Weight Loss: This Is The First Step Towards Achieving Fat Loss And Good Health – Doctor NDTV

Weight loss tips: Introspection is the first step on your weight loss journey. Read here to know how introspecting the duration and cause of weight gain and can help you lose weight in a healthy manner.

Tips for weight loss: Fat loss can be achieved by setting realistic goals for yourself

What is the first step towards weight loss and achieving good health? According to lifestyle coach Luke Coutinho, the first focus should be on fat loss achieved in a healthy way. Quick weight loss comes with several side effects like premature ageing of skin, weak immunity, thin, dry and dull hair to name a few. Thus, the first step towards fat loss and achieving good health is introspection-you should be aware of what you eat, the exercise you do and how it reflecting on your body and overall health.

When it comes to introspection, you need to ask yourself how long it took you to gain weight. Having figured out how long it took you to gain weight, ask yourself if you can lose that weight in a month, 6 months or 1 year?

For weight gain that happened over a period of 6 months or 1 year, losing that weight cannot happen in 1 or 2 months, says Luke in his live video session on Facebook.

Also read:Weight Management: 5 Practical Ways To Avoid Weight Gain

Setting a realistic target for yourself is the healthy way to lose weight, fat and gain good health. Setting unrealistic or too difficult to achieve targets for yourself can cause anxiety, frustration, disappointment and stress-which in turn can make you put on more weight.

After giving yourself realistic goals, you need to find out what made you put on that weight. It can be because of stress, overeating, partying too much, being sleep deprived, having high amounts of sugar or carbs, a new job that caused a change in lifestyle, being physically inactive or lack of exercise, etc. Doing this will make it easier for you to have an action plan for healthy and achievable weight loss.

A poor diet could be the reason behind your weight gainPhoto Credit: iStock

Work towards reducing or cutting down on the things that went wrong and caused you to gain weight.

The idea is to work on the causative factor of weight gain rather than only working on reducing weight.

Luke advises: Know your target and work only towards achieving that goal. There is no point in chasing a particular goal as it is only going to make you more anxious and gain weight instead.

Also read:Too Lazy To Workout During Winter? Do Not Compromise On Your Fitness Goals With These Weight Loss Tips

Sleep well to lose weight quickly and efficientlyPhoto Credit: iStock

The above steps, when followed with consistency, can together help you lose weight, fat and gain health. Let us know if this works for you.

Also read:7 Health Benefits Of Regular Exercise Other Than Weight Loss

(Luke Coutinho, Holistic Lifestyle Coach - Integrative Medicine)

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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Weight Loss: This Is The First Step Towards Achieving Fat Loss And Good Health - Doctor NDTV

Students reflect on cost of applying to medical school – The Michigan Daily

Engineering senior Ryuji Arimoto is on the tail end of the stressful cycle of medical school applications. After multiple rounds of online applications and 10 interviews, hes finally started to receive acceptances.

But Arimotos hard-earned acceptances have come at a cost. Factoring in testing fees, his primary and secondary applications to 40 different medical schools and the travel costs of interviewing at schools across the country, Arimoto estimated hes already approaching $10,000 in total expenses, and he hasnt finished the process yet.

Thats an obscene amount of money, Arimoto said.

The pricey application process begins with the Medical College Admission Test, or the MCAT. According to Arimoto, many students take a prep course, which can cost a few thousand dollars. The test itself costs over $300, and its not uncommon for students to take the MCAT several times.

Second-year University of Michigan Medical School student Vy Tran, a first-generation college graduate who identifies as someone from a low-income background, said even though MCAT preparation is expensive, she took a course to make sure she was setting herself up for success.

Medical school is a huge process, Tran said. You want to do everything you can, you dont want to be cheap on these things.

Next come the primary applications. Primaries are streamlined so students submit a single application package through the Association of American Medical Colleges online service. Students who applied this past cycle paid $170 for the first school and $40 for each additional one. For the 2019-2020 cycle, students applied to 17 schools on average, according to the AAMC.

If a student meets the qualifications for a medical school, theyll be asked to submit a secondary application answering school-specific questions. The cost of secondaries varies, but Arimoto said its often around $100 per school. The U-M Medical School charges $85. After secondaries, Arimoto said his total application costs were already in the range of multiple thousands of dollars, not including MCAT-related fees.

Secondary is a cash grab, Arimoto said. Obviously, you dont need a hundred dollars from every single applicant for them to send you, what, two essays?

Without family support, Arimoto said, he would have been in financial distress at this point in the cycle.

Even before my interviews started, I wouldve just been drained monetarily, Arimoto said. There would have been no question about that.

Steven Gay, assistant dean for admissions at the U-M Medical School, said though secondaries are expensive, the school-specific aspect makes sense.

Every school has its own secondary, and I think thats very appropriate, Gay said. Just like students are looking for certain things in schools, we should be attempting to get the best students to succeed in our curriculum, to become the type of physicians we feel its our mission as an institution to create.

Gay acknowledged the cost of secondaries, noting the U-M Medical School does try to alleviate it by offering fee waivers to students who reach out and demonstrate need. In addition, Gay said when the University began accepting a people skills test called CASPer as part of medical school applications, the Office of Admissions did not raise secondary fees, recognizing that students were now paying to submit those scores.

Weve worked to keep our secondaries lower in terms of the top institutions, Gay said.

There are also some scholarships available through the AAMC. For instance, Tran said she was able to get 15 or 16 schools worth of primary and secondary application fees waived, covering all the schools she applied to.

As a final step, qualified applicants hear back from medical schools with interview invitations. Arimoto said someone who applies to 20 schools might expect to get five interviews if theyre fortunate. The travel costs are not reimbursed.

If youre lucky enough to get interviews, they dont pay for your interviews, Arimoto said. If you have to fly out to California from Michigan, its like $500, and then you have to buy a hotel, thats $200 a night, and if you have to spend two nights there, then youre already at a grand for one interview.

Gay said medical schools have some ways of mitigating the cost of attending interviews. Schools in similar locations may try to coordinate interview dates so students only have to make a single trip. In addition, Gay said the U-M Medical School works to provide interviewees with more affordable housing, food and transportation options, as well as travel reimbursements for some applicants.

We tend to give travel reimbursement for our students who are low-income so that its not an issue to travel, Gay said. We have an extensive program where students can stay with other students on their visits and arent paying for places to stay.

Tran received a $200 reimbursement from the University to support her interview. She also tried to offset travel costs by grouping interviews in similar locations.

I tried to group my interviews together, Tran said. There are things like that that you can do, but that being said, sometimes you dont have that choice because the school will pick a date for you.

Tran said hearing back from the University of Michigan, one of her top schools, by early October spared her the cost of additional interviews. In addition to seeking out schools that offer a quick turnaround, she said applicants should think carefully about what schools are truly a good match, rather than just applying to as many as possible.

There are some people who dont need to apply to that many, and there will be people applying to schools that are not a good fit for them, Tran said. Just think about what the schools values are.

Gay echoed Trans sentiments, noting the one-size-fits-all primary application, which allows prospective medical students to apply online to dozens of schools at once, may encourage people to apply to more schools than necessary. He said applicants should narrow down which schools actually match their interests. For instance, some schools might better prepare students for medical research, while others might fit students aspiring to become primary-care physicians.

Part of applying to medical school, just like applying to undergrad, is the onus of when its easy to apply to all of them, you just apply to all of them, Gay said. There is responsibility on the student to be an informed consumer with some discretion, saying, these are actually the things I want.

Gay said increasing the number of schools one applies to doesnt necessarily improve the chances of getting an interview. Medical schools have specific criteria, so Gay said applicants need to be honest with themselves about what schools they are likely to be accepted to.

The application process isnt a lucky thing, Gay said. Students do the very best they can to prepare themselves to be the best candidates for medical school. But once they have done that, its important to assess what you look like as a candidate and have others with experience frankly assess what your candidacy looks like.

One thing medical schools can do to help applicants make educated choices, Gay said, is to be open with pre-med advisers and prospective students about what requirements and values theyre looking for in an applicant.

All of us, as medical schools, should be transparent in our processes, Gay said. We should be very open with letting students know how we are trying to assist them, knowing that finances can be a significant barrier to the application process. But students, equally, should work hard to pick schools they feel they have not only the best opportunity of getting into but fit who they wish to be.

Arimoto, who applied to 40 schools an above-average number said hed already accepted that going into medicine would put him into debt. The cost of applying and interviewing seemed almost insignificant compared to the overall cost of becoming a doctor.

