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The United States and other nations expelled Syrian Charge d'Affaires Zuheir Jabbour. After 14 months of violence, the country is approaching an all-out civil war. NBC's Richard Engel reports.
By msnbc.com's Alastair Jamieson and NBC News' Catherine Chomiak
Updated at 1:05 p.m. ET: The United States and a string of other nations expelled Syrian diplomats Tuesday, in?response to a United Nations announcement that most of the 108 victims of violence near?the Syrian town of Houla?had been executed.
The State Department said it had?decided to expel Charge d'Affaires Zuheir Jabbour from the U.S., an action mirrored by?Australia, Canada, Spain, the United Kingdom, Italy, France and Germany. The Syrian ambassador had previously been recalled, leaving the charge d?affaires the highest ranking official in Washington, D.C.
Images of bloodied, young bodies laid out in a shallow grave after Friday's onslaught triggered shock around the world and underlined the failure of a six-week-old U.N. cease-fire plan to stop the violence.
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The U.N. High Commissioner for Human Rights earlier said its monitors found that fewer than 20 of the victims died from artillery fire. It was first thought the majority of the deaths were caused by artillery fire.
Syrian authorities had blamed "terrorists" for the massacre, which is one of the worst carnages in the 14-month-old uprising against Syrian President Bashar al-Assad that has cost about 10,000 lives.
Clinton condemns Syria massacre: Assad's 'rule by murder' must end
The United States rejected Syria's claims that terrorists were responsible for the massacre.
"We hold the Syrian government responsible for this slaughter of innocent lives," a spokesman for State Department told NBC News in a statement. "We encourage all countries to condemn the actions of the Assad regime through similar action."
The U.S. did not?cut off relations with Syria altogether, and did not oppose "many civil service members of the Syrian government who are working to improve their country," the statement added.
"Our view is that these are civil servants; these are technical staff; these are the same people who, if and when -- and there will come a when -- the Assad regime goes and we're into a transition that they will have to restart the relationship," Victoria Nuland, spokesperson for the State Department, said.
"We are not opposed to the low- and mid-level technical staff remaining.?
A Syrian governmental crackdown is escalating prompting UN peace broker Kofi Annan to speak out and longtime Syrian ally Russia to criticize the regime. NBC's Richard Engel reports.
'Summarily executed'? Rupert Colville, spokesman for the UNHCR, told journalists in Geneva that initial investigations suggest fewer than 20 of the victims in the village of Taldou, near Houla, were killed by artillery or tank fire.
"Most of the rest of the victims in Taldou," he told the BBC, "were summarily executed in two separate incidents."
Most of the victims were shot at close range. "At this point it looks like entire families were shot in their houses," Colville was quoted as saying by The Telegraph.
He said the conclusions of the U.N. monitors are corroborated by other sources, and that witnesses blamed pro-government militias for the attacks.
The findings came as UN-Arab League envoy Kofi Annan was meeting Assad in Damascus on Tuesday.
UN Security Council condemns Syria massacre that left more than 100 dead
The U.N. Security Council on Sunday unanimously condemned the Syrian government for heavy-weapons attacks on Houla.
"The Security Council condemned in the strongest possible terms the killings, confirmed by United Nations observers, of dozens of men, women and children and the wounding of hundreds more in the village of (Houla), near Homs, in attacks that involved a series of government artillery and tank shellings on a residential neighborhood," a non-binding statement said.
U.S. Secretary of State Hillary Clinton demanded that those who carried out the killings be held accountable.
"The United States will work with the international community to intensify our pressure on Assad and his cronies, whose rule by murder and fear must come to an end," she said.
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Cases of the disappearance of domain names mostly happen at the time of registering the domains. In that case when you want to register domain you ought to keep it private and confidential. To do this you simply have to follow some simple steps that are explained below.
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Your contact information will be required in case of emergency, notices about expiry dates and also to negotiate about the domain registration. You need to provide an up to date email address. The registering companies will always use the email address to contact you about updates like when their policies change. Check the address you provide regularly and ensure that it is not tampered with and is still active. When you decide to change it you have to notify the registrar as soon as possible. When you register domain you should use a valid email address.
Merging Domains and Securing Them
Some companies will have more than one domain. If you register domain individually you will have a hard time managing them. One should therefore put all the domains under one registration and it will be very easy to manage that one account. The information provided will be similar for all the domains. Apart from ease in their management, you will also reduce the initial cost of registration and also of maintaining them. You will also save your time of accessing them and avoid the risk of forgetting and mixing domain information. Secure the full rights of updating the domain and also using it for any business. When you lock it no one else will change its details. Some of the established registration companies offer domain security service free of charge. All that is required is your approval to activate the feature.
