ScienceDaily (Oct. 30, 2012) ? Hurricane Sandy is weakening and moving faster than anticipated. Therefore a computer model developed by an engineer at The Johns Hopkins University is now predicting fewer power outages than initially expected. Seth Guikema is predicting that an overall cumulative total of 8 to 10 million people will lose power in the wake of the hurricane, based on the last storm track and intensity forecast at 2 a.m. EDT on Tuesday, Oct. 30.
It is important to note that the computer model predicts cumulative outages, not peak outages. Cumulative means the total count of anyone who has lost power, versus peak, which is the number of people without power at any one point in time. For instance, in Maryland, the local utility company reported approximately 290,000 cumulative power outages as of 10:30 a.m. on Monday, Oct. 29, but their peak was approximately 210,000 because they were actively restoring outages while new outages were occurring.
Guikema has been tracking Hurricane Sandy since late last week using his computer model, which in the early days of the storm used outage data from 11 hurricanes to estimate the fraction of customers who will lose power, based on expected gust wind speed, expected duration of strong winds greater than 20 meters per second, and population density. As the storm progressed, the model incorporated the actual track of the storm as well as the forecast. The predicted number of outages fluctuated throughout the storm based on the available forecast data.
Guikema's model may help power companies allocate resources by predicting how many people will be without power and where the most outages will take place, and it provides information that emergency managers can use to better prepare for storms. Guikema, an assistant professor in the Department of Geography and Environmental Engineering at the Johns Hopkins Whiting School of Engineering, says the goal is to restore power faster and save customers money.
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I am an American Mulatto. My Mother is Cherokee & Seminole (tall, yellow, black kinky hair, (Bette Davis) brown eyes, pretty. My Father is Italian American (tall, rock star skinny, curly blond hair, gorgeous blue eyes, incredibly handsome.
I am 5'7", 100 lbs., Size Zero, Brown Eyes, Curly Black Hair Professional Actress, Model,?Composer, Artist & Poetess
My name is pronounced vonnie monay
I have created hundreds of original musical compositions, but due to the excessiveness of the Organized Criminal Gang Stalking I have to endured on a constant basis; I have only 60 songs?and only 60 poems?copywritten.
I also have not had the time to even present my work in a professional manner.
I figured I would present it raw since these creatures think they can erase me and my life. ?They are lowlives who think they can make their outrageous "frame ups" stick.
I have been a vegetarian all of my life.
I know it is not for everyone and have never and will never try to force anyone to eat the way I do. I was forced by my mother to eat meat because of my blood disorder, Thalassemia Minor. She tried to frighten me into eating it by telling me that I would die if I didn't. I am still alive!
?
I am a True Gemini a Syzygy and a Grand Cross!
Syzygy?in?Astronomy? is an alignment of three celestial objects, as the sun, the earth, and either the moon or a planet.
In a Grand Cross, there is one planet in each astrological element (fire, earth, air and water) but all the planets are in signs of the same modality or quality.
I am a victim of child pornographers, sadistic, homosexual, pedophile, rapists, kidnapping, forced breeding & sex slavery. I am still stalked by these slanderers. I will tell anyone who will listen until I have justice. I am so fed up with them that I have begun to names names.
These brute beasts twice dead (A New Teatament description of these creatures) ought to thank me for sharing their actual "Accomplishments" Crimes.
I think it is all about the land that was stolen from my family.
Tropicana Orange Juice is on it in Bradenton, Florida, USA.
These posts are designed to disrupt the MuslimTerrorist, Zionists/Jewish, Papist/Catholic Inquisitors/Mafia & Willie Lynch Slaves/Blacks , Third World/Illegal Aliens attempts to commit The Genocide of True Americans!
One of Mitt Romney's biggest supporters, New Jersey Gov. Chris Christie, had nothing but praise for President Barack Obama today, as his state prepares to rebuild from the damage caused by Hurricane Sandy.
"I have to say, the administration, the president, himself and FEMA Administrator Craig Fugate have been outstanding with us so far," Christie said on Good Morning America. "We have a great partnership with them."
Christie told ABC's George Stephanopoulos that Obama called him on Monday night around midnight to ask if there was anything else the federal government could do to help. Christie added that they worked together to move forward with a Major Disaster Declaration for New Jersey.
The Major Disaster Declaration provides funding for recovery efforts, including infrastructure projects, temporary housing, low-cost loans to cover uninsured property loss and assistance to individuals and businesses.
"He worked on that last night with me?offered any other assets that we needed to help," Christie said. "I want to thank the president personally for his personal attention to this."
Appearing on Fox News, Christie said the storm is bigger than the election.
"I have a job in New Jersey that is much bigger than presidential politics," Gov. Chris Christie said on the show Fox & Friends. "I couldn't care less about that."
MEXICO CITY (AP) ? Mexico is putting up wind power turbines at a breakneck pace and the expansion is pitting energy companies against the Indians who live in one of the windiest spots in the world.
The country is posting one of the world's highest growth rates in wind energy, and almost all of it is concentrated in the narrow waist of Mexico known as the Isthmus of Tehuantepec, where winds from the Pacific meet winds from the Gulf of Mexico, spawning places so wind-blown that one town's formal name is simply "Windy."
The largely indigenous residents of the Isthmus complain that the wind farms take control of their land, affect fish and livestock with their vibrations, chop up birds and pit residents against each other for the damage or royalty payments. They also claim they see few of the profits from such projects.
