Wounded presage health crisis for postwar Syria






ATMEH, Syria (AP) — A baby boy joined the ranks of Syria’s tens of thousands of war wounded when a missile fired by Bashar Assad‘s air force slammed into his family home and shrapnel pierced his skull.


Four-month-old Fahed Darwish suffered brain damage and, like thousands of others seriously hurt in the civil war, he will likely need care well after the fighting is over. That’s something doctors say a post-conflict Syria won’t be able to provide.






Making things worse, there has been a sharp spike in serious injuries since the summer, when the regime began bombing rebel-held areas from the air, and doctors say a majority of the wounded they now treat are civilians.


This week, Fahed was recovering from brain surgery in an intensive care unit, his head bandaged and his body under a heavy blanket, watched over by Mariam, his distraught 22-year-old mother.


She said that after her first-born is discharged from the hospital in Atmeh, a village in an area of relative safety near the Turkish border, they will have to return to their village in a war zone in central Syria.


“We have nowhere else to go,” she said.


Even for those who have escaped direct injury, the civil war is posing a mounting health threat. Half the country’s 88 public hospitals and nearly 200 clinics have been damaged or destroyed, the World Health Organization says, leaving many without access to health care. Diabetics can’t find insulin, kidney patients can’t reach dialysis centers. Towns are running out of water-purifying materials. Many of the hundreds of thousands displaced by the fighting are exposed to the cold in tents or unheated public buildings.


“You are talking about a public health crisis on a grand scale,” said Dr. Abdalmajid Katranji, a hand and wrist surgeon from Lansing, Michigan, who regularly volunteers in Syria.


No one knows just how many people have been injured since the uprising against Assad erupted in March 2011, starting out with peaceful protests that turned into an armed insurgency in response to a violent government crackdown.


More than 43,000 have been killed in the past 21 months, said Rami Abdul-Rahman, head of the Britain-based Syrian Observatory for Human Rights, basing his count on names and details provided by activists in Syria. He said the number of wounded is so large he can only give a rough estimate, of more than 150,000.


Casualties began to rise dramatically at the start of the summer. At the time, the regime, its ground troops stretched thin, began bombing from the air to prevent opposition fighters from gaining more territory.


Seemingly random bombings have razed entire villages and neighborhoods, driving terrified civilians from their homes, with an estimated 3 million Syrians out of the country’s population of 23 million now displaced.


About 10 percent of the wounded suffer serious injuries and many of those will need long-term care and rehabilitation, said Dr. Omar Aswad of the Union of Syrian Medical Relief Organizations, an umbrella for 14 aid groups.


This includes artificial limbs and follow-up surgery. “This is of course not available and will be one of the major (health) problems in the months right after the war,” said Mago Tarzian, emergency director for the Paris-based Doctors Without Borders.


For now, aid groups are struggling to provide even emergency treatment in under-equipped clinics.


The two dozen small hospitals and field clinics in rebel-run areas of Idlib province in the north only have a few Intensive Care Unit beds between them, said Aswad. None has a CT scanner, an important diagnostic tool.


“We need generators, we need medical supplies and the most pressing is medicine,” he said.


The challenge has been compounded by new types of injuries.


The regime has begun dropping incendiary bombs that can cause severe burns, according to the New York-based Human Rights Watch, citing amateur video and witness accounts.


Ole Solvang, a researcher for the group, said he saw remnants of such a bomb on a recent Syria trip. Aswad said doctors in Idlib and nearby Aleppo province reported seeing patients with burns from such weapons.


Doctors and hospitals have also been targeted. Aswad, who fled the city of Idlib in March after regime forces entered it, said five friends in a secret association of anti-regime physicians have been arrested. Hospitals, ambulances and doctors have been attacked, Solvang said, calling it “a worrying trend that makes the medical situation even worse.”


One of the bright spots is a 50-bed emergency care clinic set up six weeks ago in a former elementary school in Atmeh.


Largely funded by a wealthy Syrian expatriate, the Orient clinic, with five ICU beds, handles some of the most serious cases in a radius of some 150 kilometers (90 miles), said its director, orthopedic surgeon Abdel Hamid Dabbak.


