Monday, July 1, 2013

Gay marriage opponents ask court to intervene

Cynthia Wides, right, and Elizabeth Carey file for a marriage certificate at City Hall in San Francisco, Saturday, June 29, 2013. Dozens of gay couples have lined up outside City Hall in San Francisco as clerks have resumed issuing same-sex marriage licenses one day after a federal appeals court cleared the way for the state of California to immediately lift a 4-year freeze. (AP Photo/Marcio Jose Sanchez)

Cynthia Wides, right, and Elizabeth Carey file for a marriage certificate at City Hall in San Francisco, Saturday, June 29, 2013. Dozens of gay couples have lined up outside City Hall in San Francisco as clerks have resumed issuing same-sex marriage licenses one day after a federal appeals court cleared the way for the state of California to immediately lift a 4-year freeze. (AP Photo/Marcio Jose Sanchez)

Cynthia Wides, right, and Elizabeth Carey exchange wedding vows at City Hall in San Francisco, Saturday, June 29, 2013. Dozens of gay couples have lined up outside City Hall in San Francisco as clerks have resumed issuing same-sex marriage licenses one day after a federal appeals court cleared the way for the state of California to immediately lift a 4-year freeze. (AP Photo/Marcio Jose Sanchez)

Jen Rainin, left, laughs as her wife Frances holds up their dog Punum after they were married at City Hall in San Francisco, Friday, June 28, 2013. A three-judge panel of the 9th U.S. Circuit Court of Appeals issued a brief order Friday afternoon dissolving, "effective immediately," a stay it imposed on gay marriages while the lawsuit challenging the ban advanced through the courts. (AP Photo/Jeff Chiu)

Army Capt. Michael Potoczniak, center left, and Todd Saunders, of El Cerrito, Calif., are married by deputy marriage commissioner John Loschmann, center, as witnesses Bill Hershon, left, and Sean Boileau watch at City Hall in San Francisco, Saturday, June 29, 2013. Dozens of gay couples waited excitedly Saturday outside of San Francisco's City Hall as clerks resumed issuing same-sex marriage licenses, one day after a federal appeals court cleared the way for the state of California to immediately lift a 4 ? year freeze. Big crowds were expected from across the state as long lines had already stretched down the lobby shortly after 9 a.m. City officials decided to hold weekend hours and let couples tie the knot as San Francisco is also celebrating its annual Pride weekend expected to draw as many as 1 million people. (AP Photo/Marcio Jose Sanchez)

Army Capt. Michael Potoczniak, at left, and Todd Saunders, right, of El Cerrito, Calif., exchange rings as they are married by deputy marriage commissioner John Loschmann, center, at City Hall in San Francisco, Saturday, June 29, 2013. Dozens of gay couples waited excitedly Saturday outside of San Francisco's City Hall as clerks resumed issuing same-sex marriage licenses, one day after a federal appeals court cleared the way for the state of California to immediately lift a 4 ? year freeze. Big crowds were expected from across the state as long lines had already stretched down the lobby shortly after 9 a.m. City officials decided to hold weekend hours and let couples tie the knot as San Francisco is also celebrating its annual Pride weekend expected to draw as many as 1 million people. (AP Photo/Marcio Jose Sanchez)

(AP) ? A wave of weddings were performed in San Francisco City Hall on the heels of the U.S. Supreme Court's historic decisions to restore same-sex marriages to California, as defeated backers of the state's gay marriage ban filed a last-ditch effort to halt the ceremonies.

Less than 24 hours after California started issuing marriage licenses to same sex couples, lawyers for the Arizona-based Alliance Defending Freedom filed an emergency petition to the high court Saturday asking it to halt the weddings on the grounds that its decision was not yet legally final. They claimed the 9th U.S. Circuit Court of Appeals acted prematurely and unfairly on Friday when it allowed gay marriage to resume by lifting a hold that had been placed on same sex unions.

The motion was filed as dozens of couples in jeans, shorts, white dresses and the occasional military uniform filled City Hall to obtain marriage licenses. On Friday, 81 same sex couples received marriage licenses.

Although a few clerk's offices around the state stayed open late on Friday, San Francisco, which is holding its annual gay pride celebration this weekend, was the only jurisdiction to hold weekend hours so that same sex couples could take advantage of their newly restored right, Clerk Karen Hong said.

A sign posted on the door of the office where a long line of couples waited to fill out applications listed the price for a license, a ceremony or both above the words "Equality=Priceless."

"We really wanted to make this happen," Hong said, adding that her whole staff and a group of volunteers came into work without having to be asked. "It's spontaneous, which is great in its own way."

The timing couldn't have been better for California National Guard Capt. Michael Potoczniak, 38, and his partner of 10 years, Todd Saunders, 47, of El Cerrito.

Potoczniak, who joined the Guard after the military's ban on openly gay service was repealed almost two years ago, was scheduled to fly out Sunday night for a month of basic training in Texas.

"I woke up this morning, shook him awake and said, 'Let's go,'" said Potoczniak, who chose to get married in his Army uniform. "It's something that people need to see because everyone is so used to uniforms at military weddings."

Also waiting to wed Saturday were Scott Kehoe, 34, and his fiance, Aurelien Bricker, 24. After finding out on Facebook that the city was issuing same sex marriage licenses Friday, the San Francisco couple rushed out to Tiffany's to buy wedding rings.

"We were afraid of further legal challenges in the state," Kehoe said.

The Supreme Court ruled on Wednesday that Proposition 8's backers lacked standing to defend the 2008 law because California's governor and attorney general have declined to defend the ban.

Then on Friday, the 9th Circuit appeared to have removed the last obstacle to making same sex matrimony legal again in California when it removed its hold on a lower court's 2010 order directing state officials to stop enforcing the ban.

Within hours, same sex couples were seeking marriage licenses. The two couples who sued to overturn Proposition 8 were wed in San Francisco and Los Angeles Friday.

Alliance Defending Freedom Senior Counsel Austin Nimocks said on Saturday that the high court's consideration of the case isn't done because his clients still have 22 days to ask the justices to reconsider Wednesday's 5-4 decision.

Under Supreme Court rules, the losing side in a legal dispute has 25 days to request a rehearing. While such requests are almost never granted, the high court said that it wouldn't finalize its judgment in the case at least until after that waiting period elapsed.

The San Francisco-based appeals court had said when it imposed the stay that it would remain in place until the Supreme Court issued its final disposition, according to Nimocks.

"Everyone on all sides of the marriage debate should agree that the legal process must be followed," he said. "On Friday, the 9th Circuit acted contrary to its own order without explanation."

Many legal experts who had anticipated such a last-ditch effort by gay marriage opponents said it was unlikely to succeed because the 9th Circuit has independent authority over its own orders ? in this case, its 2010 stay.

