Tag: 上海419龙凤

The watch world currently looks to be in the mood

first_imgThe watch world currently looks to be in the mood for a little Rhapsody in Blue, and these timepieces will surely be music to the ears of any true blue collector.1 Electric blue accents on the dial and leather strap of the Franc Vila FV Evos 8 “Cobra” Chronograph Large Date Automatic lend an extra zing to this already edgy watch, which is limited to 88 pieces. The audacious elliptical-shaped titanium case houses an automatic movement that powers the chronograph function and double-window “big date” calendar at 12 o’clock ($31,000).www.francvila.com2 The Piaget Polo FortyFive chronograph timepiece takes a different approach to the blue-faced watch. Using the color solely on the three central counters gives the dial a dynamic focus that works well for the sporty yet elegant timepiece. The titanium and stainless steel case is home to one of Piaget’s famous 880P ultra-thin self-winding movements ($18,900). www.piaget.com3 Sometimes it just takes a pop of color to transform a timepiece. Case in point: The Chronofighter Oversize Referee watch from Graham. As the Official Timekeeper of the 2012 RBS 6 Nations Championship in rugby, the 47mm titanium watch touts a colorful second counter at 3 o’clock with a colored stripe for each team’s home hue. Pair that with a blue hypoallergenic strap and this watch is ready to take the field ($9,265).www.graham-london.com4 The new Robusto Day-date watch from Cuervo y Sobrinos doesn’t owe its depth just to the rich blue of its dial and matching leather strap. Honeycomb texture on the dial and the streamlined case give the 43mm automatic watch added impact ($3,800).www.cuervoysobrinos.com5 The crystal clean look of Corum’s 42mm Admiral’s Cup Legend 42 Chrono watch has a fresh feel thanks to its blue dial and crisp steel case. This watch is faithful to the line’s iconic dodecagon-shaped bezel but overall its silhouette is sleeker ($6,350).www.corum.chlast_img read more

October 11 2013We received these wonderful photos

first_imgOctober 11, 2013We received these wonderful photos from architect Jim Horecka, who has visited Arcosanti many times over the years. Thank you so much, Jim![Photo credit for all of the photos in this report: 2013 James Horecka, AIA, Architect]On the last day of the Paolo Soleri Memorial Cosanti  and Arcosanti alumni, and friends supportive of Paolo Soleri’s efforts, gathered at the Paolo Soleri Scottsdale Bridge and Plaza.[photo: Paul from Flam Chen waiting with a large lense for the exact Solar Noon].Text of Jeff Steins speech at the Soleri Bridge on Sunday, September 22. 2013.“Thank you Donna Isaac, Mayor Jim Lane, and welcome.Thank you all for being here on a beautiful Sunday in Scottsdale, Arizona, home for 66 years to the architect, philosopher, writer, lecturer, EXPLORER – and our neighbor –  the late Paolo Soleri. We are gathered today at his Soleri Bridge and plaza to celebrate Paolo. We are here at this public place, designed by an individual, funded by a government – the city of Scottsdale – for the enjoyment of its citizens. We are those citizens.This bridge represents decades of thought and the ideals of its architect Paolo Soleri; his wish to connect us in this desert city to the sun and seasons, to earth and it’s ecology, his wish to use architecture to help connect us all to each other. That wish to define new relations and ways to celebrate them continues in this place today.The GREAT WORK of our generation: the transformative and radical effort to change human-Earth relations from disruptive and destructive to naturally enhancing and beneficial was first modeled for us by Paolo Soleri. His legacy of writing, of building, of BRIDGE-building, really, is what we celebrate today.[photos are of the FLAM CHEN performance during the event].A bridge is a way to cross over, a way to make a transition to the other side of something.  A bridge marks the end of one thing, the beginning of another. At this bridging moment in the history of our culture, we hope our presence here today will serve as a bridge for us to continue the work Paolo Soleri began to make a transition to a better, a more coherent way to be, on the land, in the world.The writer E.B.White  said, “I arise in the morning torn between a desire to save the world and a desire to savor the world. This makes it hard to plan the day.” Paolo Soleri had this same issue. But his life’s work, at Cosanti, at the enduring urban laboratory Arcosanti, including the Soleri Bridge and the new bas relief murals at the Arcosanti Interchange on I-17, all allow us new places and new ways to do both those things at once. Paolo Soleri created ways to connect and enjoy living, human connections, he modeled ways to bring together mind and heart and hand to develop a new consciousness of how the earth works, a new framework for the practice of architecture and urban design.Paolo Soleri’s work of cultivating awareness and attention entails a commitment to tend to and take responsibility for our communities. A clearer awareness of who we are in relation to the larger whole of earth’s ecology, rooted in respect and reverence for the whole, requires of us both a response and a responsibility. Paolo Soleri, who we honor here today, who lived and created in our midst for nearly 94 years, made a real effort to leave the world a little better than he found it. And we gathered here today intend to continue to create a reasonable alternative equal to the needs of our age. This is our time, our responsibility, and I congratulate you here today for recognizing this with your presence. I urge you to go forth from this place today with a renewed spirit, a new sense of what is possible based on the life and work of Paolo Soleri.  Thank you in advance for doing it.”last_img read more

