Chef John from Culinary blog Foodwishes claims that the residual oil from the pizza crust in your skillet will be reheated and make the crust crispy again and by the time this happens the cheese will have melted again and warmed the toppings. He even makes the claim that he uses this method with delivery pizza to improve the crust.
Magic Pizza Reheat Method! | YouTube
brandon jacobs brandon jacobs fred davis fred davis fracking fracking drosselmeyer
|
Essential News from The Associated Press |
|||
? ?Associated Press. All Rights Reserved.
veterans barbados resorts tiger woods helen mirren the call surrogates surrogates
MOSCOW ? Russia's president threatened on Wednesday to deploy missiles to target the U.S. missile shield in Europe if Washington fails to assuage Moscow's concerns about its plans, a harsh warning that reflected deep cracks in U.S.-Russian ties despite President Barack Obama's efforts to "reset" relations with the Kremlin.
Dmitry Medvedev said he still hopes for a deal with the U.S. on missile defense, but he strongly accused Washington and its NATO allies of ignoring Russia's worries. He said that Russia will have to take military countermeasures if the U.S. continues to build the shield without legal guarantees that it will not be aimed against Russia.
The U.S. has repeatedly assured Russia that its proposed missile defense system wouldn't be directed against Russia's nuclear forces, and it did that again Wednesday.
"I do think it's worth reiterating that the European missile defense system that we've been working very hard on with our allies and with Russia over the last few years is not aimed at Russia," said Capt. John Kirby, a Pentagon spokesman. "It is ... designed to help deter and defeat the ballistic missile threat to Europe and to our allies from Iran."
White House spokesman Tommy Vietor said the U.S. will continue to seek Russia's cooperation, but that the U.S. missile defense plan in Europe "is going well and we see no basis for threats to withdraw from it."
But Medvedev said Moscow will not be satisfied by simple declarations and wants a binding agreement. He said, "When we propose to put in on paper in the form of precise and clear legal obligations, we hear a strong refusal."
Medvedev warned that Russia will station missiles in its westernmost Kaliningrad region and other areas, if the U.S. continues its plans without offering firm and specific pledges that the shield isn't directed at its nuclear forces. He didn't say whether the missiles would carry conventional or nuclear warheads.
In Brussels, NATO Secretary-General Anders Fogh Rasmussen said he was "very disappointed" with Russia's threat to deploy missiles near alliance nations, adding that "would be reminiscent of the past and ... inconsistent with the strategic relations NATO and Russia have agreed they seek."
"Cooperation, not confrontation, is the way ahead," Rasmussen said in a statement.
The U.S. missile defense dispute has long tarnished ties between Moscow and Washington. The Obama administration has repeatedly said the shield is needed to fend off a potential threat from Iran, but Russia fears that it could erode the deterrent potential of its nuclear forces.
"If our partners tackle the issue of taking our legitimate security interests into account in an honest and responsible way, I'm sure we will be able to come to an agreement," Medvedev said. "But if they propose that we `cooperate,' or, to say it honestly, work against our own interests, we won't be able to reach common ground."
Moscow has agreed to consider a proposal NATO made last fall to cooperate on the missile shield, but the talks have been deadlocked over how the system should be operated. Russia has insisted that it should be run jointly, which NATO has rejected.
Medvedev also warned that Moscow may opt out of the New START arms control deal with the United States and halt other arms control talks, if the U.S. proceeds with the missile shield without meeting Russia's demand. The Americans had hoped that the START treaty would stimulate progress in further ambitious arms control efforts, but such talks have stalled because of tension over the missile plan.
While the New START doesn't prevent the U.S. from building new missile defense systems, Russia has said it could withdraw from the treaty if it feels threatened by such a system in future.
Medvedev reaffirmed that warning Wednesday, saying that Russia may opt out of the treaty because of an "inalienable link between strategic offensive and defensive weapons."
The New START has been a key achievement of Obama's policy of improving relations with Moscow, which had suffered badly under the George W. Bush administration.
"It's impossible to do a reset using old software, it's necessary to develop a new one," Medvedev's envoy to NATO, Dmitry Rogozin, said at a news conference.
The U.S. plan calls for placing land- and sea-based radars and interceptors in European locations, including Romania and Poland, over the next decade and upgrading them over time.
Medvedev said that Russia will carefully watch the development of the U.S. shield and take countermeasures if Washington continues to ignore Russia's concerns. He warned that Moscow would deploy short-range Iskander missiles in Kaliningrad, a Baltic Sea region bordering Poland, and place weapons in other areas in Russia's west and south to target U.S. missile defense sites. Medvedev said Russia would put a new early warning radar in Kaliningrad.
He said that as part of its response Russia would also equip its intercontinental nuclear missiles with systems that would allow them to penetrate prospective missile defenses and would develop ways to knock down the missile shield's control and information facilities.
Igor Korotchenko, a Moscow-based military expert, was quoted by the state RIA Novosti news agency as saying that the latter would mean targeting missile defense radars and command structures with missiles and bombers. "That will make the entire system useless," he said.
Medvedev and other Russian leaders have made similar threats in the past, and the latest statement appears to be aimed at the domestic audience ahead of Dec. 4 parliamentary elections.
Medvedev, who is set to step down to allow Prime Minister Vladimir Putin to reclaim the presidency in March's election, leads the ruling United Russia party list in the parliamentary vote. A stern warning to the U.S. and NATO issued by Medvedev seems to be directed at rallying nationalist votes in the polls.
Rogozin, Russia's NATO envoy, said the Kremlin won't follow the example of Soviet President Mikhail Gorbachev and take unwritten promises from the West.
"The current political leadership can't act like Gorbachev, and it wants written obligations secured by ratification documents," Rogozin said.
Medvedev's statement was intended to encourage the U.S. and NATO to take Russia seriously at the missile defense talks, Rogozin said. He added that the Russian negotiators were annoyed by the U.S. "openly lying" about its missile defense plans.
"We won't allow them to treat us like fools," he said. "Nuclear deterrent forces aren't a joke."
____
Associated Press writers Nataliya Vasilyeva in Moscow, Pauline Jelinek and Julie Pace in Washington, and Slobodan Lekic in Brussels contributed to this report.
go ask alice go ask alice nflx john mccarthy john mccarthy lumpectomy robin williams
This Friday (Nov. 25), a rather large partial eclipse of the sun will be on view ? but only for a relatively small audience.
This will be the fourth time that a new moon will orbit between the sun and Earth to cause a solar eclipse in 2011, just one eclipse shy of the maximum for the number of solar eclipses in a given year.?
The first eclipse on Jan. 4 coincided with sunrise across Europe.
