Insight: Health site woes show Washington misses out on cutting edge technology [ BeritaTerkini ]


By Andy Sullivan

WASHINGTON (Reuters) – One part of the Obama administration’s technically flawed HealthCare.gov website is actually working as promised. Unfortunately, the company that built it does not intend to seek more government business.

Working out of a garage a few blocks north of the White House, a 12-person software shop called Development Seed built a customer interface praised for its elegance and stability, a bright spot in the rollout of a website that has been an embarrassment for President Barack Obama.

But chief executive Eric Gundersen said his company will not seek another slice of the $ 82 billion the U.S. government will spend on technology this year because of the paperwork and regulatory hurdles.

“We don’t have proposal writers and lawyers. We have developers,” Gundersen said.

The technical problems since the October 1 debut of the website have cast a harsh light on the federal government’s tangled procurement process, a system that favors incumbents with long track records but leaves little room for innovation.

As a result, the government struggles to deliver the sophisticated digital services that tech-savvy consumers have come to expect.

Obama has apologized repeatedly for the performance of the website that is central to his healthcare overhaul. But he and other officials also have pointed fingers at the project’s contractors, who have been paid at least $ 174 million for their work so far. Contractors say the administration is ultimately to blame.

The site has been plagued by timeouts, errors and slow responses, although an emergency effort to get the site running smoothly for most visitors has resulted in some improvements.

Fewer than 27,000 people signed up for private health insurance plans through the federal marketplace in October, a tiny fraction of the millions ultimately needed to make it financially viable.

Technology projects have never been easy for the federal government. One problem, say former administration officials, is that agencies too often rely on established contractors. Those contractors feel little pressure to innovate because there is no competition from cutting edge companies, which are deterred by government red tape.

More nimble tech firms such as Development Seed find it hard to overcome hurdles that surround competitive bidding or dealing with risk-averse bureaucrats. All but one of the 47 companies that worked on HealthCare.gov had done previous government work, according to the Sunlight Foundation, a watchdog group.

Obama himself says government too often gets it wrong.

“How we purchase technology in the federal government is cumbersome, complicated and outdated,” he said last week.

“We might have done more to make sure that we were breaking the mold on how we were gonna be setting this up,” he said. “But that doesn’t help us now.”

POOR RECORD

Government has a poor track record in tackling large technology projects. The Standish Group, a research firm, found that 40 percent of large federal, state and local tech projects are canceled or abandoned, while only 5 percent are completed on time and on budget. The research firm did not provide reasons.

Perhaps the only thing that makes HealthCare.gov exceptional is its high visibility.

“It’s not an unusual screw-up,” said Charlene Frizzera, a former acting head of the Centers for Medicare and Medicaid Services (CMS), the agency overseeing implementation of the Patient Protection and Affordable Care Act, which passed in 2010.

Even an effort to streamline the way the government buys goods and services came in years late, at twice the anticipated cost. That website, SAM.gov, crashed shortly after going live in 2012 and is still riddled with glitches.

The HealthCare.gov site illustrates the divide between companies specializing in government work and the freewheeling start-up culture that flourishes in Silicon Valley and other tech hubs.

Development Seed did not bid on the healthcare project. It was brought in as a subcontractor by a top official at the Department of Health and Human Services (HHS) who admired its emphasis on simplicity and “open source” design, the practice of releasing software code to the public so outsiders can spot flaws and suggest fixes.

“This is cutting edge, sort of where things are going,” HHS chief technical officer Bryan Sivak said of Development Seed at a conference in March.

Development Seed reduced the number of computer servers involved in its part of the website from 32 to two, minimizing potential failure points, and finished work in June.

Gundersen said officials like Sivak, a former tech officer for the state of Maryland and the District of Columbia, ultimately had limited control.

“We’ve probably got one of the most visionary guys, that actually gets code, from a tech background, being the chief technology officer,” Gundersen said of Sivak. “And still he can’t turn the battleship?”

INSIDE TRACK

As Development Seed finished its work on the front page of HealthCare.gov this spring, a much larger company called CGI Federal scrambled to assemble the back end.

CGI Federal is a division of Montreal-based tech services provider CGI Group Inc, which globally employs 68,000 people. Roughly a quarter of its $ 1.3 billion revenue last fiscal year came from the U.S. government.

Like many large federal contractors, CGI spends handsomely to influence Washington. It spent $ 200,000 on lobbying last year, and its employees donated $ 128,500 in last year’s election to federal candidates from both parties.

CGI ultimately could earn as much as $ 292 million under the HealthCare.gov contract, which it won over three other companies in 2011.

Even if it had wanted to, a small company like Development Seed would have been unable to bid on the main HealthCare.gov contract – CMS limited the competition to 16 companies already selected as primary technology providers under an open-ended contract in 2007.

CMS shaved months off the bidding process by limiting competition to those pre-screened companies. The website needed to be up and running by October 1, 2013.

A large company like CGI handles other complex projects for CMS, and it had the resources to build the site’s complicated health exchange, said several people familiar with the process.

The company declined to comment for this story.

“Companies that compete for government business every day have to use the latest technologies to be successful,” said contracting expert Larry Allen, who said CMS had ensured an adequate level of competition when awarding the contract.

But companies with the ability to bid for big government projects often rely on technology that is years out of date, several former Obama administration officials said.

“This is a stagnant community – they do not have to keep up with the latest technology,” said Clay Johnson, a onetime Presidential Innovation Fellow who developed a tool that made it easier for small technology firms to bid on government work.

Merici Vinton, a former assistant to the chief information officer at the Consumer Financial Protection Bureau, said agency employees were better informed about technology than some vendors who competed to build its ConsumerFinance.gov site in 2010.

“I was shocked at the quality of the projects they were promising,” Vinton said in an email.

COMPLEX TASK

With HealthCare.gov, CGI took on a task of enormous complexity.

An insurance applicant’s identity and income must be verified through computer systems at the Social Security Administration, the Internal Revenue Service and the Department of Homeland Security. Then, the system checks databases from more than 170 insurance carriers to find the best plans.

The Obama administration has acknowledged it did not leave CGI and other contractors enough time to test the system before it went live.

But administration officials also have said CGI failed to meet certain development goals. A top CMS official, Henry Chao, worried three months before the site’s launch that quality problems could “crash the plane at take-off,” according to government documents obtained by Reuters.

CGI has blamed other contractors for site problems and the administration for last-minute design changes.

It is unclear whether the government would have gotten a better result if it had recruited more companies like Development Seed, rather than relying on established contractors like CGI.

Gundersen said his company lacks the scale to tackle such complex projects, and other contracting experts say it is often more cost-effective to go with a larger company that already has the engineers and other resources needed to tackle the job.

But the administration may have ended up with a better website if it had gone with a company that used some of the more current techniques now commonplace in companies that serve the private sector, former Obama administration officials say. Open source development, for example, could have enabled engineers to spot possible flaws sooner and keep the complexity of the site to a minimum.

“Government could benefit from that dynamic, but it has saddled itself with a procurement and contracting model that makes it off-limits,” said Andrew McLaughlin, a former White House deputy chief technology officer.

(Editing by David Lindsey, Ross Colvin and Grant McCool)

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Obama administration was warned of Obamacare risks in March: report [ BeritaTerkini ]


By David Morgan

WASHINGTON (Reuters) – Obama administration officials, including senior White House staff, were warned last spring of risks to the rollout of President Barack Obama’s healthcare law, including the danger of scant testing, according to a report released by congressional investigators.

In a 14-part slide presentation, consulting firm McKinsey & Co said a compressed testing window could inhibit the administration’s ability to resolve problems with the website, HealthCare.gov, that could occur after the October 1 launch.

It also found that the project lacked comprehensive testing, noted many functions were dependent on contractors and warned against taking risks to meet deadlines.

The presentation was given to officials at the Department of Health and Human Services and the White House, including Health and Human Services Secretary Kathleen Sebelius, in four presentations between March 28 and April 8.

The U.S. House of Representatives Energy and Commerce Committee, which released the report on Monday, said Sebelius testified at a panel hearing that the project was on track two weeks after seeing the presentation.

But the Centers for Medicare and Medicaid Services, or CMS, the HHS agency responsible for the rollout, said concrete action was taken to address potential risks highlighted. A McKinsey spokeswoman declined comment, saying its work for clients was confidential.

