LONDON -- Time Warner's Turner Broadcasting System International unit said Tuesday that it plans to cut about 30 percent of the staff in its Europe/Middle East/Africa (EMEA) business as part of a restructuring that will give more power to regions and cut back on central functions.
The company's overall EMEA business includes about 900 positions, so about 250-plus positions are expected to be eliminated in the restructuring. ? Gerhard Zeiler, president of TBS International, unveiled the organizational shake-up. "Some functions, which can be handled externally at the same quality, will be outsourced," the company said. It didn't detail the annual savings from the cuts.
Turner International said it anticipates the 30 percent reduction in positions across the EMEA business to become effective upon completion of a consultation process with staff representatives. "This estimation comprises open headcount, positions that became vacant and are not being reoccupied, redundancies and outsourcing," it said without detailing the likely timing of the moves. ? The decisions are part of a review process for its EMEA business that Turner International launched in September.
?This review required us taking some tough decisions, but they are absolutely necessary to put Turner International in the best possible position for future growth,? said Zeiler. ?Greater empowerment and broader accountability for local management will lead to simplified processes throughout the organization, improved efficiency and reduced costs.? ? Turner Broadcasting System International operates more than 100 channels that are versions of core Turner brands, such as CNN, TNT, Cartoon Network and Turner Classic Movies, in more than 30 languages in 200 countries around the world. Turner's EMEA business has 17 branded channels in 27 languages in more than 100 territories.
Buy on the merchant's online shopping and scan reviews. If you're attempting to seek out Stepmonster: A New Look at Why Real Stepmothers Think, Feel, and Act the Way We Do with special price. This is the most effective deals for you. Where you could realize these item is by on-line shopping stores? Read the review on Stepmonster: A New Look at Why Real Stepmothers Think, Feel, and Act the Way We Do Now, it's the simplest deal. Thus don't lose it.
Stepmonster: A New Look at Why Real Stepmothers Think, Feel, and Act the Way We Do by Wednesday Martin (85)
New!: $25.00$16.50 (as of 01/15/2013 21:54 PST) 60 Used! | New! from $13.01 (as of 01/15/2013 21:54 PST)
Stepparenting & Blended Families
An honest and groundbreaking guide to understanding the complicated emotions that develop between stepmothers and children.
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When faced with often overwhelming challenges, what woman with stepchildren is unfamiliar with that ?stepmonster? feeling? Half of all women in the United States will live with or marry a man with children. To guide women new to this role?and empower those who are struggling with it?Wednesday Martin draws upon her own experience as a stepmother. She's frank about the harrowing process of becoming a stepmother, she considers the myths and realities of being married to a man with children, and she counteracts the cultural notion that stepmothers are solely responsible for the problems that often develop. Along the way, she interviews other stepmothers and stepchildren and offers up fascinating insights from literature, anthropology, psychology, and evolutionary biology that explain the little-understood realities of this unique parent-child relationship and?in an unexpected twist?shows why the myth of the Wicked Stepmother is the single best tool for understanding who real stepmothers are and how they feel.
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Rank: #34268 in Books
Published on: 2009-05-04
Original language: English
Number of items: 1
Dimensions: 1.10" h x 6.20" w x 9.00" l, 1.05 pounds
First off, let me say this: No one was hurt. Regular readers know that I don?t generally write about local car accidents ? unless there is an appellate decision or something legally noteworthy about them. But this was an accident that my family was in.
It was the Wednesday before Thanksgiving, and I was in the front passenger seat with Mrs. NYPILB behind the wheel. We made a right at a light from one main road to another. And out of a parking area on our right came an SUV trying to cross the road. Presumably to get to the other side.
Except that we were passing in front of him; and he t-boned us. Right into the passenger side, with the brunt of the force on the back door where my son was sitting, engrossed in a book.
There are several things that might race through the brain at this point, of which these are three:
1. The Parent (Are my kids OK, and how do we make sure there is no further potential for accident or injury?)
2. The Lawyer (The other driver failed to yield the right of way)
3. ?The bureaucrat (Closely linked to the lawyer, this one seeks documentation to make sure that the ?i?s are dotted and the ?t?s crossed with respect to insurance companies.)
Now this is ?not the first time I?ve written about an accident that I was in. It happened five years ago when a car with no lights and no license plates stopped in the middle of the parkway at night. I was driving and I stopped in time. One of the cars behind me did not.
The view of the inside, with the door closed, where my son was sitting
And you know what? I?m no better prepared today for being in an accident than I was back then; because accidents are unexpected. If we expected them, well, we have a better chance of avoiding them.
Because they are unexpected, we often don?t really know, at the time of the impact, the answers to the questions that may one day flow if someone was really injured and an investigation or lawsuit ensued.
How fast were you going?
What lane where you in? (How many lanes were there?)
Where did you look in the seconds before the accident?
Where, exactly, ?were you?
While that last question might seem a bit silly, it really isn?t, most especially if it is a highway that you have driven ?hundreds of times. Your brain might well be on auto-pilot and while you know generally where you are, the exact location isn?t something that you were keyed in to. You might know, for example, that you needed exit 56, and that you were somewhere around exit 30, give or take. You don?t know exactly, because it isn?t particularly relevant.
The reality is that most of our ?recollection? of an accident is our brain reconstructing what has happened as we spin our heads around and say WTF? And when we reconstruct things, we tend to fill in the blanks. This is a mental process that I like to refer to has ?normal human behavior.? The psychs like to call it reconstructed memory, and will tell you that the brain abhors a vacuum so it provides the filler it believes to be logical.
But it?s odd when your own brain may be doing the the reconstructing, not someone else?s.
This fill-in-the-blanks view of an accident will generally lead to conflicting accounts of an event. People see things through the prism of their own experiences, both past and present and upon review of the event that just took place, and fill in the missing blanks. We may now see mileposts and exit markers, when before we were just driving merrily along knowing that we were roughly 15 minutes from our exit and keeping an eye on the car in front of us. We see intersections and people (aka witnesses) that we hadn?t really noticed or appreciated before. Because the accident, almost by definition, happened very fast and we had no time to react.
And, of course, the adrenal gland has decided that this would be a magnificent time to give the body a good old shot of hormone that sends the heart and mind racing.
After an accident, nothing is normal at all. But that moment when the mind and body are reeling is the moment the brain is imprinted with the ?details? of recollection. Since those recollections are experienced through the prisms of our own histories, the lawyer might well ?see? something different in an accident than the doctor, mechanic or cop.
All of this is something that the reader likely already knows, on an intellectual level. And yet, when one actually goes through the event, it doesn?t really matter. The god?s eye view of what happened ? that fly on the wall view of things ? may well be distorted by emotion, by experience and by reconstruction.