In the past, seriously wounded patients had to go to Turkey, risking dangerous delays at the border, he said. Now, once patients are stabilized in Atmeh, they are sent to a sister clinic across the border for follow-up care.


In Orient’s ICU, a 24-year-old rebel fighter was breathing oxygen through a mask. He had been brought in a day earlier, bleeding heavily from stomach wounds and close to death, said Dr. Maen Martini, a volunteer physician from Joliet, Illinois. After surgery, he stabilized and was taken off a respirator. A delayed crossing into Turkey would have killed him, Martini said.


The fighter’s neighbor was little Fahed, whose house had been struck by a missile on Saturday in the village of Kafr Zeita in Hama province. “The roof collapsed on us,” his mother said of the attack. “We ran out … I saw him bleeding from his head, but it was just a small cut.”


The local clinic said the injury was more serious than it seemed and the family rushed to Atmeh, more than 100 kilometers (60 miles) to the north.


Since surgery, Fahed has been nursing and has moved his arms and legs, and the doctor is hoping for a near-complete recovery.


“Clinically, he has improved dramatically,” he said.


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Google launches ‘scan and match’ music service






LOS ANGELES (AP) — Google is turning on a “scan and match” service for Google Music users to store copies of their songs online, offering for free what Apple charges $ 25 a year for.


The service, which launched Tuesday, cuts uploading time for those who want to save their music libraries online. It scans a user’s computer and gives them online access to the songs it finds, as long as they match the songs on its servers. Otherwise, it will upload songs to a user’s online locker.






The service is similar to Apple Inc.‘s iTunes Match, which includes online storage for 25,000 songs. Google Inc. allows storage for 20,000 songs and allows users to re-download the songs only at the same quality as they were at previously. Apple upgrades songs to iTunes quality.


Amazon runs a similar matching and uploading service called Cloud Player. It costs $ 25 a year for 250,000 songs. A free version is limited to 250 songs.


Google is still a fledgling entrant into music sales since debuting its store in November 2011, though it expects to benefit from the hundreds of millions of devices that use its Android operating system on mobile devices.


According to the NPD Group, Apple accounted for 64 percent of U.S. music sales online, followed by Amazon at 16 percent. Google has no more than 5 percent, according to NPD. Other services make up the rest.


Google had sold songs at a discount at the start, but that is less so the case now. For example, it was selling the top-ranked Bruno Mars song “Locked Out of Heaven” for $ 1.29 on Wednesday, the same as iTunes, and above the 99 cents on Amazon. But its album price was lower at $ 10.49 versus $ 10.99 at both iTunes and Amazon.


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“Ai Weiwei: Never Sorry,” “Bully” first theatrical releases to win duPont awards






LOS ANGELES (TheWrap.com) – Two documentary films were among the 14 winners of the 2013 Alfred I. duPont-Columbia University Award, making them the first theatrical releases to be honored with the prize. USA Today also won its first duPont award.


“Ai Weiwei: Never Sorry,” Alison Klayman‘s profile of the Chinese artist-activist, and Emmy-winning filmmaker Lee Hirsch‘s tale of schoolyard torment, “Bully,” won alongside reporting from Current TV, CBS News, NPR, PBS’s “Frontline” and USA Today.






USA Today was honored for multimedia reporting on abandoned lead factories, and NPR’s “StoryCorps” will win its first silver baton.


Five awards will go to local television and radio stations: KCET in Southern California, KLAS-TV in Las Vegas, WVUE-TV in New Orleans, Detroit’s WXYZ-TV and partnerships with WHYY and NPR.


“This exceptional group of journalists represents the best of broadcast, documentary and digital news reporting today,” Bill Wheatley, the outgoing duPont Jury chair and the former executive vice president of NBC News, said in a statement. “These groundbreaking stories set the standard for excellent reporting; journalists gained access and insight into critical issues in the public interest, and they are telling these important stories in new ways.”


Christiane Amanpour, CNN’s chief international correspondent and a global affairs anchor for ABC News will present the awards with CBS News’s Byron Pitts on Tuesday, January 22, 2013 at Columbia’s Low Memorial Library.