“As we have said, CMS has continually evaluated progress and has taken steps to prioritize and address concerns, and mitigate risk,” the agency said in a statement.

HealthCare.gov, the federal government’s website for providing subsidized health coverage to millions of uninsured people in 36 states, crashed soon after its launch on October 1 and has been plagued by technical problems since.

Administration officials have blamed the troubles on unexpectedly high volumes, acknowledged that more testing was needed before the launch and have named a contractor to oversee the repair project.

The McKinsey report also said there was a risk of problems with the federal call center for potential applications and the federal data hub, which serves as a high-tech bridge between the marketplace, states and federal agencies. But those segments of the system have been relatively problem-free.

(Editing by Peter Cooney)

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Check kids’ mobiles, parents warned [ BeritaTerkini ]

Parents are putting their children at risk of sexual abuse by failing to carry out basic checks on their mobile phones, a report has warned.

The study into child sexual exploitation found a lack of understanding among families that paedophiles often try to contact children through the mobile devices.

Smartphones are now a “key tool” used by sex offenders targeting children, according to Pace (Parents Against Child Exploitation), which commissioned the study along with Virtual College’s Safeguarding Children e-academy.

The report, Are Parents In The Picture?, found more than half (56%) of parents thought it was “most intrusive” to check text messages sent and received by children aged nine to 14.

This is despite agreement from nine out of 10 safeguarding professionals that mobile phones were a key tool for perpetrators of child sexual exploitation, Pace said.

Seven out of 10 professionals believed a lack of knowledge and engagement among parents was the most significant barrier in the fight against child sexual exploitation, the report found.

The study was based on two YouGov surveys of 945 professional staff, including more than 200 police officers, 226 social workers and 510 teachers, and 750 parents with at least one child aged nine to 17.

It follows a crackdown announced by Microsoft and Google on internet searches for horrific photographs and videos, which Prime Minister David Cameron hailed as “real progress against the absolute evil of child abuse”.

Half (51%) of professionals believed parents do not have the right information needed to keep their children safe from sexual exploitation, while 53% thought families did not understand what child sexual exploitation entails.

Nearly nine out of 10 parents (87%) said that there had been no education about child sex abuse at their children’s school

One in 10 parents admitted they did not know enough about child sexual exploitation, while four out of 10 said they were not confident they would recognise the difference between normal adolescent behaviour and key indicators that a child is being sexually exploited.

Pace chief executive Gill Gibbons said: ” It’s time to bring parents out of the shadows and into the centre of the picture. We need to build more awareness across all communities, with a stronger statutory focus on working with parents.”

Former children’s minister Tim Loughton said: “It is particularly crucial that parents are better educated and better engaged in protecting their own children.

“The huge attention given to the prolific crimes of celebrities such as Jimmy Savile should not detract from the fact that most child sexual exploitation happens at the hands of ordinary criminals targeting ordinary children from all sorts of backgrounds and mostly living at home.

“Schools must redouble their efforts to include parents in the battle against the perpetrators of CSE at an early stage and no one must be under any illusion that this could never happen to their children.”

The study comes ahead of Pace’s conference in central London tomorrow to discuss the wider impact of child sexual exploitation on families, and a week before the release of the Office of the Children’s Commissioner’s (OCC) two-year inquiry into child sexual exploitation in groups and gangs.

Yesterday Mr Cameron said the expertise of eavesdropping agency GCHQ will be used to “go after” paedophiles that exploit hidden parts of the internet.

New software will be introduced to automatically block 100,000 “unambiguous” search terms which lead to illegal content on the two search engines, and Britain’s National Crime Agency will join forces with America’s FBI in a new transatlantic task force to target paedophiles who use encrypted networks online.

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Toronto council curbs Mayor Ford’s powers after chaotic debate [ BeritaTerkini ]


By Allison Martell and Cameron French

TORONTO (Reuters) – Toronto’s City Council voted overwhelmingly at a raucous meeting on Monday to strip embattled Mayor Rob Ford of more of his authority in a move Ford denounced as a coup d’etat while promising political foes election battle next year to rival the Gulf War.

Ford, who has been under fire for his drug use and drinking, as well as the way he has handled the accusations, vowed in an interview to give up alcohol and lose weight.

Earlier at a tumultuous City Council meeting, members voted to slash Ford’s office budget and transfer some of his powers to Deputy Mayor Norm Kelly, among other limitations, by a vote of 36-5.

“This is a coup d’etat,” Ford told council, denouncing the motion.

Ford intends to seek re-election next year and warned councilors that the campaign would rival the 1991 Gulf War.

“This, folks, reminds of when I was watching with my brother when Saddam (Hussein) attacked Kuwait. And President Bush said, ‘I warn you, I warn you, do not (attack Kuwait).’ Well, folks, if you think American-style politics is nasty, you guys have just attacked Kuwait.”

On Friday, the council had suspended Ford’s authority to dismiss the deputy mayor and the heads of council committees and removed his powers to act during emergencies.

Ford has admitted to smoking crack cocaine, buying illegal drugs and driving after drinking alcohol but has ignored calls to resign.

In an interview with CBC on Monday after the City Council action, Ford said he had not had a drop of alcohol in three weeks and vowed to stop drinking completely.

“Finished,” he said when asked by host Peter Mansbridge about his drinking. “I’ve had a ‘come to Jesus moment’ if you want to call it that.”

Ford also said he planned to lose 30 pounds within five months.

Monday’s City Council meeting turned into a spectacle as Ford stalked around the meeting room, getting into an angry verbal exchange with gallery spectators, some of whom shouted “Shame! Shame!” at him. At one point, while running across the room, he collided with Councilor Pam McConnell, almost knocking her over. He later apologized.

Ford also mimed drinking and driving – apparently a jab at a councilor whose license was briefly suspended after a roadside breathalyzer test. A video clip spread quickly on social media.

APPEAL TO DEPUTY MAYOR

The council had been looking for ways to neutralize Ford since he will not quit and the council cannot remove him or strip him of roles laid out in provincial law, such as representing the city at events.

“What we’re doing is saying to our deputy mayor, please represent our city until 2014, because we trust you more than we trust the mayor,” Councilor Karen Stintz told reporters before the vote. Stintz, once a Ford ally, now plans to run against him in the October 2014 election.

Ford’s lawyer, George Rust-D’Eye, told Reuters ahead of Monday’s vote that if the mayor cannot carry out roles mandated by provincial law because of the council’s decisions, a court could intervene. He reiterated his position to reporters after the vote.

Ford, who told Fox News that he hopes to run for prime minister one day, recently admitted he has driven after consuming alcohol. And in 1999 he was arrested for impaired driving while on vacation in Florida and pleaded no contest.

The mayor’s brother, Doug Ford, – who is also a city councilor, meanwhile, brought a motion that was later ruled out of order that would have called a snap mayoral election, something the mayor also has sought.

The revelations about Ford, which started in May when two media outlets said they had seen video of him smoking from what appeared to be a crack pipe, have thrust Toronto into the international spotlight.

A new television show featuring the mayor and his brother debuted on Monday evening on Canada’s right-wing Sun News Network.

During the one-hour show, the mayor and his brother took recorded questions from viewers and defended his recent performance as mayor, but revealed nothing new about the scandal.

(Reporting by Allison Martell, additional reporting by Cameron French; Editing by Janet Guttsman, Jeffrey Benkoe, Peter Galloway, Bill Trott and Cynthia Osterman)

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U.S. Senate votes to extend worldwide anti-AIDS program [ BeritaTerkini ]


By Patricia Zengerle

WASHINGTON (Reuters) – The U.S. Senate passed legislation on Monday to extend for another five years a successful and popular program to combat AIDS worldwide started 10 years ago by former President George W. Bush.

The 100-member Senate approved the measure by unanimous voice vote. It is expected to be considered – and passed – by the House of Representatives as soon as Tuesday before going to President Barack Obama for his signature.

The bill features several provisions to increase oversight of the President’s Emergency Plan for AIDS Relief, known as PEPFAR. The widely praised program is considered a catalyst for advancing HIV treatment, particularly in Africa.

It supports almost 6 million people worldwide who are receiving anti-retroviral drugs, and has provided care and support to nearly 15 million people, including more than 4.5 million orphans and vulnerable children.

Among other things, the legislation passed on Monday extends existing funding requirements for treatment of orphans and vulnerable children.