Some Alaskans and Canadians shared a view of a partially obscured sun on the afternoon of June 1. [Photos: The First Solar Eclipse of 2011]
And perhaps just a few penguins experienced a very slight eclipse a month later off Lutzlow-Holm Bay on the coast of Antarctica.
On Friday, the moon's penumbral, or outer, shadow will brush the southern belly of the Earth, initially touching down in the South Atlantic Ocean, about 600 miles (1,000 kilometers) a southwest of Cape Town, but only managing to encompass the southern and western portion of South Africa, completely missing Lesotho and barely grazing the border of Namibia. The sun will be seen rising with a dent in its upper right rim.
The axis of the Earth's shadow, containing the cone of darkness known as the umbra, from where we could see a total solar eclipse, misses Earth entirely, passing at its nearest, only about 0.05 of the Earth's radius, or about 210 miles (340 km) out in space.
More space news from msnbc.com
Science editor Alan Boyle's Weblog: Blue Origin, the secretive rocket venture founded by Amazon.com billionaire Jeff Bezos, has unveiled a spruced-up website with some previously unreleased launch videos.
So the depth of this partial eclipse is greater than the three others that preceded it. At greatest eclipse, 90.5 percent of the sun's diameter will be covered as seen from the place nearest to the shadow axis, at a point in the Bellingshausen Sea along the west side of the Antarctic Peninsula.
Here, the sun will be seen to dip to the southern horizon at the "midnight" of its 24-hour southern late spring day, and as it slowly ascends still very low to the south-southeast horizon it turns into a delicate boat-shaped crescent in eclipse; the horizon along which the dazzling boat goes rocking is that of "The Ice" (a nickname for Antarctica, being "on the ice").
As the penumbra slides under the bottom of the Earth, the partial eclipse is visible in varying extent across the icy land continent and just as it begins to slide back out into space it (just barely) manages to pass over Tasmania as well as portions of New Zealand's South Island. In fact, the last contact of the shadow with Earth occurs just to the west of the South Island, in the Tasman Sea.
Coming attractions
If you have already obtained a calendar for 2012, be sure to put a big red circle around May 20.?
That is the date of the next solar eclipse and it promises to be a spectacular event. It will be an annular ("ring") eclipse that will be visible from parts of eight western U.S. states during the late-afternoon hours.?
For those living in parts of New Mexico and west Texas, the setting sun will be transformed into a blazing "ring of fire," in some cases lasting for more than five minutes. And across much of North America, the exception being those near and along the Atlantic Coast, the sun will appear partially eclipsed.?
Across the Pacific for parts of China and Japan, the annular eclipse will also be visible (Tokyo is directly in the eclipse track), although for Asia, being positioned to the left (west) of the International Date Line, this event will take place on the morning of May 21.?
Needless to say, in contrast to next Friday, next May's solar eclipse will have a huge viewing audience.?
Editor's note: If you snap a photo or video of the eclipse and want to share it with SPACE.com for a story or gallery, please email Clara Moskowitz at cmoskowitz@space.com and Denise Chow at dchow@space.com.
Joe Rao serves as an instructor and guest lecturer at New York's Hayden Planetarium. He writes about astronomy for The New York Times and other publications, and he is also an on-camera meteorologist for News 12 Westchester, N.Y.
? 2011 Space.com. All rights reserved. More from Space.com.
Source: http://www.msnbc.msn.com/id/45389490/ns/technology_and_science-space/
lord monckton lord monckton andy kaufman october 21 2011 ohio ohio john beck
LONDON (Reuters) ? Turkey is still determined to join the European Union despite the current crisis in the euro zone and can become the bloc's economic "growth engine," President Abdullah Gul said in an interview published on Sunday.
Gul rejected concerns that the economic problems facing the euro zone meant that any further expansion of the 27-member EU should be put on hold.
EU countries agreed unanimously in 2005 to start talks with mainly Muslim Turkey with the goal of full membership.
However, French President Nicolas Sarkozy remains opposed to Turkey joining and German Chancellor Angela Merkel says she favors a "privileged partnership" for Turkey rather than full membership.
"Some people who think in a narrow scope and who do lack a strategic perspective consider Turkey's membership a burden," Gul, who is traveling to Britain this week for a three-day visit, told Britain's Sunday Telegraph.
"But those who can think 30 years, 60 years ahead, and who can think about the changing trends in the economy and the changing centers of power, can understand how much strength Turkey can bring to the existing strength of Europe."
Gul said Turkey's membership of NATO had been considered the only reason for it to be allowed to join but now its booming economy, where GDP grew by 11 percent in the first quarter of 2011, was as valid.
"Consider the potential that Turkey has: Turkey's position, her assets, the value she can add in terms of energy resources, her population, the dynamism she can bring into Europe, and also the growth that she can bring, with Turkey being the engine of this growth."
He said Turkey viewed the euro zone crisis as a temporary situation.
"We approach the negotiations with a strategic vision, and are very determined."
Turkey has also been taking a tough approach against Syria over its crackdown on opponents of President Bashar al-Assad and Gul said his country would back the Syrian people.
"When any kind of movement has its roots among the people of the country and the walls of fear come down, then the end result is very obvious," he said.
"With a strong and clear voice we are saying that the legitimate demands of the people are being supported by us. We enable them to have their meetings and discussions in a free environment, and provide a diplomatic platform.
"I strongly believe that there is no place any more for authoritarian regimes -- single party systems that do not have accountability or transparency -- on the shores of the Mediterranean."
(Reporting by Michael Holden; Editing by Ralph Gowling)
stevens johnson syndrome verdict in michael jackson trial verdict in michael jackson trial brian urlacher matt forte dr conrad murray verdict take care
WASHINGTON ? The GOP's image as a rigidly anti-tax party is softening. Spurred by federal debt worries in Congress, the shift conceivably could reshape the Republican Party's brand ahead of the 2012 elections, forcing tough decisions by its presidential candidates.
Some of the party's staunchest fiscal conservatives have surprised colleagues by saying targeted tax hikes are acceptable if they lead Democrats to accept deep government spending cuts.
Whether or not Congress' deficit-reduction talks succeed, the Republicans' offer has touched off a debate unlikely to end soon. The altered stance would upend party orthodoxy, which holds that deficits should be tamed entirely by spending cuts, with no tax increases.
In recent months, growing numbers of Republican lawmakers and strategists have grown wary of the no-exceptions position. They fear independent voters will abandon the GOP next year if it seems too rigid and beholden to tea partyers. They also worry that another deficit-reduction impasse will further erode Congress' image, and House Republicans might be handy election targets.
Some of those Republicans hope Democrats will agree to a deal that would include cuts to Medicare and, eventually, Social Security. Such a bargain might protect Republicans from so-called "Mediscare" attacks next fall, based on their embrace of an earlier GOP budget plan that would privatize and shrink Medicare for future beneficiaries.
