U.S. Health System Among Least Efficient Before Obamacare

The U.S. health-care system was among the least efficient in the developed world two years before major changes from Obamacare began to go into effect.

Americas health-care system ranked 44th of 51 nations assessed by Bloomberg, in terms of per person spending, life expectancy and health-care cost as a percentage of the economy. Its an improvement from 46th of 48 last year, yet Serbia, Turkey and China still scored better.

Singapore, with the top ranking, spent $2,426 per person and had a life expectancy of 82.1 years in 2012, the most recent year for which data are available. In comparison, the U.S. shoveled cash into health care -- $8,895 per person, per year -- and Americans are expected to live for 78.7 years.

Theres a lack of accountability among Americans, according to policy experts. We keep protecting individuals from the health-care costs that come from the fact that we dont have healthy lifestyles, Cindy Gillespie, a senior managing director at the law and policy firm McKenna Long & Aldridge LLP. We havent accepted that people have an element of personal responsibility around their health.

This year the Patient Protection and Affordable Care Act, or Obamacare, required all Americans to get health coverage. A goal of the law is to cut costs while improving Americans health.

Bloombergs ranking used life expectancy, health care as a percentage of gross domestic product and total expenditures. It assessed 51 countries with populations of at least 5 million, per capita gross domestic product of $5,000, and life expectancies of at least 70 years.

Experts have criticized life expectancy as a sole measure of health, since factors such as income and education level affect a persons health as well. The ranking is meant to employ a simple approach and life expectancy is a reflection of how well a health-care system works.

About 60 percent of Americans get insurance through work, according to the Robert Wood Johnson Foundation -- leaving many with little ability to compare coverage prices on the open market. Even if people wanted to price shop, theres little transparency about what theyre buying, since the cost of services at hospitals a few miles apart can vary by hundreds or thousands of dollars, Gillespie said.

The countries ranked the best all have some type of national health system. Singapore, Hong Kong, Italy and Japan make up the top four.

Singapores health-care spending grew 13 percent from 2011 to $2,426 per person. Spending as a percentage of GDP was constant, 4.5 percent in 2012 from 4.4 percent in 2011.

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U.S. Health System Among Least Efficient Before Obamacare

Offering assists Health Care REIT

Published: Thursday, 9/18/2014

BY JON CHAVEZ BLADE BUSINESS WRITER

Toledos Health Care REIT Inc. said Wednesday that it has successfully completed a public offering of 17,825,000 shares that, after a sale price of $63.75 per share, raised $1.1 billion.

The company plans to use the money to repay its primary unsecured credit loans and possibly invest in more health care and seniors housing properties.

The sale included 2,325,000 shares sold to offerings underwriters. Goldman, Sachs & Co.; RBC Capital Markets, BofA Merrill Lynch, Citigroup, Deutsche Bank Securities, J.P. Morgan, and Morgan Stanley assisted Health Care REIT in the offering.

The Toledo law firm of Shumaker, Loop & Kendrick served as the sole lead counsel in the completion of the public offering.

Along with a common stock offering in May in which the company sold 16.1 million shares and reaped $1 billion, Health Care REIT has completed the two largest individual overnight marketed common stock offerings by any New York Stock Exchange-listed company thus far in 2014 based on total gross proceeds, the real estate investment trust said.

Zacks Equity Research said the public offering will reduce Health Care REITs interest expenses and strengthen its liquidity, allowing it to make more strategic investments and add to its portfolio.

But adding 17.8 million shares will dilute the companys share value, Zacks said. Health Care REIT already had 308.5 million shares outstanding.

In trading Wednesday, the companys stock fell 10 cents to close at $63.74 a share. The announcement was made after the market closed.

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US health system not properly designed to meet needs of patients nearing end of life, says IOM

PUBLIC RELEASE DATE:

17-Sep-2014

Contact: Jennifer Walsh news@nas.edu 202-334-2138 National Academy of Sciences

WASHINGTON -- The U.S. health care system is not properly designed to meet the needs of patients nearing the end of life and those of their families, and major changes to the system are necessary, says a new report from the Institute of Medicine. The 21-member committee that wrote the report envisioned an approach to end-of-life care that integrates traditional medical care and social services and that is high-quality, affordable, and sustainable. The committee called for more "advance care planning" for end-of-life by individuals, for improved training and credentialing for clinicians, and for federal and state governments and private sectors to provide incentives to patients and clinicians to discuss issues, values, preferences, and appropriate services and care.