I wrote this post six weeks ago and have been sitting on it ever since, hoping I could come up with some kind of snappy conclusion or insight. But I can?t, other than to say that the most important thing is immediate safety. For us, sitting in the roadway after the accident near a busy intersection, that mean moving the car immediately out of danger into the parking area where the offending SUV came from.
I remember my father telling me, when I was learning to drive some 35 years ago, that if I got a flat tire on a bridge that I should not stop. Drive it off the bridge, and to hell with any additional damage to the car. It is, after all, just a car.
Have you accepted that the fitness industry is failing you?
Do you really just want something to do of an evening?
Do you just want to pay for a diet that makes you feel a bit better about yourself but makes you track points, count calories and let?s you get away with so much destructive behaviour that you never get anywhere?
I understand why you might feel like this.
80% of gym users don?t get the results they want and but nobody ever speaks up because nobody else is getting results so it?s easy to think you?re just not one of the ?lucky? ones who happens to get results.
You don?t get lucky with fitness and fat loss.
Either the system you are following works or it doesn?t.
If it doesn?t, chances are you?re not following it properly but nobody is questioning YOU.
See the problem is that you don?t ask enough questions.
There?s an old interrogation principle that goes?.
?Ask enough questions and the man who is lying will eventually change his story?.
You should try applying this to those who you entrust your health and fitness.
Keep asking the owner and trainers in your gym what?s the best way to get the results YOU want.
Let?s say you want to lose fat fast and keep it off, and you keep asking me this question.
95% of the answers I will give you will be no different to what I would have said 10 years ago.
3-4 sessions per week combining strength work, dynamic sets and conditioning circuits.
Increase time under tension when lifting weights.
Drink lots of water.
Ensure most meals are protein, fats and vegetables.
Cycle carbohydrates so you keep your thyroid buzzing whilst optimising the conditions for fat burning.
Take a protein shake in after training.
Get enough sleep.
Manage your stress.
Throw in 1-2 fasting periods each week.
If finances permit, get your hormones tested.
Build your health and watch fat loss happen faster than you ever imagined.
Now imagine you had asked your commercial gym what was the best way to lose fat every year for the last 10 years.
The answers will have changed every 5 minutes.
Aerobics.
Machine based workouts for a while.
Long cardio sessions this year.
BodyPump now.
Hula hoop classes.
Zumba this time.
Flying around on straps is the latest thing.
Remember?.
?Ask enough questions and the man who is lying will eventually change his story?.
Every year, the gym will change their mind on what to recommend based not on what delivers results, but what entertains people and gives them another spark of hope that there might be some new, magic class which really does solve everything this year.
Then you ask the question again and they change their story.
Look at the places in the world where life span is the longest.
They are doing the same things they did hundreds of years ago!
The story NEVER changes and they laugh at all the modern fads that come along.
It?s like the tortoise and the hare.
In three years of the Storm Force Fitness Academy, very little has changed in what I have recommended.
Occasionally I find a way to simplify something but there?s another saying that goes?.
?Methods are many, principles are few. Methods often change, principles never do?.
The principles of fat loss NEVER change. The man who knows fat loss, will never change his story.
How often do journalists change their story on the best diet?
How often does the ?know it all? in the office, change the diet they are on then try to convince you ?this is the one??
How often do certain people switch personal trainers?
Yeah that?s right.
Not only are you being lied TO by the commercial areas of the health and fitness industry, but you may also be lying to yourself.
If you have not yet taken the time to deeply question YOURSELF about how you want to look, who you want to be and how you want to feel, you will keep lying to YOURSELF.
?He who stands for nothing falls for anything.?
Ask yourself this question.
Who would you rather be in this image below if you HAD to choose?
What do you REALLY believe in?
What person are you really deep down?
Don?t shirk the question!!!!
YOU HAVE TO CHOOSE NOW.
YOU HAVE TO BE ONE PERSON IN THE PHOTO.
Do you say one thing about who you are and what you believe then change your mind when the sh*t hits the fan?
It?s not about being a martyr but it IS about questioning whether you are just a puppet to circumstance and environment.
Are you a marketers dream?
Are you controlled by ?instant coffee? reactions to some clever jedi mind tricks that get you excited for the next big thing?
Now don?t get me wrong.
I accept my part in your life as the guy who must provide answers.
All I ask is that you start to ask the right questions of both myself and anyone else you seek help from.
Pay attention and find out whether their belief is strong enough in what they offer or if they will change tracks more often than a train with no driver.
Ask the questions and when you find someone with so much heart and so much belief in what they do because it has been proven over and over again, commit to it.
Do it properly.
Give it everything.
Believe you deserve more.
And when you believe as much as they do, you will no longer have so many questions buzzing around your head just making your life even more confusing and you?ll no longer be an ?Askhole??.
Fat loss really is quite simple, but we make it complicated by not asking enough of the right questions.
We just keep handing over money.
We just keep spending our time getting nowhere.
The money you can get back.
The time, you cannot.
Start asking questions of yourself and those who should be serving you.
Multiple sclerosis study reveals how killer T cells learn to recognize nerve fiber insulators
Monday, January 14, 2013
Misguided killer T cells may be the missing link in sustained tissue damage in the brains and spines of people with multiple sclerosis, findings from the University of Washington reveal. Cytoxic T cells, also known as CD8+ T cells, are white blood cells that normally are in the body's arsenal to fight disease.
Multiple sclerosis is characterized by inflamed lesions that damage the insulation surrounding nerve fibers and destroy the axons, electrical impulse conductors that look like long, branching projections. Affected nerves fail to transmit signals effectively.
Intriguingly, the UW study, published this week in Nature Immunology, also raises the possibility that misdirected killer T cells might at other times act protectively and not add to lesion formation. Instead they might retaliate against the cells that tried to make them mistake the wrappings around nerve endings as dangerous.
Scientists Qingyong Ji and Luca Castelli performed the research with Joan Goverman, UW professor and chair of immunology. Goverman is noted for her work on the cells involved in autoimmune disorders of the central nervous system and on laboratory models of multiple sclerosis.
Multiple sclerosis generally first appears between ages 20 to 40. It is believed to stem from corruption of the body's normal defense against pathogens, so that it now attacks itself. For reasons not yet known, the immune system, which wards off cancer and infection, is provoked to vandalize the myelin sheath around nerve cells. The myelin sheath resembles the coating on an electrical wire. When it frays, nerve impulses are impaired.
Depending on which nerves are harmed, vision problems, an inability to walk, or other debilitating symptoms may arise. Sometimes the lesions heal partially or temporarily, leading to a see-saw of remissions and flare ups. In other cases, nerve damage is unrelenting.
