Her health plan, WellPoint's Blue
Cross of California, ended up paying for only two days, not because it refused
payment for the added stay because of the error, but because before the
operation, WellPoint had only authorized a two-day stay and didn't receive a
request for an extension. (The average length of a stay for Ms. Whitfield's
procedure is 4.6 days.) The insurer says it noted nothing unusual about the
claim filed by the hospital, although the bill did list the diagnosis code for
an infusion of "mismatched blood."
Spurred by laws requiring more public
reporting of errors, some hospitals have adopted their own policies on billing
for medical errors. All hospitals in Minnesota and Massachusetts, for example,
have pledged not to charge for all or some of the errors on the never-events
list.
But others say broader policies, such
as Medicare's, could punish hospitals unfairly and force them to absorb the
costs of screening each patient for bedsores or infections at the time of
admission.
Insurers are refusing to pay for care
triggered by some complications they believe hospitals should prevent,
including:
Object left in patient after surgery
Letting patient wander or disappear
Administering wrong blood type
Artificially inseminating wrong donor
sperm or egg
Allowing patient to fall
Operating on wrong limb
Performing wrong procedure
Using contaminated drugs or devices
Discharging infant to wrong person
Mother's death or serious disability
in low-risk delivery
Hospital-acquired bedsores
Patient abduction or sexual assault
Some in the industry worry that
hospitals may find ways to turn away or divert patients at greatest risk of
developing infections or bedsores. "The concept of not paying for
complications that are often a biological inevitability, regardless of safe
practice, is discriminatory and could be punitive to those patients at greatest
risk," Michael Maves, executive vice president of the American Medical
Association, wrote in a June letter to the federal Centers for Medicare and
Medicaid Services.
Hospitals have an incentive to invest
in reducing infection rates, health-safety advocates argue. Since health plans
pick up only so much of the extra cost caused by infections, "hospitals
are losing their shirts, too," says former New York Lt. Gov. Betsy
McCaughey, who formed the Committee to Reduce Infection Deaths, a national,
nonprofit campaign to push hospitals to lower infection rates.
To lower its rate of infection, one
hospital, Pitt County Memorial Hospital in Greenville, N.C., in February
expanded its screening for methicillin-resistant staph infections to all
patients coming into the hospital. By identifying and isolating those with the
strain early, it lowered the number of MRSA pneumonia cases related to
ventilator use by 67% and MRSA urinary-tract infections by 60% within eight
months. In all, the expanded screening has cost nearly $1 million, $800,000
picked up by private and public insurers.
Steve Lawler, the hospital's
president, says it has more than recouped its $200,000 investment. Moreover,
spending the money to make the hospital safer is a "better return on
investment...than some billboard campaign," he says.
http://louis-j-sheehan.us/ImageGallery/CategoryList.aspx?id=a1206a74-5f7f-443f-97f5-9b389a4d4f9e&m=0
http://louis1j1sheehan.us/ImageGallery/CategoryList.aspx?id=36f0e6c9-8b8a-4f0a-8630-e5d3b879fad4&m=0
http://louis2j2sheehan.us/ImageGallery/CategoryList.aspx?id=14218f60-0cb6-4fa5-beba-5ee65da4b5e1&m=0
Looking to build on the success of its
iPod and iPhone devices, Apple Inc. introduced several new products including
an ultra-thin laptop computer, dubbed the Macbook Air, and a much-anticipated
online movie rental service.
The new Apple notebook computer's
major attribute is its sleek profile: it's about three-quarters of an inch
thick and weighs three pounds. The Macbook Air features a full-sized keyboard,
a 13-inch screen, a built-in camera, and Wi-Fi and Bluetooth connectivity, all
powered by an Intel Corp. dual core chip.
Appearing on stage at the company's
Macworld expo, Apple Chief Executive Steve Jobs said the computer, which he
called "world's thinnest notebook," will cost $1,799 and is scheduled
to ship in about two weeks.
With the MacBook Air, Apple becomes
the biggest name in two years to try to revive an industry it arguably began
with the introduction of its Newton handheld computer 15 years ago.
Ultramobile notebooks represent about
6% of the 270 million notebooks expected to the sold this year. Sales have of
the devices have languished, despite efforts from Lenovo Group, International
Business Machines Corp., and two years ago by Microsoft Corp. with its
"Origami" ultra mobile device.
Apple may benefit from good timing.
Asustek Computer Inc.'s recently introduced Eee PC has topped sales charts at
Amazon.com and is usually sold out at retail stores.