"Patients can, and should, take control of the quality of their life through their entire life, choosing how they live and how they die, and doctors should help initiate discussions with their patients about such decisions," said Philip Pizzo, co-chair of the committee and David and Susan Heckerman Professor of Pediatrics and Microbiology and Immunology and former dean of medicine at Stanford University. "For most people, death does not come suddenly. Instead, dying is a result of one or more diseases that must be managed carefully and compassionately over weeks, months, or even years, through many ups and downs. It is important that the health care options available to individuals facing the end of life help relieve pain and discomfort, maximize the individual's ability to function, alleviate depression and anxiety, and ease the burdens of loved ones in a manner consistent with individual preferences and choices."

Americans express strong views about the care they want to receive when they are seriously ill and approaching death. In general, they prefer to die at home and want to remain in charge of decisions about their care. However, the vast majority of Americans have not engaged in an end-of-life discussion with their health care provider or family. A 2013 national survey of adult Americans found that while 90 percent believe having family conversations about end-of-life wishes is important, fewer than 30 percent have done so.

The committee proposed a model for "advance care planning," which encompasses the whole process of discussing end-of-life care, clarifying related values and goals, and seeing that written documents and medical orders embody patients' preferences. The committee's model suggests that an initial conversation about values and life goals is held around certain mature milestones, such as obtaining a driver's license, turning 18, leaving home, or getting married. Additional situation-specific planning should occur for those in high-risk occupations; at onset of chronic illness; when applying for Medicare; when health worsens; and in the final year of expected life, when that seems to be known. These conversations can be guided by physicians, social workers, or other professionals, but should include family and loved ones. The conversations should address the patient's preferences, including possibly identifying a health care agent for the individual if they are not in a position to effectively represent their own interests.

In addition, clinicians should initiate high-quality conversations about advance care planning, and integrate them into the ongoing care plans of patients, the report says. However, too few clinicians are proficient in basic palliative care, and often clinicians are reluctant to have honest and direct conversations with patients and families about end-of-life issues. The committee called for improved training and certification -- specifically regarding communication skills, interprofessional collaboration, and symptom management -- for all clinicians who care for individuals with serious illness so they can provide quality end-of-life care consistent with patients' values and preferences. In addition, federal and state government and private sector payers should provide incentives to patients and clinicians to discuss end-of-life matters, document patient preferences, and provide appropriate services and care.

"Individuals should have time with their doctors to talk about end-of-life issues, and clinicians should receive the training and financial incentives for such discussions," said Dave Walker, co-chair of the committee and former U.S. comptroller general. "The U.S. health system is geared toward providing curative care aimed at curing disease, rather than providing the supportive and comfort care most people prefer at the end of life. Without adequate advance care planning, the default decision is for clinicians to treat a disease or condition, no matter the prognosis. This is far from a patient-centered, family-oriented approach that honors the preferences for care for those near the end of life in an affordable and sustainable manner."

"This is one of the most comprehensive and up-to-date studies that has been performed on end-of-life care for people of all ages who are approaching death," said Victor Dzau, president of the Institute of Medicine. "Health care delivery for people nearing the end of life has changed remarkably since IOM published its 1997 report Approaching Death: Improving Care at the End of Life. Since that report, the number of palliative care teams within hospital settings has increased, and palliative care is well-established in the professions of medicine, nursing, and social work. The time is now for our nation to develop a modernized end-of-life care system as envisioned by this report."

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US health system not properly designed to meet needs of patients nearing end of life, says IOM

$7.8 million given to Carver College of Medicine

$7.8 million given to Carver College of Medicine

BY BEN MARKS | SEPTEMBER 16, 2014 5:00 AM

The Carver College of Medicine will hopefully use $7.8 million donation to look for a new professorship, in addition to furthering genetic research.

