(Reuters) - Pfizer Inc on Tuesday reported better-than-expected fourth-quarter results, helped by rebounding sales in emerging markets, but the drugmaker forecast 2013 profit weaker than Wall Street estimated.
Pfizer, the largest U.S. drugmaker, said quarterly earnings quadrupled to $6.32 billion, or 86 cents per share, as it recorded a gain from selling its nutritional products business to Swiss food groups Nestle SA for about $12 billion in November.
In the year-earlier quarter, it posted a profit of $1.44 billion, or 19 cents per share.
Excluding special items, Pfizer earned 47 cents per share in the quarter. Analysts, on average, expected 44 cents per share, according to Thomson Reuters I/B/E/S.
Global company sales fell 7 percent to $15.1 billion, hurt by generic competition for its Lipitor cholesterol fighter, but came in well above expectations of $14.37 billion.
Pfizer forecast full-year 2013 earnings of $2.20 to $2.30 per share, excluding special items. The average analyst estimate was $2.29 per share, according to Thomson Reuters.
"Pfizer's 2013 forecast is a little lighter than expected, but won't cause me to lose sleep," said Judson Clark, an analyst with Edward Jones. He said he has a "buy" rating on the shares because of its strong pipeline of experimental drugs.
Clark said the company's forecast would have been 2 cents per share higher if not for interest expenses associated with a planned spinoff of its animal health business into a new company called Zoetis.
Company sales in emerging markets rose 17 percent to $2.65 billion, in contrast with a slight decline in the prior quarter.
Global Lipitor sales fell 71 percent in the quarter to $584 million, but that was offset by strong sales of other medicines.
Sales of its Prevnar vaccine against pneumococcal bacteria jumped 19 percent to $993 million, helping ease concerns about weak sales in earlier quarters. Sales of Celebrex, used to ease pain from arthritis, rose 12 percent to $750 million.
Company shares trading little changed at $26.81 before the market opened.
(Reporting by Ransdell Pierson; Editing by Jeffrey Benkoe and Maureen Bavdek)
(Reuters) - Moody's Investors Service has cut the ratings of six Canadian financial institutions, including the previously "Aaa" rated Toronto-Dominion Bank, due to concerns about rising consumer debt and high housing prices.
TD, the only publicly traded bank that still carried Moody's top rating, was downgraded along with Bank of Nova Scotia, Canadian Imperial Bank of Commerce, Bank of Montreal, National Bank of Canada and Caisse Central Desjardins, Canada's largest association of credit unions, Moody's said on Monday.
The cuts, which were widely anticipated after Moody's put the lenders on credit watch in October, were all by one notch.
The only major Canadian bank not included in the cut was top player Royal Bank of Canada. That's because Moody's cut RBC's ratings by two notches last June as part of a review of 17 global banks.
Ratings downgrades typically lift the cost of borrowing for the affected financial institution.
Canada's banking system has been named the soundest in the world four years in a row, and indeed Moody's noted the banks remain among the highest rated in the agency's global rating universe.
But the outlook for the sector has become murky due to record consumer debt levels combined with increased downside risks to the Canadian economy, Moody's said.
"High levels of consumer indebtedness and elevated housing prices leave Canadian banks more vulnerable than in the past to downside risks the Canadian economy faces," the agency said in a statement.
The agency also pointed to high capital markets exposure at Bank of Montreal and National Bank, which increases those banks' exposure to a market downturn.
Moody's now rates TD's long-term debt at Aa1, Scotiabank and Caisse central Desjardins are at Aa2, and the others are at Aa3.
Shares of the banks seemed unaffected late in the session on Monday.
(Reporting by Cameron French, additional reporting by David Gaffen in New York; Editing by Richard Chang)
By Vanessa Thorpe, The Observer Saturday, January 26, 2013 18:23 EST
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Archive documents, photos and video footage are released to the public for the first time in digital edition of Anne?s diary
Scrapbook pictures that give a bright glimpse of Anne Frank?s life before her family went into hiding are among a wealth of unpublished material made public for Holocaust Memorial Day on Sunday.
The scrapbooks, thought to have been made by her father Otto, are held in the archives of the Anne Frank Fund and their release, with rare film footage, letters and pictures, is intended to give a broader picture of the Frank family.
?Anne?s father was a keen amateur photographer, something that was more unusual at that time, and we have hundreds of images, mainly of special family occasions, but of friends too,? said Yves Kugelmann, who sits on the board of the fund.
A photo of Anne with her elder sister and parents out together in May 1941 near their home in Amsterdam is a poignant reminder of the freedom they lost, while a jaunty image of Anne, taken by her sister Margot, shows her leaning over the balcony of a block of flats and letting her hair fly. The picture was meant to include their grandmother, Rosa, but a note in the scrapbook explains that she moved out of the way at the last moment.
Original documents, diary pages and footage are all included in the first app edition of The Diary of a Young Girl, the journal written by the teenage Frank during the two years she spent concealed from the Nazis in an annexe behind a warehouse.
The content of the app is drawn from archives held in Basel, Switzerland, where Otto Frank lived after the war, and has been assembled with the help of Frank?s only surviving direct relative, Bernd Elias, known as Buddy. ?I am happy to say that interest in Anna and her times is still strong, but bringing out this now is highly important for the future of her story,? Elias told the Observer. ?The new material gives it a completely different outlook.?
In childhood Anne?s elder cousin, Buddy, was the object of her dreams. Inside the annexe at Prinsengracht 263 she drew a picture of the outfit that she hoped to wear one day when she went ice-skating with him. Now 87, Elias works with the Anne Frank Foundation and is still committed to explaining the relevance of his cousin?s story.
?It is a great thing that we have so much material available now for young people,? he said. ?In the past there was only the diary, now there are pictures and videos. Hatred, of course, and racism are still working away all over the world. They are with us. It is so important that children learn to respect all religions and all nationalities.?
Tens of millions have read The Diary of a Young Girl since it was first published in 1947; readers of the app can now see the hiding place she shared from 6 July 1942 until 4 August 1944 with her parents, her sister, the Van Pels family and a dentist called Fritz Pfeffer.
Importantly for Kugelmann and Elias, the app also shows what was happening outside the annexe. While Helena Bonham Carter reads Anne?s diary entries, users can watch videos of those who secretly helped the threatened Jewish family, or listen to original radio news broadcasts.
?When I knew Anne, she was a girl like every other girl,? said Elias. ?She was lovely and wild and we had a wonderful time playing together. But she was no real exception, although it is true that she just loved writing, even before she was in hiding. In a way, she was not somebody special, though. That was the point really.? Although Frank was ?great fun?, Elias often thinks of the rest of her family too. ?We know about Anne because of her writing, yet no one knows about her sister. Sometimes I can?t believe that she went then too. And I know that Otto felt that. Margot was highly intelligent and was always the best in her class. Anne was one victim of millions, and all these victims were each people with their own characters.?
Elias feels Anne?s wider importance now is as the best known Holocaust victim. ?She has become an icon of that time, and now I think about her every day because of my work. I get mail sent to me almost every day and I answer them all.?
