ScienceDaily (June 23, 2012) ? Studies have consistently reported that women require reading glasses or bifocal lenses earlier than men. According to a recent Investigative Ophthalmology & Visual Science paper, the gender difference is caused by factors other than focusing ability, such as arm length or preferred reading distance, which should be considered when prescribing readers or bifocals.
The new evidence was found by a team of researchers who performed a meta-analysis using nine cross-sectional studies to compare the prevalence and magnitude of presbyopia -- commonly described as the loss of near vision that occurs with age -- among men and women. The researchers further subdivided the analysis to determine what differences in presbyopia might exist between men and women.
The new evidence was found by a team of researchers who performed a meta-analysis using nine cross-sectional studies to compare the prevalence and magnitude of presbyopia -- commonly described as the loss of near vision that occurs with age -- among men and women. The researchers further subdivided the analysis to determine what differences in presbyopia might exist between men and women.
While the results of a subgroup of studies showed that there was no significant gender-related difference in the eye's ability to focus clearly on objects at near distances, the overall analysis provided evidence that women have a need for higher power reading glasses or bifocals than men of an equivalent age. According to the researchers, this discrepancy is likely due to differences in preferred reading distances or arm length as women tend to hold reading materials closer than men do.
"These findings could impact global vision care in multiple ways," said Hickenbotham. "The findings reinforce the need for presbyopia correction programs for women -- a group that often has greater unmet vision needs in developing countries. It also points out that presbyopia is a multi-factorial problem and requires solutions that are tailored to each individual."
While the researchers urge clinicians to do more than measure the eye's ability to focus when diagnosing presbyopia, they also suggest more carefully performed studies be conducted that better isolate and measure the various factors that contribute to its development. In particular, the paper states longitudinal studies that consider the interaction between the preferred reading distance and the change in accommodative amplitude across time for males and females could help determine to what extent biological factors or environmental factors plays a role in the loss of focusing ability with increasing age.
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The above story is reprinted from materials provided by Association for Research in Vision and Ophthalmology (ARVO).
Note: Materials may be edited for content and length. For further information, please contact the source cited above.
Journal Reference:
A. Hickenbotham, A. Roorda, C. Steinmaus, A. Glasser. Meta-Analysis of Sex Differences in Presbyopia. Investigative Ophthalmology & Visual Science, 2012; 53 (6): 3215 DOI: 10.1167/iovs.12-9791
Note: If no author is given, the source is cited instead.
Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.
ScienceDaily (June 23, 2012) ? A multidisciplinary team of researchers at MIT and in Spain has found a new mathematical approach to simulating the electronic behavior of noncrystalline materials, which may eventually play an important part in new devices including solar cells, organic LED lights and printable, flexible electronic circuits.
The new method uses a mathematical technique that has not previously been applied in physics or chemistry. Even though the method uses approximations rather than exact solutions, the resulting predictions turn out to match the actual electronic properties of noncrystalline materials with great precision, the researchers say. The research is being reported in the journal Physical Review Letters, published June 29.
Jiahao Chen, a postdoc in MIT's Department of Chemistry and lead author of the report, says that finding this novel approach to simulating the electronic properties of "disordered materials" -- those that lack an orderly crystal structure -- involved a team of physicists, chemists, mathematicians at MIT and a computer scientist at the Universidad Aut?noma de Madrid. The work was funded by a grant from the National Science Foundation aimed specifically at fostering interdisciplinary research.
The project used a mathematical concept known as free probability applied to random matrices -- previously considered an abstraction with no known real-world applications -- that the team found could be used as a step toward solving difficult problems in physics and chemistry. "Random-matrix theory allows us to understand how disorder in a material affects its electrical properties," Chen says.
Typically, figuring out the electronic properties of materials from first principles requires calculating certain properties of matrices -- arrays of numbers arranged in columns and rows. The numbers in the matrix represent the energies of electrons and the interactions between electrons, which arise from the way molecules are arranged in the material.
To determine how physical changes, such as shifting temperatures or adding impurities, will affect such materials would normally require varying each number in the matrix, and then calculating how this changes the properties of the matrix. With disordered materials, where the values of the numbers in the matrix are not precisely known to begin with, this is a very difficult mathematical problem to solve. But, Chen explains, "Random-matrix theory gives a way to short-circuit all that," using a probability distribution instead of deriving all the precise values.
