If you are the owner or manager of a small home improvement or building supply company, you could be missing out on the potential financial and educational benefit available through the use of a business consulting firm Using a business consulting firm that specializes in contractor marketing or contractor consulting has been proven to drastically improve the quality and productivity of management and staff.
Business consulting firms provide a wide range of educational and informative training materials and consulting advice, as well as home improvement seminars to serve small home improvement and building supply companies in meeting their educational and training needs. Seminars that are designed to expose management and staff to the proven methodology that has made contractor consulting so successful will bring about a drastic change in the attitudes and business savvy of your staff.
The goal of contractor marketing focused small business consulting is to provide renowned educational materials to home improvement business owners to help them train their staff and management in the ever evolving small business field. When these proven methods are applied to the daily functions of any small business model, they will improve the productivity and profitability of any business; whether already successful or newly formed.
Although cost of service may vary depending on your company?s specific and unique needs, quality business consulting firms often disseminate important industry-specific information to the public as well as their clients and no cost, but simply as a means to help small businesses find successful methods. In addition, most contractor consulting firms also offer clients a free monthly newsletter that is delivered electronically to their specified email account. These newsletters contain valuable real-time information regarding the ever changing and evolving opportunities for small businesses to improve productivity and profit.
Each month, scores of new home improvement and building supply companies enter the field with the intent of becoming the newest success story; it is essential for any small business owner to stay at informed of the newest methods of business success. Even if your small business has previously seen earnings gains and company growth, it is important to always remain keyed in to the changing needs of clients, and the new marketing strategies and products coming available. Taking advantage of a business consulting firm can bring nothing but good to your small home improvement business regardless of its current size or profitability and should be a part of any successful business plan.
More insights can be taken into account if you click on business consulting and try also contractor marketing.
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SARASOTA, FL (MARCH 2012) VisApp, LLC a Sarasota FL based company? provides a free Home Makeover website (www.showoff.com ) for Home Improvement and Landscape projects by homeowners as they bring their vision to life using? pictures of their home. They visualize, experiment, custom design home and landscape projects using Visualizer Apps.
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Visualizer Apps are available for Paint, Roofing, Doors & Windows, Landscaping, Outdoor Living, Home Accessories and Outdoor Lighting. Homeowners can easily test out their home design ideas and virtually see their house or landscape renovated with their choice of paint colors on walls, or a new roof, siding and landscaping before the work is implemented.
?If you?re going to invest time and money ? and your heart and soul ? into home improvements, you want to envision the finished product. Showoff.com empowers homeowners to visualize their projects at the design stage, select products, share their vision with friends and family, and even request bids from contractors,? said Showoff.com creator and VisApp founder Bobbie Ayers.
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Showoff.com displays a wide variety of Home Improvement and Landscaping? images in the Showcase of Products which are presented virtually for users to drop onto the picture of their home? for a complete photo-realistic design.? The site remains free to users as manufacturers, suppliers, contractors and other businesses provide the product information and images for homeowners to view real-world, brand name products in their projects.
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The Inspiration Gallery on showoff.com contains signature photos and images representing different styles, colors, textures and products available in the marketplace to inspire ideas. A very nice feature of showoff.com permits users to browse the Showcase of Products and the Inspiration Gallery without registering. PC Magazine ranked Showoff.com the top home improvement application among The Best Free Web Apps of 2011? and 2010.
?The tools in Showoff.com are easy to use for the hobbyist, but sophisticated enough for the most discriminating professional designer or contractor,? Ayers said. ?Our goal is to make designing and planning a fun, creative pursuit, while empowering homeowners to make real-world buying decisions.?
Almost 120 million homeowners are taking on various home improvement and landscaping projects, according to consumer and media research firm Scarborough Research.
About VisApp, LLC
VisApp LLC, based in Sarasota, Fla., is a leading developer of patented visualization technology that offers innovative and easy-to-use visualization software tools to individuals and businesses. VisApp?s flagship application for homeowners, Showoff.com, lets users design and visualize home improvement projects, select from a catalog of suppliers? products available in the marketplace, and connect with suppliers and contractors. PC Magazine ranked Showoff.com the top home improvement application among The Best Free Web Apps of 2011? and 2010. In March 2012 the website received the BizTech Innovation Award for ?Best Website for Business and Leads.? VisApp also provides a lead generation service for contractors, and allows contractors and suppliers to host the Visualizer on their own websites. For more information visit the company?s website at www.showoff.com.
It's been fun to watch Bleacher Report grow from some random publishing site for amateur sports writers to a full-blown digital sports network backed by $40+ million in venture capital. Today, with 25 million unique visitors per month, Bleacher Report has become the fourth largest sports media property on the Web. Over the last year or so, the popular sports network has been doubling down on its team-specific coverage, convinced that this has become the preeminent way that fans follow sports. Since January, the startup's so-called Team Stream apps have lived on iPhone, Android, and the iPad, offering fans personalized dashboards with headlines, top stories, and tweets from their favorite teams. And today, Bleacher Report is bringing Team Stream to its home page.
A judge praised Lindsay Lohan on Thursday for completing a probation term, but warned the perennially-troubled US actress to "stop nightclubbing" and to behave in a more mature fashion in future.