Rep Bellino announces local office hours

first_img Categories: Bellino News 09Nov Rep. Bellino announces local office hours State Rep. Joe Bellino of Monroe will host office hours on Monday, Nov. 27 to meet with residents of Monroe and Wayne counties.“Some of the best ideas are generated from the members in our community,” Rep. Bellino said. “I welcome anyone with concerns, ideas or issues to join me.”Rep. Bellino will meet with residents at the following times and locations:9 to 10 a.m. at Biggby, 26614 Telegraph Road in Flat Rock;10:30 to 11:30 a.m. at Tim Hortons, 404 S. Monroe St. in Monroe; andNoon to 1 p.m. at Carleton Branch Library, 1444 Kent St. in Carleton.Appointments are not necessary during office hours. Anyone unable to attend is encouraged to contact Rep. Bellino’s office at (517) 373-1530, email JosephBellino@house.mi.gov or visit www.RepBellino.com.last_img read more

MBC Group has partnered with Fox Networks Group Mi

first_imgMBC Group has partnered with Fox Networks Group Middle East and North Africa to bring the Fox+ streaming service to its Shahid+ platform.Shahid PlusShahid+ will broaden its catalogue of Arabic films and series by adding thousands of hours of international TV content from Fox+, which offers National Geographic documentaries, Fox Lifestyle shows, Baby TV, and a range of other TV series and movies.“With the launch of Fox Plus, viewers will be spoilt for choice, with a width of quality content that they don’t get anywhere else,” said Sanjay Raina, general manager and senior vice-president of Fox Networks Group (FNG).“We are very proud of FNG’s partnership with MBC. It’s the coming together of a global content leader and the largest international network in the region with the biggest media house in the Arab world. By bringing Fox Plus onto Shahid Plus, we are offering millions of viewers across MENA the content of their choice, at a place, time and device of their choosing.”MBC Group CEO, Sam Barnett, said: “The Arabic-speaking content we present through Shahid Plus is unique and revolutionary across the region, something we have always been proud of. We’re incredibly excited to be collaborating with Fox Networks Group MENA to add thousands of hours of high-quality global content, consisting of series and award-winning National Geographic documentaries.”last_img read more