The Anne Frank Fund makes no profits and invests in education projects, so its commercial ventures are carefully chosen. Elias believes his cousin?s legacy is liable to exploitation. ?I hated to see the musical. She is used sometimes for things that are not right. There were even some Anne Frank jeans at one time. Horrible ideas.?
At the same time it is ?heartwarming?, Elias says, that she is read all over the world. Penguin General?s app also includes 21 video clips from the Oscar-winning documentary Anne Frank Remembered and several audio recordings, including a commentary from Miep Gies, one of those who risked her life to help Anne.
But schoolchildren will not, of course, be spared the last chapter of Frank?s story. Her time in hiding ended on a summer?s day when the Austrian Nazi SS Oberscharf?hrer Karl Silberbauer entered the annexe. Those inside were all taken away and Frank went first to the Westerbork transit camp in the Netherlands, then on to Auschwitz and Bergen-Belsen, where she died from typhus three months before her 16th birthday.
We've seen home decor do a lot of things for people. It can relax you, make you happy and even have an effect on your self-image. But can it save your marriage? According to Lauren Machling of the Wall Street Journal, perhaps it can.
In a recent article, Machling speaks of the problems that often arise in a marriage when furnishings of both partners are combined during cohabiting. She says rooms become designated as "his" and "hers" and pieces of furniture start to become known as "yours" and "mine" with a wedge being driven between the two -- if there can't be a compromise.
And according to Jay Lebow, a professor of psychology and a marital therapist and researcher at the Family Institute at Northwestern University in Chicago, it's things like fighting over lamps and rugs that can make one person feel less adequate, especially if it involves one moving into another's home. "The person who was living there all along feels hurt every time something is moved or changed. And the person who moved in feels like they've lost their voice," he told the newspaper.
But Machling says that doesn't have to be the way. With books like "Luxurious Minimalism" by photographer Fritz von der Schulenburg and writer Karen Howes, newlyweds can find ways to combine their two styles and compromised. The designs in the book, Machling writes, "reflect a certain ideal?one maintained by a couple who, while equally strong-willed, have learned to make room for each other's visual style."
Of course, you can never really tell. For instance, Machling spoke with author Jackie Collins, who, after two failed marriages, refuses to share a space with a man for fear of losing her glamourous, art deco style. "I don't think I ever could do it again. I have very distinctive tastes and I'm not going to concede to anybody," she said.
Head over the the Wall Street Journal to read the full article, and comment to weigh in: Can a relationship be affected by one's furnishings?
Have something to say? Check out HuffPost Home on Twitter, Facebook, Pinterest, Tumblr and Instagram.
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Do you have a home story idea or tip? Email us at homesubmissions@huffingtonpost.com. (PR pitches sent to this address will be ignored.)
Posted on: 7:55 pm, January 25, 2013, by Cary Docter, updated on: 07:58pm, January 25, 2013
RACINE (WITI) ??A Racine puppy needs some help.?Jerome came to the Racine Campus of the Wisconsin Humane Society with a badly fractured, infected leg.
The staff at the Racine Campus began to work on relieving Jerome?s pain and evaluated the extent of his injuries. With the help of local veterinarian partners, Jerome began treatment this week that was needed to get him healthy again. Unfortunately, Jerome?s injury to his leg was so extensive that it needed to be amputated.
Jerome is now recovering and will eventually be available for adoption (several weeks).?
Now, the Racine campus of the Wisconsin Humane Society is asking for the community?s support to help fund his medical treatment, which will exceed $1,500.
You can read more about Jerome?s story and make a donation by CLICKING HERE.
Bullying, whether it's physical aggression or spreading rumors, boosts the social status and popularity of middle school students, according to a new UCLA psychology study that has implications for programs aimed at combatting school bullying. In addition, students already considered popular engage in these forms of bullying, the researchers found.
The psychologists studied 1,895 ethnically diverse students from 99 classes at 11 Los Angeles middle schools. They conducted surveys at three points: during the spring of seventh grade, the fall of eighth grade and the spring of eighth grade. Each time, students were asked to name the students who were considered the "coolest," the students who "start fights or push other kids around" and the ones who "spread nasty rumors about other kids."
Those students who were named the coolest at one time were largely named the most aggressive the next time, and those considered the most aggressive were significantly more likely to be named the coolest the next time. The results indicate that both physical aggression and spreading rumors are rewarded by middle school peers.
"The ones who are cool bully more, and the ones who bully more are seen as cool," said Jaana Juvonen, a UCLA professor of psychology and lead author of the study. "What was particularly interesting was that the form of aggression, whether highly visible and clearly confrontational or not, did not matter. Pushing or shoving and gossiping worked the same for boys and girls.
"The impetus for the study was to figure out whether aggression promotes social status, or whether those who are perceived as popular abuse their social power and prestige by putting other kids down," she said. "We found it works both ways for both 'male-typed' and 'female-typed' forms of aggression."
The research is published online in the prominent Journal of Youth and Adolescence and will be appear in an upcoming print edition of the journal.
The study implies that anti-bullying programs have to be sophisticated and subtle to succeed.
"A simple message, such as 'Bullying is not tolerated,' is not likely to be very effective," Juvonen said, when bullying often increases social status and respect.
Effective anti-bullying programs need to focus on the bystanders, who play a critical role and can either encourage or discourage bullying, said Juvonen, who has conducted research on bullying since the mid-1990s and serves as a consultant to schools on anti-bullying programs. Bystanders should be made aware of the consequences of spreading rumors and encouraging aggression and the damage bullying creates, she said.
Juvonen's current research is federally supported by the National Science Foundation and the National Institutes of Health's National Institute of Child Health and Human Development.
Juvonen and her colleagues reported in 2003 that bullies are popular and respected and are considered the "cool" kids.
The rumors middle school students spread often involve sexuality (saying a student is gay or sexually promiscuous) and family insults, she said.
Like middle school students, Juvonen noted, non-human primates also use aggression to promote social rank (although gossiping is obviously limited to humans).
Co-authors of the new study are former UCLA psychology graduate student Yueyan Wang and UCLA psychology doctoral student Guadalupe Espinoza.
In previous research, Juvonen and her colleagues have reported that nearly three in four teenagers say they were bullied online at least once during a recent 12-month period, and only one in 10 reported such cyber-bullying to parents or other adults; that nearly half of the sixth graders at two Los Angeles?area public schools said they were bullied by classmates during a five-day period; that middle school students who are bullied in school are likely to feel depressed, lonely and miserable, which in turn makes them more vulnerable to further bullying incidents; and that bullying is pervasive.
"Bullying is a problem that large numbers of kids confront on a daily basis at school; it's not just an issue for the few unfortunate ones," Juvonen has said. "Students reported feeling humiliated, anxious or disliking school on days when they reported incidents, which shows there is no such thing as 'harmless' name-calling or an 'innocent' punch.'"
Juvonen advises parents to talk with their children about bullying before it ever happens, to pay attention to changes in their children's behavior and to take their concerns seriously.
Students who get bullied often have headaches, colds and other physical illnesses, as well as psychological problems.