The Obama administration argued to the U.S. Supreme Court this week that people must be compelled to buy medical insurance (designed by the government) or the national medical-insurance market will fail. Thus, Obamacare advocates say, the insurance mandate is consistent with the powers delegated under the Commerce Clause of the U.S. Constitution.?The argument, however, contains a fatal flaw. If the medical-insurance market would indeed fail without a mandate, writes Sheldon Richman, it?s only because of other mandates the government has already imposed. Thus the government has created the rationale for an extension of its own power.
The Greater Dallas Business Ethics Awards is pleased to announce that Hunton & Williams, LLP and Mesirow Financial Consulting will take the lead in supporting the 2012 awards program.
?These are organizations that believe in doing the right thing, and their support of the Greater Dallas Business Ethics Award is part of their commitment to promoting those companies ?who do good? in our business community,? says Gary Morris, Chairman, Greater Dallas Business Ethics Awards.
Please join Hunton & Williams, LLP, Mesirow Financial Consulting and the Dallas business community at the 2012 Greater Dallas Business Ethics Awards on Thursday, May 3, 11:30 a.m.-1 p.m. at the Westin Galleria Hotel.
Updated at 8:54 a.m. ET: Qatar-based news channel al-Jazeera has pledged not to air footage of the killings carried out in France by an al-Qaida-inspired gunman after President Nicolas Sarkozy pleaded with broadcasters not to show the disturbing scenes.
France is still coming to terms with Mohamed Merah's close-range shootings of three Jewish children, a rabbi and three soldiers in the south of the country.
The killings were filmed by Merah using a camera attached to his body, BBC News reported.
"I call on executives of all TV stations that may have the images in their possession not to broadcast them under any pretext out of respect for the victims and for France," Sarkozy said following a meeting with police chiefs in Paris.
Al-Jazeera, which received a memory stick containing the footage, later announced it would not broadcast the video because it "did not add any information that was not already in public domain" and also "did not meet the television station's code of ethics for broadcast."
Sarkozy: Some Muslim clerics 'not welcome on French soil'
Zied Tarrouche, al-Jazeera's bureau chief in Paris, told French chanel BFM TV he had watched the video and it showed all of the killing.
"You see all of the attacks carried out in Toulouse and Montauban, that's to say the murder of the first soldier, then the three soldiers and finally the attack on the school," he was quoted as telling the channel in a BBC report.
"You hear the voice of the person who carried out the killings," he added. "You also hear the victims' cries. My feelings are those of any human being who sees horrible things."
The BBC said Mr Tarrouche told the channel the video also contained a mixture of religious songs, readings and Koranic verses.
The package sent to al-Jazeera was dated Wednesday, March 21 - the day that police surrounded Merah in his apartment in the city of Toulouse after a massive manhunt, according to a report in the Parisien daily newspaper.
French special forces shot the young Islamist the following day after a 30-hour siege.
"Investigators are trying to find out whether the letter was posted Tuesday night by Mohamed Merah himself or by an accomplice Wednesday morning," the newspaper wrote.
The Paris prosecutor in charge of the case said last week that the Merah had filmed each of the shootings.
The killings, and subsequent calls for tougher measures to monitor Islamic extremism, come a month before the French presidential election.
NBC News, Reuters and msnbc.com staff contributed to this report.
BRUSSELS (Reuters) ? The euro zone?s public debt crisis is not over despite calmer financial markets this year, the OECD said on Tuesday, with a warning that the bloc?s banks remain weak, debt levels are still rising and fiscal targets are far from assured.
As the euro zone heads into its second slump in just three years, the Organization for Economic Co-operation and Development (OECD) said the 17-nation area needed ambitious economic reforms and there could be no room for complacency.
?Market confidence in euro area sovereign debt is fragile,? the Paris-based economic think tank said in a report on the state of the euro zone?s health. ?The outlook for growth is unusually uncertain and depends critically on the resolution of the sovereign debt crisis,? it said.
In a departure from forecasts by the International Monetary Fund and the European Commission , the OECD sees 0.2 percent growth in the bloc in 2012, rather than an outright contraction.
While international economists are divided over just how deep any downturn will be this year, most agree that weak business confidence and budget austerity is eating into the purchasing power of European households, driving up unemployment and leaving Asian and U.S. demand holding the key to growth.
Two years into the euro zone?s sovereign debt saga, EU leaders? commitment to fiscal discipline and the European Central Bank ?s stimulus of 1 trillion euros to banks has cooled the panic in money markets late last year that drove Italian and Spanish bond yields to near unsustainable levels.
Euro zone government debt levels are likely to reach 91 percent of economic output next year, even as the bloc enacts some of the deepest austerity programs in half a century, and well above the European Union limits for a healthy economy.
For full multimedia coverage: ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^>
?MOTHER OF ALL FIREWALLS?
The OECD, which tracks industrialized economies to promote growth, cautioned that deficit-cutting goals needed to strike a balance with what was realistic and politically possible, or the EU?s enforcement systems could lose credibility.
The euro zone must ?set out more credible and detailed medium-term budgetary plans?, the OECD said. The crisis may have increased policymakers? determination to impose austerity, but recessions this year in southern European countries may make it harder for euro zone leaders and the European Commission to impose sanctions on member states should they miss targets.