The myelin sheaths on nerve cell projections are fashioned by support cells called oligodendrocytes. Newborn's brains contain just a few sections with myelinated nerve cells. An adult's brains cells are not fully myelinated until age 25 to 30.
For T cells to recognize proteins from a pathogen, a myelin sheath or any source, other cells must break the desired proteins into small pieces, called peptides, and then present the peptides in a specific molecular package to the T cells.
Scientists had previously determined which cells present pieces of a myelin protein to a type of T cell involved in the pathology of multiple sclerosis called a CD4+ T cell. Before the current study, no cells had yet been found that present myelin protein to CD8+ T cells.
Scientists strongly suspect that CD8+ T cells, whose job is to kill other cells, play an important role in the myelin-damage of multiple sclerosis. In experimental autoimmune encephalitis, which is an animal model of multiple sclerosis in humans, CD4+ T cells have a significant part in the inflammatory response. However, scientists observed that, in acute and chronic multiple sclerosis lesions, CD8+T cells actually outnumber CD4+ T cells and their numbers correlate with the extent of damage to nerve cell projections. Other studies suggest the opposite: that CD8+T cells may tone down the myelin attack.
The differing observations pointed to a conflicting role for CD8 + T cells in exacerbating or ameliorating episodes of multiple sclerosis. Still, how CD8+T cells actually contributed to regulating the autoimmune response in the central nervous system, for better or worse, was poorly understood.
Goverman and her team showed for the first time that naive CD8+ T cells were activated and turned into myelin-recognizing cells by special cells called Tip-dendritic cells. These cells are derived from a type of inflammatory white blood cell that accumulates in the brain and the spinal cord during experimental autoimmune encephalitis originally mediated by CD4+ T cells. The membrane folds and protrusions of mature dendritic cells often look like branched tentacles or cupped petals well-suited to probing the surroundings.
The researchers proposed that the Tip dendritic cells can not only engulf myelin debris or dead oligodendrocytes and then present myelin peptides to CD4 + T cells, they also have the unusual ability to load a myelin peptide onto a specific type of molecule that also presents it to CD8+ T cells. In this way, the Tip dendritic cells can spread the immune response from CD4+ T cells to CD8+ T cells. This presentation enables CD8+ T cells to recognize myelin protein segments from oligodendrocytes, the cells that form the myelin sheath. The phenomenon establishes a second-wave of autoimmune reactivity in which the CD8+ T cells respond to the presence of oligodendrocytes by splitting them open and spilling their contents.
"Our findings are consistent," the researchers said, "with the critical role of dendritic cells in promoting inflammation in autoimmune diseases of the central nervous system." They mentioned that mature dendritic cells might possibly wait in the blood vessels of normal brain tissue to activate T-cells that have infiltrated the blood/brain barrier.
The oligodendrocytes, under the inflammatory situation of experimental autoimmune encephalitis, also present peptides that elicit an immune response from CD8+T cells. Under healthy conditions, oligodendrocytes wouldn't do this.
The researchers proposed that myelin-specific CD8+T cells might play a role in the ongoing destruction of nerve-cell endings in "slow burning" multiple sclerosis lesions. A drop in inflammation accompanied by an increased degeneration of axons (electrical impulse-conducting structures) coincides with multiple sclerosis leaving the relapsing-remitting stage of disease and entering a more progressive state.
Medical scientists are studying the roles of a variety of immune cells in multiple sclerosis in the hopes of discovering pathways that could be therapeutic targets to prevent or control the disease, or to find ways to harness the body's own protective mechanisms. This could lead to highly specific treatments that might avoid the unpleasant or dangerous side effects of generalized immunosuppressants like corticosteroids or methotrexate.
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University of Washington: http://www.uwnews.org
Thanks to University of Washington for this article.
This press release was posted to serve as a topic for discussion. Please comment below. We try our best to only post press releases that are associated with peer reviewed scientific literature. Critical discussions of the research are appreciated. If you need help finding a link to the original article, please contact us on twitter or via e-mail.
If you've ever had a stray cat come in your pet door at night, you know that event usually leads to shenanigans. If you have the time and funds you can construct a secure pet door that only lets your cat or dog in after scanning the RFID tag on a pet collar, taking a webcam photo of your pet entering or exiting, and tweeting the event.
This project started as an Instructable from user e1ioan, but has now grown so popular that e1ioan has created a site for the project and offers kits for those who are lazy or uncomfortable with soldering.
It isn't a cheap project?you'll need a RFID reader, a micro server to act as a latch control, a webcam, a router running Open WRT, and several semiconductors, capacitors, resistors, and other electrical hardware as well as a flap-type pet door. From a quick look online the budget for this project seems to be in the $100-150 range if you do everything yourself. The source link below offers loads of schematics, step-by-step instructions, and the complete code needed for the project. But if you're a techy pet-lover this might be for you.
AUSTIN, Texas (AP) ? Lance Armstrong will make a limited confession to doping during his televised interview with Oprah Winfrey next week, according to a person with knowledge of the situation.
Armstrong, who has long denied doping, will also offer an apology during the interview scheduled to be taped Monday at his home in Austin, according to the person who spoke on condition of anonymity because there was no authorization to speak publicly on the matter.
While not directly saying he would confess or apologize, Armstrong sent a text message to The Associated Press early Saturday that said: "I told her (Winfrey) to go wherever she wants and I'll answer the questions directly, honestly and candidly. That's all I can say."
The 41-year-old Armstrong, who vehemently denied doping for years, has not spoken publicly about the U.S. Anti-Doping Agency report last year that cast him as the leader of a sophisticated and brazen doping program on his U.S. Postal Service teams that included use of steroids, blood boosters and illegal blood transfusions.
The USADA report led to Armstrong being stripped of his seven Tour de France titles and given a lifetime ban from the sport.
Several outlets had reported that Armstrong was considering a confession. The interview will be broadcast Thursday on the Oprah Winfrey Network and oprah.com.
A confession would come at a time when Armstrong is still facing some legal troubles.
Armstrong faces a federal whistle-blower lawsuit filed by former teammate Floyd Landis accusing him of defrauding the U.S. Postal Service, but the U.S. Department of Justice has yet to announce if it will join the case. The British newspaper The Sunday Times is suing Armstrong to recover about $500,000 it paid him to settle a libel lawsuit.
A Dallas-based promotions company has threatened to sue Armstrong to recover more than $7.5 million it paid him as a bonus for winning the Tour de France.
But potential perjury charges stemming from his sworn testimony denying doping in a 2005 arbitration fight over the bonus payments have passed the statute of limitations.
Armstrong lost most of his personal sponsorship ? worth tens of millions of dollars ? after USADA issued its report and he left the board of the Livestrong cancer-fighting charity he founded in 1997. He is still said to be worth an estimated $100 million.
