Experts say psychological effects of Sandy likely to grow

Fairfield, Connecticut (Reuters) – The devastating winds and catastrophic flooding of Superstorm Sandy may have subsided, but psychological distress from the disaster and its patchy recovery is likely to be growing, trauma experts say.

Those most vulnerable to long-term emotional fallout from the storm are people who lost loved ones or whose homes were destroyed. But the disruption to normal life could well affect millions of others, experts say.

From New York City to commuter towns to Atlantic Ocean seaside resorts, daily routines have been turned upside down by power outages, fuel shortages, blocked roads, closed schools and canceled trains and buses.

Thousands of people are scrambling to find housing, and children missed as much as a week of school. Homeowners are relying on candles, flashlights and canned food as temperatures dip to wintry levels.

Elderly people have been trapped in high-rise apartments with no lights or working elevators, and sick people living alone have been unable to refill prescriptions.

In Fairfield, Connecticut, a waitress at a downtown cafe brought her elderly mother to work. “She has nowhere to go and can’t function alone in the dark,” said the frazzled waitress.

Such challenges are “the grinding, daily wear and stress of a natural disaster,” said George Bonanno, a clinical psychology professor who specializes in post-traumatic stress disorder at Teachers College at Columbia University in New York.

Some people will develop anxiety, despair and relationship problems, he said, while others could over time see their immune systems compromised and get sick more easily.

Psychological research shows the leading impact of natural disasters is post-traumatic stress syndrome, characterized by nightmares, flashbacks or a sense of detachment, along with depression and other anxiety disorders.

Among those particularly at risk are people who feel they have little control over their lives or have a fatalistic world view, according to research.

“You definitely worry about folks getting depressed, hopeless, feeling they don’t have control,” said David Yusko, assistant clinical director at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania.

Many people may experience sleep problems, panic attacks, rapid heartbeats and gastro-intestinal distress, he said.

That sense of control is key, said Scott Feldman, a social worker who recounted helping a young displaced mother on New York‘s Staten Island, which was devastated by the storm.

The woman, with one baby 18 months old and a second just seven weeks old, called the delivery at a shelter of some special baby formula a miracle, he said.

Feldman reminded her that, rather than it being a miracle, she had advocated for her children, let neighbors know what she needed and was part of a community.

“It gave her more of a sense of control over her life, and that’s really important,” Feldman said.

(Editing by Ellen Wulfhorst and Todd Eastham)

Seniors/Aging News Headlines – Yahoo! News

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Methane warnings ignored before NZ mine disaster

WELLINGTON, New Zealand (AP) — A New Zealand coal mining company ignored 21 warnings that methane gas had accumulated to explosive levels before an underground explosion killed 29 workers two years ago, an investigation concluded.

The official report released Monday after 11 weeks of hearings on the disaster found broad safety problems in New Zealand workplaces and said the Pike River Coal company was exposing miners to unacceptable risks as it strove to meet financial targets.

“The company completely and utterly failed to protect its workers,” New Zealand Prime Minister John Key said Monday.

The country’s labor minister, Kate Wilkinson, resigned from her labor portfolio after the report’s release, saying she felt it was the honorable thing to do after the tragedy occurred on her watch. She plans to retain her remaining government responsibilities.

The Royal Commission report said New Zealand has a poor workplace safety record and its regulators failed to provide adequate oversight before the explosion.

At the time of the disaster, New Zealand had just two mine inspectors who were unable to keep up with their workload, the report said. Pike River was able to obtain a permit with no scrutiny of its initial health and safety plans and little ongoing scrutiny.

Key said he agrees with the report’s conclusion that there needs to be a philosophical shift in New Zealand from believing that companies are acting in the best interests of workers to a more proscriptive set of regulations that forces companies to do the right thing.

The commission’s report recommended a new agency be formed to focus solely on workplace health and safety problems. It also recommended a raft of measures to strengthen mine oversight.

Key said his government would consider the recommendations and hoped to implement most of them. He would not commit on forming a new agency. Workplace safety issues are currently one of the responsibilities of the Ministry of Business, Innovation and Employment.