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first_imgSponsor Advertisement I’m only speculating here, but I would guess that JPMorgan et al were covering short position like mad in all precious metals yesterdayWell, that little uptick shortly before 10:00 a.m. in London yesterday morning turned out to be the high of the day for gold.  If it made it above the $1,600 spot level, it was only for a few seconds before the buyer[s] ran into an avalanche of selling from the usual not-for-profit suspects.It was all down hill from there, of course…but the gold price managed to open the Comex trading session in the black by a few bucks, but that lasted less than five minutes before the high-frequency traders showed up and began to engineer the price lower.The most ferocious part of the price decline started at 10:30 a.m. Eastern time…and in well under twenty minutes, the gold price cratered for another fifteen bucks.That proved to be the low the day at $1,570.70 spot…and from there a nice rally began that took the gold price back to over $1,592 spot.  But that was as high as it got…or was allowed to get…and the gold price slowly drifted lower until shortly before 4:00 p.m. Eastern time…and from there traded flat into the 5:15 p.m. electronic close.Gold finished the Tuesday session at $1,582.40 spot…down $6.20 from Monday.  It should come as no surprise that the volume figures for Tuesday were 50% higher than Monday’s, as net volume was around 129,000 contracts.It was precisely the same story in silver…except the price was more ‘volatile’.  Silver’s high…around $27.65 spot…came at the same time as gold’s…shortly before 10:00 a.m. in London.  Silver was still up about a dime at the Comex open until the high-frequency traders showed up at 9:40 a.m….and then again at 10:35 a.m. Eastern time.The low in silver [$26.68 spot] came at the same as gold’s low.  The subsequent rally took silver back above its Monday close and the Tuesday opening price on the Comex…and the New York high of the day.  But that wasn’t allowed to last, and silver closed the trading session at the same closing price as Monday…$27.31 spot.  What was the chance that that was a coincidence?  Net volume was also 50% higher than Monday’s volume…with 36,000 contracts traded vs. 23,000 contracts traded on Monday.The dollar index didn’t do a whole heck of a lot during Far East or London trading on Tuesday.  It was down about twenty basis points in early Far East trading…but then rallied back to basically unchanged by the 8:00 a.m. London open.  From there it more or less traded sideways until exactly 10:00 a.m. Eastern time, which also happened to coincide with the time of the London p.m. gold fix.Then, in the space of about forty minutes, the index rallied about 40 basis points.  The dollar index high tick just coincidentally happened to coincide with the low of both gold and silver in New York yesterday morning.From that high, the index got sold off…giving up all its gains and more by 4:00 p.m. Eastern time.  From there, the dollar index traded flat into the close, finishing the Tuesday trading session down about 15 basis points at 82.92.I’d like to say that yesterday’s sell-off in the precious metals was all currency related, but that certainly doesn’t explain the decline in both metals that began at 10:00 a.m. in London…and which continued right up until 10:00 a.m. in New York.  A large chunk of the dollar index rally was in the bag before either gold or silver got sold off hard…and it’s my opinion that they didn’t fall off the turnip truck at 10:30 a.m. Eastern on their own…they got pushed.The gold stocks actually spent a few minutes in the black after trading began in the equity markets in New York yesterday morning.  But that didn’t last too long..and from there they got sold off over two percent to their low at 10:40 a.m. Eastern time.  Then they rallied sharply until a few minutes after 12 o’clock noon…and then traded sideways from there.  The HUI finished down 0.97% on the day…and back below the 400 mark.There was the odd green arrow in the silver stocks yesterday…but they closed mostly down on the day…but Nick Laird’s Silver Sentiment Index actually finished the Tuesday trading day up 0.56%.  Considering the closing price of the seven big cap silver stocks that make up this index, I found this very hard to believe…and I told Nick that.(Click on image to enlarge)The CME’s Daily Delivery Report showed that 2 gold and 436 silver contracts were posted for delivery on Thursday.  The big shocker, at least for me, was that the big short/issuer was JPMorgan in its in-house/proprietary account.  They’re delivering 426 contracts.  The biggest long/stopper was the Bank of Nova Scotia with 324 contracts…along with 63 contracts for JPMorgan in its client account…and 43 contracts for ABN Amro.  The Issuers and Stoppers Report is definitely worth looking at…and the link is here.There were no reported changes in either GLD or SLV…and the U.S. Mint didn’t have a sales report either.Over at the Comex-approved depositories, they reported receiving 599,779 troy ounces of silver on Monday…and shipped 906,225 ounces of the stuff out the door.Ted Butler pointed out to me yesterday that Sprott’s Physical Silver Trust [PSLV/PHS.U] has already reported receiving around 5.2 million ounces of the silver that it had ordered.Here’s an e-mail that I received from reader Eddie Costik yesterday…and it’s pretty much self-explanatory…Ed…”I have news for you….the home industry in the U.S. is finished as we know it. Retail sales for home improvement were down 1.6% for the month of June. I’m still in touch with wholesale distributors of building materials…nobody in that industry is making any money. My small retail lumber company is only one of five remaining in a five county area of Central Pennsylvania. Everyone is struggling. The halcyon days from the past are over. Mortgage rates are at all time lows but very few can qualify because of stringent qualification requirements. There are so many foreclosures that banks are holding them off the market so they don’t have to write them down. If Obama gets his way…. eliminating the Bush tax cuts we’re headed for an economic abyss. Then again how much worse can it get? A lot. Hold onto your behind this is not going to end well.” It was a very slow news day yesterday, so I’m delighted to report that I don’t have much reading material for you…but there are quite a few of the ones that I do have, that are well worth your time.As investors begin to realize that gold has not peaked, and that today’s “high” prices are actually just a step on the way up, I expect more of them to pile into the gold sector. The pressure to find sectors and companies with a good return will send Main Street investors, Wall Street fund managers, and sovereign wealth funds into our market. The spectacle will be, as Doug Casey likes to say, like trying to pour the contents of the Hoover Dam through a garden hose. – Louis James, Senior Metals Investment Strategist, Casey ResearchThere’s not much one can say about yesterday’s price action in all the precious metals except to say that we’ve seen this particular movie lots of times in the past…an engineered price decline behind a manufactured rally in the dollar index.As I mentioned in my closing remarks in ‘The Wrap’ yesterday…Tuesday was the cut-off for Friday’s Commitment of Traders Report, so I was prepared for anything as far as price movement went…and this price pattern didn’t surprise me one bit.I’m only speculating here, but I would guess that JPMorgan et al were covering short position like mad in all precious metals yesterday…and going further on the long side as well in the subsequent rally, which had all the hallmarks of a short covering rally.  I am hopeful that all this price action will show up in Friday’s COT report…and it should be obvious to anyone that the ‘powers that be’ want gold below $1,600 spot for as long as possible.It was gratifying to see John Hathaway come out of the closet and state that ‘da boyz’ are obviously managing the gold price…just as they are managing the LIBOR.  I would suspect that Eric King will have the audio interview of that blog posted on this website sometime today…and I will be posting it this space as soon as it becomes available.Not much happened in Far East trading during their Wednesday…and it’s pretty much the same now that London is open.  Volume is light in both metals…and the dollar index is not doing a thing, either.I haven’t a clue as to how gold will trade during the Comex session in New York today, but one can assume that the worse the news, the lower the gold price will be engineered.  As to when the precious metal prices break higher, it’s 100% up to JPMorgan et al…and when they decide to end their duties as a not-for-profit seller, it will be immediately apparent in the price…and not a moment before.I hope that your Wednesday goes well…and I’ll see you tomorrow. Bayfield Ventures Corp. (TSX.V: BYV) is exploring for gold and silver in the Rainy River District of NW Ontario. The Company’s 100% owned “Burns” Block property adjoins the immediate east of Rainy River Resources’ (TSX.V: RR) world-class gold deposit which includes an indicated resource of 5.72 million ounces of gold, averaging 1.18 g/t, in addition to an inferred resource of 2.25 million ounces of gold, averaging 0.79 g/t. Drilling to date on Bayfield’s Burns Block demonstrates that the ODM17gold zone extends from Rainy River Resources’ ground onto the Burns Block. Bayfield is currently carrying out 100,000 metres of diamond drilling on its Rainy River properties. Drill results thus far have been very encouraging. Notable drill results include 60.05 grams per tonne gold and 362.96 grams per tonne silver over 11.2 metres within 26.70 grams per tonne gold and 170.69 grams per tonne silver over 25.5 metres, as well as 35.93 grams per tonne gold and 359.65 grams per tonne silver over 10.0 metres. Bayfield also holds a 100% interest in two other properties in the Rainy River District. Claim blocks “B” and “C” are well located to the immediate east and west (respectively) of Rainy River Resources’ #433 and ODM17 gold zones. Please visit our website to learn more about the company and request information.last_img read more

