Do drunks have to go to the ER?

NEW YORK (Reuters Health) – With the help of a checklist, ambulance workers may be able to safely reroute drunk patients to detoxification centers instead of emergency rooms, according to a new study.

Researchers in Colorado found no serious medical problems were reported after 138 people were sent to a detox center to sleep it off, instead of to an ER.

In 2004, according to the researchers, it’s estimated that 0.6 percent of all U.S. ER visits were made by people without any problems other than being drunk. Those visits ended up costing about $ 900 million.

“Part of the issue has been – as it is in many busy ER departments – there’s a lot of chronic alcoholics that are brought in by ambulance, police or just come in. Often they are brought in because they have not committed a crime or there is limited space in our detoxification center. So the majority were brought to the ER department,” said Dr. David Ross, the study’s lead author from Penrose-St. Francis Health Services in Colorado Springs.

Ross said the ambulance company where he serves as medical director created the checklist with the help of the local detox center, which provided limited medical care by a nurse, and the local hospitals to reduce the number of drunks without medical needs being sent to the local ERs.

They created a checklist with 29 yes-or-no questions, such as whether the patient is cooperating with the ambulance worker’s examination and if the patient is willing to go to the detox center.

The patient was sent to the ER if the ambulance worker checked “no” on any question.

The researchers then went back to look at the patients they transported between December 2003 and December 2005 to see whether or not any of them ended up having serious medical problems at the detox center.

During that two year period, the ambulance workers transported 718 drunks. The detox center received 138 and the local ERs got 580.

Overall, 11 of the patients who were taken to detox were turned away because there was no room, their blood alcohol level exceeded the limit, their family came to pick them up or they were combative.

Another four patients at the detox center were taken to the ER because of minor complications, including chest and knee pain. However, there were no serious complications reported.

“We really believe that we did not miss anybody with a serious illness and injury that didn’t go to the ER as they should have,” said Ross.

But the researchers write in the Annals of Emergency Medicine that their study did have some limitations.

Specifically, the researchers did not plan in advance to do a study when they were creating the checklist, which means their findings are limited to whatever information was collected at the detox center and ERs.

Also, the number of people who were sent to the detox center in their study is relatively small, so it’s hard to tell how many serious complications they’d see among a larger group of people.

“We tried to estimate how likely we would have been to encounter a serious event… We estimated at most we’d encounter three serious adverse events (in 748 patients),” Ross told Reuters Health.

SOURCE: http://bit.ly/QgPCT5 Annals of Emergency Medicine, online November 9, 2012.

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Serious About Free Markets? Prove It

On Friday the Republican Study Committee, a policy shop for congressional Republicans, published a memo on how to fix copyright law. By Saturday afternoon the group’s executive director had pulled the memo, which had evidently failed to approach the subject with “all facts and viewpoints in hand.” This is Washington’s way of saying that an interest group hit the roof, and indeed, Ars Technica reports that lobbyists from the “content industry”—Hollywood and recording companies—pressured the group to renounce the memo.

Copyright being in fact broken, you can still read copies of the memo online. It lays out what copyright reform advocates have been saying for years. Copyright protections now extend 70 years past the life of the author; for a corporation, 95 years after publication. This, along with punitive laws on copyright violation, hinders creativity and innovation. These facts aren’t new. What’s new is the tone. Derek Khanna, the memo’s author, writes like an unashamed free marketeer, and in doing so manages to latch on to a larger point: Laws that help businesses often harm markets. From the memo:

Today’s legal regime of copyright law is seen by many as a form of corporate welfare that hurts innovation and hurts the consumer. It is a system that picks winners and losers, and the losers are new industries that could generate new wealth and added value. We frankly may have no idea how it actually hurts innovation, because we don’t know what isn’t able to be produced as a result of our current system. (Emphasis in the original.)

Radical stuff. There’s no one in Washington to lobby for industries that don’t exist yet, and ever so briefly, Khanna and the Republican Study Committee stepped into that breach. Then they stepped back, to gather more facts and viewpoints. Here’s one: Pro-business and pro-market are not the same thing. The most pleasant place for a business is not elbows-out in the middle of a free market, but sitting alone, atop a fat monopoly. Ask your local cable provider. The larger a business gets, the more it has to protect from the companies and industries that might follow it with something better or cheaper. And the best way to protect what you have is to have it written into law.