Spain?s Prime Minister Mariano Rajoy won a more relaxed 2012 deficit goal at a meeting of euro zone finance ministers earlier in March, but a looming recession will make even that a stretch.
Strengthening banks is also critical to any resolution of the crisis, while the bloc must agree a big enough financial firewall to stand behind the indebted economies of Italy and Spain, should they be cut off from markets, the OECD said.
Euro zone finance ministers are expected to address both issues at a meeting in Copenhagen on Friday. German Chancellor Angela Merkel signaled for the first time on Monday that she was prepared to consider boosting the firewall?s resources.
?Immediate action is required to ensure sufficient and large-scale availability of a firewall to stop the dynamics of runs against solvent sovereigns,? the OECD said.
OECD chief Angel Gurria has called for ?the mother of all firewalls? ? some 1 trillion euros ? but finance ministers look more likely to agree to a level nearer 700 billion euros.
(Reporting By Robin Emmott; editing by Rex Merrifield)
It's one of the biggest mysteries in flu: why is it a mild infection in some people, and a killer in others? The 2009 pandemic flu often caused no symptoms at all, yet was deadly in some people. Some of those cases, it now appears, may be down to a protein that normally stops some viruses from invading cells ? but which is mutated in some people.
Paul Kellam of the Sanger Institute in Cambridge, UK, and colleagues bred mice with a mutation that stopped them making a protein called IFITM3. This is normally made by cells in response to interferon, an immune signalling chemical that turns on antiviral defences. We know these are important in flu ? the virus only packs 10 genes, and one is devoted to opposing interferon.
Strains of flu that do not normally make mice very sick ? including the 2009 pandemic virus ? left mice without IFITM3 at death's door. The virus penetrated deeper into their lungs, replicated 10 times more, and induced severe pneumonia, just like bad cases of pandemic flu.
Perhaps most tellingly, people in intensive care with severe pandemic or even seasonal flu in the UK were 17 times more likely than Europeans in general to carry a mutant, non-functional gene for IFITM3.
Most of the people with severe flu didn't have the mutant, but "that isn't really surprising", says Kellam, as "many other factors affect the severity of the disease". But IFITM3 seems significant, given its effect in mice and people ? and in cultured human cells, where it reduced viral replication. The team even found that IFITM3 has become more common in humans since 10,000 years ago, just when we are thought to have first caught flu, from livestock.
The protein affects viruses ? which are normally taken up by the cell inside a bubble of membrane ? including dengue and West Nile as well as flu. It stops them reaching the cell nucleus, and instead routes them to waste disposal. The finding suggests that a drug that mimics IFITM3 might fight all those viruses ? or at least that people who make the mutant form should be prioritised for vaccination.
Meanwhile, more basic biological functions can sometimes save us from flu. An analysis of 193 children who caught the deadly H5N1 bird flu found that, as usual with flu, not everyone had a runny nose. Kids under 5 who did, however, were nearly 10 times less likely to die. The study was published last week.
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Film critic Molly Haskell famously described 'The Godfather' as "grandly mournful," a beautifully apt description. 'Once Upon a Time in Anatolia' is just as mournful but without the grandeur -- and without a story.
It beats me why 'Anatolia' took second prize at Cannes last year. But 2011 was a tough year in general for Cannes. Top prize went to "The Tree of Life," which in my view was run-of-the-mill Buddhism tarted up with kaleidoscopic visuals.
In my review of 'Tree,' I described it as a bloated over-statement. I'd describe 'Anatolia' as a bloated non-statement. If it can be imagined, 'Anatolia' has even fewer ideas than 'Tree.' And Cannes was all aflutter over these two films? It must have been a very undistinguished group of films in competition last year.
'Anatolia' is a long, slow, boring dirge. Turkish filmmaker Nuri Ceylan, who has a very good reputation among serious cinephiles (but this is the first Ceylan film I have seen), takes a bunch of middle-aged male actors out to the remote, frighteningly barren countryside of Turkey in the middle of the night and follows them around with his camera as they amble about in a sleep-deprived stupor.
They are playing policemen on a murder investigation. Why they are conducting an investigation in the middle of the night is never explained. Their caravan of broken-down vehicles pulls up to one barren location after the next, and all the men look around the ground for clues. Most of them are overweight, semi-educated imbeciles -- peasants with a high school diploma. The only one with real intelligence is a doctor, who inexplicably is along for the ride.
That doctor becomes the heart of the movie, and gradually he does emerge as a slightly interesting character. But only slightly. He, like all the other characters, has nothing to do, so his character can only be contemplated in the abstract.
In the last half-hour of this overly long film (two-and-a-half hours), I started to feel that Ceylan was a true artist. Probably only a minor one, but a true one. He does have something mournful to say about life and about people that is genuinely artistic. I just don't think he captured his artistic viewpoint very effectively here, either in the writing of the script or the directing of the film shoot.
The cinematography, art direction, and editing is consistently pedestrian. My hunch is that he consciously chose a flat style -- flat neo-realist style is very popular in high-art cinema these days (see also Iran's "A Separation," which has become such an art-house hit in America and is likely to win the Oscar for Best Foreign Film). But I don't think it served Ceylan's purpose at all. I can appreciate that he wanted to portray his characters as mind-numbingly boring and flat. But when the man behind the camera starts to seem mind-numbingly boring and flat, something has gone wrong -- at least for me.