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24HR HomeCare Now Offers All Services in Walnut Creek






24-Hour Care announced to day that they now offer all in-home care services in Walnut Creek.


Walnut Creek, Ca (PRWEB) December 19, 2012






24-Hour Care announced to day that they now offer all in-home care services in Walnut Creek. 24-Hour Care is a leading provider of in-home services to those in need.


On July 21, the Walnut Creek office opened its doors at 1399 Ygnacio Valley Road, Walnut Creek, California. 24-Hour Home Care is a quality in-home care service for disease specific clients and those in need. They provide care for a few hours a day or round-the-clock.


The client’s needs are reviewed in an in-home consultation process that results in a customized care plan, an on-call emergency guide, client health information, and a caregiver profile. 24-Hour Care develops a profile of a caregiver for a client. Disease specific care includes cancer, Alzheimer’s/dementia, heart disease, hospice and diabetes.


24-Hour Care list of services includes personal care, light housekeeping, meal preparation, medication reminders, companionship, transportation and emergency response system. Personal care includes assistance with bathing, dressing and grooming, and with mobility. Light housekeeping includes cleaning the house, taking out the trash, washing dishes and doing laundry. Meal preparation includes preparing nutritional and proper food. Medication reminders include keeping daily logs and giving right dosages. Companionship includes socialization, walking and playing stimulating games. Transportation includes accompanying the client on trips to the doctor, the hospital, on errands and on long trips to provide companionship. The emergency response system includes the installation of a system that alerts emergency personnel and family of an emergency. A simple push of a button takes care of all the necessary emergency communications.


24-Hour Care thoroughly vets their caregiver candidates for positions with local, state and national background checks in a 24 point screening process. They check candidates against the national criminal child sex offender listings with the Dru Sjodin Registry. Candidates are matched with those in need in a process that guarantees a good pairing.


24-Hour Care stresses punctuality with their employees and ensures they arrive at a client’s home on time with employee phone check-ins. They bond and insure their employees and cover them with worker’s comp insurance. An injury occurring in a client’s home is covered by worker’s comp, according to representatives. Employees are also protected with criminal bonding insurance. According to 24-Hour Care, their liability insurance covers clients from general, non-auto owned, professional, physical and sexual misconduct. They will provide proof of insurance during the client consultation upon request.


24-Hour Care has a quality assurance program that guarantees standards of high quality and service for every client. Along with the newly opened office in Walnut Creek, they serve Culver City, Encino, Irvine and Torrance. In Walnut Creek, contact them by phone at (925) 322-8627 or by visiting their website: 24hrcares.com/caregivers-walnut-creek


David Allerby
24Hr HomeCare
(800) 522-1516
Email Information


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GM to buy stake from Treasury; government may lose billions






(Reuters) – The U.S. Treasury plans to sell its stake in General Motors Co over the coming year, all but assuring a multibillion-dollar loss in a move that will end the automaker’s “Government Motors” era.


Treasury’s plan – a two-step process that includes a $ 5.5 billion stock sale to GM – is part of a broader push to wind down the controversial financial bailout under the Troubled Asset Relief (TARP) program. TARP was created by former president George W. Bush to prevent the collapse of the U.S. banking industry during the 2007-2009 financial crisis.






The planned GM sale will raise the proceeds that Treasury has recovered to $ 28.6 billion of the $ 50 billion bailout GM received. With $ 20.9 billion left from the original bailout, the government would have to sell its remaining shares at an average price of $ 69.72 to break even.


GM shares were up 7.1 percent at $ 27.31 on Wednesday afternoon on the New York Stock Exchange.


If Treasury, which will reduce its stake to about 19 percent when the buyback closes this month from about 26 percent at present, sold its remaining stock at the price GM is paying now, it would come up short by more than $ 12 billion.


“GM wins,” Jefferies analyst Peter Nesvold said, pointing to the elimination of the government stake that has been acting as a drag on the stock price and to eventual higher earnings per share. “From a government standpoint, it’s a mixed bag, but they went into it to save jobs, not as an investment.” He said the buyback was lower than the $ 30 a share he had expected at the very least and was occurring earlier than anticipated.