Trying to go into healthcare in general is just such a ludicrous business in itself, in that, even though this seems like a ton of money, you compare it to the tuition of a school, and its minuscule, Arimoto said. For example, if you want to attend Harvard Medical School, per year the amount of money that youre going to pay is around $95,000. And they dont hand out any merit-based scholarships.

Tran said its important to be financially savvy when applying to medical school, noting people do find ways to handle the cost. For instance, Tran worked all through college, accruing savings, and also managed to graduate from college relatively debt-free. She said these factors prepared her for applying to and paying for medical school. Still, Tran said she recognizes how stressful the costs associated with medical school are and understands the solutions people find are not always easy.

Tran added shes considered different ways medical schools could make application costs less of a barrier.

I especially advocate for people of low-income backgrounds or first-generation students like myself, Tran said. I support myself; I still have to support my family during this process. I feel it should not be a deterrent of medical school.

Arimoto said if anything, the expense of becoming a doctor has made him sure this is the career he wants to pursue.

I feel like that also allowed me to think in a way that may be more genuine towards the field, Arimoto said. Its like, Okay, I actually want to do this, Im giving up a lot, but even with that on the table, I still dont want to do, for example, research or engineering. I still want to do this. It provides a little bit of conviction.

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Students reflect on cost of applying to medical school - The Michigan Daily

Geisinger medical school will provide free tuitionwith a catch – FierceHealthcare

Add Geisingers medical school to those offering free tuition as an incentive toincrease the number of primary care doctors.

Geisinger Commonwealth School of Medicine announced Wednesday that it will provide free tuition to students who commit to practice primary care after their residency at its affiliated health system Geisinger Health.

Geisinger will fund the program, which will offer debt-free medical school and living assistance to 40 students each year through its Primary Care Scholars Program.

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At Geisinger, weve been able to prove that by focusing on primary care we can improve outcomes, lower costs and improve satisfaction among patients and providers, Jaewon Ryu, M.D., president and CEO at Geisinger, said in an announcement.

These scholars have the opportunity to learn and later work in Geisingers innovative primary care environment without the worry of how they will pay for their education, he said.

Medical schools have been looking at ways to encourage more students to pursue careers in primary care, where a shortage of physicians is predicted. Geisinger said the primary care shortage is projected in the areas it serves, and it hopes that by removing the financial burden of medical school it will make it easier for more students interested in primary care to enter the field.

Last year, New York Universitys medical school became the first to offer free tuition to all its students to encourage more primary care doctors. And since then others have come up with their own programs. For instance, Kaiser Permanente announced earlier this year it would offer free tuition to all the medical students in its first five graduating classes.

Nationally, medical students carry an average of $200,000 in debt, which drives many to seek careers in higher-paying specialties.

Geisinger's plan is different in that it requires students to commit to primary care and also to practice within its health system. To be eligible for the scholarship program, students must agree to remain at Geisinger for four years after completing residency. The program will select 40 students in each incoming medical class through a competitive application process. Criteria will include financial need, academic merit, diversity, experience serving their communities and predictors of whether the applicant is likely to stay in Geisingers service area, the school said. The program will cover the full tuition and fees plus a living stipend of $2,000 per month for the four years of medical school.

The program is being offered to current first- and second-year medical students. In incoming classes, medical students will be invited to apply for the program.

Link:
Geisinger medical school will provide free tuitionwith a catch - FierceHealthcare

Dell Med Joins Efforts With The Refuge For DMST To Care For Recovering Survivors Of Child Sex Trafficking At The Refuge Ranch – inForney.com

AUSTIN, Texas, Nov. 13, 2019 /PRNewswire/ -- The Refuge for DMST (Domestic Minor Sex Trafficking) is collaborating with the Department of Psychiatry at Dell Medical School at The University of Texas at Austin to help improve the lives of young people recovering from sex trafficking by providing care at The Refuge Ranch -- the largest long-term, live-in rehabilitation facility for child survivors of sex trafficking in the United States.

As part of this collaboration, two senior Department of Psychiatry faculty members, Jeffrey Newport, MD and Valerie Rosen, MD oversee psychopharmacological and evidence-based psychotherapeutic treatment, respectfully, and a senior psychiatry resident provides weekly psychiatric services. Together, the team conducts diagnostic assessment and psychiatric treatment planning for child survivors currently living at The Refuge Ranch.

The Dell Med team, led by Charles B. Nemeroff, MD, PhD, professor and acting chair of the Department of Psychiatry and Director of the Institute for Early Life Adversity Research, also plans to conduct research with The Refuge Ranch therapeutic and medical staff to better understand the specific needs of young people who have experienced sex trafficking.

The research component would involve following the child survivors at The Refuge Ranch for the next 1.5 to 2 years, from when they were first admitted, to their discharge, then during their transition from The Refuge Ranch to a new living environment. During that time, data could be collected to determine the effectiveness of various trauma-focused therapies and identify the best predictors of treatment response.

"The Refuge is an extraordinary resource, a one-of-a-kind facility for treating those who have experienced trafficking and is unique in the nation for its current level of care," said Dr. Nemeroff. "This is an extremely vulnerable group of young people who have significant health needs stemming from trauma. Understanding those particular needs requires research that's carefully conducted with appropriate safeguards in place to protect these young women during their recovery," he said.

"Our goal is to provide the very best care available for child survivors of sex trafficking," said Brooke Crowder, CEO and Founder of The Refuge for DMST. "With faculty from Dell Med rounding out our psychiatric care, The Refuge Circle of Care that wraps around each girl is complete. Through research collaboration, we also see the potential to gather empirical data about a population that has been hard to study. Trafficked children frequently run away as a self-defense mechanism and it's hard to turn off, even when they feel safe. The Refuge Ranch is a place where the girls can finally turn off that hyper-aware state of fight-flight-or-freeze and be a kid again. In this safe environment, psychiatrists can help us to assess what treatments work best. This ground-breaking data could help other facilities work with their state legislatures to inform policy decisions. With empirical data in front of them, it should be easier for states to help the most vulnerable children in the child welfare system."

The Refuge Circle of Care provides comprehensive treatment for young survivors, with trauma-focused programs addressing their unique psychological, physical, educational, social, spiritual needs, while improving community connections with relatives, and teaching independent living and job skills.

These new psychiatric services will add to current services provided by The Refuge Ranch staff, which already include weekly one-on-one therapy sessions with in-house licensed therapists specializing in Developmentally adaptive Cognitive Processing Therapy (D-CPT), Dialectical Behavioral Therapy (DBT), plus Eye Movement Desensitization and Reprocessing (EMDR) therapy, sand tray therapy, experiential therapy, equine therapy, and more, based on their individual needs. The girls also have the opportunity to participate in group therapy with other survivors. To round out the holistic approach, The Refuge Ranch provides art, farming/agricultural activities, gardening, yoga, dance, self-defense, music, etc., plus daily enrichment options for self-regulation and body awareness.

All of the The Refuge for DMST staff, not just the therapeutic staff at the ranch, are trained in Trust Based Relational Intervention (TBRI), and they receive other on-going professional training specific to the care of child survivors of sex trafficking.

The Institute for Early Life Adversity Research is within the Department of Psychiatry and a component of the Mulva Clinic for the Neurosciences.

About The Refuge for DMSTThe Refuge for DMST (Domestic Minor Sex Trafficking) is a registered 501(c)(3) nonprofit organization that has developed The Refuge Ranch, a long-term, residential, therapeutic community for 48 girls, minors through age 19, who have been rescued out of sex trafficking. Built from the ground up on 50 acres in a beautiful and restorative setting outside of Austin, TX, The Refuge Ranch provides trauma-informed, holistic care for the girls on site, including: psychiatric services provided by Dell Medical School at The University of Texas at Austin's Department of Psychiatry and the Institute for Early Life Adversity Research; education provided by the University of Texas-University Charter School (UT-UCS); medical services by community partners; and various therapeutic programs uniquely designed for the development of a child survivor. The Refuge Ranch is the largest long-term, live-in rehabilitation facility for child survivors of sex trafficking in the United States. For more information, go to http://www.therefugedmst.org.

For B-roll, photographs, logos, relevant statistics and recommended reading, visit The Refuge Press Page at https://therefugeaustin.org/press-kit.