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? TBI Magazine 2007. All rights reserved, site design by TLC Digital TBI is published by Informa Telecoms & Media which is a trading name of Informa UK Limited. Registered in England under no. 1072954 Registered Office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH
As the nation turns its eyes toward the Supreme Court and its review of the Patient Protection and Affordable Care Act (the "ACA") this coming week, people living with HIV and their advocates will be among those watching carefully and most anxiously awaiting the outcome. For many of the approximately 1.2 million people with HIV in this country, the Court's decisions will directly affect access to quality care and life-saving treatment. Though not by any means the only group with a great deal at stake here, those affected by HIV present an exceptionally strong example of the positive impact the ACA will have, and a particularly compelling argument for the statute's constitutionality.
People living with HIV have been systematically excluded from the health-care insurance and health-care markets. Only 17 percent of people living with HIV have private health insurance, compared with 67 percent of the general population. While some of the remaining 83 percent have insurance through public programs (e.g., Medicare, Medicaid, the VA, etc.), nearly 30 percent are forced to rely exclusively upon the often spotty benefits provided through the overburdened and underfunded Ryan White programs, or to go without care altogether.
The consequences of this patchwork quilt of health care for people living with HIV are devastating: they discover their status later, go longer without lifesaving care and treatment, suffer greater complications and poorer health outcomes, and continue to die at frustratingly high and unnecessary rates. These negative consequences are more pronounced and concentrated in already marginalized populations, such as low-income communities; the gay, bisexual, and transgender communities; and communities of color -- most acutely, the black community.
We have at our disposal the means to avoid many of these consequences. Antiretroviral medications (ARVs) provide us with the opportunity to seriously impede progression of the disease, especially when it is discovered in a timely fashion, to prevent most of the complications and poor health outcomes associated with an AIDS diagnosis, and to dramatically reduce the number of AIDS-related deaths each year. For those with access to consistent, quality care and treatment, HIV can now be a chronic, manageable condition -- akin to diabetes or high blood pressure.
What's more, quality care and effective treatment for those currently living with HIV will significantly curtail the further spread of HIV. ARVs work by reducing the level of virus in a person's blood to extremely low levels -- and the less virus in the blood, the lower the chances of transmitting the disease. Recent studies show that the already-lower-than-generally-realized risk of contracting HIV sexually is reduced by up to 96 percent when a person's viral load is suppressed to undetectable levels. Not only is near-universal access to quality health care good for people living with HIV, but it is also one of the best prevention tools we have.
The positive effects of the ACA and the near-universal access to health care it will provide to people living with HIV by 2015 are not just theoretical. Massachusetts, where health-care reform similar to the ACA was enacted years ago, experienced a 37-percent reduction in new HIV infections from 2005 to 2008, while the rest of the country experienced an 8-percent increase. And Massachusetts's age-adjusted HIV/AIDS death rate is almost half the national average (2 percent vs. 3.7 percent). These statistics, and the improved circumstances they describe, foretell what the nation can expect when the ACA is fully implemented.
When viewed through the prism of the HIV/AIDS epidemic, the argument for the constitutionality of the ACA's minimum coverage requirement (or "individual mandate") is relatively simple. Congress has the power to address the exclusion of a particular group -- specifically people living with HIV, but more broadly anyone with a pre-existing condition -- from a market that operates in interstate commerce. But the ban on preexisting condition exclusions will not work without the accompanying individual mandate, which requires every American to become a part of the health-care insurance pool regardless of their current health status. For that reason, the individual mandate is a necessary and proper means by which Congress can effectuate its clearly constitutional power to regulate an interstate market under the Commerce Clause.
Full implementation of the ACA is absolutely critical in our battle against HIV/AIDS. Public health authorities are already talking about the "end of AIDS," meaning the ability to prevent a person's progression from HIV-positive to an AIDS diagnosis and the most detrimental effects of the disease. Let's hope the Supreme Court recognizes the constitutionality of the action Congress took when it passed the ACA, which will similarly prevent our nation's broken health-care system from going from bad to worse -- not just for people living with HIV but for all of us.
For a more detailed explanation of the legal arguments discussed above, read the friend-of-the-court brief submitted by Lambda Legal on behalf of 16 HIV advocacy groups, which was subsequently endorsed by 130 more groups.
[unable to retrieve full-text content]Site Meter · Eastside Writer Article Directory > Communications > Mobile Phones > How Cell Phone Accessories Keep A Cellphone Secure ... The mobile phone that stormed its way to the shelves is the Motorola Droid 3.
MRI screening for women with a family history of breast cancer but no genetic predispositionPublic release date: 21-Mar-2012 [ | E-mail | Share ]
Contact: Emma Mason wordmason@mac.com ECCO-the European CanCer Organisation
Expensive but could be cost-effective for some
Vienna, Austria: Adding magnetic resonance imaging (MRI) to standard breast cancer screening approaches is expensive, though it could be cost effective for a group of women who may not have inherited the breast cancer susceptibility genes, but who have a familial risk of developing the disease. This is the conclusion of research presented at the eighth European Breast Cancer Conference (EBCC-8) today (Wednesday).