After receiving $7.8 million, the University of Iowa Carver College of Medicine will advance genomic medicine as well as hopefully establishing several new positions in the college.

The money was from the estate of Franklin D. Trueblood, who earned a law degree in at the UI in 1925 and, along with friend and fellow alum Elsie Foerstner, was a staunch supporter of the university over the years.

When he died in 1989, his will named Foerstner as a lifetime income beneficiary of his trust. After Foerstners death in April, the university was named as remainder beneficiary.

A decision on exactly where the money is to be spent in the Genetics Department has not yet been made. However, medical-school Dean Debra Schwinn said the money could be used for a variety of purposes.

We want to make sure were putting it to the absolute best use, and thats why were not making a quick decision, she said. Theres just so much that we can do, this is a huge jump-start, and we have so many projects where we can use this wisely.

UI spokesman Tom Moore said it is not one lab that will benefit from the donation but a field of study, as the $7.8 million was given to the university with the intention of promoting the field of genomic medicine at the medical school.

Genomic medicine is about tailoring treatment to a specific individuals genome, Schwinn said.

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Large study reveals new genetic variants that raise risk for prostate cancer

PUBLIC RELEASE DATE:

17-Sep-2014

Contact: Vanessa Wasta wasta@jhmi.edu 410-614-2916 Johns Hopkins Medicine @HopkinsMedicine

In an analysis of genetic information among more than 87,000 men, a global team of scientists says it has found 23 new genetic variants common differences in the genetic code -- that increase a man's risk for prostate cancer. The so-called "meta-analysis," believed to be the largest of its kind, has revealed once hidden mutations among men in a broad array of ethnic groups comprising men of European, African, Japanese and Latino ancestry.

The meta-analysis combined information from smaller studies, according to William B. Isaacs, Ph.D., a genetic scientist at the Brady Urological Institute at the Johns Hopkins University School of Medicine. "There is a power in numbers that helped us find new variants that were only hinted at in smaller study populations, especially among minority men, and as we found the same variants across several populations, the evidence became stronger that they were definitively linked to prostate cancer," Isaacs said.

To help build the number of samples for the current study, described online Sept. 14 in Nature Genetics, Isaacs and Alan Partin, M.D., Ph.D., Brady Urological Institute director, contributed blood and tissue samples and data from 800 African-American men (400 with prostate cancer and 400 cancer-free) treated at Johns Hopkins to the study. All told, the samples included information on 43,303 prostate cancer patients and 43,737 men without prostate cancer.

Scientists at the Institute of Cancer Research and Royal Marsden National Health Services Foundation Trust in London, UK, and the University of Southern California led the analysis, which scanned more than 10 million areas of the genome where one genetic building block of DNA was switched for another, referred to as genetic variants, or more specifically, single-nucleotide polymorphisms (SNPs).

The team then compared the scanned genome regions of prostate cancer patients with prostate cancer-free men to find the 23 new SNPs they now link to prostate cancer. Together with 76 previously discovered SNPs, the variants account for one-third of the inherited risk for prostate cancers in men of European descent. Because the variants are inherited commonly among populations, they can appear in men with little or no family history of prostate cancer.

"Inheriting any single one of these genetic variants has only a small effect of prostate cancer risk," says Partin. "However, a subset of men will inherit many of these variants, putting them at substantially increase risk for the disease, from three to six times the population average. Men with these risk levels may benefit from disease screening at earlier ages."

Isaacs says that men with a family history of prostate cancer are already encouraged to be screened at an earlier age, "but family history may be difficult to pin down."

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New MRI technique helps clinicians better predict outcomes following mild traumatic brain injury

PUBLIC RELEASE DATE:

17-Sep-2014

Contact: Kathryn Ryan kryan@liebertpub.com 914-740-2100 Mary Ann Liebert, Inc./Genetic Engineering News @LiebertOnline

New Rochelle, NY, September 17, 2014Diffusion Tensor Imaging (DTI), a specialized magnetic resonance imaging (MRI) technique that detects microstructural changes in brain tissue, can help physicians better predict the likelihood for poor clinical outcomes following mild traumatic brain injury compared to conventional imaging techniques such as computed tomography (CT), according to a new study published in Journal of Neurotrauma, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is available free on the Journal of Neurotrauma website until October 17, 2014.