In the seven weeks before the explosion, the Pike River company received 21 warnings from mine workers that methane gas had built up to explosive levels below ground and another 27 warnings of dangerous levels, the report said. The warnings continued right up until the morning of the deadly explosion.

The company used unconventional methods to get rid of methane, the report said. Some workers even rigged their machines to bypass the methane sensors after the machines kept automatically shutting down — something they were designed to do when methane levels got too high.

The company made a “major error” by placing a ventilation fan underground instead of on the surface, the report found. The fan failed after the first of several explosions, effectively shutting down the entire ventilation system. The company was also using water jets to cut the coal face, a highly specialized technique than can release large amounts of methane.

The report did not definitively conclude what sparked the explosion itself, although it noted that a pump was switched on immediately before the explosion, raising the possibility it was triggered by an electrical arc.

The now-bankrupt Pike River Coal company is not defending itself against charges it committed nine labor violations related to the disaster. Former chief executive Peter Whittall has pleaded not guilty to 12 violations and his lawyers say he is being scapegoated.

An Australian contractor was fined last month for three safety violations after its methane detector was found to be faulty at the time of the explosion.

Australia / Antarctica News Headlines – Yahoo! News

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Small margin splits dramatically different candidates

WASHINGTON (AP) — Suspense over the too-close-to-call presidential race has partly obscured the fact that Americans on Tuesday will choose between two dramatically different visions of government's proper role in our lives. The philosophical gulf between the two nominees is wide, even if the vote totals may be razor-thin.

With record numbers of people on food stamps and other assistance, President Barack Obama emphasizes "we're all in this together" — code for sweeping government involvement. His campaign theme song is "We Take Care of Our Own." Romney wants smaller government, including fewer regulations — rejecting Obama's contention that they're needed after the meltdowns in financial and mortgage markets and a major oil spill in the Gulf of Mexico. His theme song is the individualist anthem, "(I Was) Born Free."

For all their philosophical differences, neither man has hit Americans between the eyes with the painful truth of what it will take to tame deficit spending, driven by the public's demand for low taxes and high services.

This year's voters are unlikely to make big changes in Congress. After dramatic swings in the past three congressional elections, and ongoing assessments of the tea party's influence, power may not end up shifting on Capitol Hill for a while. The fiercely divided Congress may continue to block major presidential initiatives, regardless of who's in the White House, unless there's the type of bipartisan breakthrough that has proven elusive.

An Obama win presumably would keep the government roughly on its current course. Congressional Republicans would be unable to rescind his biggest domestic achievement, "Obamacare," which eventually will require everyone to have health insurance.

Writ large, Obama's approach to governing is a new generation of the New Deal and the Great Society. The federal government tries to balance interests such as energy exploration and the environment, private enterprise and consumer protection.

Romney's approach echoes Ronald Reagan's declaration that government is the problem, not the solution.

In a January GOP debate, Romney said: "Government has become too large. We're headed in a very dangerous direction. I believe to get America back on track, we're going to have to have dramatic, fundamental, extraordinary change in Washington to be able to allow our private sector to once again re-emerge competitively, to scale back the size of government."

Romney later said, "I was a severely conservative governor" of Massachusetts (a label at odds with his actual record there).

It's unlikely that a Romney presidency would reshape the federal government to the extent such rhetoric suggests. Like many politicians, Romney is more expansive with his promises than with details for achieving them.

He vows to slash spending and put the nation on a path to balanced budgets, for instance. Pressed for details, Romney offers few beyond ending the tiny federal subsidy to public television and "Big Bird."

Obama has gone a bit further in specifying how he would reduce the deficit. Unlike Romney, he would raise taxes on the wealthiest.

In a 50-50 nation, however, no politician wants to be the first to forcefully tell voters why it's impossible to achieve their three-pronged desire of keeping taxes low, keeping government services level and balancing the budget.

No matter who is president, the huge domestic challenge of 2013 will be to persuade Congress to compromise on tax and spending issues.

Many GOP lawmakers are adamant about keeping tax rates lower for everyone — including the richest households — than they were in Bill Clinton's presidency, which produced the last balanced budget. Congressional Democrats insist that any deficit-reduction plan include increased revenues, from the wealthiest taxpayers if no one else, along with spending cuts.