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Dell Med Joins Efforts With The Refuge For DMST To Care For Recovering Survivors Of Child Sex Trafficking At The Refuge Ranch - inForney.com

Wickenheiser working double duty with Maple Leafs, medical school – Official site of the Tampa Bay Lightning

Hayley Wickenheiser pushed herself to be the best as an athlete. She's still pushing herself, going into the Hockey Hall of Fame on Nov. 18 while going to medical school at the University of Calgary and working as an assistant director of player development for the Toronto Maple Leafs.

She knew the Hockey Hall of Fame would announce the Class of 2019 on June 25 but couldn't sit by the phone.

"I had stuff to do," she said with a laugh.

Hockey Hall of Fame officials couldn't reach her after her selection, because she was in a code blue simulation. In other words, she was practicing resuscitating someone in cardiopulmonary arrest. No phones allowed.

Eventually, she pulled out her phone, saw missed calls from the 416 Toronto area code and read text messages congratulating her. She called Hockey Hall of Fame chairman Lanny McDonald on her way home.

Wickenheiser had dueling dreams as a kid: to win the Stanley Cup with the Edmonton Oilers and go to Harvard Medical School. She was inspired by a neighborhood girl seriously injured in an accident.

"She ended up being OK, and I just remember that event being very life-changing for me, being in the hospital every day and seeing how the doctors and nurses treated her and just feeling like that's something I'd want to do," Wickenheiser said. "It's always sort of since then just really been something I thought I would see myself doing outside of being involved with hockey. It's something I could find that was close to what hockey would be like."

Wickenheiser is in her second of three years of med school. She's studying general medicine now but would like to specialize in emergency medicine.

Starting in January, she will spend six months doing electives in Toronto. She said she probably will end up doing her residency there too. But since the Maple Leafs hired her Aug. 28, 2018, she has been living in Calgary and commuting to Toronto four to 10 days per month.

Maple Leafs general manager Kyle Dubas said Wickenheiser has been a massive resource for both players and staff, mostly with Toronto of the American Hockey League and Newfoundland of the ECHL. She watches video, goes on the ice and helps build development plans, providing the insight only a world-class player can.

Last season, a player was struggling. The Maple Leafs had Wickenheiser visit with the player and talk to the coaching staff.

"The thing that Hayley has about her is, she has a certain empathy and ability to understand people and where they're at, and then she also has the ability of understanding what it takes to operate at a very high level," Dubas said. "So it's connecting the two. I could go in and read a player the riot act, but I can't speak to what it's like to play in a gold medal game and be the best player in the world and make the types of sacrifice it takes to get there."

At development camp each summer, the Maple Leafs have a staff summit. One night, they have staff members make presentations. This year, Wickenheiser spoke about performing under the pressure of high expectations.

She once wore a maple leaf on her jersey. It was red instead of blue.

"I thought it was very poignant for all of our staff because of the market we play in and the different things that happen," Dubas said. "It's very interesting to hear the way she spoke about life with Team Canada, the expectation that you're going to win all the time, how you deal with it and how you use that energy.

"Rather than look at it as a burden, it should be looked at as something you've earned because of the work that you've put in. So you shouldn't shrink from it. You should be proud when you get to that point and be excited about it."

The 41-year-old carries weight with everyone, especially the Canadian players. She represented the country at the Olympics five times (1998, 2002, 2006, 2010, 2014) and won four gold medals.

"I'm not sure that the young, young players know as much about me, but I generally say that the better the player, the higher the level, the less of an issue it is for me," she said. "Most, if not all, of the Leafs at some point have come up. We've chatted, or they've said, 'Congratulations on the Hall of Fame.' I think when I talk to them, there's a mutual respect."

Actually, Dubas used a stronger word.

"You never know how it's going to go, because you don't know if there's an underlying [attitude of], 'Yes, but she's a woman hockey player. She never played in the NHL. Women's hockey's different,' " Dubas said. "I'm not afraid to say it. You're worried about it at first.

"But then watching the way she carries herself when she walks in, the players, even our best players, there's a reverence that they have for Hayley when she arrives and she's in the building.

Top photo by Mark Blinch, Toronto Maple Leafs

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Wickenheiser working double duty with Maple Leafs, medical school - Official site of the Tampa Bay Lightning

Electronic Medical Records, Burnout, And Mans 4th Best Hospital – Forbes

Overworked doctor trying to focus.

Graduating from medical school in 1978, I started my hellish internship while reading Samuel Shems classic, The House of G-d, a scathing indictment of medical education and the mercenary incentives in patient care. I found it shocking, crude at times and disillusioningbut at its core, absolutely correct about what was happening in medicine that was so wrong.

Thus it seems fitting that I received a review copy of Shems new book, Mans 4th Best Hospital, as my medical career is coming to a close. Once again, Shem nails where medical care has lost its way. Physician burnout and dissatisfaction are increasing in step with patients unhappiness.

Much of the blame can be attributed to two thingscorporate greed and electronic medical records, which are like conjoined twins. Theres no small irony that this is what is forcing many experienced physicians, like myself, out of practice prematurely, contributing to a waste of both talent and experience that is needless and costly.

Electronic Medical Records (EMRs)

Come with me as I describe some of the changes in my own career that are reflected in Shems writing.

In the olden days, for example, I used to graph out when each antibiotic wasstarted and stopped on the TPR sheetthe hand written graph the nurses charted the patients vital signs on with temperature, pulse and respiratory rate. Sometimes I noted a new medicine or a positive blood culture. This visual display of quantitative information was invaluable to me in following the course of my patients illnesses and puzzling things out when they didnt respond as expected to therapy. For example, you could regularly see that a new fever corresponded to the addition of a particular new medicine, rather than infection.

No more. Even the early EMRs eliminated such graphics, replacing them with rows of data. While some have a generic graphical display option, among the half dozen EMRs Ive had personal experience with, none could be annotated with what I need, as I did by hand.

That was decades ago. Back then, the lab would call doctors with critically abnormal labs. For me, the emphasis was on abnormal blood and spinal fluid cultures. EMRs are not without any redeeming qualities. Meditech, my first hospitals system, had one valuable module. I could readily see my patients positive cultures including those from previous admissions. They were flagged and easily visible. None of the other half dozen systems Ive used in the past decade has had that capability.

In mid-career, I conducted many clinical trials for pharmaceutical companies, working (primarily) to develop new antibiotics and other treatments for life-threatening sepsis. Electronic gadgets replaced people who actually measured a temperature, felt a patients pulse, or counted the respiratory rate. These mechanically generated results were often wildly inaccurate, but were recorded automatically and could not be readily edited. This made identifying patients for trials, or following their course accurately on the trial, nearly impossible. Shem had number of Laws of the House of G-d. The applicable one here was #10 If you dont take a temperature, you cant find a fever.

Those EMRs were problematic, but nothing like the new generation.

Epic and newer EMRs

HAMILTON, MA - JULY 2: The pop-up on this fictitious patient's electronic health record shows ... [+] drug-disease interactions. Dr. Hugh Taylor , with Family Medicine Associates, in Hamilton, talks about records, on Wednesday, July 2, 2014. (Photo by Pat Greenhouse/The Boston Globe via Getty Images)

EMRs have lost their way, along with the rest of medicine. The initial idea dating back to ~2008 was to have interoperability and to gather data, which could be used to improve care. What has happened to that more idealistic goal?

(Note, I will refer to Epic, since I have the most recent experience with it and it is named Best in Klas, but my current criticisms could be leveled against most, if not all, EMR systems).

EMRs no longer seem to even pretend to be about patient care. The goal is to optimize billing through upcoding. You do that, in part, by documenting more, through check boxes and screens that you cant skip. The more you upcode and the more quickly you get patients discharged, the more profits go to the corporate overlords.

Physicians now spend two hours on the computer documentation for every hour with the patient on site. Many have 2-3 more hours pajama time EMR work at home. Notes used to be concise and problem lists useful. Now there is needless bloat.

The EMR in fictionalized Mans 4th Best Hospital is HEAL, described by its President Krashinsky, For billingwe monetize.As protagonists Dr. Roy Basch and Berry reminisce,

The choice in medicine back then? The Fat Mans Dream or the Money. The money won. The money wins. Not just in medicine, in pretty much everything American now, and worldwide

UPMC case study

Shortly after UPMC bought Lancaster Regional Medical Center (LRMC), where I had been working, EPIC training began in late 2017. This was an extraordinarily time-consuming and expensive process. One physician told me the conversion cost $20 million; I am awaiting confirmation from the hospitals. Six months after the launch, Epic was upgraded, requiring additional training.