Good Choice of Password and Username
The username and password that you choose when you register domain should be kept confidential. If you do not protect it some people may access it and use it maliciously against you. The password you choose should not resemble any of your information on the website, and also personal information. It should not be simple to guess. Use a different password from all the others that you have. A strong password should be more than eight characters and in addition you should mix numbers and special characters to make it hard to crack. Take care not to make it too complicated to an extent of forgetting it. Make a habit of changing the password at regular intervals. Include contact information that visitors will be using to give their feedback. Let your customer service be of high quality, and be available on a full time basis. Visitors may require assistance and they expect instant service which you should always provide.
Puppies explore the world with their mouths, but they need to be taught there are boundaries when it comes to mouthing. Victoria and Winston show you how.
In Teacher?s Pet, Victoria Stilwell shows you how to employ her Positively Method to train your dog the right way, growing your level of communication to strengthen the bond between you and your pet.
Victoria Stilwell is widely known as a dog trainer, author, and television presenter. Stilwell served as a judge on the CBS show Greatest American Dog and is best known as the host of the Animal Planet dog training TV show It?s Me or the Dog, where she counsels families with problem pets and solves their dogs? behavior problems. In 2010, she launched Positively, the world?s first global network of hand-picked world-class dog trainers dedicated to providing the public a brand name they can trust in humane, force-free training.
More tips from Victoria: http://positively.com
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Minister of Finance and Treasury Abdullah Jihad said today he would avoid cutting the salaries of civil servants in order to tackle the budget deficit which has spiralled to 27 percent of GDP.
He told Minivan News that he would seek to make savings in other areas of expenditure first.
?Civil servants are the lowest down of all government employees. We will try to cut all non-wage expenditure by 15 percent. Salaries will be considered after this,? said Jihad.
The minister?s comments today came after local newspaper Haveeru reported him as having said on Friday that the government was to review the pay of all state employees.
Jihad was reported as having said that the government may have to consider cuts of between 10 and 15 percent in order to save up to Rf2.5billion (US$162 million) from the state budget.
The Finance Ministry?s most recent weekly figures revealed the state?s expenditure to have been 140 percent of its income this year, resulting in a Rf1.5billion (US$97 million) overspend which has been predicted to reach over Rf9 billion (US$584 million) by the year?s end.
However, speaking with Minivan News today, Jihad said that the view expressed in the article was ?just an opinion? although he did confirm that a pay board, mentioned in Haveeru, was being formed in order to ?harmonise? the pay of all government employees.
The minister said that the review of public salaries will be conducted by a pay review board which will include independent commissions in order to reach an agreement on the necessary reductions.
Sun Online has quoted a senior official at the Finance Ministry as saying that the cabinet had already decided to make cuts of 15 percent to all executive branch agencies although Jihad stressed to Minivan News that no decisions had been made regarding any wage cuts.
?The Cabinet has not yet decided on any cuts,? said Jihad, ?we cannot just impose these cuts, we have to agree.?
Parliament?s Financial Committee revealed earlier this month that expected revenue for 2012 had plunged 23 percent , whilst spending was set to increase by almost 24 percent.
Between 2004 and 2009, the country?s fiscal deficit increased exponentially on the back of a 400 percent increase in the government?s wage bill. The year?s 2007 to 2009 included the most significant largesse as the World Bank found wage expenditure to have increased from Rf2billion to almost Rf5billion even as revenues began to recede.
According to statistics from the Civil Service Commission (CSC), the number of permanent civil servants has more than halved between 2006 and June 2011. There has been some contention in the past, however, that the transfer of many civil servants to state owned companies under the previous government masked the true figures.
The Maldives Monetary Authority (MMA) published?figures for May estimated that the government will spend Rf2.6billion (US$168million) on salaries and wages in 2012.
This represents only 12 percent of the ?GDP figures for 2012, predicted in November last year. The figures announced by the finance ministry earlier this month, however, suggest that salaries and wages will now make up 31 percent of the government?s income.
The Governor of the MMA Dr Fazeel Najeeb was reported as saying that the country was experiencing the worst financial crisis in recent history during a finance forum held last week on Bandos Island resort.
?Expenditure in the country has exceeded income, and as a result the budget deficit is increasing. From November 2010 inflation has also been going up,? he said.
The country last year spent 63.1 percent of its GDP on state expenses, Dr Najeeb claimed, adding that only four countries had worse percentages, including Cuba and Zimbabwe.
The Maldives Monetary Authority (MMA) figures for May estimated that the government will spend Rf2.6billion on salaries and wages in 2012.
The previous administration of President Mohamed Nasheed saw the government?s balance of payments fall from 21 percent of GDP in 2009 to an estimated 10.2 percent last year, according to the statistics provided by the Ministry of Finance and Treasury.
Jihad contended in ?Haveeru that it was the expenses of the former administration that had left the current government in financial dire straits.
ALBUQUERQUE, N.M.?? A massive, uncontrolled wildfire has neared to within two miles of a historic New Mexico mining town, leading to a mandatory evacuation Saturday of the dozen or so people there.
Crews suspect the wildfire saw a "substantial increase" overnight but were unable to send up a plane to confirm that, incident spokeswoman Iris Estes told msnbc.com.