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University of California - Los Angeles: http://www.newsroom.ucla.edu
Thanks to University of California - Los Angeles for this article.
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Algerian foreign minister Mourad Medelci speaks during an interview with the Associated Press at the 43rd Annual Meeting of the World Economic Forum, WEF, in Davos, Switzerland, Friday, Jan. 25, 2013. (AP Photo/Anja Niedringhaus)
Algerian foreign minister Mourad Medelci speaks during an interview with the Associated Press at the 43rd Annual Meeting of the World Economic Forum, WEF, in Davos, Switzerland, Friday, Jan. 25, 2013. (AP Photo/Anja Niedringhaus)
Algerian foreign minister Mourad Medelci adjusts his glasses during an interview with the Associated Press at the 43rd Annual Meeting of the World Economic Forum, WEF, in Davos, Switzerland, Friday, Jan. 25, 2013. (AP Photo/Anja Niedringhaus)
DAVOS, Switzerland (AP) ? Algeria's foreign minister acknowledged Saturday that security forces made mistakes in a hostage crisis at a Saharan gas plant in which dozens of foreign workers were killed during Algerian military strikes.
Mourad Medelci also conceded that Algeria will need international help to fight terrorism. Algeria's decision to refuse foreign offers of aid in handling the crisis, and to send the military to fire on vehicles full of hostages, drew widespread international criticism.
"We are in the process of assessing our mistakes," Medelci told The Associated Press in an interview at the World Economic Forum in Davos, Switzerland on Friday.
He did not, however, identify any mistake or address specific criticism of the chaotic and bloody operation. But overall, he suggested that the Algerian government did the right thing.
"In that assessment we are leaning more towards establishing that the operation was a success," he said.
The Jan. 16 attack, which an al-Qaida-affiliated organization has claimed responsibility for, sent scores of foreign energy workers fleeing across the desert for their lives. A four-day siege by Algerian forces on the complex left at least 37 hostages and 29 militants dead. Some of the fatalities were badly burned, making it difficult to identify them.
The minister said Algeria is likely to reinforce security measures at sites where multinationals operate in the oil- and gas-rich country. But he insisted that foreign workers in Algeria "will continue to work in Algeria and that is the best way to answer the terrorists."
He defended the government's decision to attack instead of negotiating, pointing to its years of experience dealing with Islamist extremist violence.
"Faced with such an attitude (of terrorism), it's not just words that solve the problem. It's action," he said.
But he admitted that Algeria can't face international terrorism alone.
"It absolutely needs support," he said.
He argued that Algeria wasn't the target of the attack. Instead, he said, the terrorists were targeting investors and the foreigners who work for them.
An international group of militants led by a Mali-based warlord staged the attack. The extremists demanded an end to the French-led military operation in neighboring Mali, where al-Qaida-linked groups have seized and expanded control over the past year.
___
AP correspondent Angela Charlton contributed from Davos.
Contact: Ekaterina Pesheva epeshev1@jhmi.edu 410-502-9433 Johns Hopkins Medicine
Daily baths with an ordinary antibacterial cleanser can safely reduce the risk of dangerous bloodstream infections in critically ill children, according to a trial conducted in five pediatric hospitals and led by investigators at the Johns Hopkins Children's Center.
A report on the findings of the research -- the first of its kind in children and one of the largest infection-prevention trials to date
-- will be published online Jan. 26 in The Lancet.
Conducted among more than 4,000 children hospitalized in 10 pediatric intensive care units in five U.S. hospitals, the study compared standard soap baths with antiseptic baths with diluted chlorhexidine gluconate (CHG), a commonly used cleanser that kills viruses, bacteria and fungi.
Children bathed with the antiseptic solution had a 36 percent lower risk of bloodstream infections, compared with those given soap-and-water baths.
Traditionally, bedside bathing has been viewed as nothing more than a comfort measure, the researchers say, but the study findings show that the simple, often overlooked procedure can also be a powerful infection-prevention tool.
"Daily bedside baths with an antiseptic solution may be an easy, quick and relatively cheap way to cut the risk of a potentially life-threatening infection in these vulnerable children," says lead investigator Aaron Milstone, M.D., M.H.S., a pediatric infectious disease specialist at Johns Hopkins Children's Center.
Bloodstream infections, a common occurrence among critically ill patients, can lead to serious complications, including organ damage and even death. Beyond the human toll, each infection can cost up to
$39,000 in additional treatment, the investigators say.
Notably, the researchers add, daily antiseptic baths appeared to reduce bloodstream infections of any origin.
In recent years, patient safety initiatives have focused on -- and made great strides in -- preventing one particular subtype of bloodstream infections, those caused by central venous catheters. But because bloodstream infections often occur even in children without such devices, the protective effects of antiseptic bathing may go beyond catheter-related infections, the researchers say.
"Bloodstream infections, catheter-related or not, occur in many critically ill children and cause a lot of morbidity, so our efforts should be on reducing bacteremia of any and all origins," says Trish M. Perl, M.D., M.Sc., an infectious disease expert and lead epidemiologist of the Johns Hopkins Health System.
The Johns Hopkins Children's Center initiated antibacterial baths in its intensive-care unit as an infection-control measure in 2011.
For the study, children in half of the 10 intensive-care units were bathed with washcloths soaked in CHG solution, while those in the other half received standard soap-and-water sponge baths. Midway through the yearlong study, the researchers swapped bathing procedures across units so that the wards performing soap-and-water baths switched to antiseptic baths and vice versa. Doing so, the researchers say, further ensured that any decrease in infection rate was due to the antiseptic baths rather than chance.
Most children experienced no side effects: 12 children had mild reactions to the solution, such as skin irritation.
A staple of hospital infection control since the 1970s, CHG solution is commonly used as a pre-surgery scrub and to prepare a patient's skin for surgery. It also is available over the counter as an at-home skin cleanser. The researchers caution that additional studies are needed to determine whether the benefits of antiseptic baths extend to children hospitalized outside of the ICU.
The other hospitals participating in the study were St. Louis Children's Hospital, Children's Hospital of Philadelphia, Seattle Children's Hospital and Children's National Medical Center.
###
The research was funded by Sage Products Inc., with additional support from the National Institutes of Health. Sage manufactures the prepackaged pre-soaked, one-time washcloths used in the study.
Financial interest disclosure: Milstone and Perl have received grant support from Sage Products Inc., the manufacturer of the antiseptic washcloths used in the study.
NOTE: The antiseptic solution, chlorhexidine gluconate, is not manufactured by Sage. It is produced by multiple manufacturers and is available over the counter.