The measure was introduced in the Senate and House by Senators Robert Menendez, Democratic chairman of the Senate Foreign Relations Committee, and Bob Corker, its top Republican; and Representative Eliot Engel, the ranking Democrat on the House Foreign Affairs Committee, and Ed Royce, the panel’s Republican chairman.

Aides said they expected it would pass the House because of this bipartisan support. Although the program is considered one of the most successful U.S. foreign policy efforts in history, its reauthorization in 2008 was marked by fights over social issues like birth control and abortion rights.

“Extending this vital program will bolster our efforts to combat HIV/AIDS as PEPFAR transitions from an emergency response to a sustainable effort that embraces greater partner country ownership,” Menendez said in a statement.

PEPFAR funding has fallen 12 percent since 2010. Critics have accused Obama, a Democrat, of failing to show the same level of commitment to fighting AIDS as his Republican predecessor, Bush, who poured $ 15 billion into the program to combat AIDS worldwide.

Obama has argued that his administration has expanded the program’s scope without increasing spending.

(Editing by Bill Trott)

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U.S. Senate votes to extend worldwide anti-AIDS program [ BeritaTerkini ]


By Patricia Zengerle

WASHINGTON (Reuters) – The U.S. Senate passed legislation on Monday to extend for another five years a successful and popular program to combat AIDS worldwide started 10 years ago by former President George W. Bush.

The 100-member Senate approved the measure by unanimous voice vote. It is expected to be considered – and passed – by the House of Representatives as soon as Tuesday before going to President Barack Obama for his signature.

The bill features several provisions to increase oversight of the President’s Emergency Plan for AIDS Relief, known as PEPFAR. The widely praised program is considered a catalyst for advancing HIV treatment, particularly in Africa.

It supports almost 6 million people worldwide who are receiving anti-retroviral drugs, and has provided care and support to nearly 15 million people, including more than 4.5 million orphans and vulnerable children.

Among other things, the legislation passed on Monday extends existing funding requirements for treatment of orphans and vulnerable children.

The measure was introduced in the Senate and House by Senators Robert Menendez, Democratic chairman of the Senate Foreign Relations Committee, and Bob Corker, its top Republican; and Representative Eliot Engel, the ranking Democrat on the House Foreign Affairs Committee, and Ed Royce, the panel’s Republican chairman.

Aides said they expected it would pass the House because of this bipartisan support. Although the program is considered one of the most successful U.S. foreign policy efforts in history, its reauthorization in 2008 was marked by fights over social issues like birth control and abortion rights.

“Extending this vital program will bolster our efforts to combat HIV/AIDS as PEPFAR transitions from an emergency response to a sustainable effort that embraces greater partner country ownership,” Menendez said in a statement.

PEPFAR funding has fallen 12 percent since 2010. Critics have accused Obama, a Democrat, of failing to show the same level of commitment to fighting AIDS as his Republican predecessor, Bush, who poured $ 15 billion into the program to combat AIDS worldwide.

Obama has argued that his administration has expanded the program’s scope without increasing spending.

(Editing by Bill Trott)

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Health law helpers finding more luck on HealthCare.gov [ BeritaTerkini ]


By Curtis Skinner

NEW YORK (Reuters) – Healthcare workers assisting people to sign up for insurance on the HealthCare.gov marketplace on Monday told Reuters they had noticed improvement in the problem-plagued website.

Seven organizations funded through the health reform law that assist applicants, from Kansas to Pennsylvania, said that they’d seen successes enrolling people from start to finish in recent days.

Another group of the workers, often called navigators, said problems persisted unchanged. None offered numbers.

“Saturday was the first day that I was actually able to get someone through the entire process on the website. That was pretty exciting. And I know on Saturday that wasn’t the case for everyone on my team, but more and more consistently we’re having success with it,” said Rachel Udow, program director for MHP, a community-based organization focused on migrant issues in Weslaco, Texas.

The Obama administration has pledged that the websites would be working smoothly by the end of November, just two weeks before the December 15 deadline to purchase health insurance that starts on Jan 1.

“We’ve had more completed online enrollments in the last week or so than probably all the weeks before combined, and we’re pretty excited about that,” said Laura Line, corporate assistant director of healthcare at the Philadelphia-based Resources for Human Development.

Others were more muted, but still encouraged by the improvements. Debbie Berndsen, navigator project director at the Kansas Association for the Medically Underserved, said that two of the group’s navigators were able to fully enroll applicants Monday morning.

“It just gives me the sense that things are going in the right direction,” Berndsen said.

(Reporting By Curtis Skinner; Editing by Bernard Orr)

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Aaron Paul Seeks Revenge in ‘Need for Speed’ Trailer [ BeritaTerkini ]

Aaron Paul Seeks Revenge in ‘Need for Speed’ Trailer

Action film will hit theaters on March 14th

If Need for Speed‘s new trailer is being honest with us, the upcoming action film will be a brew of “love, vengeance and motor oil – all swirling together.” So says Michael Keaton’s character in the teaser, which finds Breaking Bad star Aaron Paul navigating through high-speed car chases and craving sweet revenge.

‘Breaking Bad’ Cast Takes Over ‘Conan’

“I spent two years thinking about one moment,” says Paul’s character, Tobey, in a lengthy voiceover. “He set me up. He just left him there. That’s what I can’t forgive.” Though the the plot remains vague, the trailer shows Tobey being released from a prison stint, reconnecting with his old friends (including rapper Kid Cudi) and scheming to get his enemy (played by Dominic Cooper) behind bars. Cooper’s character learns of the plan and offers a handsome $ 6 million to “anyone who puts a stop to him.”

The two-minute trailer features a high-voltage montage of explosions, open-road craziness (including a shot of a car dangling from a helicopter), melodramatic action-flick one-liners and even a bit of romance for Paul’s character – all the elements one would expect from a film based on a popular video game.

Paul recently spoke with Entertainment Weekly about the process of working on such a stunt-driven film.

”The community of stunt men and women is a family,” he says. “During these big sequences, there’s a silence that goes on around set. Some sh-t can go down. They’d huddle around and say, ‘I’ll see you on the other side.’ It’s amazing what they do. To see that family and that brotherhood was a really cool thing.”

Need for Speed will hit theaters on March 14th, 2014.

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Broken Bells to Take ‘Disco’ on the Road in 2014 [ BeritaTerkini ]

James Mercer and Danger Mouse will launch tour in February

Weeks after sharing news of their new studio album, After the Disco, Broken Bells (a/k/a James Mercer and Danger Mouse) have announced a 10-date tour. It will kick off in February.

The 15 Greatest Stoner Songs: Broken Bells, ‘Vaporize’

The band’s first show will be in Minneapolis, Minnesota on February 28th. They’ll travel across the East Coast and Canada before closing with a gig in New Orleans on March 12th. Accompanying the band on their brief trek will be Brooklyn dream-pop outfit Au Revoir Simone. Ticket presales will be available starting Wednesday, November 20th at 10 a.m., and general ticket sales will begin on November 22nd at 10 a.m.

After the Disco will be released on Columbia Records on January 14th, and it’s currently available for pre-order on iTunes. So far, Broken Bells have teased the new LP with an album announcement trailer, a seven-minute sci-fi film and their lush new single, “Holding on for Life.”

For more information, stay tuned at the band’s website. The full 2014 tour itinerary is available below:

2/28 – Minneapolis, MN – First Avenue
3/01 – Chicago, IL – The Vic Theatre
3/03 – Toronto, ON – Danforth Music Hall
3/04 – Montreal, QC – Metropolis
3/05 – Boston, MA – House of Blues
3/07 – New York, NY – Webster Hall
3/08 – Philadelphia, PA – The Trocadero Theatre
3/09 – Washington, DC – 9:30 Club
3/11 – Atlanta, GA – Tabernacle
3/12 –New Orleans, LA – Civic Theatre

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Weight loss may help steady irregular heartbeat [ BeritaTerkini ]


By Andrew M. Seaman

NEW YORK (Reuters Health) – People with an irregular heart rhythm could see an improvement in symptoms if they lose weight in addition to managing their other heart risks, says a new study.

Researchers found that people who lost more than 30 pounds and kept their other health conditions in check saw greater improvements in atrial fibrillation symptoms than those who just managed their other health conditions without trying to lose weight.

