentencing for Fatima Saleh has been postponed to March 22.
My two year old daughter likes to ask me if she can get a tattoo. Obviously I?m not going to take her to get one, but she asks me every day anyway.
What the heck kind of toddler wants a tattoo? Children want to imitate their parents. Adi wants to imitate me. I have tattoos. A couple of them are rather large. ?One of my larger tattoos is a peacock on my right arm that goes from my shoulder to my elbow. Adi will talk to it sometimes. She?ll name all of the different parts of the bird (beak, eyes, feathers, etc), and if she sees a peacock at the zoo she?ll try to introduce it to my arm.
Two year olds are very visual kids, so one of the big ways Adi can imitate me is by painting her arms and legs to look like me. And she does. ?Whenever we?re painting together at home, Adi will start painting herself. I think it?s sweet that she wants to be like me.
I have enough tattoos in enough places that hiding them from Adi is impossible. I also plan on getting more, so if I want Adi to develop a sane and healthy attitude towards body modification I have to be open about it with her, and be a good example on how to do it properly and safely.
I let Adi sit in the room with me while I?m getting tattoos. She never stays for long (after a while it gets kind of boring) and she isn?t disruptive. Adi has seen my peacock tattoo in every stage, from start to finish.?Adi saw the peacock when it was just a sketch on paper. She saw the sketches I traded back and forth with my tattoo artist (his name is Babiery Hernandez, and he?s fantastic by the way). She knew where the peacock was going to go on my arm (right under another tattoo), and how big it would be. Tattoo design and implementation takes a long time (for me anyway) and I want Adi to appreciate that. Large tattoos like that also take a long time to physically apply and are rough on the skin, so for the first month of the bird?s existence it was just the outline and shading. Adi also sees that they hurt. I?m not screaming or anything, but tattoos hurt (more in some places) and you can see it in my face. Adi sees the artist ask if I?m okay and she always hears me say that I?m fine. Since seeing my peacock get done, I?m finding that Adi has either a higher tolerance for pain, or is otherwise less dramatic about it.
I also make sure that Adi sees me doing my aftercare routine. She sees me clean it, put on ointment, and look at it to make sure nothing gets infected. That?s hugely important. Tattoos aren?t just a ?set it and forget it? kind of thing. You have to take care of them after you get them. Adi needs to see that too.
Adi can also see that I have a friendly relationship with tattoo artists, and she sees that they?re respectful to our family. She sees that the parlor is clean. She sees that I take it seriously. If, when Adi gets older, she wants tattoos, I want her to take it seriously too.
Adi will tell people about my tattoos too. That ?the man drew the bird? on my arm with ?arm paint? and she?ll point to it. Then she?ll turn to me, point to her arm and ask me where her bird is. I?ll smile and tell her that one day, when she?s a grown up she can get one if she wants.?It?s cute. Some people think it?s a little creepy for a toddler to talk to a picture of a bird on her mother?s arm, but I think it?s cute.
Adi might not get any tattoos at all (her father doesn?t have any? maybe she?ll want to be like him), but if she does, I want to make sure she does it safely, happily, and regret free.
Rachel Figueroa-Levin is a soapmaker,?cofounder and educator at Urban Babywearing, a?hyperlocal Inwood blogger and organizer, a?political/life/religion/parenting satirist, and all around trouble maker.? She is also the creator of New York City Mayor Michael Bloomberg?s Spanish-speaking alter ego @elbloombito.? You can reach her via twitter @Jewyorican.?
A University of North Carolina sexual assault victim has been charged with violating the school's honor code and creating a hostile environment for her attacker, according to Jezebel.com.
The charge came approximately a month after Landen Gambill, a sophomore at UNC?who last spring reported being raped by a student she says is still on campus?filed a complaint with the U.S. Department of Education's Office for Civil Rights. She, as well as others who filed with her?including current and former students, and Melinda Manning, the school's former assistant dean of students?allege that the school had pressured Manning into underreporting sex offense cases.