Related:
Community-Acquired MRSA Becoming More Common in Pediatric ICU Patients
Remove Children's Catheters as Soon as Possible to Prevent Bloodstream Infections
Careful Cleaning of Children's Skin Wounds Key to Healing, Regardless of Antibiotic Choice
In the Fight Against Life-Threatening Catheter Infections, Length of Use is Key
Simple Steps Prevent Life-Threatening Bloodstream Infections in Children
Founded in 1912 as the children's hospital of the Johns Hopkins Medical Institutions, the Johns Hopkins Children's Center offers one of the most comprehensive pediatric medical programs in the country, with more than 92,000 patient visits and nearly 9,000 admissions each year. Hopkins Children's is consistently ranked among the top children's hospitals in the nation. Hopkins Children's is Maryland's largest children's hospital and the only state-designated Trauma Service and Burn Unit for pediatric patients. It has recognized Centers of Excellence in dozens of pediatric subspecialties, including allergy, cardiology, cystic fibrosis, gastroenterology, nephrology, neurology, neurosurgery, oncology, pulmonary, and transplant. For more information, visit www.hopkinschildrens.org.
[ | E-mail | Share ]
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
Contact: Ekaterina Pesheva epeshev1@jhmi.edu 410-502-9433 Johns Hopkins Medicine
Daily baths with an ordinary antibacterial cleanser can safely reduce the risk of dangerous bloodstream infections in critically ill children, according to a trial conducted in five pediatric hospitals and led by investigators at the Johns Hopkins Children's Center.
A report on the findings of the research -- the first of its kind in children and one of the largest infection-prevention trials to date
-- will be published online Jan. 26 in The Lancet.
Conducted among more than 4,000 children hospitalized in 10 pediatric intensive care units in five U.S. hospitals, the study compared standard soap baths with antiseptic baths with diluted chlorhexidine gluconate (CHG), a commonly used cleanser that kills viruses, bacteria and fungi.
Children bathed with the antiseptic solution had a 36 percent lower risk of bloodstream infections, compared with those given soap-and-water baths.
Traditionally, bedside bathing has been viewed as nothing more than a comfort measure, the researchers say, but the study findings show that the simple, often overlooked procedure can also be a powerful infection-prevention tool.
"Daily bedside baths with an antiseptic solution may be an easy, quick and relatively cheap way to cut the risk of a potentially life-threatening infection in these vulnerable children," says lead investigator Aaron Milstone, M.D., M.H.S., a pediatric infectious disease specialist at Johns Hopkins Children's Center.
Bloodstream infections, a common occurrence among critically ill patients, can lead to serious complications, including organ damage and even death. Beyond the human toll, each infection can cost up to
$39,000 in additional treatment, the investigators say.
Notably, the researchers add, daily antiseptic baths appeared to reduce bloodstream infections of any origin.
In recent years, patient safety initiatives have focused on -- and made great strides in -- preventing one particular subtype of bloodstream infections, those caused by central venous catheters. But because bloodstream infections often occur even in children without such devices, the protective effects of antiseptic bathing may go beyond catheter-related infections, the researchers say.
"Bloodstream infections, catheter-related or not, occur in many critically ill children and cause a lot of morbidity, so our efforts should be on reducing bacteremia of any and all origins," says Trish M. Perl, M.D., M.Sc., an infectious disease expert and lead epidemiologist of the Johns Hopkins Health System.
The Johns Hopkins Children's Center initiated antibacterial baths in its intensive-care unit as an infection-control measure in 2011.
For the study, children in half of the 10 intensive-care units were bathed with washcloths soaked in CHG solution, while those in the other half received standard soap-and-water sponge baths. Midway through the yearlong study, the researchers swapped bathing procedures across units so that the wards performing soap-and-water baths switched to antiseptic baths and vice versa. Doing so, the researchers say, further ensured that any decrease in infection rate was due to the antiseptic baths rather than chance.
Most children experienced no side effects: 12 children had mild reactions to the solution, such as skin irritation.
A staple of hospital infection control since the 1970s, CHG solution is commonly used as a pre-surgery scrub and to prepare a patient's skin for surgery. It also is available over the counter as an at-home skin cleanser. The researchers caution that additional studies are needed to determine whether the benefits of antiseptic baths extend to children hospitalized outside of the ICU.
The other hospitals participating in the study were St. Louis Children's Hospital, Children's Hospital of Philadelphia, Seattle Children's Hospital and Children's National Medical Center.
###
The research was funded by Sage Products Inc., with additional support from the National Institutes of Health. Sage manufactures the prepackaged pre-soaked, one-time washcloths used in the study.
Financial interest disclosure: Milstone and Perl have received grant support from Sage Products Inc., the manufacturer of the antiseptic washcloths used in the study.
NOTE: The antiseptic solution, chlorhexidine gluconate, is not manufactured by Sage. It is produced by multiple manufacturers and is available over the counter.
Related:
Community-Acquired MRSA Becoming More Common in Pediatric ICU Patients
Remove Children's Catheters as Soon as Possible to Prevent Bloodstream Infections
Careful Cleaning of Children's Skin Wounds Key to Healing, Regardless of Antibiotic Choice
In the Fight Against Life-Threatening Catheter Infections, Length of Use is Key
Simple Steps Prevent Life-Threatening Bloodstream Infections in Children
Founded in 1912 as the children's hospital of the Johns Hopkins Medical Institutions, the Johns Hopkins Children's Center offers one of the most comprehensive pediatric medical programs in the country, with more than 92,000 patient visits and nearly 9,000 admissions each year. Hopkins Children's is consistently ranked among the top children's hospitals in the nation. Hopkins Children's is Maryland's largest children's hospital and the only state-designated Trauma Service and Burn Unit for pediatric patients. It has recognized Centers of Excellence in dozens of pediatric subspecialties, including allergy, cardiology, cystic fibrosis, gastroenterology, nephrology, neurology, neurosurgery, oncology, pulmonary, and transplant. For more information, visit www.hopkinschildrens.org.
[ | 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.
The biggest trend in laptops right now is the move from traditional laptops to touch-centric tablets and convertible designs. For those who want to get the touch capability needed to make the most of Windows 8, but don't want to leave behind the standard laptop design, there are touch-enabled laptops, like the Asus VivoBook X202E-DH31T. While there are plenty of new touch laptops on the market now, not all of them are affordable, but the X202E-DH31T's price tag puts it in a reasonable price range. You may lose some of the performance and battery life offered by more expensive options, but the affordability makes up some of the difference.
Design
The X202E-DH31T is a slim ultraportable, measuring 0.8 by 11.9 by 7.9 inches (HWD) and weighing a very portable 2.9 pounds, making it about the right thickness and weight for an ultrabook, though it's missing the requisite solid-state drive or flash memory cache that's one of the requisites of the ultrabook category. While it may not bear Intel's ultrabook moniker, the X202E-DH31T is equipped with something equally compelling?a touch screen, complete with 10-finger tracking and touchable bezels to allow Windows 8 gestures such as swiping in from the sides of the screen.
Unlike convertible designs, such as the sliding Sony VAIO Duo 11 (D11213CX) or the Lenovo IdeaPad Yoga 13, the X202E-DH31T can't change out of its clamshell form factor. One point of irritation, however, is the screen's hinges, which wobble quite a bit when the screen is touched. On a device that features a touch screen, the hinges need to be sturdy enough to withstand all of the poking and prodding that comes with it.