Its been 40 years since doctors in San Antonio fi

first_imgIt’s been 40 years since doctors in San Antonio first organized a conference about breast cancer to educate local physicians. A few nationally known experts flew in, and at an airport hotel, some 140 people — mainly men — talked over slide presentations. The event has grown — and evolved — since 1978. This year, some 7,500 people gathered in early December at the San Antonio Breast Cancer Symposium, the world’s largest annual conference devoted to breast cancer. Another thing that makes the symposium special is the presence of a couple of hundred patient advocates alongside scientists and clinicians. In San Antonio, advocates stand up and ask questions after plenary talks. Patients sit on panels, contribute papers and weigh in on research prioritiesBy speaking up, advocates at the meeting have shifted the direction of breast cancer research. Some are alive, improbably, as a consequence of new treatments enabled and promoted by their advocacy. In recent years, advocates have steered attention toward metastatic disease.When I practiced oncology years ago, there was little concept of cancer-patient activism, apart from fundraising and helping spread official, doctor-approved recommendations. Since my personal breast cancer diagnosis, 16 years ago, cancer advocacy has changed dramatically.For patient advocates, now including me, visiting San Antonio has become a December ritual. We learn what’s happening in the field, network and see old friends. We hug and stroll the River Walk. We cry, remembering acquaintances who’ve died.For a growing number of patients living with metastatic breast cancer, learning has become a priority. As more clinical trials and new options for testing and treatment are becoming available, patients are educating themselves in the hope of saving themselves. And they are voicing their needs.The San Antonio symposium was one of the first medical conferences to include patient advocates. However, members of the local Alamo Breast Cancer Foundation recall the days when they weren’t invited to the sessions. Sandi Sanford, 74, runs the advocacy program for the group, which she joined in 1994. “I was six months out from surgery and still had a couple of chemotherapy treatments to go,” she told me. In 1996, she and other “Alamo” women staffed an information booth during the symposium, then held in a downtown Marriott ballroom. “There was no program for us,” Sanford told me. “We’d sneak into the sessions, stand in the back of the room and lean against the wall.”In 1998, the Alamo Breast Cancer Foundation started a grants program for advocates to help them travel to the San Antonio meeting; it expanded. Money for the Alamo educational programs comes mainly from industry. The annual budget, over $250,000, mostly goes toward room rental and convention center facility fees, video support for social media and livestreaming, Sanford told me. “These funds are used for educating advocates in an unrestricted manner,” she said. “We are not allowed to play favorites and we don’t promote any company’s drug.”Doctors attending the symposium value the patients’ participation. “There is a very clear and prominent role for patient advocates here at the meeting,” said Dr. Nikhil Wagle, a Harvard oncologist who leads the Metastatic Breast Cancer Project. At this year’s symposium, he gave a plenary talk on the genomic landscape of breast cancer. “Over the last several years, I’ve seen advocacy increase in a very positive way,” Wagle told me. “Knowing that there are patients and advocates in the room makes presenters aware of their concerns; it affects what we say and what research we do.”Speakers don’t dumb down the educational sessions for advocates. Far from it! On Wednesday evening of this year’s symposium, I stopped by a “Hot Topic” session, where experts review the days’ scientific reports. Dr. Julie Gralow of Seattle was expounding in detail on atezolizumab, a PD-L1 antibody, before a room of engaged advocates. Later, they lined up at microphones and asked detailed questions about gene mutations, fibroblasts in breast tissue and contradictory clinical trial results. Like doctors, patient advocates don’t always agree. In a lunchtime session with members of the Food and Drug Administration’s Oncology Center of Excellence, advocates raised concerns about the agency’s approval of drugs that don’t necessarily prolong survival. Some asked about the design of clinical trials. The agency’s breast cancer team, led by Dr. Tatiana Prowell, emphasized that the FDA wants to hear from patients with varied perspectives.A personal highlight of the conference — because the benefits of patient advocacy were evident — was the annual Metastatic Breast Cancer Alliance dinner held at the historic Menger hotel, steps from the Alamo.”If you went to the San Antonio Symposium in 2011, researchers had very little to say that was relevant to advanced breast cancer,” said Shirley Mertz, a former high school principal in Illinois who has been living with metastatic breast cancer since 2003. Metastatic breast cancer is an incurable condition that still carries a dim prognosis. “If you heard anything about metastatic cancer, it was on Saturday, after [most] people went home,” said Mertz, a co-founder of the alliance in 2013. Then, she added with pride, now “the program is full of metastatic breast cancer!” Dr. Elaine Schattner is a journalist, patient advocate and physician who lives in New York City. She is writing a book about public attitudes toward cancer. Copyright 2018 NPR. To see more, visit https://www.npr.org.last_img read more