Publicly, Republican lawmakers say they are motivated by the dire need to curb the deficit and reassure financial markets that the government can tax and spend responsibly.
Rep. Charles Bass, R-N.H., recently told NPR that he might renege on his pledge to oppose higher taxes, even if it hurts him politically. Bass said he also pledged to "defend America against enemies, both domestic and foreign. And I consider the debt crisis in this country to be a real threat to the future of America."
The Republican tax-hike overture has turned heads largely because its sponsors rank among Washington's best-known critics of tax increases. Sen. Pat Toomey of Pennsylvania is a former head of the conservative Club for Growth. Backers of his plan include Rep. Jeb Hensarling, R-Texas, who holds similar stature among fiscal conservatives.
Both are members of the 12-person bipartisan "supercommittee" tasked with reaching a debt-reduction deal by next week.
Toomey's plan would raise $300 billion in new tax revenues while overhauling the federal tax code. Republican officials say it would drop the top tax rate on personal income to 28 percent from the current 35 percent. It would reduce or eliminate some well-known itemized deductions and reduce the corporate tax rate.
The plan also would extend the Bush-era tax cuts, now set to expire at the end of next year. Most Democrats oppose that idea. It also would trim cost-of-living increases for Social Security recipients.
House Speaker John Boehner is among several top Republicans who have blessed Toomey's plan. Those avoiding a public position so far include House Majority Leader Eric Cantor of Virginia and Senate Minority Leader Mitch McConnell of Kentucky.
"The significance of someone as conservative as Senator Toomey putting forward a plan with revenue raisers cannot be overstated as proof of the willingness on our side to find a compromise solution," said Kyle Downey, spokesman for Sen. John Thune, R-S.D.
But congressional Democrats have not accepted Toomey's offer. They have called for greater revenue increases, and different priorities for spending cuts.
If the supercommittee fails to reach a $1.2 trillion deficit-cutting deal by Wednesday, automatic spending cuts totaling that amount would take effect beginning in 2013.
Republican presidential candidates have given varied responses to Toomey's tax overture.
"The contours that I'm hearing about are very similar to the program that I've put out," former Utah Gov. Jon Huntsman told reporters in New Hampshire. If the plan phases out tax loopholes and deductions, lowers income tax rates, broadens the base and simplifies the code, "it's something that I could be in favor of," he said.
Former Massachusetts Gov. Mitt Romney has avoided direct comment on Toomey's plan. A campaign spokeswoman said Romney "does not believe that more revenues and tax increases are the answer to our fiscal woes."
Texas Gov. Rick Perry "wants to look at details, but if those details include a tax increase, he's not going to be for it," a spokesman said.
Former House Speaker Newt Gingrich has denounced the supercommittee process rather than the Toomey plan itself. "Secret negotiations among a handful of members will lead to a gigantic bill no one understands," Gingrich said Thursday.
At an Aug. 11 presidential debate, just before Perry entered the race, all those attending said they would reject a deficit-reduction plan if it included $10 in spending cuts for every $1 in new revenues.
Support for Toomey's plan, whether it bears fruit or not, suggests many Republican officials are more open to compromise. But hardly all.
Several conservative activists lambasted Toomey's plan, predicting a voter backlash if it becomes law. Radio talk show host Hugh Hewitt called it "an enormous breach of faith with the voters" who put Republicans back in control of the House in the 2010 elections.
A conservative Arizona website, Seeing Red AZ, called Toomey's move stunning. It said Toomey, "long a conservative icon, presents a disappointing caricature as he crosses the line by supporting this tax increase."
Other conservative Republicans, however, say Toomey's effort is a savvy approach that might gather momentum.
"Republicans are starting to think, whether right or not, that the first party to walk away from some or all of its orthodoxy to make a deal is going to reap a pretty significant benefit with the public," said Republican lobbyist Mike McKenna. "If you can bring in some new revenue and open up the discussion of entitlement reform, that's a political win and a policy win."
Several Republicans said Grover Norquist, the best-known anti-tax-hike activist, has lost clout in recent months. Norquist says an adamant stand against tax increases is vital to the Republican Party's brand, even if Democrats are willing to make deep spending cuts in return.
Numerous Republicans have openly defied Norquist lately.
Rep. Frank Wolf of Virginia criticized him on a range of issues in a House floor speech last month. "Have we really reached a point where one person's demand for ideological purity is paralyzing Congress to the point that even a discussion of tax reform is viewed as breaking a no-tax pledge?" Wolf asked.
Boehner raised eyebrows recently when he referred to Norquist, a feared figure in some political circles, as "some random person."
___
Associated Press writers Steve Peoples in New Hampshire, Mike Glover in Iowa and David Espo in Washington contributed to this report.
steve jobs quotes pancreatic cancer symptoms apple stock aspergers apple computer pancreatic cancer steve jobs
derrick mason derrick mason lamichael james lamichael james epstein harrisburg pa chynna phillips
WASHINGTON ? Deadline nearing, the deficit-reduction talks in Congress sank toward gridlock Friday after supercommittee Democrats rejected a late Republican offer that included next-to-nothing in new tax revenue. Each side maneuvered to blame the other for a looming stalemate.
The panel faces a deadline of next Wednesday, the day before Thanksgiving, and lawmakers on both sides stressed they were ready to meet through the weekend in a last-ditch search for compromise.
But there was little indication after a day of closed-door meetings that a breakthrough was likely, both Democrats and Republicans emphasizing long-held political positions.
"Where the divide is right now is over taxes, and whether the wealthiest Americans should share in the sacrifices," said Washington Sen. Patty Murray, the Democratic co-chair of the panel.
But Michael Steel, a spokesman for House Speaker John Boehner, said Republicans had offered "a balanced, bipartisan plan - the fact that it was rejected makes it clear that Washington Democrats won't cut a dime in government spending without job-killing tax hikes."
While prospects for a deal faded, House Democrats checked a Republican attempt to pass a balanced budget amendment to the Constitution. The vote was 261-165, or 23 shy of the two-thirds majority required. GOP lawmakers voted overwhelmingly in favor, while Democrats generally opposed it, sealing its doom.
The vote on a noisy House floor contrasted to the secretive proceedings inside the supercommittee, a panel that projected optimism when it began its quest for a deficit deal late last summer but has yet to come to any significant compromise.
Republicans disclosed during the day they had outlined an offer on Thursday for about $543 billion in spending cuts ? leaving Medicare, Medicaid and Social Security untouched ? and $3 billion in higher tax revenue.
Most if not all of the recommended savings were items that Democrats have agreed to in earlier talks, but only, party officials said, on condition they part of a larger deal in which Republicans agreed to additional tax increases.
Democrats have long demanded that Republicans agree to significant amounts of higher taxes on the wealthy as part of any deal, and they quickly rejected the offer, according to officials in both parties.