The evacuation order is for Mogollon, a historic mining and ghost town that also has several summer homes around it. Estes said 15-16 people were thought to still be in the area.
Gusts up to 50 mph were expected Saturday, she added, making it again impossible for fire crews to deploy retardant-dumping aircraft.
The fire in southwestern New Mexico has destroyed a dozen cabins and spread smoke across the state as well as Arizona, prompting holiday weekend air-quality warnings.
The fire is burning through remote and rugged terrain around the Gila Wilderness and the last official estimate was that it had scorched 85,000 acres or more than 130 square miles.
The heavy smoke apparently disoriented six hikers Friday, prompting the New Mexico National Guard to carry out a rescue.
Col. Michael Montoya said one of them had an injured knee and had to be taken to safety by ambulance. The others were able to walk to a secure area.
More than 500 firefighters are battling the blaze that resulted from the merger earlier this week of two lightning-sparked fires. Fire officials say nearly all of the growth has come in recent days due to relentless winds.
The blaze has destroyed 12 cabins and seven small outbuildings, and the privately owned ghost town of Mogollon was placed under a voluntary evacuation order.
Story: Michigan wildfire grows to more than 21,000 acres
The strong winds pushed ash from the blaze 35 to 40 miles away, while smoke from the giant fire spread across the state and into Arizona. The haze blocked views of the Sandia Mountains in Albuquerque, and a smell of smoke permeated the air throughout northern New Mexico.
Health officials as far away as Albuquerque and Santa Fe issued alerts for the holiday weekend, advising people to limit outdoor activities, keep windows closed.
They said the effects on most people would be minor but noted mild throat and eye irritation or allergy-like symptoms could be expected. Officials warned people with heart and lung conditions to be especially diligent in minimizing their exposure to the smoky air.
Fires have been testing crews elsewhere as well over the last week:
In Colorado, officials said heavy air tankers and thousands of firefighters were on standby Friday as fire managers kept a close watch on high winds and hot temperatures at the start of Memorial Day weekend. Fire danger remains high in the southern Colorado foothills and the South Park area. Two heavy air tankers have been taken to Grand Junction in western Colorado, where the fire danger is highest. The National Weather Service said wind gusts could reach 70 mph Saturday in some western Colorado valleys.
In Southern California, firefighters worked to corral a wildfire that has chewed through 3,100 acres of tinder-dry grass and light brush east of Julian. On Friday, the fire forced about 50 people to evacuate an RV park in San Diego County. It earlier prompted the evacuation of about 100 homes in the Shelter Valley area, but residents were allowed to return late Thursday. The fire was 20 percent contained. No injuries or damage to structures were reported.
In Arizona, residents of the historic mining town of Crown King were allowed to return home after being evacuated because of a wildfire about 85 miles north of Phoenix. The fire started May 13 and has burned more than 16,000 acres. It is 35 percent contained, fire officials said.
In Nevada, questions were being raised over fire crews' initial response to a backyard burn that rekindled two days later, destroying two homes in a rural community and scorching 7,500 acres. A 911 recording obtained by The Associated Press showed a resident called Sunday to report that a neighbor's permitted burn in the Topaz Ranch Estates was out of control. Volunteer firefighters with the East Fork Fire Protection District arrived at the scene and then left, apparently without extinguishing the blaze. Gusty winds rekindled the fire Tuesday. District Fire Chief Tod Carlini did not immediately respond to messages seeking comment Friday.
WASHINGTON (AP) ? The U.S. can't count on Russia ? a major arms supplier to Syria ? to force President Bashar Assad from power, Sen. John McCain said Sunday, blaming President Barack Obama for embracing a "feckless" foreign policy and punting tough decisions until after the fall election.
It was a particularly sharp rebuke even for McCain, R-Ariz., who as a longtime critic of Obama's war strategy hasn't pulled many punches. As the top Republican on the Senate Armed Services Committee, McCain's viewpoint on complex world events often finds its way into GOP election-year talking points.
"This administration has a feckless foreign policy which abandons American leadership," McCain told "Fox News Sunday."
"What the conclusion you can draw is that this president wants to kick the can down the road on all of these issues until after the election. ... It's really an abdication of everything that America stands for and believes in," he later added.
Mitt Romney, Obama's presumed rival in this year's presidential election, said Obama "can no longer ignore calls from congressional leaders in both parties to take more assertive steps." He said the current approach has only given Assad more time to crackdown on protesters.
"The United States should work with partners to organize and arm Syrian opposition groups so they can defend themselves," Romney said.
The White House called for Assad's ouster as recently as Saturday when it blamed the Syrian government for killing more than 90 people, including 32 children, following peaceful protests. National Security Council spokeswoman Erin Pelton said the attack serves as a "vile testament to an illegitimate regime." The Syrian government has denied responsibility.