The ability to predict which patients who experience an acute head injury such as mild traumatic brain injury (mTBI) are likely to suffer ongoing dysfunction 3 or 6 months post-injury is important for providing optimal care. Esther Yuh and coauthors from University of California, San Francisco, Erasmus MC-University Medical Center (Rotterdam, The Netherlands), Mount Sinai School of Medicine (New York, NY), Seton Brain and Spine Institute (Austin, TX), University of Pittsburgh Medical Center (PA), University of Texas (Austin), Antwerp University Hospital (Edegem, Belgium), and University of Cambridge Addenbrooke's Hospital (Cambridge, UK), present the results of the first published study that compares DTI to conventional imaging and clinical factors for outcome prediction in individual patients with mTBI. DTI showed significant differences between the white matter of mTBI patients who had positive versus negative findings on CT and MRI evaluation, as described in the article "Diffusion Tensor Imaging for Outcome Prediction in Mild Traumatic Brain Injury: A TRACK-TBI Study."

John T. Povlishock, PhD, Editor-in-Chief of Journal of Neurotrauma and Professor, Medical College of Virginia Campus of Virginia Commonwealth University, Richmond, notes that "this exceptionally well done study addresses an issue of continuing controversy and confusion. The authors make an extremely important observation that MRI studies, including DTI parameters, are integral in informing prognosis after mild TBI. When taken together with the other publications from the TRACK-TBI Study Group, these findings should prove invaluable in assessing the occurrence of mild TBI and informing patient outcome."

###

About the Journal

Journal of Neurotrauma is an authoritative peer-reviewed journal published 24 times per year in print and online that focuses on the latest advances in the clinical and laboratory investigation of traumatic brain and spinal cord injury. Emphasis is on the basic pathobiology of injury to the nervous system, and the papers and reviews evaluate preclinical and clinical trials targeted at improving the early management and long-term care and recovery of patients with traumatic brain injury. Journal of Neurotrauma is the official journal of the National Neurotrauma Society and the International Neurotrauma Society. Complete tables of content and a sample issue may be viewed on the Journal of Neurotrauma website.

About the Publisher

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3 Minute Thesis 2014 Winner – Gene therapy spray: A breath of fresh air – Presentation – Video


3 Minute Thesis 2014 Winner - Gene therapy spray: A breath of fresh air - Presentation
Presenter: Harshavardini Padmanabhan Faculty of Health Sciences School of Paediatrics Thesis area: Aerosol Airway Gene Transfer Technique for Clinical Use Su...

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Dr. Ken Dychtwald – Futurist and Speaker on Marketing and the Changing Workforce – Video


Dr. Ken Dychtwald - Futurist and Speaker on Marketing and the Changing Workforce
Over the past 35+ years, Dr. Ken Dychtwald has emerged as North America #39;s foremost visionary and original thinker regarding the lifestyle, marketing, healthc...

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Ten Technologies Affecting You, Your Customers and Your Business: Futurist Jack Uldrich to Keynote an Event with the …

Chicago, IL (PRWEB) September 17, 2014

When your vision is to be the leading global resource for packaging and processing, and your mission is to improve and promote members abilities to succeed in a global marketplace calling in a global futurist like Jack Uldrich to discuss the latest technologies that will affect you and your future is smart thing to do. And that is precisely what the Packaging Machine Manufacturers Institute is doing on September 17th.

Founded in 1933, PMMI is a trade association made up of more than 650 member companies that manufacture packaging, processing and packaging-related converting machinery, commercially-available packaging machinery components, containers and materials in the United States, Canada and Mexico.

PMMI members are globally renowned for making the highest quality equipment, offering responsive service and committing to meeting their customers needs. To that end, being on the cutting of edge of technology is crucial, and Jack Uldrich, as a futurist has his finger on the pulse of the technologies that PMMI needs to be watching for and utilizing in the coming years.