“Risk factor management is a crucial component of managing atrial fibrillation,” Dr. Prashanthan Sanders, the study’s lead author from the Royal Adelaide Hospital in Australia, said.

“I think that’s what the public needs to be aware of and it’s not out there yet,” he added.

Atrial fibrillation (AF) is a type of rhythm disorder affecting the heart’s upper chambers. It can be caused by a number of issues – including heart attacks, infections and heart valve problems. Obesity is a risk factor for AF, as are high blood pressure, high cholesterol and diabetes.

Approximately five million people were diagnosed with AF in 2010. That number is expected to grow to about 12 million cases per year by 2030, according to one recent study (see Reuters Health story of Jul. 26, 2013 here: http://reut.rs/17gMbSk).

People with AF can experience racing and uncomfortable heartbeats, weakness, blood pressure problems, chest pains and other symptoms.

Sanders and his colleagues recruited 150 people with AF to participate in the study to see whether weight loss and well-managed risk factors helped ease symptoms. The results were published in the Journal of the American Medical Association.

The participants were patients between the ages of 21 and 75 years old at the Center for Heart Rhythm Disorders at the University of Adelaide. They were also all overweight.

At the beginning of the study in June 2010, the participants were randomly assigned to the weight loss group or to a comparison group.

Over a period of eight weeks, those in the weight loss group were put on low-calorie diets, which were eventually replaced with low-glycemic index meals. They were also told to exercise three times a week for 20 minutes. That eventually increased to 45 minutes three times per week.

Both groups got aggressive management of other risk factors, including medications to control blood pressure, cholesterol and blood sugar, as needed.

The participants assigned to the comparison group received nutrition and exercise advice as well.

The participants were followed for an average of 15 months. At the beginning of the study, participants in each group scored – on average – between 21 and 22 on a scale that measures AF symptoms.

The scale ranges from 3.25, for a single episode of symptoms lasting a few minutes, to 30, for continuous and intense symptoms lasting more than a couple of days.

At the end of the study, members of the weight loss group had dropped an average of 33 pounds each. And their AF symptom scale scores fell to about 9. That compared to an average score of about 19 among participants in the comparison group, whose average weight loss was about 12 pounds each.

Sanders told Reuters Health that the improvement observed in the weight loss group would also be noticeable to patients.

“Most of those patients we included were on our waiting list to undergo ablation procedures to eliminate their atrial fibrillation,” he said, adding that most patients didn’t end up needing the procedure after the study.

Dr. Bruce Lindsay told Reuters Health that he’s not surprised by the study’s findings. He’s section head of cardiac electrophysiology and pacing at the Cleveland Clinic in Ohio.

“I think there has been some knowledge in the community that obesity is linked to atrial fibrillation,” Lindsay, who was not involved in the new study, said.

“When I see patients who are overweight and I’m talking to them about the options for treatment, I try to make it clear that there are things we can do to help them but there are other things they can do,” he said. Those things include weight loss.

Sanders said that people with AF should address their risk factors and talk with their doctors about weight loss options, including programs in their local community.

Lindsay said programs that focus on lifestyle changes, such as Weight Watchers, are best.

Sanders said there is no easy way to lose weight, but people with AF are encouraged to keep going as their symptoms improve.

“When they start seeing the effect of losing weight, they get motivated,” he said.

SOURCE: http://bit.ly/1hRXAPx Journal of the American Medical Association, online November 17, 2013.

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Fewer U.S. Workers Testing Positive For Drugs: Report [ BeritaTerkini ]

workers test positive drugs
Kirby Hamilton via Getty Images

Fewer American workers, on a whole, are testing positive for drug use, according to a new report from Quest Diagnostics.

However, positive tests for specific drugs, including opiates and amphetamines, are actually increasing, according to the report.

The findings are based on 125 million urine drug tests conducted across the United States by Quest Diagnostics between 1988 and 2012.

The researchers found that positive drug tests declined 74 percent over the last 25 years, going from 13.6 percent in 1988 to 3.5 percent in 2012. However, positive drug tests nearly tripled for amphetamines from 1988 to 2012, and more than doubled for hydrocodone and hydromorphone and increased 71 percent for oxycodone (all prescription opiate drugs).

“Our data shows that an increasing number of workers are testing positive for certain prescription drugs, such as opiates and stimulants, reflecting the increased use, and potentially abuse, of prescription medications in the U.S.,” Dr. Barry Sample, the director of science and technology for Quest Diagnostics Employer Solutions, said in a statement. “We also know from other research that the steep declines in our data’s overall drug positivity rates would likely not be observed in workplaces that do not have workplace drug testing programs.”

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Princeton considers unapproved meningitis vaccine [ BeritaTerkini ]


PRINCETON, N.J. (AP) — Princeton University officials are weighing whether to give students a meningitis vaccine that hasn’t been approved in the U.S. to stop the spread of the sometimes deadly disease.

An announcement was expected Monday, a Princeton spokesman said.

Since March, seven cases of meningitis have been confirmed on the New Jersey campus with six students and a visitor diagnosed, the most recent last week. None of the cases has been fatal.

Last week, the federal Food and Drug Administration approved importing the vaccine, Bexsero, for possible use at the Ivy League school.

The Centers for Disease Control says the outbreak at Princeton is the first in the world since the vaccine against the type B meningococcal bacteria was approved in Europe and Australia this year, the only one for use against the strain. The vaccine is in the approval process in the U.S.

The B strain is among the most common in Europe and also has been found frequently in the U.S. Last year, for instance, it accounted for 160 of the 480 meningitis cases in the U.S. tallied by the Centers for Disease Control and Prevention. About one in 10 young adults with the strain dies. One in five develops a permanent disability.

Under New Jersey state law, students who live in dorms must have vaccinations against other strains of meningitis. But a different type of vaccine is needed for type B, said Pritish Tosh, a Mayo Clinic researcher who develops vaccines. He said that Bexsero, sold by Novartis, has had good results so far where it has been used.

“Since there is a product available,” he said, “it makes a lot of sense of me if the public health authorities go for it.”

Meningitis can be spread through kissing, coughing or lengthy contact. Campuses, with their concentration of young adults in close quarters, make dangerous breeding grounds for the bacteria.

Princeton school told students to wash their hands, cover their mouths when coughing and not share items such as drinking glasses and eating utensils.

On campus, students were mostly calm about the possibility of being given a not-yet-approved vaccine.

“I’m honestly not too worried,” said Paul Przytycki, a 23-year-old graduate student in computer science from Bethesda, Md. “When the vaccines come in, I’m going to get vaccinated just to be safe, but no one I know has been affected, so it’s not too scary yet.”

___

Mulvihill reported from Trenton.

//

The Statin Insanity [ BeritaTerkini ]

The medical student was confused. “Well, that’s not good.”

He was seeing, in black and white, the benefits and harms of statin medicines. After years of systematic inculcation about the power of cholesterol reduction, this was the first time he had seen the numbers.

“I don’t get it. I thought cholesterol was the big player in heart attacks.”

Not really. Three-quarters of people having a first heart attack, for instance, have normal cholesterol levels.

“Seriously?”

Indeed. In fact, 50 years ago during the Framingham Heart Study, researchers first suggested that cholesterol may be a weak risk factor for heart disease. This led to a parade of drugs (fibrates, niacin, ezetemibe, etc.) that, despite lowering cholesterol, didn’t help people live longer or avoid heart attacks.

“I’ve never heard that.”

It gets worse: When the completed, 30-year data from the study was analyzed, in most age groups high cholesterol wasn’t associated with more deaths. In fact, for older people, deaths were more common with low cholesterol.

“Now wait. Statins are supposed to be a ‘miracle drug.’ Heart disease is declining, right?”

Actually, heart disease deaths started dropping 40 years ago and the rate of that decline is completely unchanged since statins came into widespread use. On a public health scale, statins are a failure.

“This is insane.”