The new method makes it possible to translate basic information about the amount of disorder in the molecular structure of a material -- that is, just how messy its molecules are -- into a prediction of its electrical properties.
"There is a lot of interest in how organic semiconductors can be used to make solar cells" as a possible lower-cost alternative to silicon solar cells, Chen says. In some types of these devices, "all the molecules, instead of being perfectly ordered, are all jumbled up." These disordered materials are very difficult to model mathematically, but this new method could be a useful step in that direction, he says.
Essentially, what the method developed by Chen and his colleagues does is take a matrix problem that is too complex to solve easily by traditional mathematical methods and "approximates it with a combination of two matrices whose properties can be calculated easily," thus sidestepping the complex calculations that would be required to solve the original problem, he explains.
Amazingly, the researchers found that their method, although it yields an approximation instead of the real solution, turns out to be highly accurate. When the approximation is plotted on a graph along with the exact solution, "you couldn't tell the difference with the naked eye," Chen says.
While mathematicians have used such methods in the abstract, "to our knowledge, this is the first application of this theory to chemistry," Chen says. "It's been very much in the domain of pure math, but we're starting to find real applications. It's exciting for the mathematicians as well."
The incredible accuracy of the method, which uses a technique called free convolution, led the team to investigate why it was so accurate, which has led in turn to new mathematical discoveries in free probability theory. The method derived for estimating the amount of deviation between the precise calculation and the approximation is new, Chen says, "driven by our questions" for the mathematicians on the team. "It's a happy accident that it worked out as well as it did," he adds.
"Our results are a promising first step toward highly accurate solutions of much more sophisticated models," Chen says. Ultimately, an extension of such methods could lead to "reducing the overall cost of computational modeling of next-generation solar materials and devices."
David Leitner, a professor of theoretical and biophysical chemistry and chemical physics at the University of Nevada at Reno who was not involved in this work, says the potential practical impact of this research "is great, given the challenge faced in calculating the electronic structure of disordered materials and their practical importance." He adds that the key test will be to see if this approach can be extended beyond the one-dimensional systems described in this paper to systems more applicable to actual devices. "Extension to higher dimensions is critical in assessing the work's significance," he says.
Such calculations "remain a big challenge," Leitner says, and further work on this approach to the problem "could be very fruitful."
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The above story is reprinted from materials provided by Massachusetts Institute of Technology. The original article was written by David Chandler.
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Journal Reference:
Jiahao Chen, Eric Hontz, Jeremy Moix, Matthew Welborn, Troy Van Voorhis, Alberto Su?rez, Ramis Movassagh, and Alan Edelman. Error analysis of free-probability approximations to the density of states of disordered systems. Physical Review Letters, May 09, 2012
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Disclaimer: Views expressed in this article do not necessarily reflect those of ScienceDaily or its staff.
However, recent Google updates, Panda for example, represent perhaps Google?s most aggressive attempt to clean up its search results and in turn, this is having a significant impact on the skill sets required to deliver an effective natural search strategy (also known as SEO if you prefer).
Essentially, Panda targets those websites creating and hosting poor quality content. In other words, content that is usually created purely for the purposes of gaming search engines. We?ve all seen this type of content; pretty pointless, keyword stuffed articles, for example, that too often find their way into prominent search engine positions impacting the quality and relevancy of search results.
Google has been hammering well known article sharing sites, as well as blog networks in recent months, which in turn has impacted search results for businesses overly reliant on links from these sites.
Continuing the animal theme, we?ve also seen the Penguin update, focused specifically on targeting web spam, as well as the introduction of ?over-optimisation? penalties.
What impact have these updates had on natural search? The extent to which your natural search strategy needs to adapt as a result of these updates will very much depend on how you have historically approached the discipline.
Professionally, we have always lived by the mantra ?users first, search engines second?. In other words, we don?t subscribe to adopting any technique which is purely about garnering a search engine ranking. Instead, we ask the question; ?will this benefit the target audience?? As such, we have never bought links, subscribed to blog networks or ?spun? poor quality content because we deem these as techniques which offer no benefit to the target audience of a particular client. Therefore, we have seen very little, if any, of our clients negatively impacted by these updates.
But of course if you have subscribed to these techniques (and any others that go against Google?s published quality guidelines), then, in all likelihood, you are having to make significant changes to how your approach natural search and may even have found your website negatively impacted by these algorithm changes i.e. a drop in rankings and therefore traffic and sales.