While the ban's backers can still ask the Supreme Court for a rehearing, the 25-day waiting period is not binding on lower federal courts, Vikram Amar, a constitutional law professor with the University of California, Davis law school, said.

"As a matter of practice, most lower federal courts wait to act," Amar said. "But there is nothing that limits them from acting sooner. It was within the 9th Circuit's power to do what it did."

The city, home to both a federal trial court that struck down Proposition 8 as unconstitutional and the 9th Circuit, has been the epicenter of the state's gay marriage movement since then-Mayor Gavin Newsom ordered his administration in February 2004 to issue licenses to gay couples in defiance of state law.

A little more than four years later, the California Supreme Court, which is also based in San Francisco, struck down the state's one-man, one-woman marriage laws.

City Hall was the scene of many more marriages in the 4 1/2 months before a coalition of religious conservative groups successfully campaigned for the November 2008 passage of Proposition 8, which amended the state constitution to outlaw same sex marriages.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/386c25518f464186bf7a2ac026580ce7/Article_2013-06-30-Gay%20Marriage-California/id-1e27ab862a174573a710a875266d3a9a

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Tuesday, June 25, 2013

UN envoy hopes for Syria conference after July

GENEVA (AP) ? The U.N. special representative for Syria said Tuesday there is little hope that a peace conference to find a political solution to the deadly conflict in the country can take place in July as planned.

Lakhdar Brahimi told reporters he still hopes the international negotiations can be re-launched at a second peace conference in Geneva, but not until later in the summer.

Brahimi spoke as he arrived to mediate a daylong meeting between the U.S. and Russia, which are supporting opposite sides in the Syrian conflict that has killed more than 93,000 people.

"I doubt whether the conference will take place in July," he said, noting that the Syrian opposition is not meeting until early July and probably would not be ready.

He also said that Tuesday's meeting might not resolve issues such as how the conference should be conducted and who should participate.

The aim of the talks between Russia, which supports President Bashar Assad's regime, and the United States, which backs the opposition, is to lay the groundwork for another Geneva conference that will have "the best chances of success," Brahimi said.

"I am also confident that we will make progress, but I cannot be certain that we will resolve all these basic questions today," he said as he arrived for the daylong meeting between Wendy Sherman, U.S. undersecretary of state for political affairs, and Russian deputy foreign ministers Mikhail Bogdanov and Gennady Gatilov.

Source: http://news.yahoo.com/un-envoy-hopes-syria-conference-july-112117939.html

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Legal, political maneuvering let Snowden flee (Washington Post)

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Ryan: Snowden episode tests diplomatic relations (The Arizona Republic)

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Russian astronauts take spacewalk at space station

In this frame grab from video provided by NASA, two Russian flight engineers perform maintenance on the International Space Station, Monday, June 24, 2013. The crew includes three Russians, two Americans and one Italian. The Italian and one American will conduct a pair of spacewalks for NASA in July. (AP Photo/NASA)

In this frame grab from video provided by NASA, two Russian flight engineers perform maintenance on the International Space Station, Monday, June 24, 2013. The crew includes three Russians, two Americans and one Italian. The Italian and one American will conduct a pair of spacewalks for NASA in July. (AP Photo/NASA)

(AP) ? Two space station astronauts took care of a little outside maintenance Monday.

Russian flight engineers Fyodor Yurchikhin and Alexander Misurkin replaced a main valve on the International Space Station, after emerging from their 250-mile-high home.

"To save the time, I'm embroidering," one of the spacewalkers said in Russian, holding a clump of cord as he worked on the fluid valve. "It's not easy to handle all these ropes." Later, he added, "OK, now we're doing bead work."

Also on the spacewalkers' to-do list: installing clamps and retrieving science experiments. Some of the work will pave the way for the arrival of a new Russian compartment at the end of this year.

The year's third spacewalk was under the direction of Russian Mission Control outside Moscow. The four other space station residents monitored the action from inside.

Yurchikhin arrived at the space station just a few weeks ago. Misurkin has been on board since March.

The crew includes three Russians, two Americans and one Italian. The Italian and one American will conduct a pair of spacewalks for NASA in July.

Begun in 1998, the space station still is one room short.

The Russian Space Agency plans to launch a research lab to replace the Pirs air lock that has been in place since 2001. An unmanned Proton rocket will hoist the lab, which also will serve as an air lock for spacewalk preparations and a docking port for visiting craft. As for Pirs ? Russian for pier ? it will be cut loose before the launch of its replacement and burn up upon re-entry as junk.

___

Online:

NASA: http://www.nasa.gov/mission_pages/station/main/index.html

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/b2f0ca3a594644ee9e50a8ec4ce2d6de/Article_2013-06-24-Space%20Station/id-a65b880005fe400f87767977dbac13f1

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Monday, June 24, 2013

This Adorable Pencil Broom Lets You Sweep Mistakes Under the Rug

This Adorable Pencil Broom Lets You Sweep Mistakes Under the Rug

Perfect for those of us lacking the confidence to write in pen the first time, this pencil features a miniature broom head eraser on the end so you can just sweep away incorrect crossword puzzle answers, and poorly solved Sudoku puzzles. At almost $9 for a single pencil you're going to only want to sharpen this thing when it's absolutely worn down to a nub, but with ten times as much eraser as a standard pencil, you're free to make plenty of mistakes. [Artori Design via designboom]

Source: http://gizmodo.com/this-adorable-pencil-broom-lets-you-sweep-mistakes-unde-558636853

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Afghans rush to learn risky art of defusing bombs

CAMP BLACK HORSE, Afghanistan (AP) ? In a desolate field outside Kabul, an Afghan soldier hunches over a knee-high robot equipped with cameras, multidirectional pincers and tank-treads built for rough terrain. Carefully, he attaches four bottles of water and a tiny explosive charge to the robot. He uses a remote control to guide it 50 meters (yards) away to his target: a simulated backpack bomb.

"Explosion! Explosion! Explosion!" shouts the soldier, Naqibullah Qarizada, in a warning to others nearby. Then he remotely detonates the charge.

A small dust cloud kicks up. If all has gone well, the blast has pushed the water into the bomb with enough force to knock out its triggering mechanism. But to be safe, his partner, Hayatullah, climbs into a heavy protective suit before lumbering over to pluck out the blasting cap and seal it in a fortified box.

The two men are among hundreds of Afghan soldiers training to take over the dangerous fight against the war's biggest killers: the Taliban-planted bombs known as IEDs that kill and maim thousands of people each year on and around the country's roads and towns.

A few years ago, there were almost no Afghan bomb disposal experts. Now, there are 369 ? but that's far from enough. The international coalition is rushing to train hundreds more before the exit of most coalition forces by the end of next year.