UPMC announced closure of LRMC in Dec 2018. More than 500 employees were affected, though it's unclear how many lost their jobs. Its also unclear how Lancaster General, the other hospital in town, can absorb the additional patientsas well ashow patients, particularly those who are poor, will manage to reach care in a different part of the city.

Most of the staff I worked with disliked Epic and felt it hurt patient care. I saw some instances where its rigidity hurt patients. Some physicians said they were retiring rather than learn such a complicated and time-consuming system. (For a bonus, humorous thread on Epic, see Eye Contact is Evil and EPICParodyEMR on Twitter.)

EMRs and physician burnout

This complaint, that EMRs are a huge time sink was not limited to Epic. At Susquehanna, some physicians complained that their EMR system, NextGen,lowered their productivity by a third. Since their pay was tied to performance, they were not happy about either pay cuts or angry administrators. By far the worst system I had to learn was the Armys AHLTA; I hear pretty good things about the VAs EMR.

A study from the Mayo Clinic found that over 50% of physicians experienced at least one symptom of burnout and that the frequency has been increasing.

As Dr. Atul Gawande stressed in Why Doctors Hate their Computers, Mayo found that one of the strongest predictors of burnout was how much time an individual spent tied up doing computer documentation.

Gawande observes, I began to see the insidious ways that the software changed how people work together. Theyd become more disconnected; less likely to see and help one another, and often less able to.

Man's 4th Best Hospital cover

Shem nails these problems with EMRs and money-driven medical care in spades, and more graphically than all the medical journal articles. He explained to me,

Its not burnout. Its placing doctors in a moral bind. Its like being in a war you dont believe in. That kind of thingIts abuse of doctors, simply put. Because we cant practice the way we want to. Were hirelings.

He stressed that electronic records are probably a pretty good thing. It is the way they are linked to money that is the problem.

Many physicians miss caring for patients. We are now regarded by many large health systems as interchangeable widgets and shift workers. EMRs have destroyed our relationship with patients, as we are forced to interact with the computer screen rather than our patient.

In this sequel, Shem emphasizes the danger of isolation from patients and coworkers and the healing power of good connections. He waxes more philosophical and Buddhist threads run through the narrative. Basch muses,

its our job, being with patients at the crucial times in their lives, yes, illness, old age, and deathwell suffer less, spread less suffering around andheal. Heal both ways. Us and them.

The Laws of the House of G-d were funny, cynical with apt insider jokes about medical training, like Law VIII. They can always hurt you more and XIII The delivery of good medical care is to do as much nothing as possible. EMRs, practice guidelines and fear of liability pushes towards doing more. We would be better if we remembered the Fat Mans mantra, that sometimes Less is more.

The Laws of Mans 4th arent as catchy, but reflect a wise maturity in how we should respond to the crisis in health care. II. Isolation is deadly; connection heals. VIII Squeeze the money out of the machines. IX. Put the human back in medicine.

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Electronic Medical Records, Burnout, And Mans 4th Best Hospital - Forbes

Choices, trade-offs and accomplishments at the Women in Medicine and Science event – Scope

The path was rarely straight. The steps were neither easy nor obvious. Nonetheless Persis Drell, PhD, navigated the mostly male landscape of academic sciences to become Stanford's thirteenth provost. As the chief academic and chief budgetary officer, she holds a key position in setting university priorities and allocating funds to support them.

At the Stanford Medical Alumni Association's Women in Medicine and Science event, Drell, along with Stanford Medicine leaders, talked about her path to leadership -- a winding one that began as an undergraduate at Wellesley College.

"The smartest woman in every class was a woman," Drell said."You never asked, 'Do I belong?' Of course I belonged."

Graduate school, however, wasn't as welcoming. Studying physics at the University of California, Berkeley, Drell was the only woman in her class when she arrived as a student. Despite the challenges, Drell said she learned to be resilient. She built her own community and did her part to change the culture, celebrating small successes along the way, like creating the first gender neutral bathroom in the basement filled with research labs.

As Drell launched her academic career, well-meaning colleagues told her to wait until she had secured tenure before starting a family. Drell ignored the advice and interviewed at Cornell University with a six-week-old under her arm.

"Throughout your career," Drell told the room full of School of Medicine graduates and students. "You will have to make choices -- some of them will be difficult. For me, it was extremely important to chart a career path that allowed for family. That came with particular challenges and trade-offs but I owned those choices. They were my choices."

Drell loved teaching -- still does -- but along the way, she realized she liked serving in leadership positions too. "I discovered that I like to solve problems -- all kinds: structural, organizational and mission-related."

After 14 years at Cornell, Drell moved to Stanford into a laboratory leadership role, eventually becoming the director of the SLAC National Accelerator Laboratory. In 2014, she became dean of Stanford's School of Engineering and provost in 2017.

Drell's advice to the women in the room? Make the toughchoices, don't get discouraged, and build a strong network.

Mary Leonard, MD; Leslee Subak, MD; and Suzanne Pfeffer, PhD, who chair the pediatrics, obstetrics and gynecology, and biochemistry departments respectively, seconded Drell's advice.

Each told of their owns paths, which like Drell's, were not linear. They talked about the choices they made and the barriers they overcame -- which included at least one literal wall of men.

Subak told of her undergraduate studies at Dartmouth University, where her class was only the fifth to include women. In large lecture courses, the men would stand to create a physical barrier between the professor and the women. "When a woman raised her hand to ask a question," Subak said, "the men would stand around her so she couldn't be seen."

Undeterred, Subak graduated with a degree in earth sciences and economics. She found jobs as a geologist and in banking before a volunteer role at a health clinic inspired her to apply to medical school. She graduated from Stanford's School of Medicine in 1991.

During the question and answer session, the conversation turned to the perceptions of leaders and how men are often described as strong or forceful while women get tagged with less complimentary language. The department chairs also talked about the advantages they have as women in leading their departments.

"I could bringconsensus to a room," Pfeffer said. "I think we do that better than the guys."

Women are now the majority of students entering medical school nationally. A majority of bachelor's degrees earned in biological and biomedical sciences are earned by women. In medical schools, the future may, in fact, be female.

Recordings from the event will be available.

Photos by Steve Fisch

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Choices, trade-offs and accomplishments at the Women in Medicine and Science event - Scope

No Consensus on How to Bring Offshore Wind Power Ashore in NJ – NJ Spotlight

The two main choices are to build a backbone offshore-wind transmission system or to allow developers to build transmission lines directly to on-shore facilities.

The state yesterday began soliciting input on how to deliver power from offshore wind farms off the Jersey coast to customers, a dilemma that will get more complicated as the sector grows more critical to meeting New Jerseys energy needs.

For the short term, offshore wind developers will likely have relatively few problems hooking up with the electric grid, at least to achieve the Murphy administrations goals of developing 3,500 megawatts of offshore wind capacity by 2030, according to offshore wind developers at a meeting held at the War Memorial in Trenton on Tuesday.

Long term is another issue altogether, especially if the state opts to adopt a consultants projection that the state will need to nearly triple that goal and build up to 11,000 MW of offshore wind capacity by mid-century to achieve its target of 100% clean energy by then.

If so, developers, consultants, and an executive from PJM Interconnection, the regional power grid, urged the state to begin assessing long-term projections of its own, and even of other states energy demands and profiles.

You need to start thinking about what is the ultimate build-out, said Suzanne Glass, director of infrastructure planning for the PJM, the nations largest power grid, stretching from the Eastern Seaboard to Illinois.

The meeting, held by the state Board of Public Utilities, yielded no clear consensus on whether a regional so-called backbone offshore-wind transmission system would be more cost-effective than allowing developers to build transmission lines directly to on-shore facilities.

The same debate is raging in Europe, where offshore wind farms are much more prevalent and established. rsted, which has won approval to build a 1,100 MW wind farm 15 miles off Atlantic City, has typically insisted it is better to allow the developer to also build the transmission line.

The synergies of doing offshore wind and transmission together are huge, said Utrik Stridboek, a vice president of regulatory affairs in rsted. The key is I dont think you want to create impediments to those synergies.

Yet, with the tremendous growth in offshore wind in Europe, he argued that a regional backbone system is probably inevitable there, and possibly even in the U.S., depending on the growth of the sector and the value it brings to investors.

After the meeting, rsted issued a statement, saying, There may be benefits to a planned transmission system for offshore wind but there are also significant risks.

In New Jersey, the BPU has approved an underwater transmission line from rsteds proposed wind farm to the closed Oyster Creek nuclear plant to bring ashore its power to customers. A big issue for the offshore wind developers is finding suitable places to bring power on shore to customers, with most saying such options are limited.