Post Panda, today?s natural search strategies need to be underpinned by genuinely engaging and useful content and supported by social media and PR activity to deliver a sustainable and reputable search engine presence. As such, natural search, in the traditional sense, is not the stand-alone discipline it perhaps was once. The winners will ultimately be those that can join the dots between search, social media, content strategy and PR.
How have these updates impacted the skills required to deliver an effective natural search strategy? In years gone by, it is fair to say you could probably hire one person to look after your natural search activity in-house. In all likelihood they probably came from a technical background and could do a pretty decent job in improving your search engine rankings.
However, in light of how search has evolved in the last couple of years, one person is no longer equipped to manage a highly effective search strategy on their own. Whilst there remains a technical aspect to search, there is now a multitude of other skill sets that have heightened in importance following the recent Google updates described above, for example:
The freelance world might disagree with me but I simply cannot see how one person can be an expert in all of the above areas, not to mention those disciplines that haven?t been cited above such as conversion optimisation and data analysis. Quite simply, the complexity of today?s search engines, along with ever-increasing competition, requires a skillset which is beyond the ability of one person alone.
What does this mean for a brand considering managing their search strategy in-house? It means you will need to build a team probably consisting of at least four or five people. Broadly speaking, this might include a website optimisation expert, covering everything from keyword strategy through to testing. It would require a content strategist covering content creation, optimisation and an ability to market that content effectively using online PR skills. A social media expert would be integral to the team, not just because of the ?social search? angle but also to develop a community around the brand and products, whilst using social tools to communicate with customers at every stage of their buying journey from promotions to customer service. I?d also argue an analyst would be needed who can interrogate tools such as Google Analytics to understand the buying journey of customers and make informed decisions on how to optimise marketing channels and drive efficiency.
It will also need one of those people, or somebody senior to them, to have the expertise and vision to develop the strategy and ensure it is working in unison with offline marketing and PR activity. Nothing can work in a silo.
Of course, the specific skills required will differ from business to business and will be dependent on the sector but the point I seek to make here is that both in terms of skill and man hours, it is simply impossible for one person to deliver an effective search strategy on their own.
Inevitably, this means that the cost of taking search in-house is much higher than might be initially anticipated. Hiring a team of four or five is a very different proposition to hiring one person, not just in terms of salary but also the many other costs associated with recruitment and the wellbeing of staff. More often than not, it simply does not make commercial sense to build an in-house team. At least the same level of expertise and experience can be bought in at a significantly lower rate by partnering with an agency.
Another issue to consider when it comes to resourcing is the availability of skilled staff. In Econsultancy?s recent SEO Buyers Guide one of the key industry issues cited by agencies was the shortage of skilled and experienced workers. In short, there are just not enough digital marketers to satisfy a growing agency market. Therefore, brands will often find themselves competing with agencies for staff. Yet agencies can offer something that many brands cannot; the opportunity to work across a wide variety of clients and campaigns which adds greatly to the experience an employee can gain. So whilst it is by no means impossible to attract the best talent to work client side, it is by no means easy and will require a competitive package to do so.
Conclusion As the recession continues to bite, brands will rightly question the value they receive from agencies and whether costs can be cut and efficiency improved by managing their search strategy in-house.
But to do so, requires a greater investment than many brands may plan for. Natural search has evolved greatly in recent years to require a broad range of skills that, in turn, impact the resource required to deliver an effective strategy. This needs to be carefully considered before brands make the decision to manage search marketing in-house.
New online wine and spirit retailer?CellarVieWines.com?has been declared formally launched.
The UK-based retail operation, which was conceived by former CEO of BRL Hardy Europe and Constellation Europe Christopher Carson, promises to offer consumers ?something different? and ?demystify wine for the younger audience?.
Speaking of the business, Christopher said, ?Mindful that there is a wealth of outstanding young talent seeking an opportunity to establish a career with a genuine chance to flourish, and noticing the advent of online sales growth and premium wines over ?5 recording a 30% plus market share, there appeared to be a great recipe for a new business.?
Working alongside Christopher at CellarVieWines.com is his son Jonathan, with support from Charlotte Hey, former publisher at the drinks business, and Nigel Barden, BBC food and drink broadcaster and the drinks editor for Reader?s Digest magazine.
?I strongly believe CellarVie Wines has the potential to offer consumers something different, and hopefully the website and our dynamic young team can breathe new life into the conventional perceptions of the wine industry,? added Christopher.