The package of major tax hikes and spending cuts scheduled to hit on Jan. 1 — the "fiscal cliff," which could start a new recession -- will pose a huge challenge to whoever wins Tuesday.

Because of congressional gridlock, a Romney presidency might produce more dramatic changes through the other branches of government. Romney repeatedly has said he'd like to see a reversal of the 1973 Roe v. Wade decision, which legalized abortion. He might be able to appoint conservative justices to the Supreme Court to fulfill that wish.

It's hard to know how U.S. society, so accustomed to the abortion status quo of four decades, would react to states suddenly outlawing the procedure.

Hurricane Sandy is a reminder of how different political philosophies can affect people at more mundane, day-to-day levels. Romney has suggested shifting much of the responsibility for emergency management from the federal government to the states. That approach might have severely tested New Jersey this fall. But conservatives grow weary of looking to Washington to solve problem after problem.

In unguarded moments, politicians sometimes show their clearest philosophical leanings. Romney's much discussed remarks at a private fundraiser — criticizing the 47 percent of Americans who don't pay income taxes — suggested he sees a world of givers and takers. Such societies, he says, are in danger of having the government-dependent takers overwhelm the job-creating givers.

Republicans, on the other hand, pounced on Obama's non-scripted "you didn't build that" comment, his contention that people who built businesses had help, from teachers, family and other supporters — and sometimes the government. Obama said he was noting that successful businesses rely on government roads, schools, water, police protection and other tax-paid amenities.

The "you didn't build that" controversy underscored philosophical differences that voters will choose between Tuesday. Obama and Romney look at the same set of facts — in this case, successful businesses — and seize on different aspects.

The election winner may have a hard time pushing his agenda through a divided Congress. But voters have a vivid choice about what that agenda should look like.

___

EDITOR'S NOTE — Charles Babington covers national politics for The Associated Press.

An AP News Analysis

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Apple sells three million iPads over first weekend

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Springsteen Sandy telethon raises $23 million, ABC more than $10 million

(Reuters) – Bruce Springsteen, Billy Joel, Mary Blige and dozens of other musicians and celebrities helped raise some $ 23 million for victims of Hurricane Sandy on NBC television, while a Day of Giving on ABC TV networks raised more than $ 10 million.

The American Red Cross said the one-hour NBC telethon on Friday, featuring performances by celebrities with strong New York and New Jersey connections, generated a record number of individual donations by phone, text and online for victims of Sandy.

The preliminary amount raised was nearly $ 23 million, the Red Cross said in a statement.

On ABC on Monday, viewers and celebrities had raised more than $ 10 million, also for the American Red Cross, midway through a day-long fundraiser for victims of last week’s storm, which devastated the U.S. Northeast and killed more that 100 people.

Journalist Barbara Walters made a personal donation of $ 250,000 and manned phone lines during breakfast show “Good Morning America” along with Katie Couric, actor Ben Stiller and “Jersey Shore” star Nicole “Snooki” Polizzi, ABC said. Donations are expected to rise further during the day-long event.

(Reporting by Jill Serjeant in Los Angeles; Editing by Richard Chang)

Music News Headlines – Yahoo! News

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Newer Docs Might Be Driving Up Health Care Costs