Livestrong might be one reason to issue an apology or make a confession. The charity supports cancer patients and still faces an image problem because of its association with its famous founder.
Armstrong could also be hoping a confession would allow him to return to competition in elite triathlon or running events, but World Anti-Doping Code rules state his lifetime ban cannot be reduced to less than eight years. WADA and U.S. Anti-Doping officials could agree to reduce the ban further depending on what new information Armstrong provides and his level of cooperation.
Armstrong met with USADA officials recently to explore a "pathway to redemption," according to a report by "60 Minutes Sports" aired Wednesday on Showtime.
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AP Sports Columnist Jim Litke contributed to this report.
The Galaxy Nexus 4G manufactured by smartphone maker Samsung hit the mobile marketplace in December of 2011. The device made its way to the Sprint wireless network in April of 2012, and Sprint built their first ever 4G LTE system in the US late last year. That is the home of the Samsung Galaxy Nexus 4G currently, and the handset can be purchased for around $49 on contract at select retailers like the Amazon Wireless store. The handset delivers a large high-resolution screen, extensive RAM memory, a speedy dual core processor and advanced mobile Wi-Fi connectivity.
The Samsung Galaxy Nexus is available for a reduced sale price now starting at $49.99.
Acting as a central Wi-Fi hub, the Sprint Galaxy Nexus 4G offers wireless connectivity to up to 10 wireless Wi-Fi enabled devices at the same time. The handset also offers Bluetooth 3.0 wireless connectivity, and a virtual on-screen QWERTY keyboard with enhanced auto correction. The Sprint Galaxy Nexus 4G also offers a full 32 GB of built-in data storage, 1.0 GB of RAM memory and up to 7.5 hours of talk time from a single battery charge.
The handset was the first in the United States to offer the long-awaited and much heralded Ice Cream Sandwich (ICS) 4.0 Android operating system, and recently received a much-needed upgrade in the form of the smoother and faster 4.1 Jelly Bean OS. The Sprint 4G LTE network offers simultaneous voice and data capabilities, allowing you to stay connected on a voice call while checking your e-mail, browsing the web or downloading an app. Download speeds are quick at 5 to 12 megabits per second (Mbps), while upload speeds run 2 to 5 Mbps in Sprint 4G LTE coverage zones.
The upgrade to the Jelly Bean 4.1 operating system coupled with the faster Sprint 4G LTE network has given the Samsung Galaxy Nexus 4G a ?rebirth? of sorts. While delivering one of the largest high resolution screens in the entire smartphone marketplace, the handset is still thin, measuring only 0.37 inches (9.47 mm). The Sprint Galaxy Nexus 4G boasts a large 4.65 inch Super AMOLED display, and the resolution of 720 x 1,280 pixels sits at the higher end of the smartphone marketplace. Pixel density is impressive at 316 pixels per inch, and more than 16 million colors can be found on the display.
The CPU is a dual core 1.2 GHz Cortex A9 model, and a PowerVR SGX540 graphics processor is also present. The Sprint Galaxy Nexus 4G is powered by a Texas Instruments OMAP 44 microchip package, and the front facing chat cam offers video call support. Built into the back of the handset is a high resolution camcorder with 1,080P HD recording capability, measuring 5.0 megapixels.
You can purchase the Galaxy Nexus for Sprint at a discounted price tag now starting at $49.99.
After I didn't really have luck with finding a nice, long-term RP in a medieval-fantasy setting involving adventuring, detailing the world together, descriptive writing when it fits in nicely as well as short conversations when you don't need 3 paragraphs around just 2 lines of actually spoken text in a conversation.. I've finally come here to try my luck. If I seem choosy, don't worry, I'm not at all! Firstly I'm really just looking for a nice RP again, preferably also with a nice partner to get on well with while RPing, I find it makes writing a story together much more interesting if you get on well with your.. other writers?
I'd play my usual and favorite character - Kyren Leah, mostly not knighted but trying to follow knightly and brave behaviour at all times, not unfriendly but usually very direct and seemingly in a bad mood. You'll find him definitely capable of feeling and giving love, of being extremely generous, of showing mercy and trying to give solace. But if you ever ask him about why, and what for, you'll just hear that it's the right thing to do. Like it's all there is - It's your duty to protect the innocent, beggars, children and women, cows on a field.. Kyren's running like a clockwork. Assign him to a task, and if he agrees on it, he'll carry it out no matter what the cost. Something is driving him to do all of this, some cold burning flame deep inside him, that does not radiate any warmth but just keeps something going that sometimes looks like it should have died long ago.
You'll usually find him wearing a tattered leather armor, sometimes a cloaked hood. He wears his swordbealt over his chest, with an axe and a sword within a very fine made scabbard at his right, a small wooden shield tied to his back, constantly making some noise when the loosely tied belt causes axe and scabbard to collide. The pommel of the sword seems to be tied to the scabbard, making it impossible to draw the sword out of it's sheath. All his other belongings seem to be in the various leather pouches tied to the swordbelt, he'D almost looks like a travelling merchant, if not for his all around ragged look. But even though given his appearance, there's an air of dignity around him. Appearance and personality don't seem to fit. The way he moves and talks, the way his blue eyes seem to always search for something make him seem ever vigilant, here for some specific purpose, awaiting someones next move and prepared to react. Only at times, when he thinks himself to be not watched, in a dark corner of some tavern or street, you'll find his eyes unfocused and closed, his long brown hair covering his face, looking tired and worn out. As if he was just playing a role for people to see, when there are people to look.
And that fine guy would fit right into most of the medieval/fantasy themed worlds I can think of right now, also with some plots and adventures attached! Maybe you're in a city guard with Kyren? Maybe you're a travelling merchant and hire him as a mercenary? Maybe you're going to war with him, or just run into him in a tavern or marketplace? Maybe you're a exiled member of the royal family, and he's your last faithful retainer? I'm open to quite everything - Adventure, Romance, short and long-term RPs.. I'd preferably start something now with just one person, but if we somehow come to get a bigger plot going and all feel comfortable with it, why not. In any case, right now I'd like a casual and friendly start to RPing again :P
Thank you all for reading, and please excuse my bad English!
President Barack Obama?s second term will present him with opportunities to strengthen relations with rising powers, improve economic relations and increase security throughout the world. However, there are also low-probability, high-impact events that could unexpectedly derail the president?s agenda notes Martin Indyk, director of Foreign Policy at Brookings.?Foreign Policy at Brookings will release its policy recommendations for President Obama?s second term on January 17.
Gamesys acquires Richard Branson owned Virgin Games to boost gaming and igaming business
by mediamanoz 08/01/2013
Media Man www.mediamanint.com with the latest from the gaming, casino and igaming world...