GM’s planned buyback of 200 million shares will give it more freedom from government oversight and likely result in a sales boost as some consumers unhappy over the U.S. taxpayer-funded bailout give the automaker a second look, GM Chief Financial Officer Dan Ammann said.


“This is very attractive to the company, to our shareholders,” he told reporters at GM’s Detroit headquarters. “It obviously brings some clarity and certainty around the U.S. Treasury exit.


“It’s obviously good for the business in terms of continuing to remove the perception of government involvement in the company, which is going to be good for sales,” he said, also noting that the reduced share count would boost earnings.


GM approached Treasury officials after the U.S. presidential election in November, but was rebuffed when it offered only to pay market value for the government’s stock, according to a senior Treasury official. Treasury rejected a second offer of a small premium before the sides finalized the deal on Tuesday afternoon, said the Treasury official, who asked not to be identified discussing the negotiations.


“We’ve always looked at this as balancing speed of exit with maximizing return, and GM basically made us what we felt was a very attractive offer,” the Treasury official said.


TARP TRIP NEARS END


TARP was approved by Congress as a $ 700 billion program, though Treasury eventually disbursed $ 418 billion. On Wednesday it said it had recovered $ 381 billion to date, or about 90 percent.


“TARP was always meant to be a temporary, emergency program. The government should not be in the business of owning stakes in private companies for an indefinite period of time,” Treasury Assistant Secretary Timothy Massad said in a statement.


“Moving to exit our investment in GM within the next 12 to 15 months is consistent with our dual goals of winding down TARP as soon as practicable and protecting taxpayer interests.”


Under the deal, GM will pay $ 27.50 a share for the Treasury-held shares, representing a 7.9 percent premium on Tuesday’s closing price.


Treasury said it will then sell its remaining stake of about 300.1 million shares “through various means in an orderly fashion,” and could begin the process, including sales on the open market, as soon as January.


The auto giant was dubbed “Government Motors” by many critics after it received its bailout package as part of the bankruptcy restructuring in 2009 under TARP.


Treasury’s plans echo other recent moves. On Tuesday, Treasury said it would largely sell its remaining shares in bailed-out banks over the coming 12 to 15 months. Last week it sold the last of its common stock in American International Group Inc at a profit.


This also would close Treasury’s involvement with the U.S. auto sector. In June 2011, the agency sold its remaining 6 percent stake in Chrysler to Italy’s Fiat SpA , which controls the U.S. automaker.


U.S. President Barack Obama heavily promoted his decision to use public funds to rescue the auto industry and save jobs as he campaigned for re-election in swing states like Michigan and Ohio. Voters in both states backed him again in the November 6 election, providing critical support in his victory.


Treasury officials reiterated on Wednesday that the auto bailout saved more than 1 million U.S. jobs and was not meant to turn a profit.


With Treasury’s planned exit from GM, auto lender Ally Financial Inc will be the last major TARP recipient that has not yet paid back the government. Of the $ 17 billion it owes, Ally has paid back $ 5.8 billion.


SHOWING CONFIDENCE


Separately on Wednesday, Canada Finance Minister Jim Flaherty said his country had no immediate plans to sell its stake in GM. Canada and the province of Ontario have a combined 9 percent stake.


Ammann said the move and resulting Treasury plans will remove a “significant overhang” on the stock that has hurt sales and bring an “element of closure” to the bailout. Company research suggests eliminating the Treasury stake would benefit sales, he said.


Ammann said the deal was good for shareholders, when asked whether GM might be sued for paying Treasury a higher price than where the stock was trading at the time of the announcement.


However, one large shareholder loved the deal, as a spokesman for hedge fund manager David Einhorn said: “We applaud GM management for unlocking shareholder value by releasing excess capital and beginning a resolution of the government stake overhang.”


Barclays analyst Brian Johnson said that once the government reduces its stake, GM likely will be eligible for inclusion in the Standard & Poor’s 500 index <.spx>, which could serve as a catalyst to drive up the company’s stock price.</.spx>


GM will end the year with estimated liquidity of about $ 38 billion, even after the deal, Ammann said. That will add to earnings per share by reducing the number of outstanding shares by about 11 percent.