An email sent by the school last week to Gambill?who says she's facing possible expulsion for speaking out about her ordeal? reads in part:
You are being charged with the following Honor Code violation(s):
I.C.1.c. - Disruptive or intimidating behavior that willfully abuses, disparages, or otherwise interferes with another (other than on the basis of protected classifications identified and addressed in the University's Policy on Prohibited Harassment and Discrimination) so as to adversely affect their academic pursuits, opportunities for University employment, participation in University-sponsored extracurricular activities, or opportunities to benefit from other aspects of University Life.
The matter has been turned over to UNC's Honor Court. If found guilty, Gambill could be subject to a range of sanctions, including probation, suspension or even expulsion.
An avatar used by Gambill's supporters (Twitter)
"This type of gross injustice is unacceptable," Gambill wrote on her Facebook page. "It's important to me that we continue to advocate for the rights of survivors?not just because it affects me personally but because I desperately hope no one has to go [through] anything like this again."
Some of Gambill's supporters have also taken to Facebook and Twitter, changing their avatars to say "I Stand With Landen" and tweeting messages with the hashtag #standwithlanden.
Colby Bruno, managing attorney for the national Victim Rights Law Center, told InsideHigherEd.com the code violation is "outrageous.? For the university "to entertain this as a viable claim is a problem, because it's not,? Bruno said.
[Related: Fox News co-host apologizes for campus rape remark]
The university would not comment on Gambill's case, citing federal privacy laws. But at a board meeting last month, Leslie Strohm, UNC's vice chancellor and general counsel, told trustees "the allegations with respect to the underreporting of sexual assault are false, they are untrue, and they are just plain wrong."
In 2010, the Department of Justice estimated that 25 percent of college women "will be victims of rape or attempted rape before they graduate within a four-year college period," and that schools with more than 6,000 students "average one rape per day during the school year.?
According to New York University's "National Statistics about Sexual Violence on College Campuses," fewer than 5 percent of such cases are reported to law enforcement.
PTSD symptoms common among ICU survivorsPublic release date: 26-Feb-2013 [ | E-mail | Share ]
Contact: Stephanie Desmon sdesmon1@jhmi.edu 410-955-8665 Johns Hopkins Medicine
Condition long linked to war veterans found in one in 3 ventilated patients
One in three people who survived stays in an intensive care unit (ICU) and required use of a mechanical ventilator showed substantial post-traumatic stress disorder (PTSD) symptoms that lasted for up to two years, according to a new Johns Hopkins study of patients with acute lung injury.
Because acute lung injury (ALI) a syndrome marked by excessive fluid in the lungs and frequent multi-organ failure is considered an archetype for critical illness, the researchers suspect PTSD is common among other ICU survivors as well.
"We usually think of PTSD as something you develop if you go to war, are sexually assaulted or suffer a similar emotional trauma," says Dale Needham, M.D., Ph.D., a critical care specialist at the Johns Hopkins University School of Medicine and senior author of the study published online in Psychological Medicine. "Instead, it may be as common, or more common, in ICU patients as in soldiers, but it's something many doctors including psychiatrists don't fully appreciate."
"Physical weakness usually gets better, but these mental symptoms often just linger," says study leader O. Joseph Bienvenu, M.D., Ph.D., an associate professor of psychiatry and behavioral sciences at Johns Hopkins. "We need to pay more attention to preventing and treating PTSD in these patients."
Bienvenu says the unusual thing about PTSD in ICU survivors is that they often experience flashbacks about delusions or hallucinations they had in the hospital, rather than events that actually occurred. Having a life-threatening illness is itself frightening, but delirium in these patients who are attached to breathing machines and being given sedatives and narcotics may lead to "memories" of horrible things that didn't happen, he adds.
"One woman thought her husband and the nurse were plotting to kill her," Bienvenu recalls.
For the study, the Johns Hopkins team observed 520 mechanically ventilated patients with ALI, recruited from 13 ICUs at four Baltimore hospitals between October 2004 and October 2007. Fifty-three percent survived their hospitalization, and 186 patients had at least one research visit over the subsequent two-year follow-up period.
The researchers found that 66 of the 186 patients (35 percent) had clinically significant symptoms of PTSD, with the greatest apparent onset occurring by the initial, three-month follow-up visit. Sixty-two percent of the survivors who developed PTSD still had symptoms at their two-year visit. Half of this same group was taking psychiatric medications, and 40 percent had seen a psychiatrist in the two years since being hospitalized with ALI.