Click here to read more about CellarVieWines.com
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This article was published on Friday, June 22nd, 2012 at 12:50 pm. You can follow any responses to this article through the RSS 2.0 feed. You can skip to the end and leave a response.
Hayden coach Shawn Baumgartner delivers a playcall to his team during a scrimmage Friday in Hayden. The Tigers are switching to 8-man football this year after declining enrollment pushed the school below the state?s 11-man classifications.
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Susan Gillis Chapman is a therapist with a MA in Buddhist and Western Psychology. Her Buddhist teachers have included Chogyam Trungpa and Pema Chodron. She has worked for ten years with abused women and their children in the field of domestic violence, and is the founder of Greenlight Communications. The Five Keys to Mindful Communication is a book about how to develop better listening skills, inspired by both Buddhist and Western forms of psychology. Chapman sees communication as the essence of human relationships, and this book is therefore as much about relationships as it is about communication skills. She sees an increased ability in listening as the key to better communities and societies, where through really listening to each other, people can learn to appreciate each other's needs as well as their own. At the heart of this process is mindfulness:
"Mindful-communication training isn't directed at intimate relationships alone. It is a personal journey that uses the sensitive emotional ups and downs of everyday conversations as a path of self-discovery. The awakens of our natural communication system is a thread that runs through every moment of our lives. Practicing mindfulness helps us notice this truth. We can observe ourselves opening and closing in small ways throughout the day."
(The Five Keys to Mindful Communication, p.13)
The basic premise of this book is that if a person lives from a "we-first" perspective rather than a "me-first" viewpoint, both that person and those that he or she come into contact with will benefit. In the "me-first" scenario, it's all about the first person, the personality that most of us take ourselves to be. In contrast, the "we-first" way of living is not to mindlessly live from an egocentric perspective, but to live from an open mindfulness. This selfless knowing reduces the sense of self that separates me & you, thereby encouraging a more we-centered attitude. The starting point for this revolution in our lifestyles, Chapman writes, is meditation & reflection. For, when we are able to observe our mental processes and habitual responses, we are in? apposition to change the negative ones for more positive, "we-first" ones.
According to Chapman, the way to mindful communication is what she calls the 'five key elements,' which are silence, mirroring, encouraging, discerning, and responding. These skills enable us to listen more deeply, both to ourselves and to others. This two-way mindfulness is crucial, for as Chapman notes, to be truly open to ourselves is to be more receptive to others as well, for in real openness the barriers of sell and not-self break down, replaced with a genuine heart-to-heart communication. Writing of an experience that was paramount in her own mindful development, Chapman writes:
"First, I realized how I distort my view of other people when I'm reacting defensively. I also saw that when i can open up and see another person in a fresh way, my own self-image transforms. On the surface, these two insights might not seem to be that a big deal. Not as exciting as a dog and a hungry bear rolling in play. But learning how to switch out of defensiveness into a more humorous, receptive state of mind is a big deal - it is the key to happy, harmonious relationships and communities."
(Ibid. p.3)
Useful techniques that the author suggests to help in this process of opening up involve labeling listening as either green-light, red-light or yellow-light patterns. This form of mindfulness involves being aware of the mind and not merely blindly responding to other people with habitual tendencies. The author describes green-light listening as when we are able to hear what the other person is saying clearly, without our own reactions interfering with our understanding. Red-light is when we don't want to listen, or when we are distracted to the point that we cannot hear them. Yellow-light listening is when there is confusion as to whether real listening is taking place or not. One example of this is when we feel we are not being listened to, and then a sense of being rejected can set in. These listening patterns develop over years and help shape our relationships with other people. In the following extracts, firstly Chapman advises us how to use these different kinds of 'lights,' and in the second extract gives an example of the contrast between red-light and green-light listening:
"Here's a quick summary of these three steps:
1. Go with the green light: Reflecting like a mirror, to validate what you hearing by repeating the words back
2. Stop at the red light: Keep a we-first approach by refraining from harming someone's reputation.
3.When the yellow light is flashing, be encouraging: Replay the hidden gold in the story you heard by rewording it with unconditional positive regard."
(Ibid. p.56)
"Red-light Pattern:
Body: When I see you holding the baby,
Interpretation: I think you don't love me anymore.
Red-light emotion: I get angry and want revenge.