According to gaming trade publication eGR Magazine, game development company Gamesys has acquired Sir Richard Branson?s Virgin Games for an undisclosed sum.
In addition, eGR (exclusively) reports that Gamesys has signed a ?long-term deal? to develop real money and social gambling properties, globally, under the Virgin brand.
Originally started in late 2003, Virgin Games is wholly owned by Richard Branson?s Virgin Group and offers casino (poker, slots, bingo and other) games for the internet and mobile devices.
Its new owner, UK-based online gambling holding Gamesys, recently made headlines when it launched a new Facebook app called ?Bingo Friendzy?, the first to hit the social network?s App Center that lets UK users aged 18 and over to play an online game for real cash prizes (rival 888 followed up with a similar offering back in December 2012).
Gamesys operates the UK?s leading bingo and slots website Jackpotjoy and other brands, such as The Sun Bingo and Caesars Casino, aside from developing its own social gaming properties.
A Gamesys spokesman advised eGR that it aims to migrate the Virgin Games site onto its own platform and relaunch it in the UK later this quarter. In a prepared statement, Richard Branson said:
?We are delighted the Gamesys Group has acquired Virgin Games and formed a partnership to build a global games business.
Simon Burridge and his team built a strong platform and now with the help of the Gamesys Group we can expand further internationally. We believe the Gamesys Group shares our vision and will be great partners in the sector.?
Simon Burridge is the former advertising executive who started and became CEO of Virgin Games in late 2003.
According to eGR, Virgin Games had been exploring outside investments in recent months, in a bid to expand its business across Europe.
Virgin Games is likely to come up against strong competition from the likes of bwin.party digital entertainment and its PartyCasino PartyPoker and World Poker Tour, and word is that Austraila's gaming king, James Packer, head of Crown Limited, is also aiming to further expand into online gaming well beyond betfair.
Stay turned to the Media Man www.mediamanint.com and Casino News Media www.casinonewsmedia.com network as the story continues to unfold.
News...
Gamesys agrees Virgin Games purchase...
Online casino and bingo operator Gamesys Limited has agreed to acquire operator Virgin Games for an undisclosed sum while additionally inking a long-term deal to develop a range of Virgin-branded real-money and social gaming propositions.
Gamesys, the operator behind popular online bingo domain JackpotJoy, revealed that the initial focus for the new partnership will be the UK market with the virgingames proposition set to be relaunched on the Gamesys platform in Q1 2013.
Established in 2001 by Noel Hayden, Andy Dixon and Robin Tombs, Gamesys became the first online gaming operator to agree a real-money deal with social network Facebook in August while it stated that it has been a ?long term admirer? of the Virgin brand.
?We are delighted to have the opportunity to leverage our unique platform, games and services to power Virgin gaming propositions around the world,? said Hayden.
For its part, Virgin Games was founded in 2004 by Virgin Group and hosted close to 300 games from leading suppliers including Microgaming and Playtech. It additionally operates online bingo as well as games of poker using the International Poker Network from Spielo G2.
?With many new opportunities opening up across the world, it was important to attract a new partner to capitalise the power of the Virgin brand,? said Simon Burridge, Chief Executive Officer for Virgin Games.
?We are delighted Virgin Games is being acquired by Gamesys, whose track record of growth and innovation speaks for itself.?
The Digital Entertainment Group has announced plans to give away free movies when you buy an UltraViolet compatible device. If you buy a Smart TV from one of the following brands, you'll get ten free movies accessible anywhere UltraViolet titles work; including CinemaNow, Flixster, Nook and VUDU. Blu-ray players will come with five free ones and you can choose hardware from LG, Panasonic, Philips, Samsung, Sony, Toshiba and Vizio -- so most of the big brands. We assume you'll get to choose from any of the 8,500 titles available on UltraViolet from Lionsgate, Paramount, Sony Pictures, Fox, Universal or Warner. The idea of the "UltraViolet Movie Starter Pack" is to expand the user-base beyond the current nine million registered households. This and the 2013 international expansion into Australia, France, Germany, Ireland and New Zealand are expected to push UltraViolet to the next level. That just might be, but if were us, we'd focus on getting that common file format to market and by deploying single sign-on to improve the usability of the service.
TV doctor and actor, Patrick Dempsey, has apparently beat out Starbucks to buy Seattle-based Tully's Coffee, a bid Dempsey says will retain the company's jobs. Cnbc's Jane Wells reports.
By Martha C. White
Too much coffee can make anybody a little giddy.
Patrick Dempsey, best known as Dr. Derek ?McDreamy? Shepherd on medical drama "Grey's Anatomy," sent out a celebratory Tweet late last night after his investment group made the highest single bid for Tully?s Coffee in a Seattle bankruptcy auction. ?We met the green monster, looked her in the eye, and...SHE BLINKED! We got it! Thank you Seattle!? he wrote.
The ?green monster? is Starbucks, and either it or the bankruptcy judge who still has to approve the deal at a hearing next week could throw a wrench into Dempsey?s white knighthood.
The investment group of which Dempsey is a member, Global Baristas LLC, beat out the other six bidders, including the coffee giant, with an offer of $9.15 million for the 47-store chain. In a statement, Scott Pearson, CEO and president of Tully?s parent company TC Global, Inc., called the auction outcome ?a big win for Seattle.?
Tully?s, which filed for bankruptcy in October and closed 19 stores, has more than 500 employees. Dempsey said preserving those jobs was a top priority.??I?m thrilled that we won and I?m even more excited about saving Tully?s Coffee and its hundreds of jobs,? he said in a statement. ?I am honored to have the privilege to own Tully?s.?
But his grand plans and talk of ownership are a little premature. ?On its face, Dempsey won because he outbid everybody else, but they haven?t won yet,? said Anthony Michael Sabino, a bankruptcy attorney who specializes in corporate restructuring.
Global Baristas still has to get through a hearing on Jan. 11 and have a bankruptcy judge verify that its bid is the highest and best. ?The reasonable expectation is very high that the Dempsey group will be the new owner of Tully?s, but it?s not an absolute certainty yet,? Sabino said.
One roadblock could be Starbucks. ?We?ve made an offer for 25 locations and another bidder made an offer for all of the remaining assets and the combined amount of our bids is $10.56 million,? said spokesman Zack Hutson, who added that even though the auction is over, the judge hasn?t made her decision yet.?
With a bid nearly $1.5 million higher than Global Baristas, Starbucks or the unnamed second bidder could challenge the results of the auction in next week's hearing. "We're evaluating our options," Hutson said.