Mobilizing VoIP

first_img Mobilizing VoIP Register Now » Add to Queue 2 min read Learn how to successfully navigate family business dynamics and build businesses that excel. Dan O’Shea Most small-business entrepreneurs are now well aware of the economic benefits and flexibility advantages of using VoIP for their office communications needs. Now, it’s time for lesson two: How to leverage VoIP’s benefits while on the go.A big-box retailer, hearty competitor to many a small business, may seem an unlikely teacher for this lesson. Yet, Best Buy is doing an increasingly good job of addressing the technology needs of its small-business customers. As part of the Best Buy for Business concept, the retailer operates its own national VoIP service provider­–Speakeasy­–catering to the small-business market.Speakeasy, based in Seattle, was already a nationally known VoIP service brand when Best Buy acquired it in 2007. Thousands of small businesses in the U.S. use Speakeasy Hosted Voice, and late last year, Speakeasy introduced the first mobile extension of its platform, targeted at iPhone users. EasyVoice Mobile for iPhone extends an existing Speakeasy customer’s wireline calling package, including a call management feature and free calling to more than 20 countries, to a device that has become standard issue to small-business owners.Call management functions run through Remote Office, an application that integrates with an iPhone contact list and allows iPhone users to make and receive calls via their desktop office phone number. Users can also hold, forward, access voice mail and do pretty much anything they would while at the office. “It gives the impression that you’re always available,” Chatterley said.He added that the big telecom companies still do a poor job of addressing evolving small-business calling needs, delivering cellular plans targeted at small firms, but not comprehensive applications covering both the fixed office and the mobile office. Ironically, a big-box retailer may teach them a lesson, too. Magazine Contributor Speakeasy takes the popular voice alternative on the road. Technology This story appears in the February 2010 issue of Entrepreneur. Subscribe » Next Article Free Webinar | July 31: Secrets to Running a Successful Family Business –shares January 15, 2010last_img read more