President Felipe Calderon has made the inauguration of wind parks one of the main focuses of his administration's ambitious pledge to cut Mexico's carbon emissions by 30 percent by 2020, and on Tuesday ? as he has done before ? he stopped by the state of Oaxaca to inaugurate a new clutch of wind turbines, praising the extra income they provide for some farmers.
"Yes, you can fight poverty and protect the environment at the same time. This is a clear example," Calderon said at the opening ceremony.
But as in the past, he did so under tight security, as local protesters threatened to mar the inauguration. The president's office normally publishes a detailed schedule of his planned activities, but didn't do so with Tuesday's inauguration, keeping it under wraps until the event took place.
So far in 2012, Mexico has posted a startling 119 percent increase in installed wind-power capacity, more than doubling the 519 megawatts it had last year, the highest annual growth rate listed in the magazine Wind Power Monthly's "Windicator" index. Mexico had only 6 megawatts when Calderon took office in 2006.
While Mexico, with a total of around 1.3 gigawatts of wind power, is still a tiny part of the world's estimated 244 gigawatt capacity, it offers an insight into what happens when the industry focuses overwhelmingly on large farms dominated by large companies that are concentrated in a small, desirable area.
It has been mainly Spanish firms like Iberdrola, Union Fenosa and Gamesa, and U.S. firms like Sempra Energy, that have built the huge wind towers that now crowd the Isthmus of Tehuantepec, leaving the local population feeling invaded. Only 4 of Mexico's 17 wind farms are located outside the isthmus.
It raises the question of whether bigger is always better.
"We are asking these multinationals to please get out of these places," said Irma Ordonez, an activist from the Zapotec Indian town of Ixtepec, Oaxaca. "They want to steal our land, and not pay us what they should."
"When they come in they promise and promise things, that they're going to give us jobs, to our farmers and our towns, but they don't give us anything," said Ordonez, who traveled to Mexico City in October to protest outside the offices of a Mitsubishi Corp.
Industry sources say the distrust is unmerited, given the potential benefits to the poverty-stricken farming and fishing towns on the isthmus.
The latest battle focuses on a huge, 396-megawatt off-shore wind farm planned for a narrow spit of land in a lagoon near the village of San Dionisio del Mar, Oaxaca.
A source close to the project, who was not authorized to speak on the record, said the project had been approved by village assemblies, would have little impact on fishing activities in the lagoon and would contribute an amount equal to about half the township's annual budget in coming years in compensation and royalties.
But opponents and supporters engaged in a tense standoff outside the town in October, when a group of men blocked roads to prevent a planned demonstration against the wind farm.
Saul Celaya, a Huave Indian farmer and San Dionisio resident, said the lagoon project would damage mangrove swamps where fish, shrimp and other sea life breeds, and scare off the fish that locals depend on.
"Just when they were doing soil studies, there was a mass die-off of fish," Celaya said, adding that projects opponents "are being intimidated, they're afraid to leave their houses, they're threatened."
The industry source denied the company was intimidating anyone, but acknowledged the project had suffered some delays due to disputes within the community.
Others say it didn't have to be this way, big corporations pitting villagers against villagers. There are proposals to have local towns start their own wind farms, so that they could decide where they would be situated and where profits should go.
Rodrigo Penalosa, an activist who supports the town of Ixtepec's proposed 100-megwatt community wind farm, noted that "the community has already approved it. The problem is that the (government) Federal Electricity Commission won't allow the community project to get access to the network.... but it does allow the multinationals access."
Sergio Oceransky, whose Yansa Group is trying to help kick-start the community wind project, said the commission is asking for financial guarantees of millions of dollars "that no community in Mexico could meet."
"These are requirements that are basically designed to ensure that only projects presented by multinationals can compete," said Oceransky, who claims that such guarantees are not required by federal law.
The commission did not respond to repeated requests for comment.
With a limited transmission capacity for the projects, and the last lots of line capacity being auctioned off, the situation is becoming critical; what could be a sterling example of alternative energy production is threatening to become a permanent political dispute in southern Mexico.
Digital artist Salvatore Iaconesi hacked his medical records to put them online in a global search for the best treatments
See more in our gallery: "Healing arts riff on open-source medical records"
You were told you had brain cancer and your response was to hack open your medical records and publish them online. Why? When I was diagnosed I was a bit unsatisfied with what took place at the hospital: it was almost as if I had nothing to do with it. The doctor comes up, he tells you that you have a tumour, and it's like you disappear and only your clinical records remain. I didn't want to disappear. I'm not just a patient, I am a human being. I stepped out of the hospital with a copy of my digital medical records, but I found they were in a peculiar format which takes a lot of skill to open. So I hacked this format to make that data really accessible.
Last month you put this data on your website artisopensource.net/cure. What happened? It's been incredible. I have been able to become an expert in neurosurgery and neurology. Through this kind of complete openness, I could access thousands of people who have provided me with their knowledge, their skills, their testimonies, their life experiences. Roughly 60 neurologists, neurosurgeons and radiologists contacted me suggesting techniques for surgery and for treatment. They are even talking to each other.
Scans of your brain have inspired you and other artists in many ways. Tell me more. There are lots of things going on: poems, texts, narratives. An electronic music collective in Palermo, Italy, did a performance with images of my cancer as their visuals. There is this wonderful American artist, Patrick Lichty, who built a sculpture of my brain and tumour in Second Life. I have printed out a picture of my tumour, and I look at it and speak to it. It's like a meditation with your cancer, so you are not that afraid anymore. Science talks about the fact that laughing, being unafraid, being positive, being social, is good for your immune system, your psychology.