"Apple's Newton was ahead of its
time,' said Shaw Wu, an analysts with American Technology Research. "The
functionality wasn't quite there, battery life, screen technology. Now there
are products out there proving there's a market for this."
Investors seemed to be unimpressed by
the new products: Apple hares dropped more than 6% Tuesday on the Nasdaq Stock
Market.
Apple's CEO also launched the computer
maker's much-anticipated online movie rental service and unveiled an updated
Apple TV device that will let viewers bypass their computers and rent movies
directly from their widescreen TVs.
Apple's Macbook Air
Mr. Jobs said iTunes users can rent
new-release movies to watch over their computers, iPods or iPhones for $3.99
for a 30 day period. Older titles will rent for $2.99 for the same time period.
The service has the support of all
major Hollywood studios including Walt Disney Co., Time Warner Inc.'s Warner
Bros., Paramount, Universal, Sony Pictures, Metro-Goldwyn-Mayer, News Corp.'s
Fox, Lionsgate and New Line, Apple said.
Apple's push into the online video
market comes after the original Apple TV device stumbled badly with its first
effort last year. "We tried. Now were back," he said.
Apple sees the Internet video service
as another key element in its effort to put its products at the center of the
living room entertainment hub of the future, and at the same time, sell more of
its hardware products. This tactic worked before, when the Cupertino, Calif.,
company created iTunes music store to drive iPod sales.
Mr. Jobs also disclosed Apple had sold
more than four million iPhones worldwide in the 200 days since the company's
trend-setting smartphone was launched. Mr. Jobs said the iPhone had sold 3.4
million units in the U.S., outstripping even the most optimistic analyst
forecasts. Mr. Jobs said Apple now has a 19.5% share of the U.S. smartphone
market, second only to Research in Motion Ltd.
Apple also introduced an iPhone
software update, available Tuesday, that would include new features that allow
users to send texts to multiple addresses, create bookmarks that show up as
icons on the home screen. It will cost $20 for iPod Touch customers.
A highly drug-resistant superbug is
gaining resistance to more drugs and burrowing deeply into the gay communities
of San Francisco and Boston, researchers said.
Sexually active gay men are 13 times
as likely to have this strain of the highly resistant bacterium, known as MRSA,
or methicillin-resistant staphylococcus aureus.
More worrisome still, the new strain
of MRSA called USA300 is growing resistant -- or unresponsive -- to three or
even four classes of widely used antibiotics.
http://louis-j-sheehan.us/ImageGallery/CategoryList.aspx?id=a1206a74-5f7f-443f-97f5-9b389a4d4f9e&m=0
http://louis1j1sheehan.us/ImageGallery/CategoryList.aspx?id=36f0e6c9-8b8a-4f0a-8630-e5d3b879fad4&m=0
http://louis2j2sheehan.us/ImageGallery/CategoryList.aspx?id=14218f60-0cb6-4fa5-beba-5ee65da4b5e1&m=0
MRSA causes deep and stubborn skin
infections and has been called the most common cause of skin infections treated
in the nation's emergency rooms. It also more rarely can cause lethal invasive
infections such as pneumonia or sepsis (blood poisoning).
Several drug classes that have lost
their punch against the worsening strain include families that contain:
penicillin, erythromycin, clindamycin, tetracycline and fluoroquinolone drugs
such as Cipro, said Binh Diep, researcher at the University of California at
San Francisco and first author of the study in the Annals of Internal Medicine.
The toughest strain also now is
resistant to mupirocin, a topical antibiotic drug used to clear MRSA from the
skin surface and nostrils where the bug is known to colonize even people
without an infection.
The study emerged from a retrospective
review of charts from 183 patients treated for MRSA at the San Francisco
General Hospital's Positive Health Program, an outpatient clinic used by people
with HIV, the virus that causes AIDS. An additional 130 patients were studied
at Boston's Fenway Community Health clinic.
The review of charts found gay men age
18-35 to be hardest-hit. ZIP Codes around San Francisco's Castro District, a
largely gay neighborhood, were heavily affected. Previously, MRSA infections
have been documented in sports teams, prison populations, gym-goers and the
community at large.
Skin-to-skin contact, including sexual
relations, are believed to be major ways the bug spreads from person to person.
But Henry "Chip" Chambers, chief of infectious diseases at SF General
and a study co-author, said heavy antibiotic use is "the most important
factor" that the superbug's toughest strain resides among gay men.
Unlike resistant infections of the
past, which thrived mainly in hospitals, MRSA runs rampant through the
community and can crop up in people with no recent antibiotic use.