Just getting one cable landing to shore is very challenging, noted Kirsty Townsend of rsted.

If the state chooses to expand its goal of offshore wind capacity to 11,000 MW, there are not nearly enough interconnections onshore to accommodate that much capacity, agreed Janice Fuller, president of NJ Ocean Grid, a subsidiary of Anbaric Development Partners, LLC.

Anbaric asked the federal government to gauge interest in building such a transmission line earlier this year, in this instance, a 185-mile submarine line mostly off the Jersey coast.

Doug Copeland, development manager for Atlantic Shores, an offshore-wind farm project being pursued by EDF Renewables and Shell Energy off the Jersey coast, predicted that developers will be able to solve the technical issues relating to transmission, but offered the political issues may be more daunting.

The BPU is aiming to select the least-cost option to building an offshore-wind transmission system. Yesterdays hearing was the first of several it expects to hold with stakeholders to determine how to bring ashore the power from the wind farms.

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Delivery of the navy’s first Arctic and offshore patrol ship delayed until 2020 – CTV News

Michael MacDonald, THE CANADIAN PRESS Published Tuesday, November 12, 2019 12:27PM AST Last Updated Tuesday, November 12, 2019 3:31PM AST

HALIFAX -- The delivery date for the navy's first Arctic and offshore patrol ship has again been pushed back.

Irving Shipbuilding in Halifax was originally scheduled to deliver the ship in 2018, but in August that deadline was pushed to the end of 2019.

On Tuesday, Irving Shipbuilding released a statement saying the new ship, HMCS Harry DeWolf, is expected to be delivered during the first three months of 2020 -- nearly five years after construction first started.

The company says it had always intended to "revisit" the delivery deadline, given the fact it is building a newly designed ship with a new supply chain, a new shipyard and a new and growing workforce.

Irving spokesman Sean Lewis said the ship will be the largest naval vessel built in Canada in more than 50 years.

"We are now just weeks away from taking the future HMCS Harry DeWolf to sea for the first time, followed by formal sea trials and acceptance by our customer," Lewis said in a statement. "This will span into the first quarter of 2020."

Four of the Harry DeWolf-class of vessels, which will be capable of breaking through light ice and armed with a small cannon, are currently under construction in Halifax.

The Arctic patrol vessels are the first vessels to be built by Irving since it was selected as one of two shipyards under the federal government's multibillion-dollar national shipbuilding strategy.

Under the original plan, Irving was to build between six and eight Arctic patrol vessels at a total cost of around $3.1 billion, as well as the navy's new fleet of 15 warships for $24 billion, once those smaller ships were finished.

However, numerous delays and cost overruns saw the number of Arctic patrol vessels cut to five, even as the budget was increased to $3.5 billion. The 15 warships are now projected to cost $60 billion.

In November 2018, Ottawa announced it would pay $800 million for a sixth Arctic vessel as well as to slow production at Irving to prevent layoffs between the end of work on the last Arctic ship and the start of warship work.

Then in May, Prime Minister Justin Trudeau announced plans to spend an additional $15.7 billion on 18 new ships for Canadian Coast Guard, including two additional Arctic patrol vessels from Irving.

The other 16 ships are being built by Seaspan Shipbuilding in Vancouver, which was selected in 2011 as the second yard under the national shipbuilding plan.

Seaspan is also building four science vessels for the coast guard and two naval support ships.

-- With files from Lee Berthiaume

This report by The Canadian Press was first published Nov. 12, 2019.

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Delivery of the navy's first Arctic and offshore patrol ship delayed until 2020 - CTV News

Mesothelioma Compensation Center Appeals to An Offshore Oil Rig Worker with Mesothelioma Nationwide to Call for Direct Access to Attorney Erik Karst…

NEW YORK, Nov. 13, 2019 /PRNewswire/ --TheMesothelioma Compensation Centersays, "We are appealing to an offshore oil rig worker who have recently been diagnosed with mesothelioma to call us anytime at 800-714-0303 for on the spot access to attorney Erik Karst of the law firm of Karst von Oiste. Erik Karst and his colleagues at Karst von Oiste are responsible for over a billion dollars in financial compensation results for people with mesothelioma or asbestos exposure illnesses-and they will know exactly how to help an oil rig or oil field worker with mesothelioma-especially if the person's exposure to asbestos took place in the Gulf of Mexico, Alaska or offshore oil rigs off the coast of California.

"We also want to emphasize attorney Erik Karst of the law firm of Karst von Oiste and his lawyers will go anywhere the United States for a face to face meeting with the person with mesothelioma-in the home of the person with this rare cancer. This face to face meeting will allow the lawyers to understand how the person was exposed to asbestos, and to develop a plan to get this person the best financial compensation settlement results. We have endorsed the law firm of Karst von Oiste for oil/gas exploration and development workers nationwide-because they get superior compensation results for their clients as we would be happy to discuss anytime at 800-714-0303."www.karstvonoiste.com/

TheMesothelioma Compensation Centeris an advocate for power and energy workers with mesothelioma and the appealing to people like this to avoid the following types of Internet ads:

According to the CDC, the states indicated with the highest incidence of mesothelioma include Maine, Massachusetts, Connecticut, New Jersey, Pennsylvania, Ohio, West Virginia, Virginia, Michigan, Illinois, Minnesota, Louisiana, Washington, and Oregon. However, an oil field or offshore oil rig worker with mesothelioma could live in any state including California, New York, Florida, Texas, Illinois, Kentucky, Tennessee, Georgia, Alabama, Nebraska, North Dakota, Wyoming, Colorado, Nevada, New Mexico, Utah, Arizona, Idaho, or Alaska. http://MesotheliomaCompensationCenter.Com

The Mesothelioma Compensation Center specializes in assisting high-risk workers who have been diagnosed with mesothelioma. High-risk groups for exposure to asbestos include the US Navy Veterans, power plant workers, shipyard workers, oil refinery workers, public utility workers, chemical plant workers, nuclear power plant workers, oil and gas field production workers, hydro-electric workers, plumbers, electricians, welders, millwrights, pipefitters or machinists. In most instances people with mesothelioma were exposed to asbestos in the 1950's, 1960's, 1970's, or 1980's.www.karstvonoiste.com/

For more information about mesothelioma, please refer to the National Institutes of Health's web site related to this rare form of cancer:https://www.cancer.gov/types/mesothelioma

Media Contact:

Michael Thomas800-714-0303226297@email4pr.com

SOURCE Mesothelioma Compensation Center

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Hullihen Williams Moore column: Ratepayers beware on Dominion’s offshore wind project – Richmond.com

In September, Dominion Energy announced its $7.8 billion offshore wind proposal with more than 200 giant windmills to be located 27 miles off Virginias coast. It is to be the largest such facility in the nation. It sounds great unless you are a ratepayer who may have to pick up the tab.

This reminds me of another grand plan by Dominion 50 years ago. At that time, nuclear generation was the answer; some said it would be too cheap to meter. The company planned eight large nuclear units four at Surry and four at North Anna. It said the nuclear fuel would be repeatedly reprocessed and remains would be easy to store. Moreover, science would soon solve spent fuel problems. The company advised that changes and cost overruns would not be a problem. It also said these expensive plants would run almost constantly.

Reprocessing of the nuclear fuel did not materialize, construction costs skyrocketed and reliable operation of the units was many years coming. Four planned units were abandoned, costing ratepayers hundreds of millions of dollars. The catastrophe almost drove the company to bankruptcy, but the State Corporation Commission (SCC) saved it with higher rates and little examination of the companys prudence.

The four remaining nuclear units now run efficiently, but that took decades and wasted hundreds of millions of ratepayer dollars. And, the spent fuel issue is still very real.

Lets look at the offshore wind proposal compared to the approach of 50 years ago. The chutzpah of the utility is similar, but here, Dominion doesnt even bother with the pretense of promises. Virginia law encourages wind energy but does require the SCC to review Dominions plans. Unfortunately, Virginia law severely restricts what the commission can do if it finds the project wanting. A hearing was held by the SCC on the $300 million pilot for the project and the SCC found, among many other things, the following with respect to Dominions plans:

Finally, and most importantly, from the hearing: The Project would not be deemed prudent as that term has been applied by this Commission in its long history of public utility regulation or under any common application of the term.

The SCC concluded that, even with these findings, because of the limitations set by the General Assembly, it had no choice but to approve the plans.

What has happened is worse than the nuclear debacle. There, the company took some responsibility; here it takes none. Dominion can proceed to build the pilot and, if performance is poor, customers will still pay all costs and a profit as well.