The U.N. Security Council held an emergency meeting Sunday afternoon to discuss the massacre, which took place in the Syrian town of Houla. Russia has opposed a collective press statement condemning the killings and insisted on being briefed first by the U.N. mission in Syria.
Earlier this month at the meeting of leading industrial nations at Camp David, White House officials said they had hoped Russia could use some of its sway to halt the bloody crackdown and raised the possibility of modeling a regime change in Syria after Yemen. Yemen's longtime President Ali Abdullah Saleh stepped down in February as part of a U.S.-backed power transfer deal that gave him immunity from prosecution in return for relinquishing power.
According to U.S. Deputy National Security Adviser Ben Rhodes, Russian Prime Minister Dmitry Medvedev "did not dispute the fact that there needs to be a process of political transition" in Syria.
"I think the question is, just how does that manifest itself?" Rhodes told reporters at a May 19 press conference.
The United States wants to avoid escalating a confrontation with Moscow over Syria, but wants Medvedev to hear the depth of international outrage. Specifically, the U.S. wants to prevent another Security Council showdown, in which Russia might feel it had to veto any anti-Assad proposals on principle and the U.S. would lose that avenue as a practical alternative. Moscow and Beijing have already twice shielded Syria from U.N. sanctions over the crackdown.
According to one official, who spoke on condition of anonymity to discuss internal diplomacy, the U.S. focus is now on getting Russia to tolerate a "political transition" in Syria similar to Yemen.
But McCain says the U.S. would be foolish to rely on Russia, a main supplier of arms to the Syrian military.
"Here we are a year later and 10,000 killed," he said, referring to the onset of protests across the Arab world. And "our hopes rest on convincing (Russia) to ease out Assad, comparing it to Yemen, which there is no comparison. It's really just a sad story."
__
AP Writers Edith M. Lederer from the United Nations and Anne Gearan from Washington contributed to this report.
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CANNES, France (AP) ? "After Lucia" by Mexican director Michel Franco has won the top prize in the Cannes Film Festival's sidebar competition, Un Certain Regard.
It was chosen Saturday from a slate of 20 films by a jury headed by British actor Tim Roth.
Un Certain Regard focuses on new and emerging filmmakers.
The jury gave second prize to French film "Le Grand Soir" by Benoit Delepine and Gustave Kervern, and a "special distinction" citation to Bosnian film "Djeca" ("Children of Sarajevo") by Aida Begic.
Twenty-two films from around the world are competing for prizes in the festival's main competition. Winners will be announced Sunday.
Favorites for the top prize, the Palme d'Or, include Michael Haneke's "Amour" and Christian Mungiu's "Beyond the Hills."
Around five people in China are able to lead a better life after a woman donated the organs of her 11-year old son who was brain dead following a car accident.
Yuan Dezhen, a 40-year-old migrant working mother from Shenzhen, has been living in Guangzhou with her family of five since 2006.
Her husband and her youngest son -- 11-year-old Tian Gan -- were severely injured in a car accident in January. Her husband died and her son was declared brain-dead, relying on a respirator to sustain his life, Xinhua reported.
Yuan chose to take her son off life-support and donate his organs.
Her son's liver, pancreas and small intestine were given to a 53-year-old diabetic and liver cancer patient.
His kidneys were given to two women patients aged 38 and 68, while the corneas brought sight to another two patients.
Yuan also chose to donate her son's body as well, giving it to the Medical School of Shenzhen University for educational and research purposes.
Yuan said it pained her to see her son on a respirator. She slept just two or three hours a day while he was in the hospital, praying for a miracle and hoping that he might wake up.
"I felt that if his organs could save just one person, his life could be extended."
Statistics from the health ministry said that 1.5 million patients in China are in dire need of organ transplants each year, while only 10,000 end up receiving them.
It's stressful and challenging to take care of an Alzheimer's patient, which is why families are thinking about letting them move to nursing homes or assisted living facilities. Unlike before that there are only ordinary facilities, interested families can find communities that specialize in taking care of people with Alzheimer's these days.
Letting the patients move to long term care facilities doesn't mean that they are already free from their responsibilities to them. They still need to get involved but in another way. They need to ensure their safety and make sure that they are getting quality care. Aside from these, they also need to visit them regularly in order to make them feel that they are still part of the family.
But before they can do all these things, they need to choose first a facility that will make their loved ones feel comfortable, safe and loved even if they are far from home. Choose a facility that is dedicated in providing optimum custodial and medical care to its patients. It is also important to consider the ratio of the caregivers and patients. There should be enough medical professionals around that can supervise them round the clock. They should be very visible, which can give a peace of mind on families and in order for them to provide the assistance and care that the patients need.
Families who consider nursing homes should get into the planning more. It is a good idea to personally check the facility, to see if the environment is perfect for the patient and the long term care plan they have for those with Alzheimer's is very extensive and efficient. Friends may recommend a facility they have tried but it is much better if family members will get more involved in weighing the options and coming up with a decision, which they can show by visiting the facility.