It was unclear where the talks would turn next, but the GOP proposal suggested the discussions had effectively moved into a range of savings far below the $1.2 trillion the committee has been seeking.
It also appeared Republicans were jettisoning a plan for $300 billion in higher tax revenue, an offer that had exposed internal GOP divisions when it was presented two weeks ago. It also has failed to generate momentum for a compromise among Democrats.
If the panel fails to reach agreement, $1.2 trillion in automatic spending cuts are to take effect beginning in 2013, a prospect that lawmakers in both parties say they want to avoid.
That is particularly true among defense hawks, who argue that the Pentagon cannot sustain the estimated $500 billion in cuts that would be required on top of the $450 billion already in the works.
In a letter to Murray and Rep. Jeb Hensarling, R-Texas, the GOP chairman of the supercommittee, the head of the House Armed Services Committee warned of "immediate, dire and in some cases irrevocable" damage to the nation's military. "Our ability to respond to national security crises or humanitarian disasters would be disrupted," added Rep. Howard P. (Buck) McKeon, R-Calif.
Republicans familiar with the GOP plan said it included $543 billion in spending cuts, fees and other non-tax revenue, as well as the $3 billion corporate jet provision. There also would be $98 billion in reduced interest costs.
Officials familiar with the offer said it would save the government $121 billion by requiring federal civilian workers to contribute more to their pension plans, shave $23 billion from farm and nutrition programs and generate $15 billion from new auctions of broadcast spectrum to wireless companies.
It also would claim about $100 billion in savings from Pentagon civilian personnel costs and another $35 billion by increasing the fee that mortgage giants Fannie Mae and Freddie Mac charge lenders to guarantee repayment of new loans. The fee increase would add $15 a month to the monthly cost of an average new mortgage.
The per-ticket security fee to pay for Transportation Security Administration operations at the nation's airports would increase, and $18 billion would come from savings within Postal Service accounts.
__
Associated Press writer Donna Cassata contributed to this report.
chili recipe grimm jello shots tashard choice tashard choice amityville horror puss in boots
We're moving ever closer to the finale of the last season of "The Ultimate Fighter" to air on Spike before it moves to the Fox family of networks. Hopefully, that doesn't mean the last of the coaches challenges, which happens tonight. Huzzah! Read on for spoilers and recaps.
The show started out on a sweet note. Dustin Pague passed the same homeless man on the street during the drive from the house to the training center every day, so he decided to put together a bag of food, drinks and an encouraging note and handed it off to the man. The van barely slowed down long enough for him to do it, but kudos to Pague for thinking outside his own world of training.
Jason "Mayhem" Miller stopped by the house for a BBQ, and is somehow devolved into a competition of bug-eating. I don't even ... I can't even ... Why? Pague ate a bunch of bugs, so he won, I guess?
Oh, but there's a real competition this week! COACHES CHALLENGE! Nothing perks up a season of TUF like the coaches' challenge. Remember Brock Lesnar losing at football? Jens Pulver becoming a pro ping pong player? Forest Griffin dominating Quinton Jackson in basketball? Exactly.
This time around, it's air hockey. As usual, the winning coach gets $10,000 and each of his team members gets $1,000. Both Miller and Bisping say that they haven't played in years, and it's obvious by their poor technique.
Bisping scores first, second and through six until Miller finally scores. Miller is terrible, and Bisping easily took the first two games. To the surprise of no one, Bisping started talking crap, and Mayhem took the third one. The last game was tight, but Bisping took it. He jumped on the table to celebrate, but then fell off the table.
The semifinal fights continue tonight, with the winner headed to the finale. Dillashaw has an obvious wrestling advantage, while Pague is much more comfortable standing up. This isn't a big trash talk-filled bout. Dillashaw is the last bantamweight to be standing for Team Bisping, which he says proves how much better he is than his opponents.
Semifinal bout: Dustin Pague vs. T.J. Dillashaw in three-round bout
Round 1: Dillashaw landed solid strikes and then got his first takedown in the first minute. He couldn't pass guard, but he did a good job of holding off Pague's submission attempts. Dillashaw landed several big elbows and completely controlled him on the ground until the final 30 seconds. Pague pushed him off, landed a big knee, but didn't have time to get a rhythm going from his feet.
Round 2: Again, Dillashaw started with an easy takedown, but was much closer to the cage. He had to move to side control and spin Pague around slowly to get him away from the fence. For the rest of the round, Dillashaw kept Pague on his back. It wasn't exciting, but it was effective.
Between rounds, both corners realized that Pague had to get a knockout or a submission for a win, because the judges cards would be on Dillashaw's side.
Round 3: Dillashaw had a harder time getting the takedown this time, but guess what? He still did it. He also landed some nasty strikes that opened a cut on Pague's face. Aside from the blood, the second round looked exactly like the third.
Dillashaw took the decision and moved on to the finals with a score of 30-26, 30-27, 30-26. He very kindly consoled Pague after the loss.
bank transfer day daylight savings 2011 day light savings day light savings there will be blood there will be blood us geological survey
NEW YORK (Reuters) ? Intuit, the maker of accounting and tax preparation software posted a narrower loss for its first quarter than a year earlier as the growth of the products it makes for small business customers helped it weather one of its seasonally slower quarters.
Intuit has built a small-business division, which helps companies process credit-card transactions, manage employee payrolls and build websites, into a $1.5 billion-a-year operation. It was larger by revenue than the company's consumer tax division last year.
Revenue in the small business unit increased 13 percent in the quarter to $384 million.
"We're posting double digit growth in small business when the economy is still in the tank," Chief Executive Brad Smith told Reuters in an interview.
That unit helped boost Intuit results in one of its seasonally weaker quarters when people are not thinking about filing their taxes yet. Intuit's most profitable products are its tax software for consumers.
But Smith said the tax season is coming up quickly and that the company has high expectations for the performance of its TurboTax software, which now attracts customers increasingly on the Internet.
"We're expecting to have a great tax season," he said, adding the products come out after November 25.
The company forecast second-quarter revenue of $1 billion to $1.02 billion and earnings per share, excluding items, in the range of 43 cents and 47 cents. Wall Street's average expectation is for 43 cents per share for the second quarter.
It posted a first-quarter net loss of $64 million, or 21 cents per share, compared to a loss of $70 million, or 22 cents per share a year earlier.
Adjusted for stock compensation and other charges, the company reported a loss of 10 cents per share, which beat Wall Street's estimates by two cents.
Intuit's revenue rose 12 percent in its first quarter to $594 million, which beat analysts' average estimates of $580.6 million, according to Thomson Reuters I/B/E/S. (Reporting by Liana B. Baker, editing by Bernard Orr and Carol Bishopric)
christmas island antonio gates antonio gates challah oxford comma oxford comma elisabetta canalis
NEW YORK ? Justin Verlander breezed to the AL Cy Young Award on Tuesday in a unanimous vote after the Detroit Tigers' ace won the pitching version of the Triple Crown.