Each day on average, two to three roadside or buried bombs explode somewhere in Afghanistan, according to numbers compiled by the United Nations, which says that the explosives killed 868 civilians last year, 40 percent of the civilian deaths in insurgent attacks. Among international forces, buried or roadside bombs accounted for 64 percent of the 3,300 coalition troops killed or wounded last year, the NATO force says.

Known in military parlance as improvised explosives devices (IEDs), the bombs have long been a favorite Taliban weapon that can be remotely detonated by radio or mobile phone when a target passes by or triggered by pressure, like a vehicle driving over it.

The U.S. military has over the years developed advanced detection and disposal techniques that manage to defuse about 40 to 50 IEDs each day, says Col. Ace Campbell, chief of the Counter-IED training unit. The coalition is working to transfer that knowledge to the Afghans who will be responsible once most foreign troops leave next year, and Campbell says Afghan teams are now finding and disposing about half of the bombs most days.

"Whenever I hear about an IED or I find one myself ? maybe you will laugh, but I become very happy," says Hayatullah, 28, who has completed the highest level of training and like many Afghans uses just one name. "I am happy because it is my duty to defuse it, and I will save the lives of several people."

Hayatullah also has a personal reason for his chosen profession ? his father was killed in a mine explosion. He was just 13 when unknown attackers planted two anti-personnel mines outside their home in Parwan province, and he says the memory fuels his desire to save others.

The country's main bomb disposal school is located at Camp Black Horse, set among a dust-swept field on Kabul's eastern outskirts, where a rusted-out Russian tank looms on a distant hill, a reminder of Afghanistan's long legacy of war dating back to the 1980s Soviet occupation.

Here, a team of about 160 instructors runs 19 different courses, ranging from a basic four-week awareness program for regular Afghan soldiers to the eight-month advanced "IED defeat" course that is a slightly shorter version of the U.S. Army's own counter-explosives training.

"We are giving them the best instruction that we have available, and they are picking it up," said U.S. Army Maj. Joel Smith, one of the training program's leaders. "Some are getting killed, some are dropping out, but their numbers are growing."

Still, it is a race against time to produce enough experts to fill the gap left by foreign troops' withdrawal. On Tuesday, NATO formally handed over full security responsibility to Afghanistan's fledgling 350,000-strong security forces, though many of the remaining foreign troops will stay until next year in a support and training role.

The goal is to have 318 full-fledged Explosive Ordnance Disposal teams, each with two or three Afghan experts, spread out around the country. But Afghan security forces now have less than 60 percent of the bomb specialists they need ? hence the fever pitch of training.

"These guys are on a more accelerated program due to necessity," Smith said.

Equipping the Afghan teams is also a challenge. The coalition plans to distribute 12,000 metal detectors to regular police and army units, and each of the specialized disposal teams is slated to receive one of the high-tech robots that Qarizada and Hayatullah were working with. But Smith said each of the robots costs $17,000, and so far only about half of those needed are in the hands of Afghan teams. And that is not even taking into account who will maintain the sophisticated machines in a country where dust clogs nearly every machine and technical expertise is scarce.

Bomb disposal units gained widespread fame with the 2008 film "The Hurt Locker," but in real life the process ? while still dangerous ? is much slower and more methodical. The ultimate goal is to try not to approach a live bomb until it's been neutralized, which is the point of the exercise with the robot and the protective suit.

But with thousands of buried bombs and more being planted every day, it's impossible to have such sophisticated tools everywhere. That's why the program also trains regular Afghan army and police for four weeks in how to recognize signs of a smaller IED ? freshly moved earth, or perhaps a conveniently placed culvert next to a bridge ? and neutralize it in the crudest but simplest way: setting a smaller charge, moving far, far away and blowing it up in place.

Even such basic disposal takes weeks of training. Sitting attentively on rows of benches under a lean-to in the field, a group of Afghan soldiers listens to contractor James Webber, a former U.S. Air Force bomb disposal expert, as he explains how long to make a fuse so whoever sets it can then dash away for four minutes, or 240 seconds, to safety before the charge blows.

"So, 240 seconds divided by our burn rate - what do you get? Anyone got a calculator?" Webber asks.

The recruits nod, squint, calculate.

Source: http://news.yahoo.com/afghans-rush-learn-risky-art-defusing-bombs-062833351.html

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Pelosi's defense of NSA surveillance draws boos (The Arizona Republic)

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South Africans resigned over 'critical' Mandela

JOHANNESBURG (Reuters) - South Africans appeared resigned on Monday to the inevitability of one day saying goodbye to former president Nelson Mandela after the 94-year-old anti-apartheid leader's condition in hospital deteriorated to critical.

Madiba, as he is affectionately known, is revered among most of South Africa's 53 million people as the architect of the peaceful 1994 transition to multi-racial democracy after three centuries of white domination.

However, with his latest hospitalization - his fourth in six months - a realization has set in that he will not be around for ever.

His deterioration this weekend, two weeks after being admitted in a serious but stable condition with a lung infection, has caused a perceptible switch in mood from prayers for recovery to preparations for a fond farewell.

"If it's his time to go, he can go. I wish God can look after him," said nurse Petunia Mafuyeka, as she headed to work in Johannesburg.

"We will miss him very much. He fought for us to give us freedom. We will remember him every day. When he goes I will cry."

In a statement, President Jacob Zuma's office urged South Africa and the world to pray for Mandela "during this difficult time". But there was some concern among the public about doctors trying to prolong the life of one of the 20th century's most influential figures.

"I'm worried that they're keeping him alive. I feel they should let him go," said Doris Lekalakala, a claims manager. "The man is old. Let nature take its course. He must just rest."

Since stepping down in 1999 after one term as president, Mandela has stayed out of active politics in the continent's biggest and most important economy and his passing is expected to have little political impact.

His last public appearance was waving to fans from the back of a golf cart before the final of the soccer World Cup in Johannesburg's Soccer City stadium in July 2010.

During his retirement, he has divided his time between his home in the wealthy Johannesburg suburb of Houghton, and Qunu, the village in the impoverished Eastern Cape province where he was born.

The public's last glimpse of him was a brief clip aired by state television in April during a visit to his home by Zuma and other senior officials of the ruling African National Congress.

At the time, the 101-year-old liberation movement, which led the fight against white-minority rule, assured the public Mandela was "in good shape", although the footage showed a thin and frail old man sitting expressionless in an armchair.

(Reporting by Ed Cropley and Pascal Fletcher; Editing by Pascal Fletcher)

Source: http://news.yahoo.com/south-africans-resigned-over-critical-mandela-060437497.html

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Sunday, June 23, 2013

eCommerce Employment - eCommerce Investments

Smiling colleagues having a business meeting

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e-commerce Investors offering eCommerce Employment?to freelance ecommerce developers with exceptional skills for e-commerce business developments.