Ammann said the deal will be funded through cash and not tap in to the $ 11 billion credit line GM secured last month.


Citi analyst Itay Michaeli said the deal showed GM’s confidence in its ability to generate cash despite worries about the U.S. economy and the recession in Europe. “The ability to spend this amount of money on a share buyback shows they are putting their money where their mouth is,” he said.


The deal also made a winner of Ammann, considered one of a handful of GM executives who could succeed Chief Executive Dan Akerson. Ammann, along with Akerson and GM general counsel Michael Millikin, negotiated the deal with Massad, Treasury Secretary Timothy Geithner, chief investment officer Matt Pendo and government attorneys over several weeks, according to the senior Treasury official and another person familiar with the talks who asked not to be identified.


Ammann did not provide details of the talks with Treasury, when asked whether negotiations picked up following the presidential election. Analysts said Treasury likely did not want this deal to be turned into a political issue.


Treasury also may have wanted to wait for the unveiling of the critical full-size pickup trucks that will go on sale next year, analysts said. GM showed the new Chevrolet Silverado and GMC Sierra on December 13.


GM will take a charge of about $ 400 million in the fourth quarter tied to the buyback.


In addition, Treasury relinquished certain governance rights, including required levels of U.S. manufacturing and barring the purchase of corporate jets, Ammann said. Senior executive payment caps under TARP remain in place.


“For GM management, it was very important to get out from under the ‘Government Motors’ moniker,” Morgan Stanley analyst Adam Jonas said.


(Additional reporting by Alister Bull in Washington, Jennifer Ablan in New York, Paul Lienert in Detroit and Rick Rothacker in Charlotte, North Carolina; Editing by Gerald E. McCormick, Jeffrey Benkoe, Tim Ahmann, Matthew Lewis and Jan Paschal)


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Worries grow in east Congo with fighter buildup






DAKAR, Senegal (AP) — Aid workers warned Wednesday that armed groups are setting up new front lines in and around the city of Goma in eastern Congo, where the U.N. said it now has documented at least 126 rape cases last month.


Thousands of fighters from the M23 rebel group withdrew several weeks ago from Goma, and the fighters have since taken steps toward negotiating with the Congolese government.






However, residents in Goma say M23 and other armed fighters are now positioning themselves in an around the city — including inside camps for people displaced by the violence.


The arrival of several thousand fighters within the last week is prompting fear among civilians, who already have experienced years of fighting and rebellions, said Tariq Riebl, Oxfam’s humanitarian coordinator there.


“They are very concerned — people are seeing this and they don’t know what it means,” he said. “I think what everyone is scared about is that it seems like people are ramping up, ramping up but for what purpose?”


Oxfam warns that more than 1 million people could come under attack if violence again flares in Goma, where more than 100,000 people already have fled from elsewhere in the region.


“Goma is typically the last refuge safe haven and now it’s being directly called into question. If Goma falls in a big battle, where are people going to go?” Riebl said.


“This is very, very disconcerting because you have a population of over 1 million people and if war were to break out, we’re looking at a horrific situation.”


The M23 rebel group, which is believed to be backed by neighboring Rwanda, is made up of hundreds of soldiers who deserted the Congolese army in April.


They took control of many villages and towns in the mineral-rich east over the last seven months, culminating in the seizure of Goma on Nov. 20. It took days of negotiations and intense international pressure, including from the U.N., for the thousands of fighters from M23 to finally withdraw from the regional capital.


The U.N. mission says it’s received allegations of serious rights violations, including killings and wounding of civilians, rape, looting, and forced recruitment of children, by elements of the M23 rebels in Goma and neighboring areas.


Congo’s armed forces are also blamed for a series of attacks as they fled Goma in retreat in late November.


The U.N. said Tuesday it now has been able to document at least 126 rapes during that period in the Minova area, about 60 kilometers (40 miles) south of Goma.


U.N. spokesman Martin Nesirky said that two Congolese soldiers so far have been arrested in connection with the rapes, while seven others had been implicated in looting in the area.