Real markets, with real competition, are most helpful to newcomers. Small businesses and new industries create new value. Once created, they, too, move to Washington to protect it. Witness the growth of Google (GOOG) and Facebook’s (FB) lobbying operations in the Capitol. Khanna describes extended copyright protection as rent-seeking—in his words, “non-productive behavior that sucks economic productivity and potential from the overall economy.” What’s true of Hollywood and the recording industry could be said of any established industry.

Luigi Zingales, a professor at the University of Chicago Booth School of Business and a regular contributor to Bloomberg View, points out that larger companies can lobby for special exemptions in the tax code. This creates complexity in the tax code, which punishes smaller businesses that can’t pay for tax lawyers and don’t have anyone’s buttonhole on Capitol Hill. Zingales prefers simple regulations and simple taxes, which are harder for lobbyists to game and easier for democracies to understand. He sees this as a bipartisan problem. The left is inclined toward more regulation, and the right is pro-business, rather than pro-markets.

The direction Khanna was headed—a defense of open, competitive markets at the expense of existing businesses—is still wide open space, claimed by no party. This summer, conservatives such as Timothy Carney at the Examiner and Yuval Levin at National Review urged Mitt Romney to back markets, not businesses. But he chose not to, even though he, in his day, disrupted existing markets of his own. Some enterprising Republican can still do it. Derek Khanna in 2016! He’s young. Maybe VP.

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Ivory Coast: New prime minister named

ABIDJAN, Ivory Coast (AP) — President Alassane Ouattara has tapped Foreign Minister Daniel Kablan Duncan to serve as prime minister in a new government one week after the surprise dissolution of cabinet.

The appointment of Duncan, a member of the PDCI party of former President Henri Konan Bedie, was announced at a press conference Wednesday by Amadou Gon Coulibaly, general secretary of the presidency.

Ouattara dissolved the cabinet last week over a feud between his political party and the PDCI over proposed changes to the country’s marriage law.

The PDCI supported Ouattara in the November 2010 runoff election in exchange for the prime minister’s post, helping him defeat incumbent President Laurent Gbagbo. Gbagbo’s refusal to cede office led to five months of violence that claimed at least 3,000 lives before Ouattara’s forces won.

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Carpe Twitter: Vatican tweets on new Latin academy

VATICAN CITY (Reuters) – A senior Vatican cardinal tweeted in Latin on Wednesday to urge people to attend the inauguration of, you guessed it, the Holy’s See’s new Academy for Latin Studies.

“Hodie una cum Ivano Dionigi novam aperiemus academiam pontificiam latinitatis a Benedicto conditam, hora XVII, via Conciliationis V,” was the tweet by Cardinal Gianfranco Ravasi.

The approximate translation: “Today at 5 p.m., along with Ivano Dionigi, we will open the new Pontifical Academy for Latin Studies founded by Benedict. Via della Conciliazione, 5.”

It was not the first tweet in Latin – an Italian professor has been doing it for some time – but evidently Ravasi wanted to seize the day, or “carpe diem”.

The pope earlier this month announced that he had instituted the Pontifical Academy for Latin Studies, placing it under the auspices of the Vatican’s ministry for culture.

Dionigi, a Latin scholar who is rector of Bologna University – widely recognized to be the world’s oldest – is the academy’s first president.

The pope started the academy to promote the study and use of Latin in the Roman Catholic Church and beyond.

When instituting the academy, the pope said Latin, which is still the official language of the universal Church, was the subject of renewed interest around the world and the academy was mandated to encourage further growth.

(Reporting By Paolo Biondi and Philip Pullella)

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Chevy Chase Exiting “Community”

NEW YORK (TheWrap.com) – Chevy Chase is leaving “Community” after a rocky run on the NBC series.

The actor is leaving by mutual agreement with the show’s producers, a person close to the show told TheWrap. He will appear in most of the 13 episodes of the show’s upcoming fourth season, but not the final one or two episodes.