US Holiday Weekend Store Sales Fizzle

first_img December 1, 2014 Enroll Now for $5 Next Article Add to Queue –shares Black Friday Learn from renowned serial entrepreneur David Meltzer how to find your frequency in order to stand out from your competitors and build a brand that is authentic, lasting and impactful. This story originally appeared on Reuterscenter_img Fireside Chat | July 25: Three Surprising Ways to Build Your Brand Early holiday promotions and rising online shopping took a toll on in-store U.S. sales during the Thanksgiving weekend as shoppers on average spent 6.4 percent less than they did a year earlier, according to data released Sunday by an industry group.The National Retail Federation estimated shoppers on average spent $380.95 at stores this holiday weekend, which began on Thursday, compared with $407.02 a year ago, and total spending fell about 11 percent to $50.9 billion over the weekend.NRF President and Chief Executive Matthew Shay said there is an “evolutionary change” in holiday shopping among both consumers and retailers, and this trend is likely to continue.The data highlights the growing importance of online sales and the waning importance of Black Friday, which until a few years ago traditionally kicked off the holiday shopping season in the United States, as more retailers open their doors on Thanksgiving Day and start discounting merchandise earlier in November.comScore, a retail analytics firm, said U.S. online sales rose 32 percent to $766 million on Thanksgiving and 26 percent to $1.2 billion on Black Friday, driven by stronger deals online.The Thanksgiving weekend is an early gauge of consumer mood in a season that generates about 30 percent of sales and nearly 40 percent of profit for retailers.Discounted high-end apparel, televisions and toys were the most popular this year followed by items including video games, home furnishings and jewelry, according to the NRF survey of 4,631 consumers.Department stores like Macy’s were the most visited followed by discount retailers like Wal-Mart, Target and electronic chains like Best Buy.NRF said nearly two in five consumers shopped online or plan to shop online by the weekend’s end.On Saturday, research firm ShopperTrack said sales at retail stores fell 0.5 percent.RetailNext, another analytics firm, on Sunday said it found overall shopper traffic on Black Friday fell 14 percent, but on average shopper spending rose 1.9 percent, as conversion rates were higher, with shoppers spending more once in the store.”Sales on Black Friday were very disappointing but retailers managed to drive a lot of people to their websites early on which helps us remain optimistic about the overall holiday season,” said Shelley Kohan, vice president, retail consulting, at RetailNext.The NRF stuck to its forecast for retail sales to rise 4.1 percent this holiday season.(Reporting by Nandita Bose in Chicago; Editing by Jilian Mincer and Eric Walsh) U.S. Holiday Weekend Store Sales Fizzle Image credit: Reuters | Eduardo Munoz 2 min read Reuters last_img read more

Pain sensitization linked to increased risk for persistent knee pain

first_img Source:http://www.bmc.org/ Reviewed by Alina Shrourou, B.Sc. (Editor)Oct 31 2018Becoming more sensitive to pain, or pain sensitization, is an important risk factor for developing persistent knee pain in osteoarthritis (OA), according to a new study by researchers from the Université de Montréal (UdeM) School of Rehabilitation and Hôpital Maisonneuve Rosemont Research Centre (CRHMR) in collaboration with researchers at Boston University School of Medicine (BUSM). These findings have just been published in the journal Arthritis and Rheumatology.OA is a common cause of pain and altered joint function, affecting 302 million adults worldwide. It can lead to chronic disability frequently in the knee joint. Past research suggests that a number of different factors outside of structural pathology may contribute to pain experienced in patients with OA.Related StoriesAre Chronic Pain Relief Drugs for Children Effective?Arthroscopy more accurate than MRI for chondral defects of the knee, study findsYoung players may need one-year rehab time after knee surgery”Understanding the factors that contribute to the development of persistent pain is critical in improving our ability to prevent its onset and the transition to more persistent pain’, said Lisa Carlesso BSc.PT. PhD, assistant professor School of Rehabilitation UdeM and scientist CRHMR.Researchers analyzed data from a multicenter OA study that followed 852 adults (ages 50-79) with or at risk of knee OA but who were free of persistent knee pain at the beginning of the study. Sociodemographic data, pain sensitization measurements, as well as risk factors traditionally associated with knee pain such as psychological factors, widespread pain and poor sleep were collected on the participants who then were followed for development of persistent knee pain over two years.The researchers used the above risk factors and pain sensitization data to identify four distinct subgroups called pain susceptibility phenotypes (PSPs). The authors found these PSPs were primarily characterized by varying degrees of pain sensitization. The PSP with the highest degree of sensitization had the highest risk of developing persistent knee pain. Female gender, non-Caucasian race and age 65+ were significant sociodemographic predictors of being a member of the PSP with the highest degree of sensitization.The researchers believe identifying these PSPs is an important step in understanding the complex pathology of knee osteoarthritis. “Our findings suggest that therapy aimed at prevention or improvement of pain sensitization may be a novel approach to preventing persistent knee pain,” explained author Tuhina Neogi, MD, PhD, professor of medicine and epidemiology at BUSM and BU School of Public Health. “Preventing pain is crucial to improving quality of life and function in patients who suffer from OA.”last_img read more