Among the ten technologies that Uldrich will discuss with the PMMI group are things like the new Leap Motion control (hand gesture technology,) advanced 3D manufacturing techniques which may well transform and revolutionize the future of manufacturing, as well as sophisticated robotics which are already providing a healthy advantage in the production of many packaging and manufacturing materials.

When it comes to the future of manufacturing Uldrich says, "Five years ago, a 3D printera device that can manufacture physical objectscost $100,000. Today, similar printers are available for $1,000 and are poised to revolutionize the world of manufacturing. What will the world of tomorrow look like? The time to start thinking about this is now."

The Author of "The Next Big Thing is Really Small: How Nanotechnology Will Change the Future of Your Business" Uldrich will also address how nanotechnology will transform the manufacturing industry in the coming years.

Uldrich says, "In the coming year, packaging leaders can also expect to hear more about the Internet of Things. In its simplest form, the idea is that in the coming decade an estimated 50 billion physical objects will be connected to the Internet through low-cost, wireless sensors. What makes the technology so potentially revolutionary is that some of the sensors will be nano-barcodes that can authenticate products (such as valuable pharmaceutical drugs) or nano-sensors that can read a host of information, including temperature, humidity and the level of exposure to oxygen, and then relay this information to manufacturers, distributors and customers to provide a complete history of the item."

Uldrich who speaks all over the world on a variety of topics such as future trends, emerging technologies, innovation, change management and leadership, is also a leading expert on assisting businesses unlearn and adapt during times of transition. He has served as an adviser to Fortune 1000 companies and is noted for his ability to deliver provocative, new perspectives on competitive advantage, organizational change and transformational leadership.

Parties interested in learning more about him, his books, his daily blog or his speaking availability are encouraged to visit his website. Media wishing to know more about either the event or interviewing Jack as a futurist or trend expert can contact Amy Tomczyk at (651) 343.0660.

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Ten Technologies Affecting You, Your Customers and Your Business: Futurist Jack Uldrich to Keynote an Event with the ...

Mystery U.S. Government Satellite Is Now In Orbit

An Atlas V rocket lifts off with the mysterious CLIO satellite. (Credit: ULA)

Tuesday night at 8:10 EDT, a United Launch Alliance Atlas V rocket lifted off from Kennedy Space Complex after a short weather delay. This marks the 11th successful launch for ULA this year.

The rocket was carrying a satellite known only as CLIO, which it delivered into an unidentified (though probably geosynchronous) orbit. This satellite was built by Lockheed Martin and based on that companys A2100 Satellite bus. This framework is typically used for telecommunications satellites, and according to Lockheed, over 40 satellites with the A2100 bus are currently in orbit.

The level of secrecy for this satellite is somewhat unusual, especially since the which U.S. government agency is the customer for this satellite hasnt been identified at all. For example, even satellites intended for use to gather intelligence data are typically identified as being launched on behalf of the National Reconnaissance Office.

In a press release, Lockheeds executive VP, Rick Ambrose, merely commented as follows: We are very proud to deliver mission success for our U.S. Government customer. Our A2100 bus provides outstanding reliability, flexibility and proven performance, all at an affordable cost to our customers.

The next launch for ULA is scheduled for October 29, 2014, when an Atlas V rocket will deliver next generation GPS satellites into orbit on behalf of the Air Force. The next launch scheduled for September is a SpaceX launch on September 20, where it will deliver a Dragon capsule loaded with cargo to the International Space Station.

You can watch a video with highlights from the launch below:

To see what else has launched and whats planned to launch this month, please see ourSeptember launch schedule.

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Mystery U.S. Government Satellite Is Now In Orbit

Jeff Bezos' Space Company Enters Partnership To Build Next Gen Rocket Engine

Blue Origin tests its BE-3 rocket engine. (Credit: Blue Origin)

The Jeff Bezos-founded commercial space company Blue Origin announced today that it has entered into a partnership with the Boeing-Lockheed Martin joint venture United Launch Alliance. The jointly-funded partnership is aimed at developing the BE-4, a new, U.S.-built rocket engine to be used in ULAs next generation of rockets.