Aside from the comprehensive program they offer, a good facility should also have activities that can cheer up the patients and keep their loneliness at bay. It is also good to check out if it promotes interaction among residents and it helps them to become socially active again. This is also an important factor in choosing a facility since this helps in making the patient feel good and to sort of create a distraction from their present condition.
Alzheimer's patients are known to have mood swings and they tend to become very violent. They should find out how the facility handles inconvenient situations and when the patients throw tantrums. A good facility should have a good plan or strategy on how to calm down the patients and the staff know very well how to handle these episodes.
People who suffer from Alzheimer's need special attention and care that nursing homes can provide. If you are one of those families who are still looking for a facility that specialize in handling people with Alzheimer's, these facilities will not let you down. They provide quality care and they know exactly how to deal with this type of patient.
Zoe Gray is a web writer who has written volumes of articles for various industries. Her expertise are on health, finance, business, home and family. Learn more about nursing homes
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New prostate cancer screening guidelines face a tough sell, study suggestsPublic release date: 25-May-2012 [ | E-mail | Share ]
Contact: Stephanie Desmon sdesmon1@jhmi.edu 410-955-8665 Johns Hopkins Medical Institutions
Physicians have trouble stopping PSA tests, despite questionable benefits
Recent recommendations from the U.S. Preventive Services Task Force (USPSTF) advising elimination of routine prostate-specific antigen (PSA) screening for prostate cancer in healthy men are likely to encounter serious pushback from primary care physicians, according to results of a survey by Johns Hopkins investigators.
In a survey of 125 primary care doctors, the researchers found that while doctors agreed with older recommendations to curtail routine screening in men over age 75 and among those not expected to live 10 or more years, a large number said they faced significant barriers to stopping PSA testing in men who had been receiving it regularly. The most frequently cited reason by 74.4 percent of physicians was, "My patients expect me to continue getting yearly PSA tests," followed by 66 percent of them who said, "It takes more time to explain why I'm not screening than to just continue screening." More than half of those surveyed in the new study believed that, "By not ordering a PSA, it puts me at risk for malpractice."
The survey was conducted in November 2011, right after draft recommendations were made to end routine screening of all men, but before last week, when the draft recommendations were officially approved.
"It can be very difficult for doctors to break down the belief that all cancer screening tests are invariably good for all people all the time," says Craig E. Pollack, M.D., M.H.S., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine, and leader of the study published online in the journal Cancer. "Everyone agrees that PSA screening isn't as good as we want it to be. If we had a test that was a slam dunk, it would be different. But now we know that for many men, the benefits may be small and the harms significant."
Each year, more than 33,000 American men die of prostate cancer, and 20 million get the PSA test to detect the disease early.
According to the USPSTF, evidence suggests the potential harms caused by PSA screening of healthy men as a means of identifying prostate cancer outweigh its potential to save lives and that routine annual screening should be eliminated in the healthy. Elevated PSA readings are not necessarily evidence of prostate cancer, and can lead to unnecessary prostate biopsy. In addition, even when biopsies reveal signs of prostate cancer cells, evidence shows that a large proportion will never cause harm, even if left untreated. The disease in older men often progresses slowly so that those who have it frequently die of other causes.
Treatments for prostate cancer can include the removal of the prostate, radiation or other therapies, each of which has the potential to cause serious problems like erectile dysfunction, complete impotence, urinary incontinence or bowel damage. And men who choose to "watch and wait" after elevated PSA readings must live with the anxiety of knowing they have an untreated cancer that could start to progress.
In the new study, Pollack and his colleagues found that while most physicians said they took age and life expectancy into account when deciding to order PSA screening, many also said they had a hard time estimating life expectancy in their patients and could use a better tool. H. Ballentine Carter, M.D., a professor of urology at Johns Hopkins and the senior investigator on the study, is planning to investigate the potential of individualized prostate cancer screening recommendations. Specifically, he and colleagues plan to create a decision-making tool that incorporates age, life expectancy, family history and prior PSA results in order to help doctors and their patients make better choices for prostate cancer screening.
In another report derived from results of Pollack's and Carter's survey, published in April in the Archives of Internal Medicine, the researchers say nearly half of the providers agreed with the new USPSTF recommendations to eliminate routine screening for healthy men. Still, less than two percent said they would no longer order routine PSA screening in response to the draft recommendations; 21.9 percent said they would be much less likely to do so; 38.6 percent said they would be somewhat less likely to do so; and 37.7 percent said they would not change their screening practices.
"Men often expect PSA screening to be part of their annual physical," Pollack says. "To change their minds, we need to address their perceptions about screening, allow time for screening discussions and reduce concerns regarding malpractice litigation."
###
The studies were supported in part by a Maryland Cigarette Restitution Fund Research Grant to Johns Hopkins.