Sabino said price isn?t everything in bankruptcy sales, though. ?The quality of the bid can sometimes overcome higher [ ones],? Sabino said. The bankruptcy court has to weigh a variety of factors besides the dollar amount, such as how much of an offer is cash or assumption of debt versus equity, how quickly the deal is likely to close, whether or not there is likely to be any regulatory review that could delay the sale and which buyer?s plan for the company?s future will benefit stakeholders the most.
A Global Baristas spokesperson said via email it was confident it would prevail at the hearing ?because of the loss of jobs and breakup of company if others were chosen.?
Hutson countered by saying Starbucks also would keep jobs. ?If our bid is accepted along with the companion bid, we intend to invite Tully?s employees at the locations we acquire to apply for positions with us,? he said, adding that current Tully?s employees would get preference as long as they met Starbucks? job requirements.
Despite his onscreen ability to resuscitate the ailing, Dempsey doesn?t have a background in corporate turnarounds, and he began making plans to buy Tully?s only about a week before Christmas. He seemed eager to get involved, sending out Tweets throughout the day on Friday chronicling his visits to different Tully?s shops. ?Heading to Clyde Hill Tully's now to meet employees and our customers. Very exciting,? he wrote.
?I will be making Seattle my home away from home and spending a significant amount of time in the community,? he pledged.
Burry Stander, seen here in 2010, was hailed as a "South African icon and sporting great" by Oscar Pistorius.
?
By NBC News wire services
JOHANNESBURG - One of the world's top mountain bikers died Thursday after being hit by?a minibus taxi?while training on a coastal road.
Burry Stander, 25, narrowly missed out on a medal at the London Olympics, coming in fifth in the men's cross country event. He also finished 15th at the Beijing Games.
The South African was a former under-19 and under-23 world champion.
Police said Stander was killed on Thursday while cycling alone. He died at the scene of the accident in Shelly Beach, about 75 miles southwest of Durban.
'Ultra-competitive' "The taxi driver allegedly stopped after the accident until the arrival of the police. No arrest has been made at this stage," police said in a statement.
"I'm totally shattered," said Gideon Sam, president of the South African Sports Confederation and Olympic Committee. He called Stander "talented, ultra-competitive but at the same time extremely humble and a true gentleman."
Full international coverage from NBC News
The two-time Olympian's death prompted a flood of tributes on social media from South African athletes, politicians and celebrities. Oscar Pistorius, the double-amputee Olympic runner and multiple Paralympic medalist, said on Twitter he was "utterly devastated."
"A South African icon and sporting great. RIP my friend," Pistorius wrote.
Cycling South Africa said Stander was the country's most successful mountain biker and "a true icon and sporting role model."
Stander was the second leading cyclist to be killed in a road accident in South Africa in recent years. Carla Swart died in January 2011 when she was hit by a truck while training.
Reuters and The Associated Press contributed to this report.
More world stories from NBC News:
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HOUSTON (AP) The Houston Texans were looking forward to enjoying a bye this week before beginning their work in the playoffs as the AFC?s top seed.
Instead, a terrible month in which they lost three of four games dropped the Texans to the third seed. It has them in the exact same spot as year ago, hosting the Cincinnati Bengals in a wild-card playoff game Saturday.
The Texans wasted little time this week lamenting their missed opportunities, though, instead focusing on their next task.
Y-cam Showcases Wide Range of Security Cameras at CES ? Debuting First-to-Market Outdoor Cloud Camera for the Home, Professional IP Models and Award-Winning BabyPing Smart Baby Monitor
Y-cam HomeMonitorTM, Y-cam Cube HD and award-winning BabyPing smart baby monitor showcased in
Las Vegas ? January 3, 2013 ? Award-winning, British IP camera specialist Y-cam Solutions Ltd, the leading provider of affordable and easy-to-use security cameras and as well as popular smart baby monitor BabyPing, debuts HomeMonitorTM and Cube at CES ? two distinct lines of wireless cameras catering to residential and professional use, with a first-to-market outdoor cloud version offered with HomeMonitorTM. New products will be showcased in South Hall 2, Booth # MP25458, along with the award-winning BabyPing remote-viewing baby monitor, launched this past September in the United States. "We believe remote video monitoring is genuinely valuable to a wide range of consumers. Who wouldn't want the option to see what's happening at their home from anywhere or record a short clip each time someone approaches their front door?" said Devin Chawda, Y-cam CEO. "The challenge up until now is most people are put off due to high costs, technical fears or reliability issues. Y-cam HomeMonitorTM changes this. Our market-leading camera technology connects to a free secure cloud account that can be viewed on virtually any mobile, computer, tablet or even TV. HomeMonitorTM is a truly unique product, simple enough to be used by anyone, and we believe it will revolutionize the way people connect to the things they care about most."
Y-cam HomeMonitorTM HomeMonitorTM is a new 'plug & play' secure cloud camera service that makes it easier than ever for people to monitor their home, loved ones and belongings from any device, anywhere. Quick and easy set-up takes minutes: connect the HomeMonitorTM camera to a home network (through Wi-Fi or Ethernet cable), create an online account and begin viewing live from anywhere; no technical knowhow or fiddling with routers required. Users can now see and store events securely in the cloud, viewing footage from any Internet-enabled computer or smartphone, with no monthly subscription required. Having the ability to tap into home life from anywhere in the world gives users peace of mind: check on children or elderly relatives, record clips each time someone approaches a front door or vehicle, or ensure the house is safe while traveling.
HomeMonitorTM is the first-ever residential monitoring solution offering both indoor and outdoor installations that are Wi-Fi enabled and offer true cloud-based viewing and recording. HomeMonitorTM Indoor ($199.99) and HomeMonitorTM Outdoor ($349.99) both come standard with the HomeMonitorTM free service package which includes 7 days of free online cloud storage and unlimited email alerts; an upgrade package is available to increase storage time for a low yearly fee (30 days of online recording is just $39.99 per camera, per year). HomeMonitorTM is a super easy, all-in-one home monitoring solution that works right out of the box. For a full list of features and to purchase HomeMonitorTM, visit www.homemonitoronline.com.
Y-cam Cube The Cube is a professional grade, indoor IP camera providing exceptional video and audio representation, ideal for home or business customers seeking the upmost in security, integration, design and reliability. Cube offers remote viewing and recording, plus local recording to microSD or NAS. Offering the highest quality, and widest range of inter-device compatibility, each camera is filled to the brim with specialized features which provide the next level of security for high-tech homes and safety-conscious businesses, allowing users to stay in control no matter where they may be. Cube also eliminates the need for bulky camera equipment; its small and sleek design blends quietly into any setting.