Justification: I tell myself that I have the right to equal time
Green-light pattern:
Awake-body: When I see you holding the body,
Tender heart: I feel longing and sadness.
Open mind: I'm curious about the changes in our relationship and afraid of where they may lead."
(Ibid. p.99)
This is a useful book. It has many strategies & techniques to transform negative ways of listening and responding to others into very positive ones. As an experienced marriage and family therapist, Chapman cites many examples of how people have been victims of their own negative listening habits. She illustrates how this causes misunderstanding & conflict between people in the closest of relationships. And, crucially, she suggests practical ways to move out of these destructive patterns of behavior into more creative and truly communicative relationships. It seems doubtful to this reviewer that the Five Keys to Mindful Communication will lead to enlightenment and the deep wisdom of the Buddha, but then this does not appear to be the objective of the book. Rather, it takes certain aspects of traditional Buddhist practice, such as meditation & mindfulness, and presents them in ways that modern, often non-Buddhist people, can use to great fact in their lives. In this sense, this book is more valuable than a work of Buddhist philosophy in the hands of someone that doesn't ply it to their lives. Susan Chapman has, therefore, written a book that we can use in our lives, creating happier relationships not based on me-first, but on we-first.
Title & Author : The Five Keys to Mindful Communication, by Susan Gillis Chapman
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The Internet is a wonderland for sociologists, and one of the richest areas of study is Wikipedia, with its years of open?collaboration and communication?archived for posterity. But with collaboration comes conflict, and the "edit wars" that embroil hot Wikipedia?topics are dissected in detail in a new paper by researchers in Budapest.
Though the study does not make for exciting reading, there are some interesting revelations about the way such conflicts run their course, and the people who make it all happen.
After they establish criteria for a "controversial" article?(rather than articles that?are edited frequently merely because the topic requires it), the researchers unearth a few commonalities?right away:
Whether an article gets a dozen or a thousand edits in a month, they tend to be "bursty" ? that is, many edits tend to cluster together as editors add, revise, correct and, if necessary, remove new information. Both "homosexuality" and "Lady Gaga" follow this trend (below), though due to the huge amounts of updates the performer has every month, it's a bit harder to tell. Edits don't happen like drips of water from a cave ceiling, gradually forming a stalagmite. Rather, they come on?like flash floods and leave new landscapes in their wake.
Edit wars are frequently conducted between a few extremely vociferous individuals. While dozens of editors may contribute to an article over any given period of time, it is often a much?smaller number of highly opinionated editors who contribute the bulk of the edits, often redoing or removing each other's work. Below, you can see many lines representing interactions between editors in a discussion section; thicker lines represent more interactions, and red indicates negative opinions. Clearly the individuals at 11 and 3 o' clock have contributed more than their fair share to the discussion, and appear to be mostly?yammering at each other.
In theory, many articles initially considered to be controversial would level out in terms of edit rate, and over time crystallize - but only if no new events spark further interest. Below, you can see a graph of the total number of edits to Michael Jackson's entry, with salient points marked such as his acquittal?(A)?and death (D). Other highly edited entries showed similar signs of flattening out, but often would surge into action again following key events. The pace of news, not to mention the frequent arrival of opinionated editors, renders peace a forlorn hope.
If you're interested in the methodology and math behind these interesting points, you can read the entire paper online at PLoS One, but you'll need a solid foundation of statistics to understand it. On the other hand, you can investigate the topic yourself by going to any Wikipedia page and clicking the "Talk" or "View history" buttons at the top. The discussion of the entry can at times be as worthwhile to read as the entry itself.
It's well-known that information on Wikipedia is essentially peer-reviewed opinion, and this study shows just how lively?those peers ??and that review process???can be. But while the details are constantly under heated debate, the result is often a compromise that cleaves very closely to fact, despite being the middle ground between several ideas of the truth.
Devin Coldewey is a contributing writer for msnbc.com. His personal website is coldewey.cc.