The researchers also found that patients with depression before hospitalization were twice as likely to develop PTSD, and that those who spent more time in the ICU were more likely to experience symptoms.
Those who had sepsis (a severe response to infection) during their ICU stay, and those who were given high doses of opiates, were more likely to develop PTSD as well. Those given corticosteroids while in the ICU were less likely to develop PTSD, though the exact reasons why are unknown.
The delirium often associated with ICU stays and post-ICU PTSD may be partially a consequence of inflammation caused by sepsis. This inflammation may lead to a breakdown in the blood-brain barrier, which alters the impact on the brain of narcotics, sedatives and other drugs prescribed in the ICU.
Bienvenu says patients who have these risk factors need special attention. Simply educating them and their primary care doctors about the increased risk for PTSD would be a step in the right direction, he adds.
Each year, almost 1 million patients in the United States are hooked up to ventilators in an ICU, and 200,000 are estimated to develop ALI, usually as the result of infection. The lungs of healthy people allow the easy exchange of gases to enable oxygen to enter the bloodstream, and carbon dioxide to exit the body. In ALI patients, the normally light and dry lungs become heavy and soggy like a wet sponge.
People with PTSD, a form of anxiety disorder, may feel severely stressed or frightened even when they're no longer in danger. The symptoms fall into three categories: reliving the traumatic experience (flashbacks, nightmares), avoidance (feeling numb, detached, staying away from people and places that serve as reminders of the experience), and hyperarousal (being easily startled, having difficulty sleeping, irritability).
PTSD can impair quality of life and slow patients' recovery from a critical illness, keeping victims from returning to work or performing usual activities of daily life.
Needham, Bienvenu and others at Johns Hopkins are interested in whether changing care in the ICU can reduce the incidence of PTSD. Needham's team has reported on studies showing that early physical rehabilitation for ICU patients can speed and enhance recovery, and he says "psychological rehab" now deserves attention.
One European study looked at the use of ICU diaries, where nurses and family members recorded what was happening with the patients daily while they were in the ICU, sometimes taking photographs. The diaries were then given to the patients a month after leaving the ICU, with phone debriefing from a nurse. The intervention reduced PTSD symptoms by helping patients make sense of their ICU memories, Bienvenu says.
###
Other Johns Hopkins researchers involved in the study include Jonathan Gellar, M.P.H.; Benjamin M. Althouse, Sc.M.; Elizabeth Colantuoni, Ph.D.; Thiti Sricharoenchai, M.D.; Pedro A. Mendez-Tellez, M.D.; Cheryl R. Dennison, R.N., Ph.D.; and Peter J. Pronovost, M.D., Ph.D.
This research was supported by the National Institutes of Health's National Heart, Lung, and Blood Institute (Acute Lung Injury SCCOR Grant P050 HL73994 and R01 HL88045).
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
PTSD symptoms common among ICU survivorsPublic release date: 26-Feb-2013 [ | E-mail | Share ]
Contact: Stephanie Desmon sdesmon1@jhmi.edu 410-955-8665 Johns Hopkins Medicine
Condition long linked to war veterans found in one in 3 ventilated patients
One in three people who survived stays in an intensive care unit (ICU) and required use of a mechanical ventilator showed substantial post-traumatic stress disorder (PTSD) symptoms that lasted for up to two years, according to a new Johns Hopkins study of patients with acute lung injury.
Because acute lung injury (ALI) a syndrome marked by excessive fluid in the lungs and frequent multi-organ failure is considered an archetype for critical illness, the researchers suspect PTSD is common among other ICU survivors as well.
"We usually think of PTSD as something you develop if you go to war, are sexually assaulted or suffer a similar emotional trauma," says Dale Needham, M.D., Ph.D., a critical care specialist at the Johns Hopkins University School of Medicine and senior author of the study published online in Psychological Medicine. "Instead, it may be as common, or more common, in ICU patients as in soldiers, but it's something many doctors including psychiatrists don't fully appreciate."
"Physical weakness usually gets better, but these mental symptoms often just linger," says study leader O. Joseph Bienvenu, M.D., Ph.D., an associate professor of psychiatry and behavioral sciences at Johns Hopkins. "We need to pay more attention to preventing and treating PTSD in these patients."