Three versions of the Cube are available ? VGA (640 x 480 resolution) and HD (720p and full HD 1080p) ? in either black or white. All offer market-leading powerful night vision, automatic IR cut filter operation for uncompromising color and picture quality in day and night, intuitive motion detection, real-time video and audio streaming to Internet-enabled devices, and minimal bandwidth usage and storage requirements. Y-cam is also one of the few IP camera companies that supports both PC and Mac platforms.
Cube is a robust, powerful security solution providing complete reassurance and protection, 24 hours a day, 7 days a week. For a full list of specs and to purchase Cube ($199.99-$349.99) beginning in February, visit www.y- cam.com.
"Over the past five years, we've seen a trend among parents trying to use our existing Y-cam cameras for baby monitoring. As parents ourselves, we understood that our current cameras didn't meet the needs of modern parents so we tasked ourselves with creating a baby monitoring system that integrated the high-tech video and wireless Wi-Fi technology of our current lines blended with more user-friendly features and cutting-edge app development," said Chawda. "The BabyPing Video Monitor leads the Y-cam vision to make monitoring loved ones simple and affordable for everyone."
BabyPing BabyPing is a secure Wi-Fi-enabled smart baby monitor. Parents can hear, view and monitor their infant at all times via an iPhone, iPad or iPod Touch using the free BabyPing app, which runs in the background so users can continue to read books, surf the web or listen to music on their devices while simultaneously monitoring their baby.
BabyPing has developed its own technology evolving it into a truly next generation smart baby monitor ? not just a 'baby viewer.' SmartFilterTM technology cuts out background noise and static associated with traditional baby monitors, and Constant-ConnectTM acts as a permanent tether between the app and monitor notifying the user when the baby is upset or or if their Wi-Fi network status changes at any point. BabyPing+ allows for viewing when outside the home over 3G, 4G or Wi-Fi, and also gives one-tap sharing access to family and friends, wherever they are in the world. These features allow parents to not only see their baby remotely, but actually monitor their baby locally without delays or broken connections. BabyPing is currently the only Wi-Fi monitor on the market with completely invisible infrared night vision, offering round-the-clock visibility without disturbing the baby. Modern and sleek in design, BabyPing is simple to set-up directly on an iOS device with no need for a computer, and the ability to use the monitor at home when not connected to the internet ensures parents who worry about privacy and security can rest easy. BabyPing also features all the specifications you would expect from a high tech baby monitor, such as vivid full color video with 640 x 480 resolution, a high quality built-in microphone and superfast wireless Wi-Fi, double-layer security and customizable alerts (live audio or silent vibrations) to inform parents if the baby cries, if Wi-Fi connection has been broken or if the iOS device is out of range, putting parents firmly in control by creating the safest way to monitor their baby.
Launched in September 2012 in the US, BabyPing has already received the prestigious 2012 Kind Und Jugend Innovation Award for its ingenious use of the latest in modern, safe technology. To learn more or to purchase BabyPing ($199.99), visit www.babyping.com.
Every few years, the Census releases its projections for how many people of every possible combination of age, sex, race and ethnicity will live in the United States over the next half century. Curious how many 35-year-old female Hispanic American Indian/Alaskan Natives there will be in 2045? I can tell you. It?s 17,632.
One might scoff at this sort of datum. How could the Census Bureau possibly know what medical advances will prolong our lives over the next 33 years? Or what geopolitical currents will shift immigration patterns? And what about the robot apocalypse? Will the robots prey on every age group with statistical uniformity?
The Census doesn?t know, of course. A projection is a portrait of what the country will look like if present trends persist exactly as they are now: if babies are born to parents of different races at the same rates, immigration is unchanged, and people?s life spans adhere precisely to the unforgiving mathematics of decline. No one, including the Census Bureau, believes this will happen.
When your mother says, ?Keep eating like that and you?ll have a heart attack when you?re 50,? she is not predicting the future. She is commenting on your present behavior. Population projections have the same effect: They don?t tell us much about the distant future, but they tell us a surprising amount about the present.
?The idea is that if all of the assumptions were to come true, that is what we would expect the population to be at that future point in time,? says Census demographer Jennifer Ortman, who led the team that produced the projections.
In the interactive below, you can track the predicted population for any demographic profile, based on the figures released last month. Each line represents people born in a single year. You can drag the sliding bar back and forth to examine individual years of birth.
If the line rises, it is due to immigration (there is no method by which people of a given age otherwise materialize from thin air). Lines tend to tick up at the end because the Census groups everyone who is 100 or older together, and there tend to be more of them than there are 99-year-olds.
If this view is too morbid for you?I?d like to think I have more than a 3-in-4 shot at being a vibrant, dashing 77-year-old in 2060?you can switch the view in the upper right-hand corner to ?by age,? which shows a different view: How many people of an exact age, race, ethnicity and sex will live in America in the next five decades? Rather than, for example, track people who are 37 right now, this tracks the number of 37-year-olds there will be each year going forward.
I find this more interesting, because it shows us waves of births and captures the rise or decline of a given slice of the population independent of time?s cruel recall. There will be twice as many 72-year-olds in 2060 as there are today, for example?a fact that starkly captures the reality of our aging population. Dragging the bar to age zero shows projected births. Dragging it to 65 shows us that, in the next several years alone, the number of newly eligible retirees will spike dramatically.
When we look at these projections, we?re visited by the Ghost of Census Future?not, perhaps, attended by the same terror as Scrooge encountered, but with the same knowledge that what we?re really seeing is the present.
No need for routine repeated CT scans after mild head trauma, reports neurosurgeryPublic release date: 3-Jan-2013 [ | E-mail | Share ]
Contact: Connie Hughes Connie.Hughes@wolterskluwer.com 646-674-6348 Wolters Kluwer Health
If patient is stable, repeated scans unlikely to affect treatment
Philadelphia, Pa. (January 3, 2013) When initial computed tomography (CT) scans show bleeding within the brain after mild head injury, decisions about repeated CT scans should be based on the patient's neurological condition, according to a report in the January issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
The study questions the need for routinely obtaining repeated CT scans in patients with mild head trauma. "The available evidence indicates that it is unnecessary to schedule a repeat CT scan after mild head injury when patients are unchanged or improving neurologically," according to the study by Dr. Saleh Almenawer and colleagues of McMaster University, Hamilton, Ont., Canada.
Are Repeated Scans Necessary after Mild Head Trauma?
In a review of their hospital's trauma database, the researchers identified 445 adult patients with mild head injury who had evidence of intracranial hemorrhage (ICH)bleeding within the brainon an initial CT scan. In many trauma centers, it's standard practice to schedule a second CT scan within 24 hours after ICH is detected, to make sure that the bleeding has not progressed.
To evaluate the need for routine repeated scans, Dr. Almenawer and colleagues looked at how many patients needed surgery or other additional treatments, and whether the change in treatment was triggered by changes in the patients' neurological condition or based on the routine CT scan alone. (For patients whose neurological condition worsened, CT was performed immediately.)