Other Johns Hopkins researchers involved with the studies included Elizabeth A. Platz, Sc.D., M.P.H.; Nrupen A. Bhavsar, Ph.D., M.P.H.; Gary Noronha, M.D.; Gene E. Green, M.D.; and Sean Chen, B.A.
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.
New prostate cancer screening guidelines face a tough sell, study suggestsPublic release date: 25-May-2012 [ | E-mail | Share ]
Contact: Stephanie Desmon sdesmon1@jhmi.edu 410-955-8665 Johns Hopkins Medical Institutions
Physicians have trouble stopping PSA tests, despite questionable benefits
Recent recommendations from the U.S. Preventive Services Task Force (USPSTF) advising elimination of routine prostate-specific antigen (PSA) screening for prostate cancer in healthy men are likely to encounter serious pushback from primary care physicians, according to results of a survey by Johns Hopkins investigators.
In a survey of 125 primary care doctors, the researchers found that while doctors agreed with older recommendations to curtail routine screening in men over age 75 and among those not expected to live 10 or more years, a large number said they faced significant barriers to stopping PSA testing in men who had been receiving it regularly. The most frequently cited reason by 74.4 percent of physicians was, "My patients expect me to continue getting yearly PSA tests," followed by 66 percent of them who said, "It takes more time to explain why I'm not screening than to just continue screening." More than half of those surveyed in the new study believed that, "By not ordering a PSA, it puts me at risk for malpractice."
The survey was conducted in November 2011, right after draft recommendations were made to end routine screening of all men, but before last week, when the draft recommendations were officially approved.
"It can be very difficult for doctors to break down the belief that all cancer screening tests are invariably good for all people all the time," says Craig E. Pollack, M.D., M.H.S., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine, and leader of the study published online in the journal Cancer. "Everyone agrees that PSA screening isn't as good as we want it to be. If we had a test that was a slam dunk, it would be different. But now we know that for many men, the benefits may be small and the harms significant."
Each year, more than 33,000 American men die of prostate cancer, and 20 million get the PSA test to detect the disease early.
According to the USPSTF, evidence suggests the potential harms caused by PSA screening of healthy men as a means of identifying prostate cancer outweigh its potential to save lives and that routine annual screening should be eliminated in the healthy. Elevated PSA readings are not necessarily evidence of prostate cancer, and can lead to unnecessary prostate biopsy. In addition, even when biopsies reveal signs of prostate cancer cells, evidence shows that a large proportion will never cause harm, even if left untreated. The disease in older men often progresses slowly so that those who have it frequently die of other causes.
Treatments for prostate cancer can include the removal of the prostate, radiation or other therapies, each of which has the potential to cause serious problems like erectile dysfunction, complete impotence, urinary incontinence or bowel damage. And men who choose to "watch and wait" after elevated PSA readings must live with the anxiety of knowing they have an untreated cancer that could start to progress.
In the new study, Pollack and his colleagues found that while most physicians said they took age and life expectancy into account when deciding to order PSA screening, many also said they had a hard time estimating life expectancy in their patients and could use a better tool. H. Ballentine Carter, M.D., a professor of urology at Johns Hopkins and the senior investigator on the study, is planning to investigate the potential of individualized prostate cancer screening recommendations. Specifically, he and colleagues plan to create a decision-making tool that incorporates age, life expectancy, family history and prior PSA results in order to help doctors and their patients make better choices for prostate cancer screening.
In another report derived from results of Pollack's and Carter's survey, published in April in the Archives of Internal Medicine, the researchers say nearly half of the providers agreed with the new USPSTF recommendations to eliminate routine screening for healthy men. Still, less than two percent said they would no longer order routine PSA screening in response to the draft recommendations; 21.9 percent said they would be much less likely to do so; 38.6 percent said they would be somewhat less likely to do so; and 37.7 percent said they would not change their screening practices.
"Men often expect PSA screening to be part of their annual physical," Pollack says. "To change their minds, we need to address their perceptions about screening, allow time for screening discussions and reduce concerns regarding malpractice litigation."
###
The studies were supported in part by a Maryland Cigarette Restitution Fund Research Grant to Johns Hopkins.
Other Johns Hopkins researchers involved with the studies included Elizabeth A. Platz, Sc.D., M.P.H.; Nrupen A. Bhavsar, Ph.D., M.P.H.; Gary Noronha, M.D.; Gene E. Green, M.D.; and Sean Chen, B.A.
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.
Realtor & Vice President of Sales of Bryan College Station Real Estate
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May 24th, 2012 Categories: Buying, Real Estate
When a home is marketed as being ?green? in Bryan, College Station or beyond there are several things to consider before purchasing the home on faith alone. There are many variances on definitions of the word ?green.? This term can represent many different things, including environmental conservation, responsibility to the community, and financial savings. Buyers should be wary to purchase a home believing it is ?green? without first fully understanding the advertised features.
?Green? certifications are available for prospective home buyers, but can be rather expensive. These certifications set services or products apart as being environmentally sound. Several companies set standards for ?green? products as well as compose and administer programs to encourage ?greener? lifestyles and products.