Chase had a very public feud with former showrunner Dan Harmon that included Harmon airing an angry rant by Chase. The situation hardly improved when new showrunners Moses Port and David Guarascio took over this season.

The original “Saturday Night Live” player reportedly used the N-word last month in an on-set rant complaining about the racism of his character, Pierce Hawthorne. Chase asked how far the character’s bigotry would go, and whether he would be forced to say the word. He later apologized.

Chase made little effort to hide his mixed feelings about the show, telling the Huffington Post in March, “I probably won’t be around that much longer, frankly.”

“I have creative issues with this show,” he said. “I always have. With my character, with how far you can take character … just to give him a long speech about the world at the end of every episode is so reminiscent. It’s like being relegated to hell and watching ‘Howdy Doody‘ for the rest of your life. It’s not particularly necessary, but that’s the way they do these things. I think it belies the very pretenses that his character, Jeff, has, that he’s giving these talks. They’re supposed to, in some way, be a little lesson to people who watch sitcoms … to that degree, I can’t stand sitcoms. … I think, if you know me and my humor over the years, you know that this is certainly not my kind of thing.”

“Community” returns February 7.

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Ob-Gyns: Sell ‘The Pill’ Over The Counter

Women’s health and reproductive rights experts are lining up to lend support to the push to make oral contraceptives available without a prescription.

This week, the American College of Obstetricians and Gynecologists issued a committee opinion, calling for the switch.

The aim is to increase access and lower the unintended pregnancy rate, which has held steady at 50% in the U.S. for two decades.

RELATED: Affordable Care Act Won’t End Disparities

“I think it’s great,” says Jeff Peipert, MD, PhD, the Robert J. Terry professor of obstetrics and gynecology at Washington University in St. Louis. “These pills are very, very safe. Pregnancy is far riskier than taking a birth control pills. In fact aspirin has greater health risks than the birth control pill.”

“I think the benefits outweigh any downsides,” says Dan Grossman, MD, vice president for research at  Ibis Reproductive Health, a nonprofit organization dedicated to research and the promotion of reproductive rights and women’s health.

Ibis issued a statement applauding the move.

Easier access to birth control pills should help reduce the U.S. unintended pregnancy rate, according to the ACOG.  The price tag for U.S. taxpayers is about $ 11.1 billion every year.

No birth control pills are currently available over the counter. Emergency contraception (such as Plan B) is sold over the counter.

Making the pill available over the counter will reduce or remove two barriers–access and convenience, the doctors say. Teens who may be reluctant to ask a family doctor for the pill would have access.

How it will affect the barrier of cost remains to be seen. On average, the cost for birth control pills is about $ 16 a month, surveys suggest.

Some women could be affected adversely if the pills goes over-the-counter and they lose insurance coverage. While the U.S. Department of Health and Human Services guidelines require new private health plans to cover, cost-free, all FDA-approved contraceptive methods, it is not clear how those guidelines will play out. Medicaid is exempted.

RELATED: Pediatrician Group Urges Doctors To Offer Teens Emergency Birth Control In Advance

“But it’s important to remember this would [if approved by the FDA] add another way to access birth control–it wouldn’t eliminate any existing ways,” Grossman tells Take Part. “Women who want to go to a doctor [for their contraceptives] would still have that option.”

In a video released by ACOG along with the announcement, it emphasizes the importance of an annual ”well woman” visit to her doctor, regardless of  how a woman gets her birth control method.

Research suggests that those who get birth control pills without a prescription will still see their doctor for screening and other preventive health needs.

One oft-mentioned risk of oral contraceptives–blood clots–is low, the ACOG says, “and significantly lower than the risk of blood clots during pregnancy and the postpartum period.”

Women are able to determine their own health risks and decide if they should or should not take the pill, according to ACOG.

The process of reclassifying drugs from prescription to over-the-counter status is regulated by the Food and Drug Administration. It relies on its advisory panels to make the decision.

That takes time, of course. “I think the timeline might be two to four years,” Grossman says.

The complete opinion by the college is published in the December 2012 issue of the journal Obstetrics & Gynecology.

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Kathleen Doheny is a Los Angeles journalist who writes about health. She doesn’t believe inmiracle cures, but continues to hope someone will discover a way for joggers to maintain their pace.