Women who carry the BRCA1/2 gene mutations are known to be at much higher risk of developing breast cancer, and at an early age; for this reason most breast cancer screening programmes start examining them with mammography from a younger age than for the general population in order to reduce deaths from the disease in this high-risk group. The use of MRI in addition has been shown to be cost-effective for these women who carry the BRCA1/2 mutations or who have a 50% (or higher) risk of carrying it. However, until now it has not been clear whether it is cost-effective for women who do not carry the mutations, but who have first and/or second degree relatives with breast cancer, to have MRI examinations as well as standard mammography. These women have a 20% or greater chance of developing breast cancer by the age of 70 due to their familial medical history.
A group of researchers in The Netherlands conducted a cost-effectiveness analysis of 1,597 women enrolled in the Dutch MRI Screening Study between 1999 and 2007, who had an estimated cumulative lifetime risk of between 15-50% for developing breast cancer before the age of 70. The women were screened by way of a clinical breast examination every six months and an annual mammography and MRI between the ages of 25-70.
The researchers used data on diagnosis, screening and treatment costs of the women with familial risk to calculate the cost per detected cancer and estimate the life-years gained. Then they used a computer modelling technique called microsimulation to simulate screening programmes with different methods of screening and time intervals.
"We found that it costs approximately three times as much to add MRI to the screening process for every estimated one year of life saved," said Dr Sepideh Saadatmand, who is a physician and PhD student at the Erasmus University Medical Center (Rotterdam, The Netherlands). "When women were screened using clinical breast examinations, mammography and MRI, the cost per detected cancer was about 103,000. We predicted that screening women between the ages of 35-60 in this way would reduce deaths from breast cancer by 24%, at a cost per year of life gained of 30,000.
However, if these women were screened by annual mammography and clinical breast examination alone, the estimated reduction in deaths was 20%, at a cost per year of life gained of 10,000.
"It is clear from the results of this study that adding MRI to screening programmes for all women with a cumulative life time risk of 15-50% for breast cancer is highly effective, but possibly too expensive. However, it may be cost-effective for a select sub-group."
She continued: "The subgroups we expect to benefit from MRI screening are women with a cumulative lifetime risk above 20% due to their family history, who have very dense breast tissue. Breast density may strongly influence screening results, since it increases breast cancer incidence significantly and decreases the sensitivity of mammography, but not of MRI. Therefore, for women with high breast density, MRI might be cost-effective. There is a multi-centre randomised controlled trial running in The Netherlands to investigate this."
The randomised controlled trial, with which Dr Saadatmand is involved, is expected to finish in 2015. It is randomising women aged between 30-55 with a family history of breast cancer and a cumulative lifetime risk of over 20% for developing the disease into two groups: 1) annual screening by clinical breast examination and mammography, or 2) annual screening by breast examination and MRI, with a mammography every other year. Researchers will be looking at the number of tumours detected at screening examinations and in between examinations (interval tumours), and at how advanced the cancer is when diagnosed. They will also be taking into account the varying densities of the women's breasts.
Dr Saadatmand concluded: "The results of the cost-effectiveness study presented today are likely to be of relevance to other countries that have screening programmes similar to The Netherlands, such as the UK and the Scandinavian countries."
Professor David Cameron, from the University of Edinburgh (Edinburgh, UK), and chair of EBCC-8 said: "This study produces an estimate of the cost-benefit of additional MRI in screening high-risk women. It will inform the important ongoing debate about the role of MRI in screening, particularly for younger women who have a higher-than average lifetime risk of developing breast cancer."
###
Abstract no: 27, Wednesday 17.30 hrs, proffered paper session on screening, Hall F1.
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MRI screening for women with a family history of breast cancer but no genetic predispositionPublic release date: 21-Mar-2012 [ | E-mail | Share ]
Contact: Emma Mason wordmason@mac.com ECCO-the European CanCer Organisation
Expensive but could be cost-effective for some
Vienna, Austria: Adding magnetic resonance imaging (MRI) to standard breast cancer screening approaches is expensive, though it could be cost effective for a group of women who may not have inherited the breast cancer susceptibility genes, but who have a familial risk of developing the disease. This is the conclusion of research presented at the eighth European Breast Cancer Conference (EBCC-8) today (Wednesday).
Women who carry the BRCA1/2 gene mutations are known to be at much higher risk of developing breast cancer, and at an early age; for this reason most breast cancer screening programmes start examining them with mammography from a younger age than for the general population in order to reduce deaths from the disease in this high-risk group. The use of MRI in addition has been shown to be cost-effective for these women who carry the BRCA1/2 mutations or who have a 50% (or higher) risk of carrying it. However, until now it has not been clear whether it is cost-effective for women who do not carry the mutations, but who have first and/or second degree relatives with breast cancer, to have MRI examinations as well as standard mammography. These women have a 20% or greater chance of developing breast cancer by the age of 70 due to their familial medical history.
A group of researchers in The Netherlands conducted a cost-effectiveness analysis of 1,597 women enrolled in the Dutch MRI Screening Study between 1999 and 2007, who had an estimated cumulative lifetime risk of between 15-50% for developing breast cancer before the age of 70. The women were screened by way of a clinical breast examination every six months and an annual mammography and MRI between the ages of 25-70.