“The Congolese Armed Forces have started investigating those human rights violations,” he said. “The U.N. Mission is supporting the military justice procedure in conducting thorough investigations into these allegations to ensure that the perpetrators are identified and held accountable.”


Rape has long been used as a brutal weapon of war in eastern Congo, where both soldiers and various armed groups use sexual violence to intimidate, punish and control the population.


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New Android botnet discovered across all major networks






A new Android spam botnet has been discovered across all major networks that sends thousands of text messages without a user’s permission, TheNextWeb reported. The threat, which is known at SpamSoldier, was detected on December 3rd by Lookout Security in cooperation with an unnamed carrier partner. The malware is said to spread through a collection of infected phones that send text messages, which usually advertise free versions of popular paid games like Grand Theft Auto and Angry Birds Space, to hundreds of users each day.


[More from BGR: Facebook’s Instagram monetization plan: License users’ photos without paying for them]






Once a user clicks on the link to download the game, his or her phone instead downloads the malicious app. When the app is downloaded, SpamSoilder removes its icon from the app drawer, installs a free version of the game in question and immediately starts sending spam messages.


[More from BGR: How not to fix Apple Maps]


The security firm notes that the threat isn’t widespread, however it has been spotted on all major carriers in the U.S. and has potential to do serious damage if something isn’t done soon to stop it.


This article was originally published by BGR


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CBS dominates week in TV ratings






NEW YORK (AP) — CBS had little competition for dominance last week in the television ratings.


The network had 17 of the 25 most-watched programs on the air last week, according to the Nielsen company. It beat second-place NBC by an average of nearly four million viewers a night last week, and also took the 18-to-49-year-old demographic that advertisers seek.






“60 Minutes” and “NCIS” were the most popular shows on CBS last week. As is typical in the fall, NBC‘s Sunday night football matchup was the week’s most-watched show.


One end-of-year tradition, Barbara Walters‘ survey of the year’s most popular personalities, finished No. 27 in the week’s ratings with 7.6 million viewers.


On cable, Showtime’s “Dexter” and “Homeland” both hit series records for their season finale episodes on Sunday. “Dexter” had 2.8 million viewers and “Homeland” had 2.3 million. Showtime preceded each episode with a disclaimer, warning that audiences might find the shows too intense so soon after the Connecticut school killings.


CBS averaged 11.9 million viewers for the week in prime time (7.3 rating, 12 share). NBC had 7.3 million (4.5, 7), ABC had 5.1 million (3.3, 5), Fox had 4.4 million (2.7, 4), the CW had 1.7 million (1.1, 2) and ION Television had 1.3 million (0.9, 1).


Among the Spanish language networks, Univision led with an average of 3.2 million viewers (1.7, 3). Telemundo had 1.3 million (0.7, 1), TeleFutura had 850,000 (0.4, 1), Estrella had 340,000 (0.2, 0) and Azteca had 140,000 (0.1, 0).


NBC‘s “Nightly News” topped the evening newscasts with an average of 9.4 million viewers (6.3, 12). ABC’s “World News” was second with 8.3 million (5.5, 11) and the “CBS Evening News” had 7.2 million viewers (4.9, 9).


A ratings point represents 1,147,000 households, or 1 percent of the nation’s estimated 114.7 million TV homes. The share is the percentage of in-use televisions tuned to a given show.


For the week of Dec. 10-16, the top 10 shows, their networks and viewerships: NFL Football: San Francisco at New England, NBC, 23.23 million; “60 Minutes,” CBS, 19.63 million; “NCIS,” CBS, 17.65 million; “The Big Bang Theory,” CBS, 16.74 million; “NCIS: Los Angeles,” CBS, 15.12 million; “Sunday Night NFL Pre-Kick,” NBC, 14.62 million; “Person of Interest,” CBS, 14.08 million; “Two and a Half Men,” CBS, 13.34 million; “The Voice” (Monday), NBC, 12.33 million; “Criminal Minds,” CBS, 12.01 million.