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HSBC China flash PMI at 13-month high as growth quickens

BEIJING (Reuters) – China‘s vast manufacturing sector saw expansion accelerate in November for the first time in 13 months, preliminary results from a factory survey showed, a sign that the pace of economic growth has revived after seven consecutive quarters of slowdown.

The China HSBC Flash Manufacturing Purchasing Managers Index (PMI) rose to a 13-month high of 50.4 in November, the latest indicator of recovery in the real economy after data showing solid credit growth, firmer exports and rising industrial output in the previous month.

A sub-index measuring output rose to 51.3, also the highest since October 2011.

“This reflects that conditions for smaller firms, especially exporters, are looking up,” said Li Wei, a Shanghai-based economist for Standard Chartered. “The consensus in the market is already for a small, gradual improvement.”

An uptick in key economic activity indicators in October, following encouraging signs in September, cemented the view of many analysts and investors that a rebound in the world’s second largest economy gathered momentum as it entered the fourth quarter, thanks to a raft of pro-growth policies rolled out by the government over recent months.

China is currently shuffling its senior officials after the seven top leaders of the ruling Communist Party were selected at a congress last week. The new appointments should end months of uncertainty in the highest ranks, although economic policy is not expected to change abruptly in the near-term.

Even before the congress, the central bank had moved to ease liquidity by pumping short-term cash into money markets rather than resorting to the interest rate cuts or reduction in banks’ required reserve ratios that many investors had expected.

STEADY THROUGH YEAR-END

This month’s PMI reading above 50 is likely to be seen as a turning point by the market, particularly if it is born out by the final reading due on December 1 and by official indicators.

Asian shares <.MIAPJ0000PUS> extended gains slightly after the data to stand up nearly 1 percent on the day and the Australian dollar, sensitive to demand from the biggest customer for Australia’s resources, rose as far as $ 1.04.

“This confirms that the economic recovery continues to gain momentum towards the year-end,” Qu Hongbin, chief China economist at index sponsor HSBC, said in a statement accompanying the data.

“However, it is still the early stage of recovery and global economic growth remains fragile. This calls for a continuation of policy easing to strengthen the recovery.”

With a one-month exception in October 2011, the HSBC PMI — which largely reflects the private manufacturing sector — has remained stubbornly below the 50-point level separating accelerating from slowing growth since June 2011.

Unlike the patchy results seen in previous months, in November almost all the sub-indices in the HSBC survey concurred in showing an improving economy.

The one exception was a fall in the sub-index measuring output prices, demonstrating that manufacturers are still struggling with overcapacity and relatively weak domestic demand.

That could also reflect the weight in the survey of exporting firms, which have less ability to raise sales prices, said Standard Chartered’s Li.

Indeed, China’s exporters are increasingly squeezed by rising domestic costs and competition from new international suppliers, Zhou Haijiang, head of Chinese textile exporter Hodo Group, told reporters this month.

“Not only Western countries manufacture industrial goods, but also a lot of developing countries including former socialist countries who now have market economies are all exporting, thus creating a global surplus that cannot be changed,” Zhou said.

“Because of this it is hard to raise sales prices, everyone is selling and it is hard for manufactured goods prices to rise. In some cases prices have even fallen.”

Analysts expect no further cuts to interest rates this year or next after back-to-back cuts in June and July, and only one more 50 basis point cut to banks’ required reserve ratios (RRR) in 2012 after three since late 2011 that have freed an estimated 1.2 trillion yuan for new lending.

Chinese banks are on course to make new loans worth more than 8.5 trillion yuan ($ 1.4 trillion) in 2012, expansionary versus the 7.5 trillion of new loans extended in 2011 and above the 8 trillion yuan that sources told Reuters back in February was the target for 2012.

Total social financing aggregate, a broad measure of liquidity in the economy, weakened to 1.29 trillion yuan in October, down from 1.65 trillion yuan in September, but still remained on track to hit a record 14 trillion yuan this year.

China also opened many previously-closed sectors to private investment with a view to funding new infrastructure projects and supporting economic growth without piling on more debt that local governments can ill-afford.