We are building a network of ecommerce Agencies worldwide and seek to incorporate new commerce professionals to our teams of ecommerce business developers

we transform e-commerce ideas in e-commerce businesses that sell . ?And we got it because we?managing completely?the ecommerce business processes

Main difference?between us and other e-commerce agencies,?is that we first create the internet business and then the website,?and other agencies first create the website and then try to sell

Developing an e-commerce business requires many skill-sets, not just technical, also marketing, graphics, positioning, social media, ecommerce marketing service.. and all the skills combined and contributed by the right people to mold the successful online venture

Each of us in eCommerce Investments PLC?, have had our share of success and failure, and our experiences on both sides is what makes us ecommerce Experts.

We have created our own ecommerce businesess,?and the e-ommerce business for large Corporations.?so we know what to do?and when to do it,?to set up a business on internet .

We exist to facilitate the ecommerce business development knowledge to the most small or medium sized ecommerce projects that fit with our work philosophy, becoming in the Internet Partner to the Companies and entreperneurs who want to?create your online business?in a solid, sustainable and long-term way

Our Team are led for Luis Souto

Luis Souto ecommerce Specialist. ecommerce Consultant and ecommerce Investor .CEO at?eCommerce Investments PLC

From 2001 I am dedicated to manage and optimize my own Online businesess, and the ecommerce Business for large Corporations.?I created Businesses that sell online?in 14 countries .

I have the experience and knowledge to creating effective ecommerce. My experience comes from my own mistakes and sucess in the development of my ecommerce Businesess and many other ?ecommerce projects that I have participated as ecommerce Specialist Freelance.

After nine years managing my business on Internet, ?From 2010 I decided to start a new stage in my Career as a ecommerce Specialist to offer Consultancy and Small Business Finance on the ecommerce Business?development of Entrepreneurs and small -medium sized Companies Becoming on their Internet Partner and contributing with?all my experience and resources to successfully push through each new project.

From 2012 i decided to create eCommerce Investments PLC, a network of ecommerce Agencies to expand my way of working worldwide,?with a clear business philosophy, invest money and resources to develop the best companies on internet in each market niche.

ecommerce Investments company?provides economic resources, a lot of experience and a team of e-commerce Business?experts developers working as an e-commerce Agency and managing all the internet technical procesess of each project,?while the owner runs his business, Becoming us on the ?internet business partner?

Mainly I am a internet business entrepreneur, and i have as a professional way the creation and development?of sustainable and lasting business on Internet.?Seeking for a long-term relationship with each new partner and in sumary providing many Internet Business Experience?and knowledge?, financial resources and my own team of e-commerce developers. Sumary?I can offer you?three main lines of work for each project:

1- ecommerce investment:?I invest my economic resources in Internet businesses with solid business and expansion process,?also participating in the technical management of the business.?looking for a share of the company and online sales percentage

2- ecommerce Consulting:?We fully develop internet business of entrepreneurs and local businesses,?covering all creation and development costs for?a percentage of the internet sales?by an agreed time.?Looking for a Online Sales percentage

3- ecommerce Consultants:?We?participate in the development of the Internet business for companies that looking to?create online business and adapt your company to this new business. We?providing our expertise to adapt the people and processes of the company to new business?, normally?leading a team that is already part of the company. ?Adapting the Internet operations of the company processes.?looking for a fixed monthly payment + bonus for goals

Currently my network of ecommerce agencies are?developing?projects in 8 countries?and growing

This is Clear my Business Philosophy, Now if you fit and want to work with me and my team over my e-commerce projects, let me know you want to collaborate.

Source: http://ecommerce-investments.com/ecommerce-employment/?utm_source=rss&utm_medium=rss&utm_campaign=ecommerce-employment

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Kardashian baby name: the science of how names shape us

Kardashian baby name: some studies have linked unusual names to numerous disadvantages later in life. As for the Kardashian baby name, it remains to be seen.

By Elizabeth Barber,?Contributor / June 21, 2013

Kardashian baby name: This 2012 photo shows singer Kanye West, left, talking to his girlfriend Kim Kardashian before an NBA basketball game between the Miami Heat and the New York Knicks in Miami. A birth certificate released by the Los Angeles County Dept. of Public Health shows that the couple's daughter North West, was born last Saturday in Los Angeles.

Alan Diaz/AP

Enlarge

Kim Kardashian, for reasons that are not yet clear, has named her baby North West.

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It's an odd choice that's unlikely to much affect Kanye West's and Kardashian's little girl ? but, for a child born to non-famous parents, is a name that might critically shape who she grows up to be. Without the gilded Kardashian name to guarantee her success, that non-celebrity girl might struggle to fend off bullies, get hired, and overall surmount other people?s ? and eventually her own ? low expectations for her future.

Studies have increasingly shown that names are a highly relevant factor is how others perceive us and we perceive ourselves. In 2010, David Figlio of Northwestern University in Illinois analyzed names from millions of birth certificates for the probability that the name belonged to someone of low socioeconomic status ? children whose names met those criteria would go to be discriminated against throughout life, he found. Similarly, a 2003 study from The National Bureau of Economic Research found that resumes with White-sounding names receive 50 percent more callbacks for interviews than resumes with African-American-sounding names.

The significance of that research has grown in recent years, as baby names have become increasingly more unusual. In 2010, a British study of some 3,000 parents found that one-in-five of them regretted the name they had selected for their children, in that case often an unusual name or one with a strange spelling. That finding wasn?t surprising to scientists, since a growing crop of studies have linked unusual names to numerous disadvantages in life.

Much of how we perceive the world is unconscious, and our latent biases against particular names are often influential in how we treat people. A 2011 informal survey that combed baby name conversations on online message boards found that the names perceived to be highly trendy are the biggest culprits in jolting those biases and that those names often end up capping our lists of the most hated names.

Source: http://rss.csmonitor.com/~r/feeds/science/~3/8qmeDm82OMA/Kardashian-baby-name-the-science-of-how-names-shape-us

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Swiss tax windfall boosts UK public finances in May

By David Milliken and William Schomberg

LONDON (Reuters) - A windfall payment of tax by Swiss banks caused Britain's public finances to post a smaller-than-expected deficit in May, and underlying figures suggested the government was on track to meet its budget target this year.

Deficit reduction is the central economic policy of Britain's Conservative-led coalition, which came to power in May 2010. At that point Britain's budget deficit was more than 11 percent of annual economic output - one of the highest rates for a major economy.

But public borrowing has remained stubbornly high over the past year, and data showed total public net debt climbed to record levels in May.

The budget deficit stood at 7.8 percent of gross domestic product on an underlying basis in the tax year that ended in March, down only a fraction from the previous year due to sluggish economic growth.

Friday's data from the Office for National Statistics showed that two months into the new tax year, the government is on track to meet this year's similarly modest deficit-cutting goal.