Verlander dominated the balloting in much the same way he humbled hitters with his 100 mph fastball, sharp curve and wicked slider.
Now, the big question of the baseball awards season: Will he also be chosen the AL MVP next Monday?
"Do I think it's possible? Yes. Would I like to win it? Of course," Verlander said during a conference call from his home in Virginia. "It's kind of a weird scenario."
"Pitchers are on the ballot," he said. Bolstering the case of all pitchers, Verlander pointed to "the tremendous effect we have on the day of our game."
No starting pitcher has won the honor since Roger Clemens in 1986, with Dennis Eckersley the last reliever to get it in 1992. Many observers say pitchers shouldn't win the MVP, period, contending they already have their own award. Verlander's year, though, has ratcheted up the debate in a crowded MVP field that includes Curtis Granderson, Jacoby Ellsbury, Jose Bautista, Miguel Cabrera and more.
Verlander led the majors in wins by going 24-5 and topped baseball with 250 strikeouts. His 2.40 ERA was the best among AL pitchers who qualified for the title.
Verlander drew all 28 first-place votes in balloting by members of the Baseball Writers' Association of America and finished with 196 points.
Jered Weaver (18-8, 2.41) of the Los Angeles Angels was the only other pitcher listed on every ballot and second with 97 points. James Shields of Tampa Bay was third with 66, followed by CC Sabathia of the New York Yankees with 63. Tigers reliever Jose Valverde, who was perfect in 49 save chances, was fifth with 28.
Verlander pitched his second career no-hitter, won 12 straight starts down the stretch and helped the Tigers take the AL Central, their first division title since 1987.
In many games, the 28-year-old righty was simply unhittable. He pitched a no-hitter on May 7 at Toronto, missing a perfect game just by an eighth-inning walk on a full-count delivery.
In his next start, he held Kansas City hitless for 5 2-3 innings. Johnny Vander Meer is the only pitcher to throw back-to-back no-hitters.
Later in the season, the 6-foot-5 star took a pair of no-hit bids into the eighth inning ? one of those came on July 31 against Weaver and the Angels, a 3-2 win at Detroit.
"I felt like it was a statement game," Verlander said. "A lot of people had eyes on that game."
Verlander also led the majors with 251 innings, all while issuing a career-low 57 walks. He pitched four complete games, including two shutouts.
This was the ninth time there was a unanimous winner of the AL Cy Young and first since Johan Santana in 2006, when he won the AL pitching Triple Crown. This was the fourth time a Detroit pitcher won it, with Denny McLain earning the award in 1968 and tying for the honor in 1969, and reliever Willie Hernandez winning in 1984.
McLain, in 1968, and Hernandez went on to win the AL MVP awards, too.
A four-time All-Star, Verlander became the first former AL Rookie of the Year to also take the Cy Young. This win included a $500,000 bonus to his $12.75 million salary in 2011.
The only thing missing from Verlander's pitching resume is a World Series title. He is 3-3 with a 5.57 ERA in eight career postseason starts, and went 2-1 in the playoffs this year as the Tigers reached the AL championship series before losing to Texas.
Clayton Kershaw of the Los Angeles Dodgers is the favorite to win the NL Cy Young when the results are released Thursday. He won the NL pitching Triple Crown, leading with a 2.28 ERA and 248 strikeouts and tying for wins at 21.
The AL and NL Managers of the Year will be announced Wednesday.
dancing with the stars brandi glanville kristin chenoweth beanie wells beanie wells dina manzo dina manzo
![[ Back to EurekAlert! ]](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_uUcdJSkuPpn1DasJ-AHi9ePrLidOGvPJRq8f-_19TPnf0M7A2HxY3qPX50fNMwnd9N5W9ZbIch_z5yioJ3pNfyj5qaQesYKoAPYTUOA0Q=s0-d){kind=small}
Public release date: 16-Nov-2011
Share ] Contact: Laura Sussman
lsussman@mdanderson.org
713-745-2457
University of Texas M. D. Anderson Cancer Center
HOUSTON About half of male breast cancer patients who take the drug tamoxifen to prevent their disease from returning report side effects such as weight gain and sexual dysfunction, which prompts more than 20 percent of them to discontinue treatment, according to researchers at The University of Texas MD Anderson Cancer Center.
The study, which is the largest to date of how the estrogen-blocking drug is tolerated in men with breast cancer, was published today in the journal Annals of Oncology.
"While tamoxifen is effective in treating breast cancer in men, little is known about its toxicity," said Sharon Giordano, M.D., associate professor of medicine in MD Anderson's Department of Breast Medical Oncology and senior author of the study. "This research will help doctors and patients better understand the side effects men experience. With this information, patients can make more informed decisions about treatment risks and benefits."
Few Empirical Studies of Rare Disease
Only about 2,000 men are diagnosed with breast cancer in the United States each year, but its incidence is increasing. Since the disease is so rare, little published evidence exists to guide treatment decisions, and most are based on what works in women. There is limited data about the toxicity of anti-hormonal treatments in men.
Male breast cancers are almost always hormone-receptor positive. Tamoxifen blocks the growth-promoting action of estrogen on cancer cells, and it usually is prescribed to men after surgery.
MD Anderson is one of the nation's most active centers for treatment of male breast cancer. As a fellow working with Giordano, lead author Naveen Pemmaraju, M.D., now an assistant professor in MD Anderson's Department of Leukemia, saw a number of these patients.
"I was struck by how rare the disease is and how little published literature there is about it," he said. "I noticed many of these men were stopping tamoxifen therapy early, and the side effects seemed to be different from those generally reported in women."
Side Effects Different From Women
Researchers analyzed the medical records of 64 male breast cancer patients treated at MD Anderson between 1999 and 2009. Diagnoses included stages I, II and III. Patients received tamoxifen for an average of four years.
More than half (53 percent) had one or more drug-related side effect. The top two complaints were weight gain (22 percent) and sexual dysfunction (22 percent). Twenty percent of men stopped taking the drug prematurely because of adverse effects. Of 13 men who discontinued tamoxifen early, four were directed by physicians to stop for medical reasons.
Pemmaraju says men seem to experience different side effects than women, probably because their hormonal environment is different. For example, men have lower levels of estrogen and higher levels of testosterone.
After adjusting for patient age and disease stage, researchers found the outlook for men with breast cancer who take tamoxifen is similar to that of women.
Awareness, Discussion Are Key
Pemmaraju said the study shouldn't change the practice of prescribing tamoxifen for men, but he suggests doctors may want to counsel patients about the side effects and the benefits of continuing the medication.