The 11.6-inch display offers a resolution of 1,366-by-768, which?while not as exciting as the 1080p display of the Dell XPS 12?is par for the course in this price range. But while the resolution is on the acceptable side of the line dividing passable from the mediocre, the overall quality of the display is not. The viewing angles are lousy, the display is dim, even with the brightness turned up, and the display is prone to reflecting every glint and glare. It's fine for browsing the Web or typing a document, but it's still a letdown.
Slightly better are the Asus SonicMaster speakers tucked out of sight along the hinge. They offer decent sound at quiet volumes and while the sound gets tinny at high volume, it's still pretty clear, with some buzzing treble, but moderately clear bass.
The chiclet-style keyboard is approximately full-size, but the keys themselves are a little small, making for a cramped typing experience. It's not as bad as that of the Sony VAIO Duo 11, but the keys do have the same short (1.6mm) key travel. The laptop's clickable touchpad combines the right and left buttons into the 4.1-by-2.4-inch surface of the touchpad for a larger area of touch tracking. It supports both standard gestures, like two=finger scrolling and pinch zoom, and Windows-8-specific gestures, such as swiping from the edges to activate Charms and cycle through apps.
Features
The X202E-DH31T has a fairly standard selection of features, with two USB 2.0 ports and one USB 3.0 port for connecting high-speed portable drives and high capacity flash drives; VGA and HDMI outputs for connecting to monitors, projectors, or HDTV; and a compact Ethernet port for those instances when the built-in 802.11n Wi-Fi won't do the trick. A 2-in-1 card reader supports both SD cards and Sony's Memory Stick formats, while a Kensington lock slot lets you physically secure the laptop while in a public place. In addition to a stereo minijack for headphones, the X202E-DH31T also has Bluetooth 4.0, and a 0.3MP webcam is available for Skyping and other video chat applications.
The X202E-DH31T is outfitted with a 500GB hard drive, which is a fairly decent amount of storage space (the VAIO Duo 11 only had a 128GB SSD), but it lacks the additional flash memory for faster wake times and performance, which will prevent it from having the same snappy responsiveness offered by similar looking ultrabooks.
The laptop features Windows 8 Home Premium (64-bit), with programs preinstalled on both the Start Screen and the traditional desktop, including a 60-day trial of McAfee Internet Security 2012, LoJack for Laptops, an upgradeable version of Microsoft Office 2010 Starter, and Adobe Reader. Asus also has some branded apps and programs, such as Asus WebStorage and Asus Game Park Console, which provide some free online storage and basic games, respectively. Asus also covers the X202E-DH31T with both a standard one-year warranty on parts and labor, additional accident protection (covering spills, power surges, and fire damage), and a 30-day "Zero Bright Dot" warranty on the display.
Performance
The X202E-DH31T is equipped with a 1.8GHz Intel Core i3-3217U low-voltage processor, the same CPU found in the budget Editors' Choice Acer Aspire V5-571-6891. Compared to the Intel Core i5 and Core i7 processors found in the Lenovo Yoga 13, the Sony Duo 11 and the Dell XPS 12, the VivoBook's Core i3 is rather puny, and it's slowed down further by the spinning hard drive?the competitors listed all rely on solid-state drives (SSDs) for faster performance.
As a result, the X202E-DH31T's performance lagged considerably, crawling through tasks like our Photoshop test in 8 minutes 46 seconds. By comparison the Lenovo Yoga 13 (6:35) and Dell XPS 12 (6:31) both finished the same test more than two minutes faster. Handbrake scores were similarly lopsided, with the VivoBook (2 minutes 15 seconds) dragging behind the Lenovo Yoga 13 (1:34) and the Sony VAIO Duo 11 (1:25).
Additionally, while the X202E-DH31T also has Intel's integrated HD Graphics 4000 processing, it couldn't run our Aliens vs. Predator test, and only ran Heaven at 1366-by-768 resolution and medium detail for an unplayable 4 frames per second.
The real nail in the coffin, however, was battery life. Despite the sub-3-pound weight and ultra-low-voltage processor, the X202E-DH31T (and its 38Wh, 2-cell battery) only lasted 3 hours 50 minutes in our video rundown test. By comparison, the Lenovo Yoga 13 lasted five hours, while the Dell XPS 12 a little longer (5:09). The Sony Duo 11 lasted closer to that of the X202E-DH31T at 3:09.
The new range of hybrid tablets and touchable laptops on the market now may offer better performance and battery life, but the Asus VivoBook X202E-DH31T puts touch capability into an affordable price range, which may make it worthwhile despite the flaws. Compared to other 10- to 12-inch touch-capable Windows 8 laptops, it's cheap and usable, if not as portable and powerful as leading systems, like the Lenovo IdeaPad Yoga 13. But the price is hard to beat, especially when compared with the budget laptop Editors' Choice Acer Aspire V5-571-6891, which is only $50 less, without touch.
BENCHMARK TEST RESULTS:
COMPARISON TABLE Compare the Asus VivoBook X202E-DH31T with several other laptops side by side.
More laptop reviews: ??? Asus VivoBook X202E-DH31T ??? Toshiba Satellite P845-S4200 ??? HP Elitebook Folio 9470m Ultrabook ??? Asus VivoBook S400CA-UH51 ??? Asus G75VW-DH72 ?? more
U.S. Army Capt. Linda L. Bray in her home on Thursday, Jan. 24, 2013, in Clemmons, N.C. During the invasion of Panama in 1989, Bray became the first woman to lead US troops in battle. Commander of the 988th Military Police, she engaged in a firefight with elite Panamanian Special Forces unit inside a military barracks and dog kennel. Framed on the wall are awards and unit patches she collected while serving. (AP Photo/Lynn Hey)
U.S. Army Capt. Linda L. Bray in her home on Thursday, Jan. 24, 2013, in Clemmons, N.C. During the invasion of Panama in 1989, Bray became the first woman to lead US troops in battle. Commander of the 988th Military Police, she engaged in a firefight with elite Panamanian Special Forces unit inside a military barracks and dog kennel. Framed on the wall are awards and unit patches she collected while serving. (AP Photo/Lynn Hey)
U.S. Army Capt. Linda L. Bray in her home on Thursday, Jan. 24, 2013, in Clemmons, N.C. During the invasion of Panama in 1989, Bray became the first woman to lead US troops in battle. Commander of the 988th Military Police, she engaged in a firefight with elite Panamanian Special Forces unit inside a military barracks and dog kennel. Hanging on the wall in are bayonets taken from AK47s that was captured during the attack along with her MP brassard or armband. (AP Photo/Lynn Hey)
Kristen Auge, Deputy Director of Public Affairs, introduces soldiers from left, Army Sgt. 1st Class Katie Reed, Army Sgt. Cassie Mecuk, Army Staff Sgt. Andrea Drost, Army Sgt. Katie Warden, Air Force Maj. Ann Todd, and Air Force Master Sgt. Holly Caroon at the Inver Grove Heights, Minn., Training and Community Center following Secretary of Defense Leon E. Panetta's and Chairman of the Joint Chiefs of Staff General Martin E. Dempsey's announcement regarding women in combat. The Minnesota National Guard says it will integrate female soldiers into previously all-male combat infantry units. (AP Photo/The Star Tribune, Elizabeth Flores) MANDATORY CREDIT; ST. PAUL PIONEER PRESS OUT; MAGS OUT; TWIN CITIES TV OUT
FILE - In this Sept. 18, 2012 file photo, female soldiers from 1st Brigade Combat Team, 101st Airborne Division train on a firing range while testing new body armor in Fort Campbell, Ky., in preparation for their deployment to Afghanistan. The Pentagon is lifting its ban on women serving in combat, opening hundreds of thousands of front-line positions and potentially elite commando jobs after generations of limits on their service, defense officials said Wednesday, Jan. 23, 2013. (AP Photo/Mark Humphrey, File)
RALEIGH, N.C. (AP) ? Former U.S. Army Capt. Linda L. Bray says her male superiors were incredulous upon hearing she had ably led a platoon of military police officers through a firefight during the 1989 invasion of Panama.