The government's preferred measure of Britain's public borrowing, which strips out some of the effects of its bank bailouts, showed a deficit of 8.8 billion pounds in May, almost half the shortfall in May 2012 and well below analyst forecasts of a deficit of 12.6 billion pounds in a Reuters poll.

Some of the fall had been expected because of a scheduled 3.9 billion-pound cash transfer from the Bank under a controversial deal last year to return interest payments on the BoE's massively increased gilt holdings to the government.

But most economists had not expected an upcoming payment of 3.2 billion pounds from a Swiss tax deal to be booked so soon.

Swiss banks agreed last year to settle the tax affairs of British citizens with undeclared bank accounts in the Alpine country, but the exact timing of the payments was not clear.

Analysts were confident the government would meet its 2013/14 goal of borrowing no more than 120 billion pounds, excluding the boost from Bank cash transfers.

"Overall the early signs for the new fiscal year are that the government can afford to be optimistic about meeting the full-year target for core borrowing excluding the QE cash flows," said Sam Hill, a fixed income strategist at RBC.

PAST BORROWING DOWN

There was also good news for the government as the ONS revised down its previous estimates for borrowing in the last three tax years by more than 4 billion pounds although government debt is still far higher than forecast in 2010.

Britain's total net public debt, even excluding the direct costs of bailing out the country's banks, now stands at 1.189 trillion pounds - equivalent to 75.2 percent of GDP.

When Chancellor George Osborne gave his first budget after his Conservative-led coalition came to power in May 2010, he aimed to have reduced the deficit to 5.5 percent of GDP by now and for debt to peak at just over 70 percent of GDP this year before falling.

While the opposition Labour party blames this failure on an excessively rapid initial pace of deficit reduction that it says stopped the economy from growing, the finance ministry says it is largely due to the crisis in the euro area, Britain's main export market.

Next week Osborne is due to set out plans for public spending restraint until April 2016 - a year after the 2015 national election. While he set out the total amount of spending in his March budget, individual government departments have yet to find out how much they will receive.

(Editing by Hugh Lawson)

Source: http://news.yahoo.com/swiss-tax-windfall-boosts-public-finances-may-083900237.html

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Turkish street vendors turn on a dime to make a lira off Taksim protests

Swimming goggles and 'V for Vendetta' masks cropped up in street vendors' hands within days of the first demonstrations in Taksim Square.

By Tom A. Peter,?Correspondent / June 12, 2013

Turkish police firing tear gas battle antigovernment protesters as they try to reestablish police control of Taksim Square after an absence of 10 days in the heart of Istanbul, Turkey, Tuesday. Turkish street vendors were out selling swimming goggles and disposable face masks as protection against tear gas.

Scott Peterson/Getty Images/The Christian Science Monitor

Enlarge
  • A local, slice-of-life story from a monitor correspondent

After almost a decade in the Middle East and Central Asia, I?ve found local street vendors to be among the most responsive businessmen I?ve ever encountered. When I got off the plane in Istanbul today, it started to rain. By the time I took a cab into the city, street vendors were out selling Chinese umbrellas for about $3.20 a piece.

Skip to next paragraph Tom A. Peter

Correspondent

Tom A. Peter is a journalist based in Kabul, Afghanistan where he covers news and features throughout the country. He has also reported for The Monitor from Iraq, Yemen, Jordan, and throughout the United States.

Recent posts

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While most people in Turkey will tell you that they were taken completely off guard by the protests, within days street vendors were out selling swimming goggles and disposable face masks for about $2.67 each as protection against tear gas. They also had masks popularized by the movie "V is for Vendetta" and the "Anonymous" hacker group, which have been adopted by many Turkish demonstrators.

The speed at which they were able to offer these items is astonishing when you think that before the protests, most of these people were probably selling toys and products that generally?had nothing to do with protection from tear gas or revolutionary symbolism. I wouldn?t be surprised to learn that they have boxes of pro-government paraphernalia ready in case the protests are permanently squashed.

Of course, the quality of their wares is always questionable. On my first day covering the protests, I didn?t have a gas mask so I purchased a pair of swimming goggles and a face mask, the sort of thing you?d wear to hang dry wall in your basement. When I hit a cloud of tear gas the goggles provided some protection for my eyes, but immediately fogged, blinding me more than the tear gas. As for the mask? I would have been better off trying to hold my breath.

Coming back to Istanbul after yesterday's fierce clashes, I decided that I needed a real gas mask, and sought out a vendor with a brick and mortar storefront. I found an industrial safety shop where the clerk told me that in the past 10 days he?d sold more gas masks than he normally sells in three months.

Normally, Turkish people couldn't care less about industrial safety and breathing toxic fumes, especially if it means spending money, he told me, but now he has people coming in to buy masks as gifts for their friends. Still, committed to selling quality products, he lacks a street merchant?s adaptability. He told me he worried he would burn through his inventory shortly if the demand continued.

If I?m ever in an end-of-days scenario, I hope there?s a Middle Eastern street vendor around. I?m sure he?ll have something to sell me for $5 or less that will protect me (at least psychologically) from anything ranging from a Biblical plague to a zombie apocalypse. In fact, whatever I?d need to weather either of those scenarios is probably already in a box wherever street vendors store their wares.

Source: http://rss.csmonitor.com/~r/csmonitor/globalnews/~3/V3A4jrCLnuE/Turkish-street-vendors-turn-on-a-dime-to-make-a-lira-off-Taksim-protests

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Toyota showcases UK car production on Twitter - Automotive News

VINCE BOND JR.

June 21, 2013 - 2:55 pm ET

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The vehicle production process takes place every day within the "enclosed box" of auto plants, but most people rarely get to see it, said Scott Brownlee, head of social media at Toyota Great Britain.

So Toyota decided to crack the box open in front of the world Wednesday on Twitter.

Brownlee and his crew used their special "Factory to Forecourt" Twitter account to detail the birth of the Auris gasoline-electric hybrid from its beginnings as raw steel in Toyota's Burnaston, Derbyshire, plant to a finished product in showrooms.

For 14 hours, approximately 522 pre-written tweets bearing the #F2F hashtag -- some featuring onsite videos and photos -- were posted to document the 325 production processes that go into building the Auris. #F2F is short for "Factory to Forecourt."

The idea was to simulate the live production experience as if someone were at the plant tweeting on the spot.

Concise "Factory to Forecourt" tweets were sent out in rapid succession Wednesday, and Toyota's UK blog housed even more detailed descriptions on its vivid, interactive timeline. People could also tweet questions and interact with the Toyota team.

Last December, Brownlee said, they began working closely with the factory to ensure they had the process mapped out accurately and create the supporting YouTube video clips.

Last-minute preparations were still being made the day before the project went live, he said.

"It was all pre-written and the team copied and posted to a predetermined time schedule to match the process. We could not have done it live from the factory as we needed to have the material checked for accuracy and confidentiality, impossible in the 60-90 second gaps we were dealing with," Brownlee wrote in an e-mail Thursday. "So it was a simulation, but it faithfully represented the process we were describing."