//

Angel Haze on ‘Dirty Gold’ and Her Hippie Aspirations [ BeritaTerkini ]

‘I’ve always wanted to make the music that you’d go into a coffee shop and hear,’ she says

Angel Haze first broke onto the scene last year, with her excellent mixtape Classick, which included an unabashedly raw and honest cover of Eminem‘s “Cleanin’ Out My Closet.” Haze’s version detailed the harrowing story of her repeated rape and abuse when she was a child and a few weeks ago, she opened up further with a cover of Macklemore’s “Same Love” where she laments about her struggles with family over her own sexuality. This January, however, she’ll stop with the mixtapes and cover songs and finally release her long-awaited debut, Dirty Gold. Earlier this year, she dropped the U.K. single “Echelon (It’s My Way)” and the fast-paced track features more of the lyrical fire we’ve come to expect from Haze at this point. Rolling Stone spoke with the 22-year-old rapper about her new album, her aspirations of becomign a coffee-shop artist and why she’ll never be apart of the “rap club.” 

The 50 Greatest Hip-Hop Songs of All Time

How excited are you for Dirty Gold to come out?
I am in Stoked City. This morning, I woke up and got a link to the final, sterling masters and I freaked out. I’m so excited because it’s actually happening and that’s surreal for me. Fuck, I don’t even feel it completely until the day the album comes out and I just die. It’ll be an overload of emotions.

What does “dirty gold” mean anyways?
It’s how I view people in particular and, specifically, myself. Gold comes from the dirt. It’s underground and you mine it and make it better. That’s how I view people. You go through your dirt and your tough stuff and you deal and you get better. Once you come out of it, you’re fucking worth something. That’s how I saw myself in regards to the album. I looked back at where I was before I started making the album. I was obviously very dark and, when you hear this album, there’s an exponential amount of growth in every single thing that I’ve done. And I’m only saying that because it’s something that I’m very proud of.

Is that you singing on the U.K. single “Echelon (It’s My Way)” as well as rapping?
Yeah, I sing everything on the album aside from the Sia vocals and one on “Black Synagogue.” I worked overtime to get my vocal skills up. Marcus [Dravs] would trap me in rooms and make me sing for hours on end until he felt like it was good enough for him. Not just good enough for life, but good enough for him.

You’ve talked before about doing other types of music as well.
I’m gearing up for the crossover, man. [Laughs.]

After one album?
Yeah, totally. After one album. If I’m just chewing it then I’m going to be stuck.

What genre are you going to tackle?
I don’t want to say that I want to be a new Tracy Chapman, but I want to make music in the same vein. I’ve been taking guitar lessons and writing songs. I have a song on my album called “Planes Fly,” which is like an alternative version of “Fast Car”. I fucking love her. I love Jason Mraz. I’ve always wanted to make the music that you’d go into a fucking coffee shop and hear. You’d sit there and you’d feel good. I want to be a hippy basically. [Laughs.]

What’s Dirty Gold‘s sound like?
I think it’s a melting pot of a ton of different genres. I worked with a bunch of people who were able to take what I wanted it to be and make it all very cohesive. With their help, I feel like I created my own genre.

You didn’t even start listening to secular music until you were 16 and in Brooklyn, right?
When I was 16, yeah. I’m an autodidact so everything that I learn, I learn by reading. Rap wasn’t something I learned because I wanted to be like anyone. It was something I wanted to master because I wanted to challenge myself. After reading and going on all these stupid forums for rap battles and stuff, I was amazed. It was reading and memorizing all this terminology. Like multiples or wordplay and understanding what it meant to do all this stuff, and then putting it into fruition and trying and trying and trying. Obviously, I failed for the first two years, but I think I’m getting there now.

You’ve knocked off a bunch of huge hits already with the freestyles. What’s next?
I’m doing OneRepublic’s “Counting Stars.” It’s going to be amazing.

Your cover of “Same Love” blew up online. Did you plan to drop that poem in at the end all along?
No, I actually did it spur of the moment. I didn’t want to leave that space open at the end so, being an OCD freak, I just decided to write a poem then and there.

That’s crazy. You realize that, right?
The first few lines actually come from an Andrea Gibson poem called “Andrew” and then, afterwards, I said, “Let’s keep going. Why not?” So I freestyled it and it came out pretty cool.

People online have been begging for you to do a collaboration with Snow Tha Product. Are you a fan?
Really? I didn’t even realize that. Yes, I’m a fan. I think she’s amazing. Of female lyricists, she’s definitely in my top five. I had no clue that anyone was calling for that.

You have to start reading your YouTube comments.
I can’t read my YouTube comments because every other one is like, “I hate this bitch.” [Laughs.]

Being from Detroit, when did you first hear about Eminem?
I didn’t hear about Eminem until I was around fourteen when 8 Mile was out on VHS or something. It was insane. I was like, “Who is this guy?” At first I thought he was really, really hot and I used to watch the movie over and over. I still know all of his freestyle rap verses from that movie. I’m a little embarrassed about that, but who cares. Once I learned about that, all of my knowledge of music came from remembering it from movies. Soundtracks saved my life.

Was moving to Brooklyn a huge culture shock?
Yes! It’s like the most interesting amalgamation of things in life. I sat there saying, “Woah. There’s bluegrass. There’s country. There’s jazz. There’s rock. There’s pop. There’s pop rock. There’s alternative-rock. There’s alternative-rap. There’s goth-rap. There’s punk-rap!” There’s all this shit, so where do you start? I had no clue and I didn’t know how to go back. I didn’t understand the Biggies and the Tupacs.

You had no basis of knowledge for that.
Yeah, I had none. I still didn’t until like last week. One of my DJ friends came over to my house and she loaded up all of this music on my laptop and said, “You have to listen to Gang Starr, De La Soul, Wu-Tang Clan.” I was like, “Woah, woah, woah. What’s the significance?” So she opened up all their Wikipedia pages as well and told me, “Read about them. Learn about them. Know this. This is your hip-hop lesson.” It still effects me to this day because I got more interested in developing my own influence and being influenced in my own way rather than saying, “This is my favorite rapper. I want to be just like them.” I wanted to figure out the point and put it into motion on my own shit.

Everyone knows Wu-Tang Clan, but what’s it like for someone like you to hear that for the very first time?
To be honest, I was a bit underwhelmed. I felt like I didn’t understand the significance of everything, and when I want to know something, I have to know everything so I suppose I should have read their Wikipedia first. My friend played me “C.R.E.A.M” and I was like, “Oh, am I missing out on something because I don’t get it?” And then she explained it to me and I got it, so I listened again and I loved it. She made me watch a movie called Brown Sugar as well. She’s trying to get me to understand hip-hop and why everyone thinks it’s so important for me to know these things. I don’t see anything from a purely genre-specific stance. When I liked Christina Aguilera when I was younger, I liked her because her fucking passion in her voice when she sings is crazy and I’d feel something. I’ve only ever respected the artists who are capable of making me feel. So I don’t get the trendiness of all the genre-specific shit.

Do you worry about what people will say about your lack of historical knowledge?
I feel like I got the brunt of that right at the beginning when I signed. There were so many hip-hop articles about how, “She doesn’t know anything. She doesn’t deserve to be signed. She doesn’t know any of the history. Who the fuck is this? She’s not a hip-hop artist.” To this day, I still have that stain within the hip-hop community where they don’t view me as a hip-hop artist, and that’s fine. I don’t think I’ll be any more crushed than I was when I first heard it. I’m over it now. I’m just like, “Well, that’s fine. I’m still going to continue to make this fucking music and move on with my life.”

You don’t feel like you need to be a part of the “club.”
No. I don’t think I’m a part of any club and that’s what makes everything better. To be a voice for the voiceless means to be an exclusive to everything. That’s your own club.

Have you heard from any of the people whose songs you’ve covered, like Eminem or Macklemore?
Oh, yeah. Macklemore wrote me after I put out “Same Love” and he told me that he really respects it and that powerful writing is the reason they started doing what they do. I’ve been a Macklemore fan since the first time I heard his music, so that was amazing.

How about Eminem?
I know that he’s heard it. I’m not interested in feedback at all.

It wasn’t written for him or anyone else.
Yeah. I love him though. I’m just really scared to ever talk to him.

Is Dirty Gold as raw as what’s on those covers?
Of course. I think even more so. I do this thing where I try not to impose my own point of view on other people, but I’m really excited for everyone to hear my perspective. It’s not as dark as the previous music has been because I’m just past the phase of sulking in my grittiness, but it’s still very lesson-bound. I reveal sides of myself that I’ve never shown.

Do you think so many people were moved by those songs because they can relate to them?
Yeah, totally. There’s no other reason, unless you’re a pill-popping whore who wants to dance all night, to relate to music other than the fact that it makes you feel something. It makes you feel connected. It makes you feel less alone. And that’s what I’m always looking to achieve with my music.