The researchers used data on diagnosis, screening and treatment costs of the women with familial risk to calculate the cost per detected cancer and estimate the life-years gained. Then they used a computer modelling technique called microsimulation to simulate screening programmes with different methods of screening and time intervals.
"We found that it costs approximately three times as much to add MRI to the screening process for every estimated one year of life saved," said Dr Sepideh Saadatmand, who is a physician and PhD student at the Erasmus University Medical Center (Rotterdam, The Netherlands). "When women were screened using clinical breast examinations, mammography and MRI, the cost per detected cancer was about 103,000. We predicted that screening women between the ages of 35-60 in this way would reduce deaths from breast cancer by 24%, at a cost per year of life gained of 30,000.
However, if these women were screened by annual mammography and clinical breast examination alone, the estimated reduction in deaths was 20%, at a cost per year of life gained of 10,000.
"It is clear from the results of this study that adding MRI to screening programmes for all women with a cumulative life time risk of 15-50% for breast cancer is highly effective, but possibly too expensive. However, it may be cost-effective for a select sub-group."
She continued: "The subgroups we expect to benefit from MRI screening are women with a cumulative lifetime risk above 20% due to their family history, who have very dense breast tissue. Breast density may strongly influence screening results, since it increases breast cancer incidence significantly and decreases the sensitivity of mammography, but not of MRI. Therefore, for women with high breast density, MRI might be cost-effective. There is a multi-centre randomised controlled trial running in The Netherlands to investigate this."
The randomised controlled trial, with which Dr Saadatmand is involved, is expected to finish in 2015. It is randomising women aged between 30-55 with a family history of breast cancer and a cumulative lifetime risk of over 20% for developing the disease into two groups: 1) annual screening by clinical breast examination and mammography, or 2) annual screening by breast examination and MRI, with a mammography every other year. Researchers will be looking at the number of tumours detected at screening examinations and in between examinations (interval tumours), and at how advanced the cancer is when diagnosed. They will also be taking into account the varying densities of the women's breasts.
Dr Saadatmand concluded: "The results of the cost-effectiveness study presented today are likely to be of relevance to other countries that have screening programmes similar to The Netherlands, such as the UK and the Scandinavian countries."
Professor David Cameron, from the University of Edinburgh (Edinburgh, UK), and chair of EBCC-8 said: "This study produces an estimate of the cost-benefit of additional MRI in screening high-risk women. It will inform the important ongoing debate about the role of MRI in screening, particularly for younger women who have a higher-than average lifetime risk of developing breast cancer."
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Abstract no: 27, Wednesday 17.30 hrs, proffered paper session on screening, Hall F1.
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In this Feb. 25, 2012 photo, students rehearse with accordions in a practice room at the Kumsong school in Pyongyang, North Korea. A group from the school became an Internet sensation with their accordion version of 1980's pop group A-ha's "Take on Me." (AP Photo/Kim Kwang Hyon)
In this Feb. 25, 2012 photo, students rehearse with accordions in a practice room at the Kumsong school in Pyongyang, North Korea. A group from the school became an Internet sensation with their accordion version of 1980's pop group A-ha's "Take on Me." (AP Photo/Kim Kwang Hyon)
In this Feb. 25, 2012 photo, students rehearse with accordions in a practice room at the Kumsong school in Pyongyang, North Korea. A group from the school became an Internet sensation with their accordion version of 1980's pop group A-ha's "Take on Me." (AP Photo/Kim Kwang Hyon)
In this Feb. 25, 2012 photo, students rehearse with accordions in a practice room at the Kumsong school in Pyongyang, North Korea. A group from the school became an Internet sensation with their accordion version of 1980's pop group A-ha's "Take on Me." (AP Photo/Kim Kwang Hyon)
In this Feb. 25, 2012 photo, students rehearse with accordions in a practice room at the Kumsong school in Pyongyang, North Korea. A group from the school became an Internet sensation with their accordion version of 1980's pop group A-ha's "Take on Me." (AP Photo/Kim Kwang Hyon)
PYONGYANG, North Korea (AP) ? Five teenagers in school uniforms hold accordions. On the wall is a giant painting of the secret mountain hideout of their nation's founder, Kim Il Sung. Small red stickers on their instruments mark them as gifts from Kim Jong Il.
Yes, this is North Korea. But as they grind their accordions into song, what comes out is no somber ode to either of the late leaders. Instead, as more than 1.5 million YouTube viewers already know, it's one of the poppiest of 1980s pop songs, A-ha's "Take on Me."
The three young men and two women perform with gusto, swaying to the music, tapping their accordions and clapping their hands overhead. Their catchy cover, recorded in December, became a sensation as it challenged the world's preconceptions about North Koreans.
After taking their arrangement to Norway to perform at an Arctic arts festival, lead player Choe Hyang Hwa and fellow band members gave The Associated Press a peek into their lives at the Kumsong school in Pyongyang.
Outside, a gaggle of students marched across the school yard in twos, arms thrown around one another and lunch pails swinging from their hands. They walked past a huge mosaic depicting North Korea's founder, Kim Il Sung, and his son and successor, Kim Jong Il, with students working at computer terminals.
Inside, one young woman received a private lesson on the kayagum, a traditional Korean stringed instrument, while her teacher played a traditional drum called a janggo.