Instead of being lauded for her actions, the first woman in U.S. history to lead male troops in combat said higher-ranking officers accused her of embellishing accounts of what happened when her platoon bested an elite unit of the Panamanian Defense Force. After her story became public, Congress fiercely debated whether she and other women had any business being on the battlefield.
The Pentagon's longstanding prohibition against women serving in ground combat ended Thursday, when Defense Secretary Leon Panetta announced that most combat roles jobs will now be open to female soldiers and Marines. Panetta said women are integral to the military's success and will be required to meet the same physical standards as their male colleagues.
"I'm so thrilled, excited. I think it's absolutely wonderful that our nation's military is taking steps to help women break the glass ceiling," said Bray, 53, of Clemmons, N.C. "It's nothing new now in the military for a woman to be right beside a man in operations."
The end of the ban on women in combat comes more than 23 years after Bray made national news and stoked intense controversy after her actions in Panama were praised as heroic by Marlin Fitzwater, the spokesman for then-President George H.W. Bush.
Bray and 45 soldiers under her command in the 988th Military Police Company, nearly all of them men, encountered a unit of Panamanian special operations soldiers holed up inside a military barracks and dog kennel.
Her troops killed three of the enemy and took one prisoner before the rest were forced to flee, leaving behind a cache of grenades, assault rifles and thousands of rounds of ammunition, according to Associated Press news reports published at the time. The Americans suffered no casualties.
Citing Bray's performance under fire as an example, Rep. Patricia Schroeder, D-Colo., introduced a bill to repeal the law that barred female U.S. military personnel from serving in combat roles.
But the response from the Pentagon brass was less enthusiastic.
"The responses of my superior officers were very degrading, like, 'What were you doing there?'" Bray said. "A lot of people couldn't believe what I had done, or did not want to believe it. Some of them were making excuses, saying that maybe this really didn't happen the way it came out."
Schroder's bill died after top generals lobbied against the measure, saying female soldiers just weren't up to the physical rigors of combat.
"The routine carrying of a 120-pound rucksack day in and day out on the nexus of battle between infantrymen is that which is to be avoided and that's what the current Army policy does," Gen. M.R. Thurman, then the head of the U.S. Southern Command, testified before the Senate Armed Services Committee.
For Bray, the blowback got personal.
The Army refused to grant her and other female soldiers who fought on the ground in Panama the Combat Infantryman Badge. She was awarded the Army Commendation Medal for Valor, an award for meritorious achievement in a non-combat role.
Bray was also the subject of an Army investigation over allegations by Panamanian officials that she and her soldiers had destroyed government and personal property during the invasion that toppled Panamanian dictator Manuel Noriega.
Though eventually cleared of any wrongdoing, the experience soured Bray on the Army. In 1991, she resigned her commission after eight years of active duty and took a medical discharge related to a training injury.
Today's military is much different from the one Bray knew, with women already serving as fighter pilots, aboard submarines and as field supervisors in war zones. But some can't help but feel that few know of their contributions, said Alma Felix, 27, a former Army specialist.
"We are the support. Those are the positions we fill and that's a big deal ? we often run the show ? but people don't see that," Felix said. "Maybe it will put more females forward and give people a sense there are women out there fighting for our country. It's not just you're typical poster boy, GI Joes doing it."
Spc. Heidi Olson, a combat medic, received a purple heart for injuries she suffered when an IED exploded in Afghanistan last May.
"It makes it official now," Olson said. "We don't have to do the back door way of getting out into a combat zone."
___
Associated Press writer Julie Watson in San Diego and staff photographer Ted Warren in Seattle contributed to this report.
___
Follow AP writer Michael Biesecker at twitter.com/mbieseck
Crystal Cruises is eyeing affluent travelers by offering exclusive Mediterranean excursions on its spring itineraries that cannot be accessed through other travel brands.
The cruise line?s new collection of experiences called ?Boutique Adventures? will be available this spring for groups ranging from one to 15 travelers on Crystal Symphony and Crystal Serenity ships sailing to the Mediterranean. Guests will have exclusive access to estates, art studios, museums, castles and businesses.
?Our guests are looking for different ways to experience destinations and they relish insider access,? said Mimi Weisband, vice president of public relations at?Crystal Cruises, Los Angeles. ?We are continually challenging our tour operators to seek out the unusual, experiential, intimate, cultural adventures.
?Our guests do not want a mass-market excursion ? they will pay more for something if it is unique and authentic,? she said.
Cruising the Mediterranean There are seven Boutique Adventures that guests can choose. The cost ranges from $223 to more than $1,000 per guest.
Travelers can book the excursions online up to six months before their cruise.
The Florence excursion comprises a viewing of the Uffizi Gallery?s private Contini Bonacossi Collection, which is not accessible to the public.
In Funchal, Portugal, guests will have lunch with a local celebrity at Reid?s Palace or visit a family-run Madeiran winery where they will dine with the owners.
During the Rome experience, guests will make their own jewelry with instruction from a former Valentino model who now designs jewelry.
The Corfu, Greece, excursion consists of a painting lesson from the president of the Corfu Painters Society.
In Italy?s Vetriano, guests will attend the opera at Teatro Concordia, the?smallest public theater in the world.
Teatro Concordia
Excursions in Sorrento and Taormina, Italy, comprise?cooking lessons and meals with local, Michelin-star chefs.
In Taormina in Italy?s Sicily region, travelers will be served a meal while watching a classical concert at a Sicilian castle.
Crystal Cruises will promote the Boutique Adventures via its Web site, quarterly magazine and the on-board Shore Excursion team, per Ms. Weisband.
In addition, travel agents will also inform their clients about the experiences.
?The cruise industry has been becoming more aware of the large portion of the affluent travelers who shy away from cruises due to many misconceptions and overall lack of desire to be on-board the mega-ships,? said D.M. Banks, director at?DMB Public Relations, New York.
?Crystal Cruises is always looking at ways to provide the luxuries of cruises, while providing a boutique experience for their guests,? he said. ?This is another example of them thinking outside of the box to truly connect with their guests.
?Affluent travelers are more than happy to pay a premium for superior services and, more importantly, unique and personalized experiences. These intimate and semi-private excursions are great ways for guest to feel more immersed into the culture and destinations while at port.?