Do people feel like they can open up to you since you’re so open?
There’s a song on my album called “Angels & Airwaves” that’s completely derived from this guy telling me that he wanted to kill himself. He told me that he feels lost and alone in the world and nothing helps him but my music (and even sometimes that doesn’t help him). He told me all these things about his life and his struggles. I took that and I turned it into a song for him on my album.

Some people message me things like, “I really need you right now.” I’ll wake up in the middle of the night with a Direct Message notification from my Twitter and I’ll be up all night talking to them and telling them, “It’s alright. You’re going to feel trapped and lost and all these things, but the most important thing to remember is that the only way out of the labyrinth is straight and back. That is the way through. That’s it.”

What are you scared of?
I’m absolutely terrified of the dark. Terrified. There has to be noise and there has to be light coming from somewhere or I can’t sleep at all. I just think that darkness is so symbolic of the evils of life that I get so nervous about all of my demons that I can’t sleep. I feel like they’re breathing down my neck. Like Kanye West says, “So scared of my demons, I go to sleep with a nightlight.” Light scares off the darkness. It makes it go away.

//

Oregon health exchange represents biggest woe [ BeritaTerkini ]


PORTLAND, Ore. (AP) — With all the problems facing the rollout of President Barack Obama’s health care overhaul, nowhere is the situation worse or more surprising than in Oregon, a progressive state that has enthusiastically embraced the federal law but has so far failed to enroll a single person in coverage through the state’s insurance exchange.

Despite grand ambitions, an early start, millions of dollars from the federal government and a tech-savvy population, Oregon’s online enrollment system still isn’t ready more than a month after it was supposed to go live. The state has resorted to hiring or reassigning 400 people to process insurance applications by hand.

“We’re all surprised and frustrated that we’re in the position that we’re in now,” said Jesse O’Brien, a health care advocate at the Oregon State Public Interest Research Group, which lobbied for the exchange.

The state has received about 18,000 paper applications, at 19 pages each, and is scrambling to manually file and clear them. State officials have not been able to say when they expect the online system to launch, nor have they established a deadline to submit paper applications in order for coverage to begin Jan. 1. Meanwhile, the exchange’s board is demanding answers from the executive director about when the website will work and how his team will get people enrolled on time.

For consumers, the application process can be long and frustrating.

“I’ve been trying since the very first day of October just to try to find out the coverage I could get,” said Donna George, 43, a bookkeeper from Bend, Ore., who’s been uninsured for three years.

When the online system wouldn’t work, George submitted a paper application Oct. 7 for herself and her husband. Finally, on Nov. 12, she received an enrollment packet that tells her how much of a tax credit she’ll receive and lays out her coverage options. She’s now waiting to meet with her insurance agent to pick a plan and return the forms.

Oregon has long prided itself on being a leader in health policy. Its Medicaid system has been a testing ground for new innovations since the early 1990s. The state started laying the groundwork for an insurance exchange a year before Congress passed the health care law that called for one in every state. Gov. John Kitzhaber, a former emergency room physician, is a respected voice on health reform.

The state also has a large population of young, underemployed progressives who might provide a burgeoning market for affordable coverage. Its ultra-competitive health care market led to lower-than-expected premiums. Lawmakers from both parties have embraced the law. And the Portland area is a thriving hub of technology companies known as the Silicon Forest.

In other words, Oregon had everything going for it.

But its exchange, known as Cover Oregon, became a victim of its own lofty ambitions and the state’s stubborn refusal to dial them back until it was too late.

While exchanges in many states are telling applicants who appear to qualify for Medicaid to contact a separate agency, Oregon insists its exchange must be a “one-stop shop” for both Medicaid and private insurance. The state also wants its exchange to eventually be able to help enroll people in a wide array of public-assistance programs, not just health care.

Exchange leaders stuck with their plan even as risk consultants warned repeatedly that they were in danger of missing the Oct. 1 deadline to launch.

“We won’t know whether we made the right decisions until our system is up and running,” said Amy Fauver, chief communications officer for Cover Oregon. “But we’re going forward in the way we feel we can best serve Oregonians.”

Exchange officials say they haven’t fully launched their website because their software still can’t accurately determine whether applicants are eligible for Medicaid or the Children’s Health Insurance Program, particularly for people with complex family arrangements.

Kitzhaber, a Democrat, has pledged that the problems won’t “interfere with our objective of making sure that every Oregonian that wants to be enrolled” by the start of the new year “is, in fact, enrolled.”

Oregon does have one big success to brag about. The state has enrolled 70,000 people in Medicaid, reducing the ranks of the uninsured by more than 10 percent. The large number of Medicaid enrollments came in large part thanks to a “fast-track” enrollment process approved by the Obama administration. Using income data already on file, the state mailed a simple seven-question Medicaid enrollment form to people in the Supplemental Nutritional Assistance Program who qualify for health coverage under the federal health law’s expansion of Medicaid.

Pressure is growing on exchange officials to fix the problems. U.S. Rep. Kurt Schrader, a moderate Democrat who took heat after voting for the health care law, released a sharply worded statement on Friday demanding that the exchange and its main contractor, Oracle, make it work.

“The implementation of Oregon’s health insurance marketplace has been abysmal,” Schrader said. “The current situation is completely unacceptable, and I expect much more from a state with a reputation for being an innovator in the field of health care.”

___

Follow AP writer Jonathan J. Cooper at http://twitter.com/jjcooper .

//

Oregon health exchange represents biggest woe [ BeritaTerkini ]


PORTLAND, Ore. (AP) — With all the problems facing the rollout of President Barack Obama’s health care overhaul, nowhere is the situation worse or more surprising than in Oregon, a progressive state that has enthusiastically embraced the federal law but has so far failed to enroll a single person in coverage through the state’s insurance exchange.

Despite grand ambitions, an early start, millions of dollars from the federal government and a tech-savvy population, Oregon’s online enrollment system still isn’t ready more than a month after it was supposed to go live. The state has resorted to hiring or reassigning 400 people to process insurance applications by hand.

“We’re all surprised and frustrated that we’re in the position that we’re in now,” said Jesse O’Brien, a health care advocate at the Oregon State Public Interest Research Group, which lobbied for the exchange.

The state has received about 18,000 paper applications, at 19 pages each, and is scrambling to manually file and clear them. State officials have not been able to say when they expect the online system to launch, nor have they established a deadline to submit paper applications in order for coverage to begin Jan. 1. Meanwhile, the exchange’s board is demanding answers from the executive director about when the website will work and how his team will get people enrolled on time.

For consumers, the application process can be long and frustrating.

“I’ve been trying since the very first day of October just to try to find out the coverage I could get,” said Donna George, 43, a bookkeeper from Bend, Ore., who’s been uninsured for three years.

When the online system wouldn’t work, George submitted a paper application Oct. 7 for herself and her husband. Finally, on Nov. 12, she received an enrollment packet that tells her how much of a tax credit she’ll receive and lays out her coverage options. She’s now waiting to meet with her insurance agent to pick a plan and return the forms.

Oregon has long prided itself on being a leader in health policy. Its Medicaid system has been a testing ground for new innovations since the early 1990s. The state started laying the groundwork for an insurance exchange a year before Congress passed the health care law that called for one in every state. Gov. John Kitzhaber, a former emergency room physician, is a respected voice on health reform.

The state also has a large population of young, underemployed progressives who might provide a burgeoning market for affordable coverage. Its ultra-competitive health care market led to lower-than-expected premiums. Lawmakers from both parties have embraced the law. And the Portland area is a thriving hub of technology companies known as the Silicon Forest.

In other words, Oregon had everything going for it.

But its exchange, known as Cover Oregon, became a victim of its own lofty ambitions and the state’s stubborn refusal to dial them back until it was too late.

While exchanges in many states are telling applicants who appear to qualify for Medicaid to contact a separate agency, Oregon insists its exchange must be a “one-stop shop” for both Medicaid and private insurance. The state also wants its exchange to eventually be able to help enroll people in a wide array of public-assistance programs, not just health care.

Exchange leaders stuck with their plan even as risk consultants warned repeatedly that they were in danger of missing the Oct. 1 deadline to launch.

“We won’t know whether we made the right decisions until our system is up and running,” said Amy Fauver, chief communications officer for Cover Oregon. “But we’re going forward in the way we feel we can best serve Oregonians.”