"I hope this study will help raise awareness in patients and physicians, generate discussion about the side effects and begin to tease out details of why treatment is discontinued," he said.
Further Study Needed
Pemmaraju said the study shows the need for future research to help understand the problems and benefits of tamoxifen.
"It would be valuable to prospectively assess male breast cancer patients and collect data on them at the start of tamoxifen therapy and then follow them through the years to get a better sense side effects and tolerability," he said.
###
Other MD Anderson researchers involved in the study include Mark Munsell, M.S., Department of Leukemia; and Gabriel Hortobagyi, M.D., Department of Breast Medical Oncology.
About MD Anderson
The University of Texas MD Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. MD Anderson is one of only 40 comprehensive cancer centers designated by the National Cancer Institute. For eight of the past 10 years, including 2011, MD Anderson has ranked No. 1 in cancer care in "Best Hospitals," a survey published annually in U.S. News & World Report.
[ | 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.
Public release date: 16-Nov-2011 Share ] Contact: Laura Sussman
lsussman@mdanderson.org
713-745-2457
University of Texas M. D. Anderson Cancer Center
HOUSTON About half of male breast cancer patients who take the drug tamoxifen to prevent their disease from returning report side effects such as weight gain and sexual dysfunction, which prompts more than 20 percent of them to discontinue treatment, according to researchers at The University of Texas MD Anderson Cancer Center.
The study, which is the largest to date of how the estrogen-blocking drug is tolerated in men with breast cancer, was published today in the journal Annals of Oncology.
"While tamoxifen is effective in treating breast cancer in men, little is known about its toxicity," said Sharon Giordano, M.D., associate professor of medicine in MD Anderson's Department of Breast Medical Oncology and senior author of the study. "This research will help doctors and patients better understand the side effects men experience. With this information, patients can make more informed decisions about treatment risks and benefits."
Few Empirical Studies of Rare Disease
Only about 2,000 men are diagnosed with breast cancer in the United States each year, but its incidence is increasing. Since the disease is so rare, little published evidence exists to guide treatment decisions, and most are based on what works in women. There is limited data about the toxicity of anti-hormonal treatments in men.
Male breast cancers are almost always hormone-receptor positive. Tamoxifen blocks the growth-promoting action of estrogen on cancer cells, and it usually is prescribed to men after surgery.
MD Anderson is one of the nation's most active centers for treatment of male breast cancer. As a fellow working with Giordano, lead author Naveen Pemmaraju, M.D., now an assistant professor in MD Anderson's Department of Leukemia, saw a number of these patients.
"I was struck by how rare the disease is and how little published literature there is about it," he said. "I noticed many of these men were stopping tamoxifen therapy early, and the side effects seemed to be different from those generally reported in women."
Side Effects Different From Women
Researchers analyzed the medical records of 64 male breast cancer patients treated at MD Anderson between 1999 and 2009. Diagnoses included stages I, II and III. Patients received tamoxifen for an average of four years.
More than half (53 percent) had one or more drug-related side effect. The top two complaints were weight gain (22 percent) and sexual dysfunction (22 percent). Twenty percent of men stopped taking the drug prematurely because of adverse effects. Of 13 men who discontinued tamoxifen early, four were directed by physicians to stop for medical reasons.
Pemmaraju says men seem to experience different side effects than women, probably because their hormonal environment is different. For example, men have lower levels of estrogen and higher levels of testosterone.
After adjusting for patient age and disease stage, researchers found the outlook for men with breast cancer who take tamoxifen is similar to that of women.
Awareness, Discussion Are Key
Pemmaraju said the study shouldn't change the practice of prescribing tamoxifen for men, but he suggests doctors may want to counsel patients about the side effects and the benefits of continuing the medication.
"I hope this study will help raise awareness in patients and physicians, generate discussion about the side effects and begin to tease out details of why treatment is discontinued," he said.
Further Study Needed
Pemmaraju said the study shows the need for future research to help understand the problems and benefits of tamoxifen.
"It would be valuable to prospectively assess male breast cancer patients and collect data on them at the start of tamoxifen therapy and then follow them through the years to get a better sense side effects and tolerability," he said.
###
Other MD Anderson researchers involved in the study include Mark Munsell, M.S., Department of Leukemia; and Gabriel Hortobagyi, M.D., Department of Breast Medical Oncology.
About MD Anderson
The University of Texas MD Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. MD Anderson is one of only 40 comprehensive cancer centers designated by the National Cancer Institute. For eight of the past 10 years, including 2011, MD Anderson has ranked No. 1 in cancer care in "Best Hospitals," a survey published annually in U.S. News & World Report.
[ | 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.
Source: http://www.eurekalert.org/pub_releases/2011-11/uotm-tcs111611.php
toyota recall order of operations carrie underwood eric church martina mcbride sara evans lionel richie
NEW YORK?? Amy Winehouse had written all the songs that were to appear on her third album. She even picked out song titles.
But music producer Salaam Remi said the soul singer, who died over the summer, was not rushing to release that new material, instead planning to drop a jazz album first with a "supergroup" including ?uestlove of the Roots.
"She had written down everything she wanted to do," Remi said Tuesday.
Only two of the tracks Winehouse wrote were recorded and appear on her compilation album, "Lioness: Hidden Treasures," out Dec. 5 in the United Kingdom, and a day later in America.
While PEOPLE decided that Bradley Cooper was its choice for 2011, much of the web-surfing public seems to think it should ...
Winehouse died from accidental alcohol poisoning at age 27. Her body was found at her London home July 23.
Remi, who worked on the singer's two albums, "Frank" and "Back to Black," produced most of the upcoming CD, saying Winehouse was a perfectionist when it came to composing music.
"She was taking her time with it, and at the end of the day all of her songs are somewhat autobiographical, so she had to live through something, then get out of it and then look back at it to be able to write about it," he said.
Story: Posthumous Amy Winehouse album set for release"Who knows what will happen in the future with that," he said of the songs she penned.
Remi held a press listening for "Lioness" on Tuesday. The 12-track set features covers and stripped-sounding versions of released Winehouse songs, with some completed in one take.
Slideshow: Amy Winehouse (on this page)Before her third album would come out, Remi said, Winehouse wanted to record with Roots drummer ?uestlove and saxophone player Soweto Kinch.
"There were a bunch of other names bouncing around," Remi said.
Story: Coroner: Amy Winehouse died from too much alcohol?uestlove did make the new album, though. He appears on the track "Half Time." There's also a song by an 18-year-old Winehouse, another about her ex-husband's infidelity and "Best Friend," which opens with the line: "I can't wait to get away from you."