The BE-4 will be fueled by liquid oxygen and liquid nitrogen gas to produce a total of about 550,000 pounds of thrust. Blue Origin has already built a liquid natural gas testing facility in Texas, and the company says that testing of various engine components is already underway. The goal of the partnership is to have the BE-4 engine ready for testing by 2016 and flight by 2019. Two BE-4 engines will be used for ULAs next-gen rocket in order to deliver a combined thrust of 1,100,000 lbf.

In December 2013, Blue Origin debuted the BE-4s predecessor engine, the BE-3. That engine is a liquid hydrogen fueled engine that can deliver 110,000 pounds of thrust.

One thing that was mentioned today by the two companies is that contrary to previous reports, the BE-4 is not intended to serve as a replacement for the Russian-built RD-180, which currently serves as the primary engine for ULAs Atlas V rocket.

The BE-4 is not a direct replacement for the RD-180 that powers ULAs Atlas V rocket, however two BE-4s are expected to provide the engine thrust for the next generation ULA vehicles, the companies said in a FAQ document sent to the media. The details related to ULAs next generation vehicles which will maintain the key heritage components of ULAs Atlas and Delta rockets that provide world class mission assurance and reliability will be announced at a later date.

According to both ULA and Blue Origin, this development will be 100% privately funded no government money involved. However, the engine will be built to meet Air Force requirements for its Evolved Expendable Launch Vehicle program, for which ULA is the primary vendor. Both companies aim to develop the engine in a way that reduces the costs of current launches.

The team at Blue Origin is methodically developing technologies to enable human access to space at dramatically lower cost and increased reliability, and the BE-4 is a big step forward, Bezos said in a statement. With the new ULA partnership, were accelerating commercial development of the next great US-made rocket engine.

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Jeff Bezos' Space Company Enters Partnership To Build Next Gen Rocket Engine

NASA Awards Boeing And SpaceX Contracts To Deliver Astronauts To The Space Station

Concept art of Dragon docking with the space station. (Credit: SpaceX)

NASA officially announced today that both Boeing and SpaceX have been awarded Commercial Crew Transportation Capability contracts. These contracts are for the development of spacecraft that will be able to take astronauts to the International Space Station, with a target start date of 2017. The third company in the running for a contract, Sierra Nevada Corporation, did not receive an award.

This announcement from NASA partially contradicts earlier reports that Boeing was to be the primary winner of the contract, with SpaceX only receiving a secondary award. Instead, NASA doesnt appear to be distinguishing between the two companies as a primary or secondary provider, although there is a difference in the financial value of the two contracts.

Both companies are developing manned capsules which will ferry up to seven passengers and payloads to the International Space Station. Boeings CST-100 is planned to be launched by Atlas 5 rockets, which are built and operated by United Launch Alliance, a joint venture between Boeing and Lockheed. The SpaceX Dragon capsule will be launched by SpaceXs own Falcon 9 rocket.

Artist conception of Boeing CST-100 approaching the ISS. (Credit: Boeing)

According to Commercial Crew Program Manager Kathy Lueders, both companies will have to meet five separate certification milestones, and will receive payment upon completion of each one. That certification process will include a flight with one astronaut on board. Once the spacecraft are certified for delivery, each company will be contracted to conduct at least two and up to six spaceflights to the ISS with four crew members and cargo payloads.

This will enable NASA and its international partners to perform more research on the international laboratory, nearly doubling its research potential, Lueders said.

The spacecraft will also have the capability to serve as a lifeboat for up to 210 days in the event of an emergency, she added.

According to NASA Administrator Charles Bolden, the total value of the contracts to the two companies will be worth up to $6.8 billion over the life of the contract. Boeings potential award is $4.2 billion and SpaceXs potential award is for $2.6 billion.

According to Lueders, both contracts have the same goals and requirements. The values of the contracts are based on the proposals submitted by the companies themselves and the amount of money the companies believed they would need to meet the contract requirements.

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NASA Awards Boeing And SpaceX Contracts To Deliver Astronauts To The Space Station