Story time The new Boutique Adventures are meant to align with Crystal Cruises? ?Begin a New Story? ad campaign that launched last year, per Ms. Weisband.
The cruise line rebranded itself during the second quarter of 2012 through an all-encompassing campaign that centers on the notion of the travel journal and encourages consumers to share memories from past cruises.
The marketing efforts focus on cruise destinations and once-in-a-lifetime experiences, rather than the amenities of the ship.
Begin a New Story uses multiple channels including print ads with digital watermark technology, brochures, online banner ads, email, video and a smartphone app.
For instance, print ads appear in Cond? Nast Traveler, National Geographic Traveler, Town & Country, Travel & Leisure, Coastal Living, Elle D?cor, Food & Wine and Forbes Life.
Consumers can scan the ads with their smartphones to reveal a 60-second video that shows three travelers? experiences in select Crystal Cruises? destinations through watercolor animation.
The brand asked eight watercolor artists to create images that are used in all aspects of the campaign (see story).
?The trend for affluent consumers is more intimate and incredibly special ? both of which are key to these excursions,? Ms. Weisband said.
?Entering someone?s home, sharing a meal with them and just a few other guests, and being able to hear in-depth stories of living and working in that area from your host ? these are experiences that can be deeply personal, bonding and memorable, really expanding one?s understanding of a culture far beyond any info gleaned from merely sight-seeing,? she said.
?Affluent consumers crave such experiences that go beyond the norm, as so many of them travel at a level well above the basics.?
Final Take Tricia Carr, editorial assistant on Luxury Daily, New York
Tricia Carr is an editorial assistant on Luxury Daily. Her beats are apparel and accessories, arts and entertainment, education, food and beverage, fragrance and personal care, government, healthcare, home furnishings, jewelry, legal/privacy and nonprofits. Reach her at tricia@napean.com.
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Don't get me wrong, HTC's Windows Phone 8X is great and all, but the rest of Verizon Wireless' Windows Phone lineup (think the Nokia Lumia 822 and Samsung;s ATIV Odyssey) is a bit lacking in the oomph department. If a new report from The Verge's Tom Warren holds true though, that may not be the case for too much longer -- according to sources within Verizon, the carrier is gearing up to release a flagship Nokia Windows Phone with a spec sheet similar to the Lumia 920.
Experts propose overhaul of ethics oversight of researchPublic release date: 23-Jan-2013 [ | E-mail | Share ]
Contact: Susan Gilbert gilberts@thehastingscenter.org 845-424-4040 x244 The Hastings Center
Hastings Center Special Report aims to 'provoke a national conversation'
The longstanding ethical framework for protecting human volunteers in medical research needs to be replaced because it is outdated and can impede efforts to improve health care quality, assert leaders in bioethics, medicine, and health policy in two companion articles in a Hastings Center Report special report, "Ethical Oversight of Learning Health Care Systems." One of the authors calling for a new approach is the main architect of the current ethical framework.
Seven commentaries in the publication, written by leaders with national responsibility for ethical oversight of medical research and efforts to improve health care quality, find areas of agreement and offer critiques.
In an accompanying editorial, co-guest editors Mildred Z. Solomon, President of The Hastings Center and Ann C. Bonham, Chief Scientific Officer at the American Association of Medical Colleges, wrote that by inviting these commentaries, they aimed to "provoke a national conversation." According to Solomon, "The challenge is to design oversight that adequately protects patients without impeding the kinds of data collection activities we need to improve health care quality, reduce disparities, and bring down our rate of medical errors." (See video of Dr. Solomon on the importance of this debate.)
For nearly four decades, protection of human participants in medical research has been based on the premise that there is a clear line between medical research and medical treatment. But, the two feature articles argue, that distinction has become blurred now that health care systems across the country are beginning to collect data from patients when they come in for treatment or follow-up. The Institute of Medicine has recommended that health care organizations do this kind of research, calling on them to become "learning health care systems."
In particular, the articles challenge the prevailing view that participating in medical research is inherently riskier and provides less benefit than receiving medical care. They point out that more than half of medical treatments lack evidence of effectiveness, putting patients at risk of harm. On the other hand, some kinds of clinical research are no riskier than clinical care and are potentially more beneficial; an example is comparative effectiveness research to find out which of two or more widely used interventions for a particular condition works best for which patients.
"Relying on this faulty research-practice distinction as the criterion that triggers ethical oversight has resulted in two major problems," the authors write. First, it has led to "delays, confusion, and frustrations in the regulatory environment" when institutional review boards, which are responsible for the ethical oversight of research with human subjects, have difficulty distinguishing between research and clinical practice. Second, it has "resulted in a morally questionable public policy in which many patients are either underprotected from clinical practice risks (when exposed to interventions of unproven effectiveness or to risks of medical error) or overprotected from learning activities that are of low risk . . . and that stand to contribute to improving health care safety, effectiveness, and value."
The authors call for a new ethical framework that "is commensurate with the risk and burden in both realms." Their second article outlines such a framework for determining the type and level of oversight needed for a learning health care system. The basic structure consists of seven obligations: 1) to respect the rights and dignity of patients; 2) to respect the clinical judgment of clinicians; 3) to provide optimal care to each patient; 4) to avoid imposing nonclinical risks and burdens on patients; 5) to reduce health inequalities among populations; 6) to conduct responsible activities that foster learning from clinical care and clinical information; and 7) to contribute to the common purpose of improving the quality and value of clinical care and the health system. The first six obligations would be the responsibility of researchers, clinicians, health care systems administrators, payers, and purchasers. The seventh obligation would be borne by patients.
Authors of the feature articles are Nancy E. Kass, deputy director for public health in the Johns Hopkins Berman Institute of Bioethics; Ruth R. Faden, director of the Johns Hopkins Berman Institute of Bioethics; Steven N. Goodman, associate dean for clinical and translational research at the Stanford University School of Medicine; Peter Pronovost, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins; Sean Tunis, founder, president, and chief executive officer of the Center for Medical Technology Policy in Baltimore; and Tom L. Beauchamp, a professor of philosophy at Georgetown University and a senior research scholar at the Kennedy Institute of Ethics. Beauchamp was a chief architect of the Belmont Report, which established the existing research ethics framework in the United States.
The commentaries on the articles find common cause with the need to update clinical oversight for learning health care systems, but offer important critiques of the proposed framework. In particular, some hold that the research-treatment distinction is still useful and are concerned that the obligation for patients to participate in quality improvement efforts would exempt too many studies from voluntary informed consent and IRB protections.
###
The commentaries are written by Emily Largent, a PhD candidate in Harvard University's health policy program; Franklin Miller, who works in the department of bioethics at the National Institutes of Health; Steven Joffe, a pediatric hematologist/oncologist at the Dana-Farber Cancer Institute, Children's Hospital Boston and Harvard Medical School; Jerry Menikoff, director of the Office for Human Research Protections; Christine Grady, chief of the Department of Bioethics at the National Institutes of Health Clinical Center; David Wendler, head of the Unit on Vulnerable Populations in the Department of Bioethics at the National Institutes of Health Clinical Center; Joe Selby, executive director of the Patient- Centered Outcomes Research Institute; Harlan Krumholz, director of the Robert Wood Johnson Clinical Scholars Program at Yale University School of Medicine; Tom Puglisi, chief officer and director of the Office of Research Oversight in the Department of Veterans Affairs; and Joel Kupersmith, chief research and development officer of the Veterans' Health Administration.