___


ABC is owned by The Walt Disney Co. CBS is owned by CBS Corp. CW is a joint venture of Warner Bros. Entertainment and CBS Corp. Fox and My Network TV are units of News Corp. NBC and Telemundo are owned by Comcast Corp. ION Television is owned by ION Media Networks. TeleFutura is a division of Univision. Azteca America is a wholly owned subsidiary of TV Azteca S.A. de C.V.


___


Online:


http://www.nielsen.com


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Shorter hospital stays don’t mean worse care: study






NEW YORK (Reuters Health) – U.S. Veterans Affairs hospitals were able to reduce their patients’ length of stay without increasing the number of people who needed to be readmitted later on, according to a new study.


“As hospitals became more efficient there was this growing concern that we were discharging patients – as some would say – sicker and quicker,” said the study’s lead author Dr. Peter Kaboli.






“In fact, we found just the opposite,” said Kaboli, who works at the Iowa City VA Health Care System.


According to the researchers, who published their findings in the Annals of Internal Medicine, hospitals are under pressure to cut the amount of time their patients spend there.


It’s a goal that benefits everyone, they write, because getting patients out of the hospital faster reduces the risk of infection and also cuts costs.


But some worry that discharging patients earlier increases the chance they will return to the hospital for additional care. Such readmissions cost the U.S. Medicare program an estimated $ 17 billion every year, according to a 2009 study.


What’s more, on October 1 of this year, the Centers for Medicare and Medicaid Services started using readmission rates and patient outcomes as a way to determine how much money hospitals should be paid.


For the new study, Kaboli and his colleagues, wanted to see if shorter stays throughout the VA’s 129 centers meant more patients returned to the hospital within 30 days of discharge.


Using the VA’s electronic medical records, the researchers analyzed over 4 million patients’ records from between 1997 and 2010.


They found the average hospital stay decreased from about 5.5 days at the beginning of the study to about 4 days at the end.


As for the number of patients who returned to the hospital within 30 days of their discharge, the researchers found that rate fell by 3 percentage points, from 16.5 percent in 1997 to 13.8 percent in 2010.


“I felt going into this that (length of stay) wouldn’t make a difference, but showing that it reduces readmission was a positive and reassuring find,” said Kaboli.


QUALITY MEASURES


The researcher found, however, that there was a point where a short length of stay was linked to more patients being readmitted. Hospitals with lengths of stay at least one day shorter than the average ended up seeing an increase in readmissions.


There were also concerns that some of the patients died at home instead of returning to the hospital. But the researchers found that the number of people dying within 90 days of leaving the hospital also decreased during those 14 years.


“For patients, we’ve been able to take care of them more efficiently, with better quality and reducing mortality rates all at the same time,” said Kaboli.


But Morris Weinberger, of Duke University, and Dr. Eugene Oddone, of the University of North Carolina at Chapel Hill question whether readmission rates are a good measure of a hospital’s quality.


They write in an editorial accompanying the new study that a number of factors outside of a typical doctor’s control can influence the risk of a person being readmitted to the hospital.


In October, a study suggested that a person’s employment status, living situation and education are all linked to their risk of being readmitted to the hospital (see Reuters Health article of October 19, 2012 here: http://reut.rs/Z7uCy9).


Dr. Manesh Patel, an assistant professor of cardiology at Duke University in Durham, told Reuters Health that this study shows that the VA system improved in areas that patients care about.


“The good news here is that there seems to be a linkage… Some of these measures that we’re using might be reasonable measures,” said Patel, who was not involved in the new research but has studied hospital readmissions.


Kaboli added that it’s also important to not just focus on getting patients out of the hospital. It’s also important to respect their wishes.


“This is a team effort. (Patients) need to communicate their goals and wishes, and have these conversations with the nurse and doctors so everyone is working toward a common goal,” he said.


SOURCE: http://bit.ly/SLWzwm and http://bit.ly/SMrvg5 Annals of Internal Medicine, online December 17, 2012.