Defining ?green? isn?t where the complications stop. It is important to know differences between terminology to fully understand what a home and seller is really offering to the buyer. The term ?eco-friendly? is not the same thing as ?energy efficient.? This popular subject of improving the environment and essentially living a lifestyler healthier for the environment comes with its own jargon. Words such as greenie, solar, conservation, compost, vegetarian, vegan, reusable, locavore, herbivore, mindful consumption, carbon footprint, ecological footprint, vermicomposting, vermiculture, biofuel, ethanol, biodiesel, biomimicry, post-consumer recycled, compact fluorescent lightbulb, emissions, pollution, organic, global warming, and environmental can be just plain confusing.
Getting your terminology right is one of the more important things when it comes to dealing with ?green? living. To define all of these words however, would take quite a while, so instead we will focus on what it means for your house to be classified as ?green.? Keep in mind also, that even if your ?green?-friendly features in your house are not certified, they can still benefit the house by making it easier to live in and possibly even increasing the value.
It is wise for homeowners to discuss any ?green? features they wish to add to their house with an expert so they can more accurately consider their options. This will give homeowners a better idea of what they are considering in comparison to the entire field of ?green? features, and will clarify what value it can add to the house. One benefit of this is that the buyer won?t make a return on some additions, such as solar panels, for up to several years. It is also smart for homeowners who add ?green? features to their home to keep a running record of all of the items that have been added to the house. Tags, packaging receipts, and photos of these improvements should be kept and filed away. Realtors representing sellers should ask for these pieces of proof.
It is vital for consumers to ask questions, repeatedly, to ensure they fully understand what they are getting and to ensure that they are getting exactly what the seller is advertising. It is unwise for a consumer to take the sellers word for it or to feel that he or she has enough proof simply by looking at something that appears to be a ?green? feature.
If you feel uncomfortable with the information you have about a ?green? feature, do not hesitate to ask an expert. NAR Green employees are a great resource. It is beneficial to the environment to add ?green? features to your house, however there are also benefits to making your living space comfortable and cost effective that are not technically considered ?green.?
When you are advertising your home for sale, be wary of calling it ?green? without the proper certifications and standards required by certain programs. Instead, it is effective to include statements about how you have made the house more environmentally friendly and cost effective. ?We upgraded our insulation and we changed our windows? is a good alternative to using the term ?green,? which can be difficult to defend. Many avoid using ?green? and instead use ?quality.?
There are ?green? investments that are worth the cost to many buyers. There are several choices of course, the value varying depending on the homeowner?s opinion of what is most valuable. Some are low cost and some are more of an investment.
You can check your doors and your windows in your home for leaks. Making sure that the weather stripping around the home is in good shape is one way to do this. Also check to make sure that all the latches and locks are tightly secured.
Another thing you can do is switch to compact fluorescent lightbulbs. These light bulbs may cost more up front, but over time they pay back by consuming less electricity and lasting up to 10 times longer. Your savings become evident when your electricity bills begin to drop.
Spending extra money on low VOC paint is worth it to the environment. When you use paint that does not off-gas volatile organic compounds, it makes the environment healthier than it would?ve been with your alternative.
Change leaky faucets and install showerheads and spouts that are low flow. Checking for an efficient hot water heater can also save you money in the long run, as an inefficient hot water heater can actually be more draining on your budget than the cost of installing a new one altogether.
Ceiling fans are also a smart installment, as they increase air flow throughout your home and give you?re a/c a break during the long hot summers. Putting up blinds and other shades contribute as well to taking a load off of the a/c in a home by providing shade and cooling off rooms that are shaded.
Installing a rainwater catchment system will also make your home more ?green.? Those who live in the country know that in today?s time it doesn?t take much to dry up a well, and it doesn?t take much rainwater to fill up a catch system and rainwater may be the very thing that gets you through a drought.
Choosing naturally ?green? flooring and countertops will also avoid off-gassing that won?t be avoided in cheaper options.
Many people choose to implement ?green? features into their home for cost savings, but the biggest benefit is in helping the environment. You don?t have to make large investments either to go ?green.? All it requires are small daily choices that you can do to help out the environment.
PS ? Susan Hilton is Bryan College Station, Texas? real estate specialist in foreclosure sales and real estate agent career building so if you need help ? CALL! 979-219-3970
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Under Secretary of the Air Force Erin Conaton presents the Air Force?s International Affairs Excellence Award to Col. Lee Harvis during a ceremony held in the Pentagon in Washington, D.C., on May 23, 2012. Harvis currently commands the 374th Medical Group at Yokota Air Base, Japan. (U.S. Air Force photo/Andy Morataya)
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Col. Lee Harvis makes remarks after receiving the Air Force?s International Affairs Excellence Award during a ceremony held in the Pentagon in Washington, D.C., on May 23, 2012. Harvis currently commands the 374th Medical Group at Yokota Air Base, Japan. (U.S. Air Force photo/Andy Morataya)
Download HiRes Yokota Airman honored for international affairs excellence
Posted 5/24/2012 Email story?? Print story
by Tech. Sgt. Richard A. Williams Jr Air Force Public Affairs Agency
5/24/2012?-?WASHINGTON (AFNS)???An Air Force colonel was recognized May 23 for his role in supporting international relations through medical care and fostering joint relationships with Japan.