Does crowd-sourcing a cure mean you've lost faith in medicine? No, it doesn't. I want to take care of myself using medicine and surgery. Doctors are wonderful people. But I also want to take into consideration all other possible approaches. When I disclosed my records, I made it explicit that I was doing it to try to find a new definition for being sick, or ill or diseased, and also for the word "cure". In different cultures, cure means different things. It could refer to the body or the soul or to society.
Don't doctors advise against trawling the internet for information about diseases? We live in a time when, thanks to the internet, the mythology has been destroyed that people are stupid and some things can be done only by professionals. If you are open, you can have some interesting surprises. Of course your doctor will say don't go to the internet because magicians and clowns will show up selling you miracle remedies which don't work. I'm not replying to those emails - that's very important.
The Italian parliament might change the law to make medical information more open... It has been proposed and I am very happy about it.
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LANCASTER (Reuters) - Britain's construction sector, the main drag on the economy so far this year, should improve soon, Bank of England policymakerBen Broadbent said on Monday.
According to official data, Britain endured its second recession in four years between October 2011 and June 2012, when construction output slumped. Even in the third quarter, when the economy returned to growth, construction contracted while services and manufacturing output rose.
Rate-setters will decide next week whether to inject further stimulus into the economy on top of the 375 billion pounds approved since the start of the financial crisis.
In a speech on Monday, Broadbent said it was not "entirely clear that we had a double dip". The fact that, in his view, no boom preceded the "bust" in construction meant there was still spare capacity and room for the sector to grow, he said.
"The prospects for the construction sector look less unfavourable than they have been for a while," Broadbent said at the Lancaster University Management School in northern England.
The British construction sector - which accounts for less than 7 percent of GDP - was a victim of a global credit crunch, not a local boom beforehand, he said.
Broadbent, a former Goldman Sachs economist, noted that since 2008 it was the supply of mortgage debt, not the demand for it, that was driving activity in the British housing market.
Broadbent also defended inflation as the right target for the BoE's Monetary Policy Committee, noting that the MPC would continue to set policy in order to meet it.
The MPC will announce its monthly policy decision next week and Broadbent had already indicated his reluctance to vote for more quantitative easing (QE) asset purchases, saying in September that high inflation limited the central bank's scope to ease policy.
Broadbent told a regional newspaper that he had yet to reach a decision on another round of QE and said he doubted whether his fellow policymakers had done so either.
"I literally have not made up my mind and I doubt anybody else in the committee has, until they have seen everything and thought about it," he told the Lancashire Evening Post.
Annual inflation slowed to 2.2 percent in September, nearer the BoE's 2 percent target. MPC member Spencer Dale said in an interview released on Monday that inflation was sticky and he repeated his call for caution around more QE.
Comments by Dale and fellow policymaker Charlie Bean that the strong third-quarter growth was unlikely to persist suggested a decision by the central bank next week to hold fire on more bond-buying might be less clear-cut than many analysts had begun to believe.
Broadbent told the regional paper that markets suggest interest rates would stay low for some time. The Bank has held rates at a record low of 0.5 percent since March 2009.
"I will say no more than to point at what is in financial markets, that is that they are pretty flat for a pretty long time, as far as I can see," Broadbent said.
(Writing by Olesya Dmitracova; Additional reporting by Peter Griffiths; Editing by Andrew Roche)
Halloween is meant to be a fun and exciting holiday, especially for kids, but for your pets it could be very stressful.
Quincy Veterinarian Dr. Bob Reich says to keep pets from feeling anxious, give your pet a small treat each time someone rings the doorbell.
That way, he says, your pet may look forward to trick or treaters coming to the door instead of dreading it.
?Reich says?be sure?to keep chocolate out of your pets reach as well.
"Pets are moderately poisoned by chocolate. Dark chocolate is worse than milk chocolate. But they'll get in and they'll eat the whole thing of chocolate, and we see this for 2-3 days, so make sure you keep the chocolate out of your pets reach," said Reich.
When choosing a costume for your pet, Reich recommends choosing carefully and removing costume pieces that could be choking hazards or cause vision impairment by blocking your pet's full view.
"Make sure any costume your pet will wear fits properly: leg holes in the wrong places can result in pulled muscles? and costumes that cover up too much can result in elimination (bathroom) concerns." he adds.
Reich says this time of year chocolate poisoning is very common, so keep all candy high up off the floor so your pet can't get into it.
Children who are homeless or move frequently have chronically lower math and reading skills than other low-income students who don't move as much.
That's the finding of a new longitudinal study on children's risk and resilience conducted through a university-community partnership by researchers at the University of Minnesota, the Minneapolis Public Schools, the University of Pennsylvania, the University of Iowa, and Hong Kong Sue Yan University. The study appears in the journalChild Development.
About one million American school children are homeless each year, and many more are thought to move frequently. This study looked at more than 26,000 students in the Minneapolis Public Schools, a large, urban district, to examine whether homelessness and frequent moving over a six-year period are related to learning, beyond the risk of poverty.
The researchers found that students who were homeless at some point during the six-year study or moved a lot (making three or more moves in a year) had persistently lower levels of reading and math achievement in elementary and middle school compared to other low-income students and their more advantaged peers. These achievement gaps either stayed the same or worsened as students approached high school, even when the researchers took into account other factors. Students also made slower gains in math achievement during the years they were homeless or highly mobile compared to years when they were not homeless or didn't move as often.