Seniors/Aging News Headlines – Yahoo! News





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NBC’s Engel, TV crew escape abduction in Syria






BEIRUT (AP) — NBC‘s chief foreign correspondent Richard Engel said Tuesday he and members of his network crew escaped unharmed after five days of captivity in Syria, where more than a dozen pro-regime gunmen dragged them from their car, killed one of their rebel escorts and subjected them to mock executions.


Appearing on NBC’s “Today” show, an unshaven Engel said he and his team escaped during a firefight Monday night between their captors and rebels at a checkpoint. They crossed into Turkey on Tuesday.






NBC did not say how many people were kidnapped with Engel, although two other men, producer Ghazi Balkiz and photographer John Kooistra, appeared with him on the “Today” show. It was not confirmed whether everyone was accounted for.


Engel said he believes the kidnappers were a Shiite militia group loyal to the Syrian government, which has lost control over swaths of the country’s north and is increasingly on the defensive in a civil war that has killed 40,000 people since March 2011.


“They kept us blindfolded, bound,” said the 39-year-old Engel, who speaks and reads Arabic. “We weren’t physically beaten or tortured. A lot of psychological torture, threats of being killed. They made us choose which one of us would be shot first and when we refused, there were mock shootings,” he added.


“They were talking openly about their loyalty to the government,” Engel said. He said the captors were trained by the Iranian Revolutionary Guard and allied with Hezbollah, the Lebanese Shiite militant group, but he did not elaborate.


There was no mention of the kidnapping by Syria’s state-run news agency.


Both Iran and Hezbollah are close allies of the embattled Syrian government of President Bashar Assad, who used military force to crush mostly peaceful protests against his regime. The crackdown on protests led many in Syria to take up arms against the government, and the conflict has become a civil war.


Engel said he was told the kidnappers wanted to exchange him and his crew for four Iranian and two Lebanese prisoners being held by the rebels.


“They captured us in order to carry out this exchange,” he said.


Engel and his crew entered Syria on Thursday and were driving through what they thought was rebel-controlled territory when “a group of gunmen just literally jumped out of the trees and bushes on the side of the road.”


“There were probably 15 gunmen. They were wearing ski masks. They were heavily armed. They dragged us out of the car,” he said.


He said the gunmen shot and killed at least one of their rebel escorts on the spot and took the hostages into a waiting truck nearby.


Around 11 p.m. Monday, Engel said he and the others were being moved to another location in northern Idlib province.


“And as we were moving along the road, the kidnappers came across a rebel checkpoint, something they hadn’t expected. We were in the back of what you would think of as a minivan,” he said. “The kidnappers saw this checkpoint and started a gunfight with it. Two of the kidnappers were killed. We climbed out of the vehicle and the rebels took us. We spent the night with them.”


Engel and his crew crossed back into neighboring Turkey on Tuesday.


The network said there was no claim of responsibility, no contact with the captors and no request for ransom during the time the crew was missing.


NBC sought to keep the disappearance of Engel and the crew secret for several days while it investigated what happened to them. Major media organizations, including The Associated Press, adhered to a request from the network to refrain from reporting on the issue out of concern it could make the dangers to the captives worse. News of the disappearance did begin to leak out in Turkish media and on some websites on Monday.


Syria has become a danger zone for reporters since the conflict began.


According to the Committee to Protect Journalists, Syria is by far the deadliest country for the press in 2012, with 28 journalists killed in combat or targeted for murder by government or opposition forces.


Among the journalists killed while covering Syria are award-winning French TV reporter Gilles Jacquier, photographer Remi Ochlik and Britain’s Sunday Times correspondent Marie Colvin. Also, Anthony Shadid, a correspondent for The New York Times, died after an apparent asthma attack while on assignment in Syria.


The Syrian government has barred most foreign media coverage of the civil war in Syria. Those journalists whom the regime has allowed in are tightly controlled in their movements by Information Ministry minders. Many foreign journalists sneak into Syria illegally with the help of smugglers and travel with rebel escorts or drivers.


Engel joined NBC in 2003 and was named chief foreign correspondent in 2008. He previously worked as a freelance journalist for ABC News, including during the U.S. invasion of Iraq. He has lived in the Middle East since graduating from Stanford University in 1996.


Middle East News Headlines – Yahoo! News





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