Exchange officials say they haven’t fully launched their website because their software still can’t accurately determine whether applicants are eligible for Medicaid or the Children’s Health Insurance Program, particularly for people with complex family arrangements.

Kitzhaber, a Democrat, has pledged that the problems won’t “interfere with our objective of making sure that every Oregonian that wants to be enrolled” by the start of the new year “is, in fact, enrolled.”

Oregon does have one big success to brag about. The state has enrolled 70,000 people in Medicaid, reducing the ranks of the uninsured by more than 10 percent. The large number of Medicaid enrollments came in large part thanks to a “fast-track” enrollment process approved by the Obama administration. Using income data already on file, the state mailed a simple seven-question Medicaid enrollment form to people in the Supplemental Nutritional Assistance Program who qualify for health coverage under the federal health law’s expansion of Medicaid.

Pressure is growing on exchange officials to fix the problems. U.S. Rep. Kurt Schrader, a moderate Democrat who took heat after voting for the health care law, released a sharply worded statement on Friday demanding that the exchange and its main contractor, Oracle, make it work.

“The implementation of Oregon’s health insurance marketplace has been abysmal,” Schrader said. “The current situation is completely unacceptable, and I expect much more from a state with a reputation for being an innovator in the field of health care.”

___

Follow AP writer Jonathan J. Cooper at http://twitter.com/jjcooper .

//

Toronto council may further restrict embattled mayor’s powers [ BeritaTerkini ]


TORONTO (Reuters) – The Toronto city council may further curb the powers of embattled Mayor Rob Ford on Monday, slashing his office budget and offering his staff a chance to transfer to new jobs.

Ford, who has admitted to smoking crack cocaine, buying illegal drugs and driving after consuming alcohol, has issued a string of emotional apologies but refused to resign.

He plans to stand for re-election next year, and told Fox News on Sunday that he hopes to run for prime minister one day.

Under provincial law, the council cannot remove Ford from office or strip him of some roles, such as representing the city at events. But it has been looking for ways to limit his power.

At an afternoon meeting on Monday, the council was set to vote on a motion that, among other things, would cut Ford’s office budget to that of a normal city councilor, and make the deputy mayor the chair of the cabinet-like executive committee.

Ford has vowed to fight the moves in court, but his lawyer, George Rust-D’Eye, said on Monday he will not seek an injunction to stop the council meeting. That does not rule out challenging the decision later.

On Friday, the council suspended Ford’s ability to appoint and dismiss the deputy mayor and the heads of council committees. It also granted the deputy mayor, rather than the mayor, special powers to act during emergencies such as natural disasters.

A new television show featuring the mayor and his brother, councilor Doug Ford, is set to debut Monday evening on Canada’s right-wing Sun News Network. The network is touting new confessions from “the most wanted man in news.”

CNN is set to air an interview with Ford at the same time, 8:00 p.m. (0100 GMT) Monday evening.

(Reporting by Allison Martell; Editing by Janet Guttsman and Jeffrey Benkoe)

//

Free unlimited broadband for a year? Tesco has it in time for Christmas [ BeritaTerkini ]

Nothing is ever free, not really. And this is no exception – but it’s still impressive. Tesco is offering a year’s free broadband, with no limits on data, if you sign-up for a Tesco Home phone line for £14.90 a month.

This 14Mb line will be available in only limited numbers – it’s described as a “get it before it’s gone” offer. It’s actually scheduled to run until 1 December but might prove too popular to last that long.

READ: Tesco offers unlimited broadband for just £2 a month

Splashing out on a phone line might seem a bit of a waste these days, but Tesco is offering free evening and weekend calls as well as free calls to other Tesco Home phone customers to sweeten the deal.

As if all that were not enough, you also get points for your Tesco Clubcard with every phone bill. There’s a UK-based call centre if you have any issues, you get a free router thrown in, and you can choose either a 12-month contract or a rolling 30-day deal.

© copyright Pocket-lint 2013

//

What The Twin Cities Can Teach Us About Living Well [ BeritaTerkini ]

Our Living Well, On Location series explores cities and countries from around the world. How do other people pursue health and happiness? We’re going coast to coast, country to country to find out.

When most people think of Minneapolis, they think of snow. Minneapolitans are not ones to brag, so those who haven’t spent time in the area would be surprised to know that Minneaplis and twin city, St. Paul, are perennial winners on nationwide surveys of health, happiness, fitness and well-being.

How do they do it?

The twin cities are the most active metropolitan area in the country

minneapolis park

Minneapolitans are an active bunch. Nearly 83 percent of residents were active every single day — and more than half of city residents got at least the government-recommended 30 minutes of moderate activity per day, according to a survey conducted by the American College of Sports Medicine. The organization anointed the Minneapolis-St Paul area as the fittest city in the U.S. in 2012, thanks to the sportiness and overall good health of its residents.

Minneapolis boasts the best parks in the country

minneapolis bike bridge

In June 2013, the Trust for Public Land ranked Minneapolis’ parks as the very best in the country, beating out New York, Chicago and San Francisco for acreage, access and, let’s face it, sheer beauty.

“The city was built around the park system, not the other way around,” Jayne Miller, superintendent for the Minneapolis Park and Recreation Board, told the Star Tribune.

All those parks contribute to the public health, fostering relationships between citizens and nature and improving physical fitness by providing a free and pleasurable place to exercise. Parks can also help mitigate urban pollution, according to the American Planning Association, and help reenforce community ties — all important factors for citizen wellness.

12,000 Lakes

minneapolis lakes

“Technically the slogan is ‘land of 10,000 lakes,’ but everyone from Minnesota knows it’s closer to 12,000,” says HuffPost editor and native Minnesotan, Jordan Turgeon. We’re not just taking her word for it — an official government survey put the number of lakes at 11,842 statewide.

And while that staggering number refers to the entire state, the Minneapolis-St. Paul metropolitan area boasts eight distinct lakes and the Chain of Lakes park that covers 13.3 miles of water. Minneapolis is actually referred to as the “city of lakes.”

But why would lakes make you happier and healthier? While the health benefits of green space get more attention, there’s evidence that blue space — lakes, rivers, streams and oceans — can also have a positive influence over health and wellbeing, reported The Guardian.

High wages, low rent

apartment

“A reader asked me the other day for a Rent Is Too Damn High perspective on what city he should live in,” wrote Slate columnist Matthew Yglesias. “On one level, it’s a complicated question. On another level, the answer is that you should move to Minneapolis.”

Twin Cities residents earn about 23 percent above the average national household income, but their rent prices remain below the average of America’s major metropolitan areas. In an index of housing affordability, Minneapolis-St. Paul ranked as cheaper than comparable cities like Dallas, Boston, Philadelphia, Seattle, both Portlands (Maine and Oregon) and Austin, according to the Center for Housing Policy and the National Housing Conference.

The organizations scored cities based on how many of 72 professions had an average salary that would support rent on a two-bedroom apartment. According to their calculations, 59 percent of the Twin Cities’ jobs compensate at a level comfortable enough for a nice apartment.

And while money doesn’t necessarily bring happiness, the extra cushion of a well-paying job and modest expenses could be the difference between financial well-being and the health-draining stress of struggling to make ends meet. We know that people who struggle with debt and expenses are more likely to report physical health problems than those who are managing, according to a report from the Federal Reserve Bank of San Francisco.

They’ve been smoke-free since way back

no smoking

Minnesota enacted a state-wide ban of smoking in all workplaces in 2007, but the phase-out began several decades earlier when the state passed the Minnesota Clean Indoor Air Act in 1975, making it the first to ban smoking in most public places and require designated non-smoking sections in restaurants, reported the San Francisco Chronicle.

Unemployment is low — and that means better mental health

help wanted cafe

Minneapolis now has the lowest unemployment of any major metropolitan area, according to U.S. Bureau of Labor Statistics. As if the stress of looking for a job weren’t enough, unemployment is actually linked to a overall increased risk of mortality — from causes as disparate as accident, cardiovascular disease and cancer.

Minneapolitans are bookworms

bookstore minneapolis

Minneapolis ranks in the top three most literate cities, thanks to a high density of bookstores, high newspaper circulation and a well-read populace. And, as we’ve recently explored, reading can contribute to better sleep, better cognitive function and improved stress release.