Undersecretary of the Air Force Erin Conaton presented Col. (Dr.) Lee Harvis with the 2011 Air Force International Affairs Excellence Award during a ceremony at the Pentagon.
Harvis currently serves as the 374th Medical Group commander and command surgeon for the 5th Air Force and U.S. Forces Japan at Yokota Air Base, Japan.
Conaton told attendees that Harvis exemplified the Air Force?s core values and the vast skill set so pivotal to the nation?s success as a global and humanitarian power.
During Operation Tomodachi, Harvis fostered multi-national medical partnerships and supported humanitarian efforts during the worst recorded natural disaster in Japan?s history. He also helped his counterparts in the Japan Air Self-Defense Force revamp their aeromedical evacuation system and coordinated the first Air Force medical liaison position to the Japanese Ministry of Defense, which will coordinate the use of critical Air Force and Department of Defense medical assets for future support.
?I am very humbled by this, and it is really not a reflection of me but of the people I work with,? Harvis said.
He said that dedicated Airmen, Soldiers and Sailors are the key to his success and that he would not be successful in building or maintaining strong international relationships in Japan without their professionalism and innovative approaches to mission accomplishment.
?Colonel Harvis has distinguished himself as an Airman diplomat,? Conaton said. ?He has already achieved a great deal, and we look forward to the great things that he will do for our Air Force in the years ahead.?
The Air Force?s International Affairs Excellence Award annually recognizes one Airman for outstanding and innovative contributions which had the greatest impact in international affairs and were most effective in building, sustaining, expanding and guiding Air Force-to-partner air force relationships.
All active-duty Airmen, Air Force Reserve, Air National Guard and Department of the Air Force civilians, whose duties contribute to the Air Force international affairs mission are eligible to be nominated.
Posted by admin on May 24 2012. Filed under Air Force. You can follow any responses to this entry through the RSS 2.0. You can leave a response or trackback to this entry
On the lookout for utilised repo journey trailers at auction? Today?s sagging overall economy and down to earth fascination costs, could very well make this the top time to identify a remarkable deal on trailers at auction. Selecting a put to use repo trailer below retail facilitates you to help you save you dough now and when you go to sell it in the upcoming.
Beneath are many details that can make improve you discover them at affordable auction fees and save many thousand pounds.
How to See Repo Journey Trailers
There are a couple of techniques for you to come across repo trailers at auction. Just one way to discover trailer auctions is to research local newspapers classifieds and specialty RV marketing guides. An extra feasible way to see an auction locale is by checking out with local lending institutions and that consistently problem loans on RV trailers. You can start out with the organization at the moment funding your RV or talk to a couple of dealerships who they would suggest for RV financing. (Hint: There could possibly be one division dealing with RV and automotive foreclosure. Not each individual a person at the financial institution will know how to help you. Persistence my be requested) The very last, and most effectual way to find out when and where exactly trailer auctions come about is to establish a romantic relationship with a small-scale RV seller and you can ask them when, whereby and how very often these require spot. Various moments these RV dealers go to these auctions on a regular foundation. If you are lucky they may even instruct you much more about how auctions precise to your area work. Your state may very well involve a license to bid (most don?t), and an rv vendor may very well be all set to allow bid at auction in trade for a minimal price.
One more important hint when you go to bid on a chosen trailer is to know how significantly the repo trailers are really worth beforehand. Also make guaranteed you know the ceiling amount you are inclined to bid given that you really don?t want to end up being to psychological when you bid. The number of bidders at auction fluctuates considerably dependent on the time. Even if it needs you a very few auctions to come across the appropriate trailer, it could be well well worth the wait around as a result of it could virtually save you 1000s. Finest Luck on obtaining your subsequent travel trailer auction.
Eli Shonts is a scholar regarding Farmington NM RV Parks
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Public release date: 25-May-2012
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When a home is marketed as being ?green? in Bryan, College Station or beyond there are several things to consider before purchasing the home on faith alone. There are many variances on definitions of the word ?green.? This term can represent many different things, including environmental conservation, responsibility to the community, and financial savings. Buyers should be wary to purchase a home believing it is ?green? without first fully understanding the advertised features.
PS ? Susan Hilton is Bryan College Station, Texas? real estate specialist in foreclosure sales and real estate agent career building so if you need help ? CALL! 979-219-3970
Posted by admin on May 24 2012. Filed under Air Force. You can follow any responses to this entry through the RSS 2.0. You can leave a response or trackback to this entry