Even though children who were homeless or highly mobile showed low achievement as a group, there was striking variation in the achievement of individual children, with 45 percent scoring within the average range or better on these skills. This finding suggests that many children who are homeless or move frequently nonetheless show academic resilience.
"Understanding their successes may offer clues for strategies to address achievement problems in their peers," suggests J.J. Cutuli, a researcher at the University of Pennsylvania and the study's lead author. "Alleviating problems for these students requires simultaneously addressing short-term risks tied to homelessness or moving frequently and long-term risks associated with chronic poverty and disadvantage. One starting point may be understanding the protective influences that keep many of these children on track academically."
The researchers used administrative data (such as test scores, attendance, and eligibility for free and reduced-price meals and special services) on all 3rd through 8th graders in the district, comparing students identified as homeless or highly mobile to other students receiving free meals, students receiving reduced-price meals, and students who did not participate in the federal meal program. Achievement was gauged by looking at reading and math achievement scores on annual standardized tests.
###
Society for Research in Child Development: http://www.srcd.org
Thanks to Society for Research in Child Development for this article.
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New pediatric heart failure guidelines a first in Canada Public release date: 30-Oct-2012 [ | E-mail | Share ]
Contact: Jane-Diane Fraser jfraser@hsf.ca 613-569-4361 x273 Heart and Stroke Foundation of Canada
Heart failure in children often goes unrecognized until it's too late
The Canadian Cardiovascular Society is the first in Canada to issue guidelines aimed at helping primary care and emergency physicians, as well as specialists, recognize and manage heart failure in children. The guidelines were released today at the Canadian Cardiovascular Congress.
Pediatric heart failure is often fatal and occurs in about 3,000 children annually in North America. Worldwide, the problem is far greater and the causes are diverse. To date there has been little guidance to assist practitioners who deal with children with heart failure.
"The previous guidelines, produced in 2004 by the international Society for Heart and Lung Transplantation, are now dated and were not designed for front-line practitioners who deal with these children at the first encounter," says Dr. Paul F. Kantor, who chaired the guidelines and is head of pediatric cardiology at the Stollery Children's Hospital, University of Alberta.
"Providing guidance in this area may help to solve one of the biggest challenges we have: that children with heart failure are usually not recognized early and treated effectively. When heart failure presents late in the disease course, it is more dangerous and can be fatal."
Heart failure in children is far more likely to cause death than cancer, but the problem is not nearly as well recognized, says Dr. Kantor.
About half of the children who present with obvious heart failure will die, or require a heart transplant within five years. Unfortunately, awareness regarding organ donation is still relatively low among Canadian doctors and patients, and a heart transplant is not always available.
"We try our best to treat them with medication and we also use advanced devices such as the Berlin Heart and other ventricular assist devices to keep them alive. Occasionally recovery occurs and some patients will be fortunate enough to receive a transplant," Dr. Kantor says.
"The biggest issue we face is that our patients are often presenting very late and with advanced disease. The earlier they are diagnosed, the more likely it is that we will be able to offer effective treatment."
The new guidelines will provide a framework for early recognition and treatment.
The key recommendations for early recognition are:
Cardiomyopathy, or heart muscle disease, is one of the main causes of heart failure in children and should be excluded when a child presents with unexplained rapid heart rate or rapid breathing. This may be a familial condition caused by one of several gene abnormalities.
Myocarditis, a viral infection of the heart muscle, may be present when children present with abdominal pain and vomiting and have signs of poor circulation.
Specialized pediatric echocardiography is required to exclude heart failure and should be obtained in children with unexplained symptoms and signs of abnormal circulation.
"Often children are brought to the emergency room with shortness of breath and some cough and are thought to have asthma, when in fact they have very severe heart failure," says Dr. Kantor. "The clues of a very unusually fast heart rate and low blood pressure are sometimes overlooked and these children will be sent home with a 'puffer' for their breathing problems, which are actually due to heart failure."
In the same way, he says, teenagers who come to the emergency room with nausea and vomiting and abdominal pain may be thought to have gastroenteritis but may actually have myocarditis. "This is one of the earlier considerations that people in the emergency department should make, since the earlier this is diagnosed, the better the outcome."
Pediatric echocardiography is a specialty in its own right and is different from adult echocardiography. Unfortunately, echocardiography is sometimes done in a non-expert setting, which can lead to misdiagnosis and delay in starting the correct treatment, Dr. Kantor emphasized.
Key recommendations for management after diagnosis are:
Admission to a hospital that has pediatric expertise for immediate care.
Ongoing care to be provided by an expert in pediatric cardiology.
"It is very important that these children receive expert care because they tend to deteriorate rapidly," says Dr. Kantor. "They need to be admitted to a hospital that has pediatric expertise and be evaluated by a children's heart specialist, with echocardiography done by that specialist."
Key recommendations for treatment are:
Prompt use of diuretics.
Treatment with inotropic drugs to rescue the patient, and a transition to ACE inhibitors thereafter.
"We strongly recommend the use of diuretics, which are very effective in an emergency setting," says Dr. Kantor. "We also strongly recommend rescue treatment with inotropic drugs, such as epinephrine and milrinone, to restore the circulation, followed later on by ACE inhibitors, which are effective heart failure treatment in adults and appear to be effective in children as well."