"It's more virulent than standard
staph," said Shelley Gordon, an infectious-disease specialist in private
practice at California Pacific Medical Center. To avoid using the wrong drug
and fueling even more resistance, she urged testing for drug resistance,
adding, "doctors in emergency settings have to be hip to this and do
cultures."
Worry warts often believe they
inherited their tendency to stew from their parents. Biology does play a role,
research suggests, but there are things you can do to break the cycle of
agonizing.
Researchers at Yale have identified a
gene mutation for "rumination" -- the kind of chronic worry in which
people obsess over negative thoughts. It's a variation of a gene known as BDNF
that's active in the hippocampus, an area of the brain involved in thinking and
memory. In a study of 200 mothers and daughters published in the journal
Neuroscience Letters last month, the Yale scientists found that those who had
been depressed in their youth were more likely to be ruminators and to have
this particular variation of BDNF.
The discovery adds to a growing body
of evidence that depression involves an inability to control negative thoughts,
not just excess emotion, says psychologist Susan Nolen-Hoeksema, one of the
Yale investigators. And just because rumination has genetic roots doesn't mean
it's inescapable, she says. "People can learn to stop these thought
processes and have better emotional health."
Some successful professionals find
that worry works for them. Imagining everything that might go wrong, and
preparing for it, is known as "defensive pessimism."
"I spend all day thinking of ways
to gain an advantage over my adversaries, and I assume they're doing the same
thing," says Victor Bushell, a partner at Bushell, Sovak, Ozer & Gulmi
LLP. "If that was your job description, wouldn't you be worried?"
Other people use worry as a kind of
magical shield -- if they worry that the plane will crash, it won't. It
doesn't, ergo, they have to worry on every flight.
http://louis-j-sheehan.us/ImageGallery/CategoryList.aspx?id=a1206a74-5f7f-443f-97f5-9b389a4d4f9e&m=0
http://louis1j1sheehan.us/ImageGallery/CategoryList.aspx?id=36f0e6c9-8b8a-4f0a-8630-e5d3b879fad4&m=0
http://louis2j2sheehan.us/ImageGallery/CategoryList.aspx?id=14218f60-0cb6-4fa5-beba-5ee65da4b5e1&m=0
Worrying also seems to be part of some
people's personalities. "I've been furrowing my forehead forever -- you
could pick me out in kindergarten," says Pam Abramson Grisman, who runs a
custom-writing business in Mill Valley, Calif. "These days, I worry about
my parenting. Prior to that, it was focused completely on the workplace. Prior
to that, it was, 'Am I cool enough to live?' "
But worrying is wearying, she says:
"It's like chronic pain, and ultimately it doesn't shield you anymore. It
becomes a self-fulfilling prophecy. Then you have a heart attack."
Chronic worry can, in fact, lead to a
variety of health issues, including headaches, gastrointestinal problems, high
blood pressure, anxiety and depression, studies have shown. Rumination, which
focuses more on past events than future what-ifs, has also been linked to binge
eating, binge-drinking and self-harm. Ruminators may be subconsciously trying
to stop their harmful thoughts, says Dr. Nolen-Hoeksema. "Disengaging is
really, really hard -- you see that in their neural activity and in their
behavior," she adds. But studies have shown that doing something
distracting for just 10 minutes can break the cycle and help people tackle
problems more effectively.
Techniques from cognitive-behavioral
therapy can also help worriers stop the kind of thinking that just makes them
miserable.
"It's all about finding the
balance between productive and unproductive worrying," says psychologist
Robert L. Leahy, director of the American Institute for Cognitive Therapy in
New York City. "Say to yourself, 'Is this worry leading to a To Do list?'
If it doesn't lead to some action on your part today, set it aside."
He suggests literally reserving 20
minutes a day to worry. If you can postpone worrying, you are exercising
control over it, rather than letting it control you.
And learn to accept some risks.
"Worriers feel a tremendous intolerance for uncertainty. They get the idea
that worrying can eliminate it. But you can't prepare for everything," Dr.
Leahy adds. He also suggests a simple "exposure" technique: Practice
saying or writing whatever you fear most, such as, "the plane is going to
crash" or "I'm going to lose my job." "Repeat it over and
over again slowly, like a zombie, and the fear will begin to subside," he
says. Eventually, "you'll just get bored with it."
Wall Street's scramble
for foreign funds to shore up the big banks' books continues, with Merrill
Lynch this morning announcing $6.6 billion in new investments and Citigroup
$12.5 billion -- both relying heavily on cash from Asia and the Middle East.