It doesn’t hurt that Minneapolis is friendly to writers, according to a Ploughshares report, with great libraries, cafes and citywide WiFi plans that allow you to get connected from anywhere.

Do you live in the Twin Cities? Tell us what you love best

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  • Minneapolis, Minn.

    <strong>Total Score =</strong> 76.4
    <br>
    <strong>Rank = </strong>1
    <br><br>
    Minneapolis excelled when it came to an active population — with high scores for physical fitness and active lifestyle. But even the winner had areas for improvement, including a low percentage of the population who ate enough fresh produce and a high percentage of the population who suffered from asthma.

  • Washington, D.C.

    <strong>Total Score</strong> = 75.8
    <br>
    <strong>Rank </strong>= 2
    <br><br>
    Washingtonians tend not to smoke and are conscientious about maintaining good health care coverage, though the report reveals that they lack enough park space and also have a high asthma rate.

  • Boston, Mass.

    <strong>Total Score</strong> = 70.0
    <br>
    <strong>Rank</strong> = 3
    <br><br>
    People from Boston are hardy stock, according to the report, which found that Bostonians report being in excellent health at exceptional rates. Unfortunately, and somewhat paradoxically, they also had above average rates of coronary heart disease and a lack of publicly accessible recreational space.

  • San Francisco, Calif.

    <strong>Total Score</strong> = 69.0
    <br>
    <strong>Rank</strong> = 4
    <br><br>
    San Franciscans get active on their way to work — biking and walking in greater numbers. And thanks to high expenditures on parks and other public space, there is plenty of space to stay active outside of the commute. But the city’s population stumbles when it comes to mental health, reporting an above average number of days during which psychological problems persisted.

  • Hartford, Conn.

    <strong>Total Score</strong> = 68.5
    <br>
    <strong>Rank</strong> = 5
    <br><br>
    Citizens of the relatively small Hartford are active and exceptional at eating their veggies, but diabetes, heart disease and asthma remain high.

  • Sacramento, Calif.

    <strong>Total Score</strong> = 68.4
    <br>
    <strong>Rank</strong> = 6
    <br><br>
    Sacramento also had an active and veggie-loving population, thanks to a high rate of farmer’s markets and public recreation areas. But the city’s population still suffers from mental health problems, asthma, diabetes and heart disease.

  • Portland, Ore.

    <strong>Total Score</strong> = 67.9
    <br>
    <strong>Rank</strong> = 7
    <br><br>
    Despite a high obesity rate, along with diabetes, asthma and mental health problems, the city of Portland makes way for some seriously healthy behaviors like active commutes by bike and on foot, lots of recreative parks and town squares and a high percentage of farmer’s markets offering fresh produce.

  • Seattle, Wash.

    <strong>Total Score</strong> = 67.8
    <br>
    <strong>Rank</strong> = 8
    <br><br>
    The fit, veggie-loving people of Seattle helped their city score high marks for fitness, diet and environmental factors like good funding for parks, high quality physical education in schools and active commuting. But the city’s residents also suffered high asthma rates and mental health problems.

  • Denver, Colo.

    <strong>Total Score</strong> = 65.6
    <br>
    <strong>Rank</strong> = 9
    <br><br>
    Few Denver residents are obese, perhaps thanks to an extensive and well-funded parks system, and few suffer from associated conditions like diabetes and heart disease.

    But the city’s school children have a less-than-rigorous physical education department and there is an overall high rate of mental health problems.

  • Austin, Tex.

    <strong>Total Score</strong> = 63.4
    <br>
    <strong>Rank</strong> = 10
    <br><br>
    Texas’ artsiest city may be known for its bar scene, but its residents lifestyles aren’t all rock and roll, with low smoking rates and a high rate of physical activity. Still, like the rest of the state, Austin’s residents were more likely to be obese.

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//

Google, Microsoft tighten online searches to combat child porn [ BeritaTerkini ]

LONDON (Reuters) – Google and Microsoft unveiled measures to block online searches for child sex abuse images on Monday as part of a bid by British authorities to crackdown on Internet paedophiles.

The companies said as many as 100,000 search terms will now fail to produce results and trigger warnings that child abuse imagery is illegal while offering advice on where to get help.

The world’s two largest search engine operators’ move was a rare display of unity ahead of an Internet safety summit on Monday hosted by Prime Minister David Cameron.

Cameron welcomed the progress to block illegal content but said far more still needed to be done.

“If more isn’t done to stop illegal child abuse content being found, we will do what is necessary to protect our children,” he tweeted ahead of the summit that will announce a new trans-Atlantic task force to tackle online child abuse.

The summit comes after Cameron this summer called on Internet firms to do more to stop access to illegal images.

Now both companies have introduced new algorithms that will prevent searches for child abuse imagery.

Google executive chairman Eric Schmidt wrote in Britain’s Daily Mail newspaper that these changes had cleaned up the results for over 100,000 queries that might be related to the sexual abuse of children.

“As important, we will soon roll out these changes in more than 150 languages, so the impact will be truly global,” he wrote, adding the restrictions would be launched in Britain first then expanded to other languages in the next six months.

Both Google and Microsoft, who were due to join other Internet companies at the summit on Monday, have also agreed to use their technological expertise to help in the identification of abuse images.

Schmidt said Google planned to provide engineers to give technical support to the Internet Watch Foundation in Britain and the U.S. National Center for Missing and Exploited Children, and to fund internships for engineers at these organisations.

Conservative parliamentarian Claire Perry, who is Cameron’s adviser on childhood, said British and U.S. law enforcement agencies would back up this effort by tracking paedophiles using the “hidden Internet” or so-called “dark web” of encrypted networks to distribute images of child abuse.

(Reporting by Belinda Goldsmith, editing by William Hardy)

//

Police deploy in Paris after gunman attacks newspaper [ BeritaTerkini ]


PARIS (Reuters) – An assailant opened fire at the central Paris office of left-wing daily newspaper Liberation on Monday, seriously injuring one person before fleeing, police and staff at the newspaper said.

The wounded person was hit in the chest, a police official said, adding that the motive of the attacker, who was armed with a hunting rifle, was unclear.

“He walked in, fired twice and left,” Liberation’s editorial manager, Fabrice Rousselot, told reporters.

Deputy editor-in-chief Fabrice Tassel said in a tweet that the young male victim, — a photograhper’s assistant — was fighting for his life in hospital.

“As long as this person is still on the loose and we do not know the motives, this represents a threat,” Interior Minister Manuel Valls told reporters outside Liberation’s offices after visiting the scene. “We must move fast.”

Police deployed outside the offices of other media outlets in the French capital.

The mid-morning incident came days after an armed intruder entered the offices of the BFM television channel, threatening journalists before disappearing. Rousselot said it was not clear whether the two incidents were linked.

Liberation’s offices near the Place de la Republique in east-central Paris were cordoned off as forensics experts investigated.

Rousselot said the assailant was apparently a short-haired man in his 40s.

(Reporting by Gerard Bon, Brian Love and Nicolas Bertin; Editing by Mark John and Paul Taylor)

//

Police deploy in Paris after gunman attacks newspaper [ BeritaTerkini ]


PARIS (Reuters) – An assailant opened fire at the central Paris office of left-wing daily newspaper Liberation on Monday, seriously injuring one person before fleeing, police and staff at the newspaper said.

The wounded person was hit in the chest, a police official said, adding that the motive of the attacker, who was armed with a hunting rifle, was unclear.

“He walked in, fired twice and left,” Liberation’s editorial manager, Fabrice Rousselot, told reporters.

Deputy editor-in-chief Fabrice Tassel said in a tweet that the young male victim, — a photograhper’s assistant — was fighting for his life in hospital.

“As long as this person is still on the loose and we do not know the motives, this represents a threat,” Interior Minister Manuel Valls told reporters outside Liberation’s offices after visiting the scene. “We must move fast.”

Police deployed outside the offices of other media outlets in the French capital.

The mid-morning incident came days after an armed intruder entered the offices of the BFM television channel, threatening journalists before disappearing. Rousselot said it was not clear whether the two incidents were linked.

Liberation’s offices near the Place de la Republique in east-central Paris were cordoned off as forensics experts investigated.

Rousselot said the assailant was apparently a short-haired man in his 40s.

(Reporting by Gerard Bon, Brian Love and Nicolas Bertin; Editing by Mark John and Paul Taylor)

//