For myocarditis, the experts recommend supportive care, to allow the heart to recover on its own. This can mean giving the patient drugs to support blood pressure, circulation, and occasionally, use of a ventricular assist device, to improve the circulation while the heart recovers, giving it a chance to rest.
These guidelines will benefit practitioners in the field by standardizing practice across institutions, and allowing patients to benefit regardless of where they are cared for.
"Canadian Cardiovascular Society guidelines are an invaluable resource that establish best practices in patient care," says Dr. Michelle Graham, chair of the CCS Guidelines Committee. "These guidelines are important references for our healthcare practitioners in Canada and they are recognized and used by practitioners around the world."
A family's story
Tim and Theresa Miller from Delaware, Ont., lost their teenage son to heart failure in 2003.
"We got Daniel to hospital twice on a Monday, and then on the Wednesday. He had all the classic signs that they talk about in these guidelines and they were not recognized as heart failure," says Tim Miller. "Finally, they were trying to resuscitate him and the doctor said, 'It doesn't look good. He probably has myocarditis.' But by then it was too late. He had been in hospital for almost two full days."
"He was 17," adds Theresa Miller. "He was a normal, healthy, bright kid. He'd just finished his application for university, and then, just out of the blue, he got this case of the flu, but he was sicker than we had ever seen him. It was different from any other flu he'd ever had."
"It's the regular physician on the floor that needs to be aware of these guidelines to get the patient on the right track," adds Tim. "The guidelines talk about unusually high heart rate, and that was one of Daniel's symptoms. When he went in that first day, the doc came back and said, 'Wow, his heart rate is really high.'"
"And it was at that moment in time, if these guidelines were in place and had sparked that doctor to recognize the symptoms of myocarditis, that was Daniel's chance. And he was at a tertiary care facility, all the experts were there, but they looked at him as someone having the flu and never thought to look at him broadly enough and treat him in the way that he needed to be treated," says Theresa. "We think these guidelines could be hugely helpful because they give logical steps of what needs to happen if we are going to give these kids a chance."
"This was totally out of the blue, that on a Saturday you have a son, and by Thursday, you don't."
###
Statements and conclusions of study authors are solely those of the study authors and do not necessarily reflect Foundation or CCS policy or position. The Heart and Stroke Foundation and the Canadian Cardiovascular Society make no representation or warranty as to their accuracy or reliability.
The Heart and Stroke Foundation (heartandstroke.ca), a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living and advocacy.
Healthy lives free of heart disease and stroke. Together we will make it happen.
For more information and/or interviews, contact the
CCC 2012 MEDIA OFFICE AT 416-585-3781 (Oct 28-31)
OR
Diane Hargrave Public Relations
416-467-9954 ext. 104
dhprbks@interlog.com
Congress information and media registration is at www.cardiocongress.org
After October 31, 2012 contact:
Jane-Diane Fraser
Heart and Stroke Foundation
(613) 569-4361 ext 273
jfraser@hsf.ca
[ | E-mail | Share ]
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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.
New pediatric heart failure guidelines a first in Canada Public release date: 30-Oct-2012 [ | E-mail | Share ]
Contact: Jane-Diane Fraser jfraser@hsf.ca 613-569-4361 x273 Heart and Stroke Foundation of Canada
Heart failure in children often goes unrecognized until it's too late
The Canadian Cardiovascular Society is the first in Canada to issue guidelines aimed at helping primary care and emergency physicians, as well as specialists, recognize and manage heart failure in children. The guidelines were released today at the Canadian Cardiovascular Congress.
Pediatric heart failure is often fatal and occurs in about 3,000 children annually in North America. Worldwide, the problem is far greater and the causes are diverse. To date there has been little guidance to assist practitioners who deal with children with heart failure.
"The previous guidelines, produced in 2004 by the international Society for Heart and Lung Transplantation, are now dated and were not designed for front-line practitioners who deal with these children at the first encounter," says Dr. Paul F. Kantor, who chaired the guidelines and is head of pediatric cardiology at the Stollery Children's Hospital, University of Alberta.
"Providing guidance in this area may help to solve one of the biggest challenges we have: that children with heart failure are usually not recognized early and treated effectively. When heart failure presents late in the disease course, it is more dangerous and can be fatal."
Heart failure in children is far more likely to cause death than cancer, but the problem is not nearly as well recognized, says Dr. Kantor.
About half of the children who present with obvious heart failure will die, or require a heart transplant within five years. Unfortunately, awareness regarding organ donation is still relatively low among Canadian doctors and patients, and a heart transplant is not always available.
"We try our best to treat them with medication and we also use advanced devices such as the Berlin Heart and other ventricular assist devices to keep them alive. Occasionally recovery occurs and some patients will be fortunate enough to receive a transplant," Dr. Kantor says.
"The biggest issue we face is that our patients are often presenting very late and with advanced disease. The earlier they are diagnosed, the more likely it is that we will be able to offer effective treatment."
The new guidelines will provide a framework for early recognition and treatment.
The key recommendations for early recognition are:
Cardiomyopathy, or heart muscle disease, is one of the main causes of heart failure in children and should be excluded when a child presents with unexplained rapid heart rate or rapid breathing. This may be a familial condition caused by one of several gene abnormalities.
Myocarditis, a viral infection of the heart muscle, may be present when children present with abdominal pain and vomiting and have signs of poor circulation.
Specialized pediatric echocardiography is required to exclude heart failure and should be obtained in children with unexplained symptoms and signs of abnormal circulation.