FILE- In this, Friday, April 20, 2012, file photo, A visitor tries out a new iPad tablet computer at an Apple store in Klang, outside Kuala Lumpur, Malaysia. The annual charging cost of an iPad is just $1.36, according to the Electric Power Research Institute. The group, known as EPRI, saw Apple Inc.'s big iPad sales numbers and decided to study the tablet computer's power use to determine what effect the devices might have on the nation's electricity consumption (AP Photo/Lai Seng Sin, File)
FILE- In this, Friday, April 20, 2012, file photo, A visitor tries out a new iPad tablet computer at an Apple store in Klang, outside Kuala Lumpur, Malaysia. The annual charging cost of an iPad is just $1.36, according to the Electric Power Research Institute. The group, known as EPRI, saw Apple Inc.'s big iPad sales numbers and decided to study the tablet computer's power use to determine what effect the devices might have on the nation's electricity consumption (AP Photo/Lai Seng Sin, File)
NEW YORK (AP) ? That coffee you're drinking while gazing at your iPad? It cost more than all the electricity needed to run those games, emails, videos and news stories for a year.
The annual cost to charge an iPad is just $1.36, according to the Electric Power Research Institute, a non-profit research and development group funded by electric utilities.
By comparison, a 60-watt compact fluorescent bulb costs $1.61, a desktop PC adds up to $28.21 and a refrigerator runs you $65.72.
The group, known as EPRI, studied the power consumption of Apple Inc.'s iPad to determine the effect that the newly-popular devices might have on the nation's electricity use.
The answer: not much.
If the number of iPads triples from the current 67 million, they would need the electricity from one small power plant operating at full strength.
But if people are using iPads instead of televisions to play video games, or ditching their desktop computers for iPads, the shift to tablets could mean lower overall power consumption. A desktop computer uses 20 times more power than an iPad.
Baskar Vairmohan, the EPRI researcher who conducted the iPad test, said the group is now studying usage to understand whether the explosion of tablets is adding to power consumption, or reducing it.
Residential power demand is on track to fall for the third straight year, according to the government. A weak economy is keeping people in smaller houses and shacked up with others. At the same time, efficiency programs are pushing more efficient light bulbs, air conditioners and other devices into homes. Refrigerators use a quarter of the power they used a generation ago, according to EPRI.
For the iPad test, Vairmohan measured the amount of power used to charge up an iPad with a drained battery. He assumed that users would charge up every other day. Over a year, the latest version of the iPad consumed 11.86 kilowatt-hours of electricity. (Older versions consume somewhat less power.)
The juice would cost $1.36 at the U.S. average residential price of 11.49 cents per kilowatt-hour.
But there's an even cheaper way to go than the iPad. EPRI calculated the cost of power needed to fuel an iPhone 4 for year: just 38 cents.
Follow Jonathan Fahey at http://twitter.com/JonathanFahey .
Following an eight-year run, the Champs Sports Bowl is no more? at least when it comes to title sponsorship.
The Orlando-based bowl?will officially be named the Russell Athletic Bowl (Ooohh!!! Aahhhhh!!!) beginning this year and will continue under that name through 2015. The?Florida Citrus Sports announced the move in a release today.?Champs Sports, which held the title sponsorship from 2004-12, will continue its relationship with Florida Citrus Sports as an ?Official Partner? of both the newly-named bowl and the Capital One Bowl through 2014.
Additionally, Russell Athletic will help negotiate the new conference agreements following the 2013 edition of the game.
This year?s?Russell Athletic Bowl?will be played Dec. 28 and feature an ACC-Big East matchup for the right to be named the fifth-best college football conference. Last year?s game featured an 18-14 win by Florida State over Notre Dame.
Ethics should drive health policy reform, especially with physician-owned specialty hospitalsPublic release date: 20-Jun-2012 [ | E-mail | Share ]
Contact: George Vlahakis vlahakis@iu.edu 812-855-0846 Indiana University
BLOOMINGTON, Ind. -- The ethical principles that have for centuries shaped the relationship between patient and physician should also guide legislators, regulators -- and justices of the highest court -- charged with crafting U.S. health care policies that demarcate the boundaries of a physician's business practice, an Indiana University professor argues.
This is all the more pressing with the "creeping commercialization" that now characterizes medicine in the form of physician-owned specialty hospitals, according to an analysis published in the June issue of the American Business Law Journal.
Some of the clearest examples of these ethical considerations are the reforms to the physician-owned specialty-hospital industry enacted in the Patient Protection and Affordable Care Act, argues legal scholar and ethicist Joshua Perry, assistant professor of business law and ethics at the IU Kelley School of Business.
Perry argues the PPACA legislation could have gone further and completely banned physician-owned hospitals. Short of that, his article provides justification for the aggressive regulation of physician-owned hospitals contained in the PPACA.