Merrill said it is
issuing convertible, preferred stock as a long-term investment to Korean
Investment Corporation, Kuwait Investment Authority, and Mizuho Corporate Bank
of Japan. "One of my main priorities over the last several weeks has been
to ensure Merrill Lynch's balance sheet is strong, and these transactions make
certain that Merrill Lynch is well-capitalized," said John Thain, the
former New York Stock Exchange chief picked to lead Merrill last fall as the
brokerage giant was reeling from bad bets on mortgage-backed securities. The
financial breakdown among the three new investors wasn't immediately clear.
Citigroup's move to
get back on what newly installed Chief Executive Vikram Pandit called "our
'front foot'" was bigger in scale and broader in action. Citi's new funds
include $6.88 billion from the Government of Singapore Investment Corporation,
and money from Capital Research Global Investors; Capital World Investors; the
Kuwait Investment Authority; the New Jersey Division of Investment; Prince
Alwaleed bin Talal of Saudi Arabia, who's already a big Citi stockholder; and
former Citi Chairman and CEO Sanford Weill. After months of saying it wouldn't
cut its quarterly dividend, Citi is also doing just that, to 32 cents a share
from 54 cents. Citi's investment news came amid its release of quarterly
financial results that Mr. Pandit called "clearly unacceptable." Citi
posted a net loss of $9.83 billion, or $1.99 per share, on revenue of $7.22
billion -- results that reflected $18.1 billion in write-downs and higher
credit costs blamed on Citi's exposure to investments derived from
subprime-mortgages. Citi also said that burgeoning losses related to consumer
loans had raised its credit costs in the U.S. by $4.1 billion.
A source notably missing
from Citi's new list of benefactors was the China Development Bank, a
state-owned institution previously expected to invest in Citi that was
apparently pulled back by the government. It isn't clear why Beijing nixed the
deal, but The Wall Street Journal notes how much political flak such
investments by sovereign-wealth funds have been catching in the West, as well
as uncertainty about how much bigger the U.S. banks' subprime-related losses
can grow. In another announcement today with a much lower profile, the Dubai
government-controlled investment firm Istithmar said the political backlash in
the U.S. and Europe was too harsh for its tastes, and that it was considering
investments in China.
http://louis-j-sheehan.us/ImageGallery/CategoryList.aspx?id=a1206a74-5f7f-443f-97f5-9b389a4d4f9e&m=0
http://louis1j1sheehan.us/ImageGallery/CategoryList.aspx?id=36f0e6c9-8b8a-4f0a-8630-e5d3b879fad4&m=0
http://louis2j2sheehan.us/ImageGallery/CategoryList.aspx?id=14218f60-0cb6-4fa5-beba-5ee65da4b5e1&m=0
Talk about a tough
spot. While the Fed may be contemplating another rate cut in response to recession
worries, its sworn enemy inflation apparently is still stalking the land.
The price of gold,
traditionally considered both a safe haven in times of trouble and an important
inflation gauge, notched historical highs today, touching $914 an ounce overnight
before easing a bit but staying above the $900 psychological barrier. Analysts
proffered various rationales for the runup, citing concerns over inflation, the
weakening dollar -- gold like oil is denominated using the venerable buck --
and worries that the U.S. economy may be entering recessionary times. Tensions
between inflation and recession worries also twisted up the yield curve for
bonds early today, with the short side of the curve sinking in response to the
looming rate cut by the Federal Reserve. On the other hand, "the long end
of the curve is rising [and] that is suggesting that that market is very
concerned about inflation," said Lee Olver, fixed-income strategist for
SMH Capital this morning.
Shortly after midday,
the longer side of the yield curve eased somewhat, suggesting concerns over
inflation may be relaxing. But the inflation warning signs this morning likely
have many investors wondering what to make of them. Here's one takeaway: Right
now, it's good to not to be Fed chief Ben Bernanke, who finds himself having to
contend with a mix of price and economic growth data which -- in an a nightmare
scenario -- could conceivably coalesce into a stagflationary environment.
Still, few see Mr. Bernanke swiveling his white horse to confront the dragon of
inflation with recession concerns at their current pitch. Perhaps his best bet
for now is to wait for Wednesday's Consumer Price Index reading to filter out
of the Labor Department and pray it doesn't fan inflation fears further.
http://louis-j-sheehan.us/ImageGallery/CategoryList.aspx?id=a1206a74-5f7f-443f-97f5-9b389a4d4f9e&m=0
000
000000000
http://louis-j-sheehan.us/ImageGallery/CategoryList.aspx?id=a1206a74-5f7f-443f-97f5-9b389a4d4f9e&m=0
http://louis1j1sheehan.us/ImageGallery/CategoryList.aspx?id=36f0e6c9-8b8a-4f0a-8630-e5d3b879fad4&m=0
http://louis2j2sheehan.us/ImageGallery/CategoryList.aspx?id=14218f60-0cb6-4fa5-beba-5ee65da4b5e1&m=0
“That is hot ice, and wondrous
strange snow!”