Bienvenu says the unusual thing about PTSD in ICU survivors is that they often experience flashbacks about delusions or hallucinations they had in the hospital, rather than events that actually occurred. Having a life-threatening illness is itself frightening, but delirium in these patients who are attached to breathing machines and being given sedatives and narcotics may lead to "memories" of horrible things that didn't happen, he adds.
"One woman thought her husband and the nurse were plotting to kill her," Bienvenu recalls.
For the study, the Johns Hopkins team observed 520 mechanically ventilated patients with ALI, recruited from 13 ICUs at four Baltimore hospitals between October 2004 and October 2007. Fifty-three percent survived their hospitalization, and 186 patients had at least one research visit over the subsequent two-year follow-up period.
The researchers found that 66 of the 186 patients (35 percent) had clinically significant symptoms of PTSD, with the greatest apparent onset occurring by the initial, three-month follow-up visit. Sixty-two percent of the survivors who developed PTSD still had symptoms at their two-year visit. Half of this same group was taking psychiatric medications, and 40 percent had seen a psychiatrist in the two years since being hospitalized with ALI.
The researchers also found that patients with depression before hospitalization were twice as likely to develop PTSD, and that those who spent more time in the ICU were more likely to experience symptoms.
Those who had sepsis (a severe response to infection) during their ICU stay, and those who were given high doses of opiates, were more likely to develop PTSD as well. Those given corticosteroids while in the ICU were less likely to develop PTSD, though the exact reasons why are unknown.
The delirium often associated with ICU stays and post-ICU PTSD may be partially a consequence of inflammation caused by sepsis. This inflammation may lead to a breakdown in the blood-brain barrier, which alters the impact on the brain of narcotics, sedatives and other drugs prescribed in the ICU.
Bienvenu says patients who have these risk factors need special attention. Simply educating them and their primary care doctors about the increased risk for PTSD would be a step in the right direction, he adds.
Each year, almost 1 million patients in the United States are hooked up to ventilators in an ICU, and 200,000 are estimated to develop ALI, usually as the result of infection. The lungs of healthy people allow the easy exchange of gases to enable oxygen to enter the bloodstream, and carbon dioxide to exit the body. In ALI patients, the normally light and dry lungs become heavy and soggy like a wet sponge.
People with PTSD, a form of anxiety disorder, may feel severely stressed or frightened even when they're no longer in danger. The symptoms fall into three categories: reliving the traumatic experience (flashbacks, nightmares), avoidance (feeling numb, detached, staying away from people and places that serve as reminders of the experience), and hyperarousal (being easily startled, having difficulty sleeping, irritability).
PTSD can impair quality of life and slow patients' recovery from a critical illness, keeping victims from returning to work or performing usual activities of daily life.
Needham, Bienvenu and others at Johns Hopkins are interested in whether changing care in the ICU can reduce the incidence of PTSD. Needham's team has reported on studies showing that early physical rehabilitation for ICU patients can speed and enhance recovery, and he says "psychological rehab" now deserves attention.
One European study looked at the use of ICU diaries, where nurses and family members recorded what was happening with the patients daily while they were in the ICU, sometimes taking photographs. The diaries were then given to the patients a month after leaving the ICU, with phone debriefing from a nurse. The intervention reduced PTSD symptoms by helping patients make sense of their ICU memories, Bienvenu says.
###
Other Johns Hopkins researchers involved in the study include Jonathan Gellar, M.P.H.; Benjamin M. Althouse, Sc.M.; Elizabeth Colantuoni, Ph.D.; Thiti Sricharoenchai, M.D.; Pedro A. Mendez-Tellez, M.D.; Cheryl R. Dennison, R.N., Ph.D.; and Peter J. Pronovost, M.D., Ph.D.
This research was supported by the National Institutes of Health's National Heart, Lung, and Blood Institute (Acute Lung Injury SCCOR Grant P050 HL73994 and R01 HL88045).
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
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Public release date: 28-Feb-2013
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I have enough tattoos in enough places that hiding them from Adi is impossible. I also plan on getting more, so if I want Adi to develop a sane and healthy attitude towards body modification I have to be open about it with her, and be a good example on how to do it properly and safely.