Elsewhere, students in a classroom with portraits of the two late leaders above the blackboard sat hunched over scores, tapping fingers and pencils as they practiced singing classical European songs.
And then there was the "Take on Me" quintet, who happily took up their seats on white stools to re-enact their famous performance. Most North Koreans don't have access to YouTube because of tight government restrictions.
Lead accordionist Choe, a 17-year-old army officer's daughter from the border city of Kaesong, said the students study in the morning, and then practice the accordion in the afternoon. In one classroom, they gathered around a laptop computer with scores and notebooks. Later, one student chatted on a cell phone as the rest passed around plates of food: tofu, sausages, boiled eggs and oranges.
Norwegian artist Morten Traavik, who recorded the video during a trip to the school, said the performance hints at how much outsiders don't know about North Koreans.
"For many it is a revelation that North Koreans open up and play Western pop music with such great joy," he said last month.
"My idea is to challenge our perceptions of North Koreans, which is extremely negative and stigmatized," he said. "Like other people, they are proud of their country and nature."
Traavik invited the ensemble to an arts festival last month in Kirkenes, on Norway's Arctic border with Russia.
As the group performed, 250 Norwegian border guards holding colored flipboards created a small-scale version of the giant human mosaics performed at the Arirang "mass games" in Pyongyang ? but with polar bears and reindeer herders.
The audience was "greatly impressed and marveled at us, saying that young schoolchildren play the accordions very well," 15-year-old accordionist Kim Chon Ryong told the AP.
"At that time, I once again felt proud, and confident in myself, as a student of 'army-first' (North) Korea," he said, repeating a phrase used to describe late leader Kim Jong Il's military-focused rule.
The trip to Norway, "far from our fatherland," was the students' first abroad, Kim said.
Kumsong School, not far from the cottage where Kim Il Sung was born, is one of North Korea's most famous institutes for the arts and sciences.
Students are selected from cities and villages across the nation to study, said accordion instructor Im Yu Sun. Four of the students who traveled to Norway hail from small provincial towns outside Pyongyang, she said.
___
Associated Press writer Pak Won Il contributed to this story from Pyongyang.
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Fruit flies that haven't mated recently are more likely to ingest alcohol, according to a recent study.
Chronically sex-deprived fruit flies will take refuge in booze, while just-mated flies are more likely to take a pass on the alcohol, new research suggests.
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The alcoholic tendencies of the chronically rejected flies seem to be a result of decreased levels of a brain chemical called neuropeptide F (NPF), which researchers think plays a role in the fly's reward system.
When the fly does something that would be good for it evolutionarily, such as mating or eating food, an internal mechanism increases NPF levels. But NPF also can be turned up by outside factors, including alcohol. (Flies have no trouble finding alcohol, which is created by their favorite food: yeast on rotting fruit.)
"What we discovered was an interplay between internal rewards and external rewards," said study researcher Galit Shohat-Ophir of the Howard Hughes Medical Institute's Janelia Farm Research Campus, in Virginia. She did the research as a part of the Ulrike Heberlein's lab there.
"There's some kind of system in the brain, which we think NPF is regulating, that represents the level of internal reward. If there is perturbation in the level of NPF in the brain, there are behaviors that will return the levels back to normal," Shohat-Ophir told LiveScience.
Humans have a similar neuropeptide, called neuropeptide Y, in their brains. Researchers studying humans and other mammals have found a link between NPY and reward-related behaviors such as eating (and overeating).
NPY is known to inhibit alcohol consumption, and mutations in NPY have been seen in groups of alcoholics in correlational studies. Researchers have been working with NPY in mammals and NPF in flies to get a better understanding of alcoholism and to possibly design treatments for it.
Fly dates and drinking
To see how sex impacts fly drinking, the researchers placed virgin male flies in a dish with either virgin females or with already-mated females, which unlike the virgins will reject the males.
The male flies were paired up three times a day for four days before they were given the opportunity to booze it up: They were offered regular food and food with 15 percent alcohol. Mated flies drank almost no alcohol, preferring the booze-free food, while rejected flies drank twice their body weight's worth. Virgin males that had never been paired up with a female in the lab were somewhere in the middle: moderate drinkers.
"From the experiments we've done, our hypothesis is that it [alcohol] affects the fly's brain in a way similar to how it affects ours," Shohat-Ophir said. "The alcohol increases their NPF levels."
Modulating NPF
After sex a male fly's NPF levels were high (their intrinsic reward for mating), so they didn't need alcohol to increase their NFP levels. When they failed at courting females, their NPF levels were low and they went in search of outside ways to activate their reward centers, by drinking.
Researchers can test in the lab how much of a reward the flies find alcohol by pairing it with a smell and seeing whether the flies remember it. When the experiment is run on a fly with normal NPF levels, the fly will hold onto this rewarding memory of the alcohol. But if conducted on a fly with heightened levels of NPF, the alcohol will no longer be perceived as rewarding.
"This explains why mated flies in our system, which we think have higher NPF, don't consume alcohol," Shohat-Ophir said.
The study was published today (March 15) in the journal Science.
You can follow LiveScience staff writer Jennifer Welsh on Twitter @microbelover. Follow LiveScience for the latest in science news and discoveries on Twitter @livescience?and on Facebook.