Image courtesy of iStockphoto/prosot-photography

Health care spending increases have slowed over the past couple years. Still, we are spending some $ 2.6 trillion–that’s trillion with a “T”–a year on health costs, which is a higher percentage of our GDP than any other developed country. And we don’t seem to be getting that much healthier. So economists and policy researchers are looking for ways to staunch the bleeding while ensuring that care remains good. One group who can have a great influence on the overall cost of health care are the doctors–your primary care physician and your specialists. They are often the ones deciding how many tests and procedures to order and whether to follow evidence-based recommendations on the most effective options. Until now, little research had been done examining how much doctors differ in the costliness of their practice styles–just how much their work was costing insurers. A recent report conducted by the RAND Corporation, a nonprofit, nonpartisan policy institution, shows that the biggest predictor of a doctor’s overall costs to the health care system is how long he or she has been practicing. “It is possible that one driver of health care costs is that newly trained physicians practice a more costly style of medicine,” Ateev Mehrotra, an associate professor at the University of Pittsburgh School of Medicine and a researcher at RAND, said in a prepared statement. Doctors, including primary care physicians and specialists, who had less than a decade of experience had annual costs more than 13 percent above doctors who had more than four decades of experience, according to the new analysis. The findings were published online November 5 in Health Affairs. Other characteristics, among them physician gender, size of practice, credentials (such as being board-certified) and previous malpractice suits, did not seem to affect overall costs or mean cost per patient. Moreover, the higher-cost practicing styles of the less experienced physicians did not necessarily translate into better care. The researchers analyzed insurance claims filed in Massachusetts between 2004 and 2005 (before Governor Mitt Romney instituted the state’s individual health care mandate), covering 1.13 million patients (ages 18 to 65) and 12,116 physicians. They were then able to generate more than 600 types of “episodes of care” (based on categories such as similar illness, severity and procedure and controlled by age, gender and comorbidities) to see how billed costs for similar “episodes” compared across doctors of the same specialty. Health plans often use this same type of reckoning to evaluate costs. On a population scale, doctors with fewer than 10 years of experience had mean per-patient costs of about $ 14,906, whereas those with more than 40 years had mean per-patient costs of $ 10,104. Both government-run and private health insurance plans are looking for smarter ways of reducing costs while providing for quality health care. Facing a budget shortfall in 2016, for instance, Medicare is looking to adjust how it pays for services based not just on what is proscribed (tests, treatments, and so on) but also on how well that service works–whether it is the most effective and affordable option available for the given situation. Why is there such a large difference between these groups of doctors? It is possible, for example, that those fresh out of medical school are more familiar with–and more inclined to use–newer, more expensive treatments and tests (regardless of how effective they are). The authors also suggested that perhaps “lack of experience and uncertainty translates into more aggressive care,” they wrote. Additionally, this newer generation of doctors might simply continue to use higher-cost medicine even as they gain more experience. These data also suggest that unless they work to reduce costs, physicians with less experience might have a more difficult time being included to receive as much business from insurance companies and government programs that are looking for best-value providers. The findings “underscore the need to better understand physician practice patterns and what influences that behavior,” Mehrotra said. He and his colleagues recommend considering additional training programs for new doctors “to educate physicians on their responsibility to be good stewards of health care resources.”

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© 2012 ScientificAmerican.com. All rights reserved.

Seniors/Aging News Headlines – Yahoo! News

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Newspaper discloses new Cameron text messages

LONDON (AP) — A British lawmaker says he’s asked the country’s media ethics inquiry to consider newly disclosed text messages sent between Prime Minister David Cameron and Rebekah Brooks, the ex-chief executive of Rupert Murdoch‘s British newspaper division.

The Mail on Sunday newspaper on Sunday published two previously undisclosed messages exchanged between the pair, who are friends and neighbors.

Brooks is facing trial on conspiracy charges linked to Britain’s phone hacking scandal, which saw Murdoch close down The News of The World tabloid.

In one newly disclosed message, Cameron thanked Brooks in 2009 for allowing him to borrow a horse, joking it was “fast, unpredictable and hard to control but fun.”

Opposition lawmaker Chris Bryant has asked a judge-led inquiry scrutinizing ties between the press and the powerful to examine the messages.

Europe News Headlines – Yahoo! News

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Google's Android software in 3 out of 4 smartphones

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CBS making $1 million donation to Sandy, announces employee match

NEW YORK (TheWrap.com) – CBS is making a $ 1 million dollar donation to Hurricane Sandy recovery as part of a wider effort that includes PSAs and matching employee contributions through the end of the year, TheWrap has learned.

CEO Les Moonves announced the company’s Red Cross donation in a letter to employees obtained by TheWrap, in which he thanks CBS staff working in hurricane-stricken parts of the Northeast and details its charitable plans.