Health officers with surgical training are a safe alternative for performing Csections

first_img Source:https://www.ntnu.edu/ Reviewed by James Ives, M.Psych. (Editor)Feb 14 2019Task sharing in Sierra Leone — teaching emergency surgery to health officers — can help improve healthcare in a country with few doctorsSierra Leone has one of the highest maternal mortality ratios in the world — for every 100,000 live births, 1360 women will die. In Norway, that number is just 5 women per 100,000 live births; in the US, it’s 14, according to the United Nations Population Fund.Why are so many women dying in Sierra Leone? The answer is simple: childbirth can be complicated and there are simply not enough health care providers to address the needs of this small West African country of 7 million people.Before the 2014-2016 Ebola outbreak, just 10 specialist surgeons were available in public hospitals, with about 150 doctors in total.But there is hope: a new study of more than 1200 women who had C-sections in nine Sierra Leone hospitals shows that community health officers with surgical training are a safe alternative to medical doctors when it comes to outcomes for Caesarean sections. The study was conducted between October 2016 and May 2017, and has just been published in BJS, the British Journal of Surgery.”Some of these hospitals have just one or two doctors for the whole district,” said the study’s first author Alex van Duinen, a Dutch medical doctor and PhD candidate at the Norwegian University of Science and Technology (NTNU). “Human resources are a major problem. Task sharing — teaching community health officers to provide basic lifesaving surgeries — can improve that.”Building acceptance in the medical communityVan Duinen’s research is being conducted as part of his work with a non-profit organization called CapaCare, co-founded in 2011 by Håkon Bolkan, a surgeon at St Olavs Hospital and a postdoc at NTNU.CapaCare offers a two-year training programme for selected community health officers (CHO), with the goal of teaching them to do surgeries such as Caesarean sections, appendectomies and hernia repairs.After the two years of training, graduates also spend a year as an intern at one of the main hospitals in Freetown, after which they are given the position as a surgical assistant community health officer (SACHO). To date, 31 participants have graduated from the programme, with another 33 in training.But CapaCare’s work is not as simple as just producing qualified graduates — Sierra Leone’s medical community, health care officials and the population as a whole have to have confidence that the CapaCare graduates can perform surgeries at least as well as medical doctors.This evidence has to be clear, and provide scientifically documented proof that the training works. So that’s where van Duinen’s research comes in.Prospective study with a home visitOther researchers have looked at the issue of task sharing for emergency obstetric care, mainly in East Africa, but most of these studies have been retrospective, which means that researchers essentially look for patterns in medical data that have already been collected.Nevertheless, all of these studies show that task sharing can work well in places where there are just not enough doctors to go around.On the other hand, a prospective study like that conducted by van Duinen and his colleagues is seen as much stronger support for the findings from the research.Researchers in a prospective study decide which data to include before they collect it, which ensures data quality. The Sierra Leone C-section study also included a home visit 30 days after the birth, which allowed van Duinen and his colleagues to see how mother and child were doing in the period after discharge.CapaCareRelated StoriesTransobturator sling surgery shows promise for stress urinary incontinenceTackling high sugar content in baby foodStudy analyzes high capacity of A. baumannii to persist on various surfaces”We were able to check some of the outcome data,” van Duinen said. “Home visits were one of the distinguishing factors of our study.”For example, one baby that had been recorded as a stillbirth in the hospital and one baby that had been recorded as a death were both found to be alive when the researchers did the home visits.Three of the mothers and 28 of the babies who were alive when they left the hospital also died in the month after birth, which researchers wouldn’t have discovered without this extra follow up, van Duinen said.Not inferior to doctorsWhen all the numbers were tallied, the researchers found 16 postoperative maternal deaths, 15 treated by a doctor and 1 treated by a graduate of the CapaCare programme.These numbers indicate that doctors may have worse outcomes. “Although our data suggest that patients treated by doctors and graduates were mostly similar, doctors may have treated more of the complicated patients,” van Duinen said.The difference in the mortality numbers is also due to the fact that there were 50 doctors in the study compared to 12 graduated clinical officers. These 50 doctors performed 831 C-sections that were included in the study, or two-thirds, compared to 443 performed by the graduates. Of these surgeries, 85 per cent were done as emergency surgeries.However, the mortality numbers and the number of emergency surgeries are “still very high,” van Duinen said, but there are also reasons for that.”There’s a huge disincentive for women in the districts to come into the hospital to give birth,” he said. “That’s why the outcomes are so bad.”Very often, he said, women will wait until the absolute last minute to come in for care, because it may be too costly for them to both travel and get treated at the hospital. They may also be afraid of coming to the hospital because of concern of what they might find there — it was not that long ago, for example, that Ebola ravaged the country’s health care system, during which more than 14000 people were infected and 4000 died.When the researchers analysed the numbers, they found that caesarean sections done by the graduates were not associated with higher maternal mortality 30 days after the surgery than caesarean sections performed by doctors.”The message is that there is a slight difference in the two groups, because the doctors may get the more complicated cases, but overall we see that there is non-inferiority,” van Duinen said.Kismet in the jungleJust by chance, van Duinen has worked with CapaCare since the organization first started its training programme in 2011. That’s because he was working at the time at Masanga Hospital, in Sierra Leone’s Tonkolili province, as hospital director. Masanga Hospital has been the base for CapaCare’s training in Sierra Leone.The first week he was at Masanga, van Duinen met Bolkan with the first CapaCare student who was just beginning his training.The idea of training non-doctor medical personnel to do emergency surgeries — task sharing — was already something he knew about. During his medical training in the Netherlands, he was sent to Malawi for an internship, where the practice is well established.”I saw that task sharing could actually work, and then I met Håkon, and I said, ‘Yes, of course, we have to do this! It works, I have seen it!’,” he said.last_img read more