"Ethics are the bedrock of health care, the root of total trust between physician and patient and what makes health care unique among economic enterprises," Perry said. "But rising tides of commercialization have eroded longstanding, ethics-based self-regulation and internal constraints. As systemic complexities related to cost, quality and access are debated, ethics deserve a seat at the table where policies are being argued."
The PPACA legislation prohibits new or expanded physician-owned specialty hospitals from filing Medicare claims if a financial relationship exists between the referring physician and the hospital receiving the government reimbursement, among other regulations designed to promote transparency, fair competition and patient safety. However, no such restrictions were placed on existing entities, allowing for a gradual exploitation of a legislative loophole.
"A more prudent, ethically driven course would have been complete closure of existing loopholes that gave rise to physician-owned facilities and the retroactive removal of Medicare certification from those currently operating," Perry said.
Physician-owned specialty hospitals are either partially or fully owned by physician-investors, with services limited to cardiac, orthopedic or other surgical procedures.
Limiting practices to services deemed "high-profit" has led to successful medical businesses, providing tens of thousands of jobs, millions of dollars in state and federal tax revenues (which nonprofit hospitals do not pay) and hundreds of millions of dollars in cumulative payroll, according to Perry's research. Physician-owned specialty hospitals tripled between 1990 and 2003 to approximately 265 currently in operation.
However, Perry found that specialty hospitals treat a lower percentage of severely ill patients than general hospitals, suggesting that physician-owned specialty centers "either intentionally skim the cream off the top of the patient population or limit treatment to the healthiest and least costly patients."
At the same time, due to staffing levels, employee compensation and the use of single-occupancy rooms, physician-owned facilities have higher costs than general hospitals and result in higher utilization rates and greater requests for Medicare reimbursement.
Still, Perry observed that for physician owners whose personal incomes have declined over the past decade, these investments offer an environment where they can practice what they love while controlling decisions about patient care and earning opportunities -- without interference.
"One could conclude that the emergence of physician-owned specialty hospitals is directly linked to disagreements among health care providers, administrators and government bureaucrats, all of whom have failed to recognize the necessity of an interconnected health care community," Perry said.
For more than a decade, arguments for a free and largely unregulated market for health care have proliferated. But an unregulated market in medicine fails to address issues of relational trust and patient vulnerability, according to Perry, and neglects to resolve social inequities that arise when unfettered health care markets fail to provide access to the uninsured or under-insured.
Some measure of government regulation becomes essential, Perry said -- and such governmental interference must be informed by ethical principles.
"If the health care market were left to operate solely based on principles of profit maximization, many physicians -- trained at government expense and subsidized by Medicare or Medicaid programs -- would have little incentive beyond a commitment to professional or moral duty to treat those who are often the sickest and without private payment sources," Perry said.
With the Supreme Court ruling expected shortly on the PPACA, Perry urges the justices to consider the ethical dynamics of the PPACA law and the consequences that result when the health care business becomes more about business and less about care.
###
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Ethics should drive health policy reform, especially with physician-owned specialty hospitalsPublic release date: 20-Jun-2012 [ | E-mail | Share ]
Contact: George Vlahakis vlahakis@iu.edu 812-855-0846 Indiana University
BLOOMINGTON, Ind. -- The ethical principles that have for centuries shaped the relationship between patient and physician should also guide legislators, regulators -- and justices of the highest court -- charged with crafting U.S. health care policies that demarcate the boundaries of a physician's business practice, an Indiana University professor argues.
This is all the more pressing with the "creeping commercialization" that now characterizes medicine in the form of physician-owned specialty hospitals, according to an analysis published in the June issue of the American Business Law Journal.
Some of the clearest examples of these ethical considerations are the reforms to the physician-owned specialty-hospital industry enacted in the Patient Protection and Affordable Care Act, argues legal scholar and ethicist Joshua Perry, assistant professor of business law and ethics at the IU Kelley School of Business.
Perry argues the PPACA legislation could have gone further and completely banned physician-owned hospitals. Short of that, his article provides justification for the aggressive regulation of physician-owned hospitals contained in the PPACA.
"Ethics are the bedrock of health care, the root of total trust between physician and patient and what makes health care unique among economic enterprises," Perry said. "But rising tides of commercialization have eroded longstanding, ethics-based self-regulation and internal constraints. As systemic complexities related to cost, quality and access are debated, ethics deserve a seat at the table where policies are being argued."