Without prudent realistic workable plans including weather considerations, it is absurd even to consider having more than 200 windmills with blades spanning over 500 feet spinning over the ocean 27 miles from shore for the relatively small amount of electricity to be generated. Would this system survive the winds and waves of a storm like Dorian or worse? These storms are getting stronger not weaker. Dorians winds were more than 200 miles per hour in the Bahamas and created a 100-foot wave off Newfoundland. Is there replacement power available when these units do not work? If so, at what cost? Is it higher than the 78 cents? If not, why build these? These realities must be considered.

The General Assembly can encourage environmentally friendly projects including offshore wind, but it must not forget that ratepayers pay the bill. The Assembly should not take over regulation and prohibit the SCC from determining whether plans and expenditures are prudent and in the public interest. The SCC must be able to examine fully this project, including all costs and the impacts of weather. The SCC must be able to determine whether spending over $7 billion of ratepayer money for 78 cents /kWh is in the public interest.

Hullihen Williams Moore is a former member and chair of the Virginia State Corporation Commission and the Virginia Air Pollution Control Board. He also practiced public utility law for 25 years and taught economic regulation at the law schools of the University of Virginia, the College of William & Mary and Washington and Lee University. Contact him at Hullie@comcast.net

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Hullihen Williams Moore column: Ratepayers beware on Dominion's offshore wind project - Richmond.com

W&T Offshore to Participate in Upcoming Investor Conferences – EnerCom Inc.

HOUSTON, Nov. 12, 2019 (GLOBE NEWSWIRE) -- W&T Offshore, Inc. (NYSE: WTI) (W&T or the Company) today announced that the Company will be participating in two upcoming investor conferences.

Chairman and Chief Executive Officer Tracy W. Krohn will present at the Bank of America Merrill Lynch 2019 Global Energy Conference in Miami, Florida on Thursday, November 14, 2019 at 2:00 p.m. Eastern Time and will also host one-on-one meetings. The presentation will be webcast live and archived on W&Ts website, http://www.wtoffshore.com, on the Overview page in the Investor Relations section of the site. An updated investor slide deck prepared in conjunction with the Conference will be posted on the website under Presentations on November 14, prior to the presentation.

The Companys senior management will be meeting with investors at the Capital One Securities 14th Annual Energy Conference in Houston, Texas on Thursday, December 12, 2019. W&T will not be making a formal presentation. An investor deck prepared in conjunction with the Conference will be posted in the Investor Relations section of the Company's website on Thursday morning, December 12, under Presentations.

About W&T Offshore

W&T Offshore, Inc. is an independent oil and natural gas producer with operations offshore in the Gulf of Mexico and has grown through acquisitions, exploration and development. The Company currently has working interests in 53 producing fields in federal and state waters and has under lease approximately 826,000 gross acres, including approximately 605,000 gross acres on the Gulf of Mexico Shelf and approximately 221,000 gross acres in the deepwater. A majority of the Companys daily production is derived from wells it operates. For more information on W&T, please visit the Companys website at http://www.wtoffshore.com.

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Powerful winds of change: Offshore wind power has taken off but challenges persist – Down To Earth Magazine

Technological improvements and falling costs are driving a boom in offshore wind power projects worldwide. Still, the industry faces its own peculiar share of challenges

This is the first partof athree-part series:

Technology has come a long way since windmills were used centuries ago to mill grain or pump water. Modern wind turbines are highly evolved versions and the utility-scale ones are over 100 metres tall and can power thousands of homes.

A wind farm is an area with a high density of turbines for electricity generation their history goes back over a century, when engineers saw that a cluster of turbines on land could improve the electricity generation profile. The nomenclature has changed and these farms are now called onshore wind farms the reason for this is the relatively new and fascinating story of offshore wind farms.

The basics are the same: Harnessing the energy of wind, but by building wind farms in oceans where speeds are higher and land is not a concern. The electricity produced by offshore wind turbines travels back to land through a series of cable systems that lay on the seabed.

The United Kingdom has led the charge on offshore wind installations and is currently the country with most installations by a mile. Renewable energy sources generated more electricity in the UK than fossil fuel power plants for the first, straight three-month period since record-keeping began more than 100 years ago, according to an analysis published by UK-based website Carbon Brief on October 14, 2019.

Wind farms, solar panels, biomass and hydroelectric power projects generated an estimated 29.5 terawatt hours (TWhs) of electricity in the third quarter, between July and September of 2019, marginally exceeding the 29.1 TWhs produced by plants that run on fossil fuels such as coal, gas and oil.

In 2003, the 60 megawatt (MW) North Hoyle, the first offshore wind farm in the UK, became operational at a depth of less than 10 m and at a distance of 7.5 km from the shore. It was the most powerful farm at that time and could power 50,000 homes annualy.

In contrast, the 588 MW Beatrice Offshore Wind Farm, located near a former oil field in the Moray Firth, north of Scotland, and inaugurated by Prince Charles on July 29, 2019 was at a depth of 45 m and at a distance of 13 km from the coast. The 84-turbine Beatrice has the capacity to power up to 0.45 million homes.

Offshore wind energy has been identified as one of 10 industries where the UK has the potential to be a market leader and features heavily in its plans of being a net-zero emissions country by 2050. The country hopes to produce 30 gigawatt (GW) of offshore wind energy by 2030, a massive transition where 33 per cent of the UKs electricity would come from offshore wind farms up from 8 per cent in 2018.

It would be generating thousands of high-quality jobs across the UK, a strong supply chain and a fivefold increase in exports. This is our modern industrial strategy in action, Claire Perry, UKs Energy & Clean Growth minister said in a statement on March 2, 2019, when the UK Department for Business, Energy and Industrial Strategy officially launched its Offshore Wind Sector Deal.

This acceleration could not have been more unpredictable going by the lull in the initial years. The uptake of offshore wind energy was slow after 1991, when Denmark built Vindeby, the first offshore wind farm in the world with 11 small 450-kilowatt (kW) turbines in the shallow waters around Lolland the countrys fourth-largest island. The electricity industry considered the development to be too small at that time.

According to an article published in the New Scientist on October 20, 1990, special winches were used for construction as large cranes could not be used at sea. A system to control the turbines from land had to be set up using optical fibre cable incorporated into the seabed power cable taking energy from the turbines to the shore.

New turbines were prepared with three 16 m blades made from polyester reinforced with glass fibre, mounted on a 35 m tubular steel tower. The concrete foundations were built in a dry dock carved out of the shoreline of the island, which was then flooded to float the finished foundations to sea using a large catamaran, where they were lowered onto prepared bases, filled with gravel and surrounded by large boulders.

Offshore wind was born mainly due to the lack of space for the development of large onshore wind projects in the densely populated areas of Western Europe. The European countries led the offshore wind industry as they were the first to envision oceans as a clean energy resource and were aided by a facilitating policy environment that saw the need for clean energy much before others.

The import of offshore wind energy was realised in 2000 when the first large-scale offshore farm, Middelgrunden, 3.5 km off Copenhagen, was built with 20 Bonus 2 MW turbines and a capacity of 40 MW. Now, Denmarks biggest offshore wind farm, Thor, with a capacity of at least 800 MW, is set to be installed in the North Sea. Thor will supply power to 0.8 million households and create more than 8,000 jobs in the layout process.

The United States was a late entrant into the offshore wind energy field. It was in December 2016 that the country got its first operating offshore wind farm, the Block Island Wind Farm, off Rhode Island. The farm had a capacity of just 30 MW but it did show that the US was finally entering the offshore wind game.

The large coastline in the US offers the country significant potential estimated at over 2,000 GW. In December 2016, the US introduced the National Offshore Wind Strategy to develop the industry. The US Bureau of Ocean Energy Management (BoEM), the federal agency responsible for offshore resources, has already granted over 15 leases for offshore wind development.

BoEM claims that the leased offshore blocks could support over 21 GW of energy. Nine mega projects signed in New York, New Jersey and states like Massachusetts and Rhode Island, with a cumulative capacity of over 4.8 GW are expected to be commissioned in the coming years. This alone could power oversix million homes along the US coast. The effort is to spur an estimated $70 billion offshore wind industry in the US over the next decade.

Ironically, there is a political backlash for this job churning sector when the US is focused on creating more jobs. President Donald Trump has not been as supportive of wind power. Trump has made hundreds of comments on Twitter and in public opposing the expansion of wind power. They say the noise causes cancer, Trump told a crowd of supporters last spring, soliciting an immediate and strong rebuttal from the American Cancer Society.