Renault audit finds no fraud yet as Ghosn learns fate

first_imgNissan said earlier that its board had also met Thursday, when directors had received “an updated report” on its own investigations into Ghosn’s alleged misconduct. This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. Citation: Renault audit finds no fraud yet as Ghosn learns fate (2019, January 10) retrieved 17 July 2019 from https://phys.org/news/2019-01-renault-fraud-ghosn-key.html Chance of bail?Japanese media, citing Ghosn’s lawyers, said Thursday that he was suffering from a high fever and unable to meet investigators for questioning.At his dramatic court appearance on Tuesday, Ghosn appeared to have lost a lot of weight in detention but otherwise seemed in good health.”I have been wrongly accused and unfairly detained based on meritless and unsubstantiated accusations,” the once-revered car titan told the court.In a career spanning decades, during which he won praise for turning around a struggling Nissan, he said he had “always acted with integrity” and had never before been accused of any wrongdoing.But afterwards Ghosn’s lawyer said it would be “very difficult” to win bail and it could be months before his case is heard.The French government has stood by Ghosn so far, saying he must benefit from the presumption of innocence.But Transport Minister Elisabeth Borne told French radio this week that “obviously, if this situation continues we’ll have to draw the consequences.” © 2019 AFP Ghosn was told in a Japanese court that he was a flight risk The internal Nissan probe may be widening, reports say Board members weren’t told whether the meeting is about Ghosn Nissan last weekend put two executives close to Ghosn on leave of absence, suggesting that the internal investigation into the alleged misconduct could be spreading.Jose Munoz, the chief performance officer, and human resources head Arun Bajaj have not been replaced during their absences.Nissan as well as Mitsubishi, the third alliance partner, have removed Ghosn as chairman, but Renault has kept him on while appointing a deputy CEO to ensure day-to-day management.The French automaker has said internal investigations have found no signs of wrongdoing by its chief during his tenure.But pressure on Ghosn rose further Thursday after French daily Liberation reported that he had not been paying French income taxes since 2012, after moving his fiscal residency to the Netherlands.Both Renault and the French economy ministry declined to comment, but it was an unwelcome revelation for the head of a company in which the French state owns a 15-percent stake.”The leader of a French company should pay his taxes in France,” President Emmanuel Macron said in a speech last month. Explore further Renault and the French government are standing by Ghosn, for now Renault board maintains Ghosn as CEO, says pay was legal Ghosn’s requests Tuesday to be released before trial were rejected by a judge who declared he was a flight risk.One of his lawyers later conceded that Ghosn could spend a further six months behind bars before his case comes to trial.Japanese media reports have suggested new charges could be levied against him on Friday, which could ensure he remains jailed.He may be accused of understating his salary from 2015 to 2018, three years more than the original charge that he under-reported some five billion yen ($44 million) in income over five years from 2010.He could also face charges for breach of trust, reports say.The claims have heightened worries over the viability of keeping him on as Renault’s chief executive.New revelationsFrench daily Le Figaro reported Thursday that the board meeting was one of several informal gatherings held regularly since Ghosn’s arrest to discuss developments in the case. The board of French automaker Renault on Thursday said an ongoing audit into executive pay had found no sign of fraud in the last two years, as CEO Carlos Ghosn could face fresh charges in Japan. Directors gave no hint in their statement of any deliberations into Ghosn’s future at Renault, as Japanese prosecutors reportedly prepare to press new formal charges likely to keep the once-towering auto boss behind bars.The Renault meeting comes two days after Ghosn made his first court appearance over alleged financial impropriety during his years as head of the carmaker’s alliance partner Nissan.Renault’s board said an independent review had looked into the compensation of the group’s executive committee during the financial years 2017 and 2018 “and has concluded that it is both in compliance with applicable laws and free from any fraud”.But the board statement added that the audit would continue, with previous years scrutinised as it progresses. Ghosn, who has been Renault CEO since 2005, has been languishing in a Tokyo detention centre for more than 50 days as he fights multiple allegations of financial misconduct.The 64-year-old has been formally charged with under-declaring his income by tens of millions of dollars in an apparent bid to quash accusations he was overpaid.He also faces questioning in connection with alleged attempts to transfer personal investment losses to Nissan and making unnecessary payments to a Saudi associate from company funds.last_img read more