Overall, 5.6 percent of the patients required a change in treatment after the second CT scan. Most of these patients underwent surgery (craniectomy) to relieve pressure on the brain. Nearly all patients who underwent further treatment developed neurological changes leading to immediate CT scanning.
Just two patients had a change in treatment based solely on routine repeated CT scans. Both of these patients received a drug (mannitol) to reduce intracranial pressure, rather than surgery
Decisions on CT Scans Can Be Based on Neurological Status
Dr. Almenawer and colleagues extended the same method to patients reported in 15 previous studies of CT scanning after mild head injury. Including the 445 new patients, the analysis included a total of 2,693 patients. Overall, 2.7 percent of patients had a change in management based on neurological changes. In contrast, just 0.6 percent had treatment changes based on CT scans only.
Bleeding within the brain is a potentially life-threatening condition, prompting routine repeated CT scans after even mild head injury. The researchers write, "Although CT scanners are very useful tools, in an era of diminishing resources and a need to justify medical costs, this practice needs to be evaluated." Each scan also exposes the patient to radiation, contributing to increased cancer risk.
The new study questions the need for routine repeated CT scans, as long as the patient's neurological condition is improving or stable. "In the absence of supporting data, we question the value of routine follow-up imaging given the associated accumulative increase in cost and risks," Dr. Almenawer and coauthors conclude.
Neurological examination is the "simple yet important" predictive factor leading to changes in treatment and guiding the need for repeat CT scanning after mild head injury, the researchers add. They emphasize that their findings don't necessarily apply to patients with more severe head injury.
###
About Neurosurgery
Neurosurgery, the Official Journal of the Congress of Neurological Surgeons, is your most complete window to the contemporary field of neurosurgery. Members of the Congress and non-member subscribers receive 3,000 pages per year packed with the very latest science, technology, and medicine, not to mention full-text online access to the world's most complete, up-to-the-minute neurosurgery resource. For professionals aware of the rapid pace of developments in the field, Neurosurgery is nothing short of indispensable.
About Lippincott Williams & Wilkins
Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes.
LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of 3.4 billion ($4.7 billion).
[ | E-mail | Share ]
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
No need for routine repeated CT scans after mild head trauma, reports neurosurgeryPublic release date: 3-Jan-2013 [ | E-mail | Share ]
Contact: Connie Hughes Connie.Hughes@wolterskluwer.com 646-674-6348 Wolters Kluwer Health
If patient is stable, repeated scans unlikely to affect treatment
Philadelphia, Pa. (January 3, 2013) When initial computed tomography (CT) scans show bleeding within the brain after mild head injury, decisions about repeated CT scans should be based on the patient's neurological condition, according to a report in the January issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
The study questions the need for routinely obtaining repeated CT scans in patients with mild head trauma. "The available evidence indicates that it is unnecessary to schedule a repeat CT scan after mild head injury when patients are unchanged or improving neurologically," according to the study by Dr. Saleh Almenawer and colleagues of McMaster University, Hamilton, Ont., Canada.
Are Repeated Scans Necessary after Mild Head Trauma?
In a review of their hospital's trauma database, the researchers identified 445 adult patients with mild head injury who had evidence of intracranial hemorrhage (ICH)bleeding within the brainon an initial CT scan. In many trauma centers, it's standard practice to schedule a second CT scan within 24 hours after ICH is detected, to make sure that the bleeding has not progressed.
To evaluate the need for routine repeated scans, Dr. Almenawer and colleagues looked at how many patients needed surgery or other additional treatments, and whether the change in treatment was triggered by changes in the patients' neurological condition or based on the routine CT scan alone. (For patients whose neurological condition worsened, CT was performed immediately.)
Overall, 5.6 percent of the patients required a change in treatment after the second CT scan. Most of these patients underwent surgery (craniectomy) to relieve pressure on the brain. Nearly all patients who underwent further treatment developed neurological changes leading to immediate CT scanning.
Just two patients had a change in treatment based solely on routine repeated CT scans. Both of these patients received a drug (mannitol) to reduce intracranial pressure, rather than surgery
Decisions on CT Scans Can Be Based on Neurological Status
Dr. Almenawer and colleagues extended the same method to patients reported in 15 previous studies of CT scanning after mild head injury. Including the 445 new patients, the analysis included a total of 2,693 patients. Overall, 2.7 percent of patients had a change in management based on neurological changes. In contrast, just 0.6 percent had treatment changes based on CT scans only.
Bleeding within the brain is a potentially life-threatening condition, prompting routine repeated CT scans after even mild head injury. The researchers write, "Although CT scanners are very useful tools, in an era of diminishing resources and a need to justify medical costs, this practice needs to be evaluated." Each scan also exposes the patient to radiation, contributing to increased cancer risk.
The new study questions the need for routine repeated CT scans, as long as the patient's neurological condition is improving or stable. "In the absence of supporting data, we question the value of routine follow-up imaging given the associated accumulative increase in cost and risks," Dr. Almenawer and coauthors conclude.
Neurological examination is the "simple yet important" predictive factor leading to changes in treatment and guiding the need for repeat CT scanning after mild head injury, the researchers add. They emphasize that their findings don't necessarily apply to patients with more severe head injury.
###
About Neurosurgery
Neurosurgery, the Official Journal of the Congress of Neurological Surgeons, is your most complete window to the contemporary field of neurosurgery. Members of the Congress and non-member subscribers receive 3,000 pages per year packed with the very latest science, technology, and medicine, not to mention full-text online access to the world's most complete, up-to-the-minute neurosurgery resource. For professionals aware of the rapid pace of developments in the field, Neurosurgery is nothing short of indispensable.
About Lippincott Williams & Wilkins
Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes.
LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of 3.4 billion ($4.7 billion).
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
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If you've ever had a stray cat come in your pet door at night, you know that event usually leads to shenanigans. If you have the time and funds you can construct a secure pet door that only lets your cat or dog in after scanning the RFID tag on a pet collar, taking a webcam photo of your pet entering or exiting, and tweeting the event. 
Posting Rules
The Galaxy Nexus 4G manufactured by smartphone maker Samsung hit the mobile marketplace in December of 2011. The device made its way to the Sprint wireless network in April of 2012, and Sprint built their first ever 4G LTE system in the US late last year. That is the home of the Samsung Galaxy Nexus 4G currently, and the handset can be purchased for around $49 on contract at select retailers like the Amazon Wireless store. The handset delivers a large high-resolution screen, extensive RAM memory, a speedy dual core processor and advanced mobile Wi-Fi connectivity.
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Public release date: 3-Jan-2013
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