Toyota's "Factory to Forecourt" Twitter account and the automaker's corresponding UK blog are the latest multimedia tour de force coming from the auto industry recently.

Toyota's Auris experiment is from the same bloodline as such outreach efforts as Ford's "Random Acts of Fusion" -- a cross-media storytelling campaign in which Ryan Seacrest led participants through an interactive tale that used social media, radio and TV -- and the Chevy Sonic's "Let's Do This" stunt-crazed digital marketing blitz.

Automakers, trying to leapfrog the creativity of their rivals, are doing their best to leverage the Internet to reach an audience spending increasingly more time on the Web ? or, as Lincoln marketing boss Matt VanDyke once said, adjusting to the "absolute reality of the times."

Brownlee said he drew inspiration for the Auris idea several years ago after spending a day in the plant with a BBC film crew. Twitter was still new at the time, but he said there was a buzz about the platform's instant-sharing capabilities even then.

"We could have done more outreach to build awareness ? couldn't you always? -- but we felt it went well," Brownlee added. "The important thing is the legacy of the material now on the various platforms."

Toyota has officially upped the multimedia ante for its competitors, and the ball is now in their court.

Who will throw down the next slam dunk?

You can reach Vince Bond Jr. at vbond@crain.com. -- Follow Vince on Twitter

Source: http://www.autonews.com/article/20130621/BLOG06/130629964/toyota-showcases-uk-car-production-on-twitter

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Saturday, June 22, 2013

Justin Bieber, Madonna Get 15 (More) Seconds Of Fame On Instagram Video

Wiz Khalifa and Austin Mahone also take advantage of new Instagram feature, while Taylor Swift posts her first Vine.
By Chandra Johnson

Source: http://www.mtv.com/news/articles/1709440/justin-bieber-madonna-taylor-swift-instagram-vine-video.jhtml

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Facebook Bug Exposed Email Addresses, Phone Numbers Of 6 Million Users

On Friday, Facebook admitted that a bug made the private contact information -- either email addresses or phone numbers -- of 6 million users accidentally accessible to Facebookers who downloaded their account histories onto their own computers. Compared to Facebook's over 1 billion total members, 6 million isn't much. But any security flaw has the potential to frighten people away from a website.

A bug allowed "some of a person?s contact information (email or phone number) to be accessed by people who either had some contact information about that person or some connection to them," Facebook wrote in a note on its security page. Using the network's "Download Your Information" tool, some Facebook members were inadvertently sent the phone numbers or email address of Facebook friends that were otherwise private. Facebook assured users that the bug was fixed within a day, and that there is no evidence that the information was used maliciously.

The bug was found not by Facebook's team, but by someone going through Facebook's "white hat" hacker program, which offers a bounty for anyone who can find bugs on the site, paying a minimum reward of $500 per bug. The bounty is awarded "based on [the bug's] severity and creativity," according to Facebook's White Hat page. In April, HuffPost profiled one of Facebook's most prolific bug finders, Nir Goldshlager.

Earlier on HuffPost:

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Source: http://www.huffingtonpost.com/2013/06/21/facebook-bug_n_3480739.html

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Zombies gained speed, may now get smart

Movies

1 hour ago

In Brad Pitt's new movie, "World War Z," a soldier gives Pitt's character the lowdown on their undead opponent: Bullets to the body only slow them down, though head shots kill them. They sometimes ooze a kind of black tarry substance, and they love biting humans "like fat kids love Twix." And as filmgoers watch, they discover that these zombies can hear a Pepsi can drop a mile away, tackle like a Dallas Cowboy in the Super Bowl, are willing to fling themselves off skyscrapers and over giant walls, and are smart enough to use the bodies of their fellow undead as a ladder to clamber toward their human targets.

IMAGE: World War Z

Uncredited / AP

Zombies generally don't work together, but in "World War Z," they use each other's undead bodies to form a ladder to get over a wall to eat humans.

These are not your grandfather's zombies.

Moviegoers have seen the undead evolve in a thousand gruesome rotting ways since the creatures of 1932's "White Zombie" were docile enough to work in a sugar plantation. George A. Romero took the creature -- which he called a "ghoul," not a "zombie" -- to a whole new level in 1968's classic "Night of the Living Dead," making them totter out of graves to munch on the living. And from then on, Hollywood was off, shambling down a rotting cinematic pathway littered with discarded body parts and ever-evolving zombie lore.

Zombies stayed about as fast as your walker-using Aunt Fannie until the 2002 release of "28 Days Later." Purists will tell you that the infected in that film weren't dead, so are not technically zombies. But no matter, they still introduced the public to the idea of fast movie zombies who no longer staggered after you like a drunk uncle, but match Pittsburgh Steeler Hines Ward (who played a zombie on AMC's "Walking Dead") for speediness.

"I do think that if you had to be bitten by slow movers to turn, you could avoid them and eventually defeat them," said Cal Miller, author of numerous zombie books and zombie comic strip TedDead. " It would be like fighting an army of senior citizens. The fast ones are just horrifying to me. They?ll run you down."

IMAGE: World War Z

Jaap Buitendijk / AP

Brad Pitt gets knocked over by a swarm of fast-moving zombies in "World War Z."

The zombie diet has changed along with their speed. In the Romero film trilogy, zombies would munch on any part of a living human, from scalp to sole. But in 1985's "Return of the Living Dead" -- not a Romero film -- it's said that the zombies specifically consume the brains of the living because only that soothes the pain of being dead. That film explanation led to the popularization of the ever-popular "BRAAAAAINS!" quote so many associate with the living dead.

"Most people's knowledge of the zombie genre seems to be a bit limited," Miller said. "You say 'zombies' and they answer 'brainzzzzz,' But that was pretty much just in the 'Return of the Living Dead' movies/books. You try and explain that zombies eat the whole body and, well, unfamiliar people get either intrigued or grossed out."

Miller finds the brain-eating cliche a bit odd. "Human teeth can't bite through a skull," he said. "Zombies really go for the easy spots. Arms, legs, neck, belly."

IMAGE: World War Z

Jaap Buitendijk / AP

In "World War Z," Brad Pitt arms himself with an axe because any sound, including gunshots, draws the attention of the undead.

Mac Montandon, author of "The Proper Care and Feeding of Zombies," thinks zombies are resourceful when it comes to dining. "In my book, I point out that the zombie diet is not that far off from the Inuits, indigenous peoples of the Arctic region," he said. "I think that, paradoxically, when it comes down to it, zombies have a really clever survival mechanism that kicks in -- meaning if they had to eat, say, someone's elbow to go on not living, they would."