Other networks are pitching in as well: ABC is devoting its programming day Monday to fundraising, and its corporate parent, Disney, has donated $ 2 million. Fox’s parent, News Corp., has donated $ 1 million. And NBC is holding a telethon tonight. All of the networks are also making viewers aware of the recovery efforts through means ranging from crawls to PSAs.

Moonves singled out employees from all corners of the company who worked through tough conditions to keep its television and radio stations going.

“I am announcing today that November, the month of Thanksgiving, will be dedicated at all our operations to supporting the Hurricane Sandy relief efforts of the American Red Cross, with whom CBS has a long partnership in times of crisis,” he wrote. “Our local TV and radio stations, and their online counterparts, will work both individually and together… to employ our unique resources to lend additional support to those relief efforts through telethons, phone banks and comprehensive PSA campaigns. Those efforts have already begun, and are expanding as you read this.”

CBS, he noted, is producing special PSAs featuring its stars. The first, with Gary Sinise, aired during “The Big Bang Theory” on Thursday. More will air during football over the weekend.

Additionally, “Entertainment Tonight” is enlisting stars to appear in PSAs that will run in syndication on affiliates of all networks airing the show. CBS will also dedicate billboards to the relief effort.

“There will not be one division of our company that does not contribute to this effort, each in its own way, and in ways to be determined by each,” Moonves wrote.

“As a cornerstone of this month-long drive, CBS Corporation will make a $ 1 million contribution to the American Red Cross,” he added. “In addition, we are also making a commitment to match your individual contributions to any Sandy-related relief efforts by making corresponding additional gifts to the American Red Cross. The match will apply to contributions that may have already been made as well as to new donations through the end of the year.”

TV News Headlines – Yahoo! News

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Bypass tops stents in diabetics with diseased arteries

LOS ANGELES (Reuters) – Diabetics with more than one diseased artery fared significantly better if they underwent bypass surgery than those who received drug coated stents following artery clearing procedures to improve blood flow to the heart, according to data from a five-year study presented on Sunday.

After five years, the bypass group had a lower combined rate of heart attacks, strokes and deaths of 18.7 percent versus 26.6 percent for the stent group in the 1,900-patient study funded by the U.S. National Institutes of Health.

The result was deemed to be highly statistically significant, researchers said.

Previous studies had demonstrated the superiority of bypass surgery over the use of bare metal stents – tiny mesh tubes used to prop open cleared arteries. Researchers suspected that newer stents coated with drugs to prevent reclogging might negate some of the bypass advantage, but that turned out not to be the case.

“The advantages were striking in this trial and could change treatment recommendations for thousands of individuals with diabetes and heart disease,” said Dr. Valentin Fuster, from Mount Sinai School of Medicine in New York, who presented the findings at the American Heart Association scientific meeting in Los Angeles.

There was a higher incidence of stroke in bypass patients — 5.2 percent versus 2.4 percent. Stroke is a known risk of the surgical procedure in which a piece of a healthy blood vessel from another part of the body is grafted on to re-route blood flow around a blocked heart artery.

But deaths from any cause were significantly lower with bypass surgery than those who received artery clearing angioplasty and a drug eluting stent – 10.9 percent compared with 16.3 percent. There were also twice as many heart attacks among diabetics in the stent group within five years – 99 vs 48, which Fuster called “very significant.”

More than one million bypass surgeries or stenting procedures are performed in the United States each year and some 25 to 30 percent of those involve diabetics with multiple diseased arteries, researchers said.

If the results of this study alter clinical practice, it could eat into lucrative profits of the companies that sell drug coated stents, such as Abbott Laboratories, Boston Scientific Corp and Medtronic Inc. Boston Scientific and Johnson & Johnson supplied the stents used in the study, but J&J has since exited the stent business.

Dr. David Williams of Brigham and Women’s Hospital in Boston, who was not involved in the study, called the results “very convincing.”

“I think the (treatment) guidelines will recognize this and I do think it will be adopted,” he said.

However, Fuster cautioned that longer term follow-up of patients was necessary.

“We always want to know how long the effects last,” he said. “The gap could begin to close or the results could get better and better.”

(Reporting by Bill Berkrot and Deena Beasley; Editing by Marguerita Choy)

Medications/Drugs News Headlines – Yahoo! News

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