Reporters wishing to interview Mildred Solomon, President, The Hastings Center, please contact:
Susan Gilbert, Public Affairs and Communications Manager
The Hastings Center
845-424-4040 x244
gilberts@thehastingscenter.org
[ | 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.
Experts propose overhaul of ethics oversight of researchPublic release date: 23-Jan-2013 [ | E-mail | Share ]
Contact: Susan Gilbert gilberts@thehastingscenter.org 845-424-4040 x244 The Hastings Center
Hastings Center Special Report aims to 'provoke a national conversation'
The longstanding ethical framework for protecting human volunteers in medical research needs to be replaced because it is outdated and can impede efforts to improve health care quality, assert leaders in bioethics, medicine, and health policy in two companion articles in a Hastings Center Report special report, "Ethical Oversight of Learning Health Care Systems." One of the authors calling for a new approach is the main architect of the current ethical framework.
Seven commentaries in the publication, written by leaders with national responsibility for ethical oversight of medical research and efforts to improve health care quality, find areas of agreement and offer critiques.
In an accompanying editorial, co-guest editors Mildred Z. Solomon, President of The Hastings Center and Ann C. Bonham, Chief Scientific Officer at the American Association of Medical Colleges, wrote that by inviting these commentaries, they aimed to "provoke a national conversation." According to Solomon, "The challenge is to design oversight that adequately protects patients without impeding the kinds of data collection activities we need to improve health care quality, reduce disparities, and bring down our rate of medical errors." (See video of Dr. Solomon on the importance of this debate.)
For nearly four decades, protection of human participants in medical research has been based on the premise that there is a clear line between medical research and medical treatment. But, the two feature articles argue, that distinction has become blurred now that health care systems across the country are beginning to collect data from patients when they come in for treatment or follow-up. The Institute of Medicine has recommended that health care organizations do this kind of research, calling on them to become "learning health care systems."
In particular, the articles challenge the prevailing view that participating in medical research is inherently riskier and provides less benefit than receiving medical care. They point out that more than half of medical treatments lack evidence of effectiveness, putting patients at risk of harm. On the other hand, some kinds of clinical research are no riskier than clinical care and are potentially more beneficial; an example is comparative effectiveness research to find out which of two or more widely used interventions for a particular condition works best for which patients.
"Relying on this faulty research-practice distinction as the criterion that triggers ethical oversight has resulted in two major problems," the authors write. First, it has led to "delays, confusion, and frustrations in the regulatory environment" when institutional review boards, which are responsible for the ethical oversight of research with human subjects, have difficulty distinguishing between research and clinical practice. Second, it has "resulted in a morally questionable public policy in which many patients are either underprotected from clinical practice risks (when exposed to interventions of unproven effectiveness or to risks of medical error) or overprotected from learning activities that are of low risk . . . and that stand to contribute to improving health care safety, effectiveness, and value."
The authors call for a new ethical framework that "is commensurate with the risk and burden in both realms." Their second article outlines such a framework for determining the type and level of oversight needed for a learning health care system. The basic structure consists of seven obligations: 1) to respect the rights and dignity of patients; 2) to respect the clinical judgment of clinicians; 3) to provide optimal care to each patient; 4) to avoid imposing nonclinical risks and burdens on patients; 5) to reduce health inequalities among populations; 6) to conduct responsible activities that foster learning from clinical care and clinical information; and 7) to contribute to the common purpose of improving the quality and value of clinical care and the health system. The first six obligations would be the responsibility of researchers, clinicians, health care systems administrators, payers, and purchasers. The seventh obligation would be borne by patients.
Authors of the feature articles are Nancy E. Kass, deputy director for public health in the Johns Hopkins Berman Institute of Bioethics; Ruth R. Faden, director of the Johns Hopkins Berman Institute of Bioethics; Steven N. Goodman, associate dean for clinical and translational research at the Stanford University School of Medicine; Peter Pronovost, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins; Sean Tunis, founder, president, and chief executive officer of the Center for Medical Technology Policy in Baltimore; and Tom L. Beauchamp, a professor of philosophy at Georgetown University and a senior research scholar at the Kennedy Institute of Ethics. Beauchamp was a chief architect of the Belmont Report, which established the existing research ethics framework in the United States.
The commentaries on the articles find common cause with the need to update clinical oversight for learning health care systems, but offer important critiques of the proposed framework. In particular, some hold that the research-treatment distinction is still useful and are concerned that the obligation for patients to participate in quality improvement efforts would exempt too many studies from voluntary informed consent and IRB protections.
###
The commentaries are written by Emily Largent, a PhD candidate in Harvard University's health policy program; Franklin Miller, who works in the department of bioethics at the National Institutes of Health; Steven Joffe, a pediatric hematologist/oncologist at the Dana-Farber Cancer Institute, Children's Hospital Boston and Harvard Medical School; Jerry Menikoff, director of the Office for Human Research Protections; Christine Grady, chief of the Department of Bioethics at the National Institutes of Health Clinical Center; David Wendler, head of the Unit on Vulnerable Populations in the Department of Bioethics at the National Institutes of Health Clinical Center; Joe Selby, executive director of the Patient- Centered Outcomes Research Institute; Harlan Krumholz, director of the Robert Wood Johnson Clinical Scholars Program at Yale University School of Medicine; Tom Puglisi, chief officer and director of the Office of Research Oversight in the Department of Veterans Affairs; and Joel Kupersmith, chief research and development officer of the Veterans' Health Administration.
Reporters wishing to interview Mildred Solomon, President, The Hastings Center, please contact:
Susan Gilbert, Public Affairs and Communications Manager
The Hastings Center
845-424-4040 x244
gilberts@thehastingscenter.org
[ | 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.
RACINE (WITI) ??A Racine puppy needs some help.?Jerome came to the Racine Campus of the Wisconsin Humane Society with a badly fractured, infected leg.![[ Back to EurekAlert! ]](http://www.eurekalert.org/images/back2e.gif){kind=small}
Public release date: 25-Jan-2013
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The X202E-DH31T is equipped with a 1.8GHz Intel Core i3-3217U low-voltage processor, the same CPU found in the budget Editors' Choice Acer Aspire V5-571-6891. Compared to the Intel Core i5 and Core i7 processors found in the Lenovo Yoga 13, the Sony Duo 11 and the Dell XPS 12, the VivoBook's Core i3 is rather puny, and it's slowed down further by the spinning hard drive?the competitors listed all rely on solid-state drives (SSDs) for faster performance. 
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Don't get me wrong, HTC's Windows Phone 8X is great and all, but the rest of Verizon Wireless' Windows Phone lineup (think the Nokia Lumia 822 and Samsung;s ATIV Odyssey) is a bit lacking in the oomph department. If a new report from 