The PPACA legislation prohibits new or expanded physician-owned specialty hospitals from filing Medicare claims if a financial relationship exists between the referring physician and the hospital receiving the government reimbursement, among other regulations designed to promote transparency, fair competition and patient safety. However, no such restrictions were placed on existing entities, allowing for a gradual exploitation of a legislative loophole.
"A more prudent, ethically driven course would have been complete closure of existing loopholes that gave rise to physician-owned facilities and the retroactive removal of Medicare certification from those currently operating," Perry said.
Physician-owned specialty hospitals are either partially or fully owned by physician-investors, with services limited to cardiac, orthopedic or other surgical procedures.
Limiting practices to services deemed "high-profit" has led to successful medical businesses, providing tens of thousands of jobs, millions of dollars in state and federal tax revenues (which nonprofit hospitals do not pay) and hundreds of millions of dollars in cumulative payroll, according to Perry's research. Physician-owned specialty hospitals tripled between 1990 and 2003 to approximately 265 currently in operation.
However, Perry found that specialty hospitals treat a lower percentage of severely ill patients than general hospitals, suggesting that physician-owned specialty centers "either intentionally skim the cream off the top of the patient population or limit treatment to the healthiest and least costly patients."
At the same time, due to staffing levels, employee compensation and the use of single-occupancy rooms, physician-owned facilities have higher costs than general hospitals and result in higher utilization rates and greater requests for Medicare reimbursement.
Still, Perry observed that for physician owners whose personal incomes have declined over the past decade, these investments offer an environment where they can practice what they love while controlling decisions about patient care and earning opportunities -- without interference.
"One could conclude that the emergence of physician-owned specialty hospitals is directly linked to disagreements among health care providers, administrators and government bureaucrats, all of whom have failed to recognize the necessity of an interconnected health care community," Perry said.
For more than a decade, arguments for a free and largely unregulated market for health care have proliferated. But an unregulated market in medicine fails to address issues of relational trust and patient vulnerability, according to Perry, and neglects to resolve social inequities that arise when unfettered health care markets fail to provide access to the uninsured or under-insured.
Some measure of government regulation becomes essential, Perry said -- and such governmental interference must be informed by ethical principles.
"If the health care market were left to operate solely based on principles of profit maximization, many physicians -- trained at government expense and subsidized by Medicare or Medicaid programs -- would have little incentive beyond a commitment to professional or moral duty to treat those who are often the sickest and without private payment sources," Perry said.
With the Supreme Court ruling expected shortly on the PPACA, Perry urges the justices to consider the ethical dynamics of the PPACA law and the consequences that result when the health care business becomes more about business and less about care.
###
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
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Filed under: Healthy Pregnancy ? Tags: Company Profile Example
Available: Immediately Minimum term: 3 months Room: 2 Double/single rooms Rent: ?235 per calendar month (exc. bills) for a single person Deposit: ?235 and a guarantor required There are two rooms available in a shared house with one other friendly resident. The house is on North Road and it is very close to the university and Halls of Residence with the city centre a 15 minute walk away (there is also a bus stop outside). There is also quick and easy access to the A48 and M4. Downstairs there is a modern kitchen with a dining area and bathroom with a bath and shower. Outside there is a garden with a paved area and access to a lane via a gate. One of the rooms that is available is also downstairs, furnished with plenty of storage and either a single or double bed provided (depending on the tenant?s wishes). The second room is upstairs and it can be let furnished or unfurnished with either a single or double bed (again, depending on tenant?s wishes). There is also a large shared sitting room downstairs. There is gas central heating (with current gas safety certificate) and smoke/carbon monoxide alarms. The house is very recently decorated and refurbished. There is 1 additional bedroom upstairs which is currently let and a sitting room/office upstairs rented by the current tenant. There is a mixture of permit and non-permit parking on Blackweir Terrace to the rear of the property. There is wireless broadband which you can contribute towards if you want to use it, and bills would be ?50-?60 a month depending on the season.
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However, recent Google updates, Panda for example, represent perhaps Google?s most aggressive attempt to clean up its search results and in turn, this is having a significant impact on the skill sets required to deliver an effective natural search strategy (also known as SEO if you prefer).
The UK-based retail operation, which was conceived by former CEO of BRL Hardy Europe and Constellation Europe Christopher Carson, promises to offer consumers ?something different? and ?demystify wine for the younger audience?.
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Public release date: 20-Jun-2012
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