"Often children are brought to the emergency room with shortness of breath and some cough and are thought to have asthma, when in fact they have very severe heart failure," says Dr. Kantor. "The clues of a very unusually fast heart rate and low blood pressure are sometimes overlooked and these children will be sent home with a 'puffer' for their breathing problems, which are actually due to heart failure."
In the same way, he says, teenagers who come to the emergency room with nausea and vomiting and abdominal pain may be thought to have gastroenteritis but may actually have myocarditis. "This is one of the earlier considerations that people in the emergency department should make, since the earlier this is diagnosed, the better the outcome."
Pediatric echocardiography is a specialty in its own right and is different from adult echocardiography. Unfortunately, echocardiography is sometimes done in a non-expert setting, which can lead to misdiagnosis and delay in starting the correct treatment, Dr. Kantor emphasized.
Key recommendations for management after diagnosis are:
Admission to a hospital that has pediatric expertise for immediate care.
Ongoing care to be provided by an expert in pediatric cardiology.
"It is very important that these children receive expert care because they tend to deteriorate rapidly," says Dr. Kantor. "They need to be admitted to a hospital that has pediatric expertise and be evaluated by a children's heart specialist, with echocardiography done by that specialist."
Key recommendations for treatment are:
Prompt use of diuretics.
Treatment with inotropic drugs to rescue the patient, and a transition to ACE inhibitors thereafter.
"We strongly recommend the use of diuretics, which are very effective in an emergency setting," says Dr. Kantor. "We also strongly recommend rescue treatment with inotropic drugs, such as epinephrine and milrinone, to restore the circulation, followed later on by ACE inhibitors, which are effective heart failure treatment in adults and appear to be effective in children as well."
For myocarditis, the experts recommend supportive care, to allow the heart to recover on its own. This can mean giving the patient drugs to support blood pressure, circulation, and occasionally, use of a ventricular assist device, to improve the circulation while the heart recovers, giving it a chance to rest.
These guidelines will benefit practitioners in the field by standardizing practice across institutions, and allowing patients to benefit regardless of where they are cared for.
"Canadian Cardiovascular Society guidelines are an invaluable resource that establish best practices in patient care," says Dr. Michelle Graham, chair of the CCS Guidelines Committee. "These guidelines are important references for our healthcare practitioners in Canada and they are recognized and used by practitioners around the world."
A family's story
Tim and Theresa Miller from Delaware, Ont., lost their teenage son to heart failure in 2003.
"We got Daniel to hospital twice on a Monday, and then on the Wednesday. He had all the classic signs that they talk about in these guidelines and they were not recognized as heart failure," says Tim Miller. "Finally, they were trying to resuscitate him and the doctor said, 'It doesn't look good. He probably has myocarditis.' But by then it was too late. He had been in hospital for almost two full days."
"He was 17," adds Theresa Miller. "He was a normal, healthy, bright kid. He'd just finished his application for university, and then, just out of the blue, he got this case of the flu, but he was sicker than we had ever seen him. It was different from any other flu he'd ever had."
"It's the regular physician on the floor that needs to be aware of these guidelines to get the patient on the right track," adds Tim. "The guidelines talk about unusually high heart rate, and that was one of Daniel's symptoms. When he went in that first day, the doc came back and said, 'Wow, his heart rate is really high.'"
"And it was at that moment in time, if these guidelines were in place and had sparked that doctor to recognize the symptoms of myocarditis, that was Daniel's chance. And he was at a tertiary care facility, all the experts were there, but they looked at him as someone having the flu and never thought to look at him broadly enough and treat him in the way that he needed to be treated," says Theresa. "We think these guidelines could be hugely helpful because they give logical steps of what needs to happen if we are going to give these kids a chance."
"This was totally out of the blue, that on a Saturday you have a son, and by Thursday, you don't."
###
Statements and conclusions of study authors are solely those of the study authors and do not necessarily reflect Foundation or CCS policy or position. The Heart and Stroke Foundation and the Canadian Cardiovascular Society make no representation or warranty as to their accuracy or reliability.
The Heart and Stroke Foundation (heartandstroke.ca), a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living and advocacy.
Healthy lives free of heart disease and stroke. Together we will make it happen.
For more information and/or interviews, contact the
CCC 2012 MEDIA OFFICE AT 416-585-3781 (Oct 28-31)
OR
Diane Hargrave Public Relations
416-467-9954 ext. 104
dhprbks@interlog.com
Congress information and media registration is at www.cardiocongress.org
After October 31, 2012 contact:
Jane-Diane Fraser
Heart and Stroke Foundation
(613) 569-4361 ext 273
jfraser@hsf.ca
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Google may have canceled the Android event which was scheduled for 7 a.m. PT/10 a.m. ET on Monday morning because of Hurricane Sandy, but that doesn't mean we're being deprived of gadget news. The Mountain View, Calif. company has announced a new LG-made?Nexus smartphone and a 10-inch tablet by Samsung.
As expected, thanks to rumors and leaks, the new Nexus smartphone is dubbed the Nexus 4. It?has a 4.7-inch screen with a "retina"-dense?320 pixels per inch which rivals the 326 ppi found on recent iPhones.?The phone has a powerful?quad-core processor, and will run Android 4.2. (This is still nicknamed Jelly Bean, in case you were tracking those silly things.) It will be available in an 8GB version for $299 and a 16GB version for $349. You can snag it as early as Nov. 13, unlocked and without contract. If you don't mind signing a two-year service agreement, then you can get a 16GB version from T-Mobile for $199.