The roadblock for the industry came in August this year when the US Interior Department extended the environmental review for the $2.8 billion Vineyard Wind project off Massachusetts. The 800 MW project is the first of several massive wind farms planned off the East Coast. The review came in response to concerns from fisherfolk about the impact of offshore wind development on fisheries.

The question facing the industry is whether the review represents a genuine attempt to understand the environmental impacts associated with offshore wind or an effort to kill it, said Anthony Logan, an analyst who tracks the industry at Wood Mackenzie, a consulting firm, E&E News reported. Despite all that, analysts predict that the US will swiftly catch up.

I get that its a renewable energy project, and I get that people are excited about it, says Drew Minkiewicz, an attorney with the Fisheries Survival Fund, which has battled Equinors Empire Wind project, but would you allow a nuclear reactor or a coal plant to write its own environmental impact statement? says a Bloomberg report quoting Minkiewicz on October 1.

The dampening news from the US apart, global interest remains bullish. Even Asian countries have jumped on to the bandwagon. India, China, Japan, South Korea, Taiwan and Vietnam are emerging as the new areas for offshore energy growth. Taiwan is considered as an ideal destination.

Global developers are making a beeline to the country which has strong winds and a shallow coastline which make it perfect for offshore wind farms. The country introduced the Offshore Demonstration Incentive Program (DIP) in 2012 and foundation installations for a demonstration project Formosa I, with two turbines of 4 MW each off the coast of Miaoli Countybegan in 2014. The country has plans to provide 5.5 GW by 2030 through projects such as Changhua 1 and 2a.

In 2018, China had already surpassed European countries in annual installations with 1.8 GW. China is aiming to install 10 GW of offshore wind energy by 2020. Similarly, Japan, South Korea and India have a target of installing 10 GW, 12 GW and 30 GW respectively by 2030. The Asian markets are predicted to add 100 GW in offshore wind by 2030, says Alok Kumar, country manager India, Advisory at DNV GLEnergy, a technology giant that is advising and assisting India with its first offshore wind farm.

Watch this space forthe second part.

This was firstpublished in Down To Earth print edition (dated 1-15 November, 2019)

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Powerful winds of change: Offshore wind power has taken off but challenges persist - Down To Earth Magazine

A closer look at the West of Shetland’s offshore potential – Offshore Technology

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These conditions paired with the remoteness of the area have also meant that the region is relatively unexplored, despite its potential for the oil and gas sector. According to BPs estimations currently there is at least 640mn bl of oil in recoverable resources.

GlobalData upstream oil and gas analyst Daniel Rogers says: The WoS basin in comparison to the North Sea basins has been relatively under-explored. The extreme water depths, challenging subsurface, and lack of knowledge and experience in the basin lead to higher risk than the North Sea exploration. That being said, there is currently vast acreage open to explorers and yet-to-find volumes are significant.

Drilling in the area particularly peaked after the Geological Society published a study positioning the WoS area as the largest remaining exploration site with potential forsignificantnew finds, by virtue of its relative exploration immaturity.

Although the Department of Energy and Climate Change (DECC) considered the Central North Sea as the largest yet-to-find potential on the UK Continental Shelf, new research from Global Data found that for the last four years oil and gas production in the WoS has risen and it will overtake North Sea as future-major producing basin in UK.

The report showed that North Sea operations owned by BP and Shell, the UKs biggest oil and gas producers, saw significantly decreased production, especially in comparison to their interest in the WoS. BPs production in North Sea has fallen from about 100,100 barrels of equivalent per day (boed) in 2017 to about 40,000 boed in 2018, making the companys production in North Sea significantly lower than its WoS explorations. Shells exploration in the North Sea, has also declined from around 90,000 boed in 2018 to approximately 75, 000 boed in 2019 and it shows a tendency for Shells North Sea operations to notably drop below its WoS drilling from 2020 to 2022.

Furthermore, of the successful 30th UK Offshore Licensing Round in 2017, approximately 75% of the licensed WoS blocks involved European major participation. European majors have stakes in 80% of the planned and announced projects in the area compared to approximately 40% in the North Sea.

Overall, the report concludes that theWoS area retains the attention of major Exploration and Production operators in the region; however its infrastructure difficulties can impede the future growth potential in the basin.

Rogers concludes: There remains significant value to be captured within the North Sea particularly through near field exploration and marginal field developments, however, the West of Shetlands remains more attractive for operators willing to take higher exploration risks necessary to discover fields large enough to compete for capital within highly competitive global portfolios.

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A closer look at the West of Shetland's offshore potential - Offshore Technology

Australia to block illegal offshore gambling websites – The Guardian

The nations communications watchdog will soon block access to illegal gambling websites hosted offshore.

Australians spend up to $400m on the sites each year and often have difficulties recouping their winnings or deposits.

The Australian Communications and Media Authority will investigate suspect sites and, if unable to take enforcement action, order internet providers to block them.

The chair of Acma, Nerida OLoughlin, said the new laws were a valuable additional weapon against illegal online gambling.

There is little to no recourse for consumers engaging with these unscrupulous operators, OLoughlin said on Monday.

She said 65 illegal companies had left Australia since Acma began enforcing new rules against offshore sites in 2017.

The communications minister, Paul Fletcher, said the sites accounted for about $100m in lost tax revenue each year.

Too often these offshore operators are defrauding Australians and their websites typically provide very few, if any, harm-minimisation controls, Fletcher said.

Acmas new powers fulfil one of three legislative recommendations that came out of a 2015 review of interactive gambling.

The review, overseen by former NSW premier Barry OFarrell, made 19 recommendations to the government.

It raised a number of problems with the sites, including a lack of Australian consumer protections, as well as links with organised crime.

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Australia to block illegal offshore gambling websites - The Guardian

GE starts work on first offshore wind factory in Asia – Recharge

GE Renewable Energy on Tuesday started construction in China of its first offshore wind assembly plant in Asia, which will produce the world's largest turbine, the 12MW Haliade-X.

The 71,000 sq metre factory in Chinas southern city of Jieyang, Guangdong province, is expected to start to manufacture the Haliade-X in the second half of 2021, according to a statement by the US group.

GE is among the first group of manufacturers to commit to investing and building factories in Jiayangs Linggang Industry Park, its offshore wind manufacturing hub, to back the citys ambition to install 13.8GW by 2030.

China is likely to become the worlds largest offshore wind market, Rachel Duan president & CEO of GE China said. By building this industry-leading factory, we hope to facilitate Guangdong province and Chinas largest-scale offshore wind vision.

Last year Chinese local governments collectively approved over 40GW of projects, of which most hope to connect to the grid by the end of 2021. Most ambitious of all, Guangdong set out a plan to build 66.9GW by 2030.

Besides the factory, GE is also launching an offshore wind operation and development center in Guangzhou, the capital city of Guangdong. The duo will become a base for the turbine maker to expand its offshore wind footprint in the Asia Pacific region, the company statement said.

Since last year, the US group has made a speedy inroad into the Chinese wind market. Just days before the construction, the manufacturer scored an onshore turbine deal with China Huaneng to provide 286 turbines of 2.5MW to a Henan-based wind farm in the largest order for a western turbine maker to date .

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GE starts work on first offshore wind factory in Asia - Recharge

W&T Offshore (WTI) Q3 Earnings Beat on Higher Production – Yahoo Finance

W&T Offshore, Inc. WTI reported third-quarter 2019 adjusted earnings (excluding one-time items) of 13 cents per share, beating the Zacks Consensus Estimate of 1 cent but declining from the year-ago figure of 30 cents.

Meanwhile, quarterly revenues decreased to $132.2 million from $153.5 million a year ago. Moreover, the top line missed the Zacks Consensus Estimate of $134 million.

The better-than-expected earnings were supported by higher production volumes, partially offset by a decline in average realized prices and rise in lease operating expenses.

W&T Offshore, Inc. Price, Consensus and EPS Surprise

W&T Offshore, Inc. Price, Consensus and EPS Surprise

W&T Offshore, Inc. price-consensus-eps-surprise-chart | W&T Offshore, Inc. Quote

Overall Production Rises

Total oil equivalent production averaged 41,149 barrels of oil equivalent per day (Boe/d), which rose 13% from 36,508 Boe/d in the year-ago quarter. Oil production was recorded at 1.7 million barrels of oil (MMBbls), flat year over year. Natural gas liquids output totaled 283 MBbls, lower than 318 MBbls a year ago. Natural gas production of 10,606 million cubic feet (MMcf) in the reported quarter was higher than 7,939 MMcf in the year-earlier period. Of the total production in the quarter, 53% comprised liquids.