Although analysts expect fourth quarter GDP growth to outpace the 7.4 percent seen in the third quarter, full-year expansion for 2012 is expected to be the slowest in 13 years.

(Editing by Alex Richardson)

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Ivory Coast: New prime minister named

ABIDJAN, Ivory Coast (AP) — President Alassane Ouattara has tapped Foreign Minister Daniel Kablan Duncan to serve as prime minister in a new government one week after the surprise dissolution of cabinet.

The appointment of Duncan, a member of the PDCI party of former President Henri Konan Bedie, was announced at a press conference Wednesday by Amadou Gon Coulibaly, general secretary of the presidency.

Ouattara dissolved the cabinet last week over a feud between his political party and the PDCI over proposed changes to the country’s marriage law.

The PDCI supported Ouattara in the November 2010 runoff election in exchange for the prime minister’s post, helping him defeat incumbent President Laurent Gbagbo. Gbagbo’s refusal to cede office led to five months of violence that claimed at least 3,000 lives before Ouattara’s forces won.

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NJ jury convicts NY man in iPad data breach case

NEWARK, N.J. (AP) — A federal jury on Tuesday convicted a man of illegally gaining access to AT&T‘s servers and stealing more than 120,000 email addresses of iPad users including New York Mayor Michael Bloomberg and film mogul Harvey Weinstein.

Andrew Auernheimer, of New York, was convicted of identity theft and conspiracy to gain unauthorized access to computers. Each count carries a maximum prison sentence of five years.

Prosecutors said the former Fayetteville, Ark., resident was part of an online group that tricked AT&T’s website into divulging email addresses including those of Bloomberg, Weinstein, then-White House chief of staff Rahm Emanuel, who’s now Chicago’s mayor, and other celebrities.

The group then shared the addresses with the website Gawker, which published them in redacted form accompanying a news article about the breach, prosecutors said.

A second man arrested with Auernheimer early last year, Daniel Spitler, of San Francisco, pleaded guilty that June.

At the time of the arrests, U.S. Attorney Paul Fishman said there was no evidence the men used the swiped information for criminal purposes. But authorities cautioned that it could have wound up in the hands of spammers and scam artists.

According to court papers, the men used a computer script they called the iPad3G Account Slurper to fool AT&T’s servers into thinking they were communicating with an iPad. The theft of the email addresses occurred in June 2010.

Prosecutors said at the time of Auernheimer’s arrest that he had bragged about the operation in a blog posting and in an interview with CNET published online after the Gawker article. Court papers also quoted him declaring in a New York Times article: “I hack, I ruin, I make piles of money. I make people afraid for their lives.”

Auernheimer, after he was charged and released on bail, had declined to comment.

iPad maker Apple Inc., based in Cupertino, Calif., referred questions to AT&T, which acknowledged a security weak spot on a website that exposed the email addresses. AT&T said the vulnerability affected only iPad users who signed up for its 3G wireless Internet service and said it had fixed the problem.

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Singer Fiona Apple cancels tour dates to be with ailing dog

LOS ANGELES (Reuters) – Grammy award-winning singer Fiona Apple said in a handwritten letter posted on her website on Tuesday that she has canceled upcoming tour dates in North and South America to be with her ailing dog.

Apple, who vowed to make up the concerts, called off three shows in Brazil between November 27 and 30, a Buenos Aires festival appearance on December 1-2 and a December 9 performance in Mexico City, according to her record label, Epic.

The “Criminal” singer and pianist said her 13-year-old pit bull Janet has been suffering from a tumor in her chest among other ailments and appears to be dying.

“She’s my best friend and my mother and my daughter, my benefactor and she’s the one who taught me what love is,” Apple wrote in the four-page letter she penned last week but did not release until Tuesday. “I can’t come to South America. Not now.”

Apple, 35, said that she wants to appreciate the final days with her dog. “I will not be the woman who puts her career ahead of love and friendship,” Apple wrote.

The singer-songwriter, who is touring in support of “The Idler Wheel … ” album, was arrested in September in Texas and charged with felony drug possession for having four grams of hashish, a form of cannabis.

(Reporting By Eric Kelsey; editing by Patricia Reaney and Todd Eastham)

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