What Google hasn't mentioned is whether or not there will be an LTE version of the Nexus 4, or?one that would?runs on carriers such as Verizon Wireless or Sprint, which don't support the announced specs. All the models listed are GSM/HSPA+, meaning in the U.S., they'll only run on AT&T and T-Mobile. Hopefully a phone supporting CDMA and LTE will be released in the coming months, so we'll keep asking.
The new Nexus 10 tablet also doesn't come as a surprise to those who have been paying attention to the rumor mill.?The device is a larger version of the popular Nexus 7 tablet. The?Samsung device offers a high-resolution 2560 x 1600 display (that translates to 300 ppi ? more dense than the latest iPad's?264 ppi).?According to Google, the Nexus 10 can handle up to nine hours of video playback and more than 500 hours of standby time on a single charge. ?Like the Nexus 4, it will ship with Android 4.2.?You can snag a 16GB version of the Nexus 10 for $399 and a 32GB version for $499. It will be available through the Google Play Store on Nov. 13.
But wait! There's more! Google also decided to offer up several more Nexus 7 models as well. The smaller tablet will now be available in a 16GB version and 32GB version, priced at $199 and $249, respectively. An additional 32GB model with HSPA+ connectivity will be offered through AT&T for $299, starting on Nov. 13.
Want more tech news?or interesting?links? You'll get plenty of both if you keep up with Rosa Golijan, the writer of this post, by following her on?Twitter, subscribing to her?Facebook?posts,?or circling her?on?Google+.
Android 4.2 is teeming with new features and system improvements, but you can bet that Photo Sphere will be the one that's talked about most amongst consumers. While Android phones on the whole have had panoramic modes for years, Apple's iOS 6 update added even more fuel to that fire. Now, Google's taking things to an entirely new level. With Android 4.2, users can snap pictures in every direction, and the system does the stitching. What you're left with are photos that can be navigated, taking viewers "inside of the scene." Photo Spheres are stored as JPEG files, and all of the information required to view them is embedded as open XML metadata in the image itself. You'll be able to peek 'em on your phone or share them easily through Google+, and perhaps best of all, publish them to Google Maps for the world to see. Head on past the break to see what you've got to look forward to.
New York- and Seoul-based Moglue (last year's TechCrunch Disrupt Beijing finalist) has rolled out a few changes to make it easier to create and publish interactive ebooks on smartphones and tablets. Its ebook publishing platform now consists of two main elements, MoglueBuilder (used to create content-rich ebooks without programming skills) and MoglueViewer (used to preview ebooks on target devices). When we last covered Moglue back in May, the startup was focused only on iOS but has just started to offer support for Android, too. Authors can now make ebooks with MoglueBuilder, preview the content on any iOS or Android device in real-time with MoglueViewer, and then place their titles as apps directly in the App Store or Android stores - following a "step-by-step" process from within MoglueBuilder.
Two Vietnamese songwriters who face up to 20 years in jail for writing songs criticizing their government should be released immediately and unconditionally, Amnesty International said today, ahead of their trial on Tuesday 30 October 2012 at Ho Chi Minh City?s People?s Court.
Vo Minh Tri, known as Viet Khang, 34, and Tran Vu Anh Binh, known as Hoang Nhat Thong, 37 have both been detained since late 2011.
Both are accused of conducting anti-state propaganda under Article 88 of Viet Nam?s Criminal Code ? an offence that carries a sentence of up to two decades.
?This is a ludicrous way to treat people just for writing songs. These men are prisoners of conscience, detained solely for the peaceful exercise of their right to freedom of expression through their songs and non-violent activities, and should be freed,? said Rupert Abbott, Amnesty International?s Researcher on Viet Nam.
?The Vietnamese authorities must abide by their constitutional and international obligations to respect their people?s right to freedom of expression, including through music and other media.?
The songwriters criticized China?s territorial claims in the disputed South China Sea ? known in Viet Nam as the East Sea ? and the Vietnamese authorities? response to these claims. They also highlighted issues of social justice and human rights.
Police arrested Vo Minh Tri in mid-September 2011, released him shortly afterwards, but then rearrested him on 23 December 2011. Since then, he has been held in pre-trial detention at No.4 Phan Dang Luu prison in Ho Chi Minh City. Tran Vu Anh Binh was arrested on 19 September 2011 and has reportedly been held since then in the same prison.
The songwriters? trial comes as the Vietnamese authorities continue their crackdown on freedom of expression.
?There is a very disturbing trend of repression against those who peacefully voice opinions the Vietnamese authorities do not like,? said Abbott.
A further example came on 14 October 2012 when police arrested 20-year old Nguyen Phuong Uyen and with three other university students in Ho Chi Minh City. While the others were released later that day, Nguyen Phuong Uyen remains detained and has been transferred to Long An province?s detention center.
She is reportedly accused of being involved in distributing leaflets that criticised China and the Vietnamese authorities.
The authorities originally denied holding her, but have since informed her family that she, like the two songwriters, is being investigated for anti-state propaganda under Article 88 of Viet Nam?s Criminal Code.
?Rather than trying to silence the young people of Viet Nam, the Vietnamese authorities should allow them to express their opinions and have a say in the development and direction of their country?, said Abbott. ? ?The two songwriters and young university student must be released immediately and unconditionally.?
Just in case you missed out on some of the Android news today, now is the time to go ahead and get yourself fully caught up. Here on the blogs and in the Android Central Forums there is plenty to talk about. Have some questions? Need some help or just looking to chat Android? You know where to go, check out some of the threads below to get started.