Remi has produced for the Fuguees, Nas, Jazmine Sullivan and Nelly Furtado. He produced the song "Block Party" from TLC member Lisa "Left Eye" Lopes, and Winehouse sought him out after hearing the track. Remi says that Winehouse usually wrote songs while playing the guitar and that the new album sounds just as good as her critically acclaimed predecessors.
He also said he wanted to release new material from the late singer before others did so.
"Before somebody comes up with some weird song ... this is what it really is," he said. "This is the quality."
Copyright 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Source: http://today.msnbc.msn.com/id/45336444/ns/today-entertainment/
2013 ford escape stop online piracy act internet censorship protect ip act spear of destiny jessie james the descendants
WP Engine, a powerful hosted WordPress platform for existing WordPress.org users, has raised $1.2 million in new funding led by Silverton Partners with angels Eric Ries, Loic Le Meur, Dharmesh Shah, Jeremy Benken, Bill Boebel, Rob Walling participating. Automattic, the company behind WordPress.com, also made a strategic investment in WP Engine. WP Engine, which launched in July of 2010, provides a enterprise-level hosting service for WordPress.org users who are tired of managing servers and doing IT work themselves. WP Engine makes sure blogs have super fast page load times, and scale when hit with a ton of traffic.Source: http://feedproxy.google.com/~r/Techcrunch/~3/xeo-FmBAZAg/
national coffee day paw paw paw paw baltimore orioles rosh hashanah rosh hashanah amanda palmer
LONDON?? Ever since she can remember, Katherine Cummings knew she had been born into the wrong body.
"I knew I was transgendered as far back as memories go," said the 76-year old, formerly called John, who works at Australia's Gender Center for people with gender issues. "Four years of age or so."
Since her 1930s childhood, the lives of transgender people have improved dramatically in many countries. But discrimination remains widespread. Hundreds of transgender people are killed every year and many live in constant fear of attack.
"Transgenders often suffer violence, physical and social, from their families, including spouses, parents, children and siblings," Cummings said.
She spoke to Reuters ahead of the annual Transgender Day of Remembrance (TDOR) on Sunday commemorating those who have been killed because of their gender identity.
Founded after the 1998 murder of transgender woman Rita Hester in Massachusetts, the day now has a global following.
In the first nine months of 2011, 116 transgender people were murdered globally, according to Trans Murder Monitoring (TMM), a project coordinated by non-profit association Transgender Europe.
Their research indicates there have been at least 681 reports of murders in 50 countries since 2008.
It was at the age of 51, after marrying and fathering three children, that Cummings was finally ready for gender reassignment.
Despite the pervasive discrimination, she says gender activists are winning some battles. Cummings points to significant developments over the last decade, such as the recent ruling that Australians can change their gender on passports without surgery ? to male, female or indeterminate.
"I feel, on the whole, looking back over the past few decades, that matters are slowly improving," said Cummings, whose book about her transition, "Katherine's Diary," won the Australian Human Rights Commission's 1992 non-fiction award.
Only on msnbc.com
Seven of this year's murders were in the United States, TMM said. Washington. D.C., made headlines this year after a series of attacks against transgender people ? one of them the fatal shooting of 23-year-old transgender woman Myles Mclean.
"I look forward to the day that no one has to hide or be killed, or bullied or teased or rejected simply for being the person they believe themselves to be," said Eva-Genevieve Scarborough, 56, who is helping organize a remembrance event in Riverside, California.
"Society needs to be made aware that atrocities such as the murder of trans folks are still happening all around the world."
Many transgender people seek surgery or hormones to change their physical gender. Others don't, some by choice and some because discrimination or lack of means stop them accessing medical help.
Discrimination also damages their employment opportunities. And activists worldwide are battling to remove 'gender identity disorder' from lists of officially recognized mental illnesses.
Most of the murders of transgender people TMM recorded this year occurred in Latin America ? 29 in Brazil, 22 in Mexico, 11 in Venezuela and 10 in Columbia, as well as murders in 10 other Latin American countries.
TMM also noted murders in Turkey, Pakistan, India, Indonesia, Malaysia, the Philippines, and Poland.
United Nations human rights chief Navi Pillay said in May that hate crimes against lesbians, gay men, bisexuals and transgender people are on the rise around the world.
"Transgender people face the worst challenges, regardless of which country they are coming from or situated in," Liesl Theron, executive director of Gender dynamiX, an organization supporting transgender and transsexual rights in South Africa, told Reuters.
"Usually trans people are on the fringes of society, and the most marginalized."
In a 2008 paper on transgender people in Africa, she cited examples of transgender women across the continent being beaten and imprisoned.
"Most African countries still have some form of legal action, legislation and laws against homosexuality and sodomy (which includes all forms of being a trans person)," she wrote.
Poor access to medical services is the number one challenge in much of Africa, she added.
Theron quoted one Ugandan activist as saying that doctors often refuse to treat transgender people and even sometimes tip off police, leading to arrests.
Trans people in Uganda have been forced to resort to self-medication with dangerous long-term implications, the activist added.
In South Africa, the transgender community has won some victories ? the Department of Home Affairs agreed this October to change the gender and forenames of a transgender woman. Yet people awaiting gender-reassignment surgery still join a seven-year waiting list.
Slowly, gender rights are improving in many countries. But the discrimination is proving hard to stamp out.
"Humanity has an ingrained need for a 'pecking order,' that sets some people up as superior to others," said Cummings of Australia's Gender Center. "Transgender (people) will be a target for bigots for a long time."
On the other side of the world, British children's charity Mermaids works to help children who, like Cummings nearly eight decades ago, feel they were born in the wrong body.
Testimonies published on the charity's website, written by children with gender identity issues, bring home the confusion and harassment faced by so many.
"As a child, I acted as my real self, but then the bullying started," reads an extract from a poem that one of these children, Sophie, wrote at the age of 15.
"Why was I born a lie?" the piece ends.
Copyright 2011 Thomson Reuters. Click for restrictions.
Source: http://www.msnbc.msn.com/id/45327020/ns/world_news/
pumpkin bread linus pauling chris cooley chris cooley stevan ridley breast cancer awareness month breast cancer awareness month
Public release date: 14-Nov-2011 Share ] Contact: Lori J. Shanks
ljshanks@partners.org
617-534-1604
Brigham and Women's Hospital
Boston, MA The use of specific medications following a heart attack has been shown to reduce cardiovascular events and mortality, however; while highly effective, the rate of adherence to these medications is poor. Researchers from Brigham and Women's Hospital (BWH) evaluated whether eliminating co-payments for these medications would increase adherence and improve outcomes in patients who have had a heart attack. The findings will be presented as a Late Breaking Clinical Trial at the American Heart Association Scientific Sessions on November 14 and simultaneously published online in the New England Journal of Medicine.