Midsummer Night’s
Dream 5.1.59
Rather
than in a primordial soup prepared in burning fire and bubbling cauldron,
perhaps life originated in ice?
Small
amounts of liquid water still exist at -60 degrees F (salt can help maintain
liquid water down to -65 degrees F and, under more rare conditions, thin films
of liquid water can exist at – 90 degrees F)[1]
in an ice field. There are at
least one million liquid compartments –- test tubes -- in one cubic yard of sea ice. Sea ice accumulates “pollutants”
(ammonia, cyanide, etc.) from the
atmosphere and stores and concentrates them in the aforementioned liquid
compartments.
The
typical assumption is that as the temperature drops, the speed of chemical
reactions slows. However, that
general tendency does not necessarily apply when chemicals are frozen in ice;
when frozen in ice, some reactions increase in speed, especially reactions
where small molecules join together to form larger molecules, i.e., e.g.,
complex polymers. This seemingly
counter-intuitive tendency is known as “eutectic freezing.”
Eutectic
freezing involves the crystallization of water which necessarily remains
unadulterated, i.e., the pollutants are excluded. As such, the pollutants become concentrated in the remaining
liquid pockets which, in turn, causes certain pollutant molecules to collide
more often which process more than offsets[2]
the other slowing effects of cold thus accelerating the reaction(s).
Even
more, the structure of ice has a generally regular pattern of positive and
negative charges which leads to strong bonding with the liquid water remaining
in the compartments. Repeated
experiments have established that these electric charges organize the pollutants
into chains; further, those shorter chains develop into very long chains[3]
IF a single strand of RNA is placed
into the compartment to act as a template. [4],[5]
Scientists
believe cyanide[6] was abundant
on primordial Earth more than 2.5 billion years ago. Importantly, cyanide tends to self-assemble into larger
molecules and does so efficiently under freezing conditions. Tellingly, cyanide
evaporates more quickly than does water so it could only become concentrated in
cold temperatures.[7] Cold temperatures also preserve fragile
molecules – such as nucleobases – dramatically extending the time they exist
thus increasing the opportunity(ies) for further development. Frozen cyanide in the presence of
ammonia can form adenine (a nucleotide base).[8]
To state the obvious,
the above reasoning[9] has expanded
the range of worlds on which to search for extraterrestrial life.
[1] Live bacteria have been
found in these thin films of water at – 90 degrees F.
[2] Some reactions are faster
in these conditions than at room temperature.
[3] A chain of 700 bases has
been observed.
[4] The
new chain attaches to the template in the standard zipper format.
[5] If this is the path of the
development of life, the source of the very first template is unknown. Recall that even without a template,
long chains -- 30 to 40 bases long
-- can develop. By way of
contrast, the shortest RNA enzyme chains today are approximately 50 bases in
length and most are more than 100 bases in length (albeit with the functional/correct
sequences and therefore the functional/correct folding).
[6] The source(s) of cyanide
is/are variously conjectured to be comets, and/or ultraviolet light and/or lightening. This process would have ended when the
atmosphere became oxygen rich, i.e., more than 2.5 billion years ago.
[7] It is estimated that 4
billion years ago our Sun was approximately 30% dimmer than today and at one
point the Earth’s average surface temperature was about -40 degrees F and an
ice sheet 1,000 feet thick covered the majority of the Earth.
[8] While as of yet there is no
accepted theory regarding the development of enzymes in frozen conditions,
scientists have discovered that with most of the water frozen, relevant enzymes
can only join RNA chains (i.e., and not cut the RNA chains); this applies even
to enzymes modified in the laboratory causing them to not work at room
temperature (i.e., they continue to work
and to only join RNA chains in ice).
[9] In theatrical irony,
Professor Stanley Miller of the University of California at San Diego -- the
professor who stashed away ammonium cyanide in 1972 in very cold conditions and
opened the thermos 25 years later and which opening established the creation of
glycine and adenine and sparked this line of inquiry – had a stroke shortly
thereafter and his numerous other frozen experiments were incinerated by a
hazmat team fearful of the release
of toxic cyanide as his lab was being renovated. The information regarding the other thermoses was stored
only in Professor Miller’s mind.
No comments:
Post a Comment