Most communities have so-called truths which give rise to standards of behavior. Over time, some ideas get replaced by others, but a core set of beliefs often remains. Within Judaism -- where debate is encouraged -- how far can one go in advancing one's own values or convictions until one is out of the intellectual or spiritual fold?
On a recent evening, I came across a 1987 ruling by the Conservative movement's Committee on Jewish Law and Standards (CJLS), the body that issues teshuvot (responsa) from which rabbis can draw for guidance. Written by Rabbi David H. Lincoln, the committee voted unanimously that an "avowed atheist" should be barred from serving as a prayer leader. As someone who had been a finalist in Moment Magazine's "Elephant in the Room" essay contest on "Godless Judaism," I stopped short. I wondered if I would be turfed from the roster of lay leaders who serve as occasional prayer leaders at my synagogue, and for which I've spent months training over the past few years.
But what I puzzled over more generally, was whether Judaic standards are merely prescriptive, or whether they are meant to describe communities as they are. How many of my fellow worshippers might actually feel similarly to me but hadn't bothered putting their cosmology to pen and paper?
I soon learned that a rabbinical student at the Ziegler School of Rabbinic Studies had written a follow-up to Lincoln's teshuva for Rabbi Elliot Dorff's class on Conservative Judaism. A podcast reveals a provocative conversation between Matt Shapiro (who agreed with Lincoln's conclusions but issued a much broader explanatory discussion), his fellow students and Reb Mimi Feigelson. A Hasid in her spiritual approach, Reb Mimi, as she is known, disagreed with Shapiro's conclusions. An atheist who nevertheless wishes to be a prayer leader shows "honesty" and "courage," she argued.
I recently spoke to Shapiro directly. If belief in God "is at the heart of Judaism," as he put it to me, how can we negotiate between personal and communal values and convictions (including belief -- or not -- in God) on one hand, and collective norms and standards on the other? I asked him.
"At the seminary, our personal values are recognized as having tremendous importance, as is the tradition. The dance between the two is what makes up the heart of Conservative Judaism," Shapiro said.
He added, "I wouldn't be becoming a rabbi if I didn't think the text was important, but I also cannot deny my personal convictions in terms of equality, freedom and general openness in society. Those are foundational values."
Shapiro wrote his thesis on Hans-Georg Gadamer, a pioneer of the hermeneutic method, where the reader is meant to engage in a direct conversation with the text. It seems to me this approach will no doubt serve Shapiro well as he shifts into his professional rabbinic career, especially in light of contemporary values discussions, whether or not the question of faith per se is at the forefront of those debates.
One such issue that has lately come into sharp focus concerns GLBT inclusion. A 2006 CJLS ruling created a significant opening for public congregational gay and lesbian life. Almost six years later, the authors of the original paper are drafting a same-sex marriage ceremony which is expected to be voted on in late May.
I spoke with Rabbi Aaron Alexander, an associate dean at Ziegler who is also a member of the CJLS. Alexander has performed same-sex marriages using a ceremony he wrote with Rabbi Elianna Yolkut and is looking forward to seeing the final draft of the version when it comes before the committee.
"Halakha is so much more than a set of laws. It is the dynamic interaction between God, history, sacred text, authority, narrative and living people." Alexander explained. "I think that at its very core, what Jewish law wants to do is to uplift humanity and dignity, not to subvert it."
Alexander had been recently part of a landmark deliberation: allowing deaf Jews to sign the chanting of the Torah. "I was moved watching [the ruling] happen."
Many rabbi-scholars like Rabbi Bradley Shavit Artson, who advocates Process Theology, or Rabbi Arthur Green, who advances what he calls "radical Judaism," are succeeding in broadening the contemporary debate around conceptions of God. But particularly in an age where debate around Godlessness is coming squarely into the mainstream of Western thought, I don't think the question of belief is going to be settled anytime soon. And it may not need to be.
As interesting as issues surrounding faith are intellectually, and as important as they may be to private experiences of spirituality, values surrounding human dignity -- and particularly the role of those who have long been excluded from Judaic life -- might be those we need to focus on in setting community standards, while bracketing private issues of faith commitments.
If we want to make sure our communities are healthy, robust and inclusive -- and are able to withstand the test of time as the world comes to shed many of the prejudices of the past while continuing to open itself to a range of beliefs and new vocabularies around them -- this may prove essential.
An earlier version appeared on Haaretz.com.
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[unable to retrieve full-text content]If you run your own business, you should know how important it is to have proper risk management. You need to be prepared in today's competitive market place.
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Question by : What is the percentage of personal retirement (401k, 403b, IRA, roth IRA) that are invested in Wall Street ? Trying to find what amount of the personal retirement funds are invested in the NASDAQ and NYSE Best answer: Answer by
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The Obama administration argued to the U.S. Supreme Court this week that people must be compelled to buy medical insurance (designed by the government) or the national medical-insurance market will fail. Thus, Obamacare advocates say, the insurance mandate is consistent with the powers delegated under the Commerce Clause of the U.S. Constitution.?The argument, however, contains a fatal flaw. If the medical-insurance market would indeed fail without a mandate, writes Sheldon Richman, it?s only because of other mandates the government has already imposed. Thus the government has created the rationale for an extension of its own power.
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