"The elimination of co-payments for certain medications following a heart attack resulted in improved patient adherence to the medications and positively impacted rates of major vascular events," said Niteesh Choudhry, MD, PhD, lead author of the paper and a researcher in the Division of Pharmacoepidemiology and Pharmacoeconomics at BWH as well as an Associate Professor of Medicine at Harvard Medical School. "While the elimination of cost sharing did not significantly alter the trial's primary end-point, which included revascularizations along with vascular events, the intervention was successful in reducing rates of important clinical outcomes, lowering the amount that patients spent on medications and other non-drug health services, and did not increase overall health care costs."
Researchers utilized the existing structures that Aetna, a health insurance company, uses to process care and claims for their subscribers and enrolled 5,855 patients who had been discharged from a hospital following a heart attack into their study. They randomly assigned 2,845 patients to an insurance plan that provided full prescription medicine coverage and 3,010 patients to a plan that provided typical prescription medicine coverage, which includes cost-sharing. The medications that were covered by both plans are all routinely prescribed to patients following a heart attack and included statins, beta-blockers, angiotensin-converting-enzyme (ACE) inhibitors, and angiotensin-receptor blockers. Researchers tracked adherence to the medications, the number of major vascular events, which included readmission for fatal or non-fatal heart attack, unstable angina, heart failure or stroke, and the incidence of revascularization, which included a stent or angioplasty. They also determined the out-of-pocket cost for the patient and overall health care spending for each patient.
Choudhry and colleagues found that the rate of the combined endpoint of major cardiovascular events or revascularization was not significantly improved by the elimination of copayments for prescription medicines. However, when all events were considered, and not only first events, rates of this outcome were reduced significantly by 11 percent in the intervention group. They also report that when taking revascularizations out of the equation, rates of first vascular event were reduced significantly by 14 percent and the individual outcomes, which include the rates of readmission for another heart attack, angina, heart failure and stroke, were all reduced. Additionally, total healthcare spending for patients during follow up did not significantly increase, and out-of-pocket costs for patients were lower in the intervention group, a relative reduction of 26 percent.
"This research shows that by eliminating co-pays for patients who are prescribed medications that are proven to be effective, patients will use them more. In this specific study, adherence to these medications increased four to six percentage points," Choudhry said. "Even with this improvement, overall adherence to these medications is very low, with less than half of patients who are prescribed these medications actually taking them. While cost-related underuse represents 'low-hanging fruit' and the intervention we evaluated appears cost-effective, more work is needed to identify other effective strategies for increasing adherence as a way to improve patient care and simultaneously lower the cost of providing care to these patients," Choudhry said.
###
This research was funded by Aetna and the Commonwealth Fund.
Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. BWH is the home of the Carl J. and Ruth Shapiro Cardiovascular Center, the most advanced center of its kind. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives and its dedication to educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), www.brighamandwomens.org/research , BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 900 physician-investigators and renowned biomedical scientists and faculty supported by more than $537 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information about BWH, please visit www.brighamandwomens.org
[ | 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.
Public release date: 14-Nov-2011 Share ] Contact: Lori J. Shanks
ljshanks@partners.org
617-534-1604
Brigham and Women's Hospital
Boston, MA The use of specific medications following a heart attack has been shown to reduce cardiovascular events and mortality, however; while highly effective, the rate of adherence to these medications is poor. Researchers from Brigham and Women's Hospital (BWH) evaluated whether eliminating co-payments for these medications would increase adherence and improve outcomes in patients who have had a heart attack. The findings will be presented as a Late Breaking Clinical Trial at the American Heart Association Scientific Sessions on November 14 and simultaneously published online in the New England Journal of Medicine.
"The elimination of co-payments for certain medications following a heart attack resulted in improved patient adherence to the medications and positively impacted rates of major vascular events," said Niteesh Choudhry, MD, PhD, lead author of the paper and a researcher in the Division of Pharmacoepidemiology and Pharmacoeconomics at BWH as well as an Associate Professor of Medicine at Harvard Medical School. "While the elimination of cost sharing did not significantly alter the trial's primary end-point, which included revascularizations along with vascular events, the intervention was successful in reducing rates of important clinical outcomes, lowering the amount that patients spent on medications and other non-drug health services, and did not increase overall health care costs."
Researchers utilized the existing structures that Aetna, a health insurance company, uses to process care and claims for their subscribers and enrolled 5,855 patients who had been discharged from a hospital following a heart attack into their study. They randomly assigned 2,845 patients to an insurance plan that provided full prescription medicine coverage and 3,010 patients to a plan that provided typical prescription medicine coverage, which includes cost-sharing. The medications that were covered by both plans are all routinely prescribed to patients following a heart attack and included statins, beta-blockers, angiotensin-converting-enzyme (ACE) inhibitors, and angiotensin-receptor blockers. Researchers tracked adherence to the medications, the number of major vascular events, which included readmission for fatal or non-fatal heart attack, unstable angina, heart failure or stroke, and the incidence of revascularization, which included a stent or angioplasty. They also determined the out-of-pocket cost for the patient and overall health care spending for each patient.
Choudhry and colleagues found that the rate of the combined endpoint of major cardiovascular events or revascularization was not significantly improved by the elimination of copayments for prescription medicines. However, when all events were considered, and not only first events, rates of this outcome were reduced significantly by 11 percent in the intervention group. They also report that when taking revascularizations out of the equation, rates of first vascular event were reduced significantly by 14 percent and the individual outcomes, which include the rates of readmission for another heart attack, angina, heart failure and stroke, were all reduced. Additionally, total healthcare spending for patients during follow up did not significantly increase, and out-of-pocket costs for patients were lower in the intervention group, a relative reduction of 26 percent.
"This research shows that by eliminating co-pays for patients who are prescribed medications that are proven to be effective, patients will use them more. In this specific study, adherence to these medications increased four to six percentage points," Choudhry said. "Even with this improvement, overall adherence to these medications is very low, with less than half of patients who are prescribed these medications actually taking them. While cost-related underuse represents 'low-hanging fruit' and the intervention we evaluated appears cost-effective, more work is needed to identify other effective strategies for increasing adherence as a way to improve patient care and simultaneously lower the cost of providing care to these patients," Choudhry said.
###
This research was funded by Aetna and the Commonwealth Fund.
Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. BWH is the home of the Carl J. and Ruth Shapiro Cardiovascular Center, the most advanced center of its kind. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives and its dedication to educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), www.brighamandwomens.org/research , BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 900 physician-investigators and renowned biomedical scientists and faculty supported by more than $537 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information about BWH, please visit www.brighamandwomens.org
[ | 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.
Source: http://www.eurekalert.org/pub_releases/2011-11/bawh-ecf111411.php
gaddafi bodyguards muammar gaddafi muammar gaddafi lord monckton lord monckton andy kaufman october 21 2011