The rise in production was supported by the companys Mobile Bay acquisition from Exxon Mobil Corporation XOM, which added 74 million BOE of net proved reserves to its portfolio. Moreover, W&T Offshore brought online its Gladden Deep first exploration well, which achieved an initial output rate of around 4,600 gross Boe/d.

Realized Prices Decline

The average realized price for oil during the third quarter was $59.24 a barrel, lower than the year-ago level of $69.57. The average realized price of NGL softened to $15.45 from $31.70 per barrel in the prior year. The average realized price of natural gas during the September quarter was $2.23 per thousand cubic feet, down from $2.85 in the comparable period last year. Average realized price for oil equivalent output declined to $34.56 per barrel from $45.32 a year ago.

Operating Expenses

Lease operating expenses increased to $12.46 per Boe in the third quarter from $11.14 a year ago.

Capital Spending & Balance Sheet

W&T Offshore spent $188.1 million capital through the September quarter on oil and gas resources.

As of Sep 30, 2019, the company had approximately $41.7 million in cash and cash equivalents. It also had $137.8 million remaining under its revolving bank credit facility. The company had $719 million in long-term debt.

Guidance

W&T Offshore expects production for fourth-quarter 2019 within 49,300-54,500 Boe/d. For the full year, its production view has been marginally lowered to 39,800-41,100 Boe/d.

This offshore oil and gas explorer expects lease operating expenses through 2019 between $187 million and $193 million. For the fourth quarter, the metric is expected in the range of $57-$62 million.

Full-year 2019 capital expenditures, excluding acquisitions, are expected in the range of $130-$150 million.

Zacks Rank and Stocks to Consider

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Lonestars 2020 earnings per share are expected to rise 77% year over year.

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W&T Offshore (WTI) Q3 Earnings Beat on Higher Production - Yahoo Finance

Taiwan doubles next-stage offshore wind ambition to 10G – Recharge

Taiwan doubled its previous stated plans for the next stage of its offshore wind build-out with a goal to add 10GW of extra capacity from 2026 to 2035.

Taiwans President Tsai Ing-wen and its Ministry of Economic Affairs (MOEA) on Tuesday unveiled a new target for development in the Taiwan strait. The island had only previously laid down ambitions for 5GW after 2025 without specifying a timeframe.

The President made the announcement during her speech at the inauguration ceremony for the islands first offshore wind project, Formosa 1. She urged the MOEA to quickly establish a plan for the 10GW capacity for the next 10 years.

Later, minister of economic affairs Shen Jong-Chin confirmed the figure, adding that the ministry is planning to allocate 1GW per year for the 10GW goal.

The detailed plan of allocation measures will be released in the first quarter next year, the minister said.

The bidding prices of the 10GW projects are likely to lower than the average retail power rate, MOEA said in a statement.

Already getting a head start among Asian countries for offshore wind development, Taiwan should continue moving forward and plan in advance, the statement added.

Last year Taiwan held two rounds of offshore wind allocation to award seven companies a total 5.5GW capacity for its initial stage of large-scale development between 2019-2025. However, the island had yet to make clear the post-2025 roadmap and the rules for its third-round offshore project allocation.

In September, the MOEA announced it would postpone the release of a first draft of the allocation plan from the end of August to early next year due to various disagreements among project developers and the supply chain over allocation rules and localisation requirements, Recharge previously reported.

Shen today revealed that the energy regulator is considering a two-step selection process, in which the ministry would first pick eligible developers based on their localisation commitments, followed by price-competitive auctions.

Offshore wind has become a live issue in the run-up to Taiwan's next presidential election in January, with Tsai more ambitious than her rival over wind at sea.

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Taiwan doubles next-stage offshore wind ambition to 10G - Recharge

Offshore wind projects to be part of marine activity zones strategy – Irish Examiner

"Strategic marine activity zones" may be designated in coastal and offshore waters as part of the Government's new approach to marine planning.

Offshore wind projects will receive "preference" in marine areas zoned for this, a new draft framework published this morning by Minister of State for Housing Damien English states.

Renewable energy projects, commercial fishing, mineral extraction, aquaculture and other competing interests, including tourism, will be covered by a new single system of consent under long-promised revised legislation.

Ireland is actually one of the largest EU states if over 490,000 square kilometres of seabed off a 7,500km coastline is taken into account, the draft framework notes.

Mr English has released the States first such framework in draft form today (tues) for a three month public consultation period.

Ireland and other EU coastal states are obliged to establish marine spatial plans by 2021 under an EU directive, and Mr Englishs department has been assigned as lead in this.

The national marine planning framework aims to take a co-ordinated and coherent approach to management of our most important resource, it says.

The States Harnessing our Ocean Wealth strategy, has already set two economic targets doubling the value of ocean wealth to 2.4% of gross domestic product by 2030, and increasing the turnover of the ocean economy to exceed 6.4bn by 2020.

Academics at NUI Galways Socio-Economic Marine Research Unit have reported that Irelands ocean economy had a turnover at 5.5 billion in 2017.

One single national marine plan will apply to Irelands entire maritime area, extending from mean high water mark on the coast to the 200 mile limits of the exclusive economic zone and Continental Shelf.

However, the draft framework says the Government is committed to preparation of regional or sub-national plans in future marine spatial policy cycles

The framework will be underpinned by the Governments Marine Planning and Development Bill, which will replace the existing cumbersome system of foreshore leases and licenses, and will extend beyond territorial waters.

Friction between offshore renewable energy developments and fishing has already taken place in British waters, and the framework aims to plan for competing interests at a time of growing global pressure on marine resources.

Public consultation has already taken place on a baseline report, which elicited 173 responses, and a strong consensus emerged that a hybrid approach to marine spatial planning, involving zoning for specific activities or zoning certain areas was preferable to full zoning of all Irelands seas.

Adoption of the final marine planning framework is expected to be late 2020. Closing date for submissions on the draft is February 28, 2020.

The department says it will not replace or remove existing regulatory regimes or legislative requirements governing marine sectoral activities, but public bodies will be obliged to take its objectives into account .

When the new legislation is passed, consents will be issued by two departments, depending on remit the Department of Housing, Planning and Local Government, and Communications, Climate Action and Environment.

Former Environmental Protection Agency (EPA) director Michel Cinnide, who is now co-chair of environmental organisation Corrib Beo, welcomed publication of the draft framework.

However, he has questioned why the States Marine Institute or a similar experienced body is not being established to provide a secretariat for the plan.

Mr Cinnide also warned that the plan needs to be given adequate resources, and the department needs to ensure widespread consultation at both regional and local level before final agreement.

This plan will stand or fall on how well it works in individual coastal bays, he said.

Regional public events on the draft marine planning framework will open on November 21st in Limerick, continuing to Westport, Co Mayo (Nov 26), Galway (December 2nd), and Tralee, Co Kerry (December 12th), with further events in Killybegs, Co Donegal, Bantry, Co Cork, Dungarvan, Co Waterford, Dublin and Wexford.

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Offshore wind projects to be part of marine activity zones strategy - Irish Examiner

Review launched into onshore impact of offshore wind farms – The Telegraph

Norfolk and Suffolk has some of the most beautiful, valued and recognised wetland and onshore coastal habitats. It would be madness to damage these special environments by bringing renewable energy onshore in an environmentally damaging way.

Campaigners say the southern North Sea is becoming the countrys offshore energy powerhouse with up to ten wind farms proposed.

While campaigners are not opposed to renewable energy at sea, they are concerned that planning permission for additional vast onshore plants are being given the greenlight because it deemed essential power network infrastructure.

Fiona Gilmore, of SEAS, the Suffolk Energy Action Solutions group, said residents fear major onshore plant was being rushed through.

We are totally in favour of offshore renewables and wind energy but the delivery of that energy needs to be implemented in a responsible way, avoiding unnecessary devastation, she said.

Scottish Power Renewables [SPR] is planning to build a concrete jungle on virgin, coastal countryside to bring offshore wind energy onshore to connect to the Grid.

SPR has not been put under any pressure to look for existing brownfield sites and there is no impetus on firms to develop offshore wind energy transmission infrastructure solutions.

We need to be world leaders in the delivery of green energy not just in terms of producing that energy, otherwise that energy is no longer green.

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Review launched into onshore impact of offshore wind farms - The Telegraph