Zombies were once human, and movies differ on whether their intelligence or humanity still exists once they're undead. In 2004, "Shaun of the Dead" played a zombie invasion for laughs, and in 2013's "Warm Bodies," a zombie actually falls in love with a human.

"Zombies are not funny," said Montandon. "But 'Shaun of the Dead' was. In terms of ('Warm Bodies') human-zombie romance, that seems like much less of a stretch than a human-Tom Cruise romance."

Even the way to kill a zombie isn't agreed on by all moviemakers. It's generally agreed that a head injury must be involved, specifically something that destroys the undead brain. Some require zombie bodies to be burned, but in "World War Z," the fingers of a zombie that's been burned almost to solid ash are still shown to wiggle.

"The head can live if cut off at the neck," said Miller. "A personal pet peeve of mine, however, is when a disembodied head groans. No diaphragm, no lungs, no airflow, no groan."

As long as zombie movies continue to make money, the creatures will doubtlessly continue to evolve on film.

"I think zombies are ready for their 'Coneheads' moment," said Montandon, referring to the "Saturday Night Live" aliens who claimed to be French. "That is, they already have so many human characteristics, it's not hard to see them passing as humans in a suburb of Chicago, for instance."

Miller's novel, "Het Madden: A Zombie Perspective," is written from the point of view of an intelligent zombie, and he believes smart zombies will be the next wave.

"I feel there have to be smart and dumb zombies, like smart and dumb people," Miller said. "The smart ones lurk and plan. They don't walk into machetes."

Source: http://www.nbcnews.com/entertainment/movie-zombies-have-staggered-slow-fast-smart-next-6C10370274

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GIFs of the Week: June 17-21, 2013

All WWE programming, talent names, images, likenesses, slogans, wrestling moves, trademarks, logos and copyrights are the exclusive property of WWE, Inc. and its subsidiaries. All other trademarks, logos and copyrights are the property of their respective owners. ? 2013 WWE, Inc. All Rights Reserved. This website is based in the United States. By submitting personal information to this website you consent to your information being maintained in the U.S., subject to applicable U.S. laws. U.S. law may be different than the law of your home country. WrestleMania XXIX (NY/NJ) logo TM & ? 2013 WWE. All Rights Reserved. The Empire State Building design is a registered trademark and used with permission by ESBC.

Source: http://www.wwe.com/inside/gifs-of-the-week-june-17-21-2013

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Friday, June 21, 2013

Assessing performance of colonoscopy procedures improves quality

Assessing performance of colonoscopy procedures improves quality [ Back to EurekAlert! ] Public release date: 21-Jun-2013
[ | E-mail | Share Share ]

Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy

DOWNERS GROVE, Ill. June 21, 2013 A new study reports that the use of a quarterly report card is associated with improved colonoscopy quality indicators. Endoscopists at the Roudebush Veterans Affairs Medical Center in Indianapolis, Ind., who participated in the study showed an overall adjusted adenoma (precancerous polyp) detection rate increase from 44.7 percent to 53.9 percent, and a cecal intubation rate increase from 95.6 percent to 98.1 percent. These two metrics are validated measures of colonoscopy performance quality. The study appears in the June issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy (ASGE).

Colonoscopy examines the lining of the lower intestinal tract called the colon or large intestine. When used as a colon cancer prevention method, colonoscopy can find potentially precancerous growths called polyps and remove them before they turn into cancer. Studies assessing the effect of interventions to improve colonoscopy quality have shown inconsistent results. Since 2009, endoscopists (physicians specially-trained in endoscopic procedures such as colonoscopy) at the Indiana University-affiliated Roudebush Veterans Affairs Medical Center have received a quarterly "report card" summarizing individual colonoscopy quality indicators as part of an ongoing quality assurance program. The aim of this study was to determine the effect of the quality report card intervention on the quality of colonoscopy performance.

"Our study differs from previous research in several aspects. First, our report card initiative is based in an academic setting and involves a relatively small group of endoscopists. It includes 'hard' quality indicators such as adenoma detection rate and cecal intubation, but also information regarding documentation of bowel preparation quality, patient assessment before the procedure, and withdrawal time. Second, there were no financial incentives or penalties for achieving or not achieving preset targets. Third, the report cards are blinded to individual endoscopists, with minimal feedback administered confidentially as needed. Fourth, the intervention is administered regularly and relatively frequently, at 3-month intervals," said study lead author Charles J. Kahi, MD, MSCR, Indiana University School of Medicine and Roudebush Veterans Affairs Medical Center, Indianapolis. "We speculate that a combination of these factors led to the observed global improvement in the adenoma detection and cecal intubation rates, rather than a defined and measurable change in one discrete variable."

Methods

The American Society for Gastrointestinal Endoscopy introduced a quality recognition program in 2008 that recognizes endoscopy units that have implemented quality improvement and monitoring processes as an integral part of their operations. In 2009, the Roudebush Veterans Affairs Medical Center GI endoscopy unit in Indianapolis, was one of the first to receive this distinction. The transition to the new quality monitoring program occurred during the first three months of 2009. Subsequently, physicians who performed endoscopic procedures at the Medical Center started to receive quarterly "report cards," which provided data regarding colonoscopy quality indicators including documentation of bowel preparation quality, before-procedure patient assessment, cecal intubation, withdrawal time, and adenoma detection rate (ADR).

Data from six endoscopists were included. Patients were average-risk, aged 50 years or older, undergoing their first screening colonoscopy. The study time frame was July 1, 2008 to December 31, 2008 (before intervention) and April 1, 2009 to March 31, 2011 (intervention). The report card quality initiative was implemented gradually during the first few weeks of 2009. The primary outcomes were cecal intubation or the visualization of the cecum (the first part of the large intestine or colon), and adenoma detection rates, adjusted for physician, patient age, and sex. Multivariable logistic regression was performed to determine factors associated with adenoma detection. The procedures were performed by six board certified gastroenterologists or colorectal surgeons, or by GI fellows under direct supervision of these attendings.

Results

A total of 928 patients (male 93 percent, white 78 percent) were included (pre-intervention 336; post-intervention 592). There were no significant differences in patient age, sex, smoking status, body mass index, bowel preparation quality, colonoscope model, and proportion of colonoscopies performed with a trainee between the pre-intervention and post-intervention phases. In the post-intervention phase, the adjusted adenoma detection rate and cecal intubation rates were significantly higher: 53.9 percent versus 44.7 percent and 98.1 percent versus 95.6 percent, respectively. A higher trend in ADR detection in the intervention phase was found for five of the six physicians. The increment in ADR was due mostly to increased detection of proximal adenomas. These are polyps on the right side of the colon which are often more difficult to detect and have been implicated as an important factor in the efficacy of colonoscopy for colon cancer screening. There were no significant changes in serrated polyp detection, advanced neoplasm detection, number of adenomas detected per colonoscopy, and mean size of adenomas after implementation of the intervention. The report card intervention remained significantly associated with higher ADRs after adjustment for patient age, sex and physician.