Recently, National Real Estate Investor published a couple great articles about industries that boost commercial real estate fundamentals. The first article looked at how technology is boosting demand and rents in key tech hubs such as San Francisco. A follow-up explored the ways in which another resilient U.S. industry, energy, is helping some real estate markets defy the effects of the financial downturn altogether. When it comes to the few markets where energy companies, and their offices and technology, are located, it seems as if there was never an economic downturn to begin with.
The conditions that brought about the Great Recession couldn?t dampen the nation?s demand for petroleum products. As a result, energy cities? multifamily, office, and other sectors have outperformed their counterparts in non-energy markets. Until we figure out how to make wind, solar, and soybean-based energy cheaper and more efficient than oil products, markets like Houston and Dallas will maintain their strong fundamentals.?
If you?re a CRE professional in a major Texas energy market, you?re benefiting nicely from the area?s proximity to the Gulf of Mexico, oil deposits in West Texas, and a great deal of history and infrastructure backing up the state?s energy dominance.
But how can other regions get a piece of this industry? Energy isn?t like technology, which over the years has slipped out of Silicon Valley to take root in such unlikely areas as North Carolina and Ohio. Energy production is a geographically specific enterprise.
Here?s the thing: energy can be produced in other parts of the country. Here in the Mid-Atlantic and Northeastern U.S, we have the Marcellus Shale Coalition, which was formed in 2008 as a way for a variety of interested parties (i.e., basically the same big energy companies that are down in Texas) to extract natural gas via so-called fracking from the abundant shale formation deep under New York, Pennsylvania, Ohio, etc.
According to its website, MCS
works with exploration and production, midstream, and supply chain partners in the Appalachian Basin and across the country to address issues regarding the production of clean, job-creating, American natural gas from the Marcellus and Utica Shale plays.
We provide in-depth information to policymakers, regulators, media, and other public stakeholders on the positive impacts responsible natural gas production is having on families, businesses, and communities across the region.
While the public hasn?t been entirely amenable to the idea of shooting jets of chemical-laced fluid miles down, nor to the idea of poisoned or flammable drinking water, this project has been going on for a while now: drilling, extraction, and pipeline construction are a reality in the Marcellus Shale region.
For the (largely rural) areas affected by the natural gas industry, this could indeed lead to improved real estate fundamentals (which, in much of rural PA, NY, and OH, are sorely needed). Of course, there?s a possibility of economic growth for larger cities in the region, as well (such as Pittsburgh) which may present opportunities for office, industrial, and even retail and residential growth.
But there may be a problem. Writing on SeekingAlpha, David White argues,
?US natural gas prices appear to be in for another very tough year next year. It is my opinion that the EIA [Energy Information Administration] has likely seriously underestimated US natural gas output for 2013. The extra production that I see coming is likely to hurt the largest natural gas producers, but it may be some of the smallest that are least able to weather the storm.
For one thing, Marcellus Shale?s output seems smaller than it is because of the large number of pipeline projects yet to come online. Add to that the fact that demand for natural gas was curbed by the unusual warmth of last winter and it?s clear that Marcellus is still a fledgling energy producer. Local economies and commercial real estate may see growth, but it will take years.
What does the term technical redundancy really mean and are the obligations arising in a technical redundancy any different from a conventional redundancy?
Technical redundancy refers to circumstances in which an employer will no longer be able to offer employment because of developments, such as the sale of the business.
Upon the settlement of a sale, the business is handed over to the purchaser and at that point the vendor/employer no longer has work to offer to the existing work force.
Those are the circumstances in which the employees are described as being "technically" redundant.
There are a number of well-established obligations on an employer contemplating any form of redundancy. These include consultation with potentially affected staff ahead of any decisions actually being made. That obligation is reinforced by the statutory obligations in section 4 of the Employment Relations Act 2000 which require both parties to an employment relationship to be responsive and communicative with each other.
In particular, an employer proposing to make a decision likely to have an adverse effect on the continuation of employment (such as a sale of the business) is obliged to give the employees access to information relevant to the continuation of their jobs and an opportunity to comment on the information before any decision is made. This obligation can create some difficulties for an employer/vendor contemplating sale of the business. First, the employer may not want to unsettle the work force by discussing a possible sale in case nothing actually eventuates. Most employers in those situations tend to think a discussion with the work force will only be necessary once a sale is actually negotiated and confirmed. Further, many purchasers in the negotiation of a prospective business purchase insist on negotiations remaining confidential. What then is the answer to the tension between commercial expectations and the communication obligations described?
A recent decision of the Employment Relations Authority clearly confirms the obligations on an employer when a technical redundancy arises are no different from those in any other circumstances. The authority determined that a business called JMV Agri Ltd unjustifiably dismissed an employee when negotiating the sale of the business and did not consult with him until advising that the business had been sold.
The authority accepted the sale was genuine and accordingly that the employee's redundancy was genuine.
However, the failure to observe procedural requirements rendered the dismissal unjustified.
There may well be some difficulties in balancing the obligations owed as an employer with the desire to achieve commercially realistic outcomes. Getting that balance wrong will have significant financial consequences.
Simon Menzies is a partner at Harkness Henry, Lawyers, Hamilton.
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If you?re a CRE professional in a major Texas energy market, you?re benefiting nicely from the area?s proximity to the Gulf of Mexico, oil deposits in West Texas, and a great deal of history and infrastructure backing up the state?s energy dominance.