The researchers concluded that a quarterly report card was associated with improved colonoscopy quality indicators. They stated that this intervention is practical to generate and implement, and it may serve as a model for quality improvement programs in different patient and physician groups. Additional work is needed to determine whether this intervention is effective in different practice settings and its beneficial effects sustained.

###

About the American Society for Gastrointestinal Endoscopy

Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence and innovation in gastrointestinal endoscopy. ASGE, with more than 12,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit http://www.asge.org and http://www.screen4coloncancer.org for more information and to find a qualified doctor in your area.

About Endoscopy

Endoscopy is performed by specially-trained physicians called endoscopists using the most current technology to diagnose and treat diseases of the gastrointestinal tract. Using flexible, thin tubes called endoscopes, endoscopists are able to access the human digestive tract without incisions via natural orifices. Endoscopes are designed with high-intensity lighting and fitted with precision devices that allow viewing and treatment of the gastrointestinal system.


[ Back to EurekAlert! ] [ | E-mail | Share 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.


Assessing performance of colonoscopy procedures improves quality [ Back to EurekAlert! ] Public release date: 21-Jun-2013
[ | E-mail | Share Share ]

Contact: Anne Brownsey
abrownsey@asge.org
630-570-5635
American Society for Gastrointestinal Endoscopy

DOWNERS GROVE, Ill. June 21, 2013 A new study reports that the use of a quarterly report card is associated with improved colonoscopy quality indicators. Endoscopists at the Roudebush Veterans Affairs Medical Center in Indianapolis, Ind., who participated in the study showed an overall adjusted adenoma (precancerous polyp) detection rate increase from 44.7 percent to 53.9 percent, and a cecal intubation rate increase from 95.6 percent to 98.1 percent. These two metrics are validated measures of colonoscopy performance quality. The study appears in the June issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy (ASGE).

Colonoscopy examines the lining of the lower intestinal tract called the colon or large intestine. When used as a colon cancer prevention method, colonoscopy can find potentially precancerous growths called polyps and remove them before they turn into cancer. Studies assessing the effect of interventions to improve colonoscopy quality have shown inconsistent results. Since 2009, endoscopists (physicians specially-trained in endoscopic procedures such as colonoscopy) at the Indiana University-affiliated Roudebush Veterans Affairs Medical Center have received a quarterly "report card" summarizing individual colonoscopy quality indicators as part of an ongoing quality assurance program. The aim of this study was to determine the effect of the quality report card intervention on the quality of colonoscopy performance.

"Our study differs from previous research in several aspects. First, our report card initiative is based in an academic setting and involves a relatively small group of endoscopists. It includes 'hard' quality indicators such as adenoma detection rate and cecal intubation, but also information regarding documentation of bowel preparation quality, patient assessment before the procedure, and withdrawal time. Second, there were no financial incentives or penalties for achieving or not achieving preset targets. Third, the report cards are blinded to individual endoscopists, with minimal feedback administered confidentially as needed. Fourth, the intervention is administered regularly and relatively frequently, at 3-month intervals," said study lead author Charles J. Kahi, MD, MSCR, Indiana University School of Medicine and Roudebush Veterans Affairs Medical Center, Indianapolis. "We speculate that a combination of these factors led to the observed global improvement in the adenoma detection and cecal intubation rates, rather than a defined and measurable change in one discrete variable."

Methods

The American Society for Gastrointestinal Endoscopy introduced a quality recognition program in 2008 that recognizes endoscopy units that have implemented quality improvement and monitoring processes as an integral part of their operations. In 2009, the Roudebush Veterans Affairs Medical Center GI endoscopy unit in Indianapolis, was one of the first to receive this distinction. The transition to the new quality monitoring program occurred during the first three months of 2009. Subsequently, physicians who performed endoscopic procedures at the Medical Center started to receive quarterly "report cards," which provided data regarding colonoscopy quality indicators including documentation of bowel preparation quality, before-procedure patient assessment, cecal intubation, withdrawal time, and adenoma detection rate (ADR).

Data from six endoscopists were included. Patients were average-risk, aged 50 years or older, undergoing their first screening colonoscopy. The study time frame was July 1, 2008 to December 31, 2008 (before intervention) and April 1, 2009 to March 31, 2011 (intervention). The report card quality initiative was implemented gradually during the first few weeks of 2009. The primary outcomes were cecal intubation or the visualization of the cecum (the first part of the large intestine or colon), and adenoma detection rates, adjusted for physician, patient age, and sex. Multivariable logistic regression was performed to determine factors associated with adenoma detection. The procedures were performed by six board certified gastroenterologists or colorectal surgeons, or by GI fellows under direct supervision of these attendings.

Results

A total of 928 patients (male 93 percent, white 78 percent) were included (pre-intervention 336; post-intervention 592). There were no significant differences in patient age, sex, smoking status, body mass index, bowel preparation quality, colonoscope model, and proportion of colonoscopies performed with a trainee between the pre-intervention and post-intervention phases. In the post-intervention phase, the adjusted adenoma detection rate and cecal intubation rates were significantly higher: 53.9 percent versus 44.7 percent and 98.1 percent versus 95.6 percent, respectively. A higher trend in ADR detection in the intervention phase was found for five of the six physicians. The increment in ADR was due mostly to increased detection of proximal adenomas. These are polyps on the right side of the colon which are often more difficult to detect and have been implicated as an important factor in the efficacy of colonoscopy for colon cancer screening. There were no significant changes in serrated polyp detection, advanced neoplasm detection, number of adenomas detected per colonoscopy, and mean size of adenomas after implementation of the intervention. The report card intervention remained significantly associated with higher ADRs after adjustment for patient age, sex and physician.

The researchers concluded that a quarterly report card was associated with improved colonoscopy quality indicators. They stated that this intervention is practical to generate and implement, and it may serve as a model for quality improvement programs in different patient and physician groups. Additional work is needed to determine whether this intervention is effective in different practice settings and its beneficial effects sustained.

###

About the American Society for Gastrointestinal Endoscopy

Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence and innovation in gastrointestinal endoscopy. ASGE, with more than 12,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit http://www.asge.org and http://www.screen4coloncancer.org for more information and to find a qualified doctor in your area.

About Endoscopy

Endoscopy is performed by specially-trained physicians called endoscopists using the most current technology to diagnose and treat diseases of the gastrointestinal tract. Using flexible, thin tubes called endoscopes, endoscopists are able to access the human digestive tract without incisions via natural orifices. Endoscopes are designed with high-intensity lighting and fitted with precision devices that allow viewing and treatment of the gastrointestinal system.


[ Back to EurekAlert! ] [ | E-mail | Share 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/2013-